kapsellikontraktio

Kapsellikontraktio, or capsular contraction, is a fibrotic tightening of a connective tissue capsule surrounding a structure, leading to restricted movement or vision. In medical practice the term is most often used for two contexts: the ocular capsule after cataract surgery and the joint capsule in adhesive capsulitis, commonly known as frozen shoulder.

In ophthalmology, capsular contraction syndrome can occur after cataract extraction with intraocular lens implantation. Residual lens epithelial cells may proliferate and differentiate into myofibroblasts, causing fibrosis and centripetal contraction of the anterior capsule. This can shrink the capsulorhexis opening, distort the implanted lens, and reduce visual quality. Risk factors include younger age, inflammatory eye disease, and a comparatively small initial capsulotomy. Clinically, patients may present with decreased vision, glare, or irregular astigmatism due to anterior capsule contraction and possible IOL decentration. Diagnosis is based on slit-lamp examination. Management ranges from monitoring in mild cases to surgical intervention in more pronounced cases, such as anterior capsulotomy or capsuloplasty, and in extreme situations IOL exchange. Prevention centers on careful surgical technique to achieve an adequately sized capsulotomy and controlling postoperative inflammation.

In orthopedics, capsular contraction describes the pathology of adhesive capsulitis (frozen shoulder). The condition involves progressive fibrosis and tightening of the shoulder joint capsule, leading to pain followed by marked loss of passive and active range of motion. Risk factors include diabetes, thyroid disease, and prolonged immobilization. Diagnosis is clinical, aided by imaging when needed. Treatment typically starts with physical therapy and anti-inflammatory measures; corticosteroid injections and hydrodilatation may be used, with arthroscopic or open capsular release reserved for refractory cases. Most patients improve over months to years, though some experience persistent stiffness.