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Ein neues kammerwinkelchirurgisches Verfahren zur Verhinderung von Druckspitzen in der initialen postoperativen Phase nach Kataraktextraktion

  • Conference paper
9. Kongreß der Deutschsprachigen Gesellschaft für Intraokularlinsen Implantation

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Zusammenfassung

Eine passagere Erhöhung des Intraokulardrucks (IOD) nach geplanter extrakapsulärer Kataraktextraktion (ECCE) wird nicht selten beobachtet. Ursächlich wird eine vorübergehende Okklusion des Trabekelmaschenwerks durch viskoelastische Substanzen und lentikulären Debris diskutiert. Zur Vermeidung von Druckspitzen in der initialen postoperativen Phase wurde in einer prospektiv randomisierten Doppelblindstudie ein neues kammerwinkelchirurgisches Absaugverfahren auf seine drucksenkende Wirkung nach geplanter ECCE normotoner Augen untersucht. Bei 48 Patienten (Alter 73 ± 5,5 Jahre) wurde im Anschluß an die ECCE mit einer neuen Absaugkanule 180° der unteren Zirkumferenz des Kammerwinkels mit 100–200 mmHg abgesaugt. Die Kontrollgruppe umfaßt 52 Patienten (Alter 76 ± 4,6 Jahre). Postoperativ wurden keinerlei druckwirksame Medikamente appliziert. Präoperativ betrug der IOD (Mittelwert ± S.D.) für die Studiengruppe [und Kontrollgruppe] 15,8 ± 2,7 mmHg [16,1± 3,5 mm Hg]. Postoperativ lagen die Werte nach 6 Stunden bei 23,3 ± 8,3 mmHg [36,9 ± 9,5 mmHg], nach 12 Stunden bei 16,7±5,2 mmHg [17,1± 4,2 mmHg] und nach 24 Stunden bei 14,5 ± 2,6 mmHg [15,5±2,7 mmHg]. Es ließ sich ein signifikant niedriger IOD (p < 0,01) nach Anwendung des Kammerwinkelsaugverfahrens innerhalb der initialen postoperativen Phase (6 Stunden) für die Studiengruppe feststellen.

Summary

A rise in intraocular pressure is a common complication in the early postoperative period following cataract surgery. Trabecular occlusion by remnants of viscoelastic substances and lenticular debris is a major factor in the development of pressure elevation. In a prospective, double-blind study, we investigated the efficacy of a new trabecular aspiration technique on the early postoperative intraocular pressure after cataract surgery. Out of 100 patients undergoing extracapsular cataract extraction, 48 were randomly assigned to the study group, in which 180° of the inferior circumference of the chamber angle was treated with a negative suction pressure ranging between 100 and 200 mm Hg. Intraocular pressures were measured preo-peratively and early (5–7 h) and late (12–48 h) postoperatively. There was a significant mean increase in pressure from the preoperative period to the early postoperative period for both the control group (20.8 mm Hg) and the aspiration group (7.4 mm Hg). There was no significant difference between preoperative and late postoperative pressures for any of the groups. Oneway analysis of covariance of the changes in pressure from the preoperative to early postoperative period showed a significant decrease (p < 0,0041) for the aspiration group compared to the control group. From these results we conclude that trabecular aspiration proved to be most effective in preventing an increase in intraocular pressure in the early postoperative period after extracapsular cataract extraction.

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Authors
  1. P. C. Jacobi
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  2. B. Engels
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  3. G. K. Krieglstein
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Editor information

Editors and Affiliations

  1. Klinik für Ophthalmologie, Universität Kiel, Hegewischstraße 2, D-24105, Kiel, Deutschland

    Rainer Rochels  & Gernot Duncker  & 

  2. Medizinische Fakultät der Humbold-Universität zu Berlin, Universitätsklinikum Charité, Schumannstraße 20/21, D-10117, Berlin, Deutschland

    Christian Hartmann

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© 1995 Springer-Verlag Berlin Heidelberg

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Jacobi, P.C., Engels, B., Krieglstein, G.K. (1995). Ein neues kammerwinkelchirurgisches Verfahren zur Verhinderung von Druckspitzen in der initialen postoperativen Phase nach Kataraktextraktion. In: Rochels, R., Duncker, G., Hartmann, C. (eds) 9. Kongreß der Deutschsprachigen Gesellschaft für Intraokularlinsen Implantation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-93570-1_15

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  • DOI: https://doi.org/10.1007/978-3-642-93570-1_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-93571-8

  • Online ISBN: 978-3-642-93570-1

  • eBook Packages: Springer Book Archive

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