Intraocular Lens Stability in Eyes With ⩾ 30 mm Axial Length With Two Sizes of Capsular Tension Rings.

PURPOSE: To evaluate the effect of implantation of two sizes of capsular tension rings (CTRs) on intraocular lens (IOL) stability in patients with cataract who have an axial length (AL) of 30 mm or greater.

METHODS: This prospective randomized controlled study included 120 eyes (AL ⩾ 30 mm) undergoing phacoemulsification and IOL implantation, randomized into three groups (n = 40 each): large group (CTR1311 [Eyebright Medical Technology]: 13 × 11 mm), small group (CTR1210 [Eyebright Medical Technology]: 12 × 10 mm), and control group (no CTR). Postoperative assessments (1 day and 1, 3, and 6 months) included uncorrected and corrected distance visual acuity (UDVA/CDVA), area of continuous curvilinear capsulorhexis (ACCC), IOL tilt/decentration, intraocular pressure (IOP), and corneal endothelial cell (CEC) counts.

RESULTS: All groups had improved UDVA/CDVA postoperatively (P > .05). At 3 and 6 months, horizontal IOL tilt/decentration differed significantly among groups (P < .05). The control group had greater tilt at 3 and 6 months versus 1 week (P < .05) and the small group at 3 months versus 1 week (P < .05). All groups had lower ACCC at 6 months versus baseline (P < .05). The large group had the highest posterior capsule-IOL attachment rate (85%) and the lowest posterior capsular opacity rate (5% vs 12.5% in the small group and 22.5% in the control group). Postoperative IOP/CEC showed no intergroup differences (P > .05).

CONCLUSIONS: In eyes with AL of 30 mm of greater, the CTR1311 more fully supports the lens sac, reduces its shrinkage, stabilizes the IOL, and thus obtains better visual quality. However, the study had limited power (61%) due to the smaller sample size. Therefore, although selecting a large CTR in such patients is recommended based on our findings, further validation in larger studies is warranted.