Szemészet, 2008 (145. évfolyam, 1-4. szám)
2008-12-01 / 3-4. szám
145. évfolyam (2008) Supplementum I. 29 Methods: Autologous RPE transplantation was performed in patients with neovascular AMD - not suitable for other treatment options in 3 different studies. Study 1 was a pilot study to evaluate technique, outcome and complications. Study 2 was a prospective trial comparing subretinal membranectomy alone versus membrane removal combined with simultaneous RPE transplantation. Study 3 is a trial comparing outcomes of 2 different techniques of RPE-transplantation: The RPE-suspension technique and the RPE-choroidal flap technique. Results: With RPE-suspension visual improvement more than 3 lines was found in 37% after 12months. More than two lines improvement was found in 54-57% after 12 and 24 months, and 52% after 36% months respectively. After 36 months 90.5% had same or improved vision. Useful reading vision between Jg 1 and 4 was achieved in 15%. With OCT sign, lesser atrophy was diagnosed in the transplanted group in study 1 and 2 (p-0.0363).Recurrences were rare, 4.4% after 12 months 13.3% after 24 and 15.2% after 36 months. When comparing the RPE-suspension versus the full thickness RPE choroidal flap visual outcomes were similar in both groups but surgery more traumatic with the flap technique. So far a good integration in the recipient bed, vascularisation of the patch and significant subclinical function gain as well as stabilisation of vision and a low recurrence rate could be achieved in advanced AMD. The suspension technique was more efficient in younger patients with smaller lesions. Future direction will be in the area of RPE-rejuvenation or other cell sources and artificial basal lamina. Case selection has to change to eyes with better conditions of the photoreceptors, like fresh RPE-rips or earlier dry AMD. Conclusion: The possible application to several forms of retinal degenerations makes retinal transplantation a valuable therapeutic endeavour. Clearly, the future of cell based therapies will be connected with advance in other fields of retinal research Experiences and results in the treatment of anophthalmic patients with an eye prosthesis made of special glass Birke, Stefan OcularService S. Birke, Neuhaus, Germany Background: After the loss of an eye an eye prosthesis has to be fitted and worn. With it the eye socket will be prevented from contraction and the optical rebuilt of the face will enable the patients with complete rehabilitation in society. Patients and method: The use of eye prosthesis made of special glass, as well as its manufacturing and the material will be discussed. Further concept of the treatment and prosthesis it will be presented. Results: An individual treatment of eye prosthesis is the optimal treatment of anophthalmic patients. The selected patients are the representatives of this group. The treatment will be documented in sequences of pictures and so the individual concept of treatment is presented. Conclusion: An eye prosthesis made of glass is in the German-speaking area the treatment of standard. Because of the material, in the manufacturing and in the individual and anatomic fitting and the biocompatibility it is suitable to fulfil all medical demands. At last the eye prosthesis aims at the rehabilitation of the patient, gives back the patient’s natural appearance, self confidence and quality of life.
