Mike P Holzer

Universität Heidelberg, Heidelburg, Baden-Württemberg, Germany

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Publications (102)176.67 Total impact

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    ABSTRACT: Background/aims To assess over a 36-month period functional results of the modified INTRACOR femtosecond laser-based intrastromal procedure to treat presbyopia. Methods 20 eyes of 20 presbyopic patients with mild hyperopia were included. The INTRACOR procedure with a modified pattern (six concentric intrastromal ring cuts) was performed using the FEMTEC femtosecond laser (Bausch+Lomb/Technolas Perfect Vision, Munich, Germany). Patients were also randomly divided into three subgroups to compare the effect of three different small inner ring diameters (1.8/2.0/2.2 mm (Groups A/B/C)). Follow-up examinations were performed at 1, 3, 6, 12, 24 and 36 months, and included near and distance visual acuity tests, slit-lamp examinations and corneal topography. Results Median uncorrected near visual acuity (UNVA) increased from 0.7/0.7/0.7 logMAR (Groups A/B/C) to -0.1/0.1/0.1 logMAR 36 months after surgery. Uncorrected distance visual acuity changed slightly from 0.1/0.2/0.1 logMAR to 0.2/0.3/0.1 logMAR. Losses of two lines of binocular corrected distance visual acuity (CDVA) were noted in 0/25/0% of eyes. Median spherical equivalent changed from 0.75/0.75/0.75 dioptres to -0.19/0.13/-0.19 dioptres. Overall patient satisfaction with the procedure was 80%. Conclusions INTRACOR with a modified pattern improved UNVA in all patients over a 36-month follow-up period. The possibility of reduced CDVA underlines the need for careful patient selection.
    British Journal of Ophthalmology 09/2014; 99(2). DOI:10.1136/bjophthalmol-2014-305642 · 2.81 Impact Factor
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    ABSTRACT: Purpose: The aim of this study was to perform a clinical evaluation of the functional results and quality of vision after implantation of an aspheric, aberration-neutral, monofocal intraocular lens (IOL). Patients and Methods: 47 eyes of 34 patients (median age: 68 years) with cataract were enrolled in this prospective clinical study that had Ethics Committee approval. The C-flex or Superflex aspheric IOL (Rayner, UK) was implanted after phacoemulsification. Follow-up examinations were performed two to four months after surgery including subjective refraction, ETDRS uncorrected (UDVA) and corrected distance visual acuity (CDVA), wavefront analysis, analysis of stray light (C-Quant), contrast sensitivity under different lighting conditions (F. A. C. T.) and a questionnaire. Results: Two to four months after surgery, median UDVA was 0.08 logMAR (range: 0.64 to - 0.18 logMAR, n = 41). Median CDVA increased from 0.30 logMAR (range: 1.00 to - 0.02 logMAR) preoperatively to - 0.08 logMAR (range: 0.16 to - 0.22 logMAR) postoperatively (n = 47). Median difference between achieved vs. intended (Holladay 1-formula) spherical equivalent was + 0.06 D (range: - 1.06 to + 0.87 D). Median total HOA RMS (6 mm pupil size) was 0.66 µm (range: 0.41 to 1.19 µm). The median spherical aberrations were - 0.36 µm (range: - 0.70 to - 0.17 µm). Analysis of stray light (C-Quant) revealed a median value of 1.21 log(s) (range: 0.79 to 1.57 log[s]). Conclusion: The C-flex and Superflex aspheric IOLs provide good and predictable functional results. Patients are not negatively influenced by stray light and show slightly negative spherical aberrations.
