[Perioperative/Postoperative Anti-Inflammatory Therapy During/After Corneal Surgery/Transplantation].

[Perioperative/Postoperative Anti-Inflammatory Therapy During/After Corneal Surgery/Transplantation]. Klin Monbl Augenheilkd. 2019 May;236(5):653-661 Authors: Bachmann BO, Pleyer U, Maier PC, Reinhard T, Seitz B, Cursiefen C Abstract Surgical trauma, and foreign material - such as sutures or implants or antigens during tissue transplantation - may cause inflammatory reactions. Inflammatory reactions after surgical interventions distant from the vascularised limbus and without opening of the anterior chamber of the eye are usually very muted, because of the corneal immune and angiogenic privilege. A milestone in the therapy and prophylaxis of inflammation after corneal surgery has been the use of topical glucocorticoids since the 1950s. When these are used, it is important to consider the cataractogenic effect of long-term use, the possibility of steroid-induced increase in intraocular pressure (so-called steroid response), the increased risk for microbial infection and the inhibition of epithelialisation. The available glucocorticoids differ in their ability to penetrate into the eye (prednisolone best), their immunosuppressive activity (dexamethasone best) and their ability to induce a steroid response (loteprednol etabonate and fluorometholone least). Preservative-free formulations are only available for dexamethasone. The different properties must be taken into account when choosing the "best" glucocorticoid: If there is a risk of...
Source: Klinische Monatsblatter fur Augenheilkunde - Category: Opthalmology Tags: Klin Monbl Augenheilkd Source Type: research