September 12, 2016
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Pseudoexfoliation common reason for capsular tension ring insertion

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COPENHAGEN — At one Japanese practice, pseudoexfoliation was the most common reason for capsular tension ring insertion during cataract surgery, according to a speaker.

Shigeru Entani, MD, PhD, reported at the European Society of Cataract and Refractive Surgeons meeting the 14-year experience with implantation of capsular tension rings at the Entani Eye Clinic in Japan; of 23,903 cataract surgeries, 200 eyes (0.84%) were implanted with a capsular tension ring. A preoperative decision to implant a capsular tension ring was made in 94 eyes (47%), and an intraoperative decision was made in 106 eyes (53%).

The most common reason for implantation was pseudoexfoliation (66 eyes), followed, in order, by shallow anterior chamber, laser iridotomy, weak zonules, trauma, phacodonesis, zonular rupture, atopic dermatitis, retinitis pigmentosa, high myopia, vitrectomy and mature cataract.

Entani further reported that implantation of capsular tension rings helped prevent zonular damage and maintained zonular stability during cataract surgery, with use of retractors minimizing damage caused by nuclear rotation and nuclear back-and-forth movement during surgery.

“I would prefer using retractors right after capsulorrhexis,” he said. “It might be safer to use CTR in the latter part of cataract surgery with retractors. CTR might be easier to insert into the capsule where there are [fewer] nuclear fragments.” – by Patricia Nale, ELS

Reference:

Entani S. Indications and outcomes of capsular tension ring implantation in eyes with zonular weakness: a review of 23,903 cataract surgeries. Presented at: 34th Congress of the European Society of Cataract and Refractive Surgeons; Sept. 10-14, 2016; Copenhagen, Denmark.

Disclosure: Shigeru reports no relevant financial disclosures.