Cionni Ring and In-the-Bag Intraocular Lens Implantation for Subluxated Lenses: A Prospective Case Series

• Published in: American journal of ophthalmology 2012-06, Vol.153 (6), p.1144-1153.e1
• Main Authors: Vasavada, Abhay R, Praveen, Mamidipudi R, Vasavada, Viraj A, Yeh, Ru-Yin, Srivastava, Samaresh, Koul, Archana, Trivedi, Rupal H
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Biometrics; Cataract - etiology; Cataract Extraction; Cataracts; Child; Child, Preschool; Female; Humans; Irrigation; Lens Implantation, Intraocular - instrumentation; Lens Subluxation - physiopathology; Lens Subluxation - surgery; Lenses, Intraocular; Male; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Pediatrics; Prospective Studies; Prostheses and Implants; Pseudophakia - physiopathology; Surgery; Treatment Outcome; Vision systems; Visual Acuity - physiology; Young Adult
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2011.11.012

Purpose To report the intraoperative performance and postoperative outcomes of the Cionni-modified capsule tension ring (CTR) implantation in eyes with subluxated lenses. Design Prospective, observational case series. Methods This study was carried out at Iladevi Cataract & IOL Research Centre, Ahmedabad, India. The study population comprised 41 eyes with subluxated lenses that underwent lens extraction, capsular bag fixation with modified CTR, and in-the-bag single-piece AcrySof intraocular lens (IOL) implantation. Main outcome measures were intraoperative performance and postoperative best-corrected visual acuity (BCVA), IOL centration, and complications. Results The mean age was 29.46 ± 16.16 years (3-68 years). Mean extent of subluxation was 6.1 ± 1.0 clock hours. Preoperatively, vitreous was detected in the anterior chambers of 5 eyes (12.2%). Two-port anterior chamber vitrectomy was performed in 2 eyes. Mean follow-up was 45.8 ± 2.9 months. Mean preoperative BCVA was 0.66 ± 0.22 logMAR (35 eyes). Mean postoperative BCVA at final follow-up was 0.33 ± 0.21 logMAR (41 eyes) ( P < .001). BCVA improved in 35 eyes (85.4%) at the last follow-up. In 3 eyes (7.3%) IOL decentration was noted and repositioning was required in 2 eyes. Posterior capsule opacification developed in 14 eyes (34.2%); 12 eyes (29.3%) required Nd:YAG capsulotomy. Other complications included cystoid macular edema in 1 eye (2.4%), posterior synechiae in 1 eye (2.4%), and retinal detachment in 1 eye (2.4%). Conclusion In-the-bag implantation of a Cionni-modified CTR with IOL appears to be a safe option in eyes with subluxated cataract, ensuring a stable IOL with few complications.