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

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.