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Klin Monbl Augenheilkd 2016; 233(08): 914-922
DOI: 10.1055/s-0042-107152
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Sonderlinsen in der refraktiven Chirurgie

Special Intraocular Lenses in Refractive Lens Surgery
A. Liekfeld
Klinik für Augenheilkunde, Klinikum Ernst von Bergmann gGmbH, Potsdam
,
D. Befurt
Klinik für Augenheilkunde, Klinikum Ernst von Bergmann gGmbH, Potsdam
› Author Affiliations
Further Information

Publication History

eingereicht 16 December 2015

akzeptiert 15 April 2016

Publication Date:
25 August 2016 (online)

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Zusammenfassung

Hintergrund: In der refraktiven Linsenchirurgie stehen inzwischen unterschiedlichste Modelle und Typen von Sonderlinsen zur Verfügung. Vor allem die torischen und multifokalen Intraokularlinsen (IOL) benötigen bestimmte Voraussetzungen, um befriedigende Ergebnisse für den Patienten zu erreichen. Außerdem stehen sehr viele Modelle mit teilweise unterschiedlichen Wirkprinzipien besonders im Bereich der Multifokallinsen zur Verfügung. Für die optimale individuelle Versorgung der Patienten ist es von Vorteil, Kenntnisse über die möglichen Optionen zu haben. Bei den Sonderlinsen ist für die Patienten das wesentliche Ziel, brillenunabhängiger zu werden. Patienten/Material und Methoden: In der Arbeit werden publizierte Studien sowie eigene Erfahrungen und Daten genutzt, um die verschiedenen IOL zu bewerten und einzuordnen. Ergebnisse: Blaulichtfilter-IOL und asphärische IOL sind im strengen Sinne nicht als Sonderlinsen zu bewerten. Blaulichtfilter-IOL sollten grundsätzlich als Standard eingesetzt werden, asphärische IOL bringen nur in Spezialsituationen Vorteile. Torische IOL sind zuverlässig einsetzbar und erreichen gute Ergebnisse, wenn bestimmte Bedingungen beachtet werden. Die multifokalen IOL stellen nach wie vor einen optischen Kompromiss dar, sind aber die einzigen IOL für einen refraktiven Linsenaustausch, die eine komplette Brillenfreiheit zuverlässig für den Patienten erreichen können. Dabei sind jedoch ideale Bedingungen perioperativ zu schaffen, und das Modell sollte individuell den Bedürfnissen des Patienten angepasst werden. Schlussfolgerung: Viele refraktive Bedürfnisse können durch Sonderlinsen heutzutage befriedigend abgedeckt werden. Dabei sollten jedoch seitens des Operateurs ideale perioperative Bedingungen erreicht werden und detaillierte Linsenkenntnisse vorhanden sein, um den Patienten angemessen zu beraten. Nur dann sind unzufriedene Patienten und Frustration auf beiden Seiten zu vermeiden.

Abstract

Purpose: Many different models and types of special intraocular lenses (IOL) are now available for refractive lens surgery. In particular, toric and multifocal IOL need specific conditions to achieve satisfactory results. For multifocal IOL, many models with different optical principles are available. For optimal individual patient-centred care, it is necessary to consider several different options. With special refractive lenses, the principle objective for the patients is to become less dependent on glasses. Material and Methods: Different IOL are evaluated on the basis of published studies and our own experience and data. Results: IOL filtering blue light should not be classified as special IOL, but should be used as standards. Aspherical IOL are only beneficial in special situations. Toric IOL give reliable and good results, as long as certain specific requirements are considered. Multifocal IOL are still an optical compromise, although they are the only IOL that can reliably make the patient independent of glasses. To achieve satisfying results, the optimal IOL model should be selected individually. Conclusion: Many refractive needs can now be adequately satisfied by special IOL. The surgeon should provide ideal perioperative conditions, and he should be aware of the different IOL principles if he is to give the patient optimal advice. This can help to avoid upsetting both patients and ophthalmologists.

Schlüsselwörter

Sonderlinsen - refraktive Linsenchirurgie - Multifokallinsen - torische IOL - Blaulichtfilter IOL - phake IOL

Key words

special IOL - refractive lens surgery - multifocal lens - toric IOL - blue light filtering IOL - phacic IOL
 

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