Capsule anchor to manage subluxated lenses: Initial clinical experience
Received 19 December 2008; received in revised form 16 February 2009; accepted 16 February 2009.
Purpose
To evaluate the use of a capsule anchor to reposition and fixate the capsular bag to the scleral wall in eyes with subluxation of the crystalline lens.
Setting
Department of Ophthalmology, Meir Medical Center, Kfar-Saba, Israel.
Methods
This study evaluated a 1-plane poly(methyl methacrylate) intraocular implant (Capsular Anchor) that is clipped to the anterior capsule to support it. The device is composed of a central rod located in front of the anterior capsule and 2 lateral arms positioned behind the anterior capsule. The anchor is secured to the sclera with a single 9-0 or 10-0 polypropylene suture. A capsular tension ring (CTR) can be implanted in conjunction with the anchor. The anchor was implanted in eyes with subluxated cataractous lenses. After surgery, intraocular lens (IOL) centration and corrected distance visual acuity (CDVA) were monitored for 12 months.
Results
The anchor was successfully implanted in 2 patients with traumatic subluxated lenses and 2 patients with Marfan syndrome. In 1 eye, 2 anchors were used because of zonular dehiscence that extended during surgery. In 3 eyes, an IOL was implanted in the bag and in 1 eye, in the sulcus. A CTR was additionally implanted in 3 eyes. During the 12-month follow-up, the IOLs remained well centered and stable. The CDVA improved to 20/20 to 20/25 in all cases.
Conclusion
The capsule anchor was effective in fixating the lens capsule to the scleral wall in cases of significant zonular dehiscence.
From the Departments of Ophthalmology, Meir Medical Center (Assia, Ton), Kfar-Saba, and, Sorasky Medical Center (Michaeli), Tel-Aviv, and Sackler School of Medicine (Assia, Ton, Michaeli), Tel-Aviv University, Tel-Aviv, Israel
Corresponding author: Ehud I. Assia, MD, Chairman, Department of Ophthalmology, Meir Medical Center, 59 Tchernichovsky Street, Kfar-Saba, 44281 Israel.
Dr. Assia is a consultant to Hanita Lenses and the inventor of the Capsular Anchor. No other author has a financial or proprietary interest in any material or method mentioned.
Presented at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, Chicago, Illinois, USA, April 2008, and the XXVI Meeting of the European Society of Cataract & Refractive Surgeons, Berlin, Germany, September 2008.
Supported by Hanita Lenses, Kibbutz Hanita, Israel.
ABSTRACT