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Kombinierte Kataraktoperation

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

Zusammenfassung

Sind Linsentrübungen mit operablen zusätzlichen visuseinschränkenden Augenveränderungen vergesellschaftet, muß eine kombinierte Kataraktoperation erwogen werden. Dies trifft für Hornhauttrübungen, medikamentös nicht befriedigend einstellbare Glaukome, aber auch für vitrektomiebedürftige Glaskörperveränderungen zu. Im Falle der Kombination einer Keratoplastik mit einer Kataraktoperation liefert das zweizeitige Vorgehen refraktiv bessere Ergebnisse. Die Kombination einer Kataraktoperation mit einer Trabekulektomie oder Goniotrepanation wird von uns dann indiziert, wenn alten Menschen zwei konsekutive Eingriffe erspart werden sollen. Tunneltechniken ermöglichen heute ohne Probleme die Kombination vitreoretinaler Eingriffe mit Kunstlinsenimplantationen. Bei proliferativen diababetischen Retinopathien wird eine kombinierte Vorgehensweise nur dann durchgeführt, wenn die Netzhautsituation stabil und eine ausreichende Laserkoagulation durchgeführt worden ist.

Summary

A combination cataract operation must be considered in patients who have additional operable conditions limiting their vision. Examples are corneal scars, glaucoma that cannot be treated with drugs, and opacities in the vitreous cavity. When penetrating keratoplasty is combined with intraocular lens implantation, two consecutive operations yield better refractive results, i.e., a higher percentage of patients with good uncorrected visual acuity. Combined trabeculectomy and phacoemulsification is preferable in elderly glaucoma patients who are not able to tolerate two consecutive operations. Closed system phacoemulsification with a tunnel incision can be performed at every stage of a standard three-port vitrectomy. Intraocular lenses should only be implanted if there is no progressive proliferative vitreoretinopathy and photocoagulation of the fundus has been adequately performed.

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Literatur

  1. Allan BDS, Barrett GD (1993) Combined small incision phacoemulsification and trabeculectomy. J Cataract Refract Surg 19: 97–102

    PubMed  CAS  Google Scholar 

  2. Alpap JJ (1980) Keratoplasty with primary and secondary lens implantation. Arch Soc Am Ophtalmol Optom 14: 151–167

    Google Scholar 

  3. Anders N, Pham DT, Mielke C, Wollensak J (1994) Ergebnisse einer kombinierten Kataraktoperation und fistulierenden Operation mit der No-stitch-Technik. In: Pham DT, Wol-lensak J, Rochels R, Hartmann C (Hrsg) 8. Kongreß der Deutschsprachigen Gesellschaft für Intraokularlinsen Implantation. Springer, Berlin Heidelberg New York Tokyo

    Google Scholar 

  4. Binder PS (1985a) Intraocular lens powers used in the triple procedure: effect on visual acuity and refractive error. Ophthalmology 92: 1561–1566

    PubMed  CAS  Google Scholar 

  5. Binder PS (1985b) Secondary intraocular lens implantation during or after corneal transplantation. Am J Ophthalmol 99: 515–520

    PubMed  CAS  Google Scholar 

  6. Binder PS (1986) The triple procedure: refractive results. 1985 update. Ophthalmology 93: 1482–1488

    PubMed  CAS  Google Scholar 

  7. Binder PS (1989) Intraocular lens implantation after penetrating keratoplasty. Refract Corneal Surg 5: 224–230

    PubMed  CAS  Google Scholar 

  8. Bruner WE, Stark WJ, Maumenee AE (1981) Combined keratoplasty, cataract extraction, and intraocular lens implantation: experience at the Wilmer Institute. Ophthalmic Surg 12: 657–660

    PubMed  CAS  Google Scholar 

  9. Busin M, Arffa RC, McDonald MB, Kaufman HE (1987) Combined penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber intraocular lens implantation. Ophthalmic Surg 18: 272–275

    PubMed  CAS  Google Scholar 

  10. Crawford GJ, Stulting RD, Waring GO III et al. (1986) The triple procedure: analysis of outcome, refraction, and intraocular lens power calculation. Ophthalmology 93: 817–824

    PubMed  CAS  Google Scholar 

  11. Duncker G, Eckardt C (1988) Modified temporary keratoprosthesis in the triple procedure: A new surgical technique. J Cataract Refract Surg 14: 434–436

