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Secondary implantation of a capsular tension ring for IOL revision surgery

Poster Details

First Author: U.Vossmerbaeumer GERMANY

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Abstract Details


Capsular tension rings are established for the stabilization of a capsular bag if the zonular fibres are deficient and may also have a beneficient role for the position of an intraocular lens (IOL) in the capsule. The device is usually implanted during cataract surgery immediately prior to IOL implantation. It may however also be useful for later stabilization of the capsular bag structures if a revision or an exchange of the primary IOL becomes necessary.


Case series, academic hospital setting at Department of Ophthalmology, University of Mainz, Germany


We report a case series of 10 eyes in 8 patients requiring revision surgery 3-40 months after cataract surgery due to spontaneous anterior out-of-the-bag subluxation, asymmetric capsular contraction and critical decentration or opacification of the IOL. In a revision procedure, fibrosis and adhesions of the capsular bag were dissolved and the capsular bag was reopened using viscoelastic gel (Healon�Â�®, Abbott Medical Optics, USA). A capsular tension ring (CTR) (RingJect�Â�®, Ophtec, NL) was introduced into the capsular bag using a bimanual technique and the IOL was repositioned resp. replaced.


The capsular bag could be reopened completely in all cases to allow secondary implantation of a CTR. In all cases bimanually guided implantation of a PMMA CTR proved feasible without complications. Also, the intraocular lens could be repositioned into the capsular bag. In long-term follow up, all patients had stable centration and correct position of the IOL.


Our case series demonstrates the feasibility of secondary implantation of CTR and the potential value for the stabilization of the capsular bag with IOL, both over the optical axis and in the desired anterior/posterior position. It seems that as long as complete dissolution of the fibrosis of capsular bag sheets is performed, a CTR can be positioned as in a primary implantation into the equator and contributes to the stabilization of the IOL. This use is not described in the literature and we deem it worth to be made known to the community.

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