R 455
Experimental lens refilling
H.-J. Hettlich
Lens refilling was mentioned already in 1964. With developing microsurgical techniques several groups started working on this idea again during the last years especially with the aim to restore accommodation. Up to now some questions occured similar in all these experiments:
1. Is restoring of accommodationfeasable in presbyopes due to anatomical and morphological conditions?
2. Is it possible to remove the lens matrix via microincisions and microcapsulotomies?
3. Is it possible to measure and to controll the refraction of an eye intraoperatively?
4. Which is the most promising polymer according to surgical technique, biocompatibility and PCO-prevention?
Today it is without doubt that the ciliary muscle with the suspensory apparatus of the lens reacts even in presbyopes to an accommodative stimulus. Due to advanced microsurgical techniques we are at this time able to work in a complete closed system maintaining weil controlled pressure values. If laser-phaco is an additional tool for lens refilling has to be shown. Up to now there is no established method for the intraoperative measurement of refraction even if there are promising attemts with infrared refractometers combined to the operative microscope. A lot of polymers have been tested for lens refilling so far. After own results with acrylic copolymers there are again some interesting new silicone materials under investigation.
Augenklinik, Klinikum Minden, Friedrichstraße 17, D-32427 Minden