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Intraokularlinsen zur Korrektur von Refraktionsfehlern

Teil II: Phake Hinterkammerlinsen und refraktiver Linsenaustausch mit Hinterkammerlinsenimplantation

Intraocular lenses for the correction of refraction errors

Part II. Phakic posterior chamber lenses and refractive lens exchange with posterior chamber lens implantation

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Zusammenfassung

Im vorliegenden Übersichtsartikel wird der derzeitige Stand der Intraokularlinsenchirurgie zur Korrektur von Refraktionsfehlern dargestellt. Man unterscheidet zwischen additiver Chirurgie mit Kunstlinsenimplantation ohne Extraktion der kristallinen Linse [phake Intraokularlinse (PIOL)] und der Entfernung der natürlichen Linse mit Implantation einer Kunstlinse [refraktiver Linsenaustausch (RLA)]. Die phaken Intraokularlinsen (PIOL) werden in kammerwinkelgestütze und irisgetragene Vorderkammerlinsen sowie sulkusfixierte Hinterkammerlinsen unterteilt. Die Implantation der phaken IOL hat sich als effektives, sicheres, vorhersagbares und stabiles Verfahren zur Korrektur von höheren Ametropien erwiesen. Komplikationen sind selten und zwischen den 3 verschiedenen PIOL-Typen unterschiedlich, bei den Hinterkammerlinsen handelt es sich um Kataraktentwicklung und Pigmentdispersion. Der refraktive Linsenaustausch (RLA) wird bevorzugt dann bei hohen Ametropien eingesetzt, wenn keine Akkommmodationsleistung der natürlichen Linse mehr zu erwarten ist. Zu den Komplikationsmöglichkeiten des myopen RLA gehören die Netzhautablösung, zu denen des hyperopen RLA operative Schwierigkeiten bedingt durch das kurze Vordersegment.

Abstract

In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses which are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for posterior chamber lenses these are mainly cataract formation and pigment dispersion. RLE is preferable in cases of high ametropia in which the natural lens has lost its accommodative effect. The main complications for myopic RLA include retinal detachment, while hyperopic refractive lens exchange may be associated with surgical problems in the narrower anterior eye segment.

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Interessenkonflikt:

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Die Arbeitsgruppe von Prof. Kohnen an der Universitätsaugenklinik Frankfurt war an mehreren geförderten Studien zur Beurteilung von phaken Intraokularlinsen beteiligt. Keiner der Autoren hat jedoch eine finanzielles Interesse an einer der in diesem Artikel genannten Intraokularlinsen.

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  1. Klinik für Augenheilkunde, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main

    T. Kohnen, T. Kasper & E. Terzi

  2. Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA

    T. Kohnen

  3. Klinik für Augenheilkunde, Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 , Frankfurt am Main

    T. Kohnen

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  1. T. Kohnen
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  2. T. Kasper
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  3. E. Terzi
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Correspondence to T. Kohnen.

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Kohnen, T., Kasper, T. & Terzi, E. Intraokularlinsen zur Korrektur von Refraktionsfehlern. Ophthalmologe 102, 1105–1119 (2005). https://doi.org/10.1007/s00347-005-1274-7

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  • DOI: https://doi.org/10.1007/s00347-005-1274-7

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