Posteriore lamelläre Keratoplastik (DSAEK)
Tóm tắt
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.
Tài liệu tham khảo
Anshu A, Chee SP, Mehta JS, Tan DT (2009) Cytomegalovirus endotheliitis in Descemet’s stripping endothelial keratoplasty. Ophthalmology 116:624–630
Bachmann BO, Pogorelov P, Kruse FE, Cursiefen C (2008) Patient satisfaction after posterior lamellar keratoplasty (DSAEK). Klin Monatsbl Augenheilkd 225:577–581
Bahar I, Kaiserman I, Levinger E et al (2009) Retrospective contralateral study comparing Descemet stripping automated endothelial keratoplasty with penetrating keratoplasty. Cornea 28:485–488
Busin M, Arffa RC, Sebastiani A (2000) Endokeratoplasty as an alternative to penetrating keratoplasty for the surgical treatment of diseased endothelium. Ophthalmology 107:2077–2082
Cursiefen C (2007) Immune privilege and angiogenic privilege of the cornea. Chem Immunol Allergy 92:50–57
Cursiefen C, Küchle M, Naumann GOH (1998) Changing indications for penetrating keratoplasty: histopathology of 1250 corneal buttons. Cornea 17:468–470
Cursiefen C, Kruse FE (2008) [Descemet’s stripping with automated endothelial keratoplasty (DSAEK)] Ophthalmologe 105:183–190
Das S, Langenbucher A, Jacobi C et al (2006) Long-term refractive and visual outcome after penetrating keratoplasty only versus the triple procedure in Fuchs‘ dystrophy. Graefes Arch Clin Exp Ophthalmol 244:1089–1095
Gorovoy MS (2006) Descemet-stripping automated endothelial keratoplasty. Cornea 25:886–889
Ham L, Balachandran C, Verschoor CA et al (2009) Visual rehabilitation rate after isolated descemet membrane transplantation: descemet membrane endothelial keratoplasty. Arch Ophthalmol 127:252–255
Heindl LM, Hofmann-Rummelt C, Schlötzer-Schrehardt U et al (2008) Histologic analysis of Descemet’s stripping in posterior lamellar keratoplasty (DSAEK). Arch Ophthalmol 126:461–436
Jordan CS, Price MO, Trespalacios R, Price FW Jr (2009) Graft rejection episodes after Descemet stripping with endothelial keratoplasty: part one: clinical signs and symptoms. Br J Ophthalmol 93:387–390
Melles GRJ, Eggink FA, Lander F et al (1998) A surgical technique for posterior lamellar keratoplasty. Cornea 17:618–625
Melles GRJ, Ong S, Ververs B, Van der Wees J (2006) Descemet membrane endothelial keratoplasty (DMEK). Cornea 25:987–990
Nguyen N, Seitz B, Martus P et al (2007) Long-term topical steroid treatment improves graft survival following normal-risk penetrating keratoplasty. Am J Ophthalmol 144:318–319
Ouseley P, Terry MA (2005) Stability of vision, topography, and endothelial cell density from 1 year to 2 years after deep lamellar endothelial keratoplasty. Ophthalmology 112:50–57
Pogorelov P, Bachmann BO, Cursiefen C, Kruse F (2009) Changes in donor corneal lenticule thickness after Descemet’s stripping automated endothelial keratoplasty (DSAEK) with organ-cultured corneas. Br J Ophthalmol epub23
Price MO, Price FW (2006) Descemet’s stripping with endothelial keratoplasty. Ophthalmology 113:1936–1942
Price FW Jr, Price MO (2009) Does endothelial cell survival differ between DSEK and standard PK? Ophthalmology 116:367–368
Price MO, Jordan CS, Moore G, Price FW Jr (2009) Graft rejection episodes after Descemet stripping with endothelial keratoplasty: part two: the statistical analysis of probability and risk factors. Br J Ophthalmol 93:391–395
Terry MA (2007) Endothelial keratoplasty: clinical outcomes in the two years following deep lamellar endothelial keratoplasty (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 105:530–563
Terry MA, Ousley PJ (2005) Deep lamellar endothelial keratoplasty. Ophthalmology 112:1541–1549
Terry MA, Shama N, Chen ES et al (2009) Endothelial keratoplasty for Fuchs‘ dystrophy with cataract: complications and clinical results with the new triple procedure. Ophthalmology 116:631–639
Vinh L, Nguyen N, Martus P et al (2006) Surgery-related factors influencing corneal neovascularization after low-risk keratoplasty. Am J Ophthalmol 141:260–266