Efficacy of a capsular tension ring for phacoemulsification in eyes with zonular dialysis

Jacob, Soosan; Agarwal, Amar; Athiya, Agarwal; Agarwal, Sunita; Patel, Nishant; Lal, Vikas

doi:10.1016/s0886-3350(02)01534-1

Cited by 102 publications

(75 citation statements)

References 16 publications

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“…This is similar to the finding of Jacob S et al, who studied 21 eyes and calculated best corrected visual acuity to be ≥6/12 which was achieved in 71.42% patients [13] Studies by Ma X et al, and Vasavada AR et al, have also reported improved BCVA in 91.7% and 85.4% patients respectively [14,19]. Only 6 (13.33%) patients in our study had achieved visual acuity ≤6/60 which was due of pre existing fundus pathology.…”

Section: Methodssupporting

confidence: 91%

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Outcome of Capsular Tension Ring (CTR) Implant in Complicated Cataracts

Rai

Sahai²,

Kumar³

2015

JCDR

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Section: Methodssupporting

confidence: 91%

“…However among 21 eyes investigated by Jacob S et al, showed iritis in 23.8% and keratitis in only 9.28% patients [13]. Higher incidence of immediate postoperative keratitis seen in our patients can be attributed to probable higher percentage of patients with hypermature cataract and pseudoexfoliation syndrome.…”

Section: Methodsmentioning

confidence: 40%

Outcome of Capsular Tension Ring (CTR) Implant in Complicated Cataracts

Rai

Sahai²,

Kumar³

2015

JCDR

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“…13 A prospective study of 21 eyes from 19 patients, with documented zonular dialysis and CTR use, showed that 15 eyes (74.42%) had a postoperative BCVA of 6/12 or better. 13 Similarly, a study by Ionides et al 14 assessed BCVA in 17 patients with zonular dialysis, and found an acuity of 6/12 or better in 80% of patients with no previous ocular co-morbidity, and in 42.9% of patients with ocular co-morbidity.…”

Section: Discussionmentioning

confidence: 99%

Visual outcomes in patients with zonular dialysis following cataract surgery

Trikha

Agrawal

Saffari

et al. 2016

Eye

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Purpose To evaluate the visual outcomes of patients with zonular dialysis following cataract surgery. Patients and methods Medical records of all patients with documented zonular dialysis, either pre-or peri-operatively, undergoing cataract surgery between 2004-2010 at Queen Alexandra Hospital, Portsmouth, were retrospectively reviewed. Baseline demographics and biometry were analysed, and ocular co-morbidities documented. Intraoperative complications and the use of a capsular tension ring (CTR) were identified. Early and late best-corrected visual acuity (BCVA) post surgery were determined using LogMar values. Univariate and multivariate linear regression analysis was performed to determine associations with BCVA post surgery, and further subgroup analysis performed in groups determined by CTR use. Results The records of 22 312 consecutive eyes undergoing cataract surgery were reviewed. The incidence of zonular dialysis was 0.50% (111 eyes). A CTR was inserted in 46 eyes. Using a multivariate linear regression model, better initial pre-operative BCVA (P = 0.019), the use of a CTR (P = 0.014), and the absence of vitreous loss during surgery (P = 0.008, β 0.45) were associated with improved early postoperative BCVA (mean follow-up 6.6 weeks). Better medium-term postoperative BCVA was significantly associated with preoperative BCVA (P = 0.002) and the use of a CTR during surgery (P = 0.004, β − 0.41). Conclusions The overall incidence of zonular dialysis is low. CTR use intraoperatively suggests improved early and medium-term BCVA and should be considered in all cases of zonular dialysis.

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“…Zonular weakness is often described according to the number of clock hours, which reflect the degree of zonular dialysis [13][14][15]. However, a more simplified system that more easily grades zonule quality is needed (i.e., using 0 for some grades).…”

Section: Discussionmentioning

confidence: 99%

Categorization and Surgical Techniques of Weak Zonule Based on Findings at Capsulorhexis during Cataract Surgery

Yaguchi¹

2015

J Clin Exp Ophthalmol

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Purpose: We categorize weak zonule during capsulorhexis.Design: Retrospective interventional case series. Methods:The study examined 5447 consecutive eyes of 3527 cases that underwent phacoemulsification (PEA) and intraocular lens (IOL) implantation between March 2006 and March 2014 at Showa University Fujigaoka Hospital, Kanagawa, Japan. Weak zonule was categorized based on findings at capsulorhexis and difficulty in performing continuous curvilinear capsulorhexis (CCC). The categorization definitions were as follows: (1) Group N (normal) with no or slight lens movement at the start of the CCC and no difficulty in performing CCC, (2) Group W (weak) with moderate lens movement frequently accompanied by fold formation during CCC and some difficulty in performing CCC, (3) Group VW (very weak) because of severe lens movement and difficulties with the initial puncture, CCC can be performed with the aid of a highly retentive and cohesive ophthalmic viscoelastic device (OVD; Healon 5 ® ), and (4) Group EW (extremely weak) with zonular deficiency in addition to the Group VW criteria and accounted for the cases of severe phacodonesis, lens subluxation, lens luxation into the anterior chamber, and dropped nucleus into the vitreous cavity that could be categorized preoperatively. We examined capsule stabilization device use during PEA, surgical lens removal, and IOL fixation in each group. Results:We defined 5098 eyes as Group N, 251 eyes as Group W, 55 eyes as Group VW, and 43 eyes as Group EW. As the zonule became weak, the use of the capsule stabilization device increased in PEA and intracapsular cataract extraction, and scleral suture fixation of IOL increased. Pars plana vitrectomy for lens removal was performed in 5 eyes (11.63%) categorized as Group EW. Conclusions:The categorization of weak zonule at CCC may be useful for selecting an appropriate capsule stabilization device and procedure during cataract surgery.

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Efficacy of a capsular tension ring for phacoemulsification in eyes with zonular dialysis

Abstract: Phacoemulsification with in-the-bag PC IOL and CTR implantation in eyes with zonular dialysis of up to approximately 150 degrees had a success rate of 90.47%. Visual recovery was not as good as in normal eyes because of the problems associated with zonular dialysis.

Cited by 102 publications

References 16 publications

Outcome of Capsular Tension Ring (CTR) Implant in Complicated Cataracts

Outcome of Capsular Tension Ring (CTR) Implant in Complicated Cataracts

Visual outcomes in patients with zonular dialysis following cataract surgery

Categorization and Surgical Techniques of Weak Zonule Based on Findings at Capsulorhexis during Cataract Surgery

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