Zonulolysis and Lens Luxation

  • Nils-Erik BoonstraEmail author


Weak capsular support can make cataract significantly more challenging. The design of the BIL implant can be of assistance in coping with these cases. Two specific techniques, lasso suturing and the bean-shaped segments, can be used to stabilize the BIL capsule complex and are described in this chapter.


Zonulolysis Lensluxation Ectopia lentis Pseudoexfoliation syndrome Lasso sutures Prolene Bean-shaped segments Capsular tension ring 

Supplementary material

Video 17.1 Lasso 1

Traumatic cataract. Zonulolysis over 4 clock hours. Vitreous in the anterior chamber. Surgery in retrobulbar anaesthesia and pars plana access. CTR implanted and one lasso suture placed. Duration: 1m 55s. (MOV 134065 kb)

Video 17.2 Lasso 2

Traumatic cataract and tonic pupil. Trauma 30 years ago. Vitreous in the anterior chamber. Zonulolysis over 5 clock hours. Surgery in retrobulbar anaesthesia with pars plana access and iris reconstruction. CTR implanted and one lasso suture placed. Duration: 1m 43s. (MOV 179082 kb)

Video 17.3 Lasso 3

ADAMTSL4 mutation with subluxated lens and only a few remaining zonulas. Capsular hooks used. CTR implanted and two lasso sutures placed. Duration: 2m 50s. (MOV 268256 kb)

Video 17.4 Bean ring 1

Subluxated lens with microphakia. Surgery in general anaesthesia. CRT and two bean rings implanted. Duration: 59s (MOV 101925 kb)

Video 17.5 Bean ring 2

Subluxated lens with microphakia. Surgery in general anaesthesia. CRT and two bean rings implanted. Surgical iridectomy performed. Duration: 1m 58s. (MOV 185175 kb)

Video 17.6 Bean ring 3

Subluxated lens due to homocysteinuria. Surgery in general anaesthesia. Capsular hooks used. CRT and two bean rings implanted. Duration: 2m 14s. (MOV 242094 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyHaukeland University HospitalBergenNorway

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