Zusammenfassung
Die Kataraktoperation stellt mit etwa 800 000 Operationen pro Jahr eine der häufigsten
Operationen in Deutschland dar; aufgrund des demografischen Wandels ist von einem
Anstieg in den
nächsten Jahrzehnten auszugehen. Daneben erweitern sich die diagnostischen und
operativen Möglichkeiten. Ziel dieses Beitrags ist, eine strukturierte, ziel- und
patientenorientierte
Voruntersuchung zu planen und individuelle Besonderheiten aufzuzeigen.
Abstract
To plan and execute a successful and safe cataract surgery one must conduct a structured,
goal- and patient-oriented examination. The medical history provides crucial information
regarding
the planning of the anesthetic procedure, lens selection and possible intraoperative
complications. Visual acuity and refraction measurements are essential for both documentation
and
discussion of the selected target refraction. Multifocal lenses have various
contraindications to which attention must be paid during slit lamp examination and
other imaging diagnostics.
These include epithelial basement membrane dystrophy, Fuchsʼ endothelial dystrophy,
zonular weakness, and progressive retinal diseases such as progressive AMD. Tomography
reveals corneal
irregularities as well as possible refractive laser treatments that have been
performed previously. Lens calculation is complicated in these cases. Additionally,
an endothelial cell count,
aberrometry to rule out higher order aberrations, pupillometry and an analysis
of the tear film can provide further information. The patient must be informed verbally
about the severity of
the procedure and the risks relevant for him with sufficient distance to the
surgery.
Schlüsselwörter
Kataraktchirurgie - Voruntersuchung - Operationsplanung
Key words
cataract surgery - preliminary examination - surgery planning
