Glaukomchirurgie bei Vorderabschnittsdysgenesien

 

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Zusammenfassung

Kongenitale Vorderabschnittsdysgenesien sind selten und treten meist sporadisch auf. Ihre phänotypische Ausprägung ist sehr variabel. In etwa 50% aller Fälle tritt ein Glaukom auf – entweder als Teil der Dysgenesie oder als Sekundärglaukom, vor allem nach Lentektomie bei kongenitaler Katarakt. In diesem Übersichtsartikel werden neben den embryologischen Grundlagen und dem Spektrum der Erkrankungen vor allem die chirurgischen Möglichkeiten zu Senkung des intraokularen Drucks vorgestellt. Ein Schwerpunkt liegt hierbei auf der in letzter Zeit zunehmend angewandten mikrokatheterassistierten 360°-Trabekulotomie sowie dem Einsatz von Drainageimplantaten.

Abstract

Anterior segment dysgeneses are rare conditions, and mostly occur sporadically. The severity of dysgenesis and the number of structures affected are highly variable. Glaucoma occurs in approximately 50% of all patients, either as part of primary chamber angle dysgenesis or secondary to surgery, mostly for removal of congenital cataracts. This review provides a brief overview of the embryological background and the spectrum of phenotypes, such as primary congenital glaucoma, Axenfeld Rieger and Peters Anomaly. Current surgical approaches to lower intraocular pressure are discussed. Special attention is paid to the increasingly used microcatheter-assisted 360° trabeculotomy and glaucoma drainage devices in paediatric glaucoma surgery.

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