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Posteriore lamelläre Keratoplastik (DSAEK)

Descemet’s stripping automated endothelial keratoplasty (DSAEK)

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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.

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.

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Danksagung

Wir danken den Mitgliedern der Erlanger DSAEK-Gruppe: Herrn Dr. B. Bachmann, Herrn Dr. L. Heindl, Frau Dr. K. Laaser, Herrn Dr. P. Pogorelov, Herrn Dr. M. Pollhammer, Herrn Dr. Riss, Frau C. Rummelt, Frau Prof. Dr. U. Schlötzer-Schrehardt und Herrn Vogler für Hilfe bei der klinischen Dokumentation der Patienten, der Vorderabschnitts-OCT-Untersuchung, der statistischen Analyse, der digitalen Bilddokumentation sowie der histologischen Aufarbeitung des Hornhautgewebes.

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  1. Augenklinik mit Poliklinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Deutschland

    C. Cursiefen & F.E. Kruse

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  1. C. Cursiefen
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  2. F.E. Kruse
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Erlanger DSAEK Gruppe

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Correspondence to C. Cursiefen.

Additional information

Dieser Beitrag stellt eine aktualisierte Überarbeitung folgender Arbeit dar: Cursiefen C, Kruse FE (2008) Descemet’s stripping with automated endothelial keratoplasty (DSAEK). Ophthalmologe 105:183–190

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Cursiefen, C., Kruse, F. & Erlanger DSAEK Gruppe. Posteriore lamelläre Keratoplastik (DSAEK). Ophthalmologe 106, 939–954 (2009). https://doi.org/10.1007/s00347-009-2024-z

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