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| LETTER TO EDITOR |
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| Year : 2003 | Volume
: 51
| Issue : 2 | Page : 197 |
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Use of capsular tension ring in phacoemulsification. Indications and technique.
R Venkatesh
Correspondence Address:
R Venkatesh
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 12831157 
How to cite this article:
Venkatesh R. Use of capsular tension ring in phacoemulsification. Indications and technique. Indian J Ophthalmol 2003;51:197 |
Dear Editor,
We read with interest the article by Lanzetta et al regarding the use of the Capsular Tension Ring (CTR) in phacoemulsification.[1] We too follow a similar technique of inserting the CTR through the tunnel or paracentesis. However, we have observed that a few surgeons, especially those beginning to learn the use of CTR, find it difficult to insert the ring under the capsulorhexis. We have resolved the issue with the use of trypan blue dye which has a variety of uses [2],[3] other than just staining the capsule in white cataracts. The dye improves visualisation of the anterior capsule and the capsulorhexis to make the insertion of CTR safe and comfortable, particularly for beginners.
For those patients who cannot afford phaco-emulsification, or if the surgeon does not have access to a phacoemulsification machine, CTR can be used with manual small incision cataract surgery (Manual SICS) for indications as described by Lanzetta et al.[1] After staining the capsule with 0.1 ml of 0.06% Trypan blue (Auroblue, Aurolab, Madurai) and 6-7 mm diameter capsulorhexis, the CTR is inserted manually through the paracentesis which is followed by a cortical cleaving hydrodissection. The nucleus is then hydrodelineated and irrigation continues until one pole of the nucleus prolapses out of the capsular bag. The rest of the nucleus is wheeled into the anterior chamber using a sinskey hook. Manual SICS with CTR is more suitable in a well dilated pupil and without a very big nucleus so that an ideal size capsulorhexis can be performed to safely prolapse the nucleus into the anterior chamber. We have performed over 100 cases of manual SICS with CTR, most of which have shown favourable results.
| References | |  |
| 1. | Lanzetta P, Chiodini RG, Polito A, Bandello F. Use of capsular tension ring in phacoemulsification. Indications and technique. Indian J Ophthalmol 2002;50:333-37.  [ PUBMED] [ FULLTEXT] |
| 2. | Bharatiya P, Sharma N, Ray M, Sinha R, Vajpayee RB. Trypan blue assisted phacoemulsification in corneal opacities. Br J Ophthalmol 2002;86:857-59. |
| 3. | Verma L, Moolchand, Prakash G, Tewari HK. Indocyanine green enhanced maculorhexis in macular hole surgery. Indian J Ophthalmol 2002;50:357. [ PUBMED] [ FULLTEXT] |
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