Skip to main content
SpringerLink
Log in

Funktionelle Ergebnisse nach Korrektur der Presbyopie mittels bilateraler intrastromaler Femtosekundenlaserbehandlung

Functional results after bilateral intrastromal femtosecond laser correction of presbyopia

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

Zusammenfassung

Hintergrund

Ziel der Studie war es, die Ergebnisse nach bilateraler Presbyopiekorrektur mittels intrastromaler Femtosekundenlaserbehandlung (INTRACOR) zu evaluieren.

Material und Methoden

In diese prospektive Studie wurden 17 Patienten eingeschlossen, die zuvor zweizeitig bilateral behandelt wurden. Postoperativ (4 bis 8 Monate) wurden die Ergebnisse mit einer unilateral am nichtdominanten Auge behandelten Kontrollgruppe (n = 17, 24 Monate postoperativ) verglichen.

Ergebnisse

Der binokulare fernkorrigierte Nahvisus (DCNVA) zeigte bei gleichem Median eine geringere Streuung nach bilateraler Behandlung [logMAR (min/max): 0,10 (0,30/− 0,10; Studie) vs. 0,10 (0,50/− 0,10; Kontrolle)]. In der Studiengruppe fand sich jedoch ein höherer Zeilenverlust des binokularen korrigierten Fernvisus (CDVA; 0, − 1, − 2 Zeilen): 23,5%, 70,6%, 5,9% (Studie) vs. 35,3%, 64,7%, 0% (Kontrolle).

Schlussfolgerung

Im Hinblick auf die CDVA-Reduktion sollte die INTRACOR-Behandlung initial nur am nichtdominanten Auge erfolgen. In ausgewählten Fällen kann eine bilaterale Korrektur bei sorgfältiger Risiko-Nutzen-Abwägung sowie Patientenaufklärung den DCNVA verbessern.

Abstract

Purpose

The purpose of this study was to evaluate the results of bilateral intrastromal femtosecond laser correction of presbyopia (INTRACOR).

Methods

In a prospective study 17 patients were enrolled who had previously received binocular treatment in a two-step approach. Postoperative (4–8 months) outcomes were compared with a matched control group who had undergone only unilateral surgery of the non-dominant eye (n = 17 patients, 24 months after surgery).

Results

The binocular distance corrected near visual acuity (DCNVA) showed the same median but lower scattering of values after bilateral treatment: 0.10 (median in logMAR) (0.30/− 0.10 min/max) (study) versus 0.10 (0.50/− 0.10) (control). In the study group, however, a higher loss of binocular corrected distance visual acuity (CDVA) was found: 23.5 %, 70.6 %, 5.9 % (0, − 1, − 2 lines) (study) versus 35.3 %, 64.7 % and 0 %, repectively (control).

Conclusions

Regarding the reduced CDVA INTRACOR should initially only be performed in the non-dominant eye. In selected cases binocular treatment can improve DCNVA; however, careful risk-benefit assessment and informed consent are necessary.

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
Abb. 4
Abb. 5

Literatur

  1. Auffarth GU (2002) Accommodative intraocular lenses. Can synthetic lenses accommodate? Ophthalmologe 99:809–810

    Article  CAS  PubMed  Google Scholar 

  2. Auffarth GU, Rabsilber TM, Kohnen T et al (2008) Design and optical principles of multifocal lenses. Ophthalmologe 105:522–526

    Article  CAS  PubMed  Google Scholar 

  3. Becker KA, Jaksche A, Holz FG (2006) PresbyLASIK: treatment approaches with the excimer laser. Ophthalmologe 103:667–672

    Article  CAS  PubMed  Google Scholar 

  4. Bischoff G (2006) Compensation for presbyopia using contact lenses. Ophthalmologe 103:655–658, 660

    Article  CAS  PubMed  Google Scholar 

  5. Dexl AK, Seyeddain O, Riha W et al (2011) Reading performance after implantation of a small-aperture corneal inlay for the surgical correction of presbyopia: two-year follow-up. J Cataract Refract Surg 37:525–531

    Article  PubMed  Google Scholar 

  6. Dexl AK, Seyeddain O, Riha W et al (2012) One-year visual outcomes and patient satisfaction after surgical correction of presbyopia with an intracorneal inlay of a new design. J Cataract Refract Surg 38:262–269

    Article  PubMed  Google Scholar 

  7. Fintelmann RE, Naseri A (2010) Prophylaxis of postoperative endophthalmitis following cataract surgery: current status and future directions. Drugs 70:1395–1409

