Influence Of Capsular Tension Ring Implantation On Dynamic In Vivo Capsular Adhesion And Intraocular Lens Behavior In Highly Myopic Eyes

To evaluate the dynamic in vivo capsular adhesion to the intraocular lens (IOL) in highly myopic eyes following capsular tension ring (CTR) implantation using swept-source optical coherence tomography (SS-OCT), and to investigate its correlation with in-the-bag IOL behavior.

Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, China.

Highly myopic patients undergoing cataract surgery were randomized to receive CTR implantation or not. SS-OCT was performed at 1 day, 1 week, 1 month, 3 months, and 6 months to assess capsular adhesion. Postoperative aqueous depth (PAD), IOL rotation, and anterior and posterior capsular opacification (ACO/PCO) were evaluated at each follow-up visit.

A total of 29 eyes with CTR implantation and 30 eyes without CTR were included. The CTR group exhibited accelerated anterior capsular adhesion, demonstrated by a smaller lens-anterior capsule distance (LCD) at 1 day and a higher proportion of anterior capsular adhesion at 1 week. From 1 month onward, posterior capsular adhesion occurred more frequently in the CTR group. At 1 day, the average LCD positively correlated with both PAD and IOL rotation. During subsequent follow-up period, the mean capsular bend index exhibited negative correlations with the absolute changes in PAD and IOL rotational speed. The CTR group developed less severe ACO, Eyes with incomplete posterior capsular adhesion had a higher risk of PCO.

CTR implantation facilitates accelerated anterior and more complete posterior capsular adhesion to the IOL in highly myopic eyes, which may contribute to improved postoperative IOL stability and a reduced incidence of capsular opacification.