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Morphologische Veränderungen durch Konservierungsmittel in Augentropfen

Morphological alterations induced by preservatives in eye drops

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Zusammenfassung

Zahlreiche experimentelle und klinische Untersuchungen der letzten Jahre haben z. T. erhebliche zytologische und histologische Veränderungen in Augengeweben nach chronischer Anwendung von Augentropfen nachgewiesen, für die nach heutigem Wissensstand die enthaltenden Konservierungsmittel verantwortlich zu machen sind. Das am häufigsten verwendete Konservierungsmittel ist Benzalkoniumchlorid (BAC), das eine verhältnismäßig hohe Zelltoxizität aufweist. Zu den möglichen Folgen der Konservierungsmittelexposition gehören chronische Entzündungen mit nachfolgender Fibrose der Subkonjunktiva sowie Zellverlust und strukturelle Veränderungen im Konjunktivaepithel wie auch im Korneaepithel und -endothel. Häufig kommt es während der Behandlung zur Verschlechterung oder zum erstmaligen Auftreten des trockenen Auges. In den letzten Jahren wurden neue Konservierungsmittel wie Polyquad, Purite® oder SofZia entwickelt, deren Nebenwirkungsprofile günstiger erscheinen. Allerdings liegen hierzu noch vergleichsweise wenig Daten vor. Wenn man die Belastungen für die Gewebe des Auges durch Augentropfen minimieren möchte, ist eine Therapie mit konservierungsfreien Präparaten anzustreben.

Abstract

A large number of experimental and clinical investigations carried out recently have confirmed that the chronic application of eye drops induces significant cytological and histological impairment in ocular tissues. It is also generally accepted that preservatives are the components responsible for the observed changes. The most commonly used preservative in ophthalmology is benzalkonium chloride (BAC), which has a relatively high toxicity. Possible consequences of preservatives on the eye are chronic inflammation and subsequent fibrosis of the subconjunctiva and cell loss and structural changes in the conjunctival epithelium as well as in the epithelial and endothelial layers of the cornea. Frequently, dry eye symptoms occur or deteriorate during therapy. During the last few years new preservatives have been developed which seem to have fewer side effects; however, relatively little data are available with regard to these new substances. To minimize impairments of the eye, preservative-free formulations should be considered for therapy.

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Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: K.K. Huber-van der Velden und M. Eichhorn sind als Referenten für die Firmen MSD und Alcon tätig und erhalten Beraterhonorare von der Firma MSD.

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Authors and Affiliations

  1. Augenklinik, Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    K.K. Huber-van der Velden

  2. Augenklinik, Universität Mainz, Mainz, Deutschland

    H. Thieme

  3. Institut für Anatomie II, Universität Erlangen-Nürnberg, Erlangen, Deutschland

    M. Eichhorn

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  1. K.K. Huber-van der Velden
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  2. H. Thieme
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  3. M. Eichhorn
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Correspondence to K.K. Huber-van der Velden.

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Huber-van der Velden, K., Thieme, H. & Eichhorn, M. Morphologische Veränderungen durch Konservierungsmittel in Augentropfen. Ophthalmologe 109, 1077–1081 (2012). https://doi.org/10.1007/s00347-012-2639-3

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