Tendency For IOL Decentration In Eyes Operated For Cataract With More Than 180 Subluxation, With CTRs (Including CIONI Modified Rings)

Jacob Samuel Mathew

Vasan Eye Care Hospital, Cochin, India

Purpose: long term follow up to watch for IOL decentration in eyes operated with more than 180 degree subluxation implanted with CTRs (including Cioni modified) – comparing the results and noting the effect of strong residual zonular support along with the age and cause of subluxation.

Methods: 12 eyes with 180 degree or more of Subluxated cataract operated by a single surgeon using Clear Corneal Phacoemulsfiication under block. Both Open ring CTR and Cioni modified CTR used depending on the redundancy of the capsule bag, all PC IOLs being implanted in the bag. Follow up on day of surgery, 1st week, 1 month, 6 months and 1 year was done noting centration of IOL, signs of uveitis and posterior segment complications like CME.

Results: 9 eyes were done with open ring CTR (Group I) in patients less than 60 years age with traumatic subluxation with strong residual zonular support sensed during the conduct of the surgery but 3 eyes were implanted with cioni modified CTR (Group II) where the bag was redundant and the cause of subluxation was pseudoexfoliation in patients 70 years age or more, where the Remaining zonules were weak thus making the conduct of the surgery difficult. At 6 months 2 eyes in group I showed mild decentration not affecting vision or causing any dysphotopsia at 1 year there were no further aggravation of decentration and no more eyes showed any displacement of the capsule bag nor the IOL. One eye in the second group had peaking of the pupil.

Conclusions: subluxation due to trauma in younger individuals fare better during surgery as the remaining zonules afford stability to the capsule bag allowing smooth surgery and good IOL centration even with Open ring CTRs.