Download PDF
Klin Monbl Augenheilkd 2003; 220(8): 532-539
DOI: 10.1055/s-2003-41878
Klinische Studie
© Georg Thieme Verlag Stuttgart · New York

Kosteneffektivitätsanalyse der Versorgung von Kataraktpatienten mit monofokalen Intraokularlinsen aus Sicht der Leistungserstatter

Cost Effectiveness Evaluation of Cataract Patient Care in Respect of Monofocal Intraocular Lenses from the Perspective of German Statutory Health InsurancesInes  Landwehr1 , Mana  Tehrani2 , H.  Burkhard  Dick2 , Frank  Krummenauer1
  • 1Institut für Medizinische Biometrie, Epidemiologie und Informatik der Universität Mainz (Direktorin: Prof. Dr. M. Blettner)
  • 2Klinik und Poliklinik für Augenheilkunde der Universität Mainz (Direktor: Prof. Dr. N. Pfeiffer)
Diese Arbeit enthält Teilergebnisse der Dissertationsschrift „Was kostet eine gewonnene Visusstufe nach Kataraktchirurgie? Eine evidenzbasierte Kosteneffektivitätsanalyse aus Sicht der Leistungserstatter und aus Klinikperspektive” (Ines Landwehr, Mainz) und wird als Vortrag präsentiert im Rahmen des 101. Kongresses der Deutschen Ophthalmologischen Gesellschaft (DOG), September 2003 in Berlin, sowie im Rahmen der 48. Jahrestagung der Deutschen Gesellschaft für Medizinische Biometrie, Epidemiologie und Informatik (GMDS), September 2003 in Münster
Further Information

Publication History

Eingegangen: 24. Juni 2003

Angenommen: 12. August 2003

Publication Date:
03 September 2003 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund: Bisher existieren für den deutschen Sprachraum kaum Daten zur Kosteneffektivität der Kataraktchirurgie, weshalb in dieser Studie im Rahmen einer Metaanalyse der postoperative Visusanstieg als Nutzenparameter nebst Nachstarraten als häufigste Komplikation einerseits sowie die für den Eingriff aufgewandten Kosten aus Perspektive der Leistungserstatter andererseits gegenübergestellt werden sollten. Material und Methoden: Anhand der Literaturdatenbank MEDLINE wurden für den Zeitraum 1995 - 2002 Metaanalysen bezüglich des erreichten Visusanstiegs sowie der in einem Zeitraum von 5 Jahren nach Operation aufgetretenen Nachstarraten nach Kataraktchirurgie mit anschließender Implantation monofokaler Hinterkammerlinsen erhoben. Zur Schätzung der direkten Kosten aus Erstatterperspektive wurden die aktuellen, nach der BPflV gültigen Fallpauschalen eingebracht. Primärer Endpunkt der Untersuchung war das inkrementelle Kosten-Effektivitäts-Verhältnis der direkten Kosten für den Eingriff gegenüber dem dadurch erreichten Visusgewinn ausgedrückt über das ICER (incremental cost effectiveness ratio) dieses Eingriffs. Ergebnisse: In die Metaanalyse bezüglich des visuellen Outcomes nach Kataraktchirurgie konnten 51 Studien aufgenommen werden, bei welchen eine mediane Visusverbesserung um 5,2 Visusstufen (Interquartilabstand 3,6 - 8,0 Stufen) auf einen medianen postoperativen Visus von 0,8 zu beobachten war. Die in der Metaanalyse ermittelte Nachstarrate lag im Median bei 24 % (Interquartilabstand 10 - 34 %). Unter Berücksichtigung der gültigen Fallpauschalen der gesetzlichen Krankenkassen resultieren daraus für die Kataraktchirurgie mediane inkrementelle Kosten von 223,25 € pro gewonnener Visusstufe. Schlussfolgerung: Die Versorgung eines Kataraktpatienten mit einer monofokalen Intraokularlinse bedeutet mediane inkrementelle Kosten von etwa 223 € für die Krankenkassen und liefert einen im Median postoperativ erreichten Visus von 0,8. In diesem Sinne kann der Kataraktchirurgie verglichen mit anderen ambulanten ophthalmochirurgischen Eingriffen ein sehr gutes Kosten-Nutzen-Verhältnis attestiert werden.

