15/07/2025
Here is the full story in motion! We recently saw a 14-year-old girl with ectopia lentis, a diagnosis was made 10 years back.
At the time of diagnosis, the right eye underwent a lensectomy and iris claw implant. For her left eye, where the zonules initially appeared better, the surgeon performed a straightforward lensectomy and three-piece IOL implantation in the bag without a capsular tension ring (CTR).
However, as progressive zonulopathy often does, the capsular bag couldn't hold up over time. She presented to us with a severely subluxated capsular IOL complex. This was no easy fix! The IOL haptics were heavily distorted by capsular phimosis, and the entire complex was smaller than her pupil, posing a high risk of dropping into the posterior segment during maneuvering.
What followed was a meticulous, controlled explanation of the IOL and a clean Yamane scleral fixation to restore stability.
Moral of the story?
- With progressive zonulopathy, always think ahead! A CTR is a must, even if zonules look reasonably intact.
- CTR delays capsular phimosis and IOL-capsule luxation.
- Presence of CTR makes, rescuing this lens could have been a much simpler and less invasive task by Flanged Prolene belt- loop”Mccabe Belt Loop” .
