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[白内障手术的适应证]

[Indications for cataract surgery].

作者信息

Gloor B

出版信息

Klin Monbl Augenheilkd. 1982 Sep;181(3):157-63. doi: 10.1055/s-2008-1055190.

Abstract

Progress in surgical methods and advances in the correction of aphakia with contact lenses or intraocular lenses on the one hand, and the greater demands made by patients on the other are the reasons why the cataract surgery is indicated much earlier today than 20 years ago. Occupational considerations and the visual acuity required to keep a driver's licence may be determining factors in the timing of surgery and the choice of one or the other methods o correcting aphakia. To advise the patient correctly, an accurate preoperative assessment of the visual function which can be expected postoperatively has be made. Of the preoperative examinations, results with the test wih the Moiré pattern following Lotmar are mentioned. If the patient's occupation places high demands on visual acuity, as e.g. for bus drivers - 1.0 on the better and 0.8 on the second eye - it seems less risky to go for a contact lens than for an intraocular lens (cystoid macular edema!). Advantages and disadvantages and the special indications and contraindications of correction with cataract glasses, with contact lenses or with different types of intraocular lenses are tabulated. The mathematical conditions which sampling statistics and the success rates of different types of intraocular lenses and surgical procedures have to fulfill, such as extracapsular versus intracapsular cataract extraction, are explained in order to provide a basis of knowledge rather than merely belief. Finally, the indications for different types of surgery in special situations and with different forms of cataract are described, e.g. phakolytic glaucoma, subluxation and luxation of the lens and congenital cataracts.

摘要

一方面,手术方法的进步以及隐形眼镜或人工晶状体在无晶状体矫正方面的进展,另一方面患者提出了更高的要求,这些都是如今白内障手术比20年前更早进行的原因。职业因素以及维持驾照所需的视力可能是决定手术时机和选择某种无晶状体矫正方法的因素。为了给患者提供正确的建议,必须对术后预期的视觉功能进行准确的术前评估。在术前检查中,提到了洛特马之后的莫尔条纹测试结果。如果患者的职业对视力要求很高,例如公交车司机——较好眼视力为1.0,另一只眼为0.8——那么选择隐形眼镜似乎比人工晶状体风险更小(囊样黄斑水肿!)。文中以表格形式列出了白内障眼镜、隐形眼镜或不同类型人工晶状体矫正的优缺点以及特殊适应证和禁忌证。解释了抽样统计以及不同类型人工晶状体和手术程序(如囊外与囊内白内障摘除术)的成功率必须满足的数学条件,以便提供知识基础而非仅仅是观点。最后,描述了特殊情况和不同形式白内障(如晶状体溶解性青光眼、晶状体半脱位和全脱位以及先天性白内障)下不同类型手术的适应证。

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