Abstract

Background: Data on the cost effectiveness of cataract surgery with respect to the German statutory health insurance system are hardly available. Hence the increase in visual acuity as primary efficacy endpoint, order of posterior capsule opacification as primary complication endpoint and direct cost for supplementation with monofocal intraocular lenses have been assessed via meta-analyses to evaluate the procedure's cost effectiveness from the perspective of the German statutory health insurance system. Material and methods: Using the medical internet database MEDLINE two meta-analyses on publications between 1995 and 2002 were carried out, one estimating the gained increase in visual acuity, the second to estimate the frequency of posterior capsule opacification 5 years after implantation of a monofocal lens. To estimate the direct cost of German health insurances current reimbursement rates were used. The primary objective of this investigation was the individual incremental cost effectiveness ratio (ICER) linking the direct cost with the cataract surgery-associated increase in visual acuity. Results: 51 studies were included in the metaanalyses regarding the increase in visual acuity after cataract surgery. The median increase in visual acuity was about 5 visual units (interquartile range 3.6 - 8.0 units) reaching a median postoperative visual acuity of 0.8. The median incidence rate of posterior capsule opacification during the observed period of 5 years was estimated 24 % (10 - 34 %). Computation of the current reimbursement rates of German health insurances resulted in a median incremental cost of 223.25 € per gained visual unit. Conclusion: Providing of cataract patients with monofocal intraocular lenses means median incremental costs of about 223 € to be refunded by the health insurances and is associated with a median visual acuity outcome of 0.8. Therefore the cost effectiveness of cataract surgery can be regarded quite encouraging compared to the outcome of other ophthalmological outpatient surgery.

Schlüsselwörter

Kataraktchirurgie - Visusanstieg - monofokale Linsen - Nachstar - Kosteneffektivität

Key words

Cataract surgery - gain in visual acuity - monofocal lenses - cost effectiveness - posterior capsule opacification

