Endothelzellverlust bei phaken Intraokularlinsen

Tadas Naujokaitis; Gerd U. Auffarth; Grzegorz Łabuz; Ramin Khoramnia

doi:10.1055/a-2209-5251

Klinische Monatsblätter für Augenheilkunde, Inhaltsverzeichnis

Klin Monbl Augenheilkd 2024; 241(08): 923-943
DOI: 10.1055/a-2209-5251

Übersicht

Endothelzellverlust bei phaken Intraokularlinsen

Artikel in mehreren Sprachen: deutsch | English

Tadas Naujokaitis

International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland

,

Gerd U. Auffarth

International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland

,

Grzegorz Łabuz

International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland

,

Ramin Khoramnia

International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland

› Institutsangaben

Abstract

Zusammenfassung

Obwohl die Sicherheit der phaken Intraokularlinsen (pIOLs) über eine bereits 70-jährige Entwicklungsgeschichte kontinuierlich verbessert wurde, können hohe Endothelzellverluste auch bei den aktuellen pIOL-Modellen auftreten. Die Studienergebnisse zeigen, dass die Entfernung einer pIOL zum Hornhautendothel eine entscheidende Rolle beim Endothelzellverlust spielt. Allein deswegen werden bei den Vorderkammerlinsen tendenziell höhere Endothelzellverluste beobachtet als bei den Hinterkammerlinsen. Eine ausreichende präoperative Vorderkammertiefe ist essenziell, zumindest bei den irisfixierten pIOLs, um eine sichere Distanz zum Endothel zu gewährleisten. Die Vorderkammer wird jedoch mit zunehmendem Alter flacher und es kann deswegen sinnvoll sein, das Patientenalter bei den Sicherheitskriterien mitzuberücksichtigen. Obwohl der Endothelzellverlust bei den aktuellen pIOL-Modellen i. d. R. gering ist, sind regelmäßige Kontrollen mit Messung der Endothelzelldichte aufgrund großer interindividueller Unterschiede bei den Patienten mit pIOLs nach wie vor unverzichtbar. Falls ein höherer Endothelzellverlust beobachtet wird als erwartet und die nachfolgenden Kontrollen die Tendenz bestätigen, soll die pIOL rechtzeitig explantiert werden. Hierbei ist die Endothelreserve individuell zu betrachten, indem man das Patientenalter, den physiologischen Endothelzellverlust sowie den Verlust durch weitere Operationen berücksichtigen sollte. Bei einer sorgfältigen Indikationsstellung und einer langfristigen Patientenbetreuung stellen die pIOLs nach wie vor eine sichere Behandlungsoption dar.

Schlüsselwörter

refraktive Chirurgie - phake Intraokularlinsen - pIOL - Endothelzellverlust - Endothel - Hornhaut

Volltext

Referenzen

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