Evaluation of change in the orientation of intraocular lens in the bag using intraoperative spectral-domain optical coherence tomography before and after capsular tension ring implantation

Purpose: The purpose is to study the change in the contact of the IOL with the posterior capsule using intraoperative SD-OCT before and after implantation of the CTR post implantation of the IOL in the capsular bag. Methods: A total of 51 eyes of 51 patients with senile immature cataract underwent topical phacoemulsification procedure with implantation of an extended depth of focus intraocular lens by a single experienced surgeon. The Rescan 700 SD-OCT system was used for intraoperative imaging. These patients were imaged using intraoperative SD-OCT after implantation of the IOL and before and after implantation of appropriate size of CTR. The vertical height between posterior surface of the lens capsule and the posterior surface of the IOL was measured and compared across 3 CTR sizes. Results: The vertical height between the posterior surface of the lens capsule and the posterior surface of the IOL reduced significantly post CTR implantation (P value < 0.001) in all three groups. The change in height after CTR implantation was seen highest with the CTR size 13 mm and lowest with CTR size 11 mm. Conclusion: Significant improvement of contact between the IOL and the posterior capsule was shown after implantation of the CTR. Larger the size CTR, more the contact of the IOL with the bag was shown.