The impact of utilizing a single iris hook as a capsular hook during the implantation of capsular tension rings


Demirel E. E., ÖZTÜRK E., Gunduz A.

Arquivos Brasileiros de Oftalmologia, cilt.89, sa.1, 2026 (SCI-Expanded, Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 89 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.5935/0004-2749.2025-0045
  • Dergi Adı: Arquivos Brasileiros de Oftalmologia
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Anahtar Kelimeler: Capsular tension ring, Capsulorhexis, Cataract, Cataract extraction, Iris hook, Phacoemulsification, Pseudoexfoliation syndrome, Zonular weakness
  • İnönü Üniversitesi Adresli: Evet

Özet

Purpose: To evaluate the effect of using a single iris retractor, affixed to the anterior capsulorhexis at the 12 o’clock position, on the ease of capsular tension ring implantation. Methods: This prospective comparative study comprised 37 patients with zonular weakness attributed to pseudoexfoliation syndrome who underwent capsular tension ring implantation during cataract surgery. In Group 1, a single iris retractor was inserted into the anterior capsulorhexis at the 12 o’clock position. Group 2 did not receive this intervention. Zonular weakness was graded on a scale of 1–5, and the subjective difficulty of capsular tension ring implantation was categorized as easy, medium, or difficult. Results: Group 1 and 2 comprised 20 and 17 patients, respectively. There were no significant differences between the groups in age, sex distribution, and presence of glaucoma (p=0.53, p=0.28, and p=1.00, respectively). The mean zonular weakness score was significantly higher in Group 1 (3.35 ± 0.45) than in Group 2 (2.71 ± 0.59; p=0.02). Capsular tension ring implantation was significantly easier in the iris retractor group (p<0.001). Conclusions: Placement of a single iris retractor attached to the anterior capsulorhexis at the 12 o’clock position may facilitate easier capsular tension ring implantation, even in patients with greater zonular weakness. This technique could reduce the risk of capsular tension ring displacement into the iridocorneal angle or ciliary sulcus.