Hydrogel Intraocular Lens Exchange: Five-Year Experience

 

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Zusammenfassung

Hintergrund: Beurteilung der Visuswerte (BCVA) prä- und postoperativ unter Berücksichtigung peri- und postoperativer Komplikationen. Patienten und Methoden: An 55 Patienten (55 Augen) wurden eingetrübte Hydrogel-Intraokularlinsen (IOLs) (Hydroview® H 60 M, Bausch & Lomb) ausgetauscht. Prä- und postoperative BCVA sowie peri- und postoperative Komplikationen wurden im Zeitraum von 3 – 24 Monaten erfasst. Ergebnisse: Durchschnittliche BCVA verbesserte sich statistisch signifikant von 0,05 präoperativ auf 0,4 nach 3 Monaten sowie 0,2 am Ende der Beobachtungszeit. 40 Patienten (72,2 %) erreichten eine Visusbesserung. Keine Komplikationen waren bei 30 Augen (54,5 %) mit kompletter Entfernung der eingetrübten Optik und der Haptik zu verzeichnen. Perioperative Komplikationen umfassten Zonuladehiszenz bei 10 (18,2 %), En-Block-kapsuläre-IOL-Extraktion bei 2 (3,6 %), hintere Kapselruptur bei 2 (3,6 %), Hyphäma bei 3 Augen (5,5 %) sowie Haptik-Einklemmung bei 8 Augen (14,5 %). Postoperativ kam es zu Hornhautdekompensation bei 5 (9,1 %), zystoidem Makulaödem bei 15 (27,3 %), erhöhtem Intraokulardruck bei 6 (10,9 %) sowie Netzhautablösung bei einem Auge (1,8 %). Schlussfolgerung: Obwohl Sehschärfe sich nach IOL-Austausch verbessert, können okuläre Begleiterkrankungen und postoperative Komplikationen das erwartete Endergebnis beeinflussen. Ausführliche Patientenaufklärung ist daher unverzichtbar.

Abstract

Background: This study presents an evaluation of the preoperative and postoperative best corrected visual acuity (BCVA), as well as of the incidence of perioperative and postoperative complications after opacified hydrogel intraocular lens (IOL) exchange. Patients and Methods: We exchanged opacified hydrogel IOLs (Hydroview® H 60 M, Bausch & Lomb) in 55 patients (55 eyes). Preoperative and postoperative BCVA were compared. Intraoperative and postoperative complications were recorded. Follow-up period ranged from 3 months to 24 months. Results: Mean BCVA improved significantly from 0.05 preoperatively to 0.4 at 3 months postoperatively and to 0.2 at the end of the follow-up period. Forty patients (72.7 %) reported visual improvement. The procedure was uneventful in 30 eyes (54.5 %) with complete removal of the opacified IOL optics and haptics. Intraoperative complications included partial zonular dehiscence in 10 eyes (18.2 %), en block capsular bag-IOL extraction in 2 eyes (3.6 %), posterior capsule rupture in 2 eyes (3.6 %), hyphema in 3 eyes (5.5 %), retained haptics in 8 eyes (14.5 %). Postoperative complications included corneal decompensation in 5 eyes (9.1 %), cystoid macular edema in 15 eyes (27.3 %), elevated intraocular pressure in 6 eyes (10.9 %), and retinal detachment in 1 eye (1.8 %). Conclusions: Visual acuity improved after opacified hydrogel IOL exchange, however, coexistent ocular morbidity as well as the appearance of serious postoperative complications may not yield the expected results. For these reasons extensive informed consent is mandatory.

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John M. Katsimpris, MD, PhD

Ritsou & Empeirikou Street 73

26335 Patras

Greece

Phone: ++ 30/261/0 64 34 97 , ++ 30/6 93/6 95 09 50

Fax: ++ 30/26/10 64 34 97

Email: jkatsimpris@yahoo.com