Yang Jin, Lu Yi, Luo Yi, Wang Lin
Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China.
Zhonghua Yan Ke Za Zhi. 2007 Jun;43(6):519-24.
To evaluate the two-year efficacy and stabilization of the capsular tension ring (CTR) in providing capsular support during phacoemulsification in cases of a weak or partially broken ciliary zonule.
This prospective study comprised 22 eyes of 19 patients with weakness or partially broken ciliary zonule preoperatively or intraoperatively. After insertion of a CTR, phacoemulsification with intraocular lens (IOL) implantation was performed. Patients were examined preoperatively and postoperatively at 1 day, 1 week, 1, 6, 12 and 24 months. The postoperative refractive status, intraocular pressure, the decentration of capsule/IOL complex, the degree of posterior capsular opacification (PCO) and capsular contraction were examined. The extent of IOL tilting and decentration was measured using Scheimpflug Videophotography System (Pentacam, Oculus) 1, 6, 12 and 24 months postoperatively.
Twenty-four months results from this ongoing study indicated that the postoperative best corrected visual acuity improved 2 lines in 20 eyes, improved 1 lines in 2 eyes. In-the-bag fixation of CTR was achieved in 21 eyes (90.9%), CTR of 1 eye is out of capsule bag. IOL implanted was not centered in 1 eye 1 months after surgery and up to 5 eyes 24 months after the surgery. Nd: YAG laser capsulotomy was performed in 3 eyes (13.6%) by 24 months for severe PCO. The mean IOL decentration was (0.393 +/- 0.094), (0.406 +/- 0.094), (0.415 +/- 0.093) and (0.463 +/- 0.172) mm on 1, 6, 12 and 24 months postoperatively, respectively. Significant differences in IOL decentration was presented between 1 and 24 months postoperatively, also between 6 and 24 months. The mean IOL tilt was (2.637 +/- 0.369), (2.653 +/- 0.349), (2.682 +/- 0.348) and (2.714 +/- 0.360) degrees on 1, 6, 12 and 24 months postoperatively, respectively, which showed no statistically significant differences (P = 0.220) throughout the 24-month follow-up period.
CTR offers numerous advantages in situations of zonular insufficiency including reestablishment of the capsular bag contour, decrease of risk of PCO and limitation of late IOL decentration due to asymmetric capsule contraction.
评估囊袋张力环（CTR）在超声乳化白内障吸除术中为睫状小带薄弱或部分断裂的病例提供囊袋支撑的两年疗效及稳定性。
本前瞻性研究纳入了19例患者的22只眼，这些患者术前或术中存在睫状小带薄弱或部分断裂的情况。植入CTR后，进行超声乳化白内障吸除联合人工晶状体（IOL）植入术。对患者在术前以及术后1天、1周、1个月、6个月、12个月和24个月进行检查。检查术后屈光状态、眼压、囊袋/IOL复合体的偏心情况、后囊膜混浊（PCO）程度以及囊袋收缩情况。术后1个月、6个月、12个月和24个月使用三维眼前节分析系统（Pentacam，Oculus）测量IOL倾斜和偏心的程度。
这项正在进行的研究的24个月结果表明，术后最佳矫正视力在20只眼中提高了2行，在2只眼中提高了1行。21只眼（90.9%）实现了CTR在囊袋内固定，1只眼的CTR脱出囊袋。1只眼在术后1个月IOL植入未居中，至术后24个月时有5只眼IOL未居中。24个月时，3只眼（13.6%）因严重PCO进行了Nd:YAG激光后囊膜切开术。术后1个月、6个月、12个月和24个月时，IOL平均偏心分别为（0.393±0.094）、（0.406±0.094）、（0.415±0.093）和（0.463±0.172）mm。术后1个月与24个月之间以及6个月与24个月之间IOL偏心存在显著差异。术后1个月、6个月、12个月和24个月时，IOL平均倾斜分别为（2.637±0.369）、（2.653±0.349）、（2.682±0.348）和（2.714±0.360）度，在整个24个月的随访期内无统计学显著差异（P = 0.220）。
在睫状小带功能不全的情况下，CTR具有诸多优势，包括重建囊袋轮廓、降低PCO风险以及限制因不对称囊袋收缩导致IOL晚期偏心。
