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Klin Monbl Augenheilkd 2018; 235(06): 709-713
DOI: 10.1055/a-0577-7953
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Medical and Semi-surgical Treatments for Fuchs Endothelial Corneal Dystrophy

Interventionelle und pharmakologische Behandlungsansätze für Fuchs-Endotheldystrophie
Katrin Wacker
1   Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
2   Eye Clinic, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Keith H. Baratz
1   Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
,
Michael P. Fautsch
1   Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
,
Sanjay V. Patel
1   Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Further Information

Publication History

received 07 December 2017

accepted 06 February 2018

Publication Date:
03 May 2018 (online)

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Abstract

Unraveling the genetic mechanisms of Fuchs endothelial corneal dystrophy has opened new possibilities for future targeted medical therapy of the disease. Until these possibilities mature, regenerative semi-surgical approaches by cell injection or cell sheet transfer could help expand the donor pool, and possibly enable autologous transplantation. Descemet membrane stripping alone and acellular Descemet membrane transfer are more immediate surgical approaches that could be temporary treatments in some patients, though there is a lack of understanding of the factors that predict success for these procedures. Regardless of approach, clinical trials will be necessary, and clinicians should therefore try to standardize their methods of assessing disease severity and the outcomes of intervention.

Zusammenfassung

Ein Verständnis der genetischen Grundlagen der Fuchs-Endotheldystrophie eröffnet die Möglichkeit zukünftiger gezielter, nicht operativer Therapien. Bis diese Therapien ausgereift sind, könnten neue regenerative therapeutische Ansätze wie die Injektion von Endothelzellen oder der Transfer kultivierter Endothelzellschichten helfen, die Verfügbarkeit von Donorgewebe zu verbessern und vielleicht sogar autologe Transplantationen zu ermöglichen. Eher temporäre operative Ansätze für ausgewählte Patienten sind das alleinige Stripping und der azelluläre Transfer der Descemet-Membran, obgleich unklar ist, welche Patienten am meisten von diesen Verfahren profitieren können. Für alle Behandlungsverfahren werden klinische Studien notwendig sein, weshalb Kliniker anstreben sollten, die Bestimmung des Schweregrads der Fuchs-Endotheldystrophie und der postoperativen Erfolgsparameter zu standardisieren.

Key words

endothelial keratoplasty - Fuchs endothelial corneal dystrophy - trinucleotide repeat expansion - TCF4 gene - ROCK inhibitor - cell injection

Schlüsselwörter

Endothelzelltransplantation - Fuchs-Endotheldystrophie - Trinukleotid-Repeat-Expansion - TCF4-Gen - ROCK-Inhibitor - Zellinjektionen
 

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