Placement of dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis

Background:To evaluate the efficacy and safety of placing dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis.Methods:A modified capsular tension ring was inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring was inserted into the capsular bag in 20 eyes in 20 consecutive patients showing signs of ocular hypotony and ectopia lentis.Outcome measures included intraocular pressure,best-corrected visual acuity,and postoperative complications.Results:Dual capsular tension ring placement was performed in 20 patients with a mean age of 48.7 years.The cyclodialysis cleft extended over 2.9 clock hours(range 0.5-6.5).The modified capsular tension ring was successfully inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring in the capsular bag in all eyes.At the last follow-up,the cyclodialysis cleft was closed in 16/20(80.0%)eyes.The intraocular lens was stable in all patients postoperatively.Best-corrected visual acuity,in terms of the logarithm of the minimal angle of resolution,improved from 1.3±0.8 before surgery to 0.4±0.3 after surgery(P<0.001).Intraocular pressure increased significantly from 10.6±3.2 mmHg before surgery to 13.0±4.8 mmHg after surgery(P=0.040).Postoperative complications included a painful reversible intraocular pressure spike in four patients(20.0%).Logistic regression revealed no significant factors associated with successful cleft closure and a stable final intraocular pressure of≥10 mmHg.Conclusions:The placement of two capsular tension rings into the ciliary sulcus and the capsular bag is a safe,successful procedure combined for repairing a traumatic cyclodialysis cleft and managing zonular dialysis.

Placement of dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis

Background:To evaluate the efficacy and safety of placing dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis.Methods:A modified capsular tension ring was inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring was inserted into the capsular bag in 20 eyes in 20 consecutive patients showing signs of ocular hypotony and ectopia lentis.Outcome measures included intraocular pressure,best-corrected visual acuity,and postoperative complications.Results:Dual capsular tension ring placement was performed in 20 patients with a mean age of 48.7 years.The cyclodialysis cleft extended over 2.9 clock hours(range 0.5-6.5).The modified capsular tension ring was successfully inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring in the capsular bag in all eyes.At the last follow-up,the cyclodialysis cleft was closed in 16/20(80.0%)eyes.The intraocular lens was stable in all patients postoperatively.Best-corrected visual acuity,in terms of the logarithm of the minimal angle of resolution,improved from 1.3±0.8 before surgery to 0.4±0.3 after surgery(P<0.001).Intraocular pressure increased significantly from 10.6±3.2 mmHg before surgery to 13.0±4.8 mmHg after surgery(P=0.040).Postoperative complications included a painful reversible intraocular pressure spike in four patients(20.0%).Logistic regression revealed no significant factors associated with successful cleft closure and a stable final intraocular pressure of≥10 mmHg.Conclusions:The placement of two capsular tension rings into the ciliary sulcus and the capsular bag is a safe,successful procedure combined for repairing a traumatic cyclodialysis cleft and managing zonular dialysis.

Preoperative Characteristics of Ocular Biometry in Children with Unilateral Congenital Cataracts

The ocular biometry characteristics are clinically significant for children with unilateral congenital cataracts,but there is a lack of data analysis concerning the preoperative measurements.The axial length(AL),mean keratometry(Km),cor-neal astigmatism(CA),and the anterior chamber depth(ACD)from both eyes before cataract surgery were obtained from 205 patients(410 eyes,3-15 years of age)with unilateral congenital cataracts.In the congenital cataract eyes,shorter AL(22.44±1.52 mm vs.22.57±1.04 mm,p=0.036)and higher CA(-1.89±0.91 D vs.-1.24±0.67 D,p<0.001)were found,and no significant difference was found in the Km and the ACD measurements compared to the contralateral normal eyes.Females had shorter AL and shallower ACD compared to males.However,the Km and CA in the females were significantly larger than that in males.Shorter AL,larger Km,higher CA,and shallower ACD were also found in females who had a binocular axial difference(the value obtained by subtraction of the contralateral normal eye from the congenital cataract eye)that less than zero.The preoperative ocular biometry of shorter AL,larger Km,higher CA,and shallower ACD should be considered in females with unilateral congenital cataracts.The age and the binocular axial differences had a statistically significant correlation(r=-0.192,p=0.006).Therefore,changes in the binocular axial differences associated with aging may enhance the guidelines for intraocular lens selection and the management of congenital cataracts.