The effect of capsular tension rings on accommodative intraocular lens performance and the suture-guided capsular tension ring technique for eyelet positioning

Session Details

Session Title: Presented Poster Session: After Surgery

Venue: Poster Village: Pod 1

First Author: : T.Page USA

Co Author(s): :    L. Werner   N. Ellis   J. Heczko   D. Rooney   M. Gappy           

Abstract Details

Purpose:

To evaluate the effect of capsular tension rings (CTR) on surgical outcomes with accommodative intraocular lenses (AIOL) with respect to capsular bag contraction (CCS) and vaulting, refractive stability, lens performance, and CTR eyelet interaction with the IOL haptics.

Setting:

Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, and Moran Eye Center, University of Utah, Salt Lake City, Utah, United States of America

Methods:

A retrospective chart review of eyes implanted with accommodative IOLs (127 eyes) were evaluated for the presence or absence of capsular contraction syndrome (CCS) resulting in unexpected shifts in refractive error. Data collected included the presence or absence of a prophylactic CTR implanted at the time of surgery (86 eyes), post op day (POD) 7, 30, and 90 uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), refractive error, CCS, and any surgical intervention was recorded and compared between the two groups. In addition, the CTR interaction with the AIOL haptics was observed with Miyake-Apple video analysis.

Results:

There was no statistical difference in respect to UCDVA and UCNVA caused by the addition of a prophylactic CTR. In the group without a CTR, 3 eyes developed significant CCS with resulting shifts in refractive error. All three of these cases were satisfactorily managed with either YAG capsulotomy, surgical intervention with secondary CTR placement, or IOL exchange. In the group with a prophylactic CTR placed, no eyes developed significant CCS and no eyes required a return trip to the operating room. Miyake-Apple video analysis demonstrated that the CTR eyelet may interfere with haptic positioning of AIOLs.

Conclusions:

This study demonstrates that the addition of a prophylactic CTR does not limit the performance of AIOLs in respect to UCDVA or UCNVA as compared to the non-CTR group. This study validates earlier reports that CTRs are useful in preventing capsular contraction syndrome when using AIOLS, reducing subsequent surgical intervention.  The CTR eyelet extends centrally from the CTR and may interfere with the haptics of IOLs. While further study is needed to explore the interaction of IOLs with CTR eyelets, the surgeon may consider either positioning the CTR eyelets or IOL haptics so that they do not interact.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company