nach oben

Die Ophthalmologie

Erschienen in:

01.03.2014 | Das therapeutische Prinzip

Immunsuppressiva zur Verhinderung von Abstoßungsreaktionen nach allogenen Hornhauttransplantationen

verfasst von: T. Lapp, P. Maier, F. Birnbaum, G. Schlunck, T. Reinhard

Erschienen in: Die Ophthalmologie | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Zusammenfassung

Zur Unterbindung einer allogenen Hornhauttransplantatabstoßung nach perforierenden (Hochrisiko-)Keratoplastiken kommen – wie auch bei transplantierten soliden Organen – Wirkstoffe verschiedenster pharmakologischer Substanzklassen zum Einsatz. Neben Glukokortikoiden, antiproliferativen Agenzien, Small-molecule-Inhibitoren und Antikörpern stellt vor allem die Gruppe der Makrolide mit ihren zahlreichen Derivaten eine interessante Wirkstoffklasse in diesem Kontext dar. Ergänzend zu Ciclosporin A, dem erfolgreichsten Makrolid in der Transplantationsmedizin, erfolgen derzeit tierexperimentelle Studien, um die Wirksamkeit neuerer Makrolidderivate, wie z. B. Sanglifehrin A, zu testen. In dieser Übersicht werden die Wirkstoffklassen und Wirkungsweisen der derzeit im klinischen Alltag verwendeten Standardmedikamente beschrieben und neue Entwicklungen dargestellt.

Maguire MG, Stark WJ, Gottsch JD et al (1994) Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Collaborative Corneal Transplantation Studies Research Group. Ophthalmology 101:1536–1547PubMedCrossRef

Schrage N, Reinhard PDT, Seitz B et al (2011) Leistungsbericht der Deutschen Hornhautbanken 2009. Ophthalmologe 108:278–280PubMedCrossRef

Williams KA, Muehlberg SM, Lewis RF, Coster DJ (1995) How successful is corneal transplantation? A report from the Australian Corneal Graft Register. Eye (Lond Engl) 9(Pt 2):219–227

Williams KA, Muehlberg SM, Lewis RF, Coster DJ (1995) Graft survival after corneal transplantation: role of factors with the potential for recipient presensitisation. The Australian Corneal Graft Registry (ACGR). Transplant Proc 27:2141–2142PubMed

Birnbaum F, Jehle T, Schwartzkopff J et al (2008) Basiliximab following penetrating risk-keratoplasty – a prospective randomized pilot study. Klin Monatsbl Augenheilkd 225:62–65PubMedCrossRef

Mayer K, Birnbaum F, Reinhard T et al (2004) FTY720 prolongs clear corneal allograft survival with a differential effect on different lymphocyte populations. Br J Ophthalmol 88:915–919PubMedCentralPubMedCrossRef

Birnbaum F, Böhringer D, Sokolovska Y et al (2005) Immunosuppression with cyclosporine A and mycophenolate mofetil after penetrating high-risk keratoplasty: a retrospective study. Transplantation 79:964–968PubMedCrossRef

Birnbaum F, Mayweg S, Reis A et al (2009) Mycophenolate mofetil (MMF) following penetrating high-risk keratoplasty: long-term results of a prospective, randomised, multicentre study. Eye (Lond Engl) 23:2063–2070

Birnbaum F, Schwartzkopff J, Scholz C et al (2007) The new malononitrilamide immunosuppressant FK778 prolongs corneal allograft survival in the rat keratoplasty model. Eye (Lond Engl) 21:1516–1523

10.

Birnbaum F, Reis A, Böhringer D et al (2006) An open prospective pilot study on the use of rapamycin after penetrating high-risk keratoplasty. Transplantation 81:767–772PubMedCrossRef

11.

Ziaei M, Sharif-Paghaleh E, Manzouri B (2012) Pharmacotherapy of corneal transplantation. Expert Opin Pharmacother 13:829–840PubMedCrossRef

12.

Niederkorn JY, Larkin DFP (2010) Immune privilege of corneal allografts. Ocul Immunol Inflamm 18:162–171PubMedCentralPubMedCrossRef

13.

Anshu A, Price MO, Price FW Jr (2012) Risk of corneal transplant rejection significantly reduced with Descemet’s membrane endothelial keratoplasty. Ophthalmology 119:536–540PubMedCrossRef

14.

Cunnusamy K, Chen PW, Niederkorn JY (2010) Paradigm shifts in the role of CD4+T cells in keratoplasty. Discov Med 10:452–461PubMedCentralPubMed

15.

