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Klin Monbl Augenheilkd 2016; 233(09): 1024-1032
DOI: 10.1055/s-0042-109708
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Okuläre Hypotonie – Ursachen und therapeutische Möglichkeiten aus Sicht des Netzhautchirurgen

Ocular Hypotension: How the Retina Surgeon Sees the Causes and Therapeutic Options
A. M. Joussen
Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin
,
O. Strauß
Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin
,
S. Winterhalter
Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin
,
M. Klamann
Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin
,
T. Dietrich-Ntoukas
Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin
,
B. Müller
Klinik für Augenheilkunde, Charité – Universitätsmedizin Berlin
› Author Affiliations
Further Information

Publication History

eingereicht 13 May 2016

akzeptiert 31 May 2016

Publication Date:
12 September 2016 (online)

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Zusammenfassung

Die okuläre Hypotonie ist eine Folge einer fehlenden Produktion oder eines Verlusts von Kammerwasser. Intraokulare Entzündungen, Medikamente oder eine proliferative Vitreoretinopathie (PVR) mit Überwachsung des Ziliarkörpers können zu einer Sekretionsminderung des Kammerwassers führen. Bei der Hypotonie durch Kammerwasserverlust unterscheidet man externe Gründe – wie Z. n. (fistulierender) Chirurgie oder Traumata – von internen Ursachen, wie Zyklodialysespalten oder Netzhautablösungen. In diesem Übersichtsartikel wird die kausale Therapie der okulären Hypotonie aus der Sicht der Netzhaut- und Glaskörperchirurgie diskutiert: Ziliarkörperrefixation, Entfernung von Ziliarkörpermembranen, PVR-Chirurgie, die Wahl der Tamponade sowie Möglichkeiten und Grenzen des Irisdiaphragmas im Vergleich zu pharmakologischen Ansätzen.

Abstract

Ocular hypotension is a result of a lack of production or a loss of intraocular fluid. Intraocular inflammation, drugs, or proliferative vitreoretinopathy (PVR) with overgrowth of the ciliary body can result in reduced secretion of intraocular fluid. Loss of intraocular fluid can result from external loss, such as in fistulating surgery or trauma, or internally, e.g. from cyclodialysis clefts or retinal detachment. In this review, we discuss the causal therapy of ocular hypotension: fixation of the ciliary body, removal of ciliary body membranes, surgery for PVR, choice of tamponade, possibilities and limitations of an iris diaphragm, and pharmacological options.

Schlüsselwörter

Hypotonie - Ziliarkörperrefixation - PVR

Key words

hypotony - ciliary body fixation - PVR
 

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