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Perspektiven der hinteren lamellären Keratoplastik

Auf der Suche nach der perfekten Lamelle

Perspectives of posterior lamellar keratoplasty

In search of the perfect lamella

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Zusammenfassung

Endothelerkrankungen der Augenhornhaut wie die Fuchs-Endotheldystrophie und die bullöse Keratopathie gehören zu den häufigsten Indikationen für eine Keratoplastik. Der Ersatz der kompletten Hornhaut durch eine perforierende Keratoplastik (PKP) war bislang der Standardeingriff zur Behandlung der Endothelinsuffizienzen. In jüngster Vergangenheit wurden jedoch neue, progressive operative Techniken zum selektiven Endothelersatz entwickelt. Dies sind die „Descemet stripping (automated) endothelial keratoplasty“ [DS(A)EK], die „Descemet membrane endothelial keratoplasty“ (DMEK) und Hybridverfahren dieser beiden Operationstechniken. Vor- und Nachteile der lamellären und der perforierenden Verfahren machen deutlich, dass vergleichende Studien notwendig sind, um herauszufinden, welche Technik für welchen Patienten im Hinblick auf eine lang anhaltende visuelle Rehabilitation sinnvoll ist.

Abstract

Corneal endothelial diseases, such as Fuchs’ endothelial dystrophy and bullous keratopathy represent the most common indications for keratoplasty. Replacement of the entire cornea by penetrating keratoplasty has been the gold standard in treating corneal endothelial diseases for many decades. However, recently new and innovative surgical techniques for selective endothelial replacement have been developed. These are Descemet stripping (automated) endothelial keratoplasty (DS(A)EK), Descemet membrane endothelial keratoplasty (DMEK) and hybrid techniques of both. The distinct advantages and drawbacks of lamellar and penetrating techniques reveal the need of comparative studies to find out which method is suitable for which patient, particularly with regard to long-term visual rehabilitation.

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  1. Universitäts-Augenklinik Freiburg, Killianstr. 5, 79106, Freiburg im Breisgau, Deutschland

    S. Heinzelmann, P. Maier & T. Reinhard

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  1. S. Heinzelmann
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  2. P. Maier
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  3. T. Reinhard
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Correspondence to S. Heinzelmann.

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Heinzelmann, S., Maier, P. & Reinhard, T. Perspektiven der hinteren lamellären Keratoplastik. Ophthalmologe 108, 825–832 (2011). https://doi.org/10.1007/s00347-011-2330-0

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  • DOI: https://doi.org/10.1007/s00347-011-2330-0

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