They are made from one piece of pmma polymethyl methacrylate. Syringestyle micro inserters provide a high level of control during the procedure. Capsular tension ring synonyms, capsular tension ring. The study was designed as a restrospective analysis. Recent findings capsular tension rings and other newer endocapsular. This study evaluates patients with congenital aniridia and cataract who underwent phacoemulsification, capsular tension ring placement, and foldable intraocular lens implantation. The morcher capsular tension ring is a prosthetic device designed to stabilize the crystalline lens capsule in the presence of weak or partially absent zonules in adult patients undergoing cataract extraction with an intraocular lens. Selecting capsular tension ring size capsular bag dimensions dictate the size of ctr selected. Influence of capsular tension ring on posterior capsule opacification in myopic eyes article pdf available in indian journal of ophthalmology 623 september 20 with 79 reads. The capsular tension ring is a sterile, nonoptical ocular implant that is permanently. All about capsular tension rings request pdf researchgate.
To analyze clinical outcomes of cataract surgery with implantation of a toric intraocular lens iol and to evaluate the effect of capsular tension ring ctr presence or absence on the. Designs, applications, and techniques originally, the open polymethyl methacrylate pmma capsular tension ring. Pmma capsular tension ring ctr ophtec capsular tension rings are indicated for the stabilization of the capsular bag in the presence of weakened or compromised zonules. Capsular tension ring article about capsular tension.
To determine the effect of a capsular tension ring ctr implantation in preventing posterior capsular opacification pco after cataract surgery in patients with high myopia. In such cases, a cionni modified capsular tension ring and scleral suture fixation are usually needed. Prior to the advent of the capsular tension ring, many of these cases would have required vitrectomy with an anterior chamber or sutured. Capsular tension rings with integrated tinted sector shields have been.
The capsular tension ring can be implanted with the aid of forceps or an injector. Oct 05, 2005 capsular ring for implantation into the equatorial regions of a capsular sac after cataract ablation comprises an open or closed annular body 11 which has square edges and an axial width of 0. Morcher capsular tension rings stabilize the capsule in case of defective or missing zonules. Capsular tension ring implantation after lens extraction. Among other benefits, the capsular tension ring can reduce the incidence of intraoperative complications. Using capsular tension rings in cataract surgery with. These devices, approved for use in the united states in october 2003, are a significant leap forward in handing cases of weak zonules, allowing surgeons to place an intraocular lens safely in the capsular bag. The full text of this article is available in pdf format.
And finally, the capsular tension ring and modified capsular tension ring make cortical removal a little bit difficult because of the bulkiness of them. The capsular tension segment cts was designed with these considerations in mind. Ophtec capsular tension rings are indicated for the stabilization of the capsular bag in the presence of weakened or compromised zonules. Capsular tension ring ctr and iris hooks have proved to be useful devices in cataract surgery in cases of zonular weakness and dialysis. Clinical applications of capsular tension rings in cataract surgery. Capsular tension rings ctrs are valuable tools for the cataract surgeon. Question are capsular tension rings ctrs easy or difficult to implant. There is no question that capsular tension rings are of great benefit in complicated cataract cases.
Innovation and debate by lori baker schena, contributing writer it is difficult to believe that a tiny, round device no thicker than 0. Using a global network, designs for vision provides diagnostic and surgical products to a range of customers spanning across the healthcare sector. Forcepsassisted, 100 monofilament nylon, sutureguided. Indications and clinical outcome of capsular tension ring.
Generous hydrodissection should be performed to maximally free the. Capsular tension ring, phacoemulsification surgery, indications. In both cases, prior cataract surgery had been performed, which was complicated by capsular rupture. The best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration.
Descriptions and use of these devices will be discussed later in this chapter. The openended ring has a flexible horseshoe shape and is made of pmma filament, with eyelets at either end. Capsular tension ring ctr insertion pearlstips using a. The improved endocapsular tension ring is particularly adapted to provide longterm stabilization and centralization of the capsular bag during and after intraocular surgery in patients having missing or damaged zonules. Ringject is a preloaded capsular tension ring ctr in a single use injector. As a world leader in the development of cataract surgery devices, fci ophthalmics has worked with reputable manufacturers. Answer once surgeons learn when, and how, to implant the stabileyes capsular tension ring, it is a very easy product to use. Our slightly squared edged ctrs delay pco and stabilize the capsular bag in the presence of weakened zonules. Modified capsular tension ring for severe zonular damage. Eyejet ctr singleuse preloaded capsular tension ring. Effect of capsular tension ring implantation on postoperative.
