Cionni-modified CTR appears safe for subluxated lenses

This prospective study examined intraoperative performance and long-term postoperative outcomes of Cionni-modified capsule tension ring (CTR) and in-the-bag IOL implantation in eyes with subluxated lenses. The authors report in the June issue of the American Journal of Ophthalmology that this appears to be a safe option that ensures a stable IOL with few complications.

The authors say they are unaware of previous reports prospectively evaluating long-term outcomes following Cionni ring implantation in subluxated cataracts.

The study included 33 patients (41 eyes) with subluxated lenses who underwent lens extraction, capsular bag fixation with modified CTR, and in-the-bag single-piece AcrySof IOL implantation. Their mean age was 29.46 ± 16.16 years (3 to 68 years). They were followed for a mean of 45.8 ± 2.9 months.

The mean extent of subluxation was 6.1 ± 1.0 clock hours. Preoperatively, vitreous was detected in the anterior chambers of five eyes (12.2 percent). Two-port anterior chamber vitrectomy was performed in two eyes. Mean preoperative BCVA was 0.66 ± 0.22 logMAR (35 eyes). Mean postoperative BCVA at final follow-up was 0.33 ± 0.21 logMAR (41 eyes) (P < 0.001). BCVA improved in 35 eyes (85.4 percent) at the last follow-up.

IOL decentration was noted in three eyes, and repositioning was required in two eyes. Posterior capsule opacification, the most common complication, developed in 14 eyes (34.2 percent), 12 of which required Nd:YAG capsulotomy. Other complications included cystoid macular edema in one eye, posterior synechiae in one eye and retinal detachment in one eye.

Their results suggest that the procedure is safe for protecting the capsular bag, with good visual outcomes and few significant intraoperative and postoperative complications. However, it requires highly skilled expertise and cannot always be completed.