Management of zonular dialysis in phacoemulsification and IOL implantation using the capsular tension ring.

BACKGROUND AND OBJECTIVES: Cataract surgery with zonular dialysis remains a challenge for surgeons performing phacoemulsification and posterior chamber intraocular lens implantation. In this article, the authors report the results of cataract surgery with zonular dialysis that was managed with the capsular tension ring. PATIENTS AND METHODS: Of the 14 cataract surgery cases with loose or broken zonules managed with capsular tension rings that were retrospectively reviewed, 5 selected cases are presented in this article. RESULTS: The authors found that the capsular tension ring helps to avoid capsular collapse and vitreous presentation during surgery and maintains the circular contour of the capsular bag, allowing the intraocular lens to easily be placed into the bag. There was no observable decentration of the intraocular lens after surgery. CONCLUSION: The capsular tension ring may provide an alternative means to manage zonular dialysis during phacoemulsification and posterior chamber intraocular lens implantation.

The role of small-incision cataract surgery in combined cataract and glaucoma surgery.

Small-incision cataract surgery widens the scope of combined cataract and glaucoma surgery. Phacoemulsification is gaining in importance, although extracapsular extraction techniques are still commonly used. Trabeculectomy remains the standard filtration operation combined with cataract surgery. There are currently a number of areas of contention in combined trabeculectomy surgery, including-the use of shared or separate incisions, the use of antimetabolities, and the type of intraocular implant. Other adjunctive procedures such as trabeculotomy and endocyclophotocoagulation are also discussed in the context of combined surgery.