Cionni Ring and In-the-Bag Intraocular Lens Implantation for Subluxated Lenses: A Prospective Case Series

center dot PURPOSE: To report the intraoperative performance and postoperative outcomes of the Cionni-modified capsule tension ring (CTR) implantation in eyes with subluxated lenses. center dot DESIGN: Prospective, observational case series. center dot METHODS: This study was carried out at Iladevi Cataract & IOL Research Centre, Ahmedabad, India. The study population comprised 41 eyes with subluxated lenses that underwent lens extraction, capsular bag fixation with modified CTR, and in-the-bag single-piece AcrySof intraocular lens (IOL) implantation. Main outcome measures were intraoperative performance and postoperative best-corrected visual acuity (BCVA), IOL centration, and complications. center dot RESULTS: The mean age was 29.46 +/- 16.16 years (3-68 years). Mean extent of subluxation was 6.1 +/- 1.0 clock hours. Preoperatively, vitreous was detected in the anterior chambers of 5 eyes (12.2%). Two-port anterior chamber vitrectomy was performed in 2 eyes. Mean follow-up was 45.8 +/- 2.9 months. Mean preoperative BCVA was 0.66 +/- 0.22 logMAR (35 eyes). Mean postoperative BCVA at final follow-up was 0.33 +/- 0.21 logMAR (41 eyes) (P < .001). BCVA improved in 35 eyes (85.4%) at the last follow-up. In 3 eyes (7.3%) IOL decentration was noted and repositioning was required in 2 eyes. Posterior capsule opacification developed in 14 eyes (34.2%); 12 eyes (29.3%) required Nd:YAG capsulotomy. Other complications included cystoid macular edema in 1 eye (2.4%), posterior synechiae in 1 eye (2.4%), and retinal detachment in 1 eye (2.4%). center dot CONCLUSION: In-the-bag implantation of a Cionnimodified CTR with IOL appears to be a safe option in eyes with subluxated cataract, ensuring a stable IOL with few complications. (Am J Ophthalmol 2012;153: 1144-1153. (C) 2012 by Elsevier Inc. All rights reserved.)