By Vergilio Centurion, MD
    Video Journal of Cataract and Refractive Surgery
    Cataract/Anterior Segment

    In this video from Dr. Osher's Video Journal of Cataract and Refractive Surgery, Dr. Virgilio Centurion describes a rare case of capsular block syndrome (CBS) experienced at the conclusion of an otherwise routine cataract surgery. As soon as the surgeon hydrates the corneal wounds with balanced salt solution (BSS), the IOL disappears into the vitreous cavity.

    The surgeon implants a second IOL in the sulcus and completes the surgery without further complications. A week later, the patient's visual acuity declines to hand-motion, a vitreous hemorrhage is confirmed on ultrasound, and a vitrectomy and lens explantation are performed. Vision promptly returns to 20/30.

    Dr. Centurion suggests that the acute capsular block was caused by overzealous injection of BSS that infiltrated the capsular bag. The IOL was likely heaved forward, leading to significant pressure that spontaneously exploded the posterior capsule and caused a tear in the retina.