Capsular tension segment a versatile tool for severe zonular instability treatment
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WAILEA, Hawaii — The capsular tension segment is a valuable tool for cataract surgery complications such as severe zonular instability, according to a speaker here at Hawaiian Eye 2024.
In a presentation focusing on the partial PMMA ring segment, Beeran B. Meghpara, MD, overviewed when to use the capsular tension segment (CTS) and how to use it.
“It’s versatile — you can put it in temporarily during phaco to support the capsular bag, you can permanently fixate it to the sclera to provide permanent support and you can sometimes even use it in a compromised capsule,” he said. “So, if you have a small anterior tear or a small posterior tear, you can put in a capsular tension segment.”
Meghpara recommended using the CTS when a patient has more than four clock hours of significant zonulopathy or phacodonesis with general zonular weakness, especially if those patients have progressive conditions such as pseudoexfoliation. Depending on the level of zonulopathy, surgeons can implant up to two tension segments, he explained.
Ophthalmologists should first insert the capsule hooks, then remove the lens. Next, the capsular tension ring should be implanted, followed by the IOL and finally, the CTS.
“I like to have the IOL in there because it kind of acts like a barrier to protect your posterior capsule,” he said.
Meghpara recommended suture fixation or the use of flanged Prolene sutures for scleral fixation following implantation of the IOL and CTS.
“A capsular tension segment can be an invaluable tool when you want to try to save the bag when you have a lot of zonulopathy,” he said.
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Meghpara B. Capsular tension segment: Tools for complex cases: What’s in your oops kit. Presented at: Hawaiian Eye 2024; Jan. 13-19, 2024; Wailea, Hawaii.
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