Stellenwert der Ab-interno-Trabekelchirurgie in der Glaukombehandlung^[*]

Zusammenfassung

Die Ab-interno-Trabekelchirurgie lässt Sklera und Bindehaut unangetastet, sodass eine später erforderliche Filtrations- oder Glaukomimplantatchirurgie nicht negativ beeinflusst wird. Da nur der trabekuläre Widerstand chirurgisch verändert wird, kann vom Konzept eine Augendrucksenkung in den niedrig-normalen Bereich nicht erwartet werden. Die bulbuseröffnende Ab-interno-Trabekelchirurgie ist deshalb eine typische Option für Glaukompatienten mit moderat erhöhtem Augeninnendruck und nicht allzu weit fortgeschrittener Glaukomschädigung, bei denen eine Kataraktchirurgie ansteht. Die Ab-interno-Trabekelchirurgie ist i. d. R. nicht ausreichend bei Patienten mit Normaldruckglaukom oder aber auch mit sehr hohen Augendruckspitzen.

Abstract

Ab-interno trabecular surgery does not damage sclera and conjunctiva in glaucoma patients and does not prejudice subsequent anti-glaucomatous filtration or drainage device surgery. As only trabecular resistance is surgically modified, the level of intraocular pressure (IOP) can usually not be reduced in the lower teens. Consequently, incisional ab-interno trabecular surgery is a valuable option in early glaucoma stages with moderate IOP elevation, especially in combination with cataract surgery. Ab-interno trabecular surgery is an insufficient surgical tool in normal pressure glaucoma, but also in glaucoma patients with very high IOP peaks.

Schlüsselwörter

Glaukom - Anatomie - Katarakt

Key words

glaucoma - anatomy - cataract

^* Herrn Prof. Dr. G. K. Krieglstein zum 70. Geburtstag gewidmet.

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