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Klinische Ergebnisse unter besonderer Berücksichtigung von Dezentrierung und Verkippung der asphärischen Intraokularlinse FY-60AD

Clinical results of the aspheric intraocular lens FY-60AD (Hoya) with particular respect to decentration and tilt

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Zusammenfassung

Hintergrund

Asphärische Intraokularlinsen sollen durch eine Neutralisierung der sphärischen Aberration (SA) eine Funktionsverbesserung insbesondere des Kontrastsehens bewirken. Es ist andererseits bekannt, dass asphärische Linsen bei stärkerer Dezentrierung und Verkippung die Abbildungsqualität sogar verschlechtern können.

Methoden

In einer prospektiven Studie wurden 30 Patienten eingeschlossen, bei denen beidseits nach Phakoemulsifikation die asphärische Linse FY-60AD (Hoya) implantiert worden war. Bei 25 Patienten (50 Augen) wurden nach 3 Monaten folgende Parameter untersucht: Visus, Refraktion, Kontrastempfindlichkeit, Pupillenweite, Wellenfrontfehler sowie Dezentrierung und Verkippung mit einem neuen Verfahren.

Ergebnisse

Die funktionellen Ergebnisse waren sehr gut und entsprachen jenen mit anderen asphärischen Linsen. Die Refraktion betrug zu diesem Kontrollzeitpunkt: sph +0,1 dpt (±0,7 dpt), zyl 0,6 dpt (±0,8 dpt). Das sphärische Äquivalent lag bei −0,2 dpt (±0,6 dpt). Die Wellenfrontmessungen ergaben eine weitgehende Kompensation der kornealen sphärischen Aberration. Aber auch vertikale und horizontale Koma zeigten gegenläufige Werte an Hornhaut und Linse. Die Positionsbestimmung mit einem Purkinje-Meter ergab unkritische Werte für Dezentrierung und Verkippung. Die mittlere Dezentrierung (Absolutwerte) lag bei 0,2±0,2 mm in horizonataler und vertikaler Richtung. Die mittlere Verkippung (Absolutwerte) lag bei 4,0±2,1 °in horizontaler und 3,0±2,5 ° in vertikaler Richtung.

Schlussfolgerung

Die asphärische Intraokularlinse FY-60AD führt bei mittlerer Dioptrienstärke zu einer Kompensation der kornealen sphärischen Aberration und ist sehr gut zentriert. Die geringgradige Verkippung entspricht der einer natürlichen Linse im jugendlichen Auge. Sie trägt möglicherweise zu der beobachteten Kompensation der kornealen Koma bei.

Abstract

Background

Aspheric intraocular lenses (IOLs) aim to improve visual function and particularly contrast vision by neutralizing spherical aberration. One drawback of such IOLs is the enhanced sensitivity to decentration and tilt, which can deteriorate image quality.

Methods

A total of 30 patients who received bilateral phacoemulsification before implantation of the aspheric lens FY-60AD (Hoya) were included in a prospective study. In 25 of the patients (50 eyes) the following parameters could be assessed 3 months after surgery: visual acuity, refraction, contrast sensitivity, pupil size, wavefront errors and decentration and tilt using a newly developed device.

Results

The functional results were very satisfying and comparable to results gained with other aspheric IOLs. The mean refraction was sph + 0.1 D (±0.7 D) and cyl 0.6 D (±0.8 D). The spherical equivalent was −0.2 D (±0.6 D). Wavefront measurements revealed a good compensation of the corneal spherical aberration but vertical and horizontal coma also showed opposing values in the cornea and IOL. The assessment of the lens position using the Purkinje meter demonstrated uncritical amounts of decentration and tilt. The mean amount of decentration was 0.2 mm±0.2 mm in the horizontal and vertical directions. The mean amount of tilt was 4.0±2.1° in horizontal and 3.0±2.5° in vertical directions.

Conclusions

In a normal dioptric power range the aspheric IOL FY-60AD compensates the corneal spherical aberration very well with only minimal decentration. The slight tilt is symmetrical in both eyes and corresponds to the position of the crystalline lens in young eyes. This may contribute to our findings of compensated corneal coma.

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  1. Augenklinik des Knappschaftskrankenhauses, An der Klinik 10, 66280, Sulzbach, Deutschland

    U. Mester, S. Heinen &  H. Kaymak

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  1. U. Mester
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  2. S. Heinen
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  3. H. Kaymak
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Correspondence to U. Mester.

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Mester, U., Heinen, S. & Kaymak, H. Klinische Ergebnisse unter besonderer Berücksichtigung von Dezentrierung und Verkippung der asphärischen Intraokularlinse FY-60AD. Ophthalmologe 107, 831–836 (2010). https://doi.org/10.1007/s00347-009-2102-2

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