Progression of macular oedema following cataract surgery in a diabetic patient

Operacija katarakte najizvođenija je operacija u medicini. Šećerna bolest, kao jedno od najčešćih kroničnih oboljenja, povezana je s češćim i ranijim nastankom katarakte u odnosu na zdravu populaciju. Budući da je riječ o mikroangiopatskoj bolesti, u većini slučajeva imamo prisutan određeni stupanj oštećenja hematookularne barijere radi čega su pacijenti skloniji postoperativom padu vidne oštrine. Uzroci pada vidne oštrine postoperativno kod pacijenta sa šećernom bolesti nakon nekomplicirane operacije katarakte odnose se na nastanak postoperativnog cistoidnog makularnog edema ili na progresiju postojećeg dijabetičkog edema makule. Pravilnim postavljanjem dijagnoze te ordiniranjem pravilne i pravodobne terapije, navedene postoperativne komplikacije mogu se uspješno liječiti.Cataract surgery is the most performed surgery in modern medicine. Furthermore, diabetes mellitus is related to higher incidence and the earlier onset of cataract compared to a healthy population. As it is a microangiopathic disease, commonly there is a degree of hematoocular barrier damage which makes the patients susceptible to the postoperative drop in eye acuity. The causes of postoperative eye acuity reduction in diabetic patients following uncomplicated cataract surgery are related to the either onset of postoperative cystoid macular oedema or progression of existing diabetic macular oedema.Making the correct diagnosis and ensuring correct and timely therapy, postoperative complications can be succesfully treated

Progression of macular oedema following cataract surgery in a diabetic patient

Operacija katarakte najizvođenija je operacija u medicini. Šećerna bolest, kao jedno od najčešćih kroničnih oboljenja, povezana je s češćim i ranijim nastankom katarakte u odnosu na zdravu populaciju. Budući da je riječ o mikroangiopatskoj bolesti, u većini slučajeva imamo prisutan određeni stupanj oštećenja hematookularne barijere radi čega su pacijenti skloniji postoperativom padu vidne oštrine. Uzroci pada vidne oštrine postoperativno kod pacijenta sa šećernom bolesti nakon nekomplicirane operacije katarakte odnose se na nastanak postoperativnog cistoidnog makularnog edema ili na progresiju postojećeg dijabetičkog edema makule. Pravilnim postavljanjem dijagnoze te ordiniranjem pravilne i pravodobne terapije, navedene postoperativne komplikacije mogu se uspješno liječiti.Cataract surgery is the most performed surgery in modern medicine. Furthermore, diabetes mellitus is related to higher incidence and the earlier onset of cataract compared to a healthy population. As it is a microangiopathic disease, commonly there is a degree of hematoocular barrier damage which makes the patients susceptible to the postoperative drop in eye acuity. The causes of postoperative eye acuity reduction in diabetic patients following uncomplicated cataract surgery are related to the either onset of postoperative cystoid macular oedema or progression of existing diabetic macular oedema.Making the correct diagnosis and ensuring correct and timely therapy, postoperative complications can be succesfully treated

Progression of macular oedema following cataract surgery in a diabetic patient

Operacija katarakte najizvođenija je operacija u medicini. Šećerna bolest, kao jedno od najčešćih kroničnih oboljenja, povezana je s češćim i ranijim nastankom katarakte u odnosu na zdravu populaciju. Budući da je riječ o mikroangiopatskoj bolesti, u većini slučajeva imamo prisutan određeni stupanj oštećenja hematookularne barijere radi čega su pacijenti skloniji postoperativom padu vidne oštrine. Uzroci pada vidne oštrine postoperativno kod pacijenta sa šećernom bolesti nakon nekomplicirane operacije katarakte odnose se na nastanak postoperativnog cistoidnog makularnog edema ili na progresiju postojećeg dijabetičkog edema makule. Pravilnim postavljanjem dijagnoze te ordiniranjem pravilne i pravodobne terapije, navedene postoperativne komplikacije mogu se uspješno liječiti.Cataract surgery is the most performed surgery in modern medicine. Furthermore, diabetes mellitus is related to higher incidence and the earlier onset of cataract compared to a healthy population. As it is a microangiopathic disease, commonly there is a degree of hematoocular barrier damage which makes the patients susceptible to the postoperative drop in eye acuity. The causes of postoperative eye acuity reduction in diabetic patients following uncomplicated cataract surgery are related to the either onset of postoperative cystoid macular oedema or progression of existing diabetic macular oedema.Making the correct diagnosis and ensuring correct and timely therapy, postoperative complications can be succesfully treated

