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Irisnahtfixierte Hinterkammerlinse

Neue Perspektiven für eine bekannte Technik

Iris suture fixation of posterior chamber lenses

New perspectives for an old technique

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Zusammenfassung

Hintergrund

Strategien zum primären oder sekundären Aphakieausgleich umfassen Vorderkammerlinsenimplantationen, die Fixation einer Iris-Clip-Linse mittels Enklavation und nahtfixierter Hinterkammerlinse transskleral oder an der Iris.

Ziel der Arbeit

Indikation und Kontraindikation zur Irisnahtfixation, Darstellung der operativen Technik, Komplikationen, Ergebnisse, Vergleich mit alternativen Techniken.

Material und Methoden

Basierend auf einer selektiven Literaturrecherche in PubMed Analyse, Zusammenfassung und Diskussion von Originalarbeiten und Reviews.

Ergebnisse

Aktuelle operative Techniken haben der Irisnahtfixation mit guten anatomischen und funktionellen Ergebnissen neue Impulse gegeben und sie zu einer vielversprechenden Alternative werden lassen. Weitere Indikationen sind die minimal-invasive Reposition dezentrierter Intraokularlinsen (IOL) und die Refixation eines dislozierten Kapselsack-IOL-Komplexes („late-in-the-bag“), einer Spätkomplikation der Kataraktchirurgie mit zunehmender Inzidenz.

Schlussfolgerungen

Eine abschließende Bewertung bezüglich der Überlegenheit einer Methode ist nicht möglich. Jede Technik bietet Vorteile als auch potenzielle Komplikationen. Prospektive, randomisierte Studien zur Bestimmung der Sicherheit und Effektivität der verschiedenen Rehabilitationsmöglichkeiten sind notwendig.

Abstract

Background

Intraocular approaches to correct aphakia in cases of inadequate capsular support include an anterior chamber intraocular lens, fixation of a posterior chamber lens to the sclera or iris by suturing or iris claw, respectively.

Objectives

This article reviews the indications and contraindications for iris fixation with sutures and gives an overview of surgical techniques, potential complications and outcomes.

Methods

Based on a selective search of pertinent literature in PubMed the information from original articles and reviews are analyzed, summarized and discussed.

Results

New surgical techniques have imparted an impetus to iris suture fixation with encouraging functional and morphological results offering a new promising alternative to the established options. Improved aspects arise for repositioning of a decentered intraocular lens and for a minimally invasive method for repair of late in-the-bag lens dislocation as seen more frequently by cataract surgeons.

Conclusion

A final evaluation of the proposed techniques is not possible because none has clearly emerged as the optimal method. Precise determination of small differences in visual outcome or complication rates requires a large prospective, randomized clinical trial.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Gerstmeyer und W. Sekundo geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Augenklinik Johannes Wesling Klinikum Minden, Hans-Nolte-Str. 1, 32429, Minden, Deutschland

    K. Gerstmeyer

  2. Augenklinik, Philipps-Universität und Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Marburg, Deutschland

    W. Sekundo

Authors
  1. K. Gerstmeyer
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  2. W. Sekundo
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Correspondence to K. Gerstmeyer.

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Gerstmeyer, K., Sekundo, W. Irisnahtfixierte Hinterkammerlinse. Ophthalmologe 111, 210–216 (2014). https://doi.org/10.1007/s00347-013-2849-3

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  • DOI: https://doi.org/10.1007/s00347-013-2849-3

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