Publikationsserver der RWTH Aachen University
Bedeutung der Kapsulorhexis für die Nachstarentwicklung und Nachstarverhütung
Abstract
dc:descriptionINTRODUCTION: Cataract is one of the most common ophthalmologic entities. If left untreated, it inevitably leads to blindness. Current gold standard of treatment is the cataract extraction and subsequent implantation of an intraocular lens (IOL) into the posterior capsule. Posterior capsule fibrosis and subsequent opacification (PCO) represents the most prevalent long-term complication of this treatment option and the objective of this study. MATERIALS AND METHODS: 38 patients following cataract extraction and phacoemulsification were included in this trial, receiving 4 eye examinations over a 44 day period. Results were documented as digital photographs. 20 patients had received a CeeOn Edge 911A (Alcon) IOL, 18 an AcrySof MA 60 (Pharamacia). Each eye examination included determination of refraction, visus as well as a slit lamp exam of the following parameters: posterior and/or anterior capsule fibrosis, development of posterior capsule folding, localisation of capsulorhexis and lens centering. After each re-examination, rhexis length and area were determined using the photographs. RESULTS: Parameters influencing size of rhexis: Location of capsulorhexis: Group 1 (rhexis stable at 360° on lens) vs. Group 2 (rhexis < 360° on lens) showed significantly smaller diameter of rhexis in the experiment. 2. Lens type: CeeOn Edge lenses had a significantly larger diameter of the capsulorhexis than AcrySof (p<0,05). 3. Neither presence of posterior capsule folding, nor posterior/anterior capsule fibrosis correlated with rhexis diameter. Comparison CeeOn Edge vs. AcrySof: Significantly higher incidence of posterior capsule folding with AcrySof lenses (p<0,05). No significant differences between the two lenses on the parameters posterior/anterior capsule fibrosis and location of capsulorhexis. Properties of anterior capsule orifice: Group A (increasing rhexis size) vs. Group B (decreasing rhexis size) demonstrated a larger initial rhexis diameter and a noticeable larger rate of rhexis size increase. Average diameter of Group A rhexes on day 2-6 post-op was 5,09 mm vs. Group B with 4,77 mm. Parameters impacting posterior capsule fibrosis: In general, only stage 1 or 2 (very slight to slight) posterior capsule fibrosis was witnessed in this experiment. Stage 2 was only seen in Group A and in rhexes > 4,77 mm in diameter. Rhexes placed excentric of lens center also showed a tendency toward a higher prevalence of posterior capsule fibrosis. SUMMARY: The results of this study indicate that for prevention of PCO capsulrhexis diameter should be between 4,77 and 5 mm. A larger rhexis significantly increases the risk for displacement of the rhexis excentric of lens center. This study cannot statistically prove that a displacement of the rhexis increases the risk for posterior capsule fibrosis, but indicates this correlation, thus supporting numerous studies by other authors. There was a statistically higher incidence of posterior capsule folding with AcrySof lenses. With CeeOn Edge lenses we saw a worse performance in terms of capsulorhexis displacement. This lens also appears to increase the risk for posterior capsule fibrosis. A definitive evaluation and recommendation of the better lens is inhibited by the short time frame chosen for this study. A reassessment should be made in 2-3 years.
Degree
thesis:*- Grantor dc:publisher
- Publikationsserver der RWTH Aachen University
- Year dc:date
- 2005
Author and committee
dc:creator, dc:contributor.*- Author dc:creator
-
- Horn, Julia Maren
- Contributors dc:contributor
-
- Hunold, Wilfried
Subjects
dc:subject × 7Rights
dc:rights- Statement dc:rights
-
- info:eu-repo/semantics/openAccess
- Language dc:language
- ger
Identifiers
dc:identifier.*- OAI identifier oai:identifier
- oai:publications.rwth-aachen.de:60736