Cystoid macular edema after cataract surgery

Cistoidni makularni edem komplikacija je nakon operacije katarakte i najčešći je uzrok loše vidne oštrine nakon operacije katarakte. Različiti su patofiziološki mehanizmi nastanka makularnog edema, ali najčešće se dovodi u vezu s postoperativnom upalom pri kojoj se oslobađaju medijatori upale i dovode do nakupljanja tekućine u području makule. Protuupalni lijekovi, uključujući steroide i nesteroidne antireumatike, imaju veliku ulogu u profilaksi i terapiji cistoidnog makularnog edema. U ovom preglednom članku prikazani su najnoviji stavovi o patogenetskom mehanizmu nastanka edema, rizičnim faktorima, profilaksi i terapiji, proizišli iz istraživanja i kliničke prakse.Pseudophakic cystoid macular edema (PCME) is the most common complication of cataract surgery and is one of the possible causes of low visual acuity after cataract surgery. Various factors are implicated in its development but the core mechanism is likely surgically induced anterior segment inflammation that results in the release of endogenous inflammatory mediators. Anti-inflammatory medicines, including steroid and nonsteroid anti-inflammatory drugs, are postulated as having a role in both the prophylaxis and treatment of PCME. This article presents an updated review on the pathogenesis, risk factors, prophylaxis and treatment in PCME that reflect current research and practice

Cistoidni makularni edem nakon operacije katarakte

Pseudophakic cystoid macular edema (PCME) is the most common complication of cataract surgery and is one of the possible causes of low visual acuity after cataract surgery. Various factors are implicated in its development but the core mechanism is likely surgically induced anterior segment inflammation that results in the release of endogenous inflammatory mediators. Anti-inflammatory medicines, including steroid and nonsteroid anti-inflammatory drugs, are postulated as having a role in both the prophylaxis and treatment of PCME. This article presents an updated review on the pathogenesis, risk factors, prophylaxis and treatment in PCME that reflect current research and practice.Cistoidni makularni edem komplikacija je nakon operacije katarakte i najčešći je uzrok loše vidne oštrine nakon operacije katarakte. Različiti su patofiziološki mehanizmi nastanka makularnog edema, ali najčešće se dovodi u vezu s postoperativnom upalom pri kojoj se oslobađaju medijatori upale i dovode do nakupljanja tekućine u području makule. Protuupalni lijekovi, uključujući steroide i nesteroidne antireumatike, imaju veliku ulogu u profilaksi i terapiji cistoidnog makularnog edema. U ovom preglednom članku prikazani su najnoviji stavovi o patogenetskom mehanizmu nastanka edema, rizičnim faktorima, profilaksi i terapiji, proizišli iz istraživanja i kliničke prakse

Cystoid macular edema after cataract surgery

Cistoidni makularni edem komplikacija je nakon operacije katarakte i najčešći je uzrok loše vidne oštrine nakon operacije katarakte. Različiti su patofiziološki mehanizmi nastanka makularnog edema, ali najčešće se dovodi u vezu s postoperativnom upalom pri kojoj se oslobađaju medijatori upale i dovode do nakupljanja tekućine u području makule. Protuupalni lijekovi, uključujući steroide i nesteroidne antireumatike, imaju veliku ulogu u profilaksi i terapiji cistoidnog makularnog edema. U ovom preglednom članku prikazani su najnoviji stavovi o patogenetskom mehanizmu nastanka edema, rizičnim faktorima, profilaksi i terapiji, proizišli iz istraživanja i kliničke prakse.Pseudophakic cystoid macular edema (PCME) is the most common complication of cataract surgery and is one of the possible causes of low visual acuity after cataract surgery. Various factors are implicated in its development but the core mechanism is likely surgically induced anterior segment inflammation that results in the release of endogenous inflammatory mediators. Anti-inflammatory medicines, including steroid and nonsteroid anti-inflammatory drugs, are postulated as having a role in both the prophylaxis and treatment of PCME. This article presents an updated review on the pathogenesis, risk factors, prophylaxis and treatment in PCME that reflect current research and practice