Slegers TP, Rooijen N van, Rij G van, Gaag R van der (2000) Delayed graft rejection in pre-vascularised corneas after subconjunctival injection of clodronate liposomes. Curr Eye Res 20:322–324PubMedCrossRef

16.

Slegers TP, Torres PF, Broersma L et al (2000) Effect of macrophage depletion on immune effector mechanisms during corneal allograft rejection in rats. Invest Ophthalmol Vis Sci 41:2239–2247PubMed

17.

Slegers TPAM, Broersma L, Rooijen N van et al (2004) Macrophages play a role in the early phase of corneal allograft rejection in rats. Transplantation 77:1641–1646PubMedCrossRef

18.

Reinhard T, Böcking A, Pomjanski N, Sundmacher R (2002) Immune cells in the anterior chamber of patients with immune reactions after penetrating keratoplasty. Cornea 21:56–61PubMedCrossRef

19.

Flynn TH, Mitchison NA, Ono SJ, Larkin DFP (2008) Aqueous humor alloreactive cell phenotypes, cytokines and chemokines in corneal allograft rejection. Am J Transplant 8:1537–1543PubMedCrossRef

20.

Birnbaum F, Reis A, Reinhard T (2007) Topical immunosuppressives after penetrating keratoplasty. Ophthalmologe 104:381–387PubMedCrossRef

21.

Riad M, Mogos M, Thangathurai D, Lumb PD (2002) Steroids. Curr Opin Crit Care 8:281–284PubMedCrossRef

22.

Barrett AJ, Rezvani K, Solomon S et al (2003) New developments in allotransplant immunology. Hematol Am Soc Hematol Educ Program 350–371

23.

Banchereau J, Steinman RM (1998) Dendritic cells and the control of immunity. Nature 392:245–252PubMedCrossRef

24.

Reis A, Birnbaum F, Reinhard T (2007) Systemic immunosuppressives after penetrating keratoplasty. Ophthalmologe 104:373–380PubMedCrossRef

25.

King WJ, Comer RM, Hudde T et al (2000) Cytokine and chemokine expression kinetics after corneal transplantation. Transplantation 70:1225–1233PubMedCrossRef

26.

Rayner SA, King WJ, Comer RM et al (2000) Local bioactive tumour necrosis factor (TNF) in corneal allotransplantation. Clin Exp Immunol 122:109–116PubMedCentralPubMedCrossRef

27.

Bourges JL, Lallemand F, Agla E et al (2006) Evaluation of a topical cyclosporine A prodrug on corneal graft rejection in rats. Mol Vis 12:1461–1466PubMed

28.

Cosar CB, Laibson PR, Cohen EJ, Rapuano CJ (2003) Topical cyclosporine in pediatric keratoplasty. Eye Contact Lens 29:103–107PubMedCrossRef

29.

„Peri- und postoperative Behandlungsempfehlungen bei perforierender Keratoplastik“ der Sektion Kornea der DOG (n.d.). http://www.dog.org/wp-content/uploads/2010/02/Behandlungsempfehlungen-Keratoplastik.pdf

30.

Quinones MP, Estrada CA, Kalkonde Y et al (2005) The complex role of the chemokine receptor CCR2 in collagen-induced arthritis: implications for therapeutic targeting of CCR2 in rheumatoid arthritis. J Mol Med 83:672–681PubMedCrossRef

31.

Zhao Q (2010) Dual targeting of CCR2 and CCR5: therapeutic potential for immunologic and cardiovascular diseases. J Leukoc Biol 88:41–55PubMedCrossRef

32.

Boesecke C, Pett SL (2012) Clinical studies with chemokine receptor-5 (CCR5)-inhibitors. Curr Opin HIV AIDS 7:456–462PubMedCrossRef

33.

Maeda K, Das D, Nakata H, Mitsuya H (2012) CCR5 inhibitors: emergence, success, and challenges. Expert Opin Emerg Drugs 17:135–145PubMedCrossRef

34.

Ruderman EM (2012) Overview of safety of non-biologic and biologic DMARDs. Rheumatology (Oxf Engl) 51(Suppl 6):vi37–vi43

35.

Upchurch KS, Kay J (2012) Evolution of treatment for rheumatoid arthritis. Rheumatology (Oxf Engl) 51(Suppl 6):vi28–vi36

36.

