International Medical Case Reports Journal (Jul 2024)
Recurrent Posterior Capsular Opacification in Adults: A Case Report and an Overview of Literature
Abstract
Majid Moshirfar,1– 3 Alex H Brown,4 Garrett N Manion,5 Kayvon A Moin,1 Phillip C Hoopes1 1Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA; 2John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA; 3Utah Lions Eye Bank, Murray, UT, USA; 4Department of Ophthalmology, University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USA; 5Department of Ophthalmology, Creighton University School of Medicine, Omaha, NE, USACorrespondence: Majid Moshirfar, Hoopes Vision Research Center, 11820 S State St #200, Draper, UT, 84020, USA, Tel +1 801-568-0200, Fax +1 801-563-0200, Email [email protected]: Posterior capsular opacification (PCO), also known as “secondary cataract”, is a common complication following cataract surgery that can significantly impair visual acuity. The incidence of PCO varies widely in the literature, influenced by intraocular lens (IOL) type and patient risk factors. Neodymium-doped yttrium-aluminum-garnet (YAG) laser posterior capsulotomy is the standard treatment for PCO-related visual impairment. Recurrence of PCO after initial treatment with YAG capsulotomy, though more common in children, is rare in adults. Its underlying pathophysiological mechanisms are similar to that of primary PCO, which includes proliferation, migration, and/or clustering of lens epithelial cells (LECs), with subsequent reclosure of the posterior aperture. Potential risk factors for PCO recurrence that have been speculated through a comprehensive search of the current literature include younger age, female sex, high myopia, diabetes, vitrectomized status, uveitis, low-diopter IOLs, and certain IOL types with higher water content. We present a case of recurrent PCO in a highly myopic 48-year-old male following cataract surgery and implantable collamer lens (ICL) explantation who received a hydrophobic acrylic lens with 4% water content. Surgical techniques that may reduce recurrent PCO occurrence and appropriate postoperative care are emphasized to assist surgeons in their approach to patients at high-risk for this complication.Keywords: recurrent posterior capsule opacification, recurrent PCO, implantable collamer lens, ICL, repeat neodymium-doped yttrium-aluminum-garnet, repeat Nd:YAG, cataract surgery, posterior capsule reclosure, posterior capsule re-opacification, intraocular lens water content, IOL water content
