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Erschienen in: Der Ophthalmologe 2/2015

01.02.2015 | Leitthema

Hornhautchirurgie und Hornhauttransplantation bei Kindern

verfasst von: Prof. Dr. B. Bachmann, G. Avgitidou, S. Siebelmann, C. Cursiefen

Erschienen in: Die Ophthalmologie | Ausgabe 2/2015

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Zusammenfassung

Die operative Therapie kindlicher Hornhauterkrankungen stellt auch für den erfahrenen Hornhautchirurgen eine Sondersituation dar. Neben der generell erschwerten Befunderhebung bei Kindern sind die Hornhaut und die angrenzende Sklera bei Säuglingen und Kleinkindern noch sehr weich, wodurch beispielsweise bei Keratoplastik die wunddichte Nahtlegung erschwert ist. Intraoperativ sorgen die flache Augenvorderkammer im kleinen kindlichen Auge und der typischerweise recht hohe Glaskörperdruck für enge Platzverhältnisse und wenig Spielraum für chirurgische Manipulationen. Frühe Fadenlockerungen, ein erhöhtes Risiko von postoperativen Fibrinreaktionen sowie immunologischen Transplantatreaktionen nach Keratoplastik und die drohende Amblyopiegefahr machen intensive Kontrollen, teilweise unter Narkose, notwendig. Gerade bei den sehr kleinen Patienten bieten lamelläre chirurgische Verfahren wesentliche Vorteile, da hierdurch die Gefahr von Abstoßungsreaktionen reduziert und durch die geringere Invasivität des Eingriffs bei anterioren lamellären Techniken keine bzw. nur eine geringe Eröffnung der Augenvorderkammer erfolgt. Die schnellere Herstellung optisch klarer Medien bei posterioren lamellären Techniken reduziert darüber hinaus die Amblyopiegefahr.
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Metadaten
Titel
Hornhautchirurgie und Hornhauttransplantation bei Kindern
verfasst von
Prof. Dr. B. Bachmann
G. Avgitidou
S. Siebelmann
C. Cursiefen
Publikationsdatum
01.02.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Ophthalmologie / Ausgabe 2/2015
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI
https://doi.org/10.1007/s00347-014-3053-9