2965: traumatic zonulopathy noted pre-op
This case emphasizes the critical importance of a thorough preoperative evaluation. At the slit-lamp microscope, a distinct dark shadow at the lens equator tips us off to significant traumatic zonulopathy, revealing at least four clock hours of complete zonular loss. To safely manage this extensive area of missing support, our operating guest surgeon utilizes a Cionni Capsular Tension Ring (CTR). Unlike a standard CTR, the Cionni ring features an additional fixation booklet that allows it to be sutured directly to the sclera, securing and recentering the compromised capsular bag without distorting its shape. Once the bag is structurally stabilized and anchored, a three-piece intraocular lens is safely implanted. This video provides an excellent step-by-step demonstration of how to identify preoperative red flags and employ scleral-fixated capsular devices to achieve long-term, stable centration of an IOL in the setting of severe trauma.
