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Presbyopiekorrektur mittels Intraokularlinsen

Presbyopia correction using intraocular lenses

  • Leitthema
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Zusammenfassung

Die moderne Kataraktchirurgie hat in den letzten 20 Jahren eine enorme Weiterentwicklung von der kurativen zur funktionellen Intraokularlinsenchirurgie erfahren. Mit verbesserten operativen Techniken und Implantaten erweitern sich Patientenprofile und Indikationsstellungen immer mehr, sodass nicht nur die altersbedingte Katarakt, sondern auch die klare Linse im Rahmen eines refraktiven Linsenaustasches operiert wird. Gleichzeitig nimmt auch die Erwartungshaltung der Patienten gegenüber solchen Eingriffen deutlich zu. Der Akkommodationsverlust bedeutet für presbyope Patienten und insbesondere junge pseudophake Patienten subjektiv eine starke Einbuße an Lebensqualität. Multifokale Intraokularlinsen (MIOL) unterschiedlichen Aufbaus werden seit den 80er-Jahren implantiert. Die ersten MIOL waren vom refraktiven 2–3-Zonen-Design und vom diffraktiven Typ. In den ersten Jahren waren aufgrund der chirurgischen Techniken Komplikationen wie MIOL-Dezentrierungen und ein induzierter Astigmatismus nicht selten. Zusätzlich zeigten alle MIOL-Typen aus physikalisch-optischen Gründen ein herabgesetztes Kontrastsehvermögen und eine erhöhte Blendempfindlichkeit. Die neueren Entwicklungen der letzten Jahre auf diesem Sektor wie die faltbaren, multizonalen, progressiven refraktiven MIOL und asphärischen diffraktiven MIOL haben, insbesondere mit den verbesserten kataraktchirurgischen Techniken, viele dieser inititialen Probleme überwunden, sodass Multifokallinsen heutzutage (und eventuell auch akkommodative IOL in der Zukunft) außer zur reinen Aphakiekorrektur auch zur refraktiven Linsenchirurgie eingesetzt werden können.

Abstract

Modern cataract surgery has advanced tremendously over the past 20 years. Improved surgical techniques, as well as improved implant materials and designs, have enlarged patient profiles and indications not only for cataract surgery, but also for refractive lens exchange surgery. This has also created much higher patient expectations. The loss of accommodation is a loss of quality of life for presbyopic and especially young pseudophakic patients. Multifocal intraocular lenses (MIOL) have been implanted since 1986, starting with 2–3 zone refractive and diffractive designs. Due to the surgical techniques available at that time, MIOL decentration and surgically induced astigmatism were possible complications. In addition, reduced contrast perception and increased glare were common problems of MIOL because of their optical principles. New developments in this field in recent years such as the folding, multizonal, progressive refractive MIOL and aspheric diffractive MIOL in combination with improved surgical techniques have overcome those initial problems. Therefore, modern MIOL (and in the future also accommodative IOL) can be considered not only for the correction of aphakia but also for refractive purposes.

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Authors and Affiliations

  1. Heidelberger Forschungsgruppe IOL & Refraktive Chirurgie, Universitäts-Augenklinik Heidelberg

    M. P. Holzer, T. M. Rabsilber &  G. U. Auffarth

  2. Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg

    G. U. Auffarth

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  1. M. P. Holzer
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  2. T. M. Rabsilber
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  3. G. U. Auffarth
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Correspondence to G. U. Auffarth.

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Holzer, M.P., Rabsilber, T.M. & Auffarth, G.U. Presbyopiekorrektur mittels Intraokularlinsen. Ophthalmologe 103, 661–666 (2006). https://doi.org/10.1007/s00347-006-1382-z

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  • DOI: https://doi.org/10.1007/s00347-006-1382-z

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