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Capsular Tension Ring Implantation for Intraocular Lens Power Calculation in Highly Myopic Eyes: Secondary Analysis of a Randomized Clinical Trial

Haowen Lin, Jiaqing Zhang, Aixia Jin, Yi-Fan Zhang, Yu Zhang, Ling Jin, Yifan Xu, Xiaohang Xie et al.

JAMA ophthalmology, 2025

186 participants · 7 citations

Abstract

Importance

Capsular tension ring (CTR) implantation has been shown to reduce intraocular lens (IOL) decentration and tilt in high myopia. However, the effect of CTR implantation in highly myopic eyes on IOL power calculation remains unclear, particularly in new-generation formulas.

Objective

To evaluate the influence of CTR implantation on IOL power calculation in highly myopic eyes.

Design, Setting, and Participants

This is a prespecified secondary analysis of outcomes of a randomized clinical trial conducted between November 2021 and September 2023 at the Zhongshan Ophthalmic Center in Guangzhou, China. Cataract patients with an axial length (AL) of 26 mm or longer were enrolled and stratified into 3 strata based on AL (stratum 1: AL 26-<28 mm; stratum 2: AL 28-<30 mm; stratum 3: AL ≥30 mm).

Interventions

Participants were stratified based on AL and randomized to the CTR group (a C-loop IOL combined with a CTR) or the control group (only a C-loop IOL) within each stratum.

Main Outcomes and Measures

Predictive outcomes of 6 new-generation formulas and 4 traditional formulas were evaluated. The arithmetic and absolute prediction error (PE) and the percentages of eyes within ±0.25 diopter (D), ±0.50 D, ±0.75 D, and ±1.00 D of PE were analyzed.

Results

A total of 186 eyes of 186 participants were randomized into the CTR group (93 eyes [50%]) or control group (93 eyes [50%]). Excluding a withdrawal case and 24 eyes with best-corrected visual acuity less than 20/40, 80 eyes in…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 186 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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