SURGICAL MANAGEMENT OF DISLOCATED LENSES WITH TEMPORARY USE OF CAPSULAR TENSION RING.

Abstract

To compare the surgical outcomes of two techniques for managing dislocated lenses with zonular insufficiency. This study included 64 eyes of 64 patients with complete or near-complete zonular loss undergoing lens removal surgery. Patients were divided into two groups: Group 1 (n = 34) underwent phacoemulsification with temporary capsular tension ring assistance, followed by anterior vitrectomy or pars plana vitrectomy; Group 2 (n = 30) underwent ultrasonic fragmatome-assisted lens removal with perfluorocarbon liquid support and subsequent pars plana vitrectomy. Intrascleral intraocular lens fixation and peripheral iridectomy were performed in all cases. The mean age of patients was 64.1 ± 9.7 years in Group 1 and 65.7 ± 8.6 years in Group 2 ( P = 0.51). Postoperative best-corrected visual acuity significantly improved in both groups ( P < 0.001). No clinically significant intrascleral intraocular lens decentration or tilt was observed in either group. Cystoid macular edema and transient intraocular pressure elevation were noted in 5.9% of Group 1, compared with 23.3% and 20% in Group 2, respectively ( P = 0.04 and P = 0.08, respectively). Retinal detachment occurred in 3 cases (10%) in Group 2, whereas no such complications were observed in Group 1 ( P = 0.05). Cortical remnants were detected in the posterior segment in three eyes (10%) in Group 2, whereas no such complications were observed in Group 1 ( P = 0.05). Phacoemulsification with temporary capsular tension ring assistance, followed by scleral Intrascleral intraocular lens fixation and pars plana vitrectomy/anterior vitrectomy, provided a safer surgical approach with fewer complications in patients with dislocated lenses compared with fragmatome-assisted techniques.