VITREORETINAL SURGERY IN EYES WITH MULTIFOCAL LENSES

Albert J. Augustin, B. Dick (Karlsruhe/Mainz)

Pupose: To evaluate the quality of visualization in vitreoretinal surgery in eyes with multifocal lenses. Different maneuvers have been investigated.

Methods: Vitreoretinal operations of different degrees of difficulty as well as different maneuvers such as fluid-air exchange or membrane peeling have been performed in eyes with multifocal lenses. All operations were performed by means of a non-contact wide-angle observation system (BIOM). In addition, an illuminated canula-system was used in all cases which allowed bimanual surgery.

Results: No significant impairment of visualization was observed during the different procedures. Even after fluid-air exchange all structures of the posterior pole could be visualized sufficiently. The visualization of the retinal periphery was slightly impaired as compared to the posterior pole.

Conclusions: There is a controversial discussion on the question if multifocal lenses should be implanted if vitreoretinal complications might occur. In diseases such as diabetes or impending holes several authors recommend not to implant a multifocal lens. On the other hand studies on animals exist which have shown that vitreoretinal surgery is possible without any restrictions following implantation of multifocals (Lim et al, 2000). This is also true for maneuvers which reduce the quality of visualization such as fluid-air exchange. According to our observations multifocal lenses can be implanted in eyes with possible vitreoretinal complications. This is especially true when using a wide angle observation system for vitreoretinal surgery.


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