Kampik D, Ali RR, Larkin DFP (2012) Experimental gene transfer to the corneal endothelium. Exp Eye Res 95:54–59PubMedCrossRef

37.

Sin W-X, Li P, Yeong JP-S, Chin K-C (2012) Activation and regulation of interferon-β in immune responses. Immunol Res 53:25–40PubMedCrossRef

38.

Kallen J, Sedrani R, Zenke G, Wagner J (2005) Structure of human cyclophilin A in complex with the novel immunosuppressant sanglifehrin A at 1.6 A resolution. J Biol Chem 280:21965–2197PubMedCrossRef

39.

Martin Cabrejas LM, Rohrbach S, Wagner D et al (1999) Macrolide analogues of the novel immunosuppressant sanglifehrin: new application of the ring-closing metathesis reaction. Angew Chem Int Ed Engl 38:2443–2446CrossRef

40.

Sanglier JJ, Quesniaux V, Fehr T et al (1999) Sanglifehrins A, B, C and D, novel cyclophilin-binding compounds isolated from Streptomyces sp. A92-308110. I. Taxonomy, fermentation, isolation and biological activity. J Antibiot (Tokyo) 52:466–473

41.

Nicolaou KC, Xu J, Murphy F et al (1999) Total synthesis of sanglifehrin A. Angew Chem Int Ed Engl 38:2447–2451PubMedCrossRef

42.

Halestrap AP, Clarke SJ, Javadov SA (2004) Mitochondrial permeability transition pore opening during myocardial reperfusion – a target for cardioprotection. Cardiovasc Res 61:372–385PubMedCrossRef

43.

Abraham RT, Wiederrecht GJ (1996) Immunopharmacology of rapamycin. Annu Rev Immunol 14:483–510PubMedCrossRef

44.

Allen A, Zheng Y, Gardner L et al (2004) The novel cyclophilin binding compound, sanglifehrin A, disassociates G1 cell cycle arrest from tolerance induction. J Immunol (Baltim Md 1950) 172:4797–4803

45.

Woltman AM, Schlagwein N, Kooij SW van der, Kooten C van (2004) The novel cyclophilin-binding drug sanglifehrin A specifically affects antigen uptake receptor expression and endocytic capacity of human dendritic cells. J Immunol (Baltim Md 1950) 172:6482–6489

46.

Zhang L-H, Liu JO (2001) Sanglifehrin A, a novel cyclophilin-binding immunosuppressant, inhibits IL-2-dependent T cell proliferation at the G1 phase of the cell cycle. J Immunol 166:5611–5618PubMed

47.

Zenke G, Strittmatter U, Fuchs S et al (2001) Sanglifehrin A, a novel cyclophilin-binding compound showing immunosuppressive activity with a new mechanism of action. J Immunol 166:7165–7171PubMed

48.

Zhang LH, Youn HD, Liu JO (2001) Inhibition of cell cycle progression by the novel cyclophilin ligand sanglifehrin A is mediated through the NFkappa B-dependent activation of p53. J Biol Chem 276:43534–43540PubMedCrossRef

49.

Hackstein H, Thomson AW (2004) Dendritic cells: emerging pharmacological targets of immunosuppressive drugs. Nat Rev Immunol 4:24–34PubMedCrossRef

50.

Thomson AW, Turnquist HR, Raimondi G (2009) Immunoregulatory functions of mTOR inhibition. Nat Rev Immunol 9:324–337PubMedCentralPubMedCrossRef

51.

Macedo C, Turquist H, Metes D, Thomson AW (2012) Immunoregulatory properties of rapamycin-conditioned monocyte-derived dendritic cells and their role in transplantation. Transplant Res 1:16PubMedCentralPubMedCrossRef

52.

Amodio G, Gregori S (2012) Human tolerogenic DC-10: perspectives for clinical applications. Transplant Res 1:14PubMedCentralPubMedCrossRef

53.

Obermajer N, Kalinski P (2012) Generation of myeloid-derived suppressor cells using prostaglandin E2. Transplant Res 1:15PubMedCentralPubMedCrossRef

54.

Riquelme P, Geissler EK, Hutchinson JA (2012) Alternative approaches to myeloid suppressor cell therapy in transplantation: comparing regulatory macrophages to tolerogenic DCs and MDSCs. Transplant Res 1:17PubMedCentralPubMedCrossRef

55.

Yona S, Jung S (2010) Monocytes: subsets, origins, fates and functions. Curr Opin Hematol 17:53–59PubMedCrossRef

56.

