Long-Term Suture Breakage After Scleral Fixation of a Modified Capsular Tension Ring with Polypropylene 10-0 Suture

AIM: To investigate the long-term risk of suture breakage after implantation of a modified capsular tension ring (MCTR) fixated to the sclera with polypropylene 10–0 suture. METHODS: Retrospective case series of operations for subluxated phakic lenses in 2007–2015 with implantation of an MCTR secured with a 10–0 polypropylene suture as part of an intraocular lens (IOL)-capsular bag complex. RESULTS: We identified 132 eyes (92 patients) operated on with an MCTR. Of these eyes, 26 (20%) had suture breakage requiring re-operation, while another eight eyes (6%) had suture breakage that did not require surgery. The re-operations occurred after a mean 4.8±3.3 years. Suture breakage occurred in patients with a mean age of 34.0±23.3, as compared to 43.2±26.0 years for patients who did not experience this complication (p=0.36). In patients aged 40 years or younger at the time of surgery, 47% experienced suture breakage in one or both eyes, as compared to 19% in the age group 41–69 years and 13% in the age group 70 years and older (p=0.004). Of the 132 eyes that were operated on, we registered one case (0.8%) of possible suture-related late endophthalmitis. CONCLUSION: The long-term risk of suture breakage was quite high after scleral fixation of the MCTR in this patient cohort, and it seems as the risk is increased with young age.