Influence of capsular tension ring implantation on rotational stability of intraocular lenses
Reviewed by Su Young

This is a systematic review and meta-analysis aiming to determine the effect of capsular tension ring (CTR) placement on intraocular lens (IOL) rotational stability. Twelve studies (1251 eyes; 639 CTR, 612 non-CTR) were included from literature search of PubMed, EMBASE, Web of Science, CENTRAL and Google Scholar databases up to October 2025. The authors found that CTR implantation did not significantly reduce mean IOL rotation (mean difference (MD) 0.40 degrees; 95% CI, -1.20 to 0.39; p=0.322). No significant differences were observed for the proportion of eyes with rotation exceeding 5 degrees (p=0.150), 10 degrees (p=0.065), or 15 degrees (p=0.176). For IOL misalignment, the overall pooled effect was not significant (MD 1.46 degrees; 95% CI, -3.08 to 0.17; p=0.079). However, subgroup analysis demonstrated a significant interaction by haptic design (p=0.005). Capsular tension ring implantation significantly reduced misalignment for loop-haptic IOLs (MD 1.25 degrees; 95% CI, 1.73 to -0.77; p<0.001) and for plate-haptic IOLs (MD 3.18 degrees; 95% CI, -6.29 to -0.08; p=0.045). The proportion of IOL misalignment exceeding 5 degrees was significantly lower in the CTR group (RR 0.53; 95% CI, 0.31 to 0.89; p=0.018). For cataract surgeons, this review reaffirms current usage of CTRs in phacoemulsification of complex cataracts. Detailed preoperative assessment and intraoperative planning will enable effective management of intraoperative difficulties.

Influence of capsular tension ring implantation on rotational stability of intraocular lenses: a systematic review and meta-analysis. 
Liu D, Hu L, Qin R, et al.
SEMINARS IN OPHTHALMOLOGY
2026;1–11 [ePub ahead of print].