CTR and IOL trap technique
Hello I’m a glaucomatologist and cataract surgeon. Every now and then I come across cataract with loose zonule. I am interested to find out
Would you put in a CTR for mild generalised zonular weakness? My understanding is that a CTR helps with regional zonular weakness less than one quadrant. It works by stretching the bag centrifugally, such that the load of the bag and IOL is shared by all 360’ of the zonule. When the zonule is generally weak, I assume it is not going to be helpful and might even add unnecessary weight to the capsular bag, affecting long term stability. Is this correct?
When would you do this IOL trap technique for zonular weakness as linked here? https://youtu.be/WQXp5GJv2-I?si=8e7KOD9femIny1Lx
This sulcus placement + optic capture is my go-to for PCR cases with an appropriately sized CCC e.g. 5.5mm or less. But in terms of zonulopathy, I thought placing the IOL in the sulcus wouldn’t make it more stable, or would it? If so, why?
Would appreciate any feedback. Thanks!