SURGICAL MANAGEMENT OF DISLOCATED LENSES WITH TEMPORARY USE OF CAPSULAR TENSION RING
1Department of Ophthalmology, Konyagoz Eye Hospital, Konya, Turkey ; and.
Purpose:
To compare the surgical outcomes of two techniques for managing dislocated lenses with zonular insufficiency.
Methods:
This study included 64 eyes of 64 patients with complete or near-complete zonular loss undergoing lens removal surgery. Patients were divided into two groups: Group 1 (n = 34) underwent phacoemulsification with temporary capsular tension ring assistance, followed by anterior vitrectomy or pars plana vitrectomy; Group 2 (n = 30) underwent ultrasonic fragmatome-assisted lens removal with perfluorocarbon liquid support and subsequent pars plana vitrectomy. Intrascleral intraocular lens fixation and peripheral iridectomy were performed in all cases.
Results:
The mean age of patients was 64.1 ± 9.7 years in Group 1 and 65.7 ± 8.6 years in Group 2 ( P = 0.51). Postoperative best-corrected visual acuity significantly improved in both groups ( P < 0.001). No clinically significant intrascleral intraocular lens decentration or tilt was observed in either group. Cystoid macular edema and transient intraocular pressure elevation were noted in 5.9% of Group 1, compared with 23.3% and 20% in Group 2, respectively ( P = 0.04 and P = 0.08, respectively). Retinal detachment occurred in 3 cases (10%) in Group 2, whereas no such complications were observed in Group 1 ( P = 0.05). Cortical remnants were detected in the posterior segment in three eyes (10%) in Group 2, whereas no such complications were observed in Group 1 ( P = 0.05).
Conclusion:
Phacoemulsification with temporary capsular tension ring assistance, followed by scleral Intrascleral intraocular lens fixation and pars plana vitrectomy/anterior vitrectomy, provided a safer surgical approach with fewer complications in patients with dislocated lenses compared with fragmatome-assisted techniques.
