Novel Double-Flanged Technique for Managing Marfan Syndrome

Dr. Sergio Canabrava presents a new technique for fixing the capsular bag in patients with zonular dialysis greater than 120° who are undergoing cataract surgery. With this method, he uses a standard capsular tension ring (CTR) to redistribute capsular forces and a 5-0 polypropylene monofilament in a capsular tension segment (CTS) to fix the subluxated capsular bag in the sclera. He creates a flange on both sides of the polypropylene to avoid the need for suturing. In this particular case, capsular hooks were not used during surgery due to a soft nucleus. Instead, Dr. Canabrava chose to hydroprolapse the nucleus to the anterior chamber, leaving the capsular bag free of tensions as the phacoemulsification was performed above the iris plane. 

 

Dr. Canabrava has used this technique in 13 cases and thus far, the bag-CTS-CTR complex appears stable. Further studies with more patients and longer follow-up are necessary to assess the exact outcomes it can achieve among patients with zonular weakness of different etiologies.

 

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