Antiangiogene Präkonditionierung vor Keratoplastik

 

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Zusammenfassung

Einleitung: Darstellung antiangiogener und antilymphangiogener Therapiestrategien zur Verbesserung des Transplantatüberlebens nach Keratoplastik.

Methoden: PubMed-Literaturübersicht und eigene klinische und experimentelle Daten.

Ergebnisse: Es gibt 3 Ansätze zur Verbesserung des Transplantatüberlebens durch antiangiogene Therapie: (a) primäre Prävention durch Verhinderung der Angiogenese im Rahmen kornealer Erkrankungen, (b) sekundäre Prävention durch Regression vorhandener stromaler kornealer Gefäße vor der Transplantation und (c) tertiäre Prävention durch Hemmung der postoperativen Neovaskularisation.

Schlussfolgerung: Moderne antiangiogene und antilymphangiogene topische Therapien scheinen in der Lage zu sein, das Transplantatüberleben bei perforierender Keratoplastik gerade im Hochrisikobereich zu verbessern.

Abstract

Purpose: The aim of this study is to describe novel therapeutic concepts to promote graft survival in high-risk keratoplasty by targeting (lymph)angiogenesis in the transplant context.

Methods: A PubMed literature search and our own clinical and experimental data are evaluated.

Results: There are three options for anti(lymph)angiogenic preconditioning: a) primary prevention of neovascularisation during the disease process, b) secondary prevention by regressing established blood vessels prior to transplantation and (c) tertiary prevention through inhibition of post-keratoplasty neovascularisation.

Conclusion: Modern topical anti(lymph)angiogenic therapies seem to be able to reduce the risk of graft rejection especially in high-risk keratoplasty.

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