What … for? (Indications)  





Eye anatomy



Intraocular Lenses (IOL) IOLs are used at cataract or myopia.
–   Anterior chamber lenses Phakic (remaining natural lens). Refractive lenses are used for myopia, presbyopia and high hyperopia, if laser or corrective lens treatment is not done.
–   Posterior chamber lenses Aphakic (no lens). Used at cataract, the replacement of the natural lens.
Glaucoma Filtration Device Glaucoma filtration devices are used to control intraocular pressure (IOP), at previously failed trabeculectomy, at insufficient conjunctiva, scarring and complicated glaucomas.
Artificial Iris/Retina Partial or complete aniridia
Capsular tension ring Cataract, a.o.
Special implants
–   Diplopia Implant
–   Pupil Dilator
–   Implants for Children
Epiretinal Prosthesis Blindness
Eye Prostheses Trauma, Cancer
Global 19Mio 2010, 19.7Mio 2012 IOL
Cataracts account for 48% of world blindness.
Germany: 650.000 Cataract surgeries/year
Recovery from the procedure is usually within 24 hours.
Contraindications behavioral Specific job requirements (e.g. pilot, public service vehicle). Night vision important. Low change of myopia.
some may be relative  
medical Retinitis pigmentosa. Stargardt disease. Macular diseases. Any abnormality of the optic nerv. Fuchs corneal dystrophy. Macular degeneration. Diabetes mellitus.
Risks during surgery Mechanical trauma
short term No improvement, infection (0.03-0.05%), rotation of the lens, lose of vision.
long term Secondary cataract (0.6%), yearly loss of 1.8% of the endothelial cells, retinal detachment, corneal swelling (0.4%). Glaucoma, Glare, Halo (FDA)
restrictions Loss of accommodation, minimized with multifocal lenses (slight double vision, reduced contrast), difficulty with performing tasks like driving at night or in fog.
Failures Mechanical trauma, infection, optical problems
Material Intraocular Lenses Hydrophilic (25%) acrylic, hydrophobic acrylic, hydrophilic with hydrophobic surface, PMMA
  Light adjustable lens Silicone + Macromers sensitive to ultraviolet light
Artificial Iris –   Polymer fiber meshwork (for suturing)
–   Fiber free
Capsular Tension Ring PMMA
Aniridia Rings Black pemA
Cornea Implants Cornearing Ceralloy-Titanium
Glaucoma Filtration Device, valved/nonvalved Stainless steel, Acrylics
Epiretinal Prosthesis Antenna, electronic case, electrode array
Eye Prostheses Glass
Statistics No longterm studies with appropriate numbers available.
Literature –   Basic Phakic Intraocular Lenses
Capsular tension ring:
Tribus C et al: Indications and clinical outcome of capsular tension ring (CTR) implantation: A reviw of 9528 cataract surgeries, Clin Ophtalmol v.1(1), 2007 Mar
–  Problems 13.88% developed clinically relevant cataracts (with IOL, older model)
Half of explantation were caused by cataract. Alio et al. Phakic intraocular lens explantation: causes in 240 cases. J Refract Surg. 2015 Jan; 31(1): 30-5.
–  Science/Future Light adjustable lenses
Medical societies see here
Criticism PMMA vs foldable lenses, Hard vs Soft

FDA: What are he risks?

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