Purpose: This paper introduces a surgical technique for the sutureless management of zonular dialysis greater than 120° using a capsular tension segment (CTS) or a modified capsular tension ring (m-CTR; CTR with suturing eyelets) and a haptic removed from a 3-piece polypropylene IOL.
Methods: A CTR is used as normal. Cataract removal is followed by connection of the CTS or m-CTR to the single haptic and created using heat to make a flange in one haptic's extremity. The other extremity is placed in the CTS or m-CTR's central hole. The CTS or m-CTR/flanged-haptic complex is introduced into the capsular bag and aligned with the weakest zonular quadrant. A 30-gauge needle guides the externalization of the free haptic extremity through the adjacent pars plana and creates a flange on the second haptic tip permitting intrascleral fixation of the CTS or m-CTR.
Results: The result is a successful IOL implantation with a sutureless technique.
Conclusions: This double-flanged m-CTR/CTS technique allows suture-free option for managing zonular weakness or dialysis while performing cataract surgery.
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http://dx.doi.org/10.1007/s10792-017-0746-5 | DOI Listing |
ArXiv
December 2024
Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom St., Boston, MA 02114, USA.
Lens tension is essential for accommodative vision but remains challenging to measure with precision. Here, we present an optical coherence elastography (OCE) technique that quantifies both the tension and elastic modulus of lens tissue and capsule. This method derives mechanical parameters from surface wave dispersion across a critical frequency range of 1-30 kHz.
View Article and Find Full Text PDFIndian J Ophthalmol
January 2025
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.
Scleral-fixated intraocular lens (SFIOL) is a widely used technique for IOL implantation in patients where capsular support is insufficient. Most surgeons have shifted away from sutured to sutureless SFIOL techniques where haptics of a multifocal IOL are inserted in scleral tunnels/flaps. Large-scale publications have shown wide variation in the refractive status of eyes post-SFIOL even in the best of the hands.
View Article and Find Full Text PDFInt J Ophthalmol
December 2024
School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.
Aim: To present a technique of transcapsular scleral fixation of the standard capsular tension ring (CTR) through equatorial capsulotomy and in-the-bag intraocular lens (IOL) implantation in subluxated lenses.
Methods: This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction, transcapsular scleral fixation of the standard CTR through equatorial capsulotomy, in-the-bag IOL implantation and with at least 6mo follow-up. Preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), complications, and postoperative IOL tilt and decentration were recorded.
JBJS Essent Surg Tech
December 2024
Sports Medicine Center, Department of Orthopaedics, Massachusetts General Hospital, Mass General Brigham, Boston, Massachusetts.
Background: Whereas uncomplicated labral tears with preserved fibers can be effectively treated with use of labral repair techniques, complex tears and hypoplastic labra require labral reconstruction. Standard reconstruction techniques feature grafted tissue that is added to existing, deficient tissue or that is utilized to replace a hypoplastic labrum entirely. However, such approaches utilizing allografts or remote autografts are limited because they often necessitate extensive debridement of the existing labrum to prepare a site for graft implantation, an approach that can damage and devascularize the chondrolabral junction.
View Article and Find Full Text PDFCureus
November 2024
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, JPN.
We report a case of acute angle closure secondary to pupillary block caused by a dislocated intraocular lens (IOL)-capsular tension ring (CTR) complex. A 68-year-old woman, who had undergone cataract surgery 28 months earlier, presented with acute right eye pain and blurred vision. Examination revealed elevated intraocular pressure (IOP) of 80 mmHg, corneal edema, and anterior chamber shallowing, with anterior displacement of the IOL-CTR complex observed on anterior-segment optical coherence tomography.
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