Influence of capsular tension ring on posterior capsule opacification in myopic eyes

Abstract

Purpose:To determine the effect of a capsular tension ring (CTR) implantation in preventing posterior capsular opacification (PCO) after cataract surgery in patients with high myopia.Materials and Methods:In this prospective single-surgeon standardized-surgical-procedure fellow-eye comparison trial, 34 patients with high myopia had phacoemulsification surgery. Although one eye received an acrylic intraocular lens (IOL) and CTR, other eye received only an IOL as control. PCO, within the capsulorhexis overlap, was documented by standardized digital retroillumination images at least 2 years post-operatively, and the percentage area of PCO was scored (scale 0%-100%) using the POCOman software system. The PCO score and the incidence of neodymium-doped yttrium aluminum garnet (Nd: YAG) capsulotomy of groups, and correlations between PCO score and presence of CTR, age, phaco time, refraction, and axial length (AL) were determined.Results:The mean time interval from surgery to PCO measurement was 43.4 ± 11.2 months for the eyes with a CTR and 43.1 ± 11.6 months for the controls (P = 0.91). The PCO score of the eyes with a CTR was significantly lower than in the controls (5.9 ± 4.3 vs. 22.3 ± 12.2, respectively; P < 0.001). There were statistically insignificant correlations between PCO score and pre-operative refraction (r = 0.02; P = 0.90), AL (r = 0.03; P = 0.80), phaco time (r = 0.11; P = 0.53), and patient's age (r = 0.23; P = 0.55). No patient with a CTR had a Nd: YAG laser capsulotomy, but it was six in controls (P = 0.025).Conclusions:CTR implantation seems to be effective in reducing the PCO and Nd: YAG laser capsulotomy rates in high myopic eyes.

Effect of capsular tension ring implantation on capsular stability after phacoemulsification in patients with weak zonules:a randomized controlled trail. CTR implantation in cataract patients with weak zonules

“…CTR can effectively balance the tension of zonular bers, uniformly distribute the tension of the capsular bag, maintain the shape of the capsular bag, reduce loss of the vitreous body, and increase attachment between posterior capsule and IOL surface. These effects of CTR increase IOL stability after cataract extraction involving IOL implantation and reduce the occurrence of posterior capsule opaci cation and IOL dislocation [7,[22][23][24][25][26][27][28][29][30][31][32][33][34]. Whether and how CTR implantation can also bene t patients with weakened zonular bers but no lens dislocation is unclear.…”

“…We also found that the rate of complete attachment between the posterior capsule of the lens and posterior surface of the IOL was higher in the CTR group than the control group after only 1 week and even higher after 3 months. This may be because the CTR can mechanically compress the capsular bag closer to the IOL surface [26,34,40,41]. However, this effect of CTR was not obvious in patients with strong myopia, perhaps because such eyes are axially longer, and the capsular bag is larger.…”

“…The CTR maintains the shape of the capsular bag, balances the tension in zonular bers, and decreases the risk of capsular shrinkage and IOL decentration or dislocation [22][23][24][25][26][27][28][29]. While a CTR has been used for focal zonular rupture or diffuse zonulopathy either to stretch out a capsular bag or to facilitate scleral suture xation [7,[22][23][24][25][26][27][28][29][30][31][32][33][34], other studies suggested that whether the capsular bag and IOL can remain stable after CTR implantation during cataract surgery in patients with strong myopia are controversial [7,22,34]. In addition to these uncertainties, the effects of CTR on cataract surgery in patients with an abnormal zonule after PPV are unclear.…”

Influence of Intraocular Lens Material and Eye Axial Length on Posterior Capsule Opacification Dynamic Rate and Frequency

“…Keywords: рhacoemulsification, IOL, pseudophakia, PCO, myopia Несмотря на совершенство современной технологии факоэмульсификации катаракты (ФЭ) и повсеместное внедрение в клиническую практику заднекамерных ин-траокулярных линз (ИОЛ), дизайн которых направлен на снижение частоты развития вторичной катаракты, её формирование остается основным осложнением отда-ленного послеоперационного периода [1,2,3,4,5,6,7].…”

Opacificación capsular posterior: diagnóstico, prevención y tratamiento con láser Nd-YAG

“…No obstante, aunque la gran variedad de estudios demuestran que mediante los lentes de una pieza se produce menor incidencia de OCP,Mylonas et al (2013) obtuvieron que aunque los lentes de una pieza y de los de tres piezas proporcionan buenos resultados de agudeza visual, los de una pieza mostraban mayor incidencia de OCP.Anillo de tensión capsularPara prevenir la incidencia y el tiempo de desarrollo de la OCP, suele implantarse un anillo de tensión capsular (CTR)(Kavoussi et al, 2011;Tribus et al, 2007). El anillo de tensión capsular es considerado un procedimiento seguro que, mediante la expansión de la bolsa capsular, permite reducir la presencia de OCP, especialmente en pacientes con elevada miopía(Halili et al, 2014;Menapace et al, 2008) Halili et al (2014). realizaron una comparación entre los pacientes a los que se les implanta un CTR y los que no se les implanta.…”