[Visual rehabilitation of patients with large post-traumatic defects of the anterior eye segment through iris-lens diaphragm implantation]. / Sistema zritel'noi reabilitatsii patsientov s obshirnymi defektami struktur perednego otrezka glaznogo iabloka na osnove implantatsii iridokhrustalikovoi diafragmy.

The diversity of methodological approaches and lack of pathogenetically reasonable tactics for patients with combined ocular injuries became the basis for the development and systematization of surgical rehabilitation stages of patients, in whom post-traumatic cataract is combined with post-traumatic aniridia and corneal scarring. AIM: to construct a visual rehabilitation approach to patients with post-traumatic defects of the anterior eye segment following optical-reconstructive surgery that involved implantation of an iris-lens diaphragm (ILD). MATERIAL AND METHODS: We have analyzed 80 reconstructive cases with ILD implantation in patients with post-traumatic aniridia and corneal damage. These patients constituted the first study group (Group 1). We have also investigated 58 eyes with residual ametropy and stable visual function 1 year after ILD implantation before and after conducting a laser keratorefractive surgery. These patients were assigned to the second study group (Group 2). RESULTS: Rehabilitation approach to patients after anterior segment injuries that has been proposed allows to achieve high clinical and functional results and reduce the risk of intra- and postoperative complications. CONCLUSION: The proposed approach to patients after optical-reconstructive surgery with iris-lens diaphragm implantation followed by keratorefractive surgery is an effective method of visual rehabilitation of anterior eye segment post-traumatic defects.

[Special Intraocular Lenses in Refractive Lens Surgery]. / Sonderlinsen in der refraktiven Chirurgie.

PURPOSE: Many different models and types of special intraocular lenses (IOL) are now available for refractive lens surgery. In particular, toric and multifocal IOL need specific conditions to achieve satisfactory results. For multifocal IOL, many models with different optical principles are available. For optimal individual patient-centred care, it is necessary to consider several different options. With special refractive lenses, the principle objective for the patients is to become less dependent on glasses. MATERIAL AND METHODS: Different IOL are evaluated on the basis of published studies and our own experience and data. RESULTS: IOL filtering blue light should not be classified as special IOL, but should be used as standards. Aspherical IOL are only beneficial in special situations. Toric IOL give reliable and good results, as long as certain specific requirements are considered. Multifocal IOL are still an optical compromise, although they are the only IOL that can reliably make the patient independent of glasses. To achieve satisfying results, the optimal IOL model should be selected individually. CONCLUSION: Many refractive needs can now be adequately satisfied by special IOL. The surgeon should provide ideal perioperative conditions, and he should be aware of the different IOL principles if he is to give the patient optimal advice. This can help to avoid upsetting both patients and ophthalmologists.