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Erschienen in: Die Ophthalmologie 11/2021

09.06.2021 | Hornhauttransplantation | CME

Wundheilung der Kornea – Pathophysiologie und Grundlagen

verfasst von: PD Dr. med. Tobias Brockmann, FEBO, Marcus Walckling, Claudia Brockmann, Thomas A. Fuchsluger, Uwe Pleyer

Erschienen in: Die Ophthalmologie | Ausgabe 11/2021

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Zusammenfassung

Die Hornhaut bildet die vordere Begrenzung des Auges und trägt durch ihre Transparenz, Avaskularität und spezifische Krümmung wesentlich zur scharfen optischen Abbildung auf der Netzhaut bei. Hierbei ist die Hornhaut aufgrund ihrer anatomischen Einordnung und als Barriere zur Umwelt besonders exponiert gegenüber verschiedenen äußeren Einflüssen, wie sie bei Verletzungen oder durch Pathogene entstehen können. Eine regelrechte Wundheilung, insbesondere ohne die Ausbildung von lichtstreuenden Narben, ist essenziell, um die Integrität und Funktion der Hornhaut zu bewahren. Die fehlgeleitete Wundheilung ist von großer klinischer Relevanz, da sie durch Hornhautfibrosierung zum Entstehen einer Narbe mit dem Verlust der optischen Transparenz mit nachfolgender Visusreduktion bis zur Erblindung führen kann. Das Verständnis der pathophysiologischen Mechanismen der Wundheilung und Fibrogenese ist von großer Bedeutung für die Diagnostik, Therapie und Einordnung des Heilungsverlaufs kornealer Wunden, um einer dauerhaften Schädigung der Hornhaut in Zukunft frühzeitig entgegenwirken zu können.
Literatur
2.
Zurück zum Zitat Seitz B (2018) Deutsches Keratoplastik-Register. Deutsches Keratoplastik-Register der DOG-Sektion Kornea Seitz B (2018) Deutsches Keratoplastik-Register. Deutsches Keratoplastik-Register der DOG-Sektion Kornea
4.
Zurück zum Zitat Calvario A, Bozzi A, Scarasciulli M et al (2002) Herpes Consensus PCR test: a useful diagnostic approach to the screening of viral diseases of the central nervous system. J Clin Virol 25(Suppl 1):S71–S78PubMed Calvario A, Bozzi A, Scarasciulli M et al (2002) Herpes Consensus PCR test: a useful diagnostic approach to the screening of viral diseases of the central nervous system. J Clin Virol 25(Suppl 1):S71–S78PubMed
5.
Zurück zum Zitat Vrioni G, Kalogeropoulos C, Gartzonika C et al (2007) Usefulness of Herpes Consensus PCR methodology to routine diagnostic testing for herpesviruses infections in clinical specimens. Virol J 4:59PubMedPubMedCentral Vrioni G, Kalogeropoulos C, Gartzonika C et al (2007) Usefulness of Herpes Consensus PCR methodology to routine diagnostic testing for herpesviruses infections in clinical specimens. Virol J 4:59PubMedPubMedCentral
6.
Zurück zum Zitat Gaudio PA, Gopinathan U, Sangwan V et al (2002) Polymerase chain reaction based detection of fungi in infected corneas. Br J Ophthalmol 86:755–760PubMedPubMedCentral Gaudio PA, Gopinathan U, Sangwan V et al (2002) Polymerase chain reaction based detection of fungi in infected corneas. Br J Ophthalmol 86:755–760PubMedPubMedCentral
7.
Zurück zum Zitat Wynn TA, Ramalingam TR (2012) Mechanisms of fibrosis: therapeutic translation for fibrotic disease. Nat Med 18:1028–1040PubMedPubMedCentral Wynn TA, Ramalingam TR (2012) Mechanisms of fibrosis: therapeutic translation for fibrotic disease. Nat Med 18:1028–1040PubMedPubMedCentral
8.
