[A case of capsular bag necrosis syndrome]

Abstract

A 58-year-old male patient presented with a 2-year history of blurred vision and eye discomfort in the right eye. The patient had a history of cataract surgery and glaucoma surgery. Upon admission, the unaided visual acuity of the right eye was 0.4, and the intraocular pressure was 33.4 mmHg (1 mmHg=0.133 kPa). The intraocular lens was decentered towards the nasal inferior direction, with a transparent capsular bag, no fibrous degeneration, or opacification observed. The patient underwent vitrectomy, intraocular lens suspension, and glaucoma valve implantation. During surgery, the capsular bag was found to be transparent and soft, and pathological examination revealed thinning of the capsular bag with very few epithelial cells. Postoperatively, the patient's unaided visual acuity in the right eye recovered to 0.8, and the intraocular pressure was controlled. Capsular bag necrosis syndrome is a recently proposed concept, characterized by an average age of onset of about 65.7 years, displacement of the intraocular lens years after IOL implantation, a transparent and soft capsular bag without fibrous proliferation, thinning and splitting/layering of the capsular bag, and no abnormalities in the zonules during the initial cataract surgery. The clinical and pathological features of this case are consistent with this syndrome, suggesting that this syndrome may be a new cause of intraocular lens displacement, and further research is needed on its pathogenesis and treatment measures.