Literatur

  • 1 Aasuri M, Shah U, Veenashree M, Deshpande P. Performace of a truncated-edged silicon foldable intraocular lens in Indian eyes.  Journal of Cataract & Refractive Surgery. 2002;  28 1135-1140
    PubMedGoogle Scholar
  • 2 Abela-Formanek C, Amon M, Schildt G, Schauersberger J, Heinze G, Kruger A. Uveal and capsular biocompability of hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses.  Journal of Cataract & Refractive Surgery. 2002;  28 50-61
    PubMedGoogle Scholar
  • 3 Abrahamsson M, Carlsson B, Sterner B, Sjöstrand J. Changes of visual function and visual ability in daily life following cataract surgery.  Acta Ophthalmologica Scandinavica. 1996;  74 69-73
    PubMedGoogle Scholar
  • 4 Adamsons I, Vitale S, Stark W, Rubin G. The association of postoperative subjective visual function with acuity, glare, and contrast sensitivity in patients with early cataract.  Archives Ophthalmology. 1996;  114 529-536
    PubMedGoogle Scholar
  • 5 Afsar A, Patel S, Woods R, Wykes W. A comparison of visual performance between a rigid PMMA and a foldable acrylic intraocular lens.  Eye. 1999;  13 329-335
    PubMedGoogle Scholar
  • 6 Agarwal A, Agarwal S, Narang P, Narang S. Phakonit: Phacoemulsification through a 0.9 mm corneal incision.  Journal of Cataract & Refractive Surgery. 2001;  27 1548-1552
    PubMedGoogle Scholar
  • 7 Alio J, Mulet E, Shalaby A, Attia W. Phacoemulsification in the anterior chamber.  Journal of Cataract & Refractive Surgery. 2002;  28 67-75
    PubMedGoogle Scholar
  • 8 Allen E, Burton R, Webber S, Haaskjold E, Sandvig K, Jyrkkiö H, Leite E, Nyström A, Wollensak J. Comparison of a diffractive bifocal and a monofocal intraocular lens.  Journal of Cataract & Refractive Surgery. 1996;  22 446-451
    PubMedGoogle Scholar
  • 9 Armbrecht A, Findley C, Kaushal S, Aspinall P, Hill A, Dhillon B. Is cataract surgery justified in patients with age related macular degeneration? A visual function and quality of life assessment.  British Journal of Ophthalmology. 2000;  84 1343-1348
    CrossrefPubMedGoogle Scholar
  • 10 Bayraktar S, Altan T, Kücüksümer Y, Yilmas Ö. Capsular tension ring implantation after capsulorhexis in phacoemulsification of cataracts associated with pseudoexfoliation syndrome.  Journal of Cataract & Refractive Surgery. 2001;  27 1620-1628
    PubMedGoogle Scholar
  • 11 Bellucci R, Pucci V, Morselli S, Bonomi L. Cataract surgery in eyes with early cataracts.  Journal of Cataract & Refractive Surgery. 1995;  21 522-527
    PubMedGoogle Scholar
  • 12 Birinci H, Kuruoglu S, Öge I, Öge F, Acar E. Effect of intraocular lens and anterior capsule opening type on posterior capsule opacification.  Journal of Cataract & Refractive Surgery. 1999;  25 1140-1146
    PubMedGoogle Scholar
  • 13 Brazitikos P, Tsinopoulos I, Papadopoulos N, Fotiadis K, Stangos N. Ultrasonographic classification and phacoemulsification of white senile cataracts.  Ophthalmol. 1999;  106 2178-2183
    PubMedGoogle Scholar
  • 14 Busbee B, Brown M, Brown G, Sharma S. Incremental cost-effectiveness of initial cataract surgery.  Ophthalmology. 2002;  109 606-613
    CrossrefPubMedGoogle Scholar
  • 15 Castells X, Ribo C, Nara D, Teixido A, Castilla M. Factors associated with second eye cataract surgery.  British Journal of Ophthalmology. 2000;  84 9-12
    CrossrefPubMedGoogle Scholar
  • 16 Cochrane Collaboration .http://www.cochrane.de
  • 17 Cresswell P, Allen E, Tomkinson J, Chapman F, Pickering S, Donaldson L. Cost effectiveness of a single-function treatment center for cataract surgery.  Journal of Cataract & Refractive Surgery. 1996;  22 940-946
    PubMedGoogle Scholar
  • 18 Cuzzani O, Ellant J, Young P, Gimbel H, Rydz M. Potential acuity meter versus scanning laser ophthalmoskope to predict visual acuity in cataract patients.  Journal of Cataract & Refractive Surgery. 1998;  24 263-269
