Augenheilkunde up2date 2020; 10(02): 167-179
DOI: 10.1055/a-0894-8441
Katarakt und refraktive Chirurgie
Georg Thieme Verlag KG Stuttgart · New York

Refraktive Hornhautchirurgie: Nachkorrekturen

Enhancements after Refractive Corneal Surgery
Daniel Kook
,
Wolfgang J. Mayer
,
Mehdi Shajari
,
Gernot Steinwender
,
Thomas Kohnen
Further Information

Publication History

Publication Date:
17 April 2020 (online)

Zusammenfassung

In den 30 Jahren seit Beginn der laserassistierten Hornhautchirurgie sind die Techniken zur Korrektur von Fehlsichtigkeiten weiterentwickelt und verbessert worden. Dennoch muss ein Teil der Patienten nachkorrigiert werden, u. a. wegen residualer Refraktionsfehler. Darüber soll im Folgenden berichtet werden.

Abstract

This review article focusses on the management of enhancements after corneal refractive laser surgery. Fundamental issues regarding enhancement embrace identification of the underlying reason for postoperative ametropia, assurance of stability of refraction, type of primary refractive laser treatment and thorough evaluation of the given anatomical parameters of the cornea. With respect to specific inclusion and exclusion criteria, different surgical options for enhancement strategies are displayed with their particular advantages and disadvantages including preoperative planning of the according laser parameters and postoperative patient management.

Kernaussagen

Da es auch bei optimaler präoperativer Diagnostik, sorgfältiger Behandlungsplanung, komplikationsloser Chirurgie und problemlosem postoperativen Verlauf bei allen Laserverfahren weiterhin immer zu Nachkorrekturen kommen kann, sollte a priori bei Erstindikationsstellung diese Konstellation immer eingeplant werden. Grundlage für eine Nachbehandlung ist neben einer ausreichenden kornealen Stromadicke die Identifikation der Ursache der residualen Ametropie und eine Stabilität der Werte, um auf dieser Basis gemeinsam mit dem Patienten das im individuellen Einzelfall ideale Nachkorrekturverfahren auszuwählen.

 
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