Sànchez-Tilló E, Wojciechowska M, Comalada M et al (2006) Cyclophilin A is required for M-CSF-dependent macrophage proliferation. Eur J Immunol 36:2515–2524PubMedCrossRef

57.

Härtel C, Iblher P, Puzik A et al (2006) Immunosuppressive activity of the immunophilin-binding drug Sanglifehrin A in human whole blood: potent inhibition of interleukin-6 produced by lymphocytes and monocytes. Scand J Immunol 63:26–34PubMedCrossRef

58.

Steinschulte C, Taner T, Thomson AW et al (2003) Cutting edge: sanglifehrin A, a novel cyclophilin-binding immunosuppressant blocks bioactive IL-12 production by human dendritic cells. J Immunol (Baltim Md 1950) 171:542–546

59.

Hackstein H, Steinschulte C, Fiedel S et al (2007) Sanglifehrin a blocks key dendritic cell functions in vivo and promotes long-term allograft survival together with low-dose CsA. Am J Transplant 7:789–798PubMedCrossRef

60.

Immecke SN, Baal N, Wilhelm J et al (2011) The cyclophilin-binding agent sanglifehrin A is a dendritic cell chemokine and migration inhibitor. PLoS One 6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069092/ (Zugegriffen: 25. Juli 2013)

61.

Schwartzkopff J, Olivares Valdez L, Bredow L et al (2011) Sanglifehrin A promotes allograft survival in rat keratoplasty. http://www.abstractsonline.com/plan/ViewAbstract.aspx?mID=2684&sKey=a3eec449-ac9a-44c0-a3b8-b35afc120517&cKey=5d110dad-c9dd-445f-bf0c-913e43fec86d&mKey=%7B6F224A2D-AF6A-4533-8BBB-6A8D7B26EDB3 %7D

62.

Schwartzkopff J, Olivares L, Bredow L et al (2011) Hemmung von dendritischen Zellen durch Sanglifehrin A verbessert das Transplantatüberleben nach Keratoplastik. http://www.abstracts.dog.org/abstracts/abstract.html?id=6

63.

O’Neill LAJ (2006) Targeting signal transduction as a strategy to treat inflammatory diseases. Nat Rev Drug Discov 5:549–563CrossRef

64.

Sabatini DM, Lai MM, Snyder SH (1997) Neural roles of immunophilins and their ligands. Mol Neurobiol 15:223–239PubMedCrossRef

65.

Cardenas ME, Sanfridson A, Cutler NS, Heitman J (1998) Signal-transduction cascades as targets for therapeutic intervention by natural products. Trends Biotechnol 16:427–433PubMedCrossRef

66.

Shimmura-Tomita M, Shimmura S, Satake Y et al (2013) Keratoplasty postoperative treatment update. Cornea 32(Suppl 1): S60–S64PubMedCrossRef

67.

Perry HD, Doshi-Carnevale S, Donnenfeld ED et al (2006) Efficacy of commercially available topical cyclosporine A 0.05 % in the treatment of meibomian gland dysfunction. Cornea 25:171–175PubMedCrossRef

68.

Utine CA, Stern M, Akpek EK (2010) Clinical review: topical ophthalmic use of cyclosporin A. Ocul Immunol Inflamm 18:352–361PubMedCrossRef

69.

Pacharn P, Vichyanond P (2013) Immunomodulators for conjunctivitis. Curr Opin Allergy Clin Immunol 13:550–557PubMedCrossRef

70.

Birnbaum F, Reis A, Reinhard T (2009) Long term use of topical tacrolimus (FK506) in high-risk penetrating keratoplasty. Cornea 28:715–716 (author reply 716)PubMedCrossRef

71.

Magalhaes OA, Marinho DR, Kwitko S (2013) Topical 0.03 % tacrolimus preventing rejection in high-risk corneal transplantation: a cohort study. Br J Ophthalmol 97:1395–1398PubMedCrossRef

72.

Reinhard T, Reis A, Mayweg S et al (2002) Topical Fk506 in inflammatory corneal and conjunctival diseases. A pilot study. Klin Monatsbl Augenheilkd 219:125–131PubMedCrossRef

73.

Auw-Hädrich C, Reinhard T (2009) Treatment of chronic blepharokeratoconjunctivitis with local calcineurin inhibitors. Ophthalmologe 106:635–638PubMedCrossRef

74.

