Effect of Co-Implantation of a Capsular Tension Ring on Clinical Outcomes after Cataract Surgery with Monofocal Intraocular Lens Implantation

Abstract

PurposeThe objective was to evaluate the effect of co-implantation of a preloaded capsular tension ring (CTR) and aberration-free monofocal intraocular lens (IOL) on clinical outcomes and visual quality after cataract surgery.Materials and MethodsPatients who underwent cataract surgery were randomized into two groups that were implanted with a CTR and IOL (group 1, 26 eyes) or an IOL only (group 2, 26 eyes). At 1 and 3 months after surgery, visual acuity, refractive errors, refractive prediction errors, ocular aberrations, and modulation transfer function (MTF) were analyzed. At 3 months postoperatively, anterior chamber depth (ACD) and contrast sensitivity were evaluated.ResultsGroup 1 showed greater hyperopic shift, which caused the refractive prediction error at 3 months after surgery to be significantly different between the two groups (p=0.049). Differences in ACD between the preoperative and postoperative periods tended to be greater in group 1 than in group 2. At 3 months postoperatively, internal MTF values at 20, 25, and 30 cycles per degree were significantly better in group 1 than in group 2 (p=0.034, 0.017, and 0.017, respectively). Contrast sensitivity showed comparable results at almost all spatial frequencies between the groups.ConclusionRegarding visual acuity and quality, both groups showed comparable results. Co-implantation of a CTR and aberration-free monofocal IOL was associated with hyperopic refractive outcomes. Surgeons should consider the position of the IOL when planning co-implantation of a CTR and IOL.

Effect of capsular tension ring implantation on capsular stability after phacoemulsification in patients with weak zonules: a randomized controlled trial. CTR implantation in cataract patients with weak zonules

“…CTR can effectively balance the tension of zonular fibers, uniformly distribute the tension of the capsular bag, maintain the shape of the capsular bag, reduce loss of the vitreous body, and increase the attachment between posterior capsule and IOL surface. Therefore, CTR implantation can increase IOL stability after cataract extraction involving IOL implantation and reduce the occurrence of posterior capsule opacification and IOL dislocation [7,[23][24][25][26][27][28][29][30][31][32][33][34][35]. However, the benefits of CTR implantation in patients with weakened zonular fibers but no lens dislocation is unclear.…”

“…The CTR maintains the shape of the capsular bag, balances the tension in zonular fibers, and decreases the risk of capsular shrinkage and IOL decentration or dislocation [23][24][25][26][27][28][29][30]. While CTR has been used to treat focal zonular rupture or diffuse zonulopathy by stretching out the capsular bag or facilitating scleral suture fixation [7,[23][24][25][26][27][28][29][30][31][32][33][34][35], it is unclear whether the capsular bag and IOL can remain stable after CTR implantation during cataract surgery in patients with strong myopia [7,23,35]. In addition to these uncertainties, the effects of CTR on cataract surgery in patients with an abnormal zonule after PPV are unclear.…”

Effect of capsular tension ring implantation on capsular stability after phacoemulsification in patients with weak zonules:a randomized controlled trail. CTR implantation in cataract patients with weak zonules

“…CTR can effectively balance the tension of zonular bers, uniformly distribute the tension of the capsular bag, maintain the shape of the capsular bag, reduce loss of the vitreous body, and increase attachment between posterior capsule and IOL surface. These effects of CTR increase IOL stability after cataract extraction involving IOL implantation and reduce the occurrence of posterior capsule opaci cation and IOL dislocation [7,[22][23][24][25][26][27][28][29][30][31][32][33][34]. Whether and how CTR implantation can also bene t patients with weakened zonular bers but no lens dislocation is unclear.…”

“…The CTR maintains the shape of the capsular bag, balances the tension in zonular bers, and decreases the risk of capsular shrinkage and IOL decentration or dislocation [22][23][24][25][26][27][28][29]. While a CTR has been used for focal zonular rupture or diffuse zonulopathy either to stretch out a capsular bag or to facilitate scleral suture xation [7,[22][23][24][25][26][27][28][29][30][31][32][33][34], other studies suggested that whether the capsular bag and IOL can remain stable after CTR implantation during cataract surgery in patients with strong myopia are controversial [7,22,34]. In addition to these uncertainties, the effects of CTR on cataract surgery in patients with an abnormal zonule after PPV are unclear.…”

Comparative Analisys of Cataract Phakoemulsification, Complicated with the Zonular Weakness

“…Однако действующая классификация подвывиха хрусталика не оперирует достоверными количественными данными о протяженности повреждения связочного аппарата и не позволяет адекватно планировать хирургическое вмешательство. Развитие технологий в катарактальной хирургии дало возможность использования интраоперационных способов стабилизации капсульного мешка хрусталика путем имплантации устройств различной модификации, стабилизирующих капсулу [6,7].…”