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Double rings, CTR and Cionni for management for large subluxated cataracts

Poster Details

First Author: S.Chaudhary INDIA

Co Author(s):                        

Abstract Details


Capsular hooks with Cionni rings are described to manage large subluxated cataracts through 6 clock hours. However, holding the rhexis with a capsular hook to stabilize the bag, can result in capsular tears, preventing further placement of a Cionni ring and jeopardizing the whole surgery. The author advocates the use of a CTR to stabilize the bag during surgery, followed by phaco and placement of the Cionni ring to fix the capsular bag to the sclera at the subluxated part.


Eye7 Hospitals, New Delhi, India


In a 6 clock hour subluxation, the exposed face of the vitreous is plugged with a dispersive visco-elastic. After performing a CCC and a gentle hydrodissestion, a CTR is inserted into the bag to stabilize it. Phaco is now done using the direct chop technique for a better control and least pressure to the already disrupted zonules. The CTR keeps the bag stretched and prevents it from collapsing and getting punctured with the phaco tip. Cionni ring is introduced and tied to the sclera to stabilize the bag.


We were successfully able to do uncomplicated cataract surgery in a series of 4 cases using this technique. There was no incidence of capsular tears as sometimes seen when using capsular hooks to stabilize the capsular bag. The IOL was central, the bag stable and visual recovery good.


This is my preferred technique to manage large subluxated cataracts. The incidence of capsular tears is nil as compared to the use of capsular hooks, where the incidence of capsular tears was significant. Since a Cionni ring placement needs a bag with an intact CCC, the double ring technique has a definite edge over the capsular hook technique.

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