AIM: To evaluate the clinical efficacy and safety of capsular tension ring(CTR)combined with iris hooks in eyes with large traumatic zonular dialysis or weakness that underwent micro-incision coaxial phacoemulsification with posterior chamber(PC)intraocular lens(IOL)implantation.

METHODS: This prospective study was carried on 21 patients(21 eyes)with traumatic cataract and traumaticzonular dialysis(<180 degrees determined pre- or intra-operatively)in our hospital from January 2011 to September 2014. After CCC, 1-4 iris hooks might be used probably and a in-the-bag CTR was inserted in order to maintain or re-establish an extended capsular diaphragm before or at any time during cataract removal. Then micro-incision coaxial phacoemulsification with foldable acrylic PC IOL implantation was performed. Zonular dialysis range, posterior capsule rupture, vitreous loss, pupil size, best corrected visual acuity(BCVA), intraocular pressure(IOP)in the pre- and post-operative periods and postoperative IOL decentration were observed after operation.

RESULTS: The mean follow-up period was 3～12mo. No serious postoperative complication was found. BCVA in our cases: <0.3 in 1 eye, 0.4～0.7 in 15 eyes, >0.8 in 5 eyes. IOPs were in normal range too. The IOLs in 20 eyes remained the required position to the final follow-up examination except one eye in which the PC IOL was dislocated into vitreous cavity due to a postoperative spontaneity PCR, and in which vitrectomy and IOL suture fixation was performed.

CONCLUSION: In cases of cataract associated with traumatic zonular dialysis(<180°), by setting the rational parameters of phacoemulsification, the CTR and iris hooks are found to be efficient in preventing IOL decentration and reducing operation complication. In our cases, the CTR combined with iris hooks is relatively safe application.