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Impressum
`Refractive`cataract surgery - PMMA-IOLs versus foldable IOLs
Kutschan A., Wiegand W.
Abteilung für Augenheilkunde, Klinikum Nord-Heidberg, Tangstedter Landstr. 400, 22413 Hamburg
Objective: Modern cataract surgery claims to achieve the desired
refractive result immediately after surgery.
Methods: In 104 consecutive patients operated with phacoemulsification
and scleral incision recieving a 6 mm PMMA-IOL and in 70 consecutive patients
operated with temporal clear cornea incision and implantation of a foldable
6 mm IOL (Acrysof) visual acuity, refraction and astigmatism were determined
preoperatively, between the first and third postoperative day and at 5
months after surgery. The results were compared with the desired refraction
preoperatively.
Results: 1 to 3 days postoperatively a deviation of not more than
± 1.0 D (sherical equivalent ) from the desired refraction occurred
in 73.1% of the PMMA-IOL-patients and in 77.2% of the foldable IOL-patients.
At control 5 month after surgery 76.0% of the PMMA- and 85.7% of the foldable
lens group showed a deviation of not more than ±1.5 D, 88.5% of
the PMMAand 98.6% of the foldable lens group showed a deviation of not
more than ±1.5 D and 96.2% of the PMMA- and 100% of the foldable
lens group showed a deviation of not more than ±2.0 D from the
desired refraction. The individual changes of the refraction (spherical
equivalent ) between the first and the third postoperative day and the
time of control 5 months postoperatively, however, were considerable and
reached more than ±1.0 D in 20,0% of the foldable lens group and
16.3% in the PMMA lens group. Only 6.7% patients of the PMMA lens group
and more than 12.8% patients of the foldable lens group showed no change
of refraction (spherical equivalent) at all.
Conclusion: The goal of modern cataract surgery which is to achieve
a stable refraction corresponding to the preoperativ desired refraction
immediately after surgery is not yet acchieved. At present the refractive
changes in scleral incision technique as well as in clear-cornea technique
make an instant postoperative prescription of glasses impossible.