Crosslinking und Keratokonus

Stefan J. Lang; Philip Maier; Thomas Reinhard

doi:10.1055/a-1205-7737

Augenheilkunde up2date, Table of Contents

Augenheilkunde up2date 2021; 11(02): 111-125
DOI: 10.1055/a-1205-7737

Bindehaut, Hornhaut, Lederhaut

Crosslinking und Keratokonus

Crosslinking and Keratoconus

Stefan J. Lang

,

Philip Maier

,

Thomas Reinhard

Abstract

All articles of this category

Zusammenfassung

Ein Keratokonus führt zu einer progressiven Vorwölbung und Verdünnung der Hornhaut. Um dies aufzuhalten, kann ein Crosslinking durchgeführt werden. Dabei ist eine Behandlung nach dem „Dresdener Protokoll“ eine effektive und sichere Behandlungsmöglichkeit, aber auch zahlreiche neue Anwendungsprotokolle (akzeleriertes Crosslinking, transepitheliales Crosslinking) und sogar weitere Indikationen (refraktive Eingriffe, infektiöse Keratitis) wurden in den letzten Jahren veröffentlicht.

Abstract

Keratoconus leads to a progressive protrusion and thinning of the cornea. In order to stop this, corneal crosslinking can be performed if the progression of the disease is proven. Crosslinking according to the “Dresden protocol” includes abrasion of the corneal epithelium, application of riboflavin eye drops and irradiation with UV-A light of an intensity of 3 mW/cm² for 30 minutes. The efficacy has been shown in several prospective randomized studies. One of the more recent developments is accelerated crosslinking, which allows a shorter irradiation time. On the other hand, the possibility of transepithelial crosslinking was presented, which does not require an abrasion of the cornea. This should reduce the occurrence of postoperative pain. The range of indications has also been expanded. Corneal crosslinking is used for post-LASIK keratectasia as well. It is also being considered for use in infectious keratitis. Topographically controlled crosslinking can likewise be used to try to positively influence the refractive power of the cornea. The risks of crosslinking include the occurrence of pain, haze or scarring, endothelial cell damage and, rarely, the occurrence of keratitis.

Schlüsselwörter

Keratokonus - Crosslinking - Kornea

Key words

keratoconus - crosslinking - cornea

Full Text

References

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