Komplikationen nach Molteno-Implantat: Eine Falldarstellung

Zusammenfassung

Wir berichten über einen 43-jährigen Patienten mit einem Sekundärglaukom, welcher nach Einsetzen eines Molteno-Implantats und späterer perforierender Keratoplastik eine Epithelzellinvasion in die Vorderkammer aufwies. Es wird diskutiert, ob die Ursache dieser Epithelzellinvasion im Molteno-Implantat selbst oder in der nachfolgend aufgrund einer Hornhautdekompensation notwendigen Hornhauttransplantation zu sehen ist.

Abstract

We present a 43-year old patient with refractory secondary glaucoma, who showed epithelial downgrowth into the anterior chamber following Molteno implant surgery. It will be discussed, whether the Molteno implant or the following keratoplasty, which was necessary because of corneal decompensation, caused the epithelial downgrowth.

Schlüsselwörter

Glaukom - Molteno-Implantat - Epithelzellinvasion - Keratoplastik

Key words

Glaucoma - Molteno implant - epithelial downgrowth - keratoplasty

Literatur

• 1 Ancker E, Molteno A CB. Molteno drainage implant for neovascular glaucoma.  Trans Ophthalmol Soc UK. 1982;  102 122-124
• 2 Bennett T, D'Amico R A. Epithelial inclusion cyst of iris after keratoplasty.  Am J Ophthalmol. 1974;  77 87-89
• 3 Boruchoff S A, Kenyon K R, Foulks G N, Green W R. Epithelial cyst of iris following penetrating keratoplasty.  Br J Ophthalmol. 1980;  64 440-445
• 4 Brown R D, Cairns J E. Experience with Molteno long tube implant.  Trans Ophthalmol Soc UK. 1983;  103 297-312
• 5 Downes R N, Flanagan D W, Jordan K. et al . The Molteno Implant in intractable glaucoma.  Eye. 1988;  2 250-259
• 6 Feder R S, Krachmer J H. The diagnosis of epithelial downgrowth after keratoplasty.  Am J Ophthalmol. 1985;  99 697-703
• 7 Hamard P, Loison-Dayma K, Kopel J, Hamard H, Baudouin C. Molteno implant and refractory glaucoma. Evaluation of postoperative IOP control and complications with a modified surgical procedure.  J Fr Ophtalmol. 2003;  26 (1) 15-23
• 8 Hoskins H D, Kass M A. Diagnosis and therapy of the glaucomas. St. Louis, Toronto, Baltimore; The C. V. Mosby Company 1989 6. Auflage: 566-570
• 9 Knauf H P, Rowsey J J, Margo C E. Cystic epithelial downgrowth following clear-corneal cataract extraction.  Arch Ophthalmol. 1997;  115 668-669
• 10 Küchle M, Green W R. Epithelial ingrowth: a study of 207 histopathologically proven cases.  Am J Ophthalmol. 1996;  5 211-223
• 11 Leibowitz H M, Elliott J H, Boruchoff S A. Epithelization of the anterior chamber following penetrating keratoplasty.  Arch Ophthalmol. 1967;  78 613-617
• 12 Lloyd M A, Sedlak T, Heuer D K, Minckler D S, Baerveldt G, Lee M B, Martone J F. Clinical experience with the single-plate molteno implant in complicated glaucomas. Update of a pilot study.  Ophthalmology. 1992;  99 679-687
• 13 Lotufo D G. Postoperative complications and visual loss following molteno implantation.  Ophthalmic Surg. 1991;  22 650-656
• 14 Melamed S, Cahane M, Gutman I, Blumenthal M. Postoperative complications after molteno implant surgery.  Am J Ophthalmol. 1991;  111 319-322
• 15 Mermoud A, Salmon J F, Straker C, Murray A D. Use of the single plate Molteno implant in refractory glaucoma.  Ophthalmologica. 1992;  205 (3) 113-120
• 16 Minckler D S, Baerveldt G, Heurer D K. Clinical experiences with the single plate Molteno implant in complicated glaucomas.  Ophthalmology. 1988;  95 1181-1188
• 17 Molteno A CB, Ancker E, Biljon G van. Surgical technique for advanced juvenile glaucoma.  Arch Ophthalmol. 1984;  102 51-57
• 18 Sidrys L A, Demong T. Epithelial downgrowth after penetrating keratoplasty.  Can J Ophthalmol. 1982;  17 29-31
• 19 Vital P C, Katz L J. Glaucoma associated with epithelial downgrowth controlled with molteno tube shunts.  Ophthalmic Surg. 1992;  23 797-800