Skip to main content
SpringerLink
Log in

Biometrie in Katarakt-Camps

Erfahrungen aus Nordkenia

Biometry in cataract camps

Experiences from north Kenya

  • Originalien
  • Published:
Der Ophthalmologe Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Biometriemessungen haben das Potenzial, die refraktiven Ergebnisse der Kataraktchirurgie in Entwicklungsländern zu verbessern. Ihre Durchführung ist jedoch in entlegenen Gegenden logistisch schwierig.

Patienten und Methoden

Bei Kataraktpatienten in einem Camp in Nordkenia wurde eine Biometrie mit tragbaren Geräten versucht, und es wurden Gründe für ein Biometrieversagen notiert. PMMA-Linsen der Stärke 17–27 dpt wurden implantiert und ein Modell zur Berechnung des postoperativen Refraktionsfehlers bei Verwendung von Standardlinsen (22 dpt) generiert.

Ergebnisse

In 104 von 131 Augen (80%) war die Biometrie möglich. Hornhautschäden waren der Hauptgrund für ein Scheitern. Die durchschnittliche berechnete Linsenstärke für Emmetropie betrug 21,56 dpt, SD:1,96 (min: 14,78 dpt, max: 27,24 dpt). Bei Verwendung von 22 dpt Standardlinsen hätten 20% aller Patienten einen Refraktionsfehler von mehr als 2 dpt und 7% einen Fehler von mehr als 3 dpt gehabt.

Schlussfolgerung

Okuläre Komorbidität erschwert Biometrie in entlegenen Gegenden. Dennoch erscheint ihr Einsatz sinnvoll und ist notwendig, um postoperative Refraktionsfehler zu begrenzen. Ohne Biometrie kann ein schlechtes refraktives Ergebnis bei mindestens 20% aller Operierten erwartet werden.

Abstract

Background

Biometry has the potential to improve refractive outcomes of cataract surgery in developing countries. However, the procedure is difficult to carry out in remote areas.

Patients and methods

The feasibility of automated biometry using portable devices was assessed in an eye camp in a remote Kenyan community and reasons for failure were documented. PC-IOLs in the range of 17–27 dioptres (dpt) were implanted and a model was created to predict spherical refractive error if a standard 22 dpt lens had been used.

Results

In 104 out of 131 eyes (80%) biometry was possible. Failure to obtain K-readings in eyes with coexisting corneal pathology was the main limiting factor. The calculated mean IOL strength to achieve emmetropia was 21.56 dpt with a SD=1.96 (min: 14.78 dpt, max: 27.24 dpt). If 22dpt lenses had been implanted around 20% would have had an error of more than 2 dpt and 7% an error of more than 3 dpt.

Conclusion

Biometry is a challenging procedure in remote areas where comorbidities are common. However, without biometry and implantation of different IOL powers poor refractive outcome can be expected in around 20% of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Briesen S, Roberts H, Ilako D et al (2009) Are blind people more likely to accept free cataract surgery? A study of vision-related quality of life and visual acuity in Kenya. Ophthalmic Epidemiol (in press)

  2. Courtright P, Ndegwa L, Msosa J, Banzi J (2007) Use of our existing eye care human resources: assessment of the productivity of cataract surgeons trained in eastern Africa. Arch Ophthalmol 125(5):684–687

    Article  PubMed  Google Scholar 

  3. Dandona L, Dandona R, Naduvilath TJ et al (1999) Population-based assessment of the outcome of cataract surgery in an urban population in southern India. Am J Ophthalmol 127:650–658

    Article  CAS  PubMed  Google Scholar 

  4. Dang M, Raj P (1989) SRK II formula in the calculation of intraocular lens power. Br J Ophthalmol 73:823–826

    Article  CAS  PubMed  Google Scholar 

  5. Hennig A, Kumar J, Yorston D, Foster A (2003) Sutureless cataract surgery with nucleus extraction: outcome of a prospective study in Nepal. Br J Ophthalmol 87:266–270

    Article  CAS  PubMed  Google Scholar 

  6. Holladay JT, Prager TC, Chandler TY et al (1988) A three-part system for refining intraocular lens power calculations. J Cataract Refract Surg 14(1):17–24

    CAS  PubMed  Google Scholar 

  7. Jivrajka R, Shammas MC et al (2008) Variability of axial length, anterior chamber depth, and lens thickness in the cataractous eye. J Cataract Refract Surg 34(2):289–294

    Article  PubMed  Google Scholar 

  8. Kimura H, Kuroda S, Mizoguchi N et al (1999) Extracapsular cataract extraction with a sutureless incision for dense cataracts. J Cataract Refract Surg 25:1275–1279

    Article  CAS  PubMed  Google Scholar 

  9. La Nauze J, Kim Thanh T, Dinh Lap T et al (1999) Intraocular lens power prediction in a vietnamese population. A study to establish a limited set of intraocular lens powers that could be used in a vietnamese population. Ophthalmic Epidemiol 6(3):147–158

    Article  Google Scholar 

  10. Limburg H, Kumar R (1998) Follow-up study of blindness attributed to cataract in Karnataka State, India. Ophthalmic Epidemiol 5:211–223

    Article  CAS  PubMed  Google Scholar 

  11. Lindfield R, Kuper H, Polack S et al (2009) Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh. Br J Ophthalmol 93:875–880

    Article  CAS  PubMed  Google Scholar 

  12. Murray NL, Murray T (2009) The burden of ocular comorbidity in cataract patients in West Africa. Br J Ophthalmol 93:124–125

    Article  CAS  PubMed  Google Scholar 

  13. Sanders DR, Retzlaff JA, Kraff MC (1988) Comparison of the SRK II formula and other second generation formulae. J Cataract Refract Surg 14:136–141

    CAS  PubMed  Google Scholar 

  14. Sanders DR, Retzlaff JA, Kraff MC et al (1990) Comparison of the SRK/T formula and other theoretical and regression formulas. J Cataract Refract Surg 16(3):341–346

    CAS  PubMed  Google Scholar 

  15. Wanjiru Kabiru J, Kollmann M, Karimurio J (2001) What is the right intraocular lens power for cataract surgery on eye safaris? Postgraduate Dissertation, University of Nairobi

  16. Zhao J, Sui R, Jia L et al (1998) Visual acuity and quality of life outcomes in patients with cataract in Shunyi County, China. Am J Ophthalmol 126:515–523

    Article  CAS  PubMed  Google Scholar 

Download references

Danksagung

Der Einsatz wurde von der MEAK Charity (Medical and Educational Aid to Kenya) finanziert. Die Instrumente wurden von SightSavers Int. und dem Dept. of Ophthalmology, University of Nairobi (CBM Donation), zur Verfügung gestellt.

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Kwale District Eye Centre, 901-801, Mombasa, Kenia

    S. Briesen & H. Roberts

  2. Department of Ophthalmology, College of Health Sciences, University of Nairobi, Nairobi, Kenia

    J. Karimurio & M. Kollmann

Authors
  1. S. Briesen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Roberts
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Karimurio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Kollmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Briesen.

Additional information

Die vorliegende Studie wurde vom kenianischen Gesundheitsministerium (Abteilung für ophthalmologische Prävention) genehmigt. Die Prinzipien der Deklaration von Helsinki wurden befolgt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Briesen, S., Roberts, H., Karimurio, J. et al. Biometrie in Katarakt-Camps. Ophthalmologe 107, 354–358 (2010). https://doi.org/10.1007/s00347-009-2021-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00347-009-2021-2

Schlüsselwörter

Keywords

Search

Navigation