Effectiveness of prophylactic capsular tension ring implantation during cataract surgery in highly myopic eyes

Purpose: To assess the effectiveness of prophylactic capsular tension ring (CTR) implantation during cataract surgery in highly myopic eyes. Setting: EENT Hospital of Fudan University, Shanghai, China Design: Prospective cohort study. Methods: Consecutive highly myopic patients treated with cataract surgery were recruited and randomized to undergo CTR implantation or not. The outcomes compared between the two groups included axial lens position (ALP), intraocular lens (IOL) decentration and tilt, area of anterior capsule opening, severity of anterior capsular opacification (ACO), and posterior capsular opacification (PCO) at 1 year after surgery. Results: A total of 55 highly myopic eyes with CTRs implanted and 55 without were included in the analysis. At 1 year after surgery, no significant differences were detected between the CTR and non-CTR groups for the mean ALP, IOL decentration, or tilt (all P > 0.05). However, the CTR group had a significantly larger area of anterior capsule opening (23.62 ± 3.30 mm2 vs. 21.85 ± 2.30 mm2, P = 0.003), and less severe ACO (P = 0.033) and PCO (PCO-3 mm: 0.06 ± 0.13 vs. 0.13 ± 0.20, P = 0.038; PCO-C: 0.15 ± 0.18 vs. 0.25 ± 0.26, P = 0.026) than the non-CTR group. The corrected distance visual acuity, prediction error, and high-order aberrations did not differ between the two groups (all P > 0.05). Conclusions: In highly myopic eyes, although prophylactic CTR implantation can reduce the severity of capsular contraction and opacification, it does not significantly affect postoperative IOL stability or visual outcomes.