Der Ophthalmologe

, Volume 107, Issue 4, pp 370–376 | Cite as

DMEK: posteriore lamelläre Keratoplastiktechnik

Das therapeutische Prinzip

Zusammenfassung

Hintergrund

Die perforierende Keratoplastik ist bisher die Standardtechnik zur Therapie endothelialer Hornhauterkrankungen. In den letzten Jahren haben sich jedoch die Techniken der posterioren lamellären Keratoplastik [Transplantation von Descemet-Membran und Endothel mit (DSAEK) oder ohne Stromarest (DMEK)] revolutioniert.

Methoden

Literaturübersicht aus PUBMED sowie eigene klinische und experimentelle Daten.

Ergebnisse

Die isolierte Transplantation von Descemet-Membran mit Endothelzellen erlaubt die spezifische Therapie endothelialer Hornhauterkrankungen. Visusanstieg und Wundheilung verlaufen deutlich schneller als nach perforierender Keratoplastik und DSAEK.

Schlussfolgerungen

Posteriore lamelläre Keratoplastiktechniken wie DMEK werden mittelfristig ein Standardverfahren zur Therapie endothelialer Hornhauterkrankungen darstellen.

Schlüsselwörter

Hornhauttransplantation Posteriore lamelläre Keratoplastik „Descemet stripping“ DMEK 

DMEK: Descemet membrane endothelial keratoplasty

Abstract

Background

Penetrating keratoplasty is at present the gold standard for 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 membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods

A review of the literature was carried out using PUBMED and own clinical and experimental data.

Results

Isolated transplantation of Descemet’s membrane with endothelial cells after stripping the host Descemet’s membrane is a new surgical technique for Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. Visual rehabilitation seems to be faster and better with DMEK compared to penetrating keratoplasty.

Conclusion

Posterior lamellar keratoplasty techniques such as DMEK will replace penetrating keratoplasty as the gold standard for treatment of a large segment of corneal endothelial pathologies.

Keywords

Corneal transplantation Posterior lamellar keratoplasty Descemet stripping DMEK 

Literatur

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

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

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