    PubMedGoogle Scholar
  • 19 Davis E, Lindstrom R. Corneal thickness and visual acuity after phacoemulsification with 3 viscoelastic materials.  Journal of Cataract & Refractive Surgery. 2000;  26 1505-1509
    PubMedGoogle Scholar
  • 20 Desai P, Minassian D, Reidy A. National cataract surgery survey 1997 - 8: a report of the results of the clinical outcomes.  British Journal of Ophthalmology. 1999;  83 1336-1340
    PubMedGoogle Scholar
  • 21 Dick B, Schwenn O, Krummenauer F, Krist R, Pfeiffer N. Inflammation after sclerocorneal versus clear corneal tunnel phacoemulsification.  Ophthalmology. 2000;  107 241-247
    CrossrefPubMedGoogle Scholar
  • 22 Duran S, Zato M. Erbium: YAG laser emulsification of the cataractous lens.  Journal of Cataract & Refractive Surgery. 2001;  27 1025-1032
    PubMedGoogle Scholar
  • 23 Fenzl R, Gills J, Cherchio M. Refractive and visual outcome of hyperopic cataract cases operated on before and after implementation of the Holladay II Formula.  Ophthalmology. 1998;  105 1759-1764
    CrossrefPubMedGoogle Scholar
  • 24 Gross R. Kataraktoperationen - Nutzen und Risiken einer augenärztlichen Therapie.  Der Augenspiegel. 1998;  12/97 33-37
    PubMedGoogle Scholar
  • 25 Halpern M, Covert D, Battista C, Weinstein A, Levinson R, Yan L. Relationship of AcrySof acrylic and PhacoFlex silicone intraocular lenses to visual acuity and posterior capsule opacification.  Journal of Cataract & Refractive Surgery. 2001;  28 662-669
    PubMedGoogle Scholar
  • 26 Hayashi H, Hayashi K, Nakao F, Hayashi F. Quantitative comparison of posterior capsule opacification after polymethyl-methacrylate, silicone, and soft acrylic intraocular lens implantation.  Archives of Ophthalmology. 1998;  116 1579-1582
    PubMedGoogle Scholar
  • 27 Hayashi K, Hayashi H, Nakao F, Hayashi F. Changes in posterior capsule opacification after poly(methyl methacrylate), silicone, and acrylic intraocular lens implantation.  Journal of Cataract & Refractive Surgery. 2000;  27 817-824
    PubMedGoogle Scholar
  • 28 Hayashi K, Hayashi H, Nakao F, Hayashi F. Posterior capsule opacification after cataract surgery in patients with diabetes mellitus.  American Journal of Ophthalmology. 2002;  134 10-16
    CrossrefPubMedGoogle Scholar
  • 29 Hepsen I, Cekic O, Bayramlar H, Totan Y. Small incision extracapsular cataract surgery with manual phacotrisection.  Journal of Cataract & Refractive Surgery. 2000;  26 1048-1051
    PubMedGoogle Scholar
  • 30 Hessemer V, Schmidt K G, Schartner H. Minimal inflammatorische Kataraktchirurgie.  Klinisches Monatsblatt der Augenheilkunde. 1996;  209 331-339
    PubMedGoogle Scholar
  • 31 Hofeldt A, Weiss M. Illuminated near card assessment of potential acuity in eyes with cataract.  Ophthalmology. 1998;  105 1531-1536
    CrossrefPubMedGoogle Scholar
  • 32 Hollick E, Spalton D, Meacock W. The effect of capsulorhexis size on posterior capsular opacification: One-year results of a randomized prospective trial.  American Journal of Ophthalmology. 1999;  128 271-279
    CrossrefPubMedGoogle Scholar
  • 33 Hollick E, Spalton D, Ursell P, Pande M, Barman S, Boyce J, Tilling K. The effect of polymethyl-methacrylat, silicone, and polyacrylic intraocular lenses on posterior capsule opacification 3 years after cataract surgery.  Ophthalmology. 1999;  106 49-55
    CrossrefPubMedGoogle Scholar
  • 34 Hollick E, Spalton D, Ursell P, Meacock W, Barman S, Boyce J. Posterior capsular opacification with hydrogel, polymethyl-methacrylate, and silicone intraocular lenses: Two-year results of a randomized prospective trial.  American Journal of Ophthalmology. 2000;  129 577-584
    CrossrefPubMedGoogle Scholar
