Elsevier

JCRS Online Case Reports

Volume 1, Issue 2, October 2013, Pages e33-e36
JCRS Online Case Reports

Case report
Sequential and simultaneous capsular bag fixation in subluxated lens using dual support

https://doi.org/10.1016/j.jcro.2013.07.003Get rights and content

We describe the case of a 47-year-old man with bilateral inferiorly subluxated cataractous lenses of idiopathic etiology (≈ 9 clock hours of subluxation). Phacoemulsification and insertion of a single eyelet Cionni ring with a posterior chamber intraocular lens (PC IOL) were performed in the right eye. On the first postoperative day, there was a significant superior decentration of the PC IOL, with the inferior part of the Cionni ring visible in the pupillary axis. This was corrected by implanting a capsular tension segment (CTS) inferiorly. In the fellow eyes, a planned simultaneous Cionni and CTS insertion was performed and achieved adequate centration.

Financial Disclosure

No author has a financial or proprietary interest in any material or method mentioned.

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Case report

A 47-year-old man presented with gradual, painless, and progressive diminution of vision in his right eye more than in his left eye over the past year that did not improve with spectacle correction. The patient had used spectacles for the past 20 years with a corrected distance visual acuity (CDVA) of 20/20 in both eyes until 1 year earlier. There was no history of trauma, pain, redness, floaters, or intraocular surgery and no associated systemic disease.

The patient was of average build and the

Discussion

The problems in our case were (1) the management of a severely subluxated cataractous lens and (2) the management of an early decentered modified CTR–IOL complex. Management of subluxated lenses is still a challenging situation, and every case requires an individualized approach. While CTRs have been successfully used in subluxated lenses with less than 6 clock hours of zonulysis, a fixated capsular tension device (CTD) such as a Cionni or a CTS may be required to ensure centration and

First author:

Sudarshan Khokhar, MD

Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

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First author:

Sudarshan Khokhar, MD

Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

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