Verätzungen und Verbrennungen des Auges

 

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Zusammenfassung

Hintergrund: Mit dieser Übersicht soll ein Handlungsschema für die Therapie der Augenverätzung und -verbrennung in der Frühphase vorgelegt werden.

Methode: Die Erkenntnisse beruhen auf den langjährigen Erfahrungen an den Universitätsaugenkliniken in Aachen und Halle/Saale sowie der Augenklinik der Kliniken der Stadt Köln und den experimentellen Arbeiten am An-Institut der RWTH Aachen und sind mit der internationalen Literatur abgeglichen.

Ergebnisse: Ausgehend von der Einschätzung des gegenwärtigen Gefährdungspotenzials durch Augenverätzungen und -verbrennungen werden Empfehlungen zur Akutbehandlung sowie der schweregradbezogenen Therapie in der Frühphase gegeben und durch die Darstellung pathophysiologischer Abläufe begründet. Für definierte kritische Situationen werden spezielle Maßnahmen benannt sowie auf weiterführende Therapiekonzepte in der Spätphase verwiesen.

Schlussfolgerung: Nach neueren Erkenntnissen hat in der Akutbehandlung der Augenverätzung oder -verbrennung die Anwendung einer optimalen Augenspüllösung eine überragende Bedeutung. Einen bleibenden zentralen Stellenwert in den geschilderten konservativen Therapieoptionen hat die antientzündliche Therapie. Für schwere und schwerste Augenverätzungen und -verbrennungen ergänzen bewährte und weiterentwickelte operative Maßnahmen die Therapie. Sie dienen gleichsam der Entzündungshemmung und dem Gewebeschutz.

Abstract

Background: This review gives a therapeutic approach for the early treatment of chemical and thermal burns of the ocular surface (CTOS).

Method: Based on a review of international literature, the experiences of University Hospital Aachen and Halle/Saale, Eye Clinic Cologne as well as experimental data of the research institute (An-Institut) at RWTH Aachen University are considered and discussed.

Results: As the risk depends on the stage of CTOS, recommendations are given for acute treatment for different stages. Pathophysiological considerations will be discussed. Special treatment options for exceptional situations and for late phase CTOS are demonstrated.

Conclusion: According to the latest data, the most important clinical recommendation for the acute phase of CTOS is the application of a suitable rinsing solution. Furthermore, anti-inflammatory treatment is of central importance. For the therapy of severe CTOS, approved and advanced surgical methods need to be applied. In this way, anti-inflammatory and tissue-protecting mechanisms are activated simultaneously.

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