Zur chirurgischen Prophylaxe der postoperativen Endophthalmitis nach Phakoemulsifikation. Eine kurze Übersicht (und Wertung)

 

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Zusammenfassung

Zur Vermeidung der postoperativen Endophthalmitis werden verschiedene Maßnahmen empfohlen. Meist sind diese medikamentöser Natur, z. B. PVP-Jod, topische Antibiotika prä-, intra- sowie postoperativ. Aufgrund der aktuellen ESCRS-Studie zur intrakameralen Antibiotikumgabe wird derzeit fast ausschließlich medikamentös diskutiert. Daher wird in der vorliegenden Übersichtsarbeit auf die Bedeutung der chirurgischen Priorität hingewiesen, ohne deshalb die medikamentöse zu vernachlässigen. Die Tunnelkonstruktion muss auch auf Druck von außen wasserdicht sein, um mit Sicherheit eine postoperative Hypotonie zu vermeiden. Im Zweifelsfall sollte eine Naht durchgeführt werden.

Abstract

To avoid a postoperative endophthalmitis several measures have been proposed. These are predominantly drug-related, e. g. PVP-iodine, topical antibiotics pre-, intra- and postoperatively. Due to the actual ESCRS study for intracameral antibiotics, the current discussion focusses almost exclusively on drug-related causes. Therefore, in this paper the surgical priority is pointed out without neglecting the drug-related causes. The construction of the tunnel must be water-tight even under pressure from outside to avoid a postoperative hypotony. In cases of doubt the tunnel should be sutured.

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Prof. Wolfgang Behrens-Baumann

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