Die Hornhauttransplantation (Keratoplastik) dient dem Ersatz von erkranktem Hornhautgewebe
mit einer intakten gesunden Spenderhornhaut. Sie ist die älteste Gewebetransplantation
der Medizin und wurde erstmals 1905 durch Dr. Eduard Zirm erfolgreich durchgeführt
[1]. Heutzutage ist sie die häufigste und erfolgreichste Form der Transplantation am
Menschen weltweit.
Abstract
Corneal transplantation can be divided into two groups: penetrating and lamellar keratoplasty.
Newer minimally invasive procedures have emerged over the years, to improve the visual
outcome and reduce complications. This article summarizes the different procedures,
their indications and complications, and outlines the pre-, peri- and postoperative
management in a clinical setting.
Corneal transplantation is the most commonly performed transplantation of donor tissue
in modern medicine. In the last years a shift away from penetrating keratoplasty (PK)
towards minimally invasive lamellar operative techniques, associated with less complications,
can be observed. The Descemet membrane endothelial keratoplasty (DMEK) is used to
treat endothelial corneal pathologies and has overtaken the PK to become the most
commonly performed form of keratoplasty. Preparation and identification of possible
risk-factors are essential preoperative steps to reduce peri- and postoperative complications
of keratoplasties. If corneal graft rejection occurs, early and maximum therapy is
crucial for graft survival. Laser-assisted techniques offer different advantages in
lamellar and penetrating keratoplasty but are not very cost-efficient.