Using a capsular tension ring for the first time requires a deliberate, unhurried approach and a clear understanding of zonular anatomy. Before inserting the ring, assess the extent and location of zonular weakness so you can control the direction of forces during placement. Ensure the capsulorhexis is well centered and appropriately sized, as a stable capsular bag is essential for smooth advancement of the ring. Inject a generous amount of ophthalmic viscosurgical device to create space between the capsule and lens cortex. Advance the ring slowly, allowing it to glide circumferentially rather than pushing forcefully, and be prepared to pause if resistance is encountered. Using a second instrument to guide the leading eyelet can help avoid snagging on the capsulorhexis edge. Once in place, confirm that the ring is fully seated and that the bag has regained a uniform contour. Proceed with phaco carefully, recognizing that zonules may still be fragile despite improved stability.