Cataract surgery course university of michigan 04 03. An improved endocapsular tension ring and method of implanting same in a capsular bag of a human eye. Patients who underwent cataract surgery were randomized into two groups that were implanted with a. Capsular tension ring pearls for manual implantation soosan jacob with audio 5. Retinal complications after refractive lens exchange. To discuss capsular tension devices and recent evidence regarding their use. Feb 07, 2020 a 75yearold woman was referred for glaucoma with a history of cataract and lens zonular laxity, and surgery with combined phacoemulsification and capsular tension ring implantation. Devices such as capsular hooks, ctrs, and iols are used to support the capsular bag associated with zonulopathy. Listing a study does not mean it has been evaluated by the u.
Spring constants of capsular tension rings request pdf. One problem with ctr insertion is that it can become caught or snagged when it. The ctr was the first open pmma ring to be implanted during cat aract surgery, and had the advantage of having eyelets on either free end. They are very useful in cases of trauma with focal zonular loss, and may provide additional stability in certain cases of progressive zonulopathy like pseudoexfoliation. Cataract surgery focus on the capsular tension ring i served as medical monitor for the us clinical trial of the morcher gmbh stuttgart, germany capsular tension ring ctr, and i have performed approximately 350 surgeries with the device. Capsular tension rings in cataract surgery cataract coach. Indications and clinical outcomes of capsular tension ring. Supercoder answered wed 30th of september, 2015 09. Overlap of the terminal eyelets is required for maximum circumferential support. The capsular tension ring ctr was originally introduced to reinforce the zonule in eyes with zonular dehiscence and to prevent capsular phimosis in eyes at. She subsequently underwent trabeculectomy for uncontrolled intraocular pressure on maximal medical therapy. Morcher capsular tension rings type designs for vision. Indications for use the most appropriate uses for the ctr based on investigative and clinical experience. The device, also made of pmma, is a partial ring design spanning 90 degrees with a raised single eyelet centrally, which is designed to sit anterior to the anterior capsule figure 2.
A continuous circular capsulorhexis with capsular tension ring. Department of ophthalmology, johannes gutenberguniversity, and department of medical. Circular expansion and stabilization of the capsular bag. Additional versions of the ring are still considered. The mass of hard nuclear fragments provides support toward the anteroposterior and the horizontal planes, thereby providing 3dimensional capsular bag support. The role of capsular tension ring ctr in anterior capsular contraction aco the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Role of capsular tension rings in preventing capsule contraction. For the stabilization of subluxated lenses for phacoemulsification. Pdf role of capsular tension rings in preventing capsule. Wrinkling of the capsule while it is being pinched by capsulorhexis forceps is a sign of weak zonular status. Capsular tension rings ctrs, well known to ophthalmic surgeons, are cshaped devices used to stabilize the capsular bag of the crystalline lens during cataract surgery in eyes with zonular weakness. Dec 24, 2015 free em calculator l new data files l.
Various devices such as capsular hooks, iris hooks, capsular tension segments ctss, capsular tension rings ctrs, and intraocular lenses iols are used differently for providing devicespecific support to the capsular bag complex. Capsular hookassisted implantation of modified capsular. Capsular tension rings are flexible plastic loops which are designed to exert outward force at the capsular bag equator to help distribute forces and help support areas of zonular loss. Multiple capsular tension rings for the prevention of capsular contraction syndrome 2001 j cataract refract surg 27. The main outcome measures were the rates of intraoperative zonular separation and capsular. Cionni rj, osher rh, marques dm, marques ff, snyder me, shapiro s 2003 modified capsular tension ring for patients with congenital loss of zonular support. The role of capsular tension ring ctr in anterior capsular. Capsular tension ring inserter millennium surgical. We would like to describe the use of monofilament 100 nylon mfn guided ctr insertion in a subluxated cataractous lens.