Suvremeni pristup liječenju katarakte

Katarakta je zamućenje leće i vodeći uzrok sljepoće u svijetu. Radi se o multifaktorijalnoj bolesti za čiji se nastanak navode brojni faktori rizika, no kao najvažniji uzrok smatra se starija životna dob. Starenjem nastaju razne promjene u sastavu leće oka koje doprinose njezinom zamućenju. Simptomi počinju s progresivnim, bezbolnim padom vida, a u mnogim slučajevima javljaju se i miopizacija, smanjenje kontrastne osjetljivosti te monookularne i biokularne dvoslike. Na kataraktu treba posumnjati kod svakog bolesnika s navedenim simptomima. Dijagnoza se postavlja na proširene zjenice pretragom pomoću biomikroskopa kojim se uočavaju zamućenja. S obzirom na nalaz i postojeće indikacije za operaciju, oftalmolog savjetuje operativni zahvat. Postoje dvije osnovne vrste operacije katarakte, intrakapsularna ekstrakcija katarakte (ICCE) i ekstrakapsularna ekstrakcija katarakte (ECCE). ICCE se danas vrlo rijetko izvodi, uglavnom kod nekih trauma te subluksiranih i dislociranih leća. Pod suvremene metode operacije katarakte spadaju klasična ekstrakapsularna ekstrakcija katarakte koja se danas sve rjeđe izvodi zbog čestih postoperativnih komplikacija. Fakoemulzifikacija znači standard u operaciji katarakte. Tom metodom se pomoću ultrazvučne sonde razbijaju lećne mase, a potom slijedi njihova aspiracija te ugradnja mekih, savitljivih, intraokularnih leća (IOL) kroz vrlo mali korneoskelaralni rez veličine 2,8 - 3,2 mm. Ta metoda je dovela do značajnog smanjena postoperativnih komplikacija, smanjenog broja astigmatizma, većeg zadovoljstva pacijenata te boljih postoperativnih rezultata. Pod novije metode operacije katarakte spadaju i femtosecond laser te koaksijalna i bimanualna mikrokirurška operacija. Nakon operacije u pseudofakično oko se ugrađuje IOL. Nove generacije IOL se dijele na monofokalne koje se u pravilu najčešće koriste i multifokalne. Postupnim razvojem specijalnih IOL kirurgija katarakte postala je i refraktivna kirurgija.Cataract is a clouding of the lens and the leading cause of blindness in the world. Cataract is a multifactorial disease with numerous risk factors, but as the most important cause is considered to be older age. Aging entails various changes within the lens of the eye that contribute to its blur. Symptoms begin with a progressive, painless drop in sight, and in many cases, it is myopisation, reduced contrast sensitivity and monoocular and biocular double vision. The cataract should be suspected to exist in all patients with these symptoms. Diagnosis is made using the pupillary examination with a bio microscope with which blur is observed. In view of the findings and the current indications for surgery, an ophthalmologist advises surgery. There are two main types of cataract surgeries, intracapsular cataract extraction (ICCE) and extracapsular cataract extraction (ECCE). ICCE is now rarely performed, mainly on some trauma and subluxated and dislocated lens. Modern methods of cataract surgery include a traditional extra capsular cataract extraction that is rarely performed due to frequent postoperative complications. Phacoemulsification is a standard in cataract surgery. This method uses ultrasound probe with which the lens mass is broken, followed by their aspirations and installation of soft, flexible intraocular lenses (IOL) through a small incision corneoscleral cut with the size from 2.8 to 3.2 mm. This method has led to a significant decrease in postoperative complications, in reduced number of astigmatism, greater patient satisfaction and in better postoperative results. Recent methods of cataract surgery include the use of femtosecond laser and coaxial and bimanual microsurgical operations. After the operation, the IOL is built into pseudophakic eye. New generation IOL are divided into the monofocal which are generally the most commonly used and the multifocal ones. Through the gradual development of special IOL cataract surgeries refractive surgery has come into being

