Magement of cataract
- 1. MAGEMENT OF CATARACTEXTERN AKECHANOK WATCHARAPUNJAMART
- 2. Indication for Surgery 1. Visual need 2. Complication oPhacomorphic glaucoma oPhacolytic glaucoma oDislocation of cataract lens 3. Poor fundus examination or treatment Reference :
- 3. Anesthesia LOCAL anesthesia retrobulbar peribulbar techniques General anesthesia Topical anesthesia
- 4. Operation: the only effective therapy ICCE (intracapsular cataract extraction) ECCE (extracapsular cataract extraction) Phacoemulsification Pars plana lensectomy
- 5. ICCE: intracapsular cataract extraction Indication 犢犖犖÷顕犖萎犖犖犖朽犢犖÷犖÷元犖犖ム犖犖犖犖∇顕犖 犖犖迦見犖犖園犖犢犖迦犖園犖犖 犖犖迦犖犖迦犖犖犖迦権犖犖朽 hypermature 犢犖ム鍵 Subluxated cataract Absolute contraindication 犢犖犢犖犢犖 犢犖犖犖迦権犖犖朽犖÷元犖犖伍犖園犖巌犖犖犖 capsule 犖犖犖 犢犖ム犖犢犖犖朽犖犖迦 Relative contraindication 犖犖迦権犖犖迦肩犖園犖犖÷顕犖 Marfans syndrome Morgagnian cataract 犖÷元Vitreous in Anterior cahmber
- 6. In extracapsular cataract extraction, an incision is made in the eye just beneath the iris, or colored part (A). The diseased lens is pulled out (B). A prosthetic intraocular lens is placed through the incision (D), and is opened to replace the old lens (E). (Illustration by GGS Inc.) ECCE: Extracapsular cataract extraction Contraindication: Inadequate zonular integrity
- 9. Phacoemulsification 犖犢犖犖犖 犖ム犖犖伍犖園犖巌犖迦牽犖犢 犖犖迦牽犢犖犖巌犖犖ム犖犖犖犖犢犖犖 犖犖朽犢犖犖劇犖犖犖犖迦犢犖犖 (Wound related complication) 犢犖犖ム犢犖迦犖園犖犖迦権犢犖犢犖о犖о犖 犖犖迦牽犖÷賢犖犢犖犢犖犖犖ム険犖犖犢犖迦犖園犖犖園犢犖犢犖о犖о犖 犖犖迦牽犖犖園犢犖犖犖犢犖犖∇犖о犖 犖犖迦権犖犖迦犖犖朽権犖犖犖迦犢犖犖ム犢犖犖∇犖о犖 犖犢犖犢犖犖朽権 犢犖犖犖劇犖犖犖÷厳犖犖÷元犖犖迦犖迦犖犖 犢犖犖犖犖巌犖犖迦牽犖犢犖迦犖園犖∇顕犖犖犖о犖 ECCE 犖犢犖犖犖犖迦牽犖犖о顕犖÷犖迦犖迦犢犖犖犖迦牽犖犢犖迦犖園
- 10. Pars plana lensectomy Indication Congenital cataract Traumatic cataract 犖犖朽犖÷元 vitreous 犖犖ム幻犖犖犖犖犖÷顕犖犖犢犖迦犖ム犖犢 Complicated, subluxated,dislocate hypermature cataract Malignant glaucoma Retinopathy of prematurity Persistent hyperplastic primary vitreous
- 11. : 3 犖犖む県犖犖迦犖 2558 犢犖о献犖 6.20 犖.
- 12. Femtosecond Laser 犖犖迦見犖犢犖迦犖朽犢犖犖犢犖犖÷元犖犢犖犖犖迦牽犢犖犖巌犢犖犖ム犖朽 犖犖犖萎犖犖犖迦犖ム鍵犢犖犖巌犖犖伍犖犖伍犖÷犖ム犖犢犖犖 犢犖犖ム権犖園犖÷元犖犖о顕犖÷犖犖朽権犖犢犖ム鍵犖犖÷顕犖犖犖園硯犢犖犢犖犖朽犖о犖 犖犖迦牽犖犢犖迦犖園犖犖萎犖犢犢犖о献犖迦犖犖萎検犖迦 20-30 犖犖迦犖 犖犢犖犖犖迦犖園 犢犖÷犢犖犖÷顕犖萎犖園犖犢犖犖犖犖萎犖犖犖朽犖犖伍犖÷顕犖犢犖犖巌犢犖 犖犖項犖犖朽犖÷元犖犖о顕犖÷犖伍犖犖犖犖犖犖犖萎犖犖犖迦見犖犖劇賢犖犖迦牽犖犖園犢犖犖 犢犖犖犖 犖犢犖迦犖犢犖犢犖迦権犖犖項 REFERENCE: http://www.si.mahidol.ac.th/th/hotne ws_detail.asp?hn_id=1340 犢犖犢犖迦犖謹 犖 犖о険犖犖犖朽 5/10/2558
- 13. 犖犖迦硯犖萎犖犖犖犖犢犖犖犖犖犖犖犖迦牽犖犢犖迦犖園犖犢犖犖犖犖萎犖 Intraoperative Expulsive hemorrhage Iris trauma Anterior chamber hemorrhage Ruptured posterior capsule Corneal injury Vitreous loss Lens dislocation Early postoperative complications Endophthalmitis Glaucoma Uveitis Ruptured wound c/s iris prolaspe Late postoperative complications Posterior capsule opacity Retinal detachment Cystoid macular edema Corneal decompensation (corneal edema) Astigmatism
- 14. New Frontiers Researchers are continuing to explore new ways to prevent and treat cataracts, such as developing medications that would reduce or eliminate the need for surgery Until then, cataract surgery is the method to restore vision