Stefanie
Petrou-Binder MD
in Nuernberg, Germany
 |
|
Jörn
Kuchenbecker MD |
NEW studies of cataract surgery in Germany paint a picture of
a market in transition. It seems that while German surgeons have
more PMMA types of IOLs to choose from than any other kind, they
nonetheless prefer to implant acrylic lenses, according to reports
at the annual Congress of the German Ophthalmic Surgeons (DOC).
Jörn Kuchenbecker MD reviewed the findings from an online
database he created (www.iol-info.com)
which tracks surgeon choices in a presentation entitled ‘The
German IOL Report 2003’. The web site lists the entire spectrum
of intraocular implants available for anterior segment surgery
in Germany today.
"Our analysis showed that PMMA posterior chamber IOLs are
still available in the highest number in Germany, followed by
one-piece acrylic posterior chamber IOLs," Dr Kuchenbecker
noted.
Dr Kuchenbecker evaluated data which included 587 intraocular
implants from a total of 24 different providers in Germany. The
site provides information on each IOL in terms of manufacturer
(including name, address, email, phone, fax and home page), lens
type, optic material, haptic material, A constant, and ACD (ultrasound),
as well as additional technical data (diameter, haptic angle,
refractive index).
Of the 587 implants he assessed, nearly 76% were posterior chamber
lenses. Close to 8% of the total number of available IOLs were
anterior chamber lenses and 6% were capsular tension rings. Another
3% to 4% of implants were phakic IOLs, while the remaining 6%
included a variety of implants.
A total of 94% of posterior chamber lenses available to German
ophthalmic surgeons were conventional types. Between 3% and 4%
of posterior chamber lenses were for aniridia, 1% were toric and
just under 1% were anti-diplopia devices.
Some 60% of posterior chamber lens optics listed on the database
were made of PMMA, with another 20% of optics were made of acrylic
materials. Another 10% of available posterior chamber optics were
made of silicone. A small percentage of optics, less than 1%,
were made of hydroxy-ethyl-met-acrylate (HEMA), he reported.
A majority (63%) of the acrylic posterior chamber lenses had acrylic
haptics. Another 12% had PMMA haptics, 5% had polyvinyl-fluoride
(PVF) haptics and a little less than 3% had prolene haptics. The
majority of silicone optic IOLs had PMMA haptics. A few of this
type of lens had haptics made of silicone, PVF or polyamide.
Dr Kuchenbecker pointed out, however, that the types and numbers
of IOLs available to German ophthalmic surgeons represented in
his study do not necessarily reflect actual surgical practices.
According to the latest DGII/BVA survey (German-speaking Association
for Intraocular Lens Implantation and Refractive Surgery/Professional
Association of Ophthalmologists), and in strong contrast to the
data reported by Dr Kuchenbecker, ophthalmic surgeons are implanting
less than 20% PMMA posterior chamber IOLs.
Seb Ober MD reported the outcome of the survey at the DOC Congress
in Nuernberg. The DGII survey is based on the responses of 280
German ophthalmic surgeons to a surgical preferences and practices
questionnaire.
He revealed that the German ophthalmic surgeons choice of lens
material is hydrophobic acrylic lens material. Surgeons operating
in outpatient clinics implanted hydrophobic acrylic IOLs in roughly
41% of cases. The survey results vary slightly between surgeries
carried out in outpatient clinics, office surgical units and hospital
or private surgical units with reserved beds.
According to the survey, hydrophilic acrylic IOLs represented
another 26% of lenses implanted in German ambulatory clinics and
silicone lens material represented 18%. Ophthalmic surgeons opted
for PMMA lens material in only around 15% of cases.
Dr Ober’s presentation of the 2003 survey showed that the
current figures differ greatly from the DGII statistics accrued
in 1998, when acrylic lenses made up only around 20% of the lenses
implanted by ophthalmic surgeons, while they chose PMMA lenses,
by contrast, in over 60% of cases.
Dr Kuchenbecker predicts that the shift in the current surgical
practice will soon also become evident in the types and numbers
of lenses available to surgeons. He said the web site (IOL-info.com)
updates changes as they come about, as well as featuring articles
on the latest lenses and related subjects.
The site also offers helpful links to IOL-related sites, major
English and German-language journals and ophthalmological associations.
It even offers an email newsletter for interested parties.
An IOL databank is a good place for ophthalmic surgeons to turn
to when looking for an IOL to meet their personal needs and specifications.
It also provides a much-needed overview in light of the myriad
IOLs offered and also serves as an update for anyone interested
in the current IOL market, Dr Kuchenbecker said.
An English-language databank is available to surgeons at www.docholladay.com/search.cfm.
Created by Jack Holladay MD, that site allows the user to search
across numerous parameters including manufacturer, lens type and
optic material.
Jörn
Kuchenbecker MD
Otto-von-Geuricke University, Magdeburg, Germany
mail@jkuchenbecker.de
Seb Ober MD
Seb.ober@t-online.de