  • 35 Jacobi P, Dietlein T, Lüke C, Jacobi F. Multifocal intraocular lens implantation in prepresbyopic patients with unilateral cataract.  Ophthalmology. 2002;  109 680-686
    CrossrefPubMedGoogle Scholar
  • 36 Javitt J, Steinert R. Cataract extraction with multifocal intraocular lens implantation - A multinational clinical trial evaluating clinical, functional and quality of life outcomes.  Ophthalmology. 2000;  107 2040-2048
    CrossrefPubMedGoogle Scholar
  • 37 Javitt J, Brauweiler H P, Jacobi K, Klemen U, Kohnen S, Quentin C D, Teping C, Pham T, Knorz M, Pöetzsch D. Cataract extraction with multifocal intraocular lens implantation: Clinical, functional and quality-of-life outcomes - Multicenter clinical trial in Germany and Austria.  Journal of Cataract & Refractive Surgery. 2000;  26 1356-1366
    PubMedGoogle Scholar
  • 38 Jousson A, Barth U, Cubuk H, Koch H R. Effect of irrigating solution and irrigating temperature on the cornea and pupil during phacoemulsification.  Journal of Cataract & Refractive Surgery. 2000;  26 392-397
    PubMedGoogle Scholar
  • 39 Kanellopoulos A. Photolysis Investigative Group. Laser cataract surgery.  Ophthalmology. 2001;  108 649-655
    CrossrefPubMedGoogle Scholar
  • 40 Kaushik S, Kamlesh S. A clinical evaluation of an aspheric multifocal intraocular lens and its implications for the developing world.  Ophthalmic Surgery and Lasers. 2002;  33 298-303
    PubMedGoogle Scholar
  • 41 Kohnen S, Ferrer A, Brauweiler P. Visual function in pseudophakic eyes with poly(methyl methacrylat), silicone, and acrylic intraocular lenses.  Journal of Cataract & Refractive Surgery. 1996;  22 1303-1307
    PubMedGoogle Scholar
  • 42 Kruger A, Schauersberger J, Abela C, Schildt G, Amon M. Two year results: Sharp versus rounded optic edges on silicon lenses.  Journal of Cataract & Refractive Surgery. 2000;  26 566-570
    CrossrefPubMedGoogle Scholar
  • 43 Krummenauer F, Roden M, Knorz M, Dick B. Refraktiver Nutzen und inkrementelle Kosten der LASIK: Ergebnisse einer Kosten/Nutzen-Studie an zwei universitären LASIK-Zentren.  Klin Monatsbl Augenheilkd. 2003;  220 320-325
    PubMedGoogle Scholar
  • 44 Krummenauer F, Lehnert G, Dick H B. Gesundheitsökonomische Evaluation einer antibiotischen Prophylaxe gegenüber postoperativen Enophthalmitiden.  Klin Monatsbl Augenheilkd. 2002;  219 113-116
    Article in Thieme ConnectPubMedGoogle Scholar
  • 45 Kücüksümer Y, Bayraktar S, Sahin S, Yilmas Ö. Posterior capsule opacification 3 years after implantation of an AcrySof and a Memory Lens in the fellow eye.  Journal of Cataract & Refractive Surgery. 2000;  26 1176-1182
    PubMedGoogle Scholar
  • 46 Lundström M, Stenevi U, Thornburn W, Roos P. Catquest questionnaire for use in cataract surgery care: Assessment of surgical outcomes.  Journal of Cataract & Refractive Surgery. 1998;  24 968-974
    PubMedGoogle Scholar
  • 47 Lundström M, Brege K, Floren I, Stenevi U, Thornburn W. Impaired visual function after cataract surgery assessed using the Catquest questionnaire.  Journal of Cataract & Refractive Surgery. 2000;  26 101-108
    PubMedGoogle Scholar
  • 48 Lundström M, Barry P, Leite E, Seward H, Stenevi U. 1998 European Cataract Outcome Study - Report from the European Cataract Outcome Study Group.  Journal of Cataract & Refractive Surgery. 2001;  27 1176-1184
    PubMedGoogle Scholar
  • 49 Lundström M, Stenevi U, Thornborn W. Quality of life after first- and second- eye cataract surgery - Five-year data collected by the Swedish National Cataract Register.  Journal of Cataract & Refractive Surgery. 2001;  27 1553-1559
    PubMedGoogle Scholar
  • 50 Mamalis N, Crandall A, Linebarger E, Sheffield W, Leidenix M. Effect of intraocular lens size on posterior capsule opacification after phacoemulsification.  Journal of Cataract & Refractive Surgery. 1995;  21 99-102