Zurück zum Zitat Medzhitov R (2010) Inflammation 2010: new adventures of an old flame. Cell 140:771–776PubMed Medzhitov R (2010) Inflammation 2010: new adventures of an old flame. Cell 140:771–776PubMed
9.
Zurück zum Zitat Gabbiani G (2003) The myofibroblast in wound healing and fibrocontractive diseases. J Pathol 200:500–503PubMed Gabbiani G (2003) The myofibroblast in wound healing and fibrocontractive diseases. J Pathol 200:500–503PubMed
11.
Zurück zum Zitat Saika S, Yamanaka O, Sumioka T et al (2008) Fibrotic disorders in the eye: targets of gene therapy. Prog Retin Eye Res 27:177–196PubMed Saika S, Yamanaka O, Sumioka T et al (2008) Fibrotic disorders in the eye: targets of gene therapy. Prog Retin Eye Res 27:177–196PubMed
14.
Zurück zum Zitat Tandon A, Tovey JC, Sharma A et al (2010) Role of transforming growth factor Beta in corneal function, biology and pathology. Curr Mol Med 10:565–578PubMedPubMedCentral Tandon A, Tovey JC, Sharma A et al (2010) Role of transforming growth factor Beta in corneal function, biology and pathology. Curr Mol Med 10:565–578PubMedPubMedCentral
15.
Zurück zum Zitat Mohan RR, Hutcheon AE, Choi R et al (2003) Apoptosis, necrosis, proliferation, and myofibroblast generation in the stroma following LASIK and PRK. Exp Eye Res 76:71–87PubMed Mohan RR, Hutcheon AE, Choi R et al (2003) Apoptosis, necrosis, proliferation, and myofibroblast generation in the stroma following LASIK and PRK. Exp Eye Res 76:71–87PubMed
16.
Zurück zum Zitat Xing D, Bonanno JA (2009) Effect of cAMP on TGFbeta1-induced corneal keratocyte-myofibroblast transformation. Invest Ophthalmol Vis Sci 50:626–633PubMed Xing D, Bonanno JA (2009) Effect of cAMP on TGFbeta1-induced corneal keratocyte-myofibroblast transformation. Invest Ophthalmol Vis Sci 50:626–633PubMed
17.
Zurück zum Zitat West-Mays JA, Dwivedi DJ (2006) The keratocyte: corneal stromal cell with variable repair phenotypes. Int J Biochem Cell Biol 38:1625–1631PubMedPubMedCentral West-Mays JA, Dwivedi DJ (2006) The keratocyte: corneal stromal cell with variable repair phenotypes. Int J Biochem Cell Biol 38:1625–1631PubMedPubMedCentral
18.
Zurück zum Zitat Chaurasia SS, Kaur H, de Medeiros FW et al (2009) Dynamics of the expression of intermediate filaments vimentin and desmin during myofibroblast differentiation after corneal injury. Exp Eye Res 89:133–139PubMedPubMedCentral Chaurasia SS, Kaur H, de Medeiros FW et al (2009) Dynamics of the expression of intermediate filaments vimentin and desmin during myofibroblast differentiation after corneal injury. Exp Eye Res 89:133–139PubMedPubMedCentral
19.
Zurück zum Zitat Kao WW, Kao CW, Kaufman AH et al (1998) Healing of corneal epithelial defects in plasminogen- and fibrinogen-deficient mice. Invest Ophthalmol Vis Sci 39:502–508PubMed Kao WW, Kao CW, Kaufman AH et al (1998) Healing of corneal epithelial defects in plasminogen- and fibrinogen-deficient mice. Invest Ophthalmol Vis Sci 39:502–508PubMed
20.
Zurück zum Zitat Esmon CT (2005) The interactions between inflammation and coagulation. Br J Haematol 131:417–430PubMed Esmon CT (2005) The interactions between inflammation and coagulation. Br J Haematol 131:417–430PubMed
21.
