gms | German Medical Science

Capsular tension rings (CTRs) have become increasingly important in complicated cataract surgery as well as in refractive lens surgery. Here we address the variety of subsequent indications, designs and applications that have evolved. Pre-existing or intraoperative zonular defects are the classical indications for the implantation of a CTR. New aspects include the reduction of posterior capsule opacification by a capsular bending ring, reduction of capsular bag shrinkage, and decentration and rotation of the intraocular lens (IOL). Also, for profound zonular dialysis or weakness, a CTR was designed for scleral fixation, and CTRs with integrated tinted sector shields have been improved to compensate for sector iris colobomas or aniridia. Other CTRs have been designed for positional stabilization of a toric plate IOL. Flexible acrylic joints simplify the implantation of thicker CTRs, which could reduce lens epithial cell migration. Other CTR designs with multiple eyelets have proven useful for complicated cataract surgery.