Treatment options at our university hospital

The field of therapeutic options in ophthalmology is subject to constant change, and we ensure that our treatment meets our high quality standards through new surgical procedures and continuous further training in the field.

 

Therapeutic approaches in ophthalmology can be divided into several areas:

  • Conservative therapy:
    This specialist area describes therapy without surgical interaction by the ophthalmologist. This includes all eye drop therapies as well as systemic therapies with various groups of medication.
  • Surgical treatment of the eyelids and orbit:
    This area covers surgery without injury to the eye itself, typically including procedures for age-related eyelid drooping, correction of excess eyelid skin and removal of periorbital tumors, through to enucleation of the eye in severe cases.
  • Surgical treatment of the anterior segment of the eye:
    This specialty includes surgery of the eye from the cornea up to and including the lens. Typical operations include corneal transplants, glaucoma surgery and cataract surgery.
  • Surgical treatment of the posterior segment of the eye:
    This specialty describes the entire area of surgery behind the lens via the vitreous body to the retina and choroid. Typical operations include the treatment of retinal detachment, peeling of epiretinal membranes and subretinal chip implants.


Click here to go to our surgical nursing website: OR Nursing

 

Laser surgery

We offer the following laser surgery procedures as part of outpatient treatment:

  • Argon laser: welding of the retina using an argon laser for holes, degeneration or in the context of ischemic areas (diabetes, vascular occlusion)
  • Nd-YAG laser:
    • YAG iridotomy as a pressure-reducing procedure for acute glaucoma attacks
    • YAG capsulotomy for secondary cataracts
    • Suturolysis
  • Selective laser trabeculoplasty: Pressure-lowering procedure to tighten the trabecular meshwork, ideal complement to inadequate conservative eye drop therapy
  • Photodynamic therapy: Targeted activation of a dye in the eye using "cold" laser light.

 

UV crosslinking of the cornea

  • Keratoconus
    Keratoconus is a cone-shaped protrusion of the cornea, which usually manifests itself as an increasing curvature of the cornea in the 2nd and 3rd decade of life. Due to the irregular curvature of the cornea, vision can only be corrected with glasses in the early stages. Later, specially adapted contact lenses are necessary. In order to halt the progression of the disease, UV crosslinking is currently being tried. If the disease continues to progress, corneal transplantation is the final option to improve vision.
  • Keratoconus detection
    Using modern surface images of the cornea, it is possible to detect keratoconus at an early stage.
  • UV crosslinking
    In keratoconus, corneal stability is no longer guaranteed. The cornea consists of collagen fibrils. Attempts are made to crosslink these in order to restore the stability of the cornea and prevent the cornea from bulging out in a cone shape. In UV crosslinking, the surface of the cornea is first ablated and then riboflavin is allowed to penetrate the cornea. This reacts photosensitizing in conjunction with subsequent UV light irradiation. This leads to cross-linking of the central corneal structure (corneal collagen fibrils). After the treatment, a soft contact lens is placed on the cornea for protection until the surface has healed again. Pain is to be expected during this time. As long as the surface is not closed, it is checked daily.

According to current knowledge, further progression of keratoconus appears to be halted. In rare cases, regression of the astigmatism is even possible.

 

Corneal transplants

  • Perforating keratoplasty
    In the case of advanced keratoconus and other destructive corneal diseases (e.g. clouding or infection), the cornea can be replaced with a donor cornea. The penetrating keratoplasty replaces all corneal layers and is the method of choice for irreversible changes to the cornea. The transplant is held in place by sutures and fuses with the patient's cornea.
  • Lamellar keratoplasty (DMEK)
    Lamellar keratoplasty is a special form of corneal transplantation. In this case, only the posterior partial layer of the cornea is transplanted. This enables faster rehabilitation than with a transplant of the entire cornea. The prerequisite for this is intact anterior corneal layers. It is suitable for patients who suffer from a disease of the posterior corneal structure, e.g. Fuchs' corneal dystrophy.

 

Glaucoma surgery

Glaucoma is treated by means of a multi-stage therapy. After conservative treatment options using eye drops have been exhausted or if the pressure is not reduced sufficiently, there is the option of surgical pressure reduction. We offer the following procedures, among others:

  • Laser-based procedures
    • Selective laser trabeculoplasty
    • YAG iridotomy
    • Cyclo-photo-coagulation
  • Trabeculotomy ab interno with the trabectome, also in combination with cataract surgery
  • Trabeculectomy with mitomycin C application (TET+MMC, Elliot, seepage cushion, fistulating procedure)

 

Vitreous body excision / vitrectomy

  • Vitrectomy
    We offer the technique of vitrectomy and thus surgery on the posterior segment of the eye using the conventional 20G technique as well as the established, sutureless small incision techniques 23G and 25G. The advantage here is the smaller incision channels for the eye, which generally close themselves without the need for an additional suture and therefore an additional stimulus. Thanks to the further development of these techniques, many procedures are now possible using this small incision technique as standard.
  • Areas of application include Retinal detachments, surgery for retinoschisis, epiretinal gliosis (surgery with or without ILM peeling), macular holes and macular pseudo holes as well as many other...

 

Subretinal chip implantation

Our Clinical Department offers the option of subretinal chip implantation for retinal diseases. The prerequisite is that good vision must have existed in earlier years of life so that the brain has "learned" to see. Typical patients for this are those with retinitis pigmentosa.

Further information: Flyer Retina Implant