Der Ophthalmologe

, 106:939

Posteriore lamelläre Keratoplastik (DSAEK)

CME Weiterbildung · Zertifizierte Fortbildung

Zusammenfassung

Die perforierende Keratoplastik stellte bisher die Standardtechnik zur Therapie endothelialer Hornhauterkrankungen dar. In den letzten Jahren wurde jedoch die Methode der posterioren lamellären Keratoplastik (mittels Descemet-Stripping und Mikrokeratom, DSAEK) revolutioniert, was anhand einer Literaturübersicht aus PUBMED und eigenen klinischen und experimentellen Daten verdeutlicht wird. DSAEK erlaubt die zuverlässige Therapie endothelialer Hornhauterkrankungen. Visusanstieg und Wundheilung verlaufen deutlich schneller als nach perforierender Keratoplastik, der endgültige Visus erscheint im Vergleich jedoch etwas reduziert. Posteriore lamelläre Keratoplastiktechniken wie DSAEK könnten sich mittelfristig zum Standardverfahren der Therapie endothelialer Hornhauterkrankungen entwickeln.

Schlüsselwörter

Hornhauttransplantation Posteriore lamelläre Keratoplastik Mikrokeratom Descemet-Stripping DSAEK 

Descemet’s stripping automated endothelial keratoplasty (DSAEK)

Abstract

Penetrating keratoplasty has been the gold standard for the surgical treatment of corneal endothelial pathologies, but tremendous progress has been made in recent years in improving the technology of posterior lamellar keratoplasty techniques such as Descemet’s stripping automated endothelial keratoplasty (DSAEK). This progress is shown by a literature review using PubMed sources and our own clinical and experimental data. Posterior lamellar keratoplasty using a microkeratome is a reliable surgical technique for Fuchs’ endothelial dystrophy and pseudophakic bullous keratopathy. Visual rehabilitation is faster with lamellar compared with penetrating keratoplasty, but final visual acuity seems to be a bit reduced. Posterior lamellar keratoplasty techniques such as DSAEK may replace penetrating keratoplasty as the gold standard for treating a large proportion of corneal endothelial pathologies.

Keywords

Corneal transplantation Posterior lamellar keratoplasty Microkeratome Descemet stripping DSAEK 

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  1. 1.Augenklinik mit PoliklinikFriedrich-Alexander Universität Erlangen-NürnbergErlangenDeutschland

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