Unsere Vortragsthemen 2012

1 Year of Presbyopia Surgery with a rotation asymmetrical (toric) multifocal IOL (MIOL) including a sector-shaped near-vision segment

Author: D. Breyer(1)

Background: We did a prospective study of 25 patients where we implanted a (toric) multifocal IOL with a surface-embedded segment for near-vision mainly in both eyes. The optical principle is based on rotational asymmetry in contrast to other MIOLs. – Material and Method: Implantation was done (Addition +3.0 diopters) after CO-MICS through a 2.2 mm incision in about 50 eyes. Refraction, Pentacam, IOL Master, aberrometry and a patient questionaire were documented pre- and 1 as well as 3 month postoperatively. – Results: The postoperative spherical equivalent is about +0.17 diopters. More than 90% of patients did not use glasses any more and reported less halos. In comparison to other MIOL we recognized a quicker neuro adaption and a better intermediate vision.

Conclusion: We mainly use this IOL in patients who work a lot on computers and are night time drivers. Therefore it became our number one IOL in presbyopic lens exchange patients.

4 Years Experience with a bitoric monofocal IOL to correct corneal astigmatism after Coaxial Microincision Cataract Surgery (CO-MICS)

Autoren: H. Kaymak(1), D. Breyer(1), K. Klabe(2), F. Henke (Dillner) (3)

Background: This is a retrospective study of 40 eyes where we implanted a bitoric, aspheric (aberration neutral) and monofocal IOL mono- and binocular to correct corneal astigmatism. Up to 4 years postoperatively examinations were done for evaluation of visual acuity, refractive error especially cylindric refraction and high order aberrations. – Material and Method: We implanted a bitoric IOL after CO-MICS through a 1.5 – 1.8 mm incision in about 40 eyes. Subjective Refraction, Pentacam, Aberrometry and IOL orientation were examined and analyzed. – Results: IOL with a cylindric power between 0.5 and 8.5 diopters were implanted. The mean value of the postoperative spherical equivalent was -0.05 diopters and of the postoperative cylinder -0.35 diopters. No IOL re-orientation was necessary.

Conclusion: Due to its high predictability and rotation stability CO-MICS and the implantation of the bitoric IOL became a routine procedure in correcting corneal astigmatism in our cataract surgery routine.

Merkmale refraktiver Linsen

Autor: D. Breyer (1)

Zusammenfassung: Unterschiede und Merkmale von optischen Systemen modernster Multifokallinsen und die wissenschaftlichen Hintergründe, die für eine individuelle Premiumlinsen-Auswahl sprechen, wie sie im MI-LENS®-Konzept praktiziert wird.

Refractive Lenticule Extraction (ReLEx) – Introduction and management of complications

Author: D. Breyer(1)

Background: ReLEx is a new all-Femto LASIK refractive technique. A refractive lenticule is prepared by the femtosecondlaser and removed manually. The FLEx (Femto Lenticule Extraction) technique requires the preparation of flap. The smile procedure (Small Incision Lenticule Incision) can be done through a 3 mm incision. – Methods: The video shows the procedure of femtosecond flap- and intracorneal lenticule preparation in an optimum way, with unscheduled incidents and shows ways out of complications. – Results: The ReLEx procedure requires some experience with femtosecondlaser flap preparartion. Unscheduled incidents and complications could be handled without visual loss.

Conclusion: The ReLEx technique is safe but should be learned step by step: first - femtosecond flap preparation; second – flex; third - smile.

Ein Jahr Erfahrung mit Aberrometrie, kornealer Topographie und Refraktion nach Femtosekundenlaser basierter Flap- und intrakornealer Lentikel-Präperation mit verschiedenen Abtragungsprofilen

Autoren: H. Kaymak(1), D. Breyer(1), K. Klabe(2), F. Henke (Dillner) (3)

Ziel: Auswertung und Vergleich der Daten von Aberrometrie-, kornealer Topographie- und Refraktion nach Femtosekundenlaser basierter Flap- und intrakornealer Lentikel-Präperation mit verschiedenen Abtragungsmustern. – Material und Methoden: Die Flap- und Lentikel-Präperationen wurden von uns mit dem VisuMax und dem Excimer Laser Mel 80 (Carl Zeiss Meditec) durchgeführt. Die postoperative Wellenfrontanalyse erfolgte mit dem Topcon KR-1W Aberrometer. Zusätzlich wurden Messungen mittels Videokeratographie und Refraktion vorgenommen. – Ergebnisse: Aberrometrie-, korneale Topographie- und Refraktionsdaten variieren signifikant in der Femtosekundenlaser-Chirurgie.

Zusammenfassung: Die intrakorneale Femtosekundenlaser basierte Lentikel-Präperation scheint die präzisere und weniger Aberrationen induzierende Methode zu sein. In näherer Zukunft müssen Daten einer größeren Patientengruppe herangezogen werden, um statistisch hoch signifikante Ergebnisse zu erhalten.