Zurück zum Zitat Vasel M, Rutz R, Bersch C et al (2014) Complement activation correlates with liver necrosis and fibrosis in chronic hepatitis C. Clin Immunol 150:149–156PubMed Vasel M, Rutz R, Bersch C et al (2014) Complement activation correlates with liver necrosis and fibrosis in chronic hepatitis C. Clin Immunol 150:149–156PubMed
22.
Zurück zum Zitat Gardner BP, Pleyer U, Mondino BJ et al (1995) Complement-derived anaphylatoxins in human donor corneas treated with excimer laser. Ophthalmic Surg Lasers 26:568–571PubMed Gardner BP, Pleyer U, Mondino BJ et al (1995) Complement-derived anaphylatoxins in human donor corneas treated with excimer laser. Ophthalmic Surg Lasers 26:568–571PubMed
23.
Zurück zum Zitat Mondino BJ, Sumner HL (1990) Generation of complement-derived anaphylatoxins in normal human donor corneas. Invest Ophthalmol Vis Sci 31:1945–1949PubMed Mondino BJ, Sumner HL (1990) Generation of complement-derived anaphylatoxins in normal human donor corneas. Invest Ophthalmol Vis Sci 31:1945–1949PubMed
24.
Zurück zum Zitat Pleyer U, Mondino BJ, Sumner HL (1992) The effect of systemic decomplementation with cobra venom factor on corneal complement levels in guinea pigs. Invest Ophthalmol Vis Sci 33:2212–2215PubMed Pleyer U, Mondino BJ, Sumner HL (1992) The effect of systemic decomplementation with cobra venom factor on corneal complement levels in guinea pigs. Invest Ophthalmol Vis Sci 33:2212–2215PubMed
25.
Zurück zum Zitat Wilson SE, Mohan RR, Ambrósio R et al (2001) The corneal wound healing response: cytokine-mediated interaction of the epithelium, stroma, and inflammatory cells. Prog Retin Eye Res 20:625–637PubMed Wilson SE, Mohan RR, Ambrósio R et al (2001) The corneal wound healing response: cytokine-mediated interaction of the epithelium, stroma, and inflammatory cells. Prog Retin Eye Res 20:625–637PubMed
26.
Zurück zum Zitat Wynn TA, Barron L (2010) Macrophages: master regulators of inflammation and fibrosis. Semin Liver Dis 30:245–257PubMedPubMedCentral Wynn TA, Barron L (2010) Macrophages: master regulators of inflammation and fibrosis. Semin Liver Dis 30:245–257PubMedPubMedCentral
27.
Zurück zum Zitat Zhang Y, Lee TC, Guillemin B et al (1993) Enhanced IL‑1 beta and tumor necrosis factor-alpha release and messenger RNA expression in macrophages from idiopathic pulmonary fibrosis or after asbestos exposure. J Immunol 150:4188–4196PubMed Zhang Y, Lee TC, Guillemin B et al (1993) Enhanced IL‑1 beta and tumor necrosis factor-alpha release and messenger RNA expression in macrophages from idiopathic pulmonary fibrosis or after asbestos exposure. J Immunol 150:4188–4196PubMed
28.
Zurück zum Zitat Hesse M, Modolell M, La Flamme AC et al (2001) Differential regulation of nitric oxide synthase‑2 and arginase‑1 by type 1/type 2 cytokines in vivo: granulomatous pathology is shaped by the pattern of L‑arginine metabolism. J Immunol 167:6533–6544PubMed Hesse M, Modolell M, La Flamme AC et al (2001) Differential regulation of nitric oxide synthase‑2 and arginase‑1 by type 1/type 2 cytokines in vivo: granulomatous pathology is shaped by the pattern of L‑arginine metabolism. J Immunol 167:6533–6544PubMed
29.
Zurück zum Zitat Niederkorn JY (2013) Corneal transplantation and immune privilege. Int Rev Immunol 32:57–67PubMed Niederkorn JY (2013) Corneal transplantation and immune privilege. Int Rev Immunol 32:57–67PubMed
30.
