Combined special capsular tension ring and toric IOL implantation for management of post-DALK high regular astigmatism with subluxated traumatic cataract

• Main Author: Asim Kumar Kandar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Bevacizumab; intravitreal; neovascular age related macular degeneration; systemic; systematic review; systematic review of reviews; Hydrophillic nanogels; ophthalmic drug delivery; nanosponges; solid lipid nanoparticles; Adult strabismus; personality; psychosocial impact; quality of life; squint; Maculopathy; optic pit; spectral domain optical coherence tomography; Corneal hysteresis; corneal resistance factor; exfoliative glaucoma; primary open angle glaucoma; A-constant; biometry; individualized; intraocular lenses; personal; Tecnis; E-learning; medical education; methodology; Chronic macular hole; macular hole duration; macular hole size; macular hole surgery; Adult strabismus-20; functional; psychosocial; strabismus; surgery; Retinal detachment; vitreous shaving; gas; Cornea; conjunctival intraepithelial neoplasia; conjunctival squamous cell carcinoma; optical coherence tomography; Corneal Furrow degeneration; Blunt trauma; Desmarres lid retractors; globe luxation; Ophthalmology; residency training; satisfaction; Odontogenic orbital cellulitis; orbital cellulites; tooth bud abscess; Capsular tension ring; DALK; post-keratoplasty astigmatism; subluxated cataract; toric IOL
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2014;volume=62;issue=7;spage=819;epage=822;aulast=Kandar

We report a case of 18-year-old male who has undergone phacoemulsification with implantation of toric IOL (AcrySof IQ SN6AT9) after fixation of lens capsule with Cionni′s capsular tension ring (CTR) for subluxated traumatic cataract with high astigmatism after deep anterior lamellar keratoplasty (DALK). He underwent right eye DALK for advanced keratoconus four years earlier. He had history of trauma one year later with displaced clear crystalline lens into  anterior chamber and graft dehiscence, which was repaired successfully. The graft survived, but patient developed cataract with subluxated lens, for which phacoemulsification with implantation of toric IOL was done. Serial  topography showed regular corneal astigmatism of -5.50 diopter (K 1 42.75 D @130°, K 2 48.25 D @40°). At 10-month follow-up, the patient has BCVA 20/30 with + 0.75 DS/- 1.75 DC @ 110°. The capsular bag is quite stable with well-centered IOL. Combination of Cionni′s ring with toric IOL could be a good option to manage such complex cases.