Capsular tension rings (CTRs) were first described 30 years ago as a means of maintaining capsular circular contour with the additional benefit of preventing epithelial cell invasion of the posterior capsule [1]. CTRs help redistribute tension in the setting of zonular weakness and so maintain capsule integrity during cataract surgery. Other indications for CTR use include traumatic cataract, pseudoexfoliation syndrome and systemic conditions associated with zonular weakness such as Marfan’s syndrome [2]. Although their planned use can be anticipated during pre-operative evaluation, they may also be utilised due to changing intra-operative complexities.

The published literature reports that ~1% of cataract operations will require the use of a CTR [3, 4]. In some countries, CTR use is related to premium IOL usage or routinely used in highly myopic patients, and this could influence reporting of use of this surgical adjunct [5]. As ~42,000 cataract operations are performed yearly within NHS Scotland, it follows that ophthalmic trainees should be aware of the indications for CTR use, and familiar with the relevant insertion techniques.

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