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Klin Monbl Augenheilkd 2012; 229(8): 784-793
DOI: 10.1055/s-0032-1315207
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Aktueller Stand „light-adjustable lens“

Current State of the “Light-Adjustable Lens”
F. H. Hengerer
1   Augenheilkunde, Universitäts-Augenklinik, Bochum
› Author Affiliations
Further Information

Publication History

eingereicht 25 March 2012

akzeptiert 11 July 2012

Publication Date:
13 August 2012 (online)

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Zusammenfassung

Die lichtadjustierbare Intraokularlinse ermöglicht eine postoperative nicht invasive Korrektur von Refraktionsfehlern. Nach der Implantation und abgeschlossener Wundheilung kann mit UV-Licht eine individuelle Feineinstellung der Linsenbrechwerte erfolgen unter Berücksichtigung der individuellen Bedürfnisse. Dabei sind Brechwertkorrekturen von bis zu 2 Dioptrien Sphäre und Zylinder in einem Arbeitsschritt adjustierbar. Das Verfahren erhielt im Dezember 2007 die CE-Zulassung. In dieser Übersichtsarbeit werden prospektive Studien zur klinischen Evaluation dieser neuartigen Intraokularlinsentechnologie im Hinblick auf die Effektivität, Sicherheit und Langzeitstabilität der refraktiven Ergebnisse dargestellt. Darüber hinaus erfolgt eine kritische Würdigung der Chancen und Grenzen der lichtadjustierbaren Intraokularlinse sowie ein Ausblick auf zukünftige Anwendungen. Die Effektivität des Verfahrens wurde zunächst an 40 Augen über einen Nachbeobachtungszeitraum von 4 Monaten überprüft. Die Sicherheit des Einsatzes von UV-Licht zur refraktiven Korrektur der Linse wurde hinsichtlich einer möglichen Änderung der Endothelzellzahl und Hornhautdicke über 12 Monate untersucht. Die refraktive Langzeitstabilität sowie der Einsatz bei biometrisch besonders kurzen und langen Augenlängen wurde in weiteren Studien bis zu 18 Monaten nachverfolgt. Anhand der erhobenen postoperativen Daten erfolgte eine Optimierung der Konstanten zur präoperativen Kalkulation der Linsenstärke. Damit war die Möglichkeit gegeben, näher die Zielrefraktion zu erreichen und Makromere für weitere neue Beleuchtungsprofile zu rekrutieren. Zukünftige Anwendungen beinhalten zusätzliche Beleuchtungsprofile zur Korrektur von Presbyopie sowie Erzeugung von Multifokalität oder einer individuellen asphärischen Oberflächengestaltung der Linse.

Abstract

The light-adjustable intraocular lens offers the possibility to correct postoperative residual refractive errors in a non-invasive way. After implantation and healing, a fine-tuning of the refractive power can be performed using ultraviolet light based on the individual requirements of each patient. Up to 2 diopters in sphere, as well as cylinder, can be adjusted in one step. This technology received CE market approval in 2007. This review article summarises published prospective studies on clinical evaluations of the effectiveness, safety and long-term refractive stability of this innovative technique. Moreover, a critical statement about limitations and perspectives will be given and future options will be discussed. For safety reasons, following application of the UV-light during refractive adjustments, examinations of endothelial cell count changes and measurements of corneal thickness have been monitored for 12 months following treatment. Further studies have been performed to evaluate the refractive stability over an 18-month period with a patient population that included average as well as biometrically short and long eyes. An analysis of postoperative refractive data led to optimised constants for preoperative IOL power calculation enabling the surgeon to further enhance visual outcomes with the IOL by using additional nomograms for customised correction of presbyopia, multifocality and increasing depth of focus with individual corrections of asphericity.

Schlüsselwörter

Katarkt - refraktive Chirurgie - Kornea - lichtadjustierbare Intraokularlinse

Key words

cataract - refractive surgery - cornea - light-adjustable intraocular lens
 

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