Modified capsular tension ring improves posterior chamber IOL centration, stability

A modified capsular tension ring enhanced posterior chamber IOL centration with few major complications in patients with traumatic cataract and loss of zonular support, according to a study.

“The [capsular tension ring] is useful in the management of mild zonular instability,” the study authors said. “However, [capsular tension ring] implantation in eyes with more significant zonular compromise may not achieve adequate recentration and stabilization of the capsular bag and of the intraocular lens.”

The modified capsular tension ring has a fixation hook that allows surgeons to achieve scleral fixation without perforating the capsular bag.

The retrospective study included 16 eyes of 16 patients with a mean age of 47.9 years. Patients underwent phacoemulsification with implantation of a posterior chamber IOL and a single-eyelet Cionni 1L or double-eyelet Cionni 2L capsular tension ring (Morcher).

Seven patients received a single-eyelet capsular tension ring, and nine patients received a double-eyelet capsular tension ring. Mean postoperative follow-up was 12.9 months.

Study results showed that mean logMAR corrected distance visual acuity improved significantly from 0.89 preoperatively to 0.33 at final follow-up (P = .001). Corrected distance visual acuity was 20/40 or better in 12 eyes, between 20/40 and 20/200 in two eyes and worse than 20/200 in two eyes.

Mean postoperative spherical equivalent refraction was –0.23 D, and mean postoperative astigmatism was 1.59 D.

 IOLs were completely centered in all eyes. No eyes had symptomatic lens decentration throughout the follow-up period (P < .05).

Posterior capsule opacification occurred in eight eyes and was treated with Nd:YAG laser capsulotomy, the authors said.