Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"


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Abstract
Abstract

Microsurgical Therapy of Defective Corneal Regeneration

Seitz B.1, Sauer R.1, Langenbucher A.1, Hofmann-Rummelt C.1, Wenkel H.1, Kruse F. E.2
1Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen; 2Department of Ophthalmology, University of  Heidelberg

Purpose: Defective corneal regeneration can occur in ulcers of infectious (herpetic, bacterial, fungal), rheumatoid or neuroparalytic origin, in limbal stem cell deficiency after (chemical) burns, Fuchs-Stevens-Johnson syndrome or aniridia, and after penetrating keratoplasty. Recurrent corneal erosion syndrome represents a mild variant, in which adhesion complexes between epithelium and stroma are not sufficiently regenerated (qualitatively or quantitatively). The purpose of this lecture is to critically demonstrate surgical therapy options of defective corneal regeneration, that may be necessary if conservative medical approaches (unpreserved artificial tears, gels and ointments (w/o pressure patch), vitamin A or hyaluronic acid containing medications or autologous serum) fail.
Method: First, lid malformation/-position and trichiasis have to be treated. With diseases of rheumatoid origin temporary (punctum plugs) or permanent lacrimal punctum occlusion is recommended. In difficult situations a (lateral) tarsorrhaphy or botulinum toxin injection into the upper lid may be indicated, to avoid a (repeat) keratoplasty à chaud or even a conjunctival flap as ultima ratio. We consider the excimer laser PTK after generous re


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