Eintrübung von Intraokularlinsen

Zusammenfassung

Das Spektrum an Komplikationen und die Explantationsgründe bei der Verwendung von Intraokularlinsen (IOL) haben sich durch die Weiterentwicklung der Kataraktchirurgie verändert. Eintrübungen des Materials beeinflussen dabei unterschiedlich stark die optische Qualität. Im Fall einer störenden Eintrübung des Materials ist auch heute noch – trotz aller Fortschritte auf dem Gebiet der IOL-Materialien – ein Austausch der IOL die einzige Behandlungsoption.

Abstract

The spectrum of complications in the use of intraocular lenses (IOL) is different today from at the time of their introduction. Opacities in the IOL material are increasingly described in the literature as a reason for IOL explantation. This paper provides an overview of the different forms of IOL material opacities. Currently relevant forms of IOL material opacities and their effects on optical quality are summarized. The main reason for opacification in hydrophilic IOLs is calcification, whereas in hydrophobic IOLs it is mainly the formation of so-called glistenings that is reported. Most material opacities affect various optical parameters and lead to increased intraocular straylight. In case of a disturbing material opacification, the only therapeutic option is to replace the opacified IOL.

Kernaussagen

• Während als Materialveränderung bei hydrophoben IOL v. a. über sogenannte „Glistenings“ berichtet wird, steht bei hydrophilen IOL die Kalzifikation im Vordergrund.

• Art und Schweregrad der Pathologie hängen vom Linsenmaterial, dem Linsenherstellungsprozess und den örtlichen Umgebungsbedingungen ab.

• In der klinischen Praxis ist besonders auf die exakte Lage der Eintrübung zu achten (vor, innerhalb oder hinter der IOL), damit Differenzialdiagnosen ausgeschlossen werden und der Patient die korrekte Behandlung erhält.

• Bei entsprechenden Behandlungsentscheidungen sollten die Unterschiede bezüglich der Funktionsstörung, die durch die verschiedenen Formen der Materialveränderungen erzeugt werden, berücksichtigt werden.

• Liegt eine beeinträchtigende Materialveränderung vor, so muss als derzeit einzige sinnvolle therapeutische Option der IOL-Tausch besprochen werden, der allerdings mit entsprechenden Risiken einhergeht.

Schlüsselwörter

IOL - hydrophob - hydrophil - Kunstlinse

Key words

hydrophilic - hydrophobic - complication - IOL - straylight

Publication History

Article published online:
19 April 2021

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