Abstract
Objective
Zonular dialysis (ZD), referred to as the presence of a deficient zonular support
for the lenticular capsule, might be the result of several causes and be detected
only at the time of cataract surgery. The aim of this study was to evaluate pre-,
intra-, and postoperative features of eyes with ZD regardless of the etiology detected
during cataract surgery.
Methods
A single-centre retrospective observational cohort study was performed at Moorfields
Eye Hospital (NHS Foundation Trust, London, U.K.) to identify patients who underwent
cataract surgery whose procedure was intraoperatively described as being complicated
by ZD between January 1, 2014, and August 22, 2019. Patient characteristics, intraoperative
clinical findings, visual and refractive outcomes, and postoperative complications
were recorded.
Results
ZD was identified intraoperatively in 447 eyes. In most cases (213 of 223; 96.8%),
patients underwent a phacoemulsification procedure, not requiring any conversion to
intracapsular or extracapsular extraction technique. Intraoperative complications
increased to 46.2% (103 of 223), with no significant correlation with ZD width. Capsular
tension rings (CTRs) were implanted in 43.4% of patients (97 of 223). The use of CTRs
correlated with better postoperative visual and refractive outcomes.
Conclusions
ZD is a serious complication of cataract surgery requiring prompt intraoperative diagnosis
and proper management. While it tends to worsen cataract surgery outcomes, the implantation
of CTRs during the surgical procedure seems to be associated with better postoperative
visual and refractive results.
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Article info
Publication history
Published online: January 07, 2023
Accepted:
December 8,
2022
Received in revised form:
November 27,
2022
Received:
August 27,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
