Modified capsular tension ring for patients with congenital loss of zonular support.
OBJECTIVE
To evaluate the results of implantation of a modified capsular tension ring (MCTR) and a posterior chamber intraocular lens (PC IOL) in patients with congenitally subluxated crystalline lenses.


METHODS
Cincinnati Eye Institute, Cincinnati, Ohio, USA.


METHODS
Ninety eyes of 57 patients with congenital loss of zonular support (Weill-Marchesani syndrome, idiopathic ectopia lentis, and Marfan's syndrome) had phacoemulsification with PC IOL and MCTR implantation. The preoperative examination included best corrected visual acuity (BCVA) and the presence or absence of phacodonesis, lens decentration, and vitreous prolapse. The postoperative evaluation included BCVA and the presence or absence of pseudophacodonesis, PC IOL centration, and posterior capsule opacification (PCO).


RESULTS
At the last postoperative examination, the BCVA was 20/40 or better in 80 eyes (88.9%); 1 eye (1.1%) lost 1 line of acuity. Preoperatively, 18 eyes (20%) had phacodonesis; 1 eye had postoperative pseudophacodonesis. Decentration before surgery was present in 86 eyes (95.6%); 6 eyes (6.7%) developed late symptomatic PC IOL decentration a median of 17.84 months +/- 10.73 (SD) after surgery. Other complications were increased intraocular pressure (2.2%), persistent iritis (3.3%), broken suture (10.0%), retinal detachment (1.1%), and PCO (20.0%).


CONCLUSIONS
Use of the MCTR resulted in centration of the capsular bag and PC IOL in 90 eyes with congenitally subluxated crystalline lenses. Fixation of a 9-0 polypropylene suture is recommended to decrease the risk for late suture breakage.
Cionni
Robert J
RJ
Cincinnati Eye Institute, Cincinnati, Ohio 45242, USA. rcionni@cincinnatieye.com
Osher
Robert H
RH
Marques
Daniela M V
DM
Marques
Frederico F
FF
Snyder
Michael E
ME
Shapiro
Scott
S
D000328:Adult; D006801:Humans; D007429:Intraocular Pressure; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery*; D007906:Lens Subluxation / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D019736:Prostheses and Implants / Q000009:adverse effects; D012189:Retrospective Studies; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014792:Visual Acuity