Objective To compare the clinical effects of one-stage modified capsular tension ring (MCTR) scleral fixation and second-stage capsular tension ring (CTR) capsular bag complex scleral fixation in the treatment of moderate and severe subluxation of lens.Methods Retrospective study.Thirty cases (43 eyes) of patients with moderate and severe subluxation of lens from January 2012 to December 2015 were collected.Those patients were treated with phacoemulsification cataract extraction and MCTR or CTR and IOL intracapsular implantation under local anesthesia.23 eyes in group A were treated with MCTR combined with IOL implantation and one-stage scleral fixation.20 eyes in group B were treated with one-phase CTR combined with IOL implantation and second-stage of CTR-capsular bag complex scleral fixation after 3 to 6 months.The best corrected visual acuity,location of the postoperative capsular bag complex and complication were observed at 6 months after surgery.Results Postoperative 6-month,the best corrected visual acuity ≥0.6 were in 87％,95％ of the patients m group B,and there was no statistical significance difference (P ＞ 0.05).All CTR and IOL were located in the capsular bag after surgery.Two eyes in group A and 1 eye in group B were observed with moderate contraction and off-center of capsular bag,there was no significant difference (P ＞ 0.05).All groups achieved response after YAG laser anterior capsule relaxing incisions.Early complications of postoperative (1 month):3 eyes in group A and 1 eye in group B were observed with exudative membrane in anterior chamber;5 eyes in group A and 2 eyes in group B were with transient high intraocular pressure,and there was no significant difference (all P ＞ 0.05).Long-term complications of postoperative (6 months):3 eyes in group A and 1 eye in group B were observed with after cataract,and there was no significant difference (P ＞ 0.05).All groups conducted YAG laser posterior capsulotomy.Conclusion The location stability of the capsular complex after one-stage MCTR scleral fixation or secondstage CTR capsular bag sclera fixation is good.And the treatment is effective for moderate and severe lens dislocation.

Objective To investigate the stability of pouch in patients with high myopia cataract after phacoemulsification cataract extraction combined with capsular tension ring(CTR)implantation.Methods A total of 80 patients with high myopia complicated with cataract(80 eyes)were included and randomly divided into the experimental group and the control group.The experimental group received phacoemulsification cataract extraction combined with CTR implantation,while the control group was not combined with CTR implantation,and the other interventions were completely consistent.The naked eye visual acuity(UCVA),best corrected distant visual acuity(BCVA),corneal biomechanics,contrast sensitivity,intraocular lens inclination and anterior capsular opening area were compared between the two groups at 1,3 and 6 months after surgery.The incidence of late cataract(PCO)was measured 6 months after surgery.Results UCVA and BCVA were improved at 1,3 and 6 months after operation.There were no significant differences in postoperative corneal biomechanical parameters ARTh and SP-A between the two groups of patients(P＞0.05).The Corvis biomechanical index(CBI)of the experimental group was significantly higher 3 months after surgery than that of the control group(P＜0.05),and there were no significant differences at other time points between the 2 groups.There was no significant difference in contrast sensitivity at each time point after surgery between the experimental group and the control group(P＞0.05).At 3 and 6 months after operation,the anterior capsule opening area was increased in the experimental group,and IOL inclination angle was decreased compared with the control group(P＜0.05).At 6 months after operation,no PCO occurred in 38 eyes and PCO grade Ⅰ in 2 eyes.No PCO occurred in 35 eyes in the control group,3 eyes in grade Ⅰ,2 eyes in grade Ⅱ and 2 eyes in grade Ⅲ.Conclusion Phacoemulsification cataract extraction combined with CTR implantation has higher stability,long-term clinical effect and visual quality in patients with high myopia cataract,and is worthy of clinical application.

AIM: To observe the efficacy of phacoemulsification combined with capsular tension ring and intraocular lens implantation in the treatment of high myopia with cataract.METHODS: Retrospective study. A total of 82 cases(82 eyes)of high myopia complicated with cataract who admitted to the cataract department of our hospital from December 2021 to April 2023 were selected as study objects, and they were divided into control group(n=39)and combination group(n=43)according to whether or not the capsular tension ring was used intraoperatively. Patients in the control group were treated with intraocular lens implantation alone, and those in the combination group were treated with phacoemulsification combined with capsular tension ring and intraocular lens implantation. The preoperative and postoperative best corrected visual acuity, central anterior chamber depth, trabecular ciliary process, visual quality and complications were compared.RESULTS: At 1 mo after surgery, the best corrected visual acuity(LogMAR)of both groups increased significantly(combination group: 0.64±0.28 vs 0.12±0.14; control group: 0.62±0.26 vs 0.23±0.25, both P<0.001). Central anterior chamber depth in both groups were higher than those before surgery(combination group: 2.57±0.56 vs 1.97±0.40 mm; control group: 2.22±0.45 vs 1.89±0.37 mm; both P<0.001), and the best corrected visual acuity and central anterior chamber depth of the combination group were significantly better than those of the control group(both P<0.05). The distance of trabecular ciliary process showed no statistical significance(combination group: 0.68±0.22 vs 0.74±0.20 mm; control group: 0.74±0.19 vs 0.78±0.17 mm, both P>0.05). The visual quality scores of the combination group were all higher than the control group at 1 mo after surgery [watching TV: 3.00±0.38 vs 2.22±0.46 points; reading books: 2.85±0.42 vs 2.21±0.44 points; night vision: 2.71±0.34 vs 2.37±0.41 points; fine operation: 2.82±0.38 vs 2.33±0.40 points, all P<0.001]. The incidence of complication in the combination group was significantly lower than that of the control group(33% vs 14%, P<0.05).CONCLUSION: Phacoemulsification combined with capsular tension ring and intraocular lens implantation can effectively promote the recovery of visual function, improve the structure of chamber angle, and reduce the incidence of complications in the treatment of patients with high myopia and cataract.