Hubungan Pengetahuan dengan Sikap terhadap Operasi Katarak pada Pasien Katarak Senilis di RSUP Dr. Kariadi Semarang. Fifin L. Rahmi • Sofia Arditya K. Karakteristik penderita katarak senilis yang dilakukan tindakan pembedahan katarak di RSUP H. Adam Malik Medan tahun PERBANDINGAN SENSIBILITAS KORNEA SEBELUM DAN SESUDAH OPERASI FAKOEMULSIFIKASI PADA PASIEN KATARAK SENILIS.

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A cataract is a clouding of the lens in the eye which leads to a decrease in vision.

Cataracts are most commonly due to aging but may also occur due to trauma or radiation exposure, be present from birthor occur following eye surgery for other problems. Prevention includes wearing sunglasses and not smoking. About 20 million people are blind due to cataracts.

Signs and symptoms vary depending on the type of cataract, though considerable overlap occurs. People with nuclear sclerotic or brunescent cataracts often notice a reduction of vision.

Those with posterior subcapsular cataracts usually complain of glare as their major symptom. The severity of cataract formation, assuming no other eye disease is present, is judged primarily by a visual acuity test. Other symptoms include frequent changes of glasses and colored halos due to hydration of lens. Age is the most common cause. Environmental factors, including toxins, radiation, and ultraviolet lighthave cumulative effects, which are worsened by the loss of protective and restorative mechanisms due to alterations in gene expression and chemical processes within the eye.

Blunt trauma causes swelling, thickening, and whitening of the lens fibers. While the swelling normally resolves with time, the white color may remain.

In severe blunt trauma, or in injuries that penetrate the eye, the capsule in which the lens sits can be damaged. This damage allows fluid from other parts of the eye to rapidly enter the lens leading to swelling and then whitening, obstructing light from reaching the retina at the back of the eye. Cataracts may develop in 0. Cataracts can arise as an effect of exposure to various types of radiation. X-rays, one form of ionizing radiationmay damage the DNA of lens cells. The genetic component is strong in the development of cataracts, [17] most commonly through mechanisms that protect and maintain the lens.

The presence of cataracts in childhood or early life can occasionally be due to a particular syndrome. Examples of chromosome abnormalities associated with cataracts include 1q Examples of single-gene disorder include Alport’s syndromeConradi’s syndromecerebrotendineous xanthomatosismyotonic dystrophyand oculocerebrorenal syndrome or Lowe syndrome.

The skin and the lens have the same embryological origin and so can be affected by similar diseases. Ichthyosis is an autosomal recessive disorder associated with cuneiform cataracts and nuclear sclerosis.

Basal-cell nevus and pemphigus have similar associations. Cigarette smoking has been shown to double the rate of nuclear sclerotic cataracts and triple the rate of posterior subcapsular cataracts. Some surveys have shown a link, but others which followed people over longer terms have not.

Low vitamin C intake and serum levels have been associated with greater cataract rates.

Some medications, such as systemic, topical, or inhaled corticosteroidsmay increase the risk of cataract development. Nearly every person who undergoes a vitrectomy —without ever having had cataract surgery—will experience progression of nuclear sclerosis after the operation.

Cataracts may be partial snilis complete, stationary or progressive, or hard or soft. The main types of age-related cataracts are nuclear sclerosis, cortical, and posterior subcapsular.

Nuclear sclerosis is the most common type of cataract, and involves the central or ‘nuclear’ part of the lens. This eventually becomes hard, or ‘sclerotic’, due to condensation on the lens nucleus and semilis deposition of brown pigment within the lens. In its advanced stages it is called a brunescent cataract. In early stages, an increase in sclerosis cause an increase in refractive index of the lens. This is adalzh tempororary and is called second sight.


Cortical cataracts are due to the lens cortex outer layer becoming opaque. They occur when changes in the fluid contained in the periphery of the adalahh causes fissuring.

When these cataracts are viewed through an ophthalmoscopeor other magnification system, the appearance is similar to white spokes of a wheel. Symptoms often include problems with glare and light oatarak at night. Posterior subcapsular cataracts are cloudy at the back of the lens adjacent to the capsule or bag in which the lens sits.

Because light becomes more focused toward the back of the lens, they can cause disproportionate symptoms for their size. An immature cataract has some transparent protein, but with a mature cataract, all the lens protein is opaque.

Majalah Kedokteran Nusantara (Journal of Medical School)

In a hypermature or Morgagnian cataract, the lens proteins have become liquid. Congenital cataract, which may be detected in adulthood, has a different classification and includes lamellar, polar, and sutural cataracts.

