Crosslinking bei Neurodermitis: schwerwiegende Wundheilungsstörung nach kornealem Crosslinking bei einem Patienten mit Keratokonus und Neurodermitis

 

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Zusammenfassung

Dieser Fallbericht beschreibt eine Reepithelialisierungsstörung bei einem Patienten mit Keratokonus und Neurodermitis nach kornealem Crosslinking. Es zeigte sich ein deutlich verzögerter Heilungsverlauf mit persistierender Erosio trotz intensiver Hornhautpflege. Des Weiteren bildeten sich Kalzifizierungen und Vaskularisationen der Hornhaut, welche einen weiteren Epithelschluss verhinderten. Unter Therapie mit subkonjunktivalen Bevacizumab-Injektionen bildeten sich die prominenten Vaskularisationen fast vollständig zurück, sodass nach chirurgischer Entfernung der Kalzifizierungen ein vollständiger Epithelschluss bei nur noch zarten Vaskularisationen erfolgte.

Abstract

This case report describes a patient with keratoconus and neurodermitis suffering from a significantly prolonged postoperative time interval to re-epithelisation after corneal cross-linking. The development of corneal calcifications and vascularisations additionally inhibited proper re-epithelisation. Therefore the patient received four subsequent subconjunctival injections of Bevacizumab and an additional keratectomy to remove the calcifications. This therapeutic scheme led to a significant reduction of corneal vascularisation and finally a full rehabilitation of the epithelium.

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