Trans-scleral fixation of Cionni - modified capsule tension ring
I read with great interest the article entitled, “Results of intraocular lens implantation with capsular tension ring in subluxated crystalline or cataractous lenses in children,” by Das et al. I congratulate the authors for an excellent study on a very relevant issue. The authors have shown 20/40 or better vision in 16 of 18 (89%) pediatric eyes, having a zonular dialysis of 90 to 210 degrees with Polymethyl methacrylate (PMMA) or an acrylic intraocular lens (IOL), implanted with a capsular tension ring (CTR). However, I believe that patients with zonular dialysis > 180 degrees might have shown better results if Cionni-modified CTR with a single or double eyelet was inserted and sutured to the sclera. Trans-scleral fixation of Cionni-modified CTR and IOL complex may provide better fixation, centration, and long-term stability in these cases with zonular dialysis > 180 degrees. The procedure will, in addition, eliminate the possible necessity of a second procedure of scleral fixation of one haptic, to correct the increased subluxation and IOL decentration in the postoperative period.
1. Das P, Ram J, Brar GS, Dogra MR. Results of intraocular lens implantation with capsular tension ring in subluxated crystalline or cataractous lenses in children Indian J Ophthalmol. 2009;57:431–6
© 2010 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow
2. Vasavada V, Vasavada VA, Hoffman RO, Spencer TS, Kumar RV, Crandall AS. Intraoperative performance and postoperative outcomes of endocapsular ring implantation in pediatric eyes J Cataract Refract Surg. 2008;34:1499–508