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Related Experiment Video

Updated: Mar 9, 2026

Author Spotlight: Enhancing Visual Outcomes in Cataract Surgery: A Novel Technique to Prevent Posterior Capsular Opacification Through IOL Rotation
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Intraocular Lens Stability in Eyes With ⩾ 30 mm Axial Length With Two Sizes of Capsular Tension Rings.

Xiaojing Liu1,2, Yue Zhang2, Xin Zhang1,2

  • 1Department of Ophthalmology Teaching and Researching, Hebei Medical University, Shijiazhuang, Hebei Province, China.

Journal of Refractive Surgery (Thorofare, N.J. : 1995)
|March 7, 2026
PubMed
Summary

Large capsular tension rings (CTRs) improve intraocular lens (IOL) stability and visual quality in eyes with long axial lengths (AL). This study suggests larger CTRs are beneficial for cataract patients with AL ≥ 30 mm.

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering

Background:

  • Cataract surgery in patients with long axial lengths (AL ≥ 30 mm) presents unique challenges for intraocular lens (IOL) stability.
  • Capsular tension rings (CTRs) are used to support the capsular bag during and after cataract surgery.

Purpose of the Study:

  • To evaluate the impact of two different sizes of capsular tension rings (CTRs) on intraocular lens (IOL) stability.
  • To assess visual acuity, IOL position, and capsular bag dynamics in patients with axial lengths of 30 mm or greater.

Main Methods:

  • A prospective randomized controlled study involving 120 eyes with AL ≥ 30 mm undergoing phacoemulsification and IOL implantation.
  • Eyes were randomized into three groups: large CTR (13x11 mm), small CTR (12x10 mm), and a control group (no CTR).
  • Postoperative assessments included visual acuity, capsulorhexis area, IOL tilt/decentration, intraocular pressure, and endothelial cell counts at multiple time points up to 6 months.

Main Results:

  • All groups showed improved visual acuity postoperatively.
  • Significant differences in horizontal IOL tilt and decentration were observed at 3 and 6 months, with the control group exhibiting greater tilt.
  • The large CTR group demonstrated the highest posterior capsule-IOL attachment rate (85%) and the lowest rate of posterior capsular opacity (5%).

Conclusions:

  • The large CTR (13x11 mm) provides superior support to the lens sac, reduces shrinkage, and enhances IOL stability, leading to better visual quality in eyes with AL ≥ 30 mm.
  • While findings suggest recommending larger CTRs for such patients, the study's limited power necessitates further validation in larger trials.