2975: traumatic cataract with zonular loss
In this challenging surgical case a patient presents with a severe traumatic cataract featuring six clock hours of extensive zonular loss. The image captures the critical moment where the lens equator is clearly visible, requiring special techniques to stabilize the lens before removal. Our guest surgeons use a femtosecond laser to create the anterior capsulotomy and soften and divide the lens nucleus. In this case I would prefer to use capsular hooks to stabilize the bag during cataract removal, however our guest surgeons are able to successfully avoid doing so. In my opinion, the maximum degree of zonular loss that can be addressed with solely a capsular tension ring (CTR) is about 4 clock hours (120 degrees) and beyond that using a suture to secure the capsular bag with a capsular tension segment or Cionno ring would be advised. However out guest surgeons elect to use just the CTR for 6 clock hours of zonular loss. It appears relatively stable, so it prompts the question: is using just a CTR enough in this case? Please comment your opinion below.
