Eintrübung hydrophiler Acrylintraokularlinsen: Überblick zu Labormethoden der histologischen Analyse und Replikation der Kalzifikation

Zusammenfassung

Eintrübungen von Acryllinsen durch Materialveränderungen stellen schwerwiegende Komplikationen dar, welche die sehr guten postoperativen Visusergebnisse unkomplizierter Kataraktoperationen gefährden. Für hydrophobe Acryllinsen besteht die Möglichkeit einer Bildung von Glistenings, bei hydrophilen Acryllinsen besteht das Risiko einer Kalzifikation durch Kalziumphosphate. Im Laufe der Zeit wurden verschiedene Methoden entwickelt, um die Eintrübungen hydrophiler Acryllinsen zu untersuchen. Ziel der vorliegenden Arbeit ist eine Methodenübersicht über die histologischen Standardfärbungen und Möglichkeiten der Replikation einer IOL-Kalzifikation. Mittels histologischer Färbungen lässt sich die Kalzifikation von Eintrübungen anderer Art differenzieren und die Ausprägung der Kalzifikation beurteilen. Durch die Entwicklung von In-vivo- und In-vitro-Modellen zur Replikation konnten der Kalzifikation zugrunde liegende Pathomechanismen identifiziert werden. In-vivo-Modelle eignen sich zur Beurteilung der Biokompatibilität verwendeter Linsenmaterialien. Mithilfe eines In-vitro-Modells in Bioreaktoren kann die Kinetik der Kristallbildung untersucht werden. Die Verwendung einer Elektrophorese zur Replikation der Kalzifikation unter standardisierten Bedingungen erlaubt einen Vergleich verschiedener Linsenmaterialien bezüglich des Kalzifikationsrisikos. Die Kombination verschiedener Analyse- und Replikationsmethoden kann in Zukunft dazu verwendet werden, die Pathomechanismen der Kalziumphosphatbildung und den Zusammenhang zu Risikofaktoren näher zu untersuchen. Dies könnte dazu beitragen, die Kalzifikation hydrophiler Acryllinsen und damit einhergehende Explantationen und Komplikationen zu vermeiden.

Schlüsselwörter

IOL-Kalzifikation - Eintrübung - Komplikation - Kataraktchirurgie - Histologie

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