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Klin Monbl Augenheilkd 2017; 234(12): 1519-1523
DOI: 10.1055/s-0043-119691
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Spontane IOL-Dislokation – was können wir tun zur Prävention?

Spontaneous IOL Dislocation – What Can We Do for Prevention?
Joern Kuchenbecker
Augenklinik, Helios Klinikum Berlin-Buch
› Author Affiliations
Further Information

Publication History

eingereicht 26 October 2016

akzeptiert 20 July 2017

Publication Date:
27 October 2017 (online)

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Zusammenfassung

Die IOL-Dislokation stellt neben den Eintrübungen von IOLs (Intraokularlinsen) eine weitere Komplikation der modernen IOL-Implantation dar. Zurzeit ist eine Zunahme der IOL-Dislokationen zu beobachten, die verschiedene Ursachen hat. Durch Kapselsackschrumpfung, insbesondere bei Patienten mit Pseudoexfoliation (PEX) und anderen okulären Ursachen, kommt es zu einer weiteren Belastung der oft bereits geschwächten Zonula. Der Einsatz eines Kapselspannrings allein hat sich bisher als nicht ausreichend effektiv erwiesen. Die Schrumpfung des Kapselsacks und damit weitere Belastung der Zonula kann z. B. durch zusätzliche Vorderkapselinzisionen vermindert werden und die IOL bei Zonulaschwäche auch bei erhaltenem Kapselsack oder geringer intraoperativer Zonulolyse vorzugsweise retroiridal fixiert werden, um eine spätere Dislokation zu verhindern. Die Effektivität dieser Maßnahmen sollte zukünftig in größeren Studien untersucht werden.

Abstract

IOL dislocation and opacification represent further complications of modern IOL (intraocular lenses) implantation. Currently, an increase of IOL dislocation due to various reasons is observed. Due to capsular bag shrinkage, especially in patients with pseudoexfoliation (PEX) and other ocular condition, there is an increasing tension of the weakened zonula. The only use of capsular tension ring (CRT) is not sufficient. The shrinkage of the capsular bag and increasing tension of the zonula may be reduced by additional anterior capsule incisions. The IOL should, preferably, be fixated retrogradely in cases of zonula weakness, even in the case of a weakened capsular bag or minor intraoperative zonulysis, to prevent later IOL dislocation. The effectiveness of these interventions should be examined in larger studies in the future.

Schlüsselwörter

IOL - IOL-Dislokation - Kapselsackschrumpfung - Pseudoexfoliation (PEX) - Kapselspannring

Key words

IOL - IOL dislocation - capsular bag shrinkage - pseudoexfoliation (PEX) - capsular tension ring
 

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