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Innovationen in der refraktiven Laserchirurgie 2014

Innovations in refractive laser surgery 2014

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Zusammenfassung

Hintergrund

Die refraktive Laserchirurgie der Hornhaut hat sich in den letzten 3 Jahrzehnten von der experimentellen Forschung zu einem der weltweit am meisten angewandten Verfahren gemausert.

Ergebnisse

Bei den refraktiven Ergebnissen ist eine weitere Verbesserung nicht mehr zu erwarten, da die Treffergenauigkeit der modernen Laser-in-situ-Keratomileusis (LASIK) vergleichbar der Reproduzierbarkeit der manifesten Refraktion ist. Einer der Sterne am refraktiven Himmel ist die stromale Lentikelextraktion mithilfe von Femtosekundenlasern. Deren Weiterentwicklung ist ins Stocken geraten, und auch das Problem der Nachoperation ist noch pendent.

Ausblick

Obwohl der Fortschritt in der refraktiven Chirurgie sich verlangsamt hat, sind auch in den nächsten Jahren noch wichtige Entwicklungen zu erwarten.

Abstract

Background

Within less than 30 years refractive laser surgery has been developed from an experimental technique to one of the most frequently applied procedures in ophthalmology worldwide.

Results

Regarding the success rate of refractive results, myopia correction has reached a level (95 % within ± 0.5 D) that is comparable to manifest refraction so that there is not much room for improvement. The most recently developed technique is femtosecond laser lenticule extraction which was introduced in 2007 in Germany. Early clinical results were very promising but the awaited bilateral comparative studies are still lacking. Although new laser types that will be able to provide improved profiles are on the horizon, the problem of reoperations has not yet been solved. Topography-guided ablation is notoriously plagued by undercorrection so that topography-guided treatment is planned as a two step-procedure. The reason for the undercorrection is the leveling effect of the epithelium.

Perspectives

The evolution of refractive surgery has slowed down during the last years, however, some important innovations are at the advent.

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Danksagung

Den Herren Dipl. Ing. Wuellner und Donitzki sei gedankt für die produktive Zusammenarbeit und die Abb. 1 b und Abb. 3 a. Ich danke auch Herrn Dr. J. Kanellopoulos, Athen, für die Abb. 3 b.

Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Seiler ist wissenschaftlicher Berater für Alcon-Wavelight. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Seiler, T. Innovationen in der refraktiven Laserchirurgie 2014. Ophthalmologe 111, 539–542 (2014). https://doi.org/10.1007/s00347-013-2993-9

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