    PubMed  CAS  Google Scholar 

  12. Fung WE (1987) Phacoemulsification and implantation of posterior chamber intraocular lens in eyes with quiescent proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 225: 251–253

    Article  PubMed  CAS  Google Scholar 

  13. Geggel HS (1990) Intraocular lens implantation after penetrating keratoplasty. Ophthalmology 97: 1460–1467

    PubMed  CAS  Google Scholar 

  14. Gould HL (1980) Keratoplasty and intraocular lenses. J Am Intraocular Implant Soc 6: 42–44

    CAS  Google Scholar 

  15. Grehn F (1990) Chirurgische Glaukomtherapie. Fortschr Ophthalmol 87 [Suppl]: S 175–S186

    PubMed  Google Scholar 

  16. Hunkeler JD, Hyde LL (1983) The triple procedure: combined penetrating keratoplasty, extracapsular cataract extraction and lens implantation. An expanded experience. J Am Intraocular Implant Soc 9: 20–24

    CAS  Google Scholar 

  17. Hutton WL, Pesicka GA, Fuller DG (1987) Cataract extraction in the diabetic eye after vitrectomy. Am J Ophthalmol 104: 1–4

    PubMed  CAS  Google Scholar 

  18. Katz HR, Forster RK (1985) Intraocular lens calculation in combined penetrating keratoplasty, cataract extraction and intraocular lens implantation. Ophthalmology 92:1203–1207

    PubMed  CAS  Google Scholar 

  19. Koenig SB, Han DP, Mieler WF, Abrams GW, Jaffe GJ, Burton TC (1990) Combined phacoemulsification and pars plana vitrectomy. Arch Ophthalmol 108: 362–364

    Article  PubMed  CAS  Google Scholar 

  20. Koenig SB, Mieler WF, Han DP, Abrams GW (1992) Combined phacoemulsification, pars plana vitrectomy, and posterior chamber intraocular lens insertion. Arch Ophthalmol 110: 1101–1104

    Article  PubMed  CAS  Google Scholar 

  21. Kokame GT, Flynn HW, Blankenship GW (1989) Posterior chamber intraocular lens implantation during diabetic pars plana vitrectomy. Ophthalmology 96: 603–610

    PubMed  CAS  Google Scholar 

  22. Kramer SG (1985) Penetrating keratoplasty combined with extracapsular cataract extraction. Am J Ophthalmol 100: 129–133

    PubMed  CAS  Google Scholar 

  23. Lindstrom RL, Harris WS, Doughman DJ (1981) Combined penetrating keratoplasty, extracapsular cataract extraction and posterior chamber lens implantation. Am Intraocular Implant Soc 7: 130–132

    CAS  Google Scholar 

  24. Lyle WA, Jin JC (1991) Comparison of a 3- and 6-mm incision in combined phacoemulsification and trabeculectomy. Am J Ophthalmol 111:189–196

    PubMed  CAS  Google Scholar 

  25. Mackool RJ (1989) Pars plana vitrectomy and posterior chamber intraocular lens implantation in diabetic patients (letter to the editor). Ophthalmology 96: 1679–1680

    PubMed  CAS  Google Scholar 

  26. Mattax JB, McCulley JP (1989) The effect of standardized keratoplasty technique on IOL power calculation for the triple procedure. Acta Ophthalmol 67 (Suppl 192): 24–29

    Google Scholar 

  27. McCartney DL, Memmen JE, Stark WJ, Quigley HA, Maumenee AE, Gottsch JD, Bernitzky DA, Wong SK (1988) The efficacy and safety of combined trabeculectomy, cataract extraction, and intraocular lens implantation. Ophthalmology 95: 754–763

    PubMed  CAS  Google Scholar 

  28. Menapace R, Skorpik C, Grasl M (1990) Modified triple procedure using a temporary kera-toprosthesis for closed-system, small-incision cataract surgery. J Cataract Refract Surg 16: 230–234

    PubMed  CAS  Google Scholar 

  29. Meyer RF, Musch DC (1987) Assessment of success and complications of triple procedure surgery. Am J Ophthalmol 104: 233–240

    PubMed  CAS  Google Scholar 

  30. Musch DC, Meyer RF (1988) Prospective evaluation of a regression-determined formula for use in triple procedure surgery. Ophthalmology 95: 79–85

    PubMed  CAS  Google Scholar 

  31. Papapanos P, Wedrich A, Pfleger T, Menapace R (1992) Induced astigmatism following small incision cataract surgery combined with trabeculectomy. Doc Ophthalmol 82: 361–368

