Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Complete Occlusion of the Capsulorhexis Opening in a Patient with Pseudoexfoliation Syndrome - a Case Report and Review of Literature

Höhn S., Spraul C. W.
Dept. of Ophthalmology, University of Ulm

Purpose: Pseudoexfoliation syndrome (PEX) is associated with an increased risk for the development of capsular fibrosis including capsular phimosis. A complete occlusion of the anterior capsular opening is, so far, a rarely reported phenomenon.
Method: Case report and review of literature. Here we report the case of a 75 yrs. old female patient, who suffered from a secondary open-angle glaucoma caused by PEX. Three month after an uneventful cataract surgery with capsulorhexis, phakoemulsification and implantation of a posterior chamber lens (PMMA) the anterior capsular opening of her left eye was completely occluded. Additionally we have searched the literature using Medline database to identify similar cases.
Results: The patient reported a slow loss of vision (20/40 immediately after cataract surgery to 20/200 at the follow-up visit three months later). The examination revealed a complete closure of the capsulorhexis with thick, central fibrous material. The diameter of the capsulorhexis was extensively diminished. Re-opening of the anterior capsular opening utilizing YAG-laser was achieved and visual acuity increased to 20/40. Additionally, the fibrotic, secondary cataract of the posterior capsule was removed again with a YAG-laser five weeks after the first intervention and with a now free optical axis, the patient's visual acuity increased further to 20/30. We ide

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