Fish-tail technique for capsular tension ring insertion.

We describe a simple, effective technique for the insertion of a capsular tension ring (CTR) in cases of zonular instability. The fish-tail technique minimizes tangential and shearing forces on the capsule and limits further zonular damage because the CTR is not dialed into position. Instead, the CTR is folded until the trailing loops overlap, forming a fish-like configuration. The apex or mouth of the fish is inserted through the incision into the capsular bag, and the remaining arms of the CTR are then placed in the bag. The technique requires no further manipulation or rotation of the CTR.