Capsular tension ring implantation after lens extraction for management of subluxated cataracts

摘要

Purpose: To evaluate the safety and efficacy of implantation of a capsular tension ring (CTR) and posterior chamber intraocular lens (PCIOL) after lens extraction in subluxated cataracts. Setting: Department of Ophthalmology,General Hospital of PLA, Beijing, China. Design: Prospective case series. Methods: We selected 36 eyes in 34 patients with zonular dialysis <150°. After emulsification and removal of the residual cortex, we inserted a CTR into the capsular bag to center the PCIOL. We measured preoperative and postoperative best corrected visual acuity (BCVA), centration of the CTR and IOL, and perioperative complications. Results: No capsule collapseor fluctuationof the anterior chamber occurred. Most eyes (63.89%) had nuclear sclerosis of ≥3+. A CTR was implanted into the capsular bag without extension of zonular dialysis. A traumatic subluxated cataract was the most common cause (20 of 36 [55.56%]). We found a subluxated cataract in 3 eyes (3 of 36 [8.33%]) with previous acute angle-closure glaucoma. Mean follow up was 20.3±2.4 months. Preoperatively, only 5 eyes (13.89%) had a BCVA of ≥20/40, compared with 30eyes at the last visit (83.33%, P<.001). Improved BCVA was achieved in 33 eyes (91.7%) in week 1, and visual acuity remained stable up to 1 year. The CTRs with PCIOL were well centered at 1 year. Conclusion: In patients with a subluxated hard cataract <120°, CTR implantation should be performed after lens extraction without extension of zonular dialysis and capsular destabilization. Maintaining anterior chamber depth and avoiding capsular bag collapse are critical.