title: Management of large traumatic zonular dialysis with phacoemulsification and IOL implantation using the capsular tension ring.
abstract: OBJECTIVE
  To report our results and to evaluate the longterm effect of capsular tension ring (CTR) insertion in eyes with large traumatic zonular dialysis that underwent phacoemulsification with posterior chamber (PC) intraocular lens (IOL) implantation.
  
  
  METHODS
  This prospective study included 17 eyes of 17 consecutive patients with cataract and large traumatic zonular dialysis (range 80-160 degrees determined pre-or intraoperatively). After insertion of a CTR, phacoemulsification with foldable acrylic PC IOL implantation was performed. Posterior capsule rupture, vitreous loss, best corrected visual acuity (BCVA), intraocular pressure (IOP) in the pre- and postoperative periods and postoperative IOL decentration were recorded.
  
  
  RESULTS
  The mean follow-up period was 25.9 months (range 15-35 months). Capsule collapse did not occur in any eye with a CTR. Postoperatively, four eyes developed raised IOP that responded well to medical therapy. An improvement in BCVA was observed in all eyes except one because of co-existing fundus pathology. No IOL was found to be decentrated at the end of the follow-up period, apart from one eye in which the PC IOL was dislocated due to a postoperative trauma, in which an anterior chamber IOL was implanted.
  
  
  CONCLUSIONS
  In cases of cataract associated with large traumatic zonular dialysis, implanting a CTR before or during phacoemulsification with an in-the-bag PC IOL is relatively safe technique with a high success rate. The CTR was found to be efficient in preventing IOL decentration in eyes with traumatic zonular deficiency.
authors: Department of Ophthalmology, Athens University, G. Genimatas Hospital, Athens, Greece. eyenet@hellasnet.gr
authors: Gerasimos Th
authors: GT
authors: Georgopoulos
authors: Dimitrios
authors: D
authors: Papaconstantinou
authors: Ilias
authors: I
authors: Georgalas
authors: Chrysanthi N
authors: CN
authors: Koutsandrea
authors: Ioannis
authors: I
authors: Margetis
authors: Marilita M
authors: MM
authors: Moschos
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000209:etiology; D005131:Eye Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007903:Lens Capsule, Crystalline / Q000601:surgery; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries*; D008022:Ligaments / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011379:Prognosis; D011446:Prospective Studies; D019736:Prostheses and Implants; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000601:surgery*