Miyoshi Eye Clinic, Hiroshima, Japan.
Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
PLoS One. 2020 Feb 24;15(2):e0228999. doi: 10.1371/journal.pone.0228999. eCollection 2020.
To assess the influence of capsular tension ring (CTR) on surgical outcomes of toric and multifocal intraocular lenses (IOLs) in eyes at high risk of zonular instability.
Fifty-five eyes of 43 patients who had undergone phacoemulsification and IOL implantation were included in the analysis. They had some risk of zonular weakness, such as pseudoexfoliation, shallow anterior chamber, high myopia, and phacodonesis, or were judged to have unstable zonules during surgery. Toric IOL was implanted in 9 eyes with CTR and 22 eyes without CTR, while multifocal IOL was used in 9 eyes with CTR and 15 eyes without CTR. Manifest refraction, refractive astigmatism, visual acuity, and degree of IOL decentration and tilt measured using swept-source anterior segment optical coherence tomography were analyzed. Axis misalignment of toric IOLs were also evaluated.
In toric IOLs, co-implantation of CTR significantly reduced decentration and axis misalignment of IOL, resulting in better uncorrected and corrected visual acuity after surgery. In multifocal IOLs, combined use of CTR significantly prevented IOL tilt, leading to better intermediate visual acuity. Spherical equivalent and residual astigmatism were not significantly affected by the use of CTR.
CTR reduces decentration and axis misalignment of toric IOL and tilt of multifocal IOL, achieving improvement of postoperative visual function in eyes with suspected zonular instability.
评估囊袋张力环（CTR）对高易发性悬韧带松弛眼中的矫正散光型和多焦点人工晶状体（IOL）手术结果的影响。
分析了 43 例 55 只眼的资料，这些患者均接受了超声乳化白内障吸除术和 IOL 植入术，他们存在悬韧带变弱的风险，如假性剥脱综合征、浅前房、高度近视和晶状体溶解性青光眼，或在术中被判断为悬韧带不稳定。9 只眼的 IOL 为矫正散光型并植入了 CTR，22 只眼未植入；9 只眼的 IOL 为多焦点型并植入了 CTR，15 只眼未植入。使用扫频源眼前节光学相干断层扫描仪分析了术后的视力、屈光性散光、IOL 偏心和倾斜度以及 IOL 轴位的变化。还评估了矫正散光型 IOL 的轴位偏差。
在矫正散光型 IOL 中，联合使用 CTR 可显著减少 IOL 的偏心和轴位偏差，从而提高术后的裸眼和矫正视力。在多焦点 IOL 中，联合使用 CTR 可显著防止 IOL 倾斜，从而提高中间视力。CTR 的使用对等效球镜和残余散光没有显著影响。
CTR 可减少矫正散光型 IOL 的偏心和轴位偏差以及多焦点 IOL 的倾斜，从而改善疑似悬韧带不稳定眼中的术后视力功能。
