{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:06:30Z","timestamp":1790809590286,"version":"4.1.0"},"reference-count":94,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die iatrogene Keratektasie kann als postoperative Komplikation nach refraktivchirurgischen Lasereingriffen entstehen. Dabei kommt es aufgrund einer biomechanischen Schw\u00e4chung und daraus resultierenden Aufsteilung des verbliebenen Hornhautgewebes zu einer progredienten Myopie sowie einem irregul\u00e4ren Astigmatismus, verbunden mit einem deutlichen Visusverlust. Die Inzidenz der iatrogenen Keratektasie wird in der Literatur mit 0,04% bis 0,6% angegeben, wobei das Risiko nach KLEx und LASIK h\u00f6her ist als nach PRK. Aufgrund technischer Fortschritte in der pr\u00e4operativen Diagnostik und den chirurgischen Verfahren scheinen \u00e4ltere Inzidenzangaben jedoch nur eingeschr\u00e4nkt auf die heutige Praxis \u00fcbertragbar zu sein. Risikofaktoren sind dabei unter anderem eine pr\u00e4operativ d\u00fcnnere Hornhaut, eine h\u00f6here Myopie sowie eine genetische Pr\u00e4disposition oder ein unentdeckter Keratokonus. Zur Prophylaxe der iatrogenen Ektasie sind daher eine ausf\u00fchrliche pr\u00e4operative Anamnese und detaillierte klinische Diagnostik von gro\u00dfer Bedeutung. Es stehen genaue Messmethoden zur Verf\u00fcgung, welche eine differenzierte Beurteilung von kornealer Topografie, Tomografie und Biomechanik erm\u00f6glichen. Zur darauf basierenden Absch\u00e4tzung des postoperativen Ektasierisikos dienen Scores wie das \u201eEctasia Risk Score System\u201c (ERSS) sowie \u201ePercentage of tissue alteration\u201c (PTA). Zur Behandlung einer iatrogenen Keratektasie stehen f\u00fcr die visuelle Rehabilitation zun\u00e4chst konservative Ma\u00dfnahmen wie die Anpassung von Brillen oder Kontaktlinsen zur Verf\u00fcgung. Vor allem bei einer voranschreitenden Ektasie ist die Durchf\u00fchrung eines kornealen Crosslinkings indiziert. Dieses hat nicht das Ziel einer unmittelbaren Sehleistungsverbesserung, kann aber die weitere Progression aufhalten. Die Sicherheit und Wirksamkeit des Verfahrens konnte in verschiedenen Studien belegt werden. Alternativ sind die Implantation kornealer Ringsegmente aus Kunststoff (ICRS), Spenderhornhaut (CAIRS) oder, als Ultima Ratio, eine Keratoplastik m\u00f6glich. Die neueste chirurgische Methode stellt die Implantation stromaler Lentikel dar, welche aus KLEx-Eingriffen gewonnen werden. Insgesamt handelt es sich um eine komplexe Erkrankung, weshalb neben einer genauen pr\u00e4operativen Diagnostik auch postoperativ regelm\u00e4\u00dfige Kontrollen nach refraktiver Laserchirurgie empfohlen werden, um eine Ektasie fr\u00fchzeitig entdecken und behandeln zu k\u00f6nnen.<\/jats:p>","DOI":"10.1055\/a-2943-6327","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:38:42Z","timestamp":1790807922000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevention and Treatment of Iatrogenic Keratectasia"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1218-6821","authenticated-orcid":false,"given":"Anna","family":"Pretzsch","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Carl Gustav Carus, Sachsen, Germany","place":["Dresden"],"department":["Klinik und Poliklinik f\u00fcr 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