Secret in the Capsule—A CBS Case Revealed by Full-Range SS AS-OCT

A 68-year-old female patient who had undergone cataract surgery in both eyes more than a decade earlier presented with a four-month history of progressive blurred vision in her right eye. Slit-lamp examination revealed a well-positioned intraocular lens (IOL) within the capsular bag. A distinct space was observed between the posterior surface of the IOL and the posterior capsule, which exhibited a characteristic “rice-crust” pattern of opacification (Fig. 2).

Full-range swept-source anterior segment OCT (AS-OCT) further detailed these findings, demonstrating hyperreflective fluid accumulation in the retrolental space, distension of the capsular bag, and scattered cystoid cavities on the posterior capsule (Fig. 1). Three-dimensional reconstruction of the anterior segment confirmed the presence of retrolental fluid and capsular bag distension (Fig. 1, arrow). Based on these findings, the patient was diagnosed with capsular blocking syndrome (CBS).

Following Nd:YAG laser posterior capsulotomy, the patient’s corrected visual acuity improved from 0.08 to 0.8. Post-treatment AS-OCT and 3D reconstruction confirmed a central opening in the posterior capsule and complete resolution of the retrolental fluid (Fig. 3).

A 100 kHz swept-source OCT system (Yalkaid, TowardPi Medical) was used in this case to acquire high-resolution anterior segment OCT images. Ultra-wide (24 mm) and ultra-deep (15 mm) anterior segment imaging can be readily achieved. With built-in software, the system also provides comprehensive quantitative measurements and panoramic 3D reconstruction of the anterior segment.

Case courtesy of Dr. Jiexiang Xie and the team led by Prof. Pengfei Yang, Xiamen Kehong Eye Hospital.

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