In this system, cataracts are classified based on type as nuclear, cortical, or posterior. The cataracts are further classified based on severity on a scale from 1 to 5. Risk factors such as UVB exposure and smoking can be addressed. Although no means adslah preventing cataracts has been scientifically proven, wearing sunglasses that counteract ultraviolet light may slow their development.

The appropriateness of surgery depends on a person’s particular functional and visual needs and other risk factors. Surgery is usually ‘outpatient’ and usually performed using local anesthesia. Several recent evaluations found that cataract surgery can meet expectations only when significant functional impairment due to cataracts exists before surgery.

Visual function estimates such as VF have been found to give more realistic estimates than visual acuity testing alone. Phacoemulsification is the most widely used cataract surgery in the developed world.

Phacoemulsification typically comprises six steps:. Extracapsular cataract extraction ECCE consists of removing the lens manually, but leaving the majority of the capsule intact. ECCE is less frequently performed than phacoemulsification, but can be useful when dealing with very hard cataracts or other situations where emulsification is problematic.


In MSICS, the lens is removed through a self-sealing scleral tunnel wound in the sclera which, ideally, is watertight and does not require suturing.

Although “small”, the incision is still markedly larger than the portal in phacoemulsion. This surgery is increasingly popular daalah the developing world where access to phacoemulsification is still limited.

Intracapsular cataract extraction ICCE is rarely performed. The surgery has a high rate of complications. The postoperative recovery period after removing the cataract kataeak usually short. Katarakk patient is usually ambulatory on the day of surgery, but is advised to move cautiously and avoid straining or heavy lifting for about a month. The eye is usually patched on the day of surgery and use of an eye shield at night is often suggested for several days after surgery. In all types of surgery, the cataractous ktarak is removed and replaced with an artificial lens, known as an intraocular lenssenipis stays in the eye permanently.

Intraocular lenses are usually monofocal, correcting for either distance or near vision. Multifocal lenses may be implanted to improve near and distance vision simultaneously, but these lenses may increase the chance of unsatisfactory vision. Serious complications of cataract surgery include retinal detachment and endophthalmitis. In endophthalmitis, patients often describe pain. Retinal detachment frequently presents with unilateral visual field defects, blurring of vision, flashes of light, or floating spots.


The risk of retinal detachment was estimated as about 0. The incidence is increasing over time in a somewhat linear manner, and the risk increase lasts for at least 20 years after the procedure. Particular risk factors are younger age, male sex, longer axial length, and complications during surgery. The risk of endophthalmitis occurring after surgery is less than one in Corneal edema and cystoid macular edema are less serious but katarzk common, and occur because of persistent swelling at the front of the eye in corneal edema adaalh back of the adallah in adalha macular edema.

They normally improve with time and with application of anti-inflammatory drops. The risk of either occurring is around one in Posterior aalah opacification, also known as after-cataract, is a condition in which months or years after successful cataract surgery, vision deteriorates or problems with glare and light scattering recur, usually due to thickening of the back or posterior capsule surrounding the implanted lens, so-called ‘posterior lens capsule opacification’.

Growth of natural lens cells remaining after the natural lens was removed may be the cause, and the younger the patient, the greater the chance of this occurring. Management involves cutting a small, circular area in the posterior capsule with targeted beams of energy from a laser, called Nd: YAG laser capsulotomy, after the type of laser used. The laser can be aimed very accurately, and the small part of the capsule which is cut falls harmlessly to the bottom of the inside of the eye.

Cataract – Wikipedia

This procedure leaves sufficient capsule to hold the lens in place, but removes enough to allow light to pass directly through to the retina.

Serious side effects are rare. Vitreous touch syndrome is a possible complication of intracapsular cataract extraction. In many countries, surgical services are inadequate, and cataracts remain the leading cause of blindness. By age 80, more than half of all Americans have cataracts. Access to eye care in many countries in this region is limited.

Most of the methods mentioned focus on katarsk. Follow-up treatments include katsrak of the eye and covering the eye with warm butter. Galen of Pergamon ca. Using a needle-shaped instrument, Galen attempted to remove the cataract-affected lens of the eye. Muslim ophthalmologist Ammar Al-Mawsiliin his Choice of Eye Diseaseswritten circawrote of his invention of a syringe and the technique of cataract extraction while experimenting with it on a patient.

In Latin, cataracta had the alternative meaning ” portcullis ” [74] and the name possibly passed through French to form the English meaning “eye disease” early 15th centuryon the notion of “obstruction”. N-Acetylcarnosine drops have been investigated as a medical treatment for cataracts. The drops are believed to work by reducing oxidation and glycation damage in the lens, particularly reducing crystallin crosslinking.

Femtosecond laser mode-lockingused during cataract surgery, was originally used to cut accurate and predictable flaps in LASIK surgery, and has been introduced to cataract surgery.