Abstract
Purpose :
Controversy exists about the benefit of a capsular tension ring (CTR) in combination with plate haptic intraocular lenses (IOL) at the time of cataract surgery. We performed a prospective, randomized, controlled, intraindividual, comparative study to test the impact of a CTR regarding postoperative rotation, decentration and tilt on a 11.0 mm hydrophilic acrylic plate haptic IOL.
Methods :
In this prospective, randomized, controlled study 130 eyes of 65 patients with bilateral age-related cataract were included. Randomized, one eye of every patient received a CTR Model 276 (CTR group) and the CT Asphina 409MP (Carl Zeiss, Jena, Germany) IOL whereas the fellow eye received the IOL only (Control-group). Baseline measurements for rotational stability measurements based on scleral landmarks were obtained at the end of surgery (EOS). Retroillumination pictures were taken at 1 hour (1h), 1 week (1w), 1 month (1m) and 6 months (6m) postoperatively. Decentration and tilt values were assessed prior to surgery, 1w and 6m after surgery using an anterior segment SS-OCT Casia 2 (Tomey Corp., Nagoya, Japan). Results are presented as mean±SD and range [Min;Max].
Results :
Mean rotational stability values from EOS to 6m (n=128) were 2.8±3.9° [0.3;29.9] in the CTR group and 3.2±5.3° [0.1;36.5] in the Control-group, respectively (p=0.61). Mean decentration at 6m was 0.28±0.15mm [0.04;0.78] in the CTR-group and 0.24±0.12mm [0.05;0.61] in the Control-group, respectively (p=0.058). Difference in mean decentration from preoperative to 6m was 0.29±0.15mm [0.05;0.75] for the CTR-group and 0.18±0.11mm [0.02;0.51] mm for the Control-group, respectively (p<0.01). Mean tilt at 6m was 6.66±2.77° [1.5;17.7] in the CTR-group and 5.55±1.60° [2.50;9.20] in the Control-group, respectively (p<0.01).Difference in mean tilt from preoperative to 6m was 3.3±2.8° [0.1;12.4] and 1.6±1.1° [0.1;4.6], respectively(p<0.01).
Conclusions :
Until recently, it was propagated that CTRs improve IOL rotational stability, IOL centration and minimize IOL tilt after cataract surgery. In our intraindividual comparative study, the implantation of a capsular tension ring in combination with a 11.0mm plate haptic IOL showed no benefit regarding IOL rotation and had a negative impact on postoperative IOL centration and IOL tilt compared to the control group without CTR.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.