Zusammenfassung

Sind Linsentrübungen mit operablen zusätzlichen visuseinschränkenden Augenveränderungen vergesellschaftet, muß eine kombinierte Kataraktoperation erwogen werden. Dies trifft für Hornhauttrübungen, medikamentös nicht befriedigend einstellbare Glaukome, aber auch für vitrektomiebedürftige Glaskörperveränderungen zu. Im Falle der Kombination einer Keratoplastik mit einer Kataraktoperation liefert das zweizeitige Vorgehen refraktiv bessere Ergebnisse. Die Kombination einer Kataraktoperation mit einer Trabekulektomie oder Goniotrepanation wird von uns dann indiziert, wenn alten Menschen zwei konsekutive Eingriffe erspart werden sollen. Tunneltechniken ermöglichen heute ohne Probleme die Kombination vitreoretinaler Eingriffe mit Kunstlinsenimplantationen. Bei proliferativen diababetischen Retinopathien wird eine kombinierte Vorgehensweise nur dann durchgeführt, wenn die Netzhautsituation stabil und eine ausreichende Laserkoagulation durchgeführt worden ist.

Summary

A combination cataract operation must be considered in patients who have additional operable conditions limiting their vision. Examples are corneal scars, glaucoma that cannot be treated with drugs, and opacities in the vitreous cavity. When penetrating keratoplasty is combined with intraocular lens implantation, two consecutive operations yield better refractive results, i.e., a higher percentage of patients with good uncorrected visual acuity. Combined trabeculectomy and phacoemulsification is preferable in elderly glaucoma patients who are not able to tolerate two consecutive operations. Closed system phacoemulsification with a tunnel incision can be performed at every stage of a standard three-port vitrectomy. Intraocular lenses should only be implanted if there is no progressive proliferative vitreoretinopathy and photocoagulation of the fundus has been adequately performed.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • G. Duncker

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