PATIENT INFORMATION: Eye Implants

What … for? (Indications)

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

Numbers

Global 19Mio 2010, 19.7Mio 2012 IOL
Cataracts account for 48% of world blindness.
Germany: 650.000 Cataract surgeries/year

Times

Recovery from the procedure is usually within 24 hours.

Contraindications

(some may be relative)

behavioral
Specific job requirements (e.g. pilot, public service vehicle). Night vision important. Low change of myopia.

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?

Selected Patient Information

EyeWiki™

Register for Patients

n/a, no specific registry known
In the register of the registries you can check which ones are available.

If your implant is not covered:
The Implant-Register offers registration of implants online and you can download a printable version for your personal use.

Disclaimer
The information and links and whatsoever shown on this page are compiled with care. However, Implant-Register can´t take any responsibility for the information given, nor their content, nor their up-to-date nature, particularly in interlinked pages. You may help us with your contribution, granting us the decision to publish or not. Be careful with conclusions for yourself, in doubt double-check and consider medical solutions are individual and have to be found with an educated medical person.