Liquefied aftercataract: A complication of continuous curvilinear capsulorhexis and intraocular lens implantation in the lens capsule

PURPOSE: To describe a new type of aftercataract that contains a liquefied, milky white substance between the lens optic and the posterior lens capsule. METHOD: We reviewed the medical records of 41 patients identified as having this type of after-cataract. RESULTS: All 41 eyes (41 patients) underwent uneventful phacoemulsification after continuous curvilinear capsulorhexis and implantation of a posterior chamber intraocular lens made from polymethylmethacrylate. Two months to 6 years after surgery (average ± SD, 3.8 ± 1.7 years), fibrosis was noted evenly along the entire circumference and between the anterior surface of the intraocular lens optic and the edge of the capsular opening created by continuous curvilinear capsulorhexis. This led to formation of a closed chamber between the intraocular lens and the posterior lens capsule, which then accumulated a liquefied, milky white substance. Twenty-three of the 41 eyes showed liquefied aftercataract in conjunction with other types of aftercataract: in 12 eyes with fibrosis, in 11 eyes with Elschnig pearls, and in one eye with a Soemmering ring. None of the eyes had any signs of inflammation; six of the 41 eyes had reduced visual acuity caused exclusively by the liquefied aftercataract. Before cataract surgery, 14 eyes were diagnosed with diabetic retinopathy, four with glaucoma, and two with uveitis. CONCLUSION: We report a new type of aftercataract characterized by a liquefied, milky white substance that accumulates between the lens optic and the posterior lens capsule when the anterior capsular opening, originally created by continuous curvilinear capsulorhexis, becomes occluded with the lens optic.