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Nicht selten zeigten sich im Verlauf allerdings strukturelle Komplikationen einschlie\u00dflich Interface-Narben, Oberfl\u00e4chenirregularit\u00e4ten sowie sekund\u00e4re korneale Ektasien.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Fall<\/jats:title>\n                    <jats:p>Ein 55-j\u00e4hriger Patient stellte sich mit ausgepr\u00e4gter subjektiver Visusminderung des rechten Auges vor. Aufgrund einer Myopia magna erfolgte in S\u00fcdkorea vor 34\u00a0Jahren der operative Versuch der Visusbesserung durch Epikeratoplastik. Bei weiterhin unzureichendem funktionellem Visusergebnis wurde zudem eine additive photorefraktive Keratektomie (PRK) durchgef\u00fchrt. Bei ausgepr\u00e4gter Oberfl\u00e4chenirregularit\u00e4t mit anterior-stromaler Narbenbildung, Hornhautdickenzunahme auf zentral 708\u202f\u03bcm und Kontaktlinsenunvertr\u00e4glichkeit sowie bei kortikonukle\u00e4rer Katarakt wurde die Durchf\u00fchrung einer perforierenden Excimerlaser-Keratoplastik mit simultaner Kataraktoperation (Triple-PKP) empfohlen. Der Patient entschied sich jedoch zun\u00e4chst f\u00fcr die Entfernung des Lentikels in einer externen Klinik. Bei Wiedervorstellung zeigte sich in der Folgeuntersuchung eine deutliche Verd\u00fcnnung des Hornhautstromas. Daraufhin wurde die vorab empfohlene Triple-PKP am rechten Auge durchgef\u00fchrt. Postoperativ zeigte sich bereits nach sechs Monaten eine deutliche Visusbesserung von 0,05 auf\u00a00,4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Die Entfernung von Epikeratoplastiken kann mit einer Vielzahl von Komplikationen einhergehen. In diesem Fall stellte die Triple-PKP die sinnvollste Therapieoption dar, um die anatomische Stabilit\u00e4t wiederherzustellen sowie eine zeitnahe visuelle Rehabilitation zu erreichen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00347-026-02495-9","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:00:46Z","timestamp":1785772846000},"page":"814-819","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perforierende Excimerlaser-Keratoplastik bei stromaler Vernarbung nach Epikeratoplastik","Excimer laser-assisted penetrating keratoplasty for stromal scarring after epikeratoplasty"],"prefix":"10.1007","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9726-1623","authenticated-orcid":false,"given":"Anna-Sophie","family":"Heiland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fidelis","family":"Flockerzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Yoo-Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Flockerzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loay","family":"Daas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"2495_CR1","first-page":"116","volume-title":"Refraktive Chirurgie der Hornhaut","author":"J Krumeich","year":"2000","unstructured":"Krumeich\u00a0J (2000) Epikeratophakie. 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F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. F\u00fcr Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, \u00fcber die Patient\/-innen zu identifizieren sind, liegt von ihnen und\/oder ihren gesetzlichen Vertretern\/Vertreterinnen eine schriftliche Einwilligung vor.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}}]}}