Zurück zum Zitat Streilein JW (2003) Ocular immune privilege: therapeutic opportunities from an experiment of nature. Nat Rev Immunol 3:879–889PubMed Streilein JW (2003) Ocular immune privilege: therapeutic opportunities from an experiment of nature. Nat Rev Immunol 3:879–889PubMed
31.
Zurück zum Zitat Jester JV, Moller-Pedersen T, Huang J et al (1999) The cellular basis of corneal transparency: evidence for „corneal crystallins“. J Cell Sci 112(Pt 5):613–622PubMed Jester JV, Moller-Pedersen T, Huang J et al (1999) The cellular basis of corneal transparency: evidence for „corneal crystallins“. J Cell Sci 112(Pt 5):613–622PubMed
32.
Zurück zum Zitat Marino GK, Santhiago MR, Santhanam A et al (2017) Regeneration of defective epithelial basement membrane and restoration of corneal transparency after photorefractive keratectomy. J Refract Surg 33:337–346PubMedPubMedCentral Marino GK, Santhiago MR, Santhanam A et al (2017) Regeneration of defective epithelial basement membrane and restoration of corneal transparency after photorefractive keratectomy. J Refract Surg 33:337–346PubMedPubMedCentral
33.
Zurück zum Zitat Chen Y, Thompson DC, Koppaka V et al (2013) Ocular aldehyde dehydrogenases: protection against ultraviolet damage and maintenance of transparency for vision. Prog Retin Eye Res 33:28–39PubMed Chen Y, Thompson DC, Koppaka V et al (2013) Ocular aldehyde dehydrogenases: protection against ultraviolet damage and maintenance of transparency for vision. Prog Retin Eye Res 33:28–39PubMed
34.
Zurück zum Zitat Bühren J, Nagy L, Swanton JN et al (2009) Optical effects of anti-TGFbeta treatment after photorefractive keratectomy in a cat model. Invest Ophthalmol Vis Sci 50:634–643PubMed Bühren J, Nagy L, Swanton JN et al (2009) Optical effects of anti-TGFbeta treatment after photorefractive keratectomy in a cat model. Invest Ophthalmol Vis Sci 50:634–643PubMed
36.
Zurück zum Zitat Powell DW, Mifflin RC, Valentich JD et al (1999) Myofibroblasts. I. Paracrine cells important in health and disease. Am J Physiol 277:C1–C9PubMed Powell DW, Mifflin RC, Valentich JD et al (1999) Myofibroblasts. I. Paracrine cells important in health and disease. Am J Physiol 277:C1–C9PubMed
37.
Zurück zum Zitat Powell DW, Mifflin RC, Valentich JD et al (1999) Myofibroblasts. II. Intestinal subepithelial myofibroblasts. Am J Physiol 277:C183–C201PubMed Powell DW, Mifflin RC, Valentich JD et al (1999) Myofibroblasts. II. Intestinal subepithelial myofibroblasts. Am J Physiol 277:C183–C201PubMed
38.
Zurück zum Zitat Wilson SE (2020) Corneal myofibroblasts and fibrosis. Exp Eye Res 201:108272PubMed Wilson SE (2020) Corneal myofibroblasts and fibrosis. Exp Eye Res 201:108272PubMed
39.
Zurück zum Zitat Saikia P, Crabb JS, Dibbin LL et al (2020) Quantitative proteomic comparison of myofibroblasts derived from bone marrow and cornea. Sci Rep 10:16717PubMedPubMedCentral Saikia P, Crabb JS, Dibbin LL et al (2020) Quantitative proteomic comparison of myofibroblasts derived from bone marrow and cornea. Sci Rep 10:16717PubMedPubMedCentral
40.
