Sulcus fixation of a standard capsular tension ring in cataract surgery with capsular instability
Kyu Sang Eah1, Hayoung Lee1, Yoo Young Jeon1
1Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Aim:
To introduce a novel technique for stabilizing the capsular bag in cataract surgery.
Methods:
This retrospective observational case series included eyes with unstable capsular bag that underwent cataract surgery. A standard capsular tension ring (CTR) with 10-0 Prolene sutures was inserted into the capsular bag and fixated to the sulcus to stabilize the bag, enabling in-the-bag intraocular lens (IOL) implantation. Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), and slit-lamp examination were performed preoperatively and at 1 and 6mo postoperatively.
Results:
Of the 17 eyes from 15 patients (mean age 51.20±19.60y, male/female=11/6), 8 had subluxation due to Marfan syndrome, 3 due to trauma, 5 due to zonular weakness, and 1 due to acute angle closure glaucoma. The preoperative mean CDVA (logMAR) was 0.56±0.67 (mean spherical equivalent: -6.39±4.78 D). At 1mo postoperatively, the mean CDVA improved to 0.21±0.37 (mean spherical equivalent: -0.35±1.07 D). At 6mo, the mean CDVA was 0.32±0.39, and the mean spherical equivalent was -0.34±0.99 D. All patients showed significant visual improvement at both postoperative visits (P<0.05), with stable IOLs in all cases.
Conclusion:
This technique offers a viable surgical option in complex cataract cases with zonulysis.
