CTR implantation reduces IOL decentration, tilt in highly myopic eyes
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Key takeaways:
- CTR implantation reduces IOL decentration and tilt in highly myopic eyes with an axial length of 30 mm or longer.
- The same does not apply to eyes with an axial length shorter than 30 mm.
Implantation of a capsular tension ring was shown in a study to reduce IOL decentration and tilt in highly myopic eyes with an axial length of 30 mm or longer.
In addition to improving IOL stability, capsular tension ring (CTR) implantation also resulted in higher prediction accuracy, better visual quality and patient satisfaction.
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The study was conducted at the Zhongshan Ophthalmic Center in Guangzhou, China, and included 186 patients with high myopia, defined as an axial length (AL) of 26 mm or longer, randomly assigned one-to-one to undergo cataract surgery with or without CTR (275001G, Ophtec) implantation before IOL (920H Superflex, Rayner) placement. Participants were further stratified into three groups based on their AL.
The CTR group had a smaller IOL decentration (0.19 mm vs. 0.23 mm) and tilt (3.17° vs. 3.82°) vs. no CTR, with a lower proportion of patients experiencing clinically significant IOL decentration (one of 93 vs. 11 of 93) or tilt (one of 93 vs. 10 of 93). Eyes with the CTR also showed stable IOL decentration from 1 week to 3 months and had fewer higher-order aberrations and spherical aberrations and less risk of prediction error, resulting in higher patient satisfaction.
However, when eyes were stratified by AL, no difference was observed in IOL decentration and tilt between the CTR and control groups with AL shorter than 30 mm.
In highly myopic eyes, due to the longer AL and weaker zonules, decentration and tilt tend to occur more frequently and can significantly affect the outcomes of cataract surgery, particularly when premium IOLs are used.
“In this randomized clinical trial, we found that CTR could decrease IOL decentration and tilt, especially in eyes with an AL of 30 mm or longer,” Haowen Lin, MD, of State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China, and colleagues wrote.
These findings support the use of CTR implantation in eyes with an AL of 30 mm or longer, they concluded. In myopic eyes with AL shorter than 30 mm and in absence of zonular weakness, they recommended caution when considering CTR implantation.
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