Influence Of A Capsular Tension Ring On Rotational Stability Of A Plate Haptic Intraocular Lens – An Intraindividual Comparative Study

To assess the influence of a commonly used capsular tension ring (CTR) on rotational stability of a plate haptic hydrophilic intraocular lens (IOL) from end of surgery (EOS) to 6 months postoperatively. 

 

Medical University of Vienna, Department of Ophthalmology and Optometry 

 

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 capsular tension ring Model 276 (Ophtec B.V., Groningen) (CTR group) and a hydrophilic acrylic intraocular lens CT Asphina 409MP  (Carl Zeiss, Jena) whereas the fellow eye received the CT Asphina 409MP IOL only (Control-group). Baseline measurements were performed at the end of surgery. Retroillumination pictures were taken at 1 hour (1h), 1 week (1w), 1 month (1m) and 6 months (6m) postoperatively. A semiautomatic evaluation software for rotational stability measurements (Rotix) was used. Rotational stability values are presented as mean±SD [Min;Max]. 

 

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). Rotation from EOS to 1h, 1h to 1w, 1w to 1m and 1m to 6m was 1.3±1.0° [0.0;4.1],1.7±3.7° [0.0;28.7],1.5±1.3° [0.1;5.9], 1.3±1.0° [0.1;4.0] in the CTR group and 2.1±3.2° [0.0;23.9],1.3±2.1° [0.0;11.8],1.7±1.9° [0.2;9.8] and 1.0±0.8°[0.0;3.0] in the Control-group. There was no statistical difference at any of the timepoints (p=0.07,p=0.43,p=0.43,p=0.59). The proportions of IOLs showing rotation of more than 10° from EOS to 6m were 1.7% (n=1) in the CTR group and 8.5% (n=5) in the Control-group, respectively.

 

Simultaneous implantation of a capsular tension ring in addition to a hydrophilic plate haptic IOL showed on average no significant advantage compared to implantation without a capsular tension ring. Nevertheless, significantly fewer rotations of more than 10 degrees, which could lead to repositioning surgeries in the case of a toric IOL, were observed in the capsular tension ring group.