Zusammenfassung
Ein Keratokonus führt zu einer progressiven Vorwölbung und Verdünnung der Hornhaut.
Um dies aufzuhalten, kann ein Crosslinking durchgeführt werden. Dabei ist eine Behandlung
nach dem „Dresdener Protokoll“ eine effektive und sichere Behandlungsmöglichkeit,
aber auch zahlreiche neue Anwendungsprotokolle (akzeleriertes Crosslinking, transepitheliales
Crosslinking) und sogar weitere Indikationen (refraktive Eingriffe, infektiöse Keratitis)
wurden in den letzten Jahren veröffentlicht.
Abstract
Keratoconus leads to a progressive protrusion and thinning of the cornea. In order
to stop this, corneal crosslinking can be performed if the progression of the disease
is proven. Crosslinking according to the “Dresden protocol” includes abrasion of the
corneal epithelium, application of riboflavin eye drops and irradiation with UV-A
light of an intensity of 3 mW/cm² for 30 minutes. The efficacy has been shown in several
prospective randomized studies. One of the more recent developments is accelerated
crosslinking, which allows a shorter irradiation time. On the other hand, the possibility
of transepithelial crosslinking was presented, which does not require an abrasion
of the cornea. This should reduce the occurrence of postoperative pain. The range
of indications has also been expanded. Corneal crosslinking is used for post-LASIK
keratectasia as well. It is also being considered for use in infectious keratitis.
Topographically controlled crosslinking can likewise
be used to try to positively influence the refractive power of the cornea. The risks
of crosslinking include the occurrence of pain, haze or scarring, endothelial cell
damage and, rarely, the occurrence of keratitis.
Schlüsselwörter
Keratokonus - Crosslinking - Kornea
Key words
keratoconus - crosslinking - cornea
