Visual outcome and complications after modified Cionni endocapsular tension ring and intraocular lens implantation in eyes with subluxated lenses

Objective: To evaluate the visual outcome and complications after modified capsular tension ring (CTR) and intraocular lens implantation (IOL) in eyes with subluxated lenses. Methodology: This is a prospective case series managed at Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan. Thirty three eyes with subluxated lenses having zonular weakness less than 180 degrees were implanted modified CTR and IOL implant after lens matter aspiration. Main outcome measures were postoperative best-corrected visual acuity (BCVA), IOL centration, and complications. Results: The age of 24 patients ranged from 2.5 to 38 years, mean 13.34 +/- 9.8 years. The follow up period was 20.87 +/- 2.40 months. The mean pre operative logMAR BCVA was 0.98 +/- 0.52 SD and the mean post operative logMAR BCVA was 0.38 +/- 0.32 SD (p value 0.000). Intractable secondary glaucoma was seen in 01(03%) eye. One eye (03%) needed surgical anterior capsulotomy for anterior capsular phimosis. At the last follow-up visit, the modified CTR provided excellent centration and positioning in all cases. Conclusion: Modified CTR and primary IOL implantation in the capsular bag gives good visual outcome with no serious complications. However, it requires a highly experienced surgeon and sufficient patience for a relatively time-consuming procedure.