INFLUENCE OF CAPSULAR TENSION RING INSERTION ON THE REFRACTIVE OUTCOMES AFTER PHACOEMULSIFICATION IN PSEUDOEXFOLIATION SYNDROME

Τhe primary goal of this study was to evaluate the influence of capsule tension ring (CTR) implantation on the refractive outcomes after uneventful cataract surgery in eyes with pseudoexfoliation syndrome (PEX).

Ophthalmology Department of the General Hospital of Rethymnon, Greece.

In this retrospective study, a total of 47 eyes of 43 patients were included. Eyes were grouped based on the use of only IOL (Group A, n=25) or IOL with CTR (Group B, n=22). Exclusion criteria were extensive preoperative zonular detachment, intra- or postoperative complications, axial length greater than 25 mm and less than 21 mm, along with other ocular comorbidities affecting visual function. All eyes underwent phacoemulsification by the same experienced surgeon. The choice of CTR insertion was made intraoperatively in cases with evidence of loose zonules during capsulorhexis. Full ocular examination was performed preoperatively and at least 1 month postoperatively. The IOL power was calculated with the Barrett Universal II formula and all biometric measurements were performed preoperatively with the optical biometer Aladdin (Topcon Medical Systems). The refractive prediction error (PE) was compared between the two groups (determined by calculating the difference between the postoperative refractive result and the refraction predicted preoperatively).

A statistically significant difference was found between the two groups in terms of refractive prediction error, with a mean difference of 0.53 diopters (p-value < 0.05). Both groups averaged positive refractive error values (Group A 0.20+/-0.61 and Group B 0.73+/-0.40).

CTR implantation may induce hyperopic shift, which should be taken into consideration when calculating the IOL power in patients with PEX.