Zurück zum Zitat Kay EP, Lee MS, Seong GJ et al (1998) TGF-beta s stimulate cell proliferation via an autocrine production of FGF‑2 in corneal stromal fibroblasts. Curr Eye Res 17:286–293PubMed Kay EP, Lee MS, Seong GJ et al (1998) TGF-beta s stimulate cell proliferation via an autocrine production of FGF‑2 in corneal stromal fibroblasts. Curr Eye Res 17:286–293PubMed
41.
Zurück zum Zitat Wahl SM, McCartney-Francis N, Allen JB et al (1990) Macrophage production of TGF-beta and regulation by TGF-beta. Ann N Y Acad Sci 593:188–196PubMed Wahl SM, McCartney-Francis N, Allen JB et al (1990) Macrophage production of TGF-beta and regulation by TGF-beta. Ann N Y Acad Sci 593:188–196PubMed
42.
Zurück zum Zitat Wang JF, Jiao H, Stewart TL et al (2007) Fibrocytes from burn patients regulate the activities of fibroblasts. Wound Repair Regen 15:113–121PubMed Wang JF, Jiao H, Stewart TL et al (2007) Fibrocytes from burn patients regulate the activities of fibroblasts. Wound Repair Regen 15:113–121PubMed
43.
Zurück zum Zitat Wilson SE, Schultz GS, Chegini N et al (1994) Epidermal growth factor, transforming growth factor alpha, transforming growth factor beta, acidic fibroblast growth factor, basic fibroblast growth factor, and interleukin‑1 proteins in the cornea. Exp Eye Res 59:63–71PubMed Wilson SE, Schultz GS, Chegini N et al (1994) Epidermal growth factor, transforming growth factor alpha, transforming growth factor beta, acidic fibroblast growth factor, basic fibroblast growth factor, and interleukin‑1 proteins in the cornea. Exp Eye Res 59:63–71PubMed
44.
Zurück zum Zitat Singh V, Santhiago MR, Barbosa FL et al (2011) Effect of TGFβ and PDGF‑B blockade on corneal myofibroblast development in mice. Exp Eye Res 93:810–817PubMedPubMedCentral Singh V, Santhiago MR, Barbosa FL et al (2011) Effect of TGFβ and PDGF‑B blockade on corneal myofibroblast development in mice. Exp Eye Res 93:810–817PubMedPubMedCentral
45.
Zurück zum Zitat Medeiros CS, Lassance L, Saikia P et al (2018) Posterior stromal cell apoptosis triggered by mechanical endothelial injury and basement membrane component nidogen‑1 production in the cornea. Exp Eye Res 172:30–35PubMedPubMedCentral Medeiros CS, Lassance L, Saikia P et al (2018) Posterior stromal cell apoptosis triggered by mechanical endothelial injury and basement membrane component nidogen‑1 production in the cornea. Exp Eye Res 172:30–35PubMedPubMedCentral
46.
Zurück zum Zitat Medeiros CS, Marino GK, Santhiago MR et al (2018) The corneal basement membranes and stromal fibrosis. Invest Ophthalmol Vis Sci 59:4044–4053PubMedPubMedCentral Medeiros CS, Marino GK, Santhiago MR et al (2018) The corneal basement membranes and stromal fibrosis. Invest Ophthalmol Vis Sci 59:4044–4053PubMedPubMedCentral
47.
Zurück zum Zitat Medeiros CS, Saikia P, de Oliveira RC et al (2019) Descemet’s membrane modulation of posterior corneal fibrosis. Invest Ophthalmol Vis Sci 60:1010–1020PubMedPubMedCentral Medeiros CS, Saikia P, de Oliveira RC et al (2019) Descemet’s membrane modulation of posterior corneal fibrosis. Invest Ophthalmol Vis Sci 60:1010–1020PubMedPubMedCentral
48.
Zurück zum Zitat Kim WJ, Mohan RR, Wilson SE (1999) Effect of PDGF, IL-1alpha, and BMP2/4 on corneal fibroblast chemotaxis: expression of the platelet-derived growth factor system in the cornea. Invest Ophthalmol Vis Sci 40:1364–1372PubMed Kim WJ, Mohan RR, Wilson SE (1999) Effect of PDGF, IL-1alpha, and BMP2/4 on corneal fibroblast chemotaxis: expression of the platelet-derived growth factor system in the cornea. Invest Ophthalmol Vis Sci 40:1364–1372PubMed
49.
