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Optische Qualität nach refraktiver Hornhautchirurgie

Optical quality after refractive corneal surgery

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Zusammenfassung

Die Korrektur von Myopie, Hyperopie und Astigmatismus innerhalb ihres Indikationsbereichs mittels refraktiver Hornhautchirurgie, wie LASIK und Oberflächenablation (z. B. PRK), gehört heute zu den Standardverfahren in der Augenheilkunde. Nachdem Fortschritte im Bereich der operativen Techniken und der apparativen Voraussetzungen eine weitere Steigerung bezüglich Sicherheit und Vorhersagbarkeit erzielt haben, steht nun auch die optische Qualität im Mittelpunkt des wissenschaftlichen Interesses. Die „optische Qualität“ ist kein gut definierter Parameter, sondern kann nur indirekt anhand direkt messbarer Größen verdeutlicht werden. Am Anfang stehen die anatomischen Eigenschaften des Auges, welche die optischen Eindrücke auf retinaler Bildebene bedingen. Die retinale Bildqualität beeinflusst die Funktion, also das Auflösungsvermögen und die Erkennung von Kontrasten. Am Ende steht die subjektive Wahrnehmung eines Seheindrucks. Die subjektive Einschätzung des eigenen Seheindrucks durch den Patienten spiegelt die eigentliche „optische Qualität“ wider. Im Besonderen sind drei Phänomene für die Verringerung der retinalen Abbildungsqualität verantwortlich: Beugung, Aberration und Streuung. Zu den Messmethoden zur Beschreibung der optischen Qualität gehören subjektive Fragebögen, funktionelle Testverfahren zur Messung von Visus- und Kontrastsensitivität, optische Messverfahren zur Bestimmung der optischen Qualität sowie Biomikroskopie, Aberrometrie und korneale Topographie zur Auswertung der anatomischen Veränderung.

Abstract

Correction of myopia, hyperopia and astigmatism within its indicated margin by means of refractive corneal surgical procedures such as LASIK and surface ablation (e.g. PRK) is one of the standard procedures in ophthalmology. Now that advances in the fields of surgical techniques and the technical devices employed have further progressed in terms of safety and predictability, research also focuses on optical quality. “Optical quality” is not a clearly defined parameter, but can be captured indirectly by means of directly measured data. One has to start with the anatomical properties of the eye, which determine the optical images on the retinal level. The quality of the retinal image influences the eye’s function, i.e. acuity and contrast perception. Finally, there is the subjective perception of the image we receive. “Optical quality” as such is reflected by the patient’s evaluation of this image perception. Three phenomena are especially responsible for deterioration of the quality of the retinal image: diffraction, aberrations and dispersion. Some of the methods for measuring optical quality are subjective questionnaires, functional testing procedures for measuring visual acuity and contrast sensitivity, optical measuring procedures for the determination of optical quality, as well as biomicroscopy, aberrometry and corneal topography for assessing anatomical changes.

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Authors and Affiliations

  1. Klinik für Augenheilkunde, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main

    T. Kohnen, J. Bühren, M. Cichocki, T. Kasper, E. Terzi & C. Ohrloff

  2. Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA

    T. Kohnen

  3. Department of Ophthalmology, University of Rochester, Rochester, NY, USA

    J. Bühren

  4. Klinik für Augenheilkunde, Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 , Frankfurt am Main

    T. Kohnen

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  1. T. Kohnen
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  2. J. Bühren
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Correspondence to T. Kohnen.

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Kohnen, T., Bühren, J., Cichocki, M. et al. Optische Qualität nach refraktiver Hornhautchirurgie. Ophthalmologe 103, 184–191 (2006). https://doi.org/10.1007/s00347-006-1315-x

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