Capsular Tension Ring Placement Research Articles

Encircling continuous suture technique for the management of extensive traumatic cyclodialysis: A case report.

To report a surgical technique of cyclopexy, wherein two laps of encircling continuous sutures are placed around the limbus to treat refractory extensive cyclodialysis. Color fundus photography, swept-source optical coherence tomography (OCT) for the anterior segment, and spectral-domain OCT for the macula. Previous attempts, including indirect cyclopexy and direct external cyclopexy with gas injection, failed to successfully resolve the severe cyclodialysis and associated hypotonic maculopathy. In the third surgery, two laps of encircling continuous sutures were placed around the limbus at the distances of 2-3 mm and 3-4 mm, along with phacoemulsification, intraocular lens implantation, and capsular tension ring placement. Following the surgery, hypotony and hypotonic maculopathy were effectively resolved, resulting in a significant improvement in visual acuity, that has been maintained over a year. The described surgical technique of encircling continuous sutures may be a viable option for the treatment of severe cyclodialysis.

Accuracy of intraoperative aberrometry versus modern preoperative methods in post-myopic laser vision correction eyes undergoing cataract surgery with capsular tension ring placement

PurposeTo assess the accuracy of intraoperative wavefront aberrometry (IWA) versus modern intraocular lens formulas in post-myopic laser vision correction (LVC) patients undergoing cataract surgery with capsular tension ring placement.MethodsThis is a retrospective chart review conducted at an academic outpatient center. All post-myopic LVC eyes undergoing cataract surgery with IWA from a single surgeon from 05/2017 to 12/2019 were included. All patients received a capsular tension ring (CTR). Mean numerical error (MNE), median numerical error (MedNE), and percentages of prediction error within 0.50D, 0.75D, and 1.00D were calculated for the above formulas.ResultsTwenty-seven post-myopic LVC eyes from 18 patients were included. In post-myopic LVC, MNE with Optiwave Refractive Analysis (ORA), Barrett True K (BTK), Haigis, Haigis-L, Shammas, SRK/T, Hill-RBF v3.0, and W-K AL-adjusted Holladay 1 were + 0.224, − 0.094, + 0.193, − 0.231, − 0.372, + 1.013, + 0.860, and + 0.630 (F = 8.49, p < 0.001). MedNE were + 0.125, − 0.145, + 0.175, + 0.333, + 0.333, + 1.100, + 0.880, and + 0.765 (F = 7.89, p < 0.001), respectively. BTK provided improved accuracy in both MNE (p < 0.001) and MedNE (p = .033) when compared to ORA in pairwise analysis. If the ORA vs. BTK-suggested IOL power were routinely selected, 30% and 15% of eyes would have projected hyperopic outcomes, respectively (p = 0.09).ConclusionsOur study suggests that in post-myopic LVC eyes undergoing cataract surgery with CTRs, BTK performed more accurately than ORA with regard to accuracy and yielded a lower percentage of eyes with hyperopic outcomes. Haigis, Haigis-L, and Shammas yielded similar results to ORA with regard to accuracy and percentage of eyes with hyperopic outcomes. On average, Shammas and Haigis-L suggested IOLs that would yield outcomes more myopic than expected when compared to BTK.

Combined phacovitrectomy with capsular tension ring and gas tamponade for chronic cyclodialysis cleft unresponsive to conventional closure

Traumatic cyclodialysis clefts, a rare diagnosis after blunt injury to the eye, are typically amenable to closure with either medical therapy or direct surgical cyclopexy. However, when cyclodialysis clefts cannot be closed through these methods, unorthodox techniques may be required. We describe a method to close a traumatic cyclodialysis cleft involving simultaneous vitrectomy, capsular tension ring placement, and insertion of an intraocular lens.

Placement of dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis

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.

Congenital aniridia with cataract: case series

BackgroundThis study evaluates patients with congenital aniridia and cataract who underwent phacoemulsification, capsular tension ring placement, and foldable intraocular lens implantation.MethodsIn this prospective case series, 10 patients (17 eyes) underwent cataract surgery via a 3.2 mm clear corneal incision. A continuous circular capsulorhexis with <6 mm diameter was employed. A capsular tension ring and HOYA yellow foldable posterior chamber intraocular lens was implanted. All patients wore color contact lenses postoperatively. Paired t test was used to compare visual acuity, intraocular pressure, and corneal endothelial changes before and after surgery.ResultsA single surgeon performed all surgeries. The best-corrected visual acuity improved from value 1.03 ± 0.27LogMAR preoperatively to value 0.78 ± 0.26LogMAR postoperatively (p = 0.000). The photophobic symptoms improved significantly after surgery. The mean corneal endothelial cell density before and after surgery was 3280 ± 473 cells/mm2 and 2669 ± 850 cells/mm2, respectively (p = 0.006). None of the patients developed corneal endothelial decompensation or secondary glaucoma after surgery.ConclusionsTreatment of congenital aniridia and coexistent cataract by phacoemulsification, posterior chamber foldable lens implantation, capsular tension ring placement was safe and effective. Use of colored contact lenses in the postoperative period can reduce photophobic symptoms in this group of patients.Trial registrationChiCTR-OOC-17011638 (retrospectively registered at 12,June,2017)

Use of Nucleus as Temporary Capsular Tension Device to Delay Capsular Tension Ring Placement in Subluxed Hard Cataract

Use of Nucleus as Temporary Capsular Tension Device to Delay Capsular Tension Ring Placement in Subluxed Hard Cataract