Treatment of cataracts. Surgical treatment of cataract.
Surgical technique to date remains the primary method of treatment of cataracts and the return of vision. The best results are obtained by removing mature cataracts. But in determining the surgical treatment guided by ground-state function of both eyes. If there is a cataract on the one hand, and the sight of the second eye is saved, the operation can be postponed until the maturation of cataract. With a decrease in vision in both eyes, surgery may be delayed uskoreno.Pri mature cataract surgery is dangerous because it can develop an attack of acute glaucoma with complete loss of visual function.
Before operative treatment the patient should be examined in detail. Concomitant diseases should be treated as possible and transferred to the stage of compensation. Assigned to dental health, treatment of hypertension, etc. Removal or extraction of the lens to date in two ways:
extracapsular
intracapsular removal of the lens.
Intracapsular extraction of lens when the lens is extracted together with the capsule. After cutting the lens capsule is removed with tweezers, erizofaka - special suction cups or by krioekstraktsii.
Cryo extraction - this method primorazhivaniya lens to a cooled metal tools, followed by extraction of the lens.
After extraction with lens capsule in the wound suture.
In the method of extracapsular cataract expose the anterior lens capsule and squeeze the nucleus, and lenticular masses of aspirate using a special instrument. The eye retained lenticular ligament and lenticular bag. This allows us to keep the vitreous body, the loss of any part of which is extremely undesirable. In addition, the remainder of the capsule can be placed an artificial lens.
Section at these methods, cataract removal is broad and can lead to the development of postoperative astigmatism. So far developed methods of cataract extraction through micro size in the cornea and the sclera, a width of 3 to 4 mm. In this case the entire lens or its nucleus removed and can not for the destruction of the lens used different ways to fragmentation.
Phaco fragmentation - a mechanical crushing of the lens using the instrument vitreotom, fotoemulsifikation- splitting the nucleus lens of the ultrasound. At the same lenticular nucleus initially crushed with an ultrasonic device, and then suck the ruined masses. It is especially effective this method, if the substance is dense lens. If the lenticular masses softened, this method is not applicable.
There is also a method of splitting the nucleus through the lens of the laser radiation. Laser energy is used for removing muddy rear of the lens capsule during cataract scarious. The application of modern techniques has allowed to achieve better results in the treatment of cataracts.
After removal of the cataract there is a condition in which the lens is missing - aphakia. In the aphakia, a strong far-sightedness, so adjustment is needed. Various methods are: wearing glasses implantation of intraocular lenses refractive epikeratoplastic.
In some cases, wearing glasses, but it is accompanied by a limited field of view and with unilateral cataract, the use of points possible.
Perhaps the use of contact lenses in children, but their use is limited by the appearance of hypersensitive, allergic reactions, infectious complications. The best effect is obtained by introducing into the eyes of intraocular lenses. These lenses can be perednekamernye, iris-clip-lens, posterior chamber. The best result is obtained by application of posterior chamber lenses.
