Zonule Problems

One of the most dreaded moments during cataract surgery is the discovery of zonular instability.

The zonules hold the capsule in place. The capsule contains the cataract. Since the goal of cataract surgery is usually to take the cataract out of the capsule and the place an artificial lens implant into the capsule, having a rock solid capsule is important. Problems with the zonules impede a rock solid capsule, which is why this is such an issue.

In the March 2025 edition of the Journal of Cataract & Refractive Surgery, Dr. Abdelrahman Elhusseiny and colleagues published an article. It provided data for what many of us already felt we knew from experience–zonule problems in the right eye increase the chances of zonule problems in the left eye. Once zonule issues occur in one eye, I am always on high alert for them in the same patient’s other eye.