title: Complication from combined use of capsule retractors and capsular tension rings in zonular dehiscence.
abstract: We describe a new complication associated with capsular tension ring (CTR) implantation after placement of capsule retractors. We report 3 cases from 3 different surgeons of inadvertent threading of a CTR through a capsule retractor loop. In each case, the distal loop was opened or amputated to facilitate hook removal. We report this case series to alert cataract surgeons to a potential complication of using CTRs and capsule retractors together and to offer potential strategies for preventing and managing an intracapsular entanglement.
  
  
  BACKGROUND
  Dr. Kim is a consultant to Alcon Surgical, Inc. Dr. Chang receives personal fees from Abbott Medical Optics, Inc. Dr. Condon receives personal fees from Alcon Surgical, Inc. and Microsurgical Technology. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From Duke University (Grove, Kim), Durham, North Carolina; Allegheny Ophthalmic and Orbital Associates (Condon), Pittsburgh, Pennsylvania; Palo Alto Medical Foundation (Erny) and Altos Eye Physicians (Chang), Los Altos, California, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Grove
authors.affiliation: From Duke University (Grove, Kim), Durham, North Carolina; Allegheny Ophthalmic and Orbital Associates (Condon), Pittsburgh, Pennsylvania; Palo Alto Medical Foundation (Erny) and Altos Eye Physicians (Chang), Los Altos, California, USA.
authors.forename: Garry
authors.initials: G
authors.lastname: Condon
authors.affiliation: From Duke University (Grove, Kim), Durham, North Carolina; Allegheny Ophthalmic and Orbital Associates (Condon), Pittsburgh, Pennsylvania; Palo Alto Medical Foundation (Erny) and Altos Eye Physicians (Chang), Los Altos, California, USA.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Erny
authors.affiliation: From Duke University (Grove, Kim), Durham, North Carolina; Allegheny Ophthalmic and Orbital Associates (Condon), Pittsburgh, Pennsylvania; Palo Alto Medical Foundation (Erny) and Altos Eye Physicians (Chang), Los Altos, California, USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Chang
authors.affiliation: From Duke University (Grove, Kim), Durham, North Carolina; Allegheny Ophthalmic and Orbital Associates (Condon), Pittsburgh, Pennsylvania; Palo Alto Medical Foundation (Erny) and Altos Eye Physicians (Chang), Los Altos, California, USA. Electronic address: terry.kim@duke.edu.
authors.forename: Terry
authors.initials: T
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008022:Ligaments / Q000473:pathology*; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects* / Q000295:instrumentation; D019736:Prostheses and Implants / Q000009:adverse effects*