Nachstardiszision bei Silikonimplantat

Zusammenfassung

Nach 15 Jahren Praxiserfahrung mit der Silikonchirurgie der „Rotterdamer Schule“ erlauben wir uns, erste Follow-up-Ergebnisse einer von uns entwickelten, manuellen Methodik mitzuteilen, die möglicherweise das Angstpotential „Silikon in der Vorderkammer“ nach üblicher Nachstarbehandlung mindern dürfte.

Summary

The problem: eyes after vitrectomy and silicone implant develop — membranes of secondary cataract earlier and more severely in cases of pseudophakia.

In the case of such membranes, we can obtain ameliorization of visual acuity, but usually also well-known complications: silicone oil in the Chamber, with subsequent damages of the cornea or secondary glaucoma.

We developed a simple method to avoid these complications. After local anesthesia (subconjunctival), we introduce a small cannula in the eye at 3–4-mm distance from the limbus. Then we penetrate the membrane posterior to the IOL and inject viscoelastic substances between the IOL and the posterior membrane. At the end of this procedure, we make cutting movements with the sharp end of the cannula thus obtaining a clear central opening in the membrane.

Up to now, follow-up experience has been 6 to 26 months for 6 eyes only. All the patients were operated with silicone implant after vitrectomy because of retinopathia diabetica proliferans.

We observed no kind of inflammation, rubeosis iridis, or irritation of IOP. This means there was no slightest trace of silicone oil in the achter chamber.