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Asphärische Intraokularlinsen

Aspheric intraocular lenses

Der Ophthalmologe volume 105, pages 234–240 (2008)Cite this article

Zusammenfassung

Hintergrund

Die Implantation von Intraokularlinsen (IOL) ist in den vergangenen Jahren zu einem sicheren, effektiven, stabilen und gut vorhersagbaren Verfahren der Katarakt- und refraktiven Linsenchirurgie geworden. Vermehrt richtet sich nun die Aufmerksamkeit auf die mit den IOLs zu erreichende optische Qualität. Da sich die sphärische Abberation der natürlichen Augenlinse mit dem Alter vom Negativen zum Positiven wandelt und so die optische Qualität verschlechtert, sollte eine asphärische Intraokularlinse mit negativer, neutraler oder individuell bestimmter sphärischer Aberration, welche der juvenilen natürlichen Augenlinse nachempfunden ist, die optische Qualität verbessern. Zur Bewertung der optischen Qualität werden Parameter wie der Visus, die Kontrast- und Blendempfindlichkeit, das Nachtsehen, die Abbildungsfehler höherer Ordnung und subjektive Fragebögen herangezogen.

Methode

Die Arbeit gibt eine Übersicht über verschiedene Arten und Prinzipien von asphärischen Intraokularlinsen, über aktuelle wissenschaftliche Studien zum Thema und zeigt die Kriterien, nach denen der Nutzen dieser Linsen bewertet wird auf.

Ergebnisse

Ein positiver Effekt von asphärischen Intraokularlinsen konnte in mehreren Studien gezeigt werden. Der Ausgleich von positiver sphärischer Aberration der Hornhaut durch asphärische Intraokularlinsen kann jedoch oft erst bei weiten Pupillen demonstriert werden. Für junge Patienten mit deutlich weiterer skotopischer und mesopischer Pupille sollten bevorzugt asphärische Intraokularlinsen implantiert werden. Es wird auch zu berücksichtigen sein, dass sich verschiedene Abbildungsfehler niedriger und höherer Ordnung im optischen System Auge gegenseitig beeinflussen. Da sich die sphärische Aberration individuell sehr unterscheidet, kann auch eine Individualisierung der Asphärizität sinnvoll sein, entweder durch die Wahl verschiedener IOLs je nach vorliegender sphärischer Aberration der Hornhaut oder durch eine individuelle Gestaltung der IOL-Oberfläche.

Schlussfolgerung

Der Einsatz von asphärischen Intraokularlinsen als Linsenersatz bewirkt eine Reduktion der sphärischen Aberrationen des Auges und kann eine Verbesserung der optischen Qualität bewirken.

Abstract

Background

Over the last years, the implantation of intraocular lenses (IOLs) has become a safe, effective, stable, and well-predictable procedure of lens replacement surgery. Therefore, manufacturers and surgeons have given special attention to the optical quality these lenses can achieve. Because spherical aberration of the natural lens changes in life from negative to positive values and hence impairs optical quality, implanting an aspheric IOL based on the young natural lenses’ asphericity parameters, inducing negative, neutral, or individual spherical aberration, should improve the optical quality. Parameters used to evaluate optical quality are visual acuity, contrast sensitivity, glare disability, night vision, higher-order aberrations, and subjective questionnaires.

Method

This article provides a survey of different kinds and principles of aspheric IOLs, current trials, and criteria used to estimate lens benefits.

Results

Benefits of aspheric lenses have been shown in several studies. However, adjustment of the cornea’s positive spherical aberration by an aspheric IOL can be demonstrated only in larger pupils. For young patients with distinctly larger mesopic and scotopic pupils who undergo refractive lens exchange, aspheric IOLs should be implanted. As higher-order and lower-order aberrations of the eye interact with each other, this fact will have to be taken into consideration when correcting spherical aberration. Spherical aberrations differ interindividually; therefore, individualisation of asphericity may be useful, either by choosing different IOLs depending on the eye’s spherical aberration or by individual IOL surface design.

Conclusion

The use of aspheric IOLs for lens replacement reduces spherical aberration and therefore improves the optical quality of the eye.

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Affiliations

  1. Klinik für Augenheilkunde, Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland

    T. Kohnen & O.K. Klaproth

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

    T. Kohnen

Authors
  1. T. Kohnen
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  2. O.K. Klaproth
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Correspondence to T. Kohnen.

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Kohnen, T., Klaproth, O. Asphärische Intraokularlinsen. Ophthalmologe 105, 234–240 (2008). https://doi.org/10.1007/s00347-008-1718-y

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Schlüsselwörter

  • Sphärische Aberration
  • Asphärizität
  • Asphärische Intraokularlinsen
  • Optische Qualität

Keywords

  • Spherical aberration
  • Asphericity
  • Aspheric intraocular lenses
  • Optical quality