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Möglichkeiten und Grenzen der operativen Glaukomtherapie

Possibilities and limitations of glaucoma surgery

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Zusammenfassung

Hintergrund

Die Glaukomerkrankung ist die zweithäufigste Erblindungsursache weltweit und in vielen Fällen konservativ nicht ausreichend therapierbar.

Fragestellung

Es erfolgt die Darstellung des Stellenwertes operativer Verfahren der Glaukomchirurgie im Behandlungsalgorithmus.

Material und Methoden

Unterschiedliche operative Verfahren werden schematisch aufgearbeitet und bewertet.

Ergebnisse

Die Trabekulektomie ist der Goldstandard der Glaukomchirurgie und erfordert eine sorgfältige Nachsorge. Neuere, minimalinvasive Verfahren sind insbesondere bei mäßig fortgeschrittenen, unkomplizierten Stadien indiziert, während sich für komplexe Glaukomerkrankungen filtrierende Schlauchimplantate oder zyklodestruktive Verfahren eignen.

Diskussion

Bei konservativ nicht regulierbaren Glaukomfällen stehen dem Ophthalmochirurgen unterschiedlich aufwendige Verfahren zur Verfügung, die je nach Schwere, Progression und Risikofaktoren der Erkrankung ihr jeweiliges Indikationsspektrum aufweisen.

Abstract

Background

Glaucoma is the second leading cause of blindness worldwide and in many cases cannot be adequately controlled with conservative treatment.

Materials and methods

Schematic evaluation of various surgical techniques.

Results

Trabeculectomy is the gold standard of glaucoma surgery and requires close follow-up care. Novel, minimally invasive procedures are suitable for patients with moderately advanced, uncomplicated stages of the disease, whereas filtrating tube implants or cyclodestructive techniques are required in patients with complex glaucoma.

Conclusion

Various surgical techniques are available and have their specific indication window for the glaucoma surgeon, depending on the severity, progression, and risk factors of the disease.

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Authors and Affiliations

  1. Augenklinik der Technischen Universität München, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Deutschland

    L. Reznicek & I. M. Lanzl

  2. Chiemsee Augen Tagesklinik, Prien, Deutschland

    Y. Boghos & I. M. Lanzl

Authors
  1. L. Reznicek
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  2. Y. Boghos
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  3. I. M. Lanzl
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Corresponding author

Correspondence to L. Reznicek.

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Interessenkonflikt

L. Reznicek, Y. Boghos und I.M. Lanzl geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Reznicek, L., Boghos, Y. & Lanzl, I.M. Möglichkeiten und Grenzen der operativen Glaukomtherapie. Ophthalmologe 113, 833–837 (2016). https://doi.org/10.1007/s00347-016-0333-6

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  • DOI: https://doi.org/10.1007/s00347-016-0333-6

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