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Klin Monbl Augenheilkd 2018; 235(04): 413-415
DOI: 10.1055/s-0044-101010
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Cataract Surgery in High Hyperopia

Kataraktchirurgie bei hoher Hyperopie
Nicolas Philipp Waldmann
1   Ophthalmology, Universitätsspital Basel, Basel, Switzerland
,
Nadine Gerber
1   Ophthalmology, Universitätsspital Basel, Basel, Switzerland
,
Warren Hill
2   East Valley Ophthalmology, Mesa, Arizona, United States
,
David Goldblum
1   Ophthalmology, Universitätsspital Basel, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

received 19 September 2017

accepted 05 January 2018

Publication Date:
18 April 2018 (online)

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Abstract

Background Although cataract surgery is a well-established and standardised procedure, it can be demanding and associated with higher complication rates in high hyperopia. We present clinical data for highly hyperopic patients who underwent cataract surgery over a 12-year period (2005 – 2016) and at a single centre.

Patients and Methods Out of a total of 11 434 cataract operations, 41 highly hyperopic eyes (SN60AT ≥ 31 dpt) were included for analysis. We compared the target spherical equivalent to the final postoperative spherical equivalent for five different formulas. We also reviewed the best corrected distance visual acuity (BCDVA) before and after surgery and any complications.

Results LogMAR BCDVA increased significantly from a mean of 0.5 before to 0.37 after surgery (p = 0.02). The main reasons for the reduced final BCDVA were glaucoma, Fuchs corneal endothelial dystrophy, and age-related macular degeneration. One eye suffered a radial capsule tear and received a sulcus implanted intraocular lens (IOL). There was no statistically significant difference between formulas with respect to aberration of the final spherical equivalent.

Conclusions Patients with high hyperopia often have ocular comorbidities. Such eyes may be surgically challenging, resulting in reduced benefits from cataract surgery compared to normal eyes.

Zusammenfassung

Hintergrund Die Kataraktoperation ist ein gut etablierter und standardisierter Eingriff. Trotzdem kann die Operation bei starker Hyperopie anspruchsvoll und mit höheren Komplikationsraten verbunden sein. Wir präsentieren klinische Daten für alle Kataraktoperationen an hoch hyperopen Augen innert 12 Jahren an einem Zentrum.

Patienten und Methodik Von insgesamt 11 434 Kataraktoperationen wurden 41 hoch hyperope Augen (SN60AT ≥ 31 dpt) in die Analyse integriert. Wir verglichen das angestrebte mit dem schlussendlichen sphärischen Äquivalent (SE) für 5 verschiedene Formeln sowie den bestkorrigierten Fernvisus (BCDVA) vor und nach der Operation und Komplikationen.

Resultate Der logMAR-BCDVA verbesserte sich statistisch signifikant vom Mittelwert 0,5 vor auf 0,37 nach der Operation (p = 0,02). Hauptgründe für einen reduzierten postoperativen BCDVA waren Glaukom, Fuchsʼsche Endotheldystrophie und altersabhängige Makuladegeneration. Ein Auge erlitt einen radiären Kapseleinriss und erhielt eine sulkusimplantierte Linse. Zwischen den verschiedenen Formeln gab es keine statistisch signifikante Differenz betreffend dem finalen SE.

Diskussion Patienten mit hoher Hyperopie haben oft okuläre Komorbiditäten und können chirurgisch anspruchsvoller zu operieren sein, was verglichen zu normalen Augen zu einem reduzierten Nutzen der Kataraktoperation führt.

Key words

cataract surgery - high hyperopia - biometry - SN60AT

Schlüsselwörter

Kataraktoperation - hohe Hyperopie - Biometrie - SN60AT
 

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