Intraoperative and postoperative complications of Cionni endocapsular ring implantation

Abstract

Purpose: To analyze the intraoperative and postoperative complications of Cionni ring implantation in eyes with a subluxated lens or zonular weakness.

Setting: Departamento de Oftalmología, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona, Spain.

Methods: This case series comprised 7 eyes of 5 patients with a subluxated lens or zonular weakness secondary to Marfan's syndrome (n = 2), traumatic cataract (n = 2), or megalocornea (n = 1) or of unknown etiology (n = 2). An AcrySof (Alcon) foldable intraocular lens (IOL) was implanted in all eyes. A 2-eyelet Cionni ring was implanted in 1 eye and a 1-eyelet Cionni ring, in 6 eyes. The Cionni ring was secured in position with a transscleral suture knotted to the ring's hook, avoiding peripheral perforation of the capsular bag.

Results: In 1 eye, corectopia was inadvertently produced by passing the suture needle through the iris root; lens subluxation temporarily increased during ring rotation and implantation. However, after the transscleral suture was tightened, capsular bag centration was excellent. In the eye with megalocornea, traction from the 2 hooks tore the edge of the anterior capsule rim. The most frequent postoperative complication was posterior capsule opacification, which occurred in 5 eyes, 2 of which required a neodymium:YAG posterior capsulotomy. After 1 year, the Cionni ring continued to provide excellent stability and capsular bag and IOL positioning in all cases.

Conclusions: Results indicate that Cionni ring implantation is an acceptable procedure to correct limited lens subluxation, preserves the capsular bag, and has few significant complications.