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Capsular Tension Rings

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Cataract and Refractive Surgery

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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In 1991, Hara and co-workers were the first to publish the idea of inserting an endocapsular ring into the capsular bag [1]. They used a closed ring made of soft silicone with a groove on its inner surface for the loops of the intraocu lar lens (IOL). The ring was thought not only to main tain the circular contour of the capsular bag equator, but also to withhold lens epithelial cell (LEC) migration. The inability of the closed silicone ring to adapt to all capsular bag sizes obviated routine use in human eyes. At about the same time, Nagamoto independently presented the concept of using an open ring made of rigid poly (methyl methacrylate) (PMMA) in order to maintain the circular contour of the capsular bag and thus avoid deformation or decentration of soft intraocular lenses [2]. In cadaver eyes, a 12.5-mm ring diameter was found most appro priate for the human capsular bag [3]. Implantation of a PMMA ring in human eyes was first reported in 1993 (“The Capsular Ring: A New Device for Complicated Cataract Surgery,” film presented at the third American-International Congress of Cataract, IOL and Refractive Surgery, Seattle, May 1993). This ring was produced by Morcher (Stuttgart, Germany) and marketed under the name ‘capsular tension ring’ (CTR). It carried character istic eyelets at its ends for atraumatic insertion and better manipulation. This, and similar CTR types soon gained widespread use especially in Europe. The various brands differ significantly in resilience as defined by the spring constant [4]. While softer rings cause less zonular stress during insertion, more rigid rings counteract fibrotic capsular bag contraction. Figures 3.1 and 3.2 depict the various CTR modifications to be described in the chap ters to follow.

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Authors and Affiliations

  1. Department of Ophthalmology, Medical University of Vienna Vienna General Hospital, Waehringer Guertel 18-20, Vienna, 1090, Austria

    Rupert Menapace

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  1. Rupert Menapace
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Editors and Affiliations

  1. Professor of Ophthalmology Department of Ophthalmology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany

    Thomas Kohnen

  2. Baylor College of Medicine Cullen Eye Institute, 6565 Fannin, Suite NC205, Houston, TX, 77030, USA

    Thomas Kohnen

  3. Department of Ophthalmology, Baylor College of Medicine Cullen Eye Institute, 6565 Fannin, Suite NC205, Houston, TX, 77030, USA

    Douglas D. Koch

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Menapace, R. (2009). Capsular Tension Rings. In: Kohnen, T., Koch, D.D. (eds) Cataract and Refractive Surgery. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-76380-2_3

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  • DOI: https://doi.org/10.1007/978-3-540-76380-2_3

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