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    ABSTRACT: Hintergrund Ziel der Studie war es, die Ergebnisse nach bilateraler Presbyopiekorrektur mittels intrastromaler Femtosekundenlaserbehandlung (INTRACOR) zu evaluieren. Material und Methoden In diese prospektive Studie wurden 17 Patienten eingeschlossen, die zuvor zweizeitig bilateral behandelt wurden. Postoperativ (4 bis 8 Monate) wurden die Ergebnisse mit einer unilateral am nichtdominanten Auge behandelten Kontrollgruppe (n = 17, 24 Monate postoperativ) verglichen. Ergebnisse Der binokulare fernkorrigierte Nahvisus (DCNVA) zeigte bei gleichem Median eine geringere Streuung nach bilateraler Behandlung [logMAR (min/max): 0,10 (0,30/− 0,10; Studie) vs. 0,10 (0,50/− 0,10; Kontrolle)]. In der Studiengruppe fand sich jedoch ein höherer Zeilenverlust des binokularen korrigierten Fernvisus (CDVA; 0, − 1, − 2 Zeilen): 23,5%, 70,6%, 5,9% (Studie) vs. 35,3%, 64,7%, 0% (Kontrolle). Schlussfolgerung Im Hinblick auf die CDVA-Reduktion sollte die INTRACOR-Behandlung initial nur am nichtdominanten Auge erfolgen. In ausgewählten Fällen kann eine bilaterale Korrektur bei sorgfältiger Risiko-Nutzen-Abwägung sowie Patientenaufklärung den DCNVA verbessern.
    Der Ophthalmologe 12/2013; 110(12). DOI:10.1007/s00347-012-2760-3 · 0.72 Impact Factor
  • Der Ophthalmologe 05/2013; 110(5):470. · 0.72 Impact Factor
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    ABSTRACT: To analyze the refractive outcomes and safety of three-piece silicone toric sulcus-fixated add-on intraocular lenses (IOLs) (HumanOptics/Dr.Schmidt Intraocularlinsen, Erlangen, Germany) in complex clinical cases with high astigmatism such as in cases with previous penetrating keratoplasty. Interventional case series of 21 eyes of 20 patients enrolled at two German centers. Functional results including power vector analysis, accuracy of IOL power calculation, rotational stability, and postoperative complications were evaluated from 2 months to 6 years postoperatively. The preoperative subjective cylinder exceeded or was equal to -6.00 diopters (D) in 81% of eyes (range: -2.00 to -17.00 D). The median follow-up period was 7.6 months (range: 57 days to 6 years). The efficacy analysis focused on the 2 to 6 months follow-up visit. Postoperatively, there was a median reduction of astigmatism by 70.59% (subjective cylinder range: 0.00 to -5.00 D), improvement of uncorrected distance visual acuity, and unchanged median corrected distance visual acuity. The attempted spherical equivalent was achieved within ± 0.50 D in 45% and within ± 1.00 D in 65% of cases. Five eyes received secondary surgical alignment of axis. Other complications related to the surgical procedure were mainly transient shortly after implantation, such as intraocular pressure elevation (2 of 21 eyes) or corneal edema (2 of 21 eyes). Persisting changes were seen only in rare cases and included pigment dispersion (1 of 21 eyes) or corneal edema requiring a second keratoplasty within 9 months after surgery (2 of 21 eyes). Toric add-on IOLs may be useful in reducing high astigmatism and anisometropia and increasing spectacle independence even in complex clinical conditions with high refractive errors.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 03/2013; 29(3):187-93. DOI:10.3928/1081597X-20130212-01 · 2.78 Impact Factor
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    ABSTRACT: PURPOSE: The purpose of this study was to evaluate the results of bilateral intrastromal femtosecond laser correction of presbyopia (INTRACOR). METHODS: In a prospective study 17 patients were enrolled who had previously received binocular treatment in a two-step approach. Postoperative (4-8 months) outcomes were compared with a matched control group who had undergone only unilateral surgery of the non-dominant eye (n = 17 patients, 24 months after surgery). RESULTS: The binocular distance corrected near visual acuity (DCNVA) showed the same median but lower scattering of values after bilateral treatment: 0.10 (median in logMAR) (0.30/- 0.10 min/max) (study) versus 0.10 (0.50/- 0.10) (control). In the study group, however, a higher loss of binocular corrected distance visual acuity (CDVA) was found: 23.5 %, 70.6 %, 5.9 % (0, - 1, - 2 lines) (study) versus 35.3 %, 64.7 % and 0 %, repectively (control). CONCLUSIONS: Regarding the reduced CDVA INTRACOR should initially only be performed in the non-dominant eye. In selected cases binocular treatment can improve DCNVA; however, careful risk-benefit assessment and informed consent are necessary.
