The Effect of Capsular Tension Ring in Patients with a History of Acute Primary Angle Closure

Jung Won Park; Hyun Ho Jung; Sang Woo Park

doi:10.3341/jkos.2013.54.9.1395

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Park, Jung, and Park: The Effect of Capsular Tension Ring in Patients with a History of Acute Primary Angle Closure

Original Article

J Korean Ophthalmol Soc 2013;54(9):1395-1400.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.9.1395

The Effect of Capsular Tension Ring in Patients with a History of Acute Primary Angle Closure

Jung Won Park, MD, Hyun Ho Jung, MD, Sang Woo Park, MD, PhD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea

Address reprint requests to Sang Woo Park, MD, PhD Department of Ophthalmology, Chonnam National University Hospital, #42 Jebong-ro, Dong-gu, Gwangju 501-757, Korea Tel: 82-62-220-6742, Fax: 82-62-227-1642 E-mail: exo70@naver.com

Received 8 February 201312 April 2013 Accepted 27 June 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effect of a capsular tension ring (CTR) on the change in postoperative refractive errors and ante-rior chamber depth after cataract surgery in patients with a history of acute primary angle closure (APAC).

Methods

We retrospectively reviewed medical records of 45 patients who underwent cataract surgery with a history of APAC. Forty five eyes were divided into 2 groups based on whether a CTR was implanted (n = 21) or not (n = 24). Spherical equivalent (SE) refractive errors were compared between the 2 groups for 12 months postoperatively. The post-operative anterior chamber depth (ACD) and volume (ACV) were compared between the 2 groups.

Results

SE refractive errors in the CTR group were -0.59 ± 1.08 D at 6 months and -0.61 ± 1.04 D at 12 months postoperatively. In the non-CTR group, -0.64 ± 1.30 D, at 6 months and -0.67 ± 1.19 D at 12 months postoperatively. There was no statistically significant difference between 2 groups (p = 0.89, p = 0.84) and postoperative SE refraction shifted to myopic refractive power in both groups (p < 0.01). The postoperative ACD and ACV also showed no difference between the 2 groups (p = 0.13, p = 0.47).

Conclusions

The postoperative ACD, ACV and myopic shift in patients with a history of APAC demonstrated no significant difference between CTR-implanted and non-CTR-implanted patient groups.

Keywords: Acute angle closure, Capsular tension ring, Cataract, Glaucoma, Refractive error

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Figure 1.

Comparisons of postoperative spherical equivalent between CTR group and Non-CTR group. CTR = capsular tension ring; TR = target refraction; SE = spherical equivalent. ^* p-values (comparison between TR and postoperative SE in CTR group) < 0.01; ^† p-values (comparison between TR and postoperative SE in Non-CTR group) < 0.01.

Table 1.

Demographic and clinical data for CTR and Non-CTR group

	CTR group	Non-CTR group	p
Number of patients	21	24
Mean age (years)	65.43 ± 8.74	69.79 ± 10.53	0.18
Sex (male/female)	4/17	5/19	1.00
Axial Length (mm)	22.69 ±0.80	22.01 ± 0.72	0.61
Preoperative BCVA (log MAR)	0.37 ± 0.26*	0.35 ± 0.28*	0.83
Postoperative BCVA (log MAR)	0.15 ± 0.13*	0.14 ± 0.17*	0.94
Preoperative IOP (mm Hg)	18.52 ± 4.99*	17.17 ± 4.61*	0.35
Postoperative IOP (mm Hg)	14.38 ± 2.22*	13.96 ± 2.99*	0.59

Values are presented as mean ± SD.

Independent t-test; comparison between CTR and Non-CTR group.

CTR = capsular tension ring; BCVA = best corrected visual acuity; IOP = intraocular pressure.

^* p-values (comparison of pre and post operation by paired t-test ) < 0.01.

Table 2.

Postoperative spherical equivalent, refractive error and absolute error in CTR group and Non-CTR group

	CTR group			Non-CTR group			P1	P2	P3
	SE (D)	CTR group SE - TR	｜ SE - TR｜	N SE (D)	Non-CTR group SE - TR	p ｜SE - TR｜	P1	P2	P3
TR (D)		0.29 ± 0.33			0.26 ± 0.41			0.80
Postop. 1 week	0.07 ± 0.99	-0.21 ± 1.10	0.83 ± 0.72	-0.02 ± 1.01	-0.27 ± 1.16	0.89 ± 0.76	0.77	0.86	0.77
Postop. 1 month	-0.01 ± 1.05	-0.30 ± 1.17	0.92 ± 0.75	-0.11 ± 1.21	-0.37 ± 1.28	1.02 ± 0.84	0.76	0.84	0.70
Postop. 3 months	-0.29 ± 1.01^*	-0.57 ± 1.08	0.97 ± 0.72	-0.33 ± 1.25^*	-0.59 ± 1.32	1.15 ± 0.85	0.89	0.96	0.44
Postop. 6 months	-0.31 ± 0.95^*	-0.59 ± 1.08	0.99 ± 0.71	-0.39 ± 1.20^*	-0.64 ± 1.30	1.16 ± 0.85	0.81	0.89	0.47
Postop. 12 months	-0.32 ± 0.92^*	-0.61 ± 1.04	1.00 ± 0.64	-0.42 ± 1.10^*	-0.97 ± 1.19	1.09 ± 0.80	0.75	0.84	0.67

Values are presented as mean ± SD.

Independent samples t-test; P1, P2, P3. P1 = Comparison of SE between CTR and Non-CTR group; P2 = Comparison of SE-TR between CTR and Non-CTR group; P3 = Comparison of ｜ SE - TR｜ between CTR and Non-CTR group.

TR = target refraction; SE = spherical equivalent; ｜ SE - TR｜ = Absolute value of difference between the postoperative spherical equivalent and target refraction.

^* p-values (comparison between TR and postoperative SE by paired t-test) < 0.01.

Table 3.

Pre- and post-operative biometric measurements in eyes with CTR group and Non-CTR group

	CTR group		Non-CTR group		P1	P2	P3	P4
	Pre. Op.	Post. Op.	Pre. Op.	Post. Op.	P1	P2	P3	P4
ACD (mm)	1.48 ± 0.46	3.30 ± 0.86	1.60 ± 0.22	3.67 ± 0.91	<0.01	<0.01	0.22	0.13
ACV (mm³)	72.11 ± 23.05	153.43 ± 29.56	91.06 ± 61.82	156.50 ± 38.89	<0.01	<0.01	0.09	0.47

Values are presented as mean ± SD.

Paired t-test; P1, P2. Independent samples t-test; P3, P4. P1 = Comparison between pre and post operative values in CTR group; P2 = Comparison between pre and postoperative values in Non-CTR group; P3 = Comparison of preoperative values between CTR group and Non-CTR group; P4 = Comparison of postoperative values between CTR group and Non-CTR group. ACD = anterior chamber depth; ACV = anterior chamber volume.

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