• Written By: Liliana Werner, MD, PhD
    Cataract/Anterior Segment

    This paper describes a technique for managing cataracts in eyes with zonular weakness using a combination of microhook iris retractors to fixate the capsulorhexis, a capsular tension ring, and IOL optic capture. The authors report good results using this technique in 70 eyes after a 13-month mean follow-up.

    It seems that use of the technique they describe could really impact the rates of long-term in-the-bag IOL dislocation in cases with zonular weakness. We continue to receive a lot of in-the-bag dislocated IOLs in our lab, mostly from pseudoexfoliation cases.

    Inclusion criteria for the use of the technique in the 70 patients were a well-dilated pupil through which the extent of any dialysis, capsule instability and/or capsular bag collapse during the capsulorhexis process could be seen. They had predisposing factors, such as pseudoexfoliation, uveitis, retinitis pigmentosa, and long axial length without a capsule tear and vitreous loss.

    There were no complications during surgery. All eyes had perfectly round pupils and a satisfactory postoperative recovery without inflammation, IOP elevation, or IOL decentration.