A retrospective study of the indications and outcomes of capsular tension ring insertion during cataract surgery at a tertiary teaching hospital

Figures & data

Table 1 Identifiable preoperative indications for capsular tension ring insertion (please note that some patients had more than one risk factor)

Risk factors	Participant eyes
None	21 (25.0%)
Mature cataract	25 (29.8%)
Trauma	16 (19.0%)
Pseudoexfoliation	16 (19.0%)
High myopia	7 (8.3%)
Phacodonesis	6 (7.1%)
Previous vitrectomy	2 (2.4%)
Weill–Marchesani syndrome	2 (2.4%)

Table 2 Characteristics of the surgical procedure of study participants

	Participant eyes
Surgical procedure
Phacoemulsification only	61 (72.6%)
Phacoemulsification and anterior vitrectomy (unplanned)	21 (25.0%)
Phacoemulsification and conversion to extracapsular cataract extraction (unplanned)	7 (8.3%)
Phacoemulsification and iridoplasty (planned)	3 (3.6%)
Phacoemulsification and insertion of iris prosthesis (planned)	1 (1.2%)
Phacoemulsification and bleb needling (planned)	1 (1.2%)
Type of CTR inserted
Alcon Laboratories ReFORM® Capsular Tension Rings (Fort Worth, TX, USA)	26 (31.0%)
Abbott Medical Optics, Inc, StabilEyes™ Capsular Tension Rings (Abbott Park, iL, USA)	23 (27.4%)
Carl Zeiss Meditec. Tensiobag® Capsular Tension Rings (Jena, Germany)	9 (10.7%)
Morcher GmBH Morcher® Capsular Tension Rings (Stuttgart, Germany)	14 (16.7%)
Type of IOL inserted
Single-piece IOL	57 (67.9%)
Three-piece IOL	24 (28.6%)
Intraocular lens placement
Posterior chamber IOL in bag	72 (85.7%)
Posterior chamber IOL in sulcus	6 (7.1%)
Anterior chamber IOL	6 (7.1%)
Intraoperative complications
None	78 (92.9%)
Posterior capsule tear	3 (3.6%)
CTR explanted	2 (2.4%)
Iridodialysis	1 (1.2%)

Abbreviations: CTR, capsular tension ring; IOL, intraocular lens.

Table 3 Postoperative complications and secondary postoperative procedures of study participants

	Participant eyes
Postoperative complication
None	67 (79.8%)
Decentered intraocular lens	7 (8.3%)
Corneal edema	5 (6.0%)
Raised intraocular pressure	3 (3.6%)
Vitreous prolapse	2 (2.4%)
Suture abscess	1 (1.2%)
Retinal detachment	1 (1.2%)
Decompensated phoria	1 (1.2%)
Secondary postoperative procedures
None	70 (83.3%)
YAG capsulotomy	9 (10.7%)
Anterior vitrectomy	4 (4.8%)
Removal of capsular tension ring	2 (2.4%)
Repositioning of capsular tension ring	1 (1.2%)
Intraocular lens exchange	1 (1.2%)
Squint surgery	1 (1.2%)
Retinal detachment repair	1 (1.2%)
Trabeculectomy	1 (1.2%)

Abbreviation: YAG, yttrium aluminum garnet.

Table 4 Intraoperative procedures and outcomes of cataract surgery for training surgeons and senior surgeons

	Training surgeon	Senior surgeon
Visual acuity
Preoperative – mean	20/60	20/60
Postoperative – mean	20/30	20/30
IOL placement
Posterior chamber IOL in bag	37 (88.1%)	35 (83.3%)
Posterior chamber IOL in sulcus	4 (9.5%)	2 (4.8%)
Anterior chamber IOL	1 (2.4%)	5 (11.9%)

Abbreviation: IOL, intraocular lens.

Table 5 Intraoperative procedures and outcomes of cataract surgery for planned capsular tension ring insertion and unplanned capsular tension ring insertion

	Planned CTR insertion	Unplanned CTR insertion
Visual acuity
Preoperative – mean	20/120	20/60
Postoperative – mean	20/30	20/30
IOL placement
Posterior chamber IOL in bag	25 (89.3%)	41 (83.7%)
Posterior chamber IOL in sulcus	1 (3.6%)	4 (8.2%)
Anterior chamber IOL	2 (7.1%)	4 (8.2%)

Abbreviations: CTR, capsular tension ring; IOL, intraocular lens.