The Use of Capsular Tension Rings to Reduce Refractive Shift in Patients With Implantation of Trifocal Intraocular Lenses

PURPOSE: To determine whether use of a capsular tension ring (CTR) can increase refractive stability in patients with implantation of two different trifocal intraocular lenses (IOLs). METHODS: A prospective, consecutive series of eyes underwent refractive lens exchange with implantation of two different trifocal IOL designs: FineVision Micro F (non-toric) and FineVision POD FT (toric) (PhysIOL, Liege, Belgium). Power calculation was determined using the Haigis formula. Refractive lens exchange surgery was performed according to the standard Memira protocol. Refractive results and stability were assessed at 2 weeks and 3 months postoperatively. RESULTS: Three hundred eighty-eight eyes were included in the analysis. Overall, 71% and 76% of MicroF eyes implanted with (n = 139) and without (n = 104) a CTR, respectively, had hyperopic shift; 9% of MicroF eyes with a CTR had a shift of greater than +0.50 to +0.75 or less diopters (D) and 4% had a shift of greater than +0.75 D. In MicroF eyes without a CTR, 12% and 3% of eyes experienced a refractive shift of greater than +0.50 to +0.75 D or less and greater than +0.75 D, respectively. In the POD FT group, 72% and 69% of eyes with (n = 81) and without (n = 64) a CTR, respectively, had hyperopic shift; 10% of POD FT eyes with a CTR had a change of greater than +0.50 to +0.75 D or less and 7% had a shift of greater than +0.75 D. In POD FT eyes without a CTR, 13% and 3% experienced a refractive shift of greater than +0.50 to +0.75 D or less and greater than +0.75 D, respectively. For the MicroF design, the best refractive stability was found in the CTR group and the poorest stability in the non-CTR group ( P = .084). For the POD FT design, the best refractive stability was found in the non-CTR group and the poorest stability in the CTR group ( P = .297). CONCLUSIONS: Up to 7% of eyes implanted with FineVision trifocal IOLs had a hyperopic shift of greater than +0.75 D approximately 2 weeks to 3 months postoperatively. Using a CTR in MicroF eyes had no statistically significant effect on refractive stability. Placing a CTR with POD FT IOLs appeared to reduce refractive stability, although not significantly. [ J Refract Surg. 2017;33(12):802–806.]