Morcher gmbh kapuzinerweg 12 d70374 stuttgart germany description. Whereas the capsular tension segment is less bulky and its there for easier to remove cortical material. How to bill capsular tension rings ophthalmology coding. Effect of coimplantation of a capsular tension ring on. Synonyms for capsular tension ring in free thesaurus. Tips for using the morcher ring a surgeon whos used capsular tension rings since their trials began tells when and how to use them. Spinning the lens free from residual capsule attachments using 2 rotation hooks, detaching the lens from the capsular bag using viscoelastic material, and using a morcher ring with noncurved ends prevents inadvertent cortical. Effect of coimplantation of a capsular tension ring on clinical. Capsular tension ring article about capsular tension ring. Jan 01, 2002 clinical applications of capsular tension rings in cataract surgery. Oneyear outcome of low dose laser cyclophotocoagulation for. Pdf influence of capsular tension ring on posterior capsule. The objective was to evaluate the effect of coimplantation of a preloaded capsular tension ring ctr and aberration free monofocal intraocular lens iol on clinical outcomes and visual quality after cataract surgery.
To evaluate the influence of a capsular bending ring cbr or tension ring ctr on capsular bag shrinkage. Capsular tension ring implantation after capsulorhexis in. Spinning the lens free from residual capsule attachments using 2 rotation hooks. Both rings are open circular pmma filament with an eyelet at both free ends of the ring.
Capsular tension ring pearls for manual implantation soosan. Circular expansion and stabilization of the capsular bag s afe iol centration in eyes with zonular dehiscence. May 19, 2004 there is no question that capsular tension rings are of great benefit in complicated cataract cases. Sep 17, 2008 capsular tension rings ctrs are valuable tools for the cataract surgeon. Since the introduction of the original capsular tension rings in 1991, there has been a progressive evolution of this device to help deal with profound zonular weakness. In a traumatic subluxed lens, the anterior capsule is usually tough from prolonged inflammation, and the capsulorrhexis is difficult to initiate and complete due to the lack of counter traction. Resistance to compression of the capsular tension ring. Acpi11 is a readytouse pmma capsular tension ring in a preloaded singleuse injector system. The experience my colleagues and i gained from the fda trial gave us surgical insights into using the ctr. Clinical applications of capsular tension rings in cataract. Since the first introduction of the capsular ring in 1991, the open capsular tension ring proved to be efficient in various indications and applications. To report the indications and clinical outcomes of all capsular tension ring ctr implantations in a large series of consecutive cataract surgeries during a five year interval in a university eye hospital. Capsular tension rings are used to stabilize weakened, broken, or missing zonules during cataract extraction using phacoemulsification and continuous curvilinear capsulorhexis techniques.
The objective was to evaluate the effect of coimplantation of a preloaded capsular tension ring ctr and aberrationfree monofocal intraocular. The morcher capsular tension ring is a prosthetic device designed to stabilize the crystalline lens capsule in the presence of weak or partially absent zonules in adult patients undergoing cataract extraction with an. Stabileyes capsular tension ring abbott medical optics. Capsular tension rings ctrs, modified capsular tension rings mctrs see figure 1 and capsular tension segments ctss do provide us a better opportunity to successfully manage these cases and allow for implantation of a pc iol into the capsular bag. Capsular tension rings ctrs, well known to ophthalmic surgeons, are cshaped devices used to stabilize the capsular bag of the crystalline lens. Implantation of the capsular ring eyejet ctr type 14 size open 12. Use of capsular tension ring in phacoemulsification.
The author demonstrates bimanual,microincisional insertion of. He was treated by lens aspiration and twopoint capsular support using a modif ied capsular tension ring mctr and capsular tension segment cts sutured to the sclera along with implantation of. Ophtec capsular tension rings are indicated for the stabilization of the capsular bag in. With preexisting zonular defects such as those caused by blunt trauma, the ctr is inserted before phacoemulsification is started. Acpi11 is used for repositioning of loose or desinserted zonulas in order to thwart the contraction strength of the capsular bag. Clinical applications of capsular tension rings in. In cataract surgeries requiring a ctr, the device can be implanted at any point after the capsulorrhexis. While there is a brief learning curve, any surgeon who can implant a posterior chamber iol can implant a ctr.
Thirtynine eyes that did not have a ctr implanted served as a control. Sep 14, 2017 here we show a trick for inserting a capsular tension ring ctr, utilizing the commonlyavailable sinskey hook. These newer devices, which permit scleralsuture fixation, include the modified capsular tension ring and the capsular tension segment. Injectors are used to implant the morcher capusular tension ring. To analyze clinical outcomes of cataract surgery with implantation of a toric intraocular lens iol and to evaluate the effect of capsular tension ring.