Prophylactic Capsular Tension Ring Implantation In Pseudoexfoliation Syndrome Without Clinical Zonular Weakness: A Prospective Comparative Study
Published 2026 - 44th Congress of the ESCRS
Reference: FP03.08 | Type: Free paper | DOI: 10.82333/bzzn-5q45
Authors: Prof. Dr Umida Mavlyanova* 1 , Prof. Dr Azamat Yusupov 1 , Dr Sevara Mavlyanova 1
1REPUBLICAN SPECIALIZED SCIENTIFIC AND PRACTICAL MEDICAL CENTER OF EYE MICROSURGERY,Tashkent,Uzbekistan
Purpose
To evaluate the clinical and functional effectiveness of prophylactic capsular tension ring (CTR) implantation during phacoemulsification in patients with pseudoexfoliation syndrome (PEX) without clinically evident zonular weakness.
Setting
Prospective comparative clinical study conducted at a tertiary ophthalmic surgical center.
Methods
A total of 124 eyes of 124 patients with cataract and PEX without clinical signs of zonular instability were included. Patients were allocated into two groups: Group 1 (n=62) underwent phacoemulsification with prophylactic CTR implantation; Group 2 (n=62) underwent standard phacoemulsification without CTR. Preoperative evaluation included slit-lamp biomicroscopy, biometry, and anterior segment optical coherence tomography. Postoperative follow-up at 1 month and 6 months included best-corrected visual acuity (BCVA), intraocular lens (IOL) centration, refractive prediction error, and anterior capsule contraction. Statistical analysis was performed using appropriate parametric and non-parametric tests, with p<0.05 considered significant.
Results
Intraoperative complications occurred in 2 eyes (3.2%) in the CTR group and 8 eyes (12.9%) in the control group (p=0.04). Zonular dialysis requiring additional stabilization occurred in 0 eyes in Group 1 versus 5 eyes (8.1%) in Group 2 (p=0.02). At 6 months, mean BCVA was comparable between groups (p>0.05). However, clinically significant IOL decentration (≥0.5 mm) was observed less frequently in the CTR group (1.6% vs 11.3%, p=0.03). Anterior capsule contraction occurred in 4.8% versus 16.1% of eyes, respectively (p=0.04). Refractive predictability (within ±0.5 D of target) was higher in the CTR group (85.5% vs 71.0%, p=0.048).
Conclusions
Prophylactic CTR implantation in patients with PEX without clinically apparent zonular weakness significantly reduces intraoperative instability and postoperative capsular bag–related complications. The findings support consideration of preventive CTR use in selected PEX cases to enhance surgical safety and long-term IOL stability.
The authors have no financial interest in any material or method mentioned.