This video features a challenging case of global zonulopathy where the lens stability is severely compromised. When zonular weakness is this extensive, a standard capsular tension ring alone is insufficient to support the bag. The surgeon demonstrates a specialized technique using two capsular tension segments, placed 180 degrees apart, to provide more capsular stability. These segments are carefully positioned and secured to the scleral wall using Prolene sutures and the flange technique, ensuring the entire capsular bag is centered and taut. By fixating the bag at two distinct points, the surgeon creates a reliable scaffold for the intraocular lens. The procedure highlights the importance of early recognition of zonular issues and the precise execution of scleral fixation. This approach preserves the natural capsule while providing long term centration for the patient, even in the absence of healthy zonular support.
