Title OPERACIJA KATARAKTE U PACIJENATA SA PEX GLAUKOMOM
Title (english) CATARACT SURGERY IN PATIENTS WITH PEX GLAUCOMA
Author Ivan Kujundžić
Mentor Maja Merlak (mentor)
Committee member Damir Kovačević (predsjednik povjerenstva)
Committee member Ines Brajac (član povjerenstva)
Committee member Sandra Milić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Ophthalmology) Rijeka
Defense date and country 2021-06-28, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Ophthalmology
Abstract Katarakta je svako zamućenje inače prozirne leće, a pacijent ju doživljava zamućenjem slike i pojavom monokularne diplopije. ( 3) Glaukom je kronična progresivna optička neuropatija koju karakterizira propadanje ganglijskih stanica unutar mrežnice i gubitak aksonskih vlakana u vidnom živcu. ( 1) Pseudoeksfolijativni sindrom je sistemska bolest karakterizirana taloženjem fibrilarnog materijala u prednjem segmentu oka i drugim organima.( 22) Pseudoeksfolijativni materijal u oku taloži se uz rub zjenice, na prednjoj kapsuli leće, endotelu rožnice, trabekularnoj mreži i u krvim žilama šarenice. Taj materijal ometa otjecanje očne vodice uzrokujući povišenje IOT-a i nastanak pseudoeksfolijativnog glaukoma koji spada u sekundarni glaukom otvorenog kuta. ( 14) Prevalancija PEX glaukoma kod PEX sindroma iznosi oko 50%. ( 23) Operacija katarakte u pacijenata sa PEX glaukomom je komplicirana operacija koja zahtjeva iskusnog kirurga jer postoji veći rizik za intraoperativne i postoperativne komplikacije te se sama operacija izvodi složenije od operacije katarakte bez pridruženih bolesti oka. ( 30) Operacija katarakte sa PEX glaukomom najčešće se izvodi fakoemulzifikacijom. Kod operacije moramo posebno paziti na zonule, endotel rožnice, količinu PEX materijala u odvodnom sustavu i cijeloj prednjoj očnoj sobici i veličinu otvora na prednjoj kapsuli leće. Intraoperativne komplikacije uključuju slabu midrijazu, plitku i duboku prednju komoru, dijalizu zonula i prolaps nukleusa. U rane postoperativne komplikacije ubrajamo keratopatiju, cistoidni makularni edem, naslage na intraokularnoj leći i skokove intraokularnog tlaka. Kasne postoperativne komplikacije uključuju prednju kapsularnu kontrakciju, fibrozu stražnje kapsule i dislokaciju IOL. ( 31)
Abstract (english) A cataract is any blurring of an otherwise transparent lens, and the patient experiences it with blurred vision and the appearance of monocular diplopia. (3) Glaucoma is a chronic progressive optic neuropathy characterized by the decay of ganglion cells within the retina and the loss of axonal fibers in the optic nerve. (1) Pseudoexfoliative syndrome is a systemic disease characterized by the deposition of fibrillar material in the anterior segment of the eye and other organs. This material interferes with the outflow of aqueous humor causing an increase in IOP and the formation of pseudoexfoliative glaucoma which belongs to secondary open-angle glaucoma. (14) The prevalence of PEX glaucoma in PEX syndrome is about 50%. (23) Cataract surgery in patients with PEX glaucoma is a complicated operation that requires an experienced surgeon because there is a higher risk of intraoperative and postoperative complications; and the operation itself is performed with more complexity than cataract surgeries without associated eye diseases. (30) Cataract surgery with PEX glaucoma is most often performed using the phacoemulsification. During the operation, we must pay special attention to the zonal, corneal endothelium, the amount of PEX material in the drainage system and the entire anterior chamber of the eye, and the size of the opening on the anterior capsule of the lens. Intraoperative complications include weak mydriasis, shallow and deep anterior chamber, zonal dialysis and nucleus prolapse. Early postoperative complications include keratopathy, cystoid macular edema, intraocular lens deposits, and intraocular pressure spikes. Late postoperative complications include anterior capsular contraction, posterior capsule fibrosis, and IOL dislocation. (31)
Keywords
katarakta
pseudoeksfolijativni glaukom
fakoemulzifikacija
intraokularni tlak
intraokularna leća
Keywords (english)
cataract
pseudoexfoliative glaucoma
phacoemulsification
intraocular lens
intraocular pressure
Language croatian
URN:NBN urn:nbn:hr:184:638351
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access Embargo expiration date: 2021-07-16
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Created on 2021-07-09 06:58:47