CTS device used to reposition capsular bag in cases of zonular dialysis

A versatile endocapsular device (Capsular Tension Segment [CTS], Morcher GmbH) can be used during cataract surgery as a support for zonular weakness, according to Sebastien Gagne, MD, University of Toronto.

The CTS device, available for use internationally and on a compassionate use basis in the United States because it is not yet FDA approved, can be implanted early in the cataract procedure (soon after capsulorhexis) or at the end of the procedure. The device is similar to a modified capsular tension ring (Cionni Modified Capsular Tension Ring, Morcher) and can be sutured in place with 9-0 prolene sutures or removed at the end of the case, Dr. Gagne said.

Dr. Gagne successfully implanted and sutured the device in 103 patients with severe zonular instability. The mean age of patients was 50 years and the mean follow-up was 18 months. The preoperative diagnoses included trauma in 37 patients, pseudoexfoliation in 28 patients, Marfan's syndrome in 21, ectopia lentis in 13, and other in 4.

Best-corrected visual acuity improved from a mean of 20/250 to the 20/40 level. Only 5% of patients experience mild IOL tilt and none had significant problems with tilt, Dr. Gagne said.

Postoperative complications included posterior capsule opacification in 22 eyes, postoperative IOP spike in 15 eyes, and three eyes required additional surgery.