[Analysis of clinical features and related factors of three types of capsule-related complications after phacoemulsification].

Abstract

Objective: To describe the clinical characteristics of three types of capsule-related complications following phacoemulsification: capsular contraction syndrome (CCS), capsular block syndrome (CBS), and dead bag syndrome (DBS). Methods: A retrospective case series study was conducted. Clinical data of 32 patients (33 eyes) diagnosed with CCS, CBS, or DBS, including age, sex, laterality, visual acuity, and intraocular pressure, were collected at the Chinese PLA General Hospital from 2010 to 2025 and presented as mean±standard deviation, median (interquartile range), or frequency (percentage). The Mann-Whitney U test was used to analyze the association between the onset or consultation time and clinical factors such as the lens nucleus hardness, type of the implanted intraocular lens (IOL), and axial length. Results: Patients with higher lens nucleus hardness had earlier onsets than those with lower hardness [2.00 (1.00, 24.00) vs. 72.00 (36.00, 132.00) months, P=0.029]. Intergroup differences in onset or consultation time were observed for several IOL-related factors. The hydrophilic material was associated with an earlier consultation time compared with the hydrophobic material [6.00 (2.00, 32.00) vs. 103.00 (36.75, 171.50) months, P=0.034]. The aspheric IOLs demonstrated an earlier onset time [1.00 (0.00, 13.50) vs. 48.00 (21.00, 87.00) months, P=0.020] and consultation time [5.50 (2.00, 22.75) vs. 80.00 (27.75, 158.00) months, P=0.026]. Patients with axial length>24 mm showed a later consultation time than those with axial length≤24 mm [71.00 (33.00, 102.00) vs. 5.00 (2.00, 10.75) months, P=0.013]. Conclusions: The CCS, CBS, and DBS all presented with decreased visual acuity as the predominant manifestation, frequently accompanied by refractive shift and IOL decentration or dislocation. The postoperative intervention significantly improved visual function in the affected eyes. Patients with higher lens nucleus hardness and those implanted with hydrophilic IOLs or aspheric optic IOLs tended to have earlier onset or consultation times numerically, whereas patients with axial length>24 mm had relatively later consultation times. Clinical attention should be paid to the phenotypic differences and related factors of different complications. However, these conclusions are limited by the retrospective design and small sample size, and need to be validated by prospective studies.