To endoscopically assess the positioning of the intraocular lens (IOL)-capsular tension ring (CTR)- capsular bag complex in relation to the ciliary body in eyes with compromised zonular support. Prospective, interventional case series. In four eyes with fragile zonules undergoing cataract surgery, a CTR was inserted during surgery, followed by IOL implantation into the capsular bag. An ophthalmic endoscope was introduced through a temporal corneal incision to visualize the positioning of the CTR-IOL-capsular bag complex relative to the ciliary body in the 180-degree quadrant opposite the corneal incision. In two eyes, the equator of the CTR-IOL-capsular bag complex contacted the area slightly below the apex of the ciliary processes. In the other two cases, the equator of the complex was secured within the ciliary sulcus across the visualized region, effectively resolving phacodonesis which had been observed preoperatively and during capsulorhexis creation. The exploratory study provides the endoscopic evidence that the CTR-IOL-capsular bag complex can be fixed in the ciliary sulcus in some cases, potentially enhancing postoperative stability in eyes with compromised zonules.
Shimowake et al. (Fri,) studied this question.