Kari O, Saari KM (2010) Updates in the treatment of ocular allergies. J Asthma Allergy 3:149–158PubMedCentralPubMed

75.

Li XQ, Buch G, Otasevic L et al (2008) Prolongation of corneal allograft survival by topical application of everolimus in experimental keratoplasty. Ophthalmic Res 40:309–314PubMedCrossRef

76.

Birnbaum F, Schwartzkopff J, Scholz C, Reinhard T (2007) Topical pimecrolimus does not prolong clear graft survival in a rat keratoplasty model. Graefes Arch Clin Exp Ophthalmol 245:1717–1721PubMedCrossRef

77.

Zapata G, Racca L, Tau J, Berra A (2012) Topical use of rapamycin in herpetic stromal keratitis. Ocul Immunol Inflamm 20:354–359PubMedCrossRef

78.

Knapp S, Bertelmann E, Hartmann C et al (2003) Intraocular availability of topically applied mycophenolate mofetil in rabbits. J Ocul Pharmacol Ther 19:181–192PubMedCrossRef

79.

Bertelmann E, Knapp S, Rieck P et al (2003) Transcorneal-paracorneal penetration route for topical application of drugs to the eyt. Mycophenolate mofetil as a model substance. Ophthalmologe 100:696–701PubMedCrossRef

80.

Pleyer U, Milani JK, Dukes A et al (1995) Effect of topically applied anti-CD4 monoclonal antibodies on orthotopic corneal allografts in a rat model. Invest Ophthalmol Vis Sci 36:52–61PubMed

81.

Haïm-Boukobza S, Balabanian K, Teicher E et al (2013) Blockade of CCR5 to protect the liver graft in HIV/HCV co-infected patients. J Hepatol 59:613–615PubMedCrossRef

82.

Gilliam BL, Riedel DJ, Redfield RR (2011) Clinical use of CCR5 inhibitors in HIV and beyond. J Transl Med 9(Suppl 1):S9PubMedCentralPubMedCrossRef

83.

Bachelerie F, Ben-Baruch A, Burkhardt AM et al (2014) International Union of Pharmacology. LXXXIX. Update on the extended family of chemokine receptors and Introducing a new nomenclature for atypical chemokine receptors. Pharmacol Rev 66:1–79PubMedCentralPubMedCrossRef

84.

Hall AV, Jevnikar AM (2003) Significance of endothelial cell survival programs for renal transplantation. Am J Kidney Dis 41:1140–1154PubMedCrossRef

85.

Romagnani P, Crescioli C (2012) CXCL10: a candidate biomarker in transplantation. Clin Chim Acta 413:1364–1373PubMedCrossRef

86.

Reinhard T, Sundmacher R, Godehardt E, Heering P (1997) Preventive systemic cyclosporin A after keratoplasty at increased risk for immune reactions as the only elevated risk factor. Ophthalmologe 94:496–500PubMedCrossRef

87.

Reinhard T, Möller M, Sundmacher R (1999) Penetrating keratoplasty in patients with atopic dermatitis with and without systemic cyclosporin A. Cornea 18:645–651PubMedCrossRef

88.

Benelli U, Lepri A, Del Tacca M, Nardi M (1996) FK-506 delays corneal graft rejection in a model of corneal xenotransplantation. J Ocul Pharmacol Ther 12:425–431PubMedCrossRef

89.

Sloper CM, Powell RJ, Dua HS (2001) Tacrolimus (FK506) in the management of high-risk corneal and limbal grafts. Ophthalmology 108:1838–1844PubMedCrossRef

90.

Reis A, Reinhard T, Sundmacher R et al (1998) A comparative investigation of FK506 and cyclosporin A in murine corneal transplantation. Graefes Arch Clin Exp Ophthalmol 236:785–789PubMedCrossRef

91.

Brattström C, Tydén G, Säwe J et al (1996) A randomized, double-blind, placebo-controlled study to determine safety, tolerance, and preliminary pharmacokinetics of ascending single doses of orally administered sirolimus (rapamycin) in stable renal transplant recipients. Transplant Proc 28:985–986PubMed

92.

Morris RE, Huang X, Gregory CR et al (1995) Studies in experimental models of chronic rejection: use of rapamycin (sirolimus) and isoxazole derivatives (leflunomide and its analogue) for the suppression of graft vascular disease and obliterative bronchiolitis. Transplant Proc 27:2068–2069PubMed

93.