Suvremeni pristup liječenju katarakte

Katarakta je zamućenje leće i vodeći uzrok sljepoće u svijetu. Radi se o multifaktorijalnoj bolesti za čiji se nastanak navode brojni faktori rizika, no kao najvažniji uzrok smatra se starija životna dob. Starenjem nastaju razne promjene u sastavu leće oka koje doprinose njezinom zamućenju. Simptomi počinju s progresivnim, bezbolnim padom vida, a u mnogim slučajevima javljaju se i miopizacija, smanjenje kontrastne osjetljivosti te monookularne i biokularne dvoslike. Na kataraktu treba posumnjati kod svakog bolesnika s navedenim simptomima. Dijagnoza se postavlja na proširene zjenice pretragom pomoću biomikroskopa kojim se uočavaju zamućenja. S obzirom na nalaz i postojeće indikacije za operaciju, oftalmolog savjetuje operativni zahvat. Postoje dvije osnovne vrste operacije katarakte, intrakapsularna ekstrakcija katarakte (ICCE) i ekstrakapsularna ekstrakcija katarakte (ECCE). ICCE se danas vrlo rijetko izvodi, uglavnom kod nekih trauma te subluksiranih i dislociranih leća. Pod suvremene metode operacije katarakte spadaju klasična ekstrakapsularna ekstrakcija katarakte koja se danas sve rjeđe izvodi zbog čestih postoperativnih komplikacija. Fakoemulzifikacija znači standard u operaciji katarakte. Tom metodom se pomoću ultrazvučne sonde razbijaju lećne mase, a potom slijedi njihova aspiracija te ugradnja mekih, savitljivih, intraokularnih leća (IOL) kroz vrlo mali korneoskelaralni rez veličine 2,8 - 3,2 mm. Ta metoda je dovela do značajnog smanjena postoperativnih komplikacija, smanjenog broja astigmatizma, većeg zadovoljstva pacijenata te boljih postoperativnih rezultata. Pod novije metode operacije katarakte spadaju i femtosecond laser te koaksijalna i bimanualna mikrokirurška operacija. Nakon operacije u pseudofakično oko se ugrađuje IOL. Nove generacije IOL se dijele na monofokalne koje se u pravilu najčešće koriste i multifokalne. Postupnim razvojem specijalnih IOL kirurgija katarakte postala je i refraktivna kirurgija.Cataract is a clouding of the lens and the leading cause of blindness in the world. Cataract is a multifactorial disease with numerous risk factors, but as the most important cause is considered to be older age. Aging entails various changes within the lens of the eye that contribute to its blur. Symptoms begin with a progressive, painless drop in sight, and in many cases, it is myopisation, reduced contrast sensitivity and monoocular and biocular double vision. The cataract should be suspected to exist in all patients with these symptoms. Diagnosis is made using the pupillary examination with a bio microscope with which blur is observed. In view of the findings and the current indications for surgery, an ophthalmologist advises surgery. There are two main types of cataract surgeries, intracapsular cataract extraction (ICCE) and extracapsular cataract extraction (ECCE). ICCE is now rarely performed, mainly on some trauma and subluxated and dislocated lens. Modern methods of cataract surgery include a traditional extra capsular cataract extraction that is rarely performed due to frequent postoperative complications. Phacoemulsification is a standard in cataract surgery. This method uses ultrasound probe with which the lens mass is broken, followed by their aspirations and installation of soft, flexible intraocular lenses (IOL) through a small incision corneoscleral cut with the size from 2.8 to 3.2 mm. This method has led to a significant decrease in postoperative complications, in reduced number of astigmatism, greater patient satisfaction and in better postoperative results. Recent methods of cataract surgery include the use of femtosecond laser and coaxial and bimanual microsurgical operations. After the operation, the IOL is built into pseudophakic eye. New generation IOL are divided into the monofocal which are generally the most commonly used and the multifocal ones. Through the gradual development of special IOL cataract surgeries refractive surgery has come into being