    Der Ophthalmologe 01/2013; · 0.72 Impact Factor
  • M P Holzer
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    ABSTRACT: The surgical correction of presbyopia is gaining more and more popularity in the field of refractive surgery. Besides intraocular treatment with multifocal or accommodative intraocular lenses more and more corneal laser approaches are being established. These are performed either with the Excimer laser as laser in situ keratomileusis (LASIK) or the femtosecond laser. The femtosecond laser treatment is done purely intrastromally without dissection of the epithelium and is characterized by an extremely low risk of infection and inflammation. The procedure leads to a central corneal steepening with more prolate shape and increase in depth of field. This leads to a better uncorrected near visual acuity, however, corrected distance visual acuity might be reduced due to these changes.
    Der Ophthalmologe 01/2013; 110(3). DOI:10.1007/s00347-012-2743-4 · 0.72 Impact Factor
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    ABSTRACT: PURPOSE: To clinically evaluate different near additions (adds) (+3.00 diopters [D] and +4.00 D) of the M-flex 630F refractive multifocal intraocular lens (IOL). SETTING: Departments of Ophthalmology, University of Heidelberg, Germany, and Lithuanian University of Health Sciences, Kaunas, Lithuania. DESIGN: Clinical prospective nonrandomized unmasked study. METHODS: Preoperatively, cataract patients were assigned to receive bilateral +3.00 D IOLs, +4.00 D IOLs, or +3.00 D (dominant eye) and +4.00 D (nondominant eye) IOLs. Follow-up examinations were performed up to 6 months postoperatively and included refraction, visual acuity (near at 40 cm and distance), the defocus curve, contrast sensitivity, and a subjective questionnaire. RESULTS: Fifty-two patients were enrolled. No significant differences were found in the visual acuity results (P>.05). Four to 6 months postoperatively, the following median uncorrected and corrected distance visual acuity, uncorrected and distance-corrected near visual acuity, and corrected near visual acuity (logMAR) were found in all patients: -0.08, -0.12, 0.20, 0.10, and 0.10. Ninety-eight percent of patients reported being satisfied. The highest near peak versus the biggest intermediate decline in the median monocular defocus curves comparing +3.00 D and +4.00 D multifocal IOLs (logMAR) were 0.16 at 40 cm versus 0.22 at 33 cm (P=.24) and 0.38 at 66 cm versus 0.54 at 50 cm (P<.01). CONCLUSION: Compared with the +4.00 D add, the +3.00 D near add gave better intermediate results in the defocus curve without compromising distance or near visual acuity. FINANCIAL DISCLOSURE: Drs. Rabsilber, Holzer, and Auffarth have received travel reimbursement and lecture fees from Rayner Intraocular Lenses Ltd. No other author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 01/2013; DOI:10.1016/j.jcrs.2012.09.026 · 2.75 Impact Factor
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    ABSTRACT: To objectively measure the strength of the capsulotomy performed with a femtosecond laser-assisted technique or performed manually in a pig-eye laboratory study. International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. Experimental study. Ten fresh pig eyes were randomly assigned to femtosecond laser-assisted capsulotomy or manual capsulotomy. The capsule was immersed in hyaluronic acid, and retractors were fixed in the capsule opening with a pull-force measuring device. The force necessary to break the capsulotomy was measured in millinewtons (mN); the maximum stretching ratio was also assessed. The observed mean rupture force (ie, maximum amount of force measured immediately before tissue rupture) was 113 mN ± 12 (SD) in the laser-assisted procedure and 73 ± 22 mN in the manual procedure (P<.05). The stretching ratios were 1.60 ± 0.10 (femtosecond) and 1.35 ± 0.04 (manual) (P<.05). In this laboratory pig-eye study, femtosecond laser-assisted capsulotomy resulted in a significantly stronger anterior capsule opening than the standard manually performed capsulotomy. Drs. Auffarth, Reddy, and Holzer have received research and travel grants from Technolas Perfect Vision GmbH. Mr. Ritter is an employee of Technolas Perfect Vision GmbH, Munich, Germany.