Murgia MG, Jordan S, Kahan BD (1996) The side effect profile of sirolimus: a phase I study in quiescent cyclosporine-prednisone-treated renal transplant patients. Kidney Int 49:209–216PubMedCrossRef

94.

Vu MD, Qi S, Xu D et al (1998) Synergistic effects of mycophenolate mofetil and sirolimus in prevention of acute heart, pancreas, and kidney allograft rejection and in reversal of ongoing heart allograft rejection in the rat. Transplantation 66:1575–1580PubMedCrossRef

95.

Chatel M-A, Larkin DFP (2010) Sirolimus and mycophenolate as combination prophylaxis in corneal transplant recipients at high rejection risk. Am J Ophthalmol 150:179–184PubMedCrossRef

96.

Stanojlovic S, Schlickeiser S, Appelt C et al (2010) Influence of combined treatment of low dose rapamycin and cyclosporin A on corneal allograft survival. Graefes Arch Clin Exp Ophthalmol 248:1447–1456PubMedCrossRef

97.

Reis A, Reinhard T, Voiculescu A et al (1999) Mycophenolate mofetil versus cyclosporin A in high risk keratoplasty patients: a prospectively randomised clinical trial. Br J Ophthalmol 83:1268–1271PubMedCentralPubMedCrossRef

98.

Wlodarczyk Z, Vanrenterghem Y, Krämer BK et al (2012) A multicenter, randomized, double-blind study comparing different FK778 doses (manitimus) with tacrolimus and steroids vs. MMF with tacrolimus and steroids in renal transplantation. BMC Nephrol 13:68PubMedCentralPubMedCrossRef

99.

Polack FM (1965) Inhibition of immune corneal graft rejection by azathioprine (imuran). Arch Ophthalmol 74:683–689PubMedCrossRef

100.

Pleyer U (2003) Immunomodulation in penetrating keratoplasty. Current status and perspectives. Ophthalmologe 100:1036–1044PubMedCrossRef

101.

Schmitz K, Hitzer S, Behrens-Baumann W (2002) Immune suppression by combination therapy with basiliximab and cyclosporin in high risk keratoplasty. A pilot study. Ophthalmologe 99:38–45PubMedCrossRef

102.

Tabbara KF (2008) Pharmacologic strategies in the prevention and treatment of corneal transplant rejection. Int Ophthalmol 28:223–232PubMedCrossRef

103.

Reis A, Megahed M, Reinhard T et al (2002) Synergism of RAD and cyclosporin A in prevention of acute rat corneal allograft rejection. Cornea 21:81–84PubMedCrossRef

104.

Baspinar Y, Bertelmann E, Pleyer U et al (2008) Corneal permeation studies of everolimus microemulsion. J Ocul Pharmacol Ther 24:399–402PubMedCrossRef

105.

Reis A, Megahed M, Reinhard T et al (2000) Coadministration of the new macrolide immunosuppressant RAD and mycophenolate mofetil in experimental corneal transplantation. Transplantation 70:1397–1401PubMedCrossRef

106.

Vincenti F, Tedesco Silva H, Busque S et al (2012) Randomized phase 2b trial of tofacitinib (CP-690,550) in de novo kidney transplant patients: efficacy, renal function and safety at 1 year. Am J Transplant 12:2446–2456PubMedCrossRef

Titel: Immunsuppressiva zur Verhinderung von Abstoßungsreaktionen nach allogenen Hornhauttransplantationen
verfasst von: T. Lapp
P. Maier
F. Birnbaum
G. Schlunck
T. Reinhard
Publikationsdatum: 01.03.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Die Ophthalmologie / Ausgabe 3/2014
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI: https://doi.org/10.1007/s00347-013-3016-6

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Immunsuppressiva zur Verhinderung von Abstoßungsreaktionen nach allogenen Hornhauttransplantationen

Zusammenfassung

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Bakterielle endogene Endophthalmitis

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Update Augenheilkunde

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2014

Sekundäre Intraokularlinsenimplantation von Sklera-nahtfixierten Intraokularlinsen

In-vitro- und In-vivo-Untersuchung einer modifizierten textilen Keratoprothese

Irisnahtfixierte Hinterkammerlinse

Gelbe Flecke der Makula

Unterschiede in den Messergebnissen nach Goldmann-Applanationstonometrie mit und ohne Fluoreszein

Transiente Sehverschlechterung bei Kälteexposition, phaker Vorderkammerlinse und Forme-fruste-Keratokonus

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Bakterielle endogene Endophthalmitis

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Update Augenheilkunde