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Chirurgische Therapie

  • B. Kirchhof

Zusammenfassung

Bereits 1977 wurden Glaskörperblutungen bei AMD mittels Vitrektomie beseitigt (Treister u. Machemer 1977). Gegenwärtig sind die begrenzten Erfolge der Lichtkoagulation der AMD Anlaß, nach alternativen Behandlungen zu suchen. Die Photokoagulationsstudie der Makula (MPS 1991) zeigt zwar, daß die Koagulation selbst subfovealer Gefäe dem natürlichen Verlauf überlegen ist. Dennoch, 2 Jahre nach Photokoagulation sehen 82% der Patienten 0,1 oder schlechter. 51% zeigen entweder neue oder persistierende Neovaskularisationen. Submakuläre Chirurgie wird nur dann einen Fortschritt bedeuten, wenn die Neovaskularisationen — insbesondere auch die subfoveal gelegenen Gefäßneubildungen — kontrolliert und atraumatisch entfernt werden. Rezidive dürfen nicht oder zumindest deutlich seltener als nach Lichtkoagulation auftreten. Der Pigmentepitheldefekt muß gering gehalten oder durch funktionsfähige RPE-Zellen ersetzt werden.

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© Springer-Verlag Berlin Heidelberg 1997

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  • B. Kirchhof

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