Effect of Capsular Tension Ring on Refractive Outcomes in Patients With Implantation of the Quadrifocal Acrysof PanOptix TFNT00 IOL

Purpose To evaluate the effect of a capsular tension ring (CTR) on refractive outcomes in eyes undergoing implantation of the quadrifocal Acrysof PanOptix TFNT00 intraocular lens (IOL) (Alcon Laboratories, Inc). Methods A retrospective case-control study was undertaken of 91 eyes implanted with the TFNT00 IOL. Of these 91 eyes, a CTR was implanted in 33 and these eyes were compared to the 58 eyes in which a CTR was not implanted. The main outcome measure was the mean absolute error (MAE) of the refractive prediction error. To evaluate the consistency of refractive outcomes, variance of MAE was measured. Using a swept-source optical coherence tomography device, postoperative aqueous depth (AQD) was measured to estimate the position of the IOL. Results Eyes with a CTR showed a significantly smaller MAE when compared with eyes without a CTR (P = .038 at 1 m, P = .003 at 2 m, and P = .001 at 6 m). There was a lower variance of MAE in the eyes implanted with a CTR, with higher precision of refraction (P = .058 at 1 m, P = .007 at 2 m, and P = .001 at 6 m). There was a significant difference in the percentage of the eyes showing more than 0.50 D from the estimated target of the Barrett Universal II formula (P = .007 at 1 m, P = .064 at 2 m, and P = .004 at 6 m, respectively). AQD was significantly shallower in eyes with a CTR than in eyes without a CTR (P = .006). Conclusions Use of the CTR enhanced the accuracy of postoperative refractive outcomes after TFNT00 IOL implantation by preventing the posterior bowing of the optic-haptic junction. [J Refract Surg. 2021;37(3):174-179.].