Suvremeni pristup liječenju katarakte

Katarakta je zamućenje leće i vodeći uzrok sljepoće u svijetu. Radi se o multifaktorijalnoj bolesti za čiji se nastanak navode brojni faktori rizika, no kao najvažniji uzrok smatra se starija životna dob. Starenjem nastaju razne promjene u sastavu leće oka koje doprinose njezinom zamućenju. Simptomi počinju s progresivnim, bezbolnim padom vida, a u mnogim slučajevima javljaju se i miopizacija, smanjenje kontrastne osjetljivosti te monookularne i biokularne dvoslike. Na kataraktu treba posumnjati kod svakog bolesnika s navedenim simptomima. Dijagnoza se postavlja na proširene zjenice pretragom pomoću biomikroskopa kojim se uočavaju zamućenja. S obzirom na nalaz i postojeće indikacije za operaciju, oftalmolog savjetuje operativni zahvat. Postoje dvije osnovne vrste operacije katarakte, intrakapsularna ekstrakcija katarakte (ICCE) i ekstrakapsularna ekstrakcija katarakte (ECCE). ICCE se danas vrlo rijetko izvodi, uglavnom kod nekih trauma te subluksiranih i dislociranih leća. Pod suvremene metode operacije katarakte spadaju klasična ekstrakapsularna ekstrakcija katarakte koja se danas sve rjeđe izvodi zbog čestih postoperativnih komplikacija. Fakoemulzifikacija znači standard u operaciji katarakte. Tom metodom se pomoću ultrazvučne sonde razbijaju lećne mase, a potom slijedi njihova aspiracija te ugradnja mekih, savitljivih, intraokularnih leća (IOL) kroz vrlo mali korneoskelaralni rez veličine 2,8 - 3,2 mm. Ta metoda je dovela do značajnog smanjena postoperativnih komplikacija, smanjenog broja astigmatizma, većeg zadovoljstva pacijenata te boljih postoperativnih rezultata. Pod novije metode operacije katarakte spadaju i femtosecond laser te koaksijalna i bimanualna mikrokirurška operacija. Nakon operacije u pseudofakično oko se ugrađuje IOL. Nove generacije IOL se dijele na monofokalne koje se u pravilu najčešće koriste i multifokalne. Postupnim razvojem specijalnih IOL kirurgija katarakte postala je i refraktivna kirurgija.Cataract is a clouding of the lens and the leading cause of blindness in the world. Cataract is a multifactorial disease with numerous risk factors, but as the most important cause is considered to be older age. Aging entails various changes within the lens of the eye that contribute to its blur. Symptoms begin with a progressive, painless drop in sight, and in many cases, it is myopisation, reduced contrast sensitivity and monoocular and biocular double vision. The cataract should be suspected to exist in all patients with these symptoms. Diagnosis is made using the pupillary examination with a bio microscope with which blur is observed. In view of the findings and the current indications for surgery, an ophthalmologist advises surgery. There are two main types of cataract surgeries, intracapsular cataract extraction (ICCE) and extracapsular cataract extraction (ECCE). ICCE is now rarely performed, mainly on some trauma and subluxated and dislocated lens. Modern methods of cataract surgery include a traditional extra capsular cataract extraction that is rarely performed due to frequent postoperative complications. Phacoemulsification is a standard in cataract surgery. This method uses ultrasound probe with which the lens mass is broken, followed by their aspirations and installation of soft, flexible intraocular lenses (IOL) through a small incision corneoscleral cut with the size from 2.8 to 3.2 mm. This method has led to a significant decrease in postoperative complications, in reduced number of astigmatism, greater patient satisfaction and in better postoperative results. Recent methods of cataract surgery include the use of femtosecond laser and coaxial and bimanual microsurgical operations. After the operation, the IOL is built into pseudophakic eye. New generation IOL are divided into the monofocal which are generally the most commonly used and the multifocal ones. Through the gradual development of special IOL cataract surgeries refractive surgery has come into being