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 Table of Contents  
Year : 2020  |  Volume : 58  |  Issue : 2  |  Page : 127-128

Fish in the eye

Department of Ophthalmology, Shri Lal Bahadur Shastri Government Medical College and Hospital, Mandi, Himachal Pradesh, India

Date of Submission26-Feb-2020
Date of Acceptance03-Apr-2020
Date of Web Publication17-Jun-2020

Correspondence Address:
Dr. Anubhav Chauhan
Department of Ophthalmology, Shri Lal Bahadur Shastri Government Medical College and Hospital, Nerchowk, Mandi, Himachal Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_12_20

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How to cite this article:
Chauhan A, Sharma D, Thakur P, Wapa A. Fish in the eye. TNOA J Ophthalmic Sci Res 2020;58:127-8

How to cite this URL:
Chauhan A, Sharma D, Thakur P, Wapa A. Fish in the eye. TNOA J Ophthalmic Sci Res [serial online] 2020 [cited 2023 Feb 4];58:127-8. Available from: https://www.tnoajosr.com/text.asp?2020/58/2/127/286927

  Case Top

A 40-year-old female presented with diminution of vision in the left eye for the past 1 month. There was a history of uneventful cataract extraction with posterior chamber intraocular lens implantation in the left eye 4 months back. On examination, the best-corrected visual acuity was 6/24 in the left eye, and slit-lamp examination revealed pseudophakia with the presence of radial folds in the capsular bag and anterior capsular phimosis resembling a fish, i.e., the lateral half resembling the eye and the medial half resembling the caudal fin of a fish [Figure 1] and [Figure 2]. Rest of the slit-lamp and fundus examination of the left eye was within normal limits. The right eye was within normal limits. The patient underwent yttrium aluminum garnet (YAG) capsulotomy in the left eye, and his vision improved to 6/9 on the last follow-up.
Figure 1: Anterior capsular phimosis

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Figure 2: Anterior capsular phimosis

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  Discussion Top

Anterior capsule contraction syndrome is a rare, late complication of cataract extraction, which was described first in 1993. It usually occurs 3 to 6 months after phacoemulsification and is characterized by progressive constriction and opacification of the anterior lens capsule.[1] It has been described as an exaggerated fibrotic response that can lead to reduction in the size of the anterior capsulotomy and capsular bag diameter following capsulorrhexis.[2]

This syndrome is more common in elderly patients and patients with pseudoexfoliation, diabetes mellitus, a history of uveitis, myotonic dystrophy, or retinitis pigmentosa because of an imbalance between the centrifugal forces of the zonules and the tensile force of the intraocular lens haptic, on the one hand, and the centripetal forces of the proliferated and metaplastic residual lens epithelial cells, on the other hand.[3] Neodymium-doped:YAG laser anterior capsulotomy is the treatment of choice, which causes a clear visual axis and prevents further intraocular lens decentration.[4]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Tsinopoulos IT, Tsaousis KT, Symeonidis C, Dimitrakos SA. Bilateral manifestation of severe anterior capsule contraction syndrome after implantation of a preloaded intraocular lens. Clin Exp Optom 2009;92:503-4.  Back to cited text no. 1
Al-Kharashi SA, Al-Obailan M. Capsular phimosis with complete occlusion of the anterior capsular opening after intact continuous curvilinear capsulorrhexis. Saudi J Ophthalmol 2009;23:175-8.  Back to cited text no. 2
Cheour M, Brour J, Boukari M, Kraiem A. Capsulorhexis contraction syndrome despite capsular tension ring implantation. Bull Soc Belge Ophtalmol 2010;315:19-21.  Back to cited text no. 3
Chawla JS, Shaikh MH. Neodymium: YAG laser parabolic anterior capsulotomy in extreme capsule contraction syndrome. J Cataract Refract Surg 1999;25:1415-7.  Back to cited text no. 4


  [Figure 1], [Figure 2]


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