Surgical technique for removal of posteriorly dislocated capsular tension ring

Using a Capsular Tension Ring (CTR) Inserter for CTR Explantation in Cases of Posteriorly Dislocated Intraocular Lens-CTR-Capsule Complex

PURPOSE

Explantation of a dislocated capsular tension ring (CTR) from the vitreous cavity can be challenging, typically requiring a bimanual hand-shake technique or cutting the CTR into segments. We present three cases of dislocated intraocular lens (IOL)-CTR-capsule complexes in which CTRs were explanted efficiently and safely by using a CTR inserter (CTR-I) through a clear corneal incision.

METHODS

Retrospective case series.

RESULTS

Capsular tension rings were successfully explanted by freeing the eyelet of the CTR from the capsule, engaging it with the CTR-I hook and retracting the CTR into the device's shaft while maintaining the entire IOL-CTR-capsule complex in a safe position behind the iris plane. No complications of the procedure were observed in all three cases. All patients had subsequent uneventful IOL exchange through sutureless scleral fixation during the same surgery.

CONCLUSION

The CTR inserter provides a simple and efficient approach to CTR removal from IOL-CTR-capsule complexes dislocated into the vitreous cavity. Greater awareness of this technique among providers is needed.

NEW, SIMPLE, AND SAFE SURGICAL TECHNIQUE FOR THE REMOVAL OF A DISLOCATED CAPSULAR TENSION RING-INTRAOCULAR LENS-CAPSULAR BAG COMPLEX

BACKGROUND/PURPOSE

To report a safe and simple surgical technique for the removal of a dislocated capsular tension ring (CTR)-intraocular lens (IOL)-capsular bag (CB) complex.

METHODS

We present an extraocular surgical removal technique for a dislocated CTR-IOL-CB complex. Although the entire complex is typically removed with a large incision, this approach applies a CTR injector and anterior capsule forceps in a less invasive manner.

RESULTS

After vitrectomy, the complex was moved to the anterior chamber, where the tip of the CTR was separated from the IOL-CB using anterior capsule forceps and hooked onto the tip of the CTR injector. Subsequently, the CTR, as well as part of the CB, was gradually separated from the IOL-CB and stored in the CTR injector. This was completed while also supporting the IOL-CB complex using the forceps. Once the whole CTR and the part of CB were removed from the anterior chamber, the residual IOL and CB were then removed.

CONCLUSION

Our methodology, using the CTR injector and anterior capsule forceps, enables the procedure to be completed with only a small corneal incision, thereby allowing for the safe and simple removal of a CTR-IOL-CB complex.

Surgical technique for removal of a capsular tension ring from the vitreous cavity

PURPOSE

To describe a surgical technique for removing a posteriorly dislocated capsular tension ring (CTR).

METHODS

Retrospective interventional case report.

CASE REPORT

A 68-year-old African American man underwent cataract surgery. Early in the procedure, a CTR was placed at the equator of the lens capsule. Subsequently, the posterior capsule ruptured. The CTR was left in place, and an intraocular lens was placed in the sulcus. On postoperative Day 6, the CTR subluxated into the vitreous cavity and was removed without complication by pars plana vitrectomy, using the CTR inserter.

CONCLUSION

The technique of using the CTR inserter to remove the CTR from the vitreous cavity appears to be safe and effective.