| What … for? (Indications) |
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| 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 |
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| Epiretinal Prosthesis | Blindness | |||||||||
| Eye Prostheses | Trauma, Cancer | |||||||||
| Numbers Global 19Mio 2010, 19.7Mio 2012 IOL Cataracts account for 48% of world blindness. Germany: 650.000 Cataract surgeries/year |
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| Times Recovery from the procedure is usually within 24 hours. |
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| 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 |
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| 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 |
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| – 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. |
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| – Science/Future | Light adjustable lenses | |||||||||
| Medical societies | see here | |||||||||
| Criticism | PMMA vs foldable lenses, Hard vs Soft | |||||||||
| Selected Patient Information | EyeWiki™ | |||||||||
| Register for Patients | n/a | |||||||||
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