Topics of our lectures we held in 2017
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Neueste Erkenntnisse unserer wissenschaftlichen Tätigkeit: Keratokonus, Multifokallinsen, ReLEx SMILE
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New Versus Former-Generation Diffractive Trifocal Intraocular Lens
Presenter / Co-Authors: Timon Ax (1,4), Detlev Breyer (1,4), Hakan Kaymak (1,4), Karsten Klabe (1,4), Philipp Hagen(1,4), Florian Kretz (2,4), Gerd Auffarth (3,4)
Affiliations: (1) Breyer, Kaymak & Klabe Augenchirurgie,(2) Dr. Gerl & Kollegen Ahaus-Raesfeld-Rheine,(3) Universitaets-Augenklinik Heidelberg, (4) International Vision Correction Research Center Network(IVCRC.net)
Purpose:
Ring patterns in diffractive MIOL can be designed such that the first order diffraction coincides with the zeroth, effectively improving the far focus of the lens. Within this retrospective analysis we evaluate the visual outcome and quality of vision after implantation of such a new diffractive trifocal IOL and compare the results with those of a former trifocal generation.Setting/Venue:
All MIOL implantations were performed at the Breyer-Kaymak-Klabe Eyesurgery in Duesseldorf, Germany, which is part of the International Vision Correcton Research Center (IVCRC.net).Methods:
This retrospective quality management investigation comprises results after bilateral implantation of the new trifocal aspheric AcrySof IQ PanOptix (Alcon) in 15 patients and of the (bitoric) trifocal AT Lisa Tri (Carl Zeiss Meditec) in 104 patients. Follow up exams were performed 1, 3 and 6 months after surgery. Manifest refraction, defocus curves, halos & glare assessment and a patient questionnaire were documented.Results:
The mean postoperative UDVA at 3 months was 0.04logMAR and -0.03logMAR for PanOptix and LISA tri, respectively, whereas. UNVA was 0.03logMAR and 0.13logMAR. The defocus curves showed better far vision for LISA tri, whereas PanOptix had higher visual acuity in for 40cm. A deviation from target SE of +/-0.5D was achieved in 71% and 64% of eyes and 93% and 91% of eyes were within +/-1.0D. Halo & Glare were significantly higher than in phakic eyes but predominantly described as undisturbing. The questionnaire revealed a high patient safisfaction: 95% of patients would choose the trifocal IOL again.Conclusions:
Our first results indicate that the new PanOptix has slightly better near vision whereas LISA tri is better at far. Both diffractive trifocal lenses accomplish patients’ needs very well.MIGS beyond Pressure Lowering – Mikroinvasive Glaukomchirurgie
Impact of Increased PTA Values on Biomechanical Indices and Visual Outcome up to 5 Years After Small-Incision Lenticule Extraction
Presenter / Co-Authors: Timon Ax (1,4), Detlev Breyer (1,4), Hakan Kaymak (1,4), Karsten Klabe (1,4), Philipp Hagen(1,4), Florian Kretz (2,4), Gerd Auffarth (3,4)
Affiliations: (1) Breyer, Kaymak & Klabe Augenchirurgie, (2) Dr. Gerl & Kollegen Ahaus-Raesfeld-Rheine, (3) Universitaets-Augenklinik Heidelberg, (4) International Vision Correction Research Center (IVCRC.net)
Purpose:
Former studies showed comparable visual recovery after ReLEx SMILE and Femto-LASIK. For LASIK, however, there is evidence that PTA (Percent Tissue Altered) values >40% can be seen as a contributing factor in the development of keratectasia. This retrospective analysis addresses the question whether this also holds for increased PTA values in case of ReLEx SMILE.Setting/Venue:
All ReLEx SMILE (VisuMax, CZM) surgeries were performed at the Breyer, Kaymak & Klabe Eyesurgery in Duesseldorf, Germany, which is part of the International Vision Correction Research Center (IVCRC.net).Methods:
We analyzed the impact of high PTA-values by comparing the results of 2 ReLEx SMILE groups; 350 eyes with PTA<40% and 350 eyes with PTA>40%. Follow up was performed between 1 day and up to 5 years postoperatively. Visual outcome was evaluated in terms of visual acuity and manifest refraction. Development of ectasia was assessed using a combined analysis of corneal Scheimpflug tomography data (Belin-Ambrosio Enhanced Ectasia Display, Pentacam, Oculus) and deformation response parameters from a non-contact tonometer (Corvis, Oculus). Among others, we compared the values for R_min, BAD-D and TBI as well as the recently developed biomechanical parameter CBI.Results:
Overall PTA values ranged from 29% to 53%. We could not detect significant differences between the two PTA-groups (<40% and >40%) in terms of visual acuity and manifest refraction. Both groups showed a mean monocular UDVA of <0.05 LogMAR one year after treatment. Furthermore, the postoperative progression of the values for R_min, BAD-D, TBI and CBI were similar in both groups with and no significant differences could be found.Conclusions:
For ReLEx SMILE with PTA above 40% our analysis of tomographic and biomechanical indices did not provide evidence for keratectasia development. Further studies with longer follow-up time and larger number of patients will be needed to confirm these first findings.Bekannt aus:
