gms | German Medical Science

Patients with generalized zonular weakness and/or zonular dialysis presents significant challenges for the cataract surgeon. One can expect increased risk of capsular tears, vitreous prolapse, IOL instability and “IOL-capsular bag” complex decentration postoperatively. Different devices can be used in patients with localized zonular defects. Malyuginmodified CTR (Morcher GmbH, Germany) is designed to center the subluxated lens capsule by securing it to the scleral wall. The basic idea of this device consists of moving the fixation element to the very tip of the ring. This makes the device completely retractable into the injector tube. Also the curved portion of the CTR slides along the equator of the capsular bag during its injection. Thus the risk of perforating the capsular fornix with the tip of the CTR is completely eliminated. In this presentation surgical tips in managing patients with compromised zonules utilizing different capsular supporting devices will be highlighted.