    Article  CAS  PubMed  Google Scholar 

  8. Fitting A, Ehmer A, Rabsilber TM et al (2011) Agreement of subjective and objective refraction measurements following INTRACOR femtosecond laser treatment. Ophthalmologe 108:852–858

    Article  CAS  PubMed  Google Scholar 

  9. Fitting A, Menassa N, Auffarth GU et al (2012) Effect of intrastromal correction of presbyopia with femtosecond laser (INTRACOR) on mesopic contrast sensitivity. Ophthalmologe 109:1001–1007

    Article  CAS  PubMed  Google Scholar 

  10. Holzer MP, Knorz MC, Tomalla M et al (2012) Intrastromal femtosecond laser presbyopia correction: 1-year results of a multicenter study. J Refract Surg 28:182–188

    Article  PubMed  Google Scholar 

  11. Holzer MP, Mannsfeld A, Ehmer A et al (2009) Early outcomes of INTRACOR femtosecond laser treatment for presbyopia. J Refract Surg 25:855–861

    Article  PubMed  Google Scholar 

  12. Holzer MP, Rabsilber TM, Auffarth GU (2006) Presbyopia correction using intraocular lenses. Ophthalmologe 103:661–666

    Article  CAS  PubMed  Google Scholar 

  13. Klaproth OK, Titke C, Baumeister M et al (2011) Accommodative intraocular lenses – principles of clinical evaluation and current results. Klin Monatsbl Augenheilkd 228:666–675

    Article  CAS  PubMed  Google Scholar 

  14. Knorz MC (2008) Multifocal intraocular lenses: overview of their capabilities, limitations, and clinical benefits. J Refract Surg 24:215–217

    PubMed  Google Scholar 

  15. Kohnen T, Kook D, Auffarth GU et al (2008) Use of multifocal intraocular lenses and criteria for patient selection. Ophthalmologe 105:527–532

    Article  CAS  PubMed  Google Scholar 

  16. Kohnen T, Neuhann T, Knorz M (2011) Evaluation and quality assurance of refractive surgery procedures by the German Ophthalmological Society and the Professional Association of German Ophthalmologists. Status: May 2011. Ophthalmologe 108:869–882

    Article  CAS  PubMed  Google Scholar 

  17. Menassa N, Fitting A, Auffarth GU et al (2012) Visual outcomes and corneal changes after intrastromal femtosecond laser correction of presbyopia. J Cataract Refract Surg 38:765–773

    Article  PubMed  Google Scholar 

  18. Ruiz LA, Cepeda LM, Fuentes VC (2009) Intrastromal correction of presbyopia using a femtosecond laser system. J Refract Surg 25:847–854

    Article  PubMed  Google Scholar 

  19. Semoun O, Bourcier T, Dupas B et al (2008) Early bacterial keratitis after presbyopic LASIK. Cornea 27:114–116

    Article  PubMed  Google Scholar 

  20. Yilmaz OF, Bayraktar S, Agca A et al (2008) Intracorneal inlay for the surgical correction of presbyopia. J Cataract Refract Surg 34:1921–1927

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: IVCRC wird von Technolas Perfect Vision GmbH, München, mit Forschungsgeldern unterstützt. Beratung: Prof. Holzer. Erstattungen von Reisekosten: Prof. Holzer, Prof. Auffarth. Vortragshonorare: Prof. Holzer, Prof. Auffarth, PD Dr. Rabsilber.

Author information

Authors and Affiliations

  1. International Vision Correction Research Centre (IVCRC), Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    R. Khoramnia, M. P. Holzer, A. Fitting, G. U. Auffarth &  T. M. Rabsilber

Authors
  1. R. Khoramnia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. P. Holzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Fitting
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. U. Auffarth
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. M. Rabsilber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. M. Rabsilber.

Additional information

__ ____

Dieses Manuskript basiert auf einem Vortrag, gehalten auf dem DOG-Kongress 2012.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Khoramnia, R., Holzer, M., Fitting, A. et al. Funktionelle Ergebnisse nach Korrektur der Presbyopie mittels bilateraler intrastromaler Femtosekundenlaserbehandlung. Ophthalmologe 110, 1163–1170 (2013). https://doi.org/10.1007/s00347-012-2760-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00347-012-2760-3

Schlüsselwörter

Keywords

Search

Navigation