gms | German Medical Science

To demonstrate the development of a new foldable closed capsular tension and foldable closed bending ring system with sharp edge design. All previous capsular tension ring systems were rigid and open with the potential to compromise the capsular bag integrity during implantation.

The closed foldable capsular rings (CFCR) consist of a mixture of 8 hydrophilic and 8 hydrophobic ring segments of copolymer from hydroxyethyl methacrylate (HEMA) and methyl methacrylate (MMA) with a water content of 28 % and polymethyl methacrylate (PMMA) segments (Morcher, Stuttgart, Germany) as a result of a long-term research project (with permission of the local Ethics Committee). All CFCRs were implanted through various kinds of cartridge systems (e.g., Monarch, Silver Series, B&L Injector, Sapphire, Emerald, ThinOptix Injector) as well as in the two-folded status using forceps in over 100 human adult eyes after phacoemulsification without complications.

The CFCRs have different diameters (e.g., 10.2 mm overall diameter) and were implanted through a small incision without intraoperative complications. No postoperative complications like capsular folds, inward-bending or increased inflammation were noted in these eyes after 6 months follow-up. Posterior and especially anterior capsular opacification was minimal or absent in all eyes because of the square edge design.

To the authors knowledge this is the first report on the development and use of closed foldable foldable tension and bending rings in human eyes after cataract surgery. CFCR allowed implantation without any additional specific devices or compromise of the capsular bag integrity including zonular fibers. In contrast to rigid capsular tension rings the foldable capsular rings formed a predesigned capsular bag size and help to keep the capsular bag open.