Intrascleral fixation of standard capsular tension ring: a modified-simple technique for managing moderate and severe
Li Ning1,2,3, Yingying Hong1,2,3, Yinghong Ji1,2,4
1Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Background:
Moderate-to-severe lens subluxation poses surgical challenges due to extensive zonular weakness and the need to maintain stable intraocular lens (IOL) positioning while preserving the capsular bag.
Objectives:
To evaluate the outcomes and safety of a modified technique using intrascleral suture fixation of a standard capsular tension ring (CTR) to preserve the capsular bag in moderate-to-severe lens subluxation.
Design:
Retrospective, single-center case series.
Methods:
Consecutive eyes with 120°-300° zonular dialysis underwent phacoemulsification via a 2.4 mm clear corneal incision and a 0.8 mm lateral incision. Capsular bag stabilization was achieved by intrascleral fixation of a standard CTR using a knotless Z-suture with double-strand 8-0/9-0 polypropylene, followed by in-the-bag IOL implantation. Primary outcomes were postoperative IOL centration and corrected-distance visual acuity (CDVA); secondary outcomes included refractive error and complications. Follow-up was scheduled at 1, 3, 6 months (some at 12 months) and annually thereafter.
Results:
Sixteen eyes of nine patients were included. Median follow-up was 328.0 days (interquartile range (IQR) 256.5, 443.0). Median logMAR CDVA improved from 0.35 (IQR 0.30, 0.57) preoperatively to 0.19 postoperatively. Mean absolute spherical equivalent decreased from 9.82 ± 1.02 D to 1.16 ± 0.25 D. IOLs were well‑centered in 13 eyes (81.3%); a slight, clinically insignificant tilt was observed in 3 eyes (18.7%). One intraoperative posterior capsule rupture did not preclude in-the-bag IOL implantation. Two eyes had transient postoperative intraocular pressure elevation managed medically. No other significant complications occurred.
Conclusion:
Intrascleral fixation of a standard CTR is a simple, accessible, and effective bag-preserving technique for moderate-to-severe lens subluxation, enabling stable in-the-bag IOL implantation with favorable visual and refractive outcomes.
Registration:
ClinicalTrials.gov: NCT06627062.
Related Concept Videos
01:24Simple Staining Technique
01:10Tension
01:29Impression Management Techniques I: Managing Appearances
02:57Surface Tension, Capillary Action, and Viscosity
The various IMFs between identical molecules of a substance are examples of cohesive forces. The molecules within a liquid are surrounded by other molecules and are attracted equally in all directions by the cohesive forces within the liquid. However, the molecules on the surface of a liquid are attracted only by about one-half as many molecules. Because of the unbalanced molecular attractions on the surface molecules, liquids contract to form a shape that minimizes the number...
01:29Impression Management Techniques II: Ingratiation
01:23Stress Prevention and Stress Management Techniques II
Type A Personality: Driven and Easily Stressed
Individuals with Type A personalities are often highly competitive and ambitious and operate with a strong sense of urgency. Commonly labeled as...