Zurück zum Zitat Suzuki N, Yamaguchi T, Shibata S et al (2019) Cytokine levels in the aqueous humor are associated with corneal thickness in eyes with Bullous Keratopathy. Am J Ophthalmol 198:174–180PubMed Suzuki N, Yamaguchi T, Shibata S et al (2019) Cytokine levels in the aqueous humor are associated with corneal thickness in eyes with Bullous Keratopathy. Am J Ophthalmol 198:174–180PubMed
50.
51.
Zurück zum Zitat Ferreira CS, Figueira L, Moreira-Gonçalves N et al (2018) Clinical and microbiological profile of bacterial microbial keratitis in a Portuguese tertiary referral center-where are we in 2015? Eye Contact Lens 44:15–20PubMed Ferreira CS, Figueira L, Moreira-Gonçalves N et al (2018) Clinical and microbiological profile of bacterial microbial keratitis in a Portuguese tertiary referral center-where are we in 2015? Eye Contact Lens 44:15–20PubMed
52.
Zurück zum Zitat Ibrahim YW, Boase DL, Cree IA (2009) Epidemiological characteristics, predisposing factors and microbiological profiles of infectious corneal ulcers: the Portsmouth corneal ulcer study. Br J Ophthalmol 93:1319–1324PubMed Ibrahim YW, Boase DL, Cree IA (2009) Epidemiological characteristics, predisposing factors and microbiological profiles of infectious corneal ulcers: the Portsmouth corneal ulcer study. Br J Ophthalmol 93:1319–1324PubMed
53.
Zurück zum Zitat Labetoulle M, Auquier P, Conrad H et al (2005) Incidence of herpes simplex virus keratitis in France. Ophthalmology 112:888–895PubMed Labetoulle M, Auquier P, Conrad H et al (2005) Incidence of herpes simplex virus keratitis in France. Ophthalmology 112:888–895PubMed
54.
Zurück zum Zitat Stanzel TP, Diaz JD, Mather R et al (2014) The epidemiology of herpes simplex virus eye disease in Northern California. Ophthalmic Epidemiol 21:370–377PubMed Stanzel TP, Diaz JD, Mather R et al (2014) The epidemiology of herpes simplex virus eye disease in Northern California. Ophthalmic Epidemiol 21:370–377PubMed
55.
Zurück zum Zitat Young RC, Hodge DO, Liesegang TJ et al (2010) Incidence, recurrence, and outcomes of herpes simplex virus eye disease in Olmsted County, Minnesota, 1976–2007: the effect of oral antiviral prophylaxis. Arch Ophthalmol 128:1178–1183PubMedPubMedCentral Young RC, Hodge DO, Liesegang TJ et al (2010) Incidence, recurrence, and outcomes of herpes simplex virus eye disease in Olmsted County, Minnesota, 1976–2007: the effect of oral antiviral prophylaxis. Arch Ophthalmol 128:1178–1183PubMedPubMedCentral
56.
Zurück zum Zitat Ghosh S, Salvador-Culla B, Kotagiri A et al (2019) Acute chemical eye injury and Limbal stem cell deficiency—A prospective study in the United Kingdom. Cornea 38:8–12PubMed Ghosh S, Salvador-Culla B, Kotagiri A et al (2019) Acute chemical eye injury and Limbal stem cell deficiency—A prospective study in the United Kingdom. Cornea 38:8–12PubMed
57.
Zurück zum Zitat Islam SS, Doyle EJ, Velilla A et al (2000) Epidemiology of compensable work-related ocular injuries and illnesses: incidence and risk factors. J Occup Environ Med 42:575–581PubMed Islam SS, Doyle EJ, Velilla A et al (2000) Epidemiology of compensable work-related ocular injuries and illnesses: incidence and risk factors. J Occup Environ Med 42:575–581PubMed
58.
