New classification of capsular block syndrome

PURPOSE: To propose a new classification of capsular block syndrome (CBS) to improve understanding of the etiology and provide effective treatment. SETTING: Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, and Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan. METHODS: Three groups of eyes with CBS were reviewed: eyes originally reported and diagnosed as having CBS; eyes experiencing CBS after hydrodissection and luxation of the lens nucleus; and eyes with CBS accompanying liquefied aftercataract or capsulorhexis-related lacteocrumenasia. RESULTS: In all 3 groups, the CBS occurred in eyes with a continuous curvilinear capsulorhexis (CCC). It was characterized by accumulation of a liquefied substance within a closed chamber inside the capsular bag, formed because the lens nucleus or the posterior chamber intraocular lens (IOL) optic occluded the anterior capsular opening created by the CCC. Depending on the time of onset, CBS can be classified as intraoperative (CBS seen at the time of lens luxation following hydrodissection), early postoperative (original CBS), and late postoperative (CBS with liquefied aftercataract or lacteocrumenasia). The etiology of the accumulated substance and the method of treatment are different in each type. CONCLUSION: Capsular block syndrome is a complication of cataract/IOL surgery that can occur during and after surgery. Correctly identifying the type of CBS is crucial to understanding the nature and effective treatment of this disorder.