Nachstarrate, Zentrierverhalten, Biokompatibilität und Fixation intraokularer Faltlinsen - eine Milleniums-Analyse 1221 pseudophaker Autopsieaugen[1] [2]

Zusammenfassung

Hintergrund Die fortlaufende Entwicklung von Faltlinsendesigns macht es erforderlich, die einzelnen Typen im Hinblick auf ihre unterschiedlichen Eigenschaften nach der Implantation zu untersuchen. Die über 16 500 Intraokularlinsen umfassende Datenbank unseres Labors, erlaubte eine klinisch-pathologische Analyse pseudophaker Autopsieaugen aus weltweiten Quellen, insbesondere aus den Lions-Hornhautbanken der USA.Material und Methode Sechs geläufige intraokulare Faltlinsendesigns und als Vergleichsgruppe, der Standard nicht faltbarer Linsentypen, das 1-piece-PMMA-Design, wurden in die Studie aufgenommen. Die Miyake-Apple-posteriore-Fototechnik erlaubte eine sichere Beurteilung des Grades der Nachstarbildung, des Zentrierverhaltens, der Haptikfixation und des Ausmaßes und Intensität der Soemmerring-Ring-Bildung.Ergebnisse Die vier Intraokularlinsen mit den niedrigsten Kapsulotomieraten (zwischen 3,8 % und 21,7 %) und Nachstarraten waren neuere Designs, die meist erst nach 1992 implantiert wurden. Höhere Nachstarraten zeigten die zwei älteren Linsentypen. Die Dezentrierungswerte und Nachstarraten waren am geringsten bei Kapselsackimplantation. Frühere Untersuchungen, wie auch die aktuelle Analyse zeigten, dass die AcrySof™-IOL die günstigsten Biokompatibilitätswerte aufwies.Schlussfolgerung Die Inzidenz der zwei Hauptkomplikationen der Hinterkammerlinsenimplantation, Dezentrierung und Nachstar ist zur Jahrtausendwende deutlich rückläufig.

Background The ongoing and fast evolution of foldable IOL designs established the necessity to evaluate the different abilities of each lens style. The large IOL database (over 16,500 specimens) acquired in our laboratory, has permitted us to perform a clinico-pathological analysis on pseudophakic autopsy globes provided from sources worldwide, especially many Lions Eye banks in the United States.Material and methods We analyzed 6 foldable IOL styles commonly implanted in the United States, using one type of rigid IOL design (1-piece design rigid PMMA optics) as a comparison group. Posterior capsule opacification (PCO) score, decentration, fixation, presence or absence of a Nd:YAG laser posterior capsulotomy and area and intensity of Soemmerring's ring formation was discerned by examination under an operating microscope using the Miyake-Apple posterior photographic technique.Results The four lenses with the lowest rates ranging between 3.8 % and 21.7 % are modern designs, mostly implanted after 1992. The two lenses with the higher rates ranging between 23.1 % and 30.4 %, were all older designs, already prevalent prior to 1992. IOL fixation with both haptics in the capsular bag showed the best centration values and PCO scores. Our studies to date have shown in a preliminary fashion that the AcrySof™ IOL displays the the lowest (best) biocompatibility score.Conclusions Entering the new millenium, with evolution of modern surgical techniques and IOL designs, the incidence of the two major complications of cataract surgery, decentration and PCO are now finally diminishing.

Schlüsselwörter

Hinterkammerlinse - Nachstar - Dezentrierung - Biokompatibilität

Key words

intraocular lens - posterior capsule opacification - decentration - biocompatibility

1 Manuskript erstmalig eingereicht am 27. 5. 01 und in der vorliegenden Form angenommen.

2 Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, NY and a Max Kade postdoctoral research grant (Schmidbauer), Max Kade Foundation, New York, NY.

Literatur

1 Manuskript erstmalig eingereicht am 27. 5. 01 und in der vorliegenden Form angenommen.

2 Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, NY and a Max Kade postdoctoral research grant (Schmidbauer), Max Kade Foundation, New York, NY.

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