    Article  PubMed  CAS  Google Scholar 

  32. Poliner LS, Christianson DJ, Escoffery RF, Kolker AE, Gordon ME (1985) Neovascular glaucoma after intracapsular and extracapsular cataract extraction in diabetic patients. Am J Ophthalmol 100: 637–643

    PubMed  CAS  Google Scholar 

  33. Pradera I, Ibrahim O, Waring GO III (1989) Refractive results of successful penetrating keratoplasty, intraocular lens implantation with selective suture removal. Refract Corneal Surg 5: 231–239

    PubMed  CAS  Google Scholar 

  34. Rice TA, Michels RG, Maguire MG, Rice EF (1983) The effect of lensectomy on the incidence of iris neovascularization and neovascular glaucoma after vitrectomy for diabetic retinopathy. Am J Ophthalmol 95: 1–11

    PubMed  CAS  Google Scholar 

  35. Samples JR, Binder PS (1985) Visual acuity, refractive error, and astigmatism following corneal transplantation for pseudophacic bullous keratopathy. Ophthalmology 92: 1554–1560

    PubMed  CAS  Google Scholar 

  36. Savage JA, Thomas JV, Belcher D, Simmons RJ (1985) Extracapsular cataract extraction and posterior chamber intraocular lens implantation in glaucomatous eyes. Ophthalmology 92: 1506–1516

    PubMed  CAS  Google Scholar 

  37. Schönherr U, Händel A, Ruprecht KW, Naumann GOH (1988) Simultane perforierende Keratoplastik, Katarakt-Extraktion und Kunstlinsen-Implantation („Triple-Procedure“) 1981–1987. Klin Monatsbl Augenheilkd 192: 644–649

    Article  PubMed  Google Scholar 

  38. Schwenn O, Grehn F (1995) Cataract extraction combined with trabeculotomy. German J Ophthalmol 4: 16–20

    CAS  Google Scholar 

  39. Simmons ST, Litoff D, Nichols DA, Sherwood MB, Spaeth GL (1987) Extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy in patients with glaucoma. Am J Ophthalmol 104: 465–470

    PubMed  CAS  Google Scholar 

  40. Skorpik C, Paroussis P, Gnad HD, Menapace R (1987) Trabeculectomy and intraocular lens implantation: A combined procedure. J Cataract Refract Surg 13: 39–42

    PubMed  CAS  Google Scholar 

  41. Slusher MM, Greven CM, Yu DD (1992) Posterior chamber intraocular lens implantation combined with lensectomy-vitrectomy and intraretinal foreign-body removal. Arch Ophthalmol 110:127–129

    Article  PubMed  CAS  Google Scholar 

  42. Slusher MM, Sarin LK, Federman JL (1982) Management of intraretinal foreign bodies. Ophthalmology 89: 369–373

    PubMed  CAS  Google Scholar 

  43. Smiddy WE, Stark WJ, Michels RG, Maumenee AE, Terry AC, Glaser BM (1987) Cataract extraction after vitrectomy. Ophthalmology 94: 483–487

    PubMed  CAS  Google Scholar 

  44. Straatsma BR, Pettit TH, Wheeler N, Miyamasu W (1983) Diabetes mellitus and intraocular lens implantation. Ophthalmology 90: 336–343

    PubMed  CAS  Google Scholar 

  45. Taylor DM, Stern AL, McDonald P (1986) The triple procedure: 2 to 10 year follow-up. Trans Am Ophthalmol Soc 84: 221–249

    PubMed  CAS  Google Scholar 

  46. Treumer H, Duncker G (1987) Refraktion des Auges nach perforierender Keratoplastik. Fortschr Ophthalmol 84: 503–505

    PubMed  CAS  Google Scholar 

  47. Wedrich A, Menapace R, Radax U, Papapanos P, Amon M (1992) Combined small-incision cataract surgery and trabeculectomy — technique and results. Int Ophthalmol 16: 409–414

    Article  PubMed  CAS  Google Scholar 

  48. Wedrich A, Menapace R, Radax U, Papapanos P (1995) Long-term results of combined trabeculectomy and small incision cataract surgery. J Cataract Refract Surg 21: 49–54

    PubMed  CAS  Google Scholar 

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Authors
  1. G. Duncker
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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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Duncker, G. (1995). Kombinierte Kataraktoperation. 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_2

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  • DOI: https://doi.org/10.1007/978-3-642-93570-1_2

  • 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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