    Journal of Cataract and Refractive Surgery 01/2013; 39(1):105-9. DOI:10.1016/j.jcrs.2012.08.065 · 2.75 Impact Factor
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    ABSTRACT: To evaluate functional results and corneal changes after femtosecond laser correction of presbyopia (INTRACOR, Technolas Perfect Vision GmbH) in emmetropes using a modified treatment pattern over a 12-month period. Twenty eyes from 20 emmetropic patients were treated with a modified intrastromal INTRACOR pattern consisting of 5 central rings and 8 radial cuts in a prospective, nonrandomized, uncontrolled, open, single-center, clinical study. Refraction, visual acuity, endothelial cell density, corneal pachymetry, total corneal power, and stray light were evaluated preoperatively and 1 (except endothelial cell density and stray light), 3, 6, and 12 months postoperatively. Patients filled out a subjective questionnaire at 12 months postoperatively. Comparison of preoperative versus 12-month postoperative median values revealed a significant improvement in uncorrected near visual acuity (UNVA) from 0.60 (20/80) to 0.10 logMAR (20/25) (P<.0001) and a significant decrease in corrected distance visual acuity (CDVA) from -0.10 (20/16) to 0.00 logMAR (20/20), which equals a median loss of one line (P=.0005). Fifteen percent of patients lost two lines of CDVA in the treated eye. Subjective spherical equivalent refraction remained unchanged at 0.00 diopters (D) (P=.194). After INTRACOR treatment, significant corneal steepening of 1.40 D and midperipheral flattening of 0.50 D occurred (both P<.0001). Corneal pachymetry at the thinnest point and endothelial cell density did not change significantly (P=.829 and P=.058, respectively). After 12 months, the modified INTRACOR pattern improved UNVA in emmetropic patients without inducing a myopic shift or significant changes in endothelial cell density or pachymetry.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 12/2012; 28(12):872-8. DOI:10.3928/1081597X-20121115-03 · 2.78 Impact Factor
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    ABSTRACT: We report a 66-year-old patient who presented with increasing hyperopia, astigmatism, and presbyopia in both eyes 8 years after bilateral laser in situ keratomileusis (LASIK) and LASIK enhancement in the left eye aiming for spectacle independence. Bilateral multifocal toric Lentis Mplus intraocular lenses (IOLs) with an embedded near segment and individually customized cylinder correction were implanted uneventfully following phacoemulsification. The Haigis-L formula after previous hyperopia correction was chosen for IOL power calculation and provided reliable results. Emmetropia was targeted and achieved. Three months postoperatively, the uncorrected distance visual acuity had increased from 0.40 logMAR to 0.10 logMAR in the right eye and from 0.20 logMAR to 0.00 logMAR in the left eye. The patient gained 6 lines of uncorrected near visual acuity: 0.20 logMAR in the right eye and 0.10 logMAR in the left eye. This case shows that customized premium IOL implantation can provide accurate results even in challenging cases. FINANCIAL DISCLOSURE: The International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany, has received research grants, lecture fees, and travel reimbursement from Oculentis GmbH.
    Journal of Cataract and Refractive Surgery 11/2012; 38(11):2049-52. DOI:10.1016/j.jcrs.2012.08.042 · 2.75 Impact Factor
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    ABSTRACT: Die kontralaterale autologe Keratoplastik ist eine selten angewandte Therapieoption bei vorliegender funktioneller Einäugigkeit. Hierbei erfolgt der Transfer gesunden Hornhautgewebes vom sehbehinderten Partnerauge zum erkrankten Oculus ultimus. Wir berichten im Folgenden über den Fall einer immunologischen Transplantatabstoßung nach autologer Keratoplastik bei gleichzeitigem Überleben des homologen Transplantats eines Fremdspenders am Partnerauge.
