Differenzialdiagnose und Therapie der Transplantatabstoßung nach Keratoplastik

Zusammenfassung

Immunmediierte Abstoßungsreaktionen sind Hauptursache des Transplantatversagens nach perforierender Keratoplastik. Klinisch können sie sich isoliert oder auch kombiniert als akut auftretende Veränderung am Empfängerepithel, -stroma oder -endothel manifestieren. Die Differenzierung von anderen morphologischen Veränderungen im postoperativen Verlauf nach Hornhauttransplantation kann sich schwierig gestalten, hat für die Therapie jedoch unmittelbare Bedeutung. Der vorliegende Beitrag soll die wichtigsten Differenzialdiagnosen und therapeutischen Maßnahmen zusammenfassend darstellen.

Abstract

Allograft rejection is the leading cause of corneal graft failure after perforating keratoplasty. Clinically, graft rejection may present as acute changes in corneal host tissue. All three corneal layers, epithelium, stroma and endothelium, can be affected separately or manifest combinations of rejection. Differentiation from other postoperative morphological changes following corneal transplantation can prove to be difficult, but is critical in treatment. This article is intended to provide a review on differential diagnoses and current therapeutic measures.

Schlüsselwörter

Hornhaut - Keratitis - Therapie - Transplantatabstoßung

Key words

Cornea - keratitis - therapy - allograft rejection

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