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Tension Rings

Product Description

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A CTR is a 270 degree open PMMA ring placed in the capsular bag during cataract surgery in cases with zonular instability or weakness.

Aurolab manufactures 3 types of CTR.

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Product Features:

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All types made from Clinical Quality UV absorbing PMMA, they are

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  • Capsular tension rings (standard type)

  • For cases involving less than 4 clock hours (4 positions) of zonular dialysis, a standard CTR is suitable.

  • Cionni rings with single and double loop.

  • For cases involving greater than 4 clock hours or progressive zonular damage.

  • Capsular tension segment.

  • Partial ring used in cases that cannot be supported by CTR.

 

Indications:

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  • Stabilization of the crystalline lens capsule in the presence of weak or absent zonules.

  • Pseudoexfoliation (lead to lens capsular damage, most common in glaucoma).

  • Prior trauma which leads to Zonulysis( damage of zonules) or capsular rupture.

  • Expected complications during phaco surgery.

  • Situations in which sudden unfolding of a foldable IOL might cause zonular breakage or dislocation of the IOL.

  • Repositioning of IOL decentration.

  • Marfan syndrome (results in subluxated lens with weak zonules).

Capsular Tension Ring (CTR)

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  • CTR is an open-ended,

    • flexible horseshoe-shaped polymethyl methacrylate (PMMA) filament.

    • with two eyelets at either end.

​Benefits:

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  • It is used in cases involving less than 4 clock hours of zonular dialysis.

  • Ensures stable conditions during surgery.

  • Prevents capsular fibrosis.

Models:

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Cionni Rings 

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  • In cases of profound zonulysis (i.e., greater than 4 clock hours) or extensive progressive zonular dialysis, a standard CTR may not provide adequate centration and stability.

  • In these case, a modified CTR designed by Cionni adds a comma-shaped filament attached to the main ring with an additional eyelet that allows it to be sutured to the scleral wall without piercing the capsular bag.

  • The eyelet is offset anteriorly to allow it to sit outside the capsular bag.

  • A double eyelet configuration is available for cases requiring additional support.

Models:

  • Cionni with single right eyelet (CCR).

  • Cionni with single left eyelet (CCL).

  • Cionni with double right & left eyelet (CCLR).

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Capsular Tension Segment

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  • This is a zonular support device that provides support for in-the bag implantation.

  • Its versatility enable early or late placement within the capsular bag.

  • It can be used in cases that cannot be supported by CTRs.

  • It is a partial ring with a fixation hook

Implantation:

  • CTR/ Cionni can be implanted manually or with the help of specially designed injector.

  • Requires presence of intact capsulorhexis and capsular bag.

  • Can be implanted at any step after capsulorhexis, but early placement makes cortical removal more difficult and tedious.

  • For these reasons, it is helpful to maintain multiple iris retractors at the capsulorhexis edge to stabilize the capsular bag during phacoemulsification and cortical removal.

  • After lens extraction, the iris retractors can be removed once the CTR has been safely implanted into the capsular bag prior to IOL insertion.

Advantages:

  • Circular expansion of capsular bags.

  • Stablizes conditions during surgery.

  • Improves IOL centration.

  • Reduces risk of capsular fibrosis.

  • Resists capsular shrinkage.

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