Application of capsular tension ring implantation during phacoemulsification for ultra-high myopia complicated with cataract

Objective

To investigate the effect of phacoemulsification combined with capsular tension ring implantation in patients with ultra-high myopia and cataract.

Methods

A randomized-controlled study was performed.The clinical data of 48 eyes of 48 patients with ultra-high myopia and cataract were collected at Shanghai Jiaotong University Affiliated Sixth People’s Hospital South Campus from October 2016 to December 2018.The patients were randomly divided into a control group and a clinical trial group using a random number table method, with 24 eyes in each group.The eyes in the control group underwent phacoemulsification, and capsular tension ring implantation was performed during the surgery in the trial group.The patients were followed up for 3 months.Best corrected visual acuity (BCVA), intraocular pressure, corneal endothelial cell count, intraocular lens (IOL) decentration, and subjective visual quality were observed and compared preoperatively and 1 week, 1 month and 3 months postoperatively, and the postoperative inclination angle of the IOL and surgical complications were compared between the two groups.Written informed consent was obtained from each patient prior to entering the study cohort.This study conformed to the tenets of the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Shanghai Jiaotong University Affiliated Sixth People’s Hospital South Campus (No.2016-KY-05).

Results

The operation procedure was successfully completed, and the IOL was implanted into capsular bag in all the eyes.The postoperative BCVA was higher than that before surgery in both groups, with significant differences between them (all at P<0.05). There were no significant differences in intraocular pressure and the corneal endothelial cell count between the two groups (F=0.122, P=0.729; F=0.006, P=0.939). The level of IOL horizontal decentration, vertical decentration, or total decentration were not significantly different between the two groups at 1 month and 3 months after operation (all at P>0.05). At 1 month after operation, the horizontal and total inclination angles of the IOL in the trial group were statistically significantly lower than those in the control group (P<0.05). At 3 months after operation, the vertical and total inclination angles of the IOL were significantly lower than those in the control group (both at P<0.05). The total inclination in the trail group was significantly lower than that of the control group (P<0.05). The subjective visual quality scores of the patients in the trial group at 1 week, 1 month, and 3 months after operation were 2.85±0.24, 3.30±0.36, and 3.43±0.42, respectively, and those in the control group were 2.34±0.23, 2.65±0.44, and 2.57±0.39, respectively, both significantly improved over the preoperative 1.31±0.22 and 1.19±0.17 (all at P<0.01).

Conclusions

The use of a bag tension ring in phacoemulsification for ultra-high myopia with cataract is safe and effective, and can result in good visual quality.