Abstract:

 Objective To observe the clinical effects of common capsular tension ring(CTR) fixed in the ciliary sulcus at the second stage for moderate and severe lens subluxation. Design Retrospective case series. Participants 45 eyes of 33 patients with moderate and severe lens subluxation were treated and followed up in the Department of Cataract of Hebei Province Eye Hospital from March 2013 to May 2015. Methods At the first stage the common CTR and the intraocular lens(IOL) were implanted in the lens capsule after phacoemulsification. At the second stage the CTR were sutured to the ciliary sulcus with polypropylene suture three months after the first stage. All patients were followed up for 3 months. The postoperative best corrected visual acuity(BCVA), the visual quality, the center of the IOL and the complications were recorded. Main Outcome Measures The BCVA, ocular coma, Strehl ratio, the IOL offset, the complications. Results We successfully fixed the CTR in the ciliary sulcus in 45 eyes. The postoperative BCVA was 0.6~1.0 in 32 eyes(71%), 0.3~0.5 in 8 eyes(18%) and 0.1~0.2 in 5 eyes(11%). The BCVA improved after 3 months in all the 45 eyes. The mean ocular coma after the first stage was (4.08±3.17) μm, which improved to (0.39±0.10) μm after the second stage, the difference was significant (t=5.102, P=0.000). The mean Strehl ratio after the first stage was (0.035±0.018), which improved to (0.164±0.041) after the second stage, the difference was significant (t=14.881, P=0.003). This illustrated the visual quality increased. The mean IOL offset after the first stage was (3.02±0.47) mm, which improved to (0.31±0.11) mm, the difference was significant (t=17.298, P=0.000).  The IOL offset at the first stage was correlated with the range of the lens dislocation(r=0.634, P=0.012). The intraocular pressure increased in 3 eyes. No complications such as macular edema or capsular contraction occurred. Conclusions The capsular tension ring fixed in the ciliary sulcus at the second stage was an effective treatment for moderate and severe lens subluxation． Separating operations into two stages reduces the difficulty and complications of surgery. (Ophthalmol CHN, 2016, 25: 77-81)

Key words:  , lens subluxation；capsular tension ring；ciliary sulcus