Zusammenfassung
Hornhauterosionen sind der häufigste Grund für dringende augenärztliche Beratung. In der Regel ist es ein selbstbegrenzendes und gutartiges Ereignis, aber es verursacht oft große Beschwerden. Eine ideale Therapie sollte Augenschmerzen verringern und eine Infektion verhindern, ohne die Wundheilung zu beeinträchtigen. Aus traditioneller Sicht werden topische Anästhetika widersprüchlich beurteilt. Basierend auf der verfügbaren Literatur suggerieren wir, dass es einen Platz für topische Anästhetika in der Behandlung von Hornhautabschürfungen gibt.
Summary
Corneal abrasions are the most common reason for urgent ophthalmological consultation. However in general it is a self-limiting and benign entity, it can cause major discomfort. Clinical standards vary but an ideal therapy should minimize ocular pain and prevent infection without compromising wound healing. From a traditional point of view, topical anesthetics are seen as contraindicated because are known to inhibit epithelialization. This article reviews the available literature and concludes that short term supervised use of topical anesthetics has no deleterious effects on wound healing.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Swaminathan A, Otterness K, Milne K, Rezaie S. The safety of topical anesthetics in the treatment of corneal abrasions: a review. J Emerg Med. 2015;49(5):810–5.
Puls H, Cabrera D, Murad M, Erwin P, Bellolio M. Safety and effectiveness of topical anesthetics in corneal abrasions: systematic review and meta-analysis. J Emerg Med. 2015;49(5):816–24.
Dua H, And Forrester J. Clinical patterns of corneal epithelial wound healing. Am J Ophthalmol. 1987;104(5):481–9.
Ehlers P, Shah C. (Hrsg.) The Wills eye manual 5E. Philadelphia: Wolters-Kluwer and Lippincott-Williams; 2008.
Moreira L, Kasetsuwan N, Sanchez D, Shah S, Labree L, McDonnel P. Toxicity of topical anesthetic agents to human keratocytes in vivo. J Cataract Refract Surg. 1999;25(7):975–80.
Fraunfelder F. Corneal toxicity from topical ocular and systemic medications. Cornea. 2006;25(10):1133–8.
Tappeiner C, Flueckiger F, Boehnke M, Goldblum D, Garweg J. Effect of topical anesthetic agents and ethanol on corneoepithelial wound healing in an ex vivo whole-globe porcine model. J Cataract Refract Surg. 2012;38(3):519–24.
Yeniad B, Canturk S, Esin Ozdemir F, Alparslan N, Akarcay K. Toxic keratopathy due to abuse of topical anesthetic drugs. Cutan Ocul Toxicol. 2010;29(2):105–9.
Katsimpris J, Sarantoulakou M, Kordelou A, Petkou D, Petropoulos I. Clinical findings in patients with topical anaesthetic abuse keratitis: a report of five cases. Klin Monbl Augenheilkd. 2007;224(4):303–8.
Penna E, Tabbara K. Oxybuprocaine keratopathy: a preventable disease. Br J Ophthalmol. 1986;70(3):202–4.
Fukuda M, Sasaki H. Effects of fluoroquinolone-based antibacterial ophthalmic solutions on corneal wound healing. J Ocul Pharmacol Ther. 2015;31(9):536–40.
Shahinian L, Jain S, Jager R, Lin D, Sanislo S, Miller J. Dilute topical proparacaine for pain relief after photorefractive keratectomy. Ophthalmology. 1997;104(8):1327–32.
Verma S, Corbett M, Patmore A, Heacock G, Marshall J. A comparative study of the duration and efficacy of tetracaine 1 % and bupivacaine 0.75 % in controlling pain following photorefractive keratectomy (PRK). Eur J Ophthalmol. 1997;7:327–33.
Verma S, Corbett M, Marshall J. A prospective, randomized, double-masked trial to evaluate the role of topical anesthetics in controlling pain after photorefractive keratectomy. Ophthalmol. 1995;102:1918–24.
Rao S, Wong V, Cheng A, Lam P, Lam D. Topical anesthesia-induced keratopathy after laser-assisted subepithelial keratectomy. J Cataract Refract Surg. 2007;33(8):1482–4.
Lee J, Stark W. Anesthetic keratopathy after photorefractive keratectomy. J Cataract Refract Surg. 2008;34(10):1803–5.
Faktorovich E, Melwani K. Efficacy and safety of pain relief medications after photorefractive keratectomy: review of prospective randomized trials. J Cataract Refract Surg. 2014;40(10):1716–30.
Ting J, Barns K, Holmes J. Management of Ocular Trauma in Emergency (MOTE) Trial: a pilot randomized double-blinded trial comparing topical amethocaine with saline in the outpatient management of corneal trauma. J Emerg Trauma Shock. 2009;2(1):10.
Ball I, Seabrook J, Desai N, Allen L, Anderson S. Dilute proparacaine for the management of acute corneal injuries in the emergency department. CJEM. 2010;12(5):389–96.
Waldman N, Densie I, Herbison P. Topical tetracaine used for 24 hours is safe and rated highly effective by patients for the treatment of pain caused by corneal abrasions: a double-blind, randomized clinical trial. Acad Emerg Med. 2014;21(4):374–82.
Woreta F, Gupta A, Hochstetler B, Bower K. Management of post-photorefractive keratectomy pain. Surv Ophthalmol. 2013;58(6):529–35.
Nomura K, Singer D, Aguavella J. Corneal sensation after topical anesthesia. Cornea. 2001;20(2):191–3.
Pelosini L, Treffene S, Hollick E. Antibacterial activity of preservative-free topical anesthetic drops in current use in ophthalmology departments. Cornea. 2009;28(1):58–61.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
S. Luyten gibt an, dass kein Interessenkonflikt besteht.
Rights and permissions
About this article
Cite this article
Luyten, S. Die Verwendung von Lokalanästhetika in der Hornhautabschürfungs-Behandlung. Spektrum Augenheilkd. 31, 6–9 (2017). https://doi.org/10.1007/s00717-017-0330-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00717-017-0330-4