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Refraktive und therapeutische Hornhautchirurgie

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Optische Kohärenztomographie des vorderen Augenabschnitts

Zusammenfassung

Die Vorstellung, „sich die Augen lasern zu lassen“, um anschließend keine Sehhilfsmittel wie Brillen oder Kontaktlinsen mehr zum scharfen Sehen zu benötigen, ist für viele Menschen mit Sehfehler (und für einige Augenärzte) eines der faszinierendsten Kapitel der modernen Medizin. Die ersten Beschreibungen zur Modifizierung der Hornhautbrechkraft mittels Lasersystemen gehen auf Stephen Trockel im Jahr 1983 zurück. Erste Anwendungen dieser „Excimer“-Lasersysteme am Menschen wurden in Berlin in Form der photorefraktiven Keratektomie (PRK) von Theo Seiler 1987 durchgeführt. Im Rahmen moderner therapeutischer und refraktiver Hornhautchirurgie werden zurzeit zwei physikalisch unterschiedliche Lasersysteme eingesetzt, um die Hornhaut zu modellieren: Excimer- und Femtosekundenlaser. Die kontrollierte Anwendung von Excimer-generiertem UV-Licht der Wellenlänge 193 nm bei der therapeutischen und refraktiven Hornhautchirurgie ermöglicht eine sehr präzise Modulation von Hornhautgewebe. Die heutigen Excimerlaser emittieren das UV-Licht mit einer Frequenz von 500–1000 Hz. Mittels eines einzelnen Impulses findet dabei ein Gewebsabtrag von ca. 0,25 μm in der Tiefe und 0,6 mm2 in der Fläche statt. Sie werden daher zur Oberflächenbehandlung der Hornhaut eingesetzt, um primär entweder deren Form zu ändern (refraktive Behandlung von Hyperopie/Myopie/Astigmatismus) oder therapeutisch zum Abtragen von Narben und/oder Regularisierung der Hornhautoberfläche.

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Authors and Affiliations

  1. zentrumsehstärke am UKE, Universitätsklinikum Hamburg-Eppendorf (UKE) Hamburg, Hamburg, Deutschland

    Stephan J. Linke & Johannes Steinberg

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  1. Stephan J. Linke
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  2. Johannes Steinberg
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Correspondence to Stephan J. Linke .

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Editors and Affiliations

  1. Zentrum für Augenheilkunde, Universität zu Köln, Köln, Deutschland

    Ludwig M. Heindl

  2. Universität zu Köln, Köln, Deutschland

    Sebastian Siebelmann

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Linke, S.J., Steinberg, J. (2022). Refraktive und therapeutische Hornhautchirurgie. In: Heindl, L.M., Siebelmann, S. (eds) Optische Kohärenztomographie des vorderen Augenabschnitts. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63273-4_8

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  • DOI: https://doi.org/10.1007/978-3-662-63273-4_8

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