Effect of a capsular tension ring on prevention of intraocular lens decentration and tilt and on anterior capsule contraction after cataract surgery

Purpose  To investigate the effect of a capsular tension ring (CTR) on the prevention of marked decentration and tilt of the intraocular lens (IOL), severe anterior capsule contraction, and refractive prediction error after cataract surgery. Methods  Forty-seven eyes of 43 patients that had an implantation of a CTR during phacoemulsification surgery due to zonular instability (CTR group), and 34 fellow eyes that did not receive a CTR (no-CTR group) were enrolled. The degree of IOL decentration and tilt and the anterior capsule opening area were measured using a Scheimpflug videophotography system. Results  No significant differences were found between the two groups in the mean degree of IOL decentration (0.34 mm in the CTR group, 0.29 mm in the no-CTR group; P = 0.1401), tilt angle (2.82° in the CTR group, 2.56° in the no-CTR group; P = 0.3173), anterior capsule opening area (24.3 mm² in the CTR group, 23.6 mm² in the no-CTR group; P = 0.7620), or refractive prediction error (P = 0.3459). Conclusion  In eyes with either zonular dehiscence or weakness, a CTR can prevent marked IOL decentration and tilt and severe anterior capsule contraction, and may lead to prevention of refractive prediction error.