Abstract

P 076

Inward bowing of closed foldable capsular rings in myopic eyes

Renieri G.¹, Thieme H.¹, Dick B.², Kurz S.¹, Pfeiffer N.^1
1Department of Ophthalmology, Mainz University, ²Department of Ophthalmology, Bochum University

Objective: Capsular tension rings (CTR) are used in cataract surgery to manage zonular dehiscence and generalized zonular weakness. CTRs also improve IOL centration. In 2005 a closed foldable capsular ring (CFCR) with a sharp-edged design was introduced into clinical practice. Through continous capsular contact this capsular tension and bending ring system could achieve a 360-degree reduction of PCO, and an extension of the capsular bag preventing capsular shrinkage.
Methods: The CFCR (Morcher) consists of 16 segments of a copolymer comprising 2-hydroxyethyl methacrylate (HEMA) and methylmetacrylate (MMA). The transition zone between HEMA and MMA segments is angulated to provide stiffness and shape memory. The angulation also increases resistance to capsular bag shrinkage. From 2002 to 2005 more than 500 CFCRs were implanted in our hospital. We observed two cases of intracapsular inward bowing of the CFCR following cataract surgery.
Results: Both patients received a Morcher CFCR Type 2A with a diameter of 10.2 mm and a foldable three-pieces acrylic IOL with sharp edge design (AMO AR40M). No intraoperative complications were encountered. Four and nine months postoperatively a marked inward bowing of the CFCR was noted. In one case the CFCR was folded and completely displaced towards the pupillary center. This caused disturbing glare and halos, even with a good IOL centration. Visual symptoms resolved after CFCR explantation. Both patients had preoperatively a high myopia with axial lengths of 33.55 and 33.77 mm.
Conclusions: In previous studies no inward bending or capsular folds were reported with the CFCR after 3 or 6 months follow-up periods. We observed dislocation and bending of the CFCR in two myopic eyes. Capsular bag shrinkage positively correlates with axial length. A closed capsular ring might fold and dislocate in response to capsular contraction forces, while the end terminals of an open ring could just overlap. Inward bending in our cases may also be due to inadequate ring size. In myopic eyes, special attention must be used in selection of capsular support devices.

Copyright: Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.