Komplikationen nach posteriorer lamellärer Keratoplastik (DSAEK): Vermeiden, Erkennen und Behandeln

Zusammenfassung

Hintergrund: Posteriore lamelläre Keratoplastiktechniken, wie die Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK), nehmen zunehmend Einzug in die klinische Routine. Ziel der Arbeit ist es, typische Komplikationen nach DSAEK, deren Management sowie Strategien zur Vermeidung darzustellen. Methoden: Literaturübersicht aus PUBMED und eigene klinische Ergebnisse. Ergebnisse: Die postoperative Flapdislokation, die mit erneuter Luftfüllung der Vorderkammer behandelt werden kann, ist die häufigste und typischste Komplikation nach DSAEK (10 – 30 % der Patienten). Schlussfolgerung: Eine sorgfältige Indikationsstellung, Operationstechnik und Nachsorge können die DSAEK zu einem relativ sicheren und effektiven Therapieverfahren bei endothelialen Hornhauterkrankungen machen.

Abstract

Purpose: The aim of this study was to outline typical complications after Descemet’s stripping automated endothelial keratoplasty (DSAEK) and to discuss their prevention and management. Methods: Our own clinical results and PUBMED literature search were evaluated. Results: Postoperative flap dislocation, which can be effectively treated by re-bubbling the graft, is the most common and typical complication after DSAEK. Conclusions: Careful preoperative indication, surgery and postoperative care make DSAEK a safe and effective new therapeutic option for patients with endothelial corneal disease.

Schlüsselwörter

Kornea - Katarakt - Bindehaut - posteriore lamelläre Keratoplastik - DSAEK - DMEK

Key words

cornea - conjunctiva - cataract - posterior lamellar keratoplasty - DSAEK - DMEK

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