Avtor/Urednik		Pfeifer, Vladimir; Krapež, Maja
Naslov		Katarakte v otroštvu - smernice pri operativni terapiji
Prevedeni naslov		Pediatric cataract surgery
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 71, št. Suppl 2
Leto izdaje		2002
Obseg		str. II-7-10
Jezik		slo
Abstrakt		Background. The paper consists of two parts; the first part concentrates on the theoretical fundation of the PCCC surgical technique, while the second part brings forward the results of the study, in which some techniques of cataract surgery were compared. Methods. The study comprised 22 eyes of 19 children who had their primary cataract surgery performed between 1998 and June 2000. All the patients were operated by one surgeon. Eyes with systemic diseases that cause ectopic lenses were excluded from the study. In the example of 2 eyes, lensectomy without IOL implantation was performed, whereas in others, PC IOLs were implanted. (15 Baush and Lomb Hydroview, length 12.50 mm and 2 Alcon AcrySof, length 13 mm). In 6 eyes, the posterior capsule was left intact (all of the patients were older than 5 years) in 14 eyes PCCC was performed; of these, 13 with and 1 without anterior vitrectomy. Results. Secondary cataract developed in both aphakic eyes, in 3 eyes with intact posterior capsules, and in 2 eyes that had PCCC. Posterior capsule opacification still remains a major problem in pediatric cataract surgery and IOL implantation, but no other postoperative complications were present. The best visual outcome was achieved in posttraumatic cases, and the worst in children who had associated ocular anomalies. Conclusions. After early diagnosis and surgery postoperative treatment is also very important. Correction of residual refractive error and orthoptic-pleoptic treatment is necessary for successful visual rehabilitation.
Izvleček		Izhodišča. V prvem delu prispevka je opisana teoretična podlaga za operativno zdravljenje katarakt v otroštvu, v drugem pa predstavljene naše izkušnje pri različnih tehnikah operativnega zdravljenja. Metode. V študijo smo vključili 22 oči 19 otrok, ki so v letih 1998 do junija 2000 imeli primarno operacijo katarakte, opravil jo je isti kirurg. Izvzeti so bili otroci s tistimi sistemskimi boleznimi, ki povzročijo med drugim tudi ektopijo leč (Marfanov sindrom, hemocistinurija). Pri dveh otrocih je bila narejena lensektomija in zaradi pridruženih očesnih anomalij in bolezni intraokularne leče (IOL) ni bila vstavljena, ostala sta afaka. Pri 6 otrocih je zadnja kapsula ostala intaktna (vsi so bili starejši od 5 let). Pri 14 otrocih je bila narejena posteriorna kurvilinearna kapsuloreksa (PCCC), pri 1 brez anteriorne vitrektomije z ujetjem IOL. Pri 13 otrocih je bila narejena PCCC z anteriorno vitrektomijo, od tega pri 4 brez t.i. ujetja IOL in pri 9 z ujetjem IOL. Vstavljenih je bilo 17 IOL (15 Baush and Lomb Hydroview, totalni premer 12,50 mm ter 2 Alconovi AcrySof s totalnim premerom 13 mm). Rezultati. Do sekundarne fibroze je prišlo pri 2 afakih, pri 3 očeh z intaktno zadnjo kapsulo in pri 2, pri katerih je bila narejena PCCC. Razvoj sekundarne fibroze zadnje kapsule je bil edini pooperativni zaplet. Vidna ostrina se je najbolj izboljšala pri otrocih, ki so bili operirani zardi travmatske katarakte, najmanj pa pri tistih, ki so imeli pridružene očesne anomalije. Zaključki. Za dober vidni izvid so ključni tako zgodnja diagnoza in operativno zdravljenje kot ustrezno pooperativno vodenje korekcije rezidualne refrakcijske napake in ortoptično-pleoptično zdravljenje, ko je to potrebno.
Deskriptorji		CATARACT CATARACT EXTRACTION CHILD TREATMENT OUTCOME