    Der Ophthalmologe 10/2012; 109(10). DOI:10.1007/s00347-012-2560-9 · 0.72 Impact Factor
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    ABSTRACT: A 41-year-old patient presented with hyperopia, astigmatism, and presbyopia for refractive treatment 6 years following cataract surgery. A toric multifocal additive intraocular lens with a near addition of +3.5 diopters (D) for sulcus implantation was chosen and implanted uneventfully. Follow-up examinations were performed from the first day until 9 months after surgery. A predictable refractive correction was seen, with a residual error of +0.125 D (spherical equivalent) in the right eye and emmetropia in the left eye. Monocular uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) (40 cm) improved to 0.1 logMAR. It could not be improved further with near-add spectacles. Binocular UDVA and UNVA were 0.0 logMAR and 0.1 logMAR (80 cm), respectively. Both additive IOLs remained centered and on axis during the follow-up period. Spectacle independence was achieved, as was high patient satisfaction. FINANCIAL DISCLOSURE: The International Vision Correction Research Centre received research grants related to this publication from the following companies: Dr. Schmidt Intraocularlinsen GmbH, Rayner Intraocular Lenses, Ltd., and Carl Zeiss Meditec AG. No author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 08/2012; 38(8):1495-8. DOI:10.1016/j.jcrs.2012.06.014 · 2.75 Impact Factor
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    ABSTRACT: The aim of this study was to examine the mesopic contrast sensitivity (CS) and glare sensitivity following intrastromal femtosecond laser correction of presbyopia (INTRACOR). In this study 25 patients with slight hyperopia and presbyopia underwent femtosecond laser correction in the non-dominant eye. Mesotest II measurements (OCULUS Optikgeräte, Wetzlar, Germany) were performed with and without glare at each of four different contrast levels preoperatively as well as 3, 6, 12, 18 and 24 months postoperatively. Data were compared using the Wilcoxon-test with a level of significance of p < 0.05. After 24 months the median CS decreased from 1:2 to 1:2.7 without glare and from 1:23 to 0 with glare. Of all patients 36% showed loss in CS without and 52% with glare and CS did not show any statistically significant differences between the treated and the untreated fellow eyes after 12 and 24 months. Overall 9 out of 18 monocular treated patients showed no binocular night driving ability according to the recommendations of the German Society of Ophthalmology (DOG) and the Professional Association of German Ophthalmologists (BVA) 24 months following INTRACOR. INTRACOR can lead to a slight reduction of mesopic contrast sensitivity and an increase of glare sensitivity. Possible consequences on night driving ability should be discussed with the patients prior to treatment.
    Der Ophthalmologe 07/2012; 109(10):1001-7. DOI:10.1007/s00347-012-2624-x · 0.72 Impact Factor
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    ABSTRACT: We present a 58-year-old man who had cataract surgery in his right eye 8 months after femtosecond laser intrastromal presbyopia treatment (Intracor). The intraocular lens (IOL) power was calculated using the standard optical biometry data and the Holladay I formula without adjusting factors. Routine cataract removal was performed without complications followed by implantation of a monofocal IOL. The achieved spherical equivalent postoperatively was +0.25 diopters (D), which was +0.26 D different than the target refraction of the Holladay 1 formula. In conclusion, the IOL power calculation was predictable and the effect of the femtosecond intrastromal presbyopia treatment remained stable and improved further after cataract surgery: The pre-treatment uncorrected near visual acuity of 20/125 improved to 20/40 after treatment and to 20/25 six months after cataract surgery. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 07/2012; 38(7):1293-7. DOI:10.1016/j.jcrs.2012.04.023 · 2.75 Impact Factor
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    ABSTRACT: To assess the effect of intrastromal femtosecond laser presbyopia treatment on uncorrected near visual acuity (UNVA) and corneal integrity over an 18-month period. Department of Ophthalmology, International Vision Correction Research Centre, University of Heidelberg, Heidelberg, Germany. Clinical trial. The UNVA (at 40 cm), corneal pachymetry, and true net power were evaluated preoperatively and 1, 3, 6, 12, and 18 months after femtosecond intrastromal presbyopic treatment (Intracor). Endothelial cell density (ECD) was measured preoperatively and 3, 6, and 12 months postoperatively. Data were analyzed with the Wilcoxon test at a P=.01 level of significance. The median UNVA improved significantly from 0.7 logMAR preoperatively to 0.4 logMAR, 0.2 logMAR, 0.2 logMAR, 0.3 logMAR, and 0.2 logMAR at 1, 3, 6, 12, and 18 months, respectively (all P<.001). The median corneal true net power increased significantly by 1.1 diopters (D) to 0.7 D, 0.8 D, 1.0 D, and 0.9 D, respectively (all P<.001); pachymetry showed no significant thinning postoperatively. There was no significant difference in ECD between preoperatively and postoperatively. Intrastromal femtosecond presbyopic treatment yielded a significant and stable gain of UNVA and corneal steepening without significant loss of endothelial cells or corneal thinning up to 18 months postoperatively. No significant regression of visual acuity or further corneal steepening occurred during the follow-up period. Dr. Auffarth and Dr. Holzer received lecture and consulting fees from Technolas Perfect Vision GmbH. No author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 05/2012; 38(5):765-73. DOI:10.1016/j.jcrs.2011.11.051 · 2.75 Impact Factor
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    ABSTRACT: Autologous keratoplasty from an amblyopic eye to the fellow oculus ultimus is a rarely used procedure. This is due to the relatively uncommon constellation of pathology. The following article reports the case of a graft rejection after autologous keratoplasty, while the homologous graft on the amblyopic fellow eye remained clear.
