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Klin Monbl Augenheilkd 2018; 235(07): 809-819
DOI: 10.1055/s-0043-102577
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Morphologische Hornhautveränderungen nach Crosslinking bei Keratokonus

Morphologic Corneal Changes after Crosslinking for Keratoconus
P. L. Müller
1   Universitäts-Augenklinik Bonn, Bonn, Deutschland
2   Sektion Ophthalmopathologie, Universitäts-Augenklinik Bonn, Bonn, Deutschland
,
K. U. Löffler
1   Universitäts-Augenklinik Bonn, Bonn, Deutschland
2   Sektion Ophthalmopathologie, Universitäts-Augenklinik Bonn, Bonn, Deutschland
,
M. Kohlhaas
3   Augenklinik des St. Johannes Hospital, Dortmund, Deutschland
,
F. G. Holz
1   Universitäts-Augenklinik Bonn, Bonn, Deutschland
,
M. C. Herwig-Carl
1   Universitäts-Augenklinik Bonn, Bonn, Deutschland
2   Sektion Ophthalmopathologie, Universitäts-Augenklinik Bonn, Bonn, Deutschland
› Institutsangaben
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Publikationsverlauf

eingereicht 21. Dezember 2016

akzeptiert 24. Januar 2017

Publikationsdatum:
03. Mai 2017 (online)

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Zusammenfassung

Der Keratokonus ist eine relativ häufige (1 : 2000), meist bilateral auftretende Erkrankung, die zu einer Verdünnung, Veränderung der biochemischen und biomechanischen Struktur sowie Vorwölbung der Hornhaut führt. Seit mehr als 10 Jahren steht das Crosslinking als therapeutisches Verfahren für den progredienten Keratokonus zur Verfügung. Dabei wird mittels Riboflavin und UVA-Bestrahlung eine Verfestigung der Quervernetzung der Kollagenfasern in den vorderen 300 µm des Hornhautstromas erreicht. Es ist als wirksam und komplikationsarm beschrieben worden, sofern entsprechende Protokolle und Indikationen eingehalten werden. Diese Übersicht beinhaltet die physiologischen und pathologischen morphologischen Veränderungen der Hornhaut vor und nach Crosslinking bei Keratokonus. Die verfügbare Literatur wird aufgearbeitet und um eigene Beobachtungen und Erfahrungen, basierend auf histopathologischen Untersuchungen, ergänzt.

Abstract

Keratoconus is a relatively common (1 : 2000) bilateral disease leading to a change in biochemical and biomechanical corneal structure as well as thinning and ectasia. For more than 10 years, crosslinking has been a therapeutic option in cases of progression. Using riboflavin and UVA-radiation, the anterior corneal stroma (300 µm) gets stiffened by crosslinking of collagen fibers. When protocols and limitations are adhered, the procedure is described to be effective and of low-risk. This review gives an overview about physiologic and pathologic changes in keratoconic corneas before and after crosslinking. Based on histopathologic examination, the current knowledge in published literature is reviewed and is complemented by our own investigations.

Schlüsselwörter

Crosslinking - Ophthalmopathologie - Keratokonus

Key words

crosslinking - ophthalmic pathology - keratoconus
 

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