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Intrakamerale Applikation von Kortikosteroiden zur Therapie der schweren endothelialen Abstoßung nach perforierender Keratoplastik

Intracameral application of corticosteroids for treating severe endothelial rejection after penetrating keratoplasty

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Zusammenfassung

Die häufigste Ursache für die Eintrübung eines Transplantats nach perforierender Keratoplastik ist die Abstoßungsreaktion. Die endotheliale Immunreaktion ist die häufigste und zugleich für das Transplantat gefährlichste Form der Abstoßung, da sie das Transplantatendothel zerstören und damit zum Transplantatversagen führen kann. Die Therapie der „akuten“ endothelialen Abstoßungsreaktion besteht in der lokalen und ggf. systemischen Gabe von Steroiden. Die intrakamerale Applikation von Kortikosteroiden mittels Vorderkammerspülung zur Therapie der schweren endothelialen Abstoßung nach perforierender Keratoplastik ist eine zusätzliche Maßnahme, welche besonders schnell die Immunreaktion stoppen kann. Die Durchführung dieser Maßnahme wird bei allen mittelschweren und schweren endothelialen Abstoßungsreaktionen empfohlen.

Abstract

Immune reaction is the main cause for graft failure following penetrating keratoplasty. Endothelial immune reaction is the most frequent and most dangerous subtype of rejection because destruction of the graft endothelium can lead to graft failure. “Acute” endothelial rejection is treated by administration of topical and systemic steroids. Intracameral application of corticosteroids by means of an anterior chamber flush is an adjunctive measure that can stop the immune reaction immediately. This measure is thus recommended in all intermediate and severe endothelial rejections.

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  1. Universitäts-Augenklinik Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland

    F. Birnbaum, P. Maier & T. Reinhard

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  1. F. Birnbaum
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  2. P. Maier
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  3. T. Reinhard
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Correspondence to F. Birnbaum.

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Birnbaum, F., Maier, P. & Reinhard, T. Intrakamerale Applikation von Kortikosteroiden zur Therapie der schweren endothelialen Abstoßung nach perforierender Keratoplastik. Ophthalmologe 104, 813–816 (2007). https://doi.org/10.1007/s00347-007-1615-9

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  • DOI: https://doi.org/10.1007/s00347-007-1615-9

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