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Augenheilkunde up2date 2018; 8(02): 139-149
DOI: 10.1055/a-0598-8068
Glaukom
Georg Thieme Verlag KG Stuttgart · New York

Chirurgische Möglichkeiten der Glaukomtherapie

Surgical Options in Glaucoma Management
Thomas S. Dietlein
,
André Rosentreter
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Publikationsverlauf

Publikationsdatum:
17. Mai 2018 (online)

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Zusammenfassung

Die Glaukomchirurgie erfährt einen Innovationsschub insbesondere durch neue Mikroimplantate. Auch lange bestehende glaukomchirurgische Verfahren, wie die Trabekulektomie oder die Drainageimplantatchirurgie, erleben eine Aufwertung durch eine Verbesserung ihres Risiko-Nutzen-Profils. Dieser Beitrag gibt einen Überblick über die aktuellen chirurgischen Optionen der Glaukombehandlung.

Abstract

During the last few years, there has been a considerable capacity of innovations in glaucoma surgery owing to new micro-stents increasing the aqueous outflow via transscleral routes, via the trabecular meshwork or the suprachoroidal space. These interventions can be easily performed in combination with small-incision cataract surgery. Even the well-known filtering procedures, trabeculectomy and drainage device surgery, formerly perceived as being outdated, re-achieve better reputation owing to refinements in surgical technique and improved surgical experience. Although enthusiasm is understandable, considering the technical advances, we must wait for clinical long-term results and compare the new procedures with the established ones.

Kernaussagen

  • In der chirurgischen Behandlung des Offenwinkelglaukoms besitzt die Trabekulektomie mit Mitomycin C weiter einen überragenden Platz in der primären Behandlung.

  • Allerdings wird ihr dieser Platz in der kombinierten Glaukom-Katarakt-Chirurgie mehr und mehr streitig gemacht von den kammerwinkelchirurgischen Verfahren.

  • Letztere können mit wenig Zeitaufwand und Risiko in die Kleinschnittkataraktchirurgie integriert werden.

  • Bei den komplizierten Glaukomen setzt sich auch in Deutschland zunehmend die Drainageimplantatchirurgie durch, während die Zyklodestruktion eher abnimmt.

  • Bei aller Euphorie über die chirurgischen Innovationen muss mit kritischem Abstand abgewartet werden, welches der neueren chirurgischen Verfahren langfristig dem klinischen Vergleich mit den etablierten Verfahren standhält.

Schlüsselwörter

Augendruck - Glaukomchirurgie - Glaukomimplantat - Trabekulektomie

Key words

intraocular pressure - glaucoma surgery - glaucoma drainage device - trabeculectomy
 

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