Capsular Tension Ring Suturing Technique for Toric IOLs Stable Despite Axial Length

A capsular tension ring suturing technique for toric intraocular lens (IOL) implantation provides excellent rotational stability in eyes with long axial length (AL) and does not require additional intervention, according to research published in International Ophthalmology.

Researchers evaluated the efficacy of the toric IOL and suturing technique in the eyes with long AL with a high risk of toric IOL rotation in a retrospective observational case series.

The team analyzed the data from 30 eyes of 29 patients (mean age, 59.46±10.05 years; 51.7% men and 48.3% women), with a regular total corneal astigmatism of ≥1.5 D and an AL of ≥26.0 mm, that underwent acrylic toric IOL implantation with the toric IOL and capsular tension ring suturing technique for cataract and astigmatism or toric IOL repositioning. Patients were implanted with 1 of 2 different models of toric IOLs. The researchers assessed preoperative and postoperative astigmatism, uncorrected distance visual acuity (UDVA), IOL rotation, intraoperative, and postoperative complications. 

All patients underwent postoperative examinations at 1 day, 1 week, 1 month,
and 3 months after cataract removal. Patients had a mean AL of 27.82±1.53 mm (range, 26.08-31.07). The mean UDVA significantly improved from 0.84±0.20 logMAR preoperatively to 0.04±0.06 logMAR postoperatively (P <.001). The mean corneal astigmatism was significantly reduced from 3.08±1.01 D preoperatively to 0.59 ± 0.32 D postoperatively (P <.001).

Patients who underwent the and capsular tension ring suturing technique a mean degree of postoperative rotation of 0.50±2.01° and observed only 2 eyes (6.2%) with postoperative toric IOL rotation (5° and 10°). No intraoperative complications were observed.

“[P]ostoperative misalignment is the main factor responsible for unsuccessful and unsatisfactory visual outcomes following toric IOL implantation. Therefore, it is very important to stabilize the toric IOL on the target axis to accomplish the best astigmatic correction,” explain the researchers. The capsular tension ring suturing technique with toric IOL implantation is the leading method developed for toric IOL stabilization, according to the study authors.

Limitations of the study included the retrospective design, small sample size, and absence of a digital marker system.