Supplementary Material for: Capsular Block Syndrome After an Intravitreal Injection of Ranibizumab: A Case Report

Introduction: We present a case of capsular block syndrome that occurred after intravitreal injection of ranibizumab in a patient with age-related macular degeneration, which has not been reported in the literature.
Case Presentation: A 78-year-old male presented with decreased visual acuity in the right eye. Slit-lamp examination findings were unremarkable; however, AMD was diagnosed based on fundus examination, fluorescein angiography, and optical coherence tomography (OCT). Subsequently, the patient was administered an intravitreal injection of ranibizumab. A slit-lamp examination revealed residual cortical material, numerous inflammatory cells, and posterior capsular distension one week after the injection. OCT showed an adhesion of the intraocular lens to the continuous curvilinear capsulorhexis site. The patient's vision improved following Nd:YAG laser posterior capsulotomy.
Conclusion: Meticulous cortical removal is crucial during phacoemulsification to prevent capsular block syndrome. In patients with a history of cataract surgery, verifying the absence of residual cortical material before administering an intravitreal injection of ranibizumab is important.

引言：本文报告1例年龄相关性黄斑变性（age-related macular degeneration, AMD）患者接受雷珠单抗（ranibizumab）玻璃体内注射后发生囊膜阻滞综合征的病例，该病例目前尚未见文献报道。
病例报告：1例78岁男性患者因右眼视力下降就诊。裂隙灯检查结果无明显异常，但结合眼底检查、荧光素眼底血管造影及光学相干断层扫描（optical coherence tomography, OCT）结果，确诊为年龄相关性黄斑变性。随后，患者接受雷珠单抗玻璃体内注射。注射后1周的裂隙灯检查可见残留皮质物质、大量炎性细胞及后囊膜扩张。OCT检查显示人工晶状体黏附于连续环形撕囊术部位。患者接受Nd:YAG激光后囊膜切开术后视力得到改善。
结论：超声乳化白内障吸除术中细致清除皮质对于预防囊膜阻滞综合征至关重要。对于有白内障手术史的患者，在实施雷珠单抗玻璃体内注射前，需确认无残留皮质物质残留，该操作具有重要临床意义。