Biometric and refractive changes in a bilateral anterior capsular contraction treated with Nd:YAG – A case report

This case reports a bilateral capsular contraction syndrome (CCS) in a patient implanted with hydrophilic intraocular lenses (IOLs) after cataract surgery. The capsular contraction caused posterior IOL displacement and capsule phimosis, reducing visual acuity. Four to six months post surgery, the patient presented with bilateral visual decline and dense capsular fibrosis with posteriorly displaced AKREOS MI60 IOLs. CCS was diagnosed based on clinical findings, and Nd:YAG laser treatment was performed to rupture the anterior capsular fibrosis, reducing capsular tension. This resulted in an anterior IOL shift of 540 µm (right eye) and 640 µm (left eye) at 1 week, reducing the hyperopic refractive error by +0.50 to +0.75D. At 1-month follow-up, outcomes remained stable with minimal refractive changes. This case highlights the importance of early CCS detection and intervention. Nd:YAG laser effectively reduced capsular tension, improved visual acuity, and corrected hyperopic refractive errors, preventing more invasive procedures.