    PubMedGoogle Scholar
  • 51 Mamalis N, Phillips B, Kopp C, Crandall A, Olson R. Neodymium: YAG capsulotomy rates after phacoemulsification with silicon posterior chamber intraocular lenses.  Journal of Cataract & Refractive Surgery. 1996;  22 1296-1302
    PubMedGoogle Scholar
  • 52 Mangione C, Orav J, Lawrence M, Phillips R, Seddon J, Goldman L. Prediction of visual function after cataract surgery - a prospectively validated model.  Archives Ophthalmology. 1995;  113 1305-1311
    PubMedGoogle Scholar
  • 53 Martin L. Cataract and high-pass resolution perimetry.  Acta Ophthalmologica Scandinavica. 1997;  75 174-177
    PubMedGoogle Scholar
  • 54 Meacock W, Spalton D, Boyce J, Jose R. Effect of optic size on posterior capsule opacification: 5.5 mm versus 6.0 mm AcrySof intraocular lenses.  Journal of Cataract & Refractive Surgery. 2001;  27 1194-1198
    PubMedGoogle Scholar
  • 55 Mönestam E, Wachtmeister L. Cataract surgery from a gender perspective - a population based study in Sweden.  Acta Ophthalmologica Scandinavica. 1998;  76 711-716
    CrossrefPubMedGoogle Scholar
  • 56 Mönestam E, Wachtmeister L. Dissatisfaction with cataract surgery in relation to visual results in a population based study in Sweden.  Journal of Cataract & Refractive Surgery. 1999;  25 1127-1134
    PubMedGoogle Scholar
  • 57 Mönestam E, Wachtmeister L. Impact of cataract surgery on visual acuity and subjective functional outcomes: a population-based study in Sweden.  Eye. 1999;  13 711-719
    PubMedGoogle Scholar
  • 58 Murphy C, Tuft S, Minassian D. Refractive error and visual outcome after cataract extraction.  Journal of Cataract & Refractive Surgery. 2002;  28 62-66
    PubMedGoogle Scholar
  • 59 Nijkamp M, Nuijts R, Borne B van den, Webers C, Horst F van der , Hendrikse F. Determinants of patient satisfaction after cataract surgery in 3 settings.  Journal of Cataract & Refractive Surgery. 2000;  26 1379-1388
    PubMedGoogle Scholar
  • 60 Norregaard J, Hindsberger C, Alonso J, Bellan L, Bernth-Peterson P, Black C, Dunn E, Andersen T, Espallargues M, Andersen G. Visual outcomes of cataract surgery in the United States, Canada, Denmark and Spain - Report from the International Cataract Surgery Outcomes Study.  Archives of Ophthalmology. 1998;  116 1095-1100
    PubMedGoogle Scholar
  • 61 Olson R, Crandall A. Silicon versus polymethyl-methacrylate intraocular lenses with regard to capsular opacification.  Ophthalmic Surgery and Lasers. 1998;  29 55-58
    PubMedGoogle Scholar
  • 62 Oner F, Gunenc Ü, Ferliel S. Posterior capsule opacification after phacoemulsification: Foldable acrylic versus poly(methylmethacrylate) intraocular lenses.  Journal of Cataract & Refractive Surgery. 2000;  26 722-726
    CrossrefPubMedGoogle Scholar
  • 63 Orme M, Paine A, Tale C, Kennedy L. Cost-effectiveness of the AMOArray multifokal intraocular lens in cataract surgery.  Journal of Cataract & Refractive Surgery. 2002;  18 162-168
    PubMedGoogle Scholar
  • 64 Oshika T, Suzuki Y, Kizaki H, Yaguchi S. Two year clinical study of a soft acrylic intraocular lens.  Journal of Cataract & Refractive Surgery. 1996;  22 104-109
    PubMedGoogle Scholar
  • 65 Phillips B, Crandall A, Mamalis N, Olson R. Intraoperative miotics and posterior capsular opacification following phacoemulsification with intraocular lens insertion.  Ophthalmic Surgery and Lasers. 1997;  28 911-914
    PubMedGoogle Scholar
  • 66 Pötzsch D, Lösch-Pötzsch C. Four year follow-up of the MemoryLens.  Journal of Cataract & Refractive Surgery. 1996;  22 1336-1341
    PubMedGoogle Scholar
  • 67 Ram J, Pandey S, Apple D, Werner L, Brar G, Singh R, Chaudhary K, Gupta A. Effect of in-the-bag intraocular lens fixation on the prevention of posterior capsule opacification.  Journal of Cataract & Refractive Surgery. 2001;  27 1039-1046
