|Year : 2020 | Volume
| Issue : 2 | Page : 127-128
Fish in the eye
Anubhav Chauhan, Deepak Sharma, Pankaj Thakur, Anchit Wapa
Department of Ophthalmology, Shri Lal Bahadur Shastri Government Medical College and Hospital, Mandi, Himachal Pradesh, India
|Date of Submission||26-Feb-2020|
|Date of Acceptance||03-Apr-2020|
|Date of Web Publication||17-Jun-2020|
Dr. Anubhav Chauhan
Department of Ophthalmology, Shri Lal Bahadur Shastri Government Medical College and Hospital, Nerchowk, Mandi, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chauhan A, Sharma D, Thakur P, Wapa A. Fish in the eye. TNOA J Ophthalmic Sci Res 2020;58:127-8
| Case|| |
A 40-year-old female presented with diminution of vision in the left eye for the past 1 month. There was a history of uneventful cataract extraction with posterior chamber intraocular lens implantation in the left eye 4 months back. On examination, the best-corrected visual acuity was 6/24 in the left eye, and slit-lamp examination revealed pseudophakia with the presence of radial folds in the capsular bag and anterior capsular phimosis resembling a fish, i.e., the lateral half resembling the eye and the medial half resembling the caudal fin of a fish [Figure 1] and [Figure 2]. Rest of the slit-lamp and fundus examination of the left eye was within normal limits. The right eye was within normal limits. The patient underwent yttrium aluminum garnet (YAG) capsulotomy in the left eye, and his vision improved to 6/9 on the last follow-up.
| Discussion|| |
Anterior capsule contraction syndrome is a rare, late complication of cataract extraction, which was described first in 1993. It usually occurs 3 to 6 months after phacoemulsification and is characterized by progressive constriction and opacification of the anterior lens capsule. It has been described as an exaggerated fibrotic response that can lead to reduction in the size of the anterior capsulotomy and capsular bag diameter following capsulorrhexis.
This syndrome is more common in elderly patients and patients with pseudoexfoliation, diabetes mellitus, a history of uveitis, myotonic dystrophy, or retinitis pigmentosa because of an imbalance between the centrifugal forces of the zonules and the tensile force of the intraocular lens haptic, on the one hand, and the centripetal forces of the proliferated and metaplastic residual lens epithelial cells, on the other hand. Neodymium-doped:YAG laser anterior capsulotomy is the treatment of choice, which causes a clear visual axis and prevents further intraocular lens decentration.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Tsinopoulos IT, Tsaousis KT, Symeonidis C, Dimitrakos SA. Bilateral manifestation of severe anterior capsule contraction syndrome after implantation of a preloaded intraocular lens. Clin Exp Optom 2009;92:503-4.
Al-Kharashi SA, Al-Obailan M. Capsular phimosis with complete occlusion of the anterior capsular opening after intact continuous curvilinear capsulorrhexis. Saudi J Ophthalmol 2009;23:175-8.
Cheour M, Brour J, Boukari M, Kraiem A. Capsulorhexis contraction syndrome despite capsular tension ring implantation. Bull Soc Belge Ophtalmol 2010;315:19-21.
Chawla JS, Shaikh MH. Neodymium: YAG laser parabolic anterior capsulotomy in extreme capsule contraction syndrome. J Cataract Refract Surg 1999;25:1415-7.
[Figure 1], [Figure 2]