Endocapsular Ring Implantation for Traumatic Subluxated Cataract: Modified Techniques

Purpose: To establish the modifications in techniques for endocapsular ring insertion and its scleral fixation in subluxated cataract that causes minimal stress to capsulo-zonular complex. To assess the intraoperative performance and post-operative outcomes with our modified techniques. Design: Prospective, interventional, non-comparative case series. Methods: The study population consisted of 29 eyes with various degree of subluxated cataract that underwent endocapsular ring implantation with techniques modified by us followed by phacoemulsification and implantation of intraocular lens (IOL) in the capsular bag. Main outcome measures were success rate of endocapsular ring implantation, intraoperative performance, IOL centration and best corrected visual acuity (BCVA) at last visit. Secondary outcome measures included posterior capsular opacification (PCO) and other postoperative complications. Result: The mean age was 37.03 ± 12.37years. Mean degree of subluxation was 140 ± 66 degree. Preoperatively vitreous detected in anterior chamber of 6 eyes (20.69%). Two port anterior vitrectomy was performed in 6 eyes (20.69%). We could implant the intended endocapsular ring in 28 out of 29 eyes (96.55%). In one eye we could not implant the endocapsular ring because of extension of zonular dialysis due to weak zonules. Mean follow-up was 22.42 ± 2.31 months. Mean preoperative BCVA was + 0.68 ± 0.22 log MAR (24 eyes). Mean postoperative BCVA at final follow-up was +0.27 ± 0.16 log MAR (28 eyes).BCVA 20/40 or better was seen in 26 eyes (92.86%) at final followup. In 2 eyes (7.14%) mild IOL decentration was noted but none were symptomatic and required no intervention.PCO developed in 5 eyes (17.85%); 3 eyes (10.71%) required Nd:YAG capsulotomy. Other complications included cystoid macular edema in 1 eye (3.57%), and mild uveitis in 3 eyes (10.71%). Conclusion: With our modified techniques for endocapsular ring insertion and its scleral fixation, we could smoothy and safely implant the endocapsular rings in subluxated cataract with higher success rate, minimal intraoperative complications and good postoperative outcome.