Zonular repair addresses weakness or breakage of the tiny fibres (zonules) that suspend the lens inside the eye. Damage can arise from trauma, pseudoexfoliation, or congenital conditions.
Surgical Techniques
During cataract or lens surgery, devices such as capsular tension rings, hooks, or sutures help support the capsule when zonules are deficient. In more severe cases, lenses may be sutured to the iris or sclera instead.
- Early recognition of zonular weakness is critical for surgical planning
- Support devices distribute forces around the capsule to reduce further tearing
- Special instrumentation aids safe lens removal and implantation
- Complex cases may require referral to experienced anterior segment surgeons
Outcomes
Effective zonular repair allows stable placement of an intraocular lens and reduces the risk of later dislocation. However, these eyes remain at higher risk of complications.
- Post‑operative monitoring checks lens centration and capsule integrity
- Late IOL subluxation is possible and may require repositioning
- Patients should avoid significant trauma and report visual change promptly
- Long‑term follow‑up with imaging can be helpful in high‑risk cases