    PubMedGoogle Scholar
  • 68 Ravalico G, Tognetto D, Palomba M, Busatto P, Baccara F. Capsulorhexis size and posterior capsule opacification.  Journal of Cataract & Refractive Surgery. 1996;  22 98-103
    PubMedGoogle Scholar
  • 69 Riley A, Malik T, Grupcheva C, Fisk M, Craig J, McGhee C. The Auckland Cataract Study: co-morbidity, surgical techniques and clinical outcome in a public hospital service.  British Journal of Ophthalmology. 2001;  86 185-191
    PubMedGoogle Scholar
  • 70 Scaramuzza A, Fernando G, Crayford B. Posterior capsule opacification and lens epithelial cell layer formation: Hydroview hydrogel versus AcrySof acrylic intraocular lenses.  Journal of Cataract & Refractive Surgery. 2001;  27 1047-1054
    PubMedGoogle Scholar
  • 71 Schmack W H, Gerstmeyer K. Long-term results of the foldable CeeOn Edge intraocular lens.  Journal of Cataract & Refractive Surgery. 2000;  26 1172-1175
    PubMedGoogle Scholar
  • 72 Schöffski O, Schulenburg J. Gesundheitsökonomische Evaluationen (2nd Ed.). Heidelberg; Springer 2000
    Google Scholar
  • 73 Shin D, Vandenbelt S, Kim P, Gross J, Keole N, Lee S, Birt C, Reed S. Comparison of long-term incidence of posterior capsule opacification between phacoemulsification and phacotrabeculectomie.  American Journal of Ophthalmology. 2002;  133 40-47
    CrossrefPubMedGoogle Scholar
  • 74 Steinert R, Aker B, Trentacost B, Smith P, Tarantino N. A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal lens.  Ophthalmology. 1999;  106 1243-1255
    PubMedGoogle Scholar
  • 75 Steinberg E, Javitt J, Sharkey P, Zuckerman A, Legro M, Anderson G, Bass E, O'Day D. The content and cost of cataract surgery.  Archives Ophthalmology. 1993;  111 1041-1049
    PubMedGoogle Scholar
  • 76 Sundelin K, Sjöstrand J. Posterior capsule opacification 5 years after extracapsular cataract extraction.  Journal of Cataract & Refractive Surgery. 2000;  25 246-250
    PubMedGoogle Scholar
  • 77 Sundelin K, Friberg-Riad Y, Östberg A, Sjöstrand J. Posterior capsule opacification with AcrySof and poly(methyl-methacrylate) intraocular lenses.  Journal of Cataract & Refractive Surgery. 2001;  27 1586-1590
    CrossrefPubMedGoogle Scholar
  • 78 Superstein R, Boyaner D, Overbury O. Functional complaints, visual acuity, spatial contrast sensitivity and glare disability in preoperative and postoperative cataract patients.  Journal of Cataract & Refractive Surgery. 1999;  25 275-281
    PubMedGoogle Scholar
  • 79 Ursell P, Spalton D, Pande M, Hollick E, Barman S, Boyce J, Tilling K. Relationship between intraocular lens biomaterials and posterior capsule opacification.  Journal of Cataract & Refractive Surgery. 1998;  24 352-360
    PubMedGoogle Scholar
  • 80 Uusitalo R, Tarkkanen A. Outcomes of small incision cataract surgery.  Journal of Cataract & Refractive Surgery. 1998;  24 212-221
    PubMedGoogle Scholar
  • 81 Vasavada A, Singh R. Phacoemulsification in eyes with posterior polar cataract.  Journal of Cataract & Refractive Surgery. 1999;  25 238-245
    PubMedGoogle Scholar
  • 82 Wong T, Hingorani M, Lee V. Phacoemulsification time and power requirements in phaco chop and divide and conquer nucleofractis techniques.  Journal of Cataract & Refractive Surgery. 2000;  26 1373-1378
    PubMedGoogle Scholar
  • 83 Yamada K, Nagamoto T, Yozawa H, Kato K, Kurosaka D, Miyajima H, Kimura C. Effect of intraocular lens design on posterior capsule opacification after continuous curvilinear capsulorhexis.  Journal of Cataract & Refractive Surgery. 1995;  21 696-700
    PubMedGoogle Scholar

HD Dr. Frank Krummenauer

Institut für Medizinische Biometrie, Epidemiologie und Informatik

Obere Zahlbacher Straße 69

55131 Mainz

Phone: 06131/173107

Fax: 06131/172968

Email: krummi@imbei.uni-mainz.de

      >