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Korneale Wundheilungsreaktionen nach hyperoper PRK und LASIK

Corneal wound healing after hyperopic PRK and LASIK

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Zusammenfassung

Hintergrund

Ziel dieser Untersuchungen war es, den Einfluss unterschiedlicher postoperativer Nachbehandlungen auf die Wundheilungsreaktionen bei PRK und LASIK zu beurteilen.

Material und Methoden

72 Hornhäute refraktiv-chirurgisch behandelter Kaninchenaugen, die unterschiedlich lokal antibiotisch und/oder mit Steroiden sowie mit UV-B-Bestrahlung behandelt worden waren, wurden 6 Monate postoperativ sowohl licht- als auch transmissionselektronenmikroskopisch ausgewertet.

Ergebnisse

Bei den mittels PRK behandelten Augen zeigte sich am Übergang vom Epithel zum oberflächlichen Stroma eine deutliche Verzahnung beider Strukturen. An den durch LASIK behandelten Augen traten Irritationen im Grenzbereich zwischen Epithel und Stroma nur im Schnittbereich auf. In der „Interface“-Region ist eine dezent vermehrte Ablagerung fibrillären extrazellulären Materials erkennbar.

Schlussfolgerung

Die klinisch bekannten postoperativen Zustände des „haze“ bei der PRK haben ihren Ursprung in der heftigen Verzahnungsreaktion zwischen Epithel und oberem Stroma. Die nur zarten Reaktionen im Schnittbereich bei der LASIK stehen in Einklang mit dem klinischen Befund guter postoperativer Transparenz der Hornhäute.

Abstract

Background

The purpose of this study was to investigate the influence of different postoperative treatments on the wound healing reaction in the anterior stroma after PRK and in the interface area after LASIK.

Methods

Seventy-two corneal buttons of refractively treated rabbit eyes underwent different postoperative eyedrop regimens with antibiotics and/or steroids or additional UV-B irradiation. Morphological and immunohistological investigations were performed 6 months postoperatively by light and transmission electron microscopy.

Results

PRK eyes showed interdigitations between the epithelia and the anterior stroma. LASIK-treated eyes showed only minor changes between epithelia and stroma in the incisional region. Only a slight increase in deposits of fibrillar extracellular matrix components were detectable in the interface region.

Conclusions

The clinically important problem of haze after PRK is caused by the interdigitations between epithelia and anterior stroma. The delicate wound healing reactions in the interface region in LASIK eyes corresponded to the clinically visible minor changes in these corneas.

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Authors and Affiliations

  1. Augenklinik und Poliklinik, Martin-Luther-Universität, Halle-Wittenberg

    T. Hammer & G. I. W. Duncker

  2. Vista-Klinik, Binningen, Schweiz

    S. Gießler

  3. Institut für Anatomie und Zellbiologie, Martin-Luther-Universität, Halle-Wittenberg

    E. Peschke

  4. Augenklinik und Poliklinik, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 , Halle (Saale)

    T. Hammer

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  1. T. Hammer
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  2. S. Gießler
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  3. G. I. W. Duncker
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  4. E. Peschke
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Correspondence to T. Hammer.

Additional information

Gefördert durch die Deutsche Forschungsgemeinschaft (GI321/1-1).

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Hammer, T., Gießler, S., Duncker, G.I.W. et al. Korneale Wundheilungsreaktionen nach hyperoper PRK und LASIK. Ophthalmologe 102, 39–45 (2005). https://doi.org/10.1007/s00347-004-1059-4

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  • DOI: https://doi.org/10.1007/s00347-004-1059-4

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