New technique for refixating CTR-IOL-capsular bag complex

This article describes a three-point ab externo technique to refixate and recenter a subluxated Cionni capsular tension ring (CTR)–IOL–capsular bag complex to the sclera that avoids explantation and large incisions and ensures stable and central fixation of the IOL.

A 9-0 polypropylene suture on a curved needle is looped through the eyelet of the CTR and back through a Hoffman scleral tunnel. Two other sutures passed in a similar fashion through the fibrotic continuous curvilinear capsulorhexis edge are used to complete a tripod fixation, which centers and stabilizes the IOL.

This approach avoids the surgical trauma of removing and replacing a subluxated CTR-IOL-capsular bag complex and retains the optimal anatomical position.

I have only one case like this that I performed in a similar fashion, and it turned out well. However, it wasn’t that easy. All the more reason that we should be using Gore-Tex sutures so we won't see these Prolene suture breakages.