Supplementary Material for: Late-Onset Capsular Block Syndrome with Pupillary Block Angle Closure after Cataract Surgery with Posterior Chamber Intraocular Lens Implantation: A Case Report

<b><i>Introduction:</i></b> Pseudophakic pupillary block angle-closure glaucoma is an uncommon complication following uneventful cataract surgery with posterior chamber intraocular lens (IOL) implantation. Interestingly, capsular block syndrome (CBS) has been reported as another plausible cause of pseudophakic pupillary block angle-closure glaucoma, especially in the early postoperative period. Unlike early postoperative CBS, late postoperative CBS is not associated with a shallow anterior chamber, myopic shift, or elevated intraocular pressure. We report a case of late postoperative CBS presenting with an acute-onset pupillary block angle-closure attack occurring 13 years after uneventful cataract surgery with posterior chamber IOL implantation, which has not been reported in the literature. <b><i>Case Presentation:</i></b> An 87-year-old male diagnosed with pseudoexfoliation syndrome developed pseudophakic pupillary block following uneventful cataract surgery with posterior chamber IOL implantation. Late-onset CBS has been identified as the underlying cause of the pupillary block. The combination of zonular laxity observed in pseudoexfoliation syndrome and the presence of a Soemmering ring are potential predisposing factors for this condition. After performing laser peripheral iridotomy (LPI) followed by Nd: YAG capsulotomy, the pupillary block was resolved and vision was improved. <b><i>Conclusion:</i></b> CBS should be considered as a potential cause of pseudophakic pupillary block, even in the late postoperative period. The management of late-onset CBS accompanied by pupillary block angle-closure glaucoma typically includes LPI to eliminate the pupillary block, followed by Nd: YAG capsulotomy.

**引言：** 人工晶状体眼瞳孔阻滞性闭角型青光眼是行平稳白内障摘除联合后房型人工晶状体（intraocular lens, IOL）植入术后的一种少见并发症。值得注意的是，囊袋阻滞综合征（capsular block syndrome, CBS）被报道为人工晶状体眼瞳孔阻滞性闭角型青光眼的另一可能病因，尤其多见于术后早期。与术后早期CBS不同，术后晚期CBS通常不会出现前房变浅、近视漂移或眼压升高。本文报告1例行平稳白内障摘除联合后房型IOL植入术后13年，出现以急性瞳孔阻滞性闭角发作为表现的术后晚期CBS病例，该病例在既往文献中尚未见报道。
**病例报告：** 1例确诊为假性剥脱综合征的87岁男性患者，在平稳行白内障摘除联合后房型IOL植入术后出现人工晶状体眼瞳孔阻滞。经检查，迟发性CBS被确定为该瞳孔阻滞的潜在病因。假性剥脱综合征患者所伴有的悬韧带松弛，以及索莫林环（Soemmering ring）的存在，是该病症的潜在易感因素。予患者行激光周边虹膜切除术（laser peripheral iridotomy, LPI）联合Nd:YAG激光晶状体后囊膜切开术后，瞳孔阻滞得以解除，视力得到改善。
**结论：** 即便在术后晚期阶段，也应将CBS纳入人工晶状体眼瞳孔阻滞的潜在病因考量范围。伴瞳孔阻滞性闭角型青光眼的迟发性CBS的典型治疗方案为：先行激光周边虹膜切除术解除瞳孔阻滞，随后行Nd:YAG激光晶状体后囊膜切开术。