Efficacy analysis of capsular tension ring ciliary sulcus suture fixation for lens subluxation

To explore the long-term therapeutic effect of capsular tension ring (CTR) suture fixation in patients with lens subluxation. A retrospective analysis was conducted on 29 (29 eyes) patients with lens subluxation who underwent phacoemulsification, in-the-bag intraocular lens (IOL) implantation, and ciliary sulcus suture fixation of the CTR at Qingdao Eye Hospital Affiliated to Shandong First Medical University from October 2019 to July 2024. The patients’ postoperative best-corrected visual acuity (BCVA), refraction, intraocular pressure (IOP), complications, and IOL position were observed. All patients were followed up for at least 12 months (range: 12–48 months). Postoperative BCVA was significantly improved compared with preoperative values (t=-7.43, P < 0.001). The average postoperative residual refractive error was 0.42 ± 0.39D (range: 0-1.25 D). Postoperative IOP was significantly lower than preoperative IOP (t = 2.42, P = 0.023). Postoperatively, 2 eyes developed dislocation of the IOL-CTR-capsular bag complex and underwent complex suspension surgery; 1 eye had transient high IOP; 1 eye had a small amount of nasal vitreous hernia; and 1 eye developed posterior capsular opacification (PCO) during follow-up, which was treated with YAG posterior capsulotomy. CTR suture fixation can effectively improve visual acuity, maintain stable IOP, and has a low complication rate in patients with lens subluxation. It provides a safe and effective treatment method for lens subluxation. What is known: Lens subluxation causes severe visual impairment and complications; capsular tension ring (CTR) implantation improves surgical outcomes, but simple CTR is ineffective for extensive subluxation. Various suture fixation techniques have been developed, but most rely on special commercial devices with limited accessibility. What is new: Ciliary sulcus suture fixation of conventional CTR with 9 − 0 double-strand polypropylene suture effectively preserves the capsular bag, improves visual acuity, stabilizes intraocular pressure (IOP), and has a low complication rate for lens subluxation (90°–240°). This technique is a safe, cost-effective alternative without special devices, and provides an emergency option for intraoperatively detected subluxation.