Korean J Ophthalmol.  2006 Dec;20(4):246-249. 10.3341/kjo.2006.20.4.246.

A Modified Iris Repair Technique and Capsular Tension Ring Insertion in a Patient with Coloboma with Cataracts

• Kim JH
• Kang MH
• Kang SM
• Song BJ

• KMID: 754592
• DOI: http://doi.org/10.3341/kjo.2006.20.4.246

Abstract

PURPOSE: We describe our successful experience using a capsular tension ring (CTR) and iris repair during cataract surgery in a patient with bilateral coloboma. METHODS: A 67-year-old woman had no history of trauma, but had zonular deficiency and inferonasal iris defects in both eyes. An extracapsular cataract extraction and intraocular lens (IOL) scleral fixation was performed in the left eye. A CTR was implanted in the right eye through a sclerocorneal incision. After the IOL was placed centrally in the capsular bag, two paracenteses were made at the limbus (5 o'clock and 7 o'clock). A long, straight needle was passed through the 7 o'clock paracentesis site into a angled, blunt tipped 27 gauge needle inserted from the 5 o'clock paracentesis. The two needles were pulled out at 5 o'clock. After inserting the long needle into the blunt tipped needle at 7 o'clock, both were passed back through the 7 o'clock paracentesis site. The needles were pulled out again at the 5 o'clock paracentesis site tied. Equal tension was used to tie both sides. RESULTS: Visual acuity improved to 20/20 in the right eye. CONCLUSIONS: Both capsular tension ring implantation and iris repair was successfully performed at the time of cataract surgery in a coloboma patient, which resulted in improvements in visual function and cosmesis.

Keyword

Capsular tension ring; Cataract; Coloboma; Iris repair; Phacoemulsification

MeSH Terms

Prosthesis Implantation/*methods
*Prostheses and Implants
Lens Implantation, Intraocular
Iris/*surgery
Humans
Follow-Up Studies
Female
Coloboma/complications/*surgery
Cataract Extraction
Cataract/*complications
Aged

Figure

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  Fig. 1 A long, straight needle was passed through the 7 o'clock paracentesis into the angled, blunt needle coming from 5 o'clock.

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  Fig. 2 The right and left iris borders were picked up by the long, straight needle while the angled, blunt needle countered the pressure of the needle.

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  Fig. 3 The needle was pulled out to the opposite site (5 o'clock).

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  Fig. 4 After inserting the long needle into the blunt needle again, both were passed back through the 7 o'clock.

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  Fig. 5 A single knot was made loosely.

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  Fig. 6 The needle was pulled out through the 5 o'clock limbus to be tied.

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  Fig. 7 The tying was made with equal tension in both sides.

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  Fig. 8 Comparison between the preoperative and postoperative eye. Inferonasal coloboma showed significant cosmetic and functional improvement (10A: preoperative eye, 10B: postoperative eye).

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