Zurück zum Zitat Islam SS, Nambiar AM, Doyle EJ et al (2000) Epidemiology of work-related burn injuries: experience of a state-managed workers’ compensation system. J Trauma 49:1045–1051PubMed Islam SS, Nambiar AM, Doyle EJ et al (2000) Epidemiology of work-related burn injuries: experience of a state-managed workers’ compensation system. J Trauma 49:1045–1051PubMed
59.
Zurück zum Zitat Aydin Kurna S, Altun A, Oflaz A et al (2015) Evaluation of the impact of persistent subepithelial corneal infiltrations on the visual performance and corneal optical quality after epidemic keratoconjunctivitis. Acta Ophthalmol 93:377–382PubMed Aydin Kurna S, Altun A, Oflaz A et al (2015) Evaluation of the impact of persistent subepithelial corneal infiltrations on the visual performance and corneal optical quality after epidemic keratoconjunctivitis. Acta Ophthalmol 93:377–382PubMed
60.
Zurück zum Zitat Meyer-Rusenberg B, Loderstadt U, Richard G et al (2011) Epidemic keratoconjunctivitis: the current situation and recommendations for prevention and treatment. Dtsch Arztebl Int 108:475–480PubMedPubMedCentral Meyer-Rusenberg B, Loderstadt U, Richard G et al (2011) Epidemic keratoconjunctivitis: the current situation and recommendations for prevention and treatment. Dtsch Arztebl Int 108:475–480PubMedPubMedCentral
61.
Zurück zum Zitat Cheng KH, Leung SL, Hoekman HW et al (1999) Incidence of contact-lens-associated microbial keratitis and its related morbidity. Lancet 354:181–185PubMed Cheng KH, Leung SL, Hoekman HW et al (1999) Incidence of contact-lens-associated microbial keratitis and its related morbidity. Lancet 354:181–185PubMed
63.
Zurück zum Zitat Köberlein J, Beifus K, Schaffert C et al (2013) The economic burden of visual impairment and blindness: a systematic review. BMJ Open 3:e3471PubMedPubMedCentral Köberlein J, Beifus K, Schaffert C et al (2013) The economic burden of visual impairment and blindness: a systematic review. BMJ Open 3:e3471PubMedPubMedCentral
64.
Zurück zum Zitat The Lewin Group I (2013) Cost-benefit analysis of corneal transplant. Eye Bank Association of America, The Lewin Group I (2013) Cost-benefit analysis of corneal transplant. Eye Bank Association of America,
65.
Zurück zum Zitat DOG/BVA (2011) Leitlinie-Nr.-13-Keratitis. Berufsverband der Augenärzte Deutschlands e. V. und Deutsche Ophthalmologische Gesellschaft e. V. DOG/BVA (2011) Leitlinie-Nr.-13-Keratitis. Berufsverband der Augenärzte Deutschlands e. V. und Deutsche Ophthalmologische Gesellschaft e. V.
66.
Zurück zum Zitat Daas L, Szentmáry N, Eppig T et al (2015) The German Acanthamoeba keratitis register: Initial results of a multicenter study. Ophthalmologe 112:752–763PubMed Daas L, Szentmáry N, Eppig T et al (2015) The German Acanthamoeba keratitis register: Initial results of a multicenter study. Ophthalmologe 112:752–763PubMed
Metadaten
Titel
Wundheilung der Kornea – Pathophysiologie und Grundlagen
verfasst von
PD Dr. med. Tobias Brockmann, FEBO
Marcus Walckling
Claudia Brockmann
Thomas A. Fuchsluger
Uwe Pleyer
Publikationsdatum
09.06.2021
Verlag
Springer Medizin
Erschienen in
Die Ophthalmologie / Ausgabe 11/2021
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI
https://doi.org/10.1007/s00347-021-01423-3

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