    Der Ophthalmologe 04/2012; 109(10):1014-6. · 0.72 Impact Factor
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    ABSTRACT: To investigate functional outcomes of the INTRACOR femtosecond laser-based intrastromal procedure to treat presbyopia. Sixty-three eyes from 63 presbyopic patients (median age: 54 years) with mild hyperopia were enrolled in this prospective, ethics committee-approved, multi-center, nonrandomized clinical trial. The INTRACOR procedure was performed using the Technolas femtosecond laser (Technolas Perfect Vision GmbH) in the nondominant eye. Postoperatively, follow-up was performed at 1 day, 1 week, and 1, 3, 6, and 12 months and included near and distance visual acuity tests, slit-lamp examinations, and corneal topography. All 63 surgeries were uneventful. Twelve months postoperatively, outcomes of 58 (92.1%) eyes were available for evaluation. Median uncorrected distance visual acuity (0.1 logMAR [range: 0.5 to 0.0 preoperatively and 0.5 to -0.1 postoperatively]) and corrected distance visual acuity (CDVA) (0.0 logMAR [range: 0.2 to -0.2 preoperatively and 0.3 to -0.1 postoperatively]) remained stable. Median spherical equivalent changed from +0.63 diopters (D) preoperatively to 0.00 D postoperatively. Median uncorrected near visual acuity increased significantly from 0.7 logMAR (range: 1.0 to 0.2) preoperatively to 0.2 logMAR (range: 0.8 to -0.1) postoperatively and eyes gained a median of 4 lines (range: 1 to 9 lines). Losses of 2 lines of CDVA were noted in 7.1% of eyes. Ring cuts were faintly visible at 12 months. The INTRACOR presbyopia procedure showed good and stable visual acuity outcomes over 12-month follow-up but loss of CDVA occurred in 7% of eyes. Overall patient satisfaction with the procedure was approximately 80%. Short treatment time and maintained corneal surface integrity are advantages of this procedure.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 03/2012; 28(3):182-8. DOI:10.3928/1081597X-20120203-01 · 2.78 Impact Factor
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    ABSTRACT: Zusammenfassung Hintergrund Multifokale Intraokularlinsen (MIOL) rufen entsprechend dem individuellen optischen Prinzip mehr oder weniger optische Phänomene hervor. Anhand der Streulichtmessung mit dem C-Quant (Oculus, Deutschland) und einem individuellen Fragebogen sollen 3 verschiedene Multifokallinsenmodelle und -prinzipien verglichen werden. Patienten und Methoden Die AMO ReZoom (refraktiv, n=10), die AMO ZM900 (diffraktiv, n=10) und die Oculentis Mplus (Segment-MIOL, n=10) wurden verglichen. Es wurden sowohl Katarakt- als auch refraktive Patienten eingeschlossen. Mindestens 3 Monate postoperativ wurden funktionelle Ergebnisse untersucht, der Streulichtparameter gemessen und eine subjektive Befragung der Patienten durchgeführt. Ergebnisse Alle Operationen wurden komplikationslos durchgeführt. Die Gruppen wurden entsprechend Alter, IOL-Stärke und bestkorrigiertem Fernvisus angeglichen. Die MIOLs unterscheiden sich hinsichtlich des Streulichtparameters (Median) signifikant (Kruskal-Wallis-Test, p
    Der Ophthalmologe 10/2011; DOI:10.1007/s00347-011-2411-0 · 0.72 Impact Factor
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    ABSTRACT: HintergrundZiel dieser Studie war die Prüfung der Messgenauigkeit der Autorefraktion bei Patienten nach INTRACOR intrastromaler Femtosekundenlaser-Presbyopiebehandlung. Patienten und MethodeFür die Studie wurden die Daten von 19Patienten (mittleres Alter 56,5±6,0Jahre) nach INTRACOR-Behandlung verwendet. Verglichen wurden Ergebnisse aus subjektiver Refraktion und Autorefraktion mittels Nidek-660A präoperativ und 12Monate postoperativ in Miosis. Durch das INTRACOR-Verfahren entsteht mittels Femtosekundenlaser eine Serie von 5 konzentrischen Ringen innerhalb der Hornhaut, die eine Aufsteilung der