Kapsül kontraksiyon sendromu

Kapsül kontraksiyon sendromu rezidüel lens proteinlerinin fibröz metaplazisi nedeni ile kapsüler bag’in kontraksiyonu sonucu gerçekleşmektedir. Aşırı ön kapsül büzüşmesi izlenen kapsül kontraksiyon sendromunda kapsül bütünlüğünü sağlayan güçler arasında bir dengesizlik meydana gelir ve bu durum zonüler zayıflık oluşmasına neden olur. Kapsül kontraksiyon sendromunun psödoeksfoliasyon, ileri yaş, üveit, pars planit ve myotonik musküler distrofi ile ilişkili olduğu görülmüştür. Kapsül kontraksiyon sendromu riskini azaltmak için ön kapsüloreksis alanı 5.5 mm-6mm boyutlarında açılmalı, acrysoft intraoküler lens kullanılmalı ve lens epitel proliferasyonu ve metaplazisini önlemek amacıyla, ön kapsülün alt yüzeyindeki lens epitel hücreleri aspire edilmelidir. Postoperatif kapsül kontraksiyonu saptanmışsa, postoperatif 2.-3. haftada Nd-YAG laser kapsülotomi ile ön kapsülotomi uygulanmalıdır. Nd-YAG laserin etkili olmadığı olgularda cerrahi mikroinzisyonlarla kapsül gerginliği giderilmelidir. Biz bu çalışmada kapsül kontraksiyon sendromunun nedenlerini, önlenmesi için dikkat edilmesi gereken noktaları ve tedavisi konusunda nasıl bir yol izleneceğini güncel literatür eşliğinde değerlendirdik.

Capsule contraction syndrome

Capsule contraction syndrome occurs after fibrous metaplasia of lens proteins that leads to capsular bag contraction. Excessive front capsular wrinkling is seen in capsule contraction syndrome and there is an imbalance between powers supplying capsular integrity. This situation leads to zonular weakness. Capsule contraction syndrome is associated with pseudoexfoliation, older age, uveitis, pars planitis and myotonic muscular dystrophy. In order to decrease the risk of capsule contraction syndrome, front capsulerhexis area should be open as 5.5-6 mm diameter and a curysoft intraocular lens should be used. In order to prevent lens epithelial proliferation and metaplasia, lens epithelial cells at inferior surface of front capsule should be aspirated carefully. If postoperative capsular contraction detected, front capsulotomy should be performed by Nd-YAG laser at postoperative 2 to 3 weeks. In patients that Nd-YAG laser is unsuccessful, capsular tension should be decreased by surgical microincisions. In present study, we evaluated etiology, prevention and management of capsule contraction syndrome in the light of actual literature knowledge.

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