Abstract
BackgroundTo evaluate the efficacy and safety of placing dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis.MethodsA modified capsular tension ring was inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring was inserted into the capsular bag in 20 eyes in 20 consecutive patients showing signs of ocular hypotony and ectopia lentis. Outcome measures included intraocular pressure, best-corrected visual acuity, and postoperative complications.ResultsDual capsular tension ring placement was performed in 20 patients with a mean age of 48.7 years. The cyclodialysis cleft extended over 2.9 clock hours (range 0.5–6.5). The modified capsular tension ring was successfully inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring in the capsular bag in all eyes. At the last follow-up, the cyclodialysis cleft was closed in 16/20 (80.0%) eyes. The intraocular lens was stable in all patients postoperatively. Best-corrected visual acuity, in terms of the logarithm of the minimal angle of resolution, improved from 1.3 ± 0.8 before surgery to 0.4 ± 0.3 after surgery (P < 0.001). Intraocular pressure increased significantly from 10.6 ± 3.2 mmHg before surgery to 13.0 ± 4.8 mmHg after surgery (P = 0.040). Postoperative complications included a painful reversible intraocular pressure spike in four patients (20.0%). Logistic regression revealed no significant factors associated with successful cleft closure and a stable final intraocular pressure of ≥ 10 mmHg.ConclusionsThe placement of two capsular tension rings into the ciliary sulcus and the capsular bag is a safe, successful procedure combined for repairing a traumatic cyclodialysis cleft and managing zonular dialysis.
Highlights
To evaluate the efficacy and safety of placing dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis
Gupta et al [11] reported a case of cataract, zonular dialysis, cyclodialysis, and iridodialysis following blunt trauma that was successfully treated in a single procedure by placing two capsular tension rings (CTRs)
We previously performed phacoemulsification combined with an internal tamponade by insertion of a modified capsular tension ring (MCTR) into the ciliary sulcus to close cyclodialysis clefts and treat cataracts [12, 13]
Summary
To evaluate the efficacy and safety of placing dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis. Various non-surgical and surgical methods to close the cyclodialysis cleft and center the dislocated lens have been proposed [4,5,6,7,8,9,10,11,12,13]. Gupta et al [11] reported a case of cataract, zonular dialysis, cyclodialysis, and iridodialysis following blunt trauma that was successfully treated in a single procedure by placing two capsular tension rings (CTRs). We previously performed phacoemulsification combined with an internal tamponade by insertion of a modified capsular tension ring (MCTR) into the ciliary sulcus to close cyclodialysis clefts and treat cataracts [12, 13]. Implantation of an MCTR, an adjacent zonular apparatus, achieved the best possible outcomes in terms of long-term stability and centering of the intraocular lens (IOL) in patients with ectopia lentis following continuing refinement of surgical techniques [15,16,17]
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