zentralen Hornhaut bewirken und damit der Presbyopie entgegenwirken sollen. ErgebnisseDer Vergleich zwischen subjektiver Refraktion und Autorefraktion ergab prä- und postoperativ in der Sphäre und im sphärischen Äquivalent (SÄ) keine signifikanten Unterschiede (t-Test, p>0,05 und Wilcoxon-Test, p>0,05). Die Zylinderwerte der beiden Messverfahren waren signifikant unterschiedlich (t-Test, p<0,05). Die Übereinstimmung der beiden Messungen (Werte innerhalb ±0,5dpt) war postoperativ in der Sphäre 89%, 100% im Zylinder und 68% im sphärischen Äquivalent. Mit einer Ausnahme lagen alle Patienten prä- und postoperativ in Sphäre, Zylinder und sphärischem Äquivalent innerhalb von ±1,25dpt. Die Durchführung der Autorefraktion mittels Nidek-660A war leicht erschwert, und es musste bei einigen Patienten häufiger gemessen werden. SchlussfolgerungInsgesamt war die Übereinstimmung zwischen subjektiver Refraktion und objektiv mittels Nidek-660A gemessener Refraktion bei Patienten nach einer INTRACOR-Behandlung zufriedenstellend. Ein signifikanter Unterschied zeigte sich jedoch bei den gemessenen Zylinderwerten. Die Autorefraktometerwerte sollten daher immer mit einer subjektiven Refraktion abgeglichen und hinterfragt werden. BackgroundThe goal of this study was to determine the accuracy of autorefraction measurements in patients after INTRACOR intrastromal femtosecond laser treatment of presbyopia by comparing the agreement between the subjective and objective refraction. Patients and methodsIn this study the data of 19 patients with a mean age of 56.5±6.0 years following INTRACOR treatment were analyzed pre-operatively and 12 months postoperatively. Measurements of the subjective refraction and the results of the autorefractor Nidek-660A in miosis were compared. INTRACOR is a refractive intrastromal femtosecond laser treatment to correct presbyopia. During the procedure a series of five concentric rings in the central stroma are cut which cause a change in the curvature of the cornea. ResultsThe differences in sphere and spherical equivalent between subjective refraction and autorefraction were not significant (t-test p>0.05 and Wilcoxon test p>0.05). Comparing the cylinder of the two measurements a significant difference (t-test p<0.05) was found. Focusing on the difference of the postoperative measurements of the subjective refraction and autorefraction a correlation (within ±0.5D) of 89% in the sphere, 100% in cylinder and 68% in the spherical equivalent was detected. With one exception the differences in sphere, cylinder and the spherical equivalent were within ±1.25D. In several patients the performance of the autorefraction with the Nidek-660A was somewhat complicated and the measures had to be repeated frequently. ConclusionThe agreement between subjective refraction and objective measurements of the Nidek-660A of patients following INTRACOR-treatment was good. However there was a significant difference in the cylinder values. Therefore thorough comparison of measurements obtained with the autorefractor and the subjective refraction is recommended. SchlüsselwörterINTRACOR–Autorefraktion–Refraktion–Presbyopie–Femtosekundenlaser KeywordsINTRACOR–Autorefraction–Refraction–Presbyopia–Femtosecond laser
    Der Ophthalmologe 09/2011; 108(9):852-858. DOI:10.1007/s00347-011-2398-6 · 0.72 Impact Factor

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1k Citations
176.67 Total Impact Points


  • 2005–2014
    • Universität Heidelberg
      • Department of Ophthalmology
      Heidelburg, Baden-Württemberg, Germany
  • 2002–2005
    • Medical University of South Carolina
      • Storm Eye Institute
      Charleston, South Carolina, United States
  • 2001
    • Humboldt-Universität zu Berlin
      Berlín, Berlin, Germany
  • 2000
    • Charité Universitätsmedizin Berlin
      Berlín, Berlin, Germany