What are the other Names for this Condition? (Also known as/Synonyms)

• Anterior Capsule Contraction Syndrome (ACCS)
• Anterior Capsule Fibrosis and Phimosis
• CCS (Capsule Contraction Syndrome)

What is Anterior Capsular Contraction Syndrome? (Definition/Background Information)

• Anterior Capsular Contraction Syndrome (ACCS) is an uncommon eye condition that develops as a complication following cataract surgery and intraocular lens implantation
• This may result in vision impairment (post-surgery) due to visual axis obstruction. Anterior Capsular Contraction Syndrome may also lead to implanted lens complications such as tilting, dislocation, and slight vibrations or movement
• ACCS is mostly observed in individuals with certain eye conditions prior to surgery, such as inflammatory eye conditions, pseudoexfoliation syndrome, and uncontrolled diabetes

Who gets Anterior Capsular Contraction Syndrome? (Age and Sex Distribution)

• Anterior Capsular Contraction Syndrome is typically rare and is only observed in individuals who have undergone cataract surgery with intraocular lens implantation
• Both males and females may be affected
• Worldwide, individuals of all races and ethnicity are prone to developing the condition

What are the Risk Factors for Anterior Capsular Contraction Syndrome? (Predisposing Factors)

Anterior Capsular Contraction Syndrome (ACCS) is a post-surgical complication of cataract surgery and intraocular lens implantation. The following predisposing/pre-existing factors may increase an individual’s risk for ACCS:

• Advancing age
• Behcet’s syndrome
• Chronic intraocular inflammation
• Diabetes mellitus
• Myotonic muscular dystrophy
• Pseudoexfoliation syndrome
• Retinitis pigmentosa
• Severe shortsightedness
• Uveitis
• Zonular laxity
• Zonular weakness due to disease or eye injury

It is also reported that the cataract surgery procedure adopted, the devices used, and the material and design of the intraocular lens all play a role in the development of ACCS.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Anterior Capsular Contraction Syndrome? (Etiology)

The cause of development of Anterior Capsular Contraction Syndrome (ACCS) is not well understood. It is exclusively seen in individuals who have undergone cataract removal surgery along-with intraocular lens (IOL) implantation.

Some of the proposed explanations relate to:

• Contraction of capsulorhexis openings that are created during surgery
• Mesenchymal transition (metaplasia and fibroses) of residual lens epithelial cells

ACCS is observed to develop in individuals with a background of one or more predisposing factors such as old age, diabetes, and zonal weaknesses.

What are the Signs and Symptoms of Anterior Capsular Contraction Syndrome?

Anterior Capsular Contraction Syndrome is associated with a reduction in visual acuity after surgery. This may occur anywhere within 2-12 weeks or more, following cataract extraction surgery. The condition is typically painless and asymptomatic in a majority of individuals.

In some, the following signs and symptoms may be noted:

• Blurry vision that gets worse
• Double vision
• Light sensitivity and glare
• Clouding of the capsular opening resulting in partial to total vision loss
• Dislocation of the lens can lead to sudden loss of vision
• Discomfort and irritation

How is Anterior Capsular Contraction Syndrome Diagnosed?

Anterior Capsular Contraction Syndrome may be diagnosed by the following observations and tests:

• Physical examination and medical history evaluation (including history of cataract removal surgery)
• Assessment of presenting signs and symptoms
• General eye exam may reveal post-surgical complications
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Anterior Capsular Contraction Syndrome?

The complications of Anterior Capsular Contraction Syndrome may include:

• Emotional stress
• Retinal detachment
• Ciliary body detachment
• Severe loss of vision in the affected eye
• Necessity to undergo multiple surgeries
• Increased risk for recurrence

How is Anterior Capsular Contraction Syndrome Treated?

The treatment of Anterior Capsular Contraction Syndrome is based on the severity and rate of progression of the condition. The treatment measures include:

• Neodymium:YAG (Nd:YAG) laser anterior capsulotomy is the treatment of choice
• Nd:YAG laser capsulotomy is considered for severe cases

Close follow-up is recommended to evaluate treatment response and prevent any further post-surgical complications.

How can Anterior Capsular Contraction Syndrome be Prevented?

Currently, there are no methods to prevent Anterior Capsular Contraction Syndrome.

• Individuals with certain pre-surgical eye conditions may need to be made aware of surgical risks and complications
• Healthcare providers are informed to adhere to best medical practices while performing cataract extraction surgeries

What is the Prognosis of Anterior Capsular Contraction Syndrome? (Outcomes/Resolutions)

The prognosis of the Anterior Capsular Contraction Syndrome (ACCS) depends on the severity of the condition and timeliness of management.

• In many individuals, the condition is mild and non-progressive that responds well to laser therapy
• In the absence of treatment, ACCS can result in sudden vision loss from dislodgment of the implanted lens

Additional and Relevant Useful Information for Anterior Capsular Contraction Syndrome:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/