Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür

Agca, Alper; GÜRKAN, Sedat; altan, tugrul; DOĞAN, Mustafa; ELTUTAR, Kadir

Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür

Alper AĞCA, (İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye)

Kadir ELTUTAR, (İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye)

Mustafa DOĞAN, (İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye)

Tuğrul ALTAN, (İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye)

Sedat GÜRKAN (İstanbul Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Türkiye)

Glokom Katarakt

4 0

Yıl: 2011 Cilt: 6 Sayı: 3 Sayfa Aralığı: 135 - 142 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür

Öz:

Konjenital katarakt çocukluk çağının önlenebilir körlük nedenleri arasında ilk sırada gelmektedir. Gelişmekte olan ülkelerde konjenital katarakta bağlı körlük daha sık görülmektedir. Sıklıkla idiopatiktir. Tek taraflı olanlarda prognoz daha kötü olup, eşlik eden oküler anomaliler çift taraflı olanlara göre daha sıktır. Çift taraflı olanlarda ise prognoz daha iyi ama eşlik eden sistemik problemler tek taraflı olanlara kıyasla daha sıktır. Erken cerrahi çok önemlidir ancak postnatal dört haftadan küçüklerde ameliyat sırasında ve ameliyat sonrası yüksek komplikasyon oranı nedeniyle yaşamın ilk dört haftası beklenebilir. Cerrahi sonrası hemen refraktif düzeltme yapılıp ambliyopi tedavisi başlanmalıdır. Bilateral konjenital kataraktta primer operasyon esnasında lens koymak için uygun görülen alt yaş sınırı hastayı ikinci bir ameliyattan kurtarmak için son yıllarda giderek aşağıya doğru inmektedir. Tek taraflı kataraktlarda ise konvansiyonel yaklaşım ile ambliyopi tedavisi ve son görme keskinliği tatmin edici olmadığından, hem hastayı ikinci bir ameliyattan kurtarmak hem de hastanın ilerideki refraktif durumunu nispeten ikinci plana atıp kısa vadedeki ambliyopi tedavisine faydası olabileceği düsüncesi ile (tartışmalı olmakla birlikte) primer ameliyat esnasında eğer göz anatomik olarak müsaitse hasta kaç yaşında olursa olsun lens takılabilir. Bulunduğu süre zarfında ambliyopi tedavisini aksatacağından arka kapsül opasifikasyonunu önlemek erişkin hastalara göre çok daha önemlidir. Arka kapsüloreksis ve ön vitektomi yapılıp yapılmadığı erişkin hastaların tersine- seçilen lens materyalinden önce gelmektedir.

Anahtar Kelime:

Konular: Göz Hastalıkları

Congenital cataracts: Etiology, clinical management and surgical approach

Öz:

Congenital cataract is the leading cause of preventable blindness among children. Blindness due to congenital cataract is seen more frequently in developing countries. It is most frequently idiopathic. Monocular congenital cataract is more frequently associated with ocular anomalies and the prognosis is worse even with timely intervention. Bilateral congenital cataract is more frequently associated with systemic anomalies however visual prognosis is better when compared to monocular congenital cataract. Early surgery is very important however the surgery may be postponed at least four weeks postnatally due to the high incidence of peroperative and postoperative complications. Postsurgical amblyopia treatment in accordance with refractive correction should be started as soon as possible. The lowest acceptable age limit for intraocular lens implantation is getting progressively earlier for bilateral congenital cataracts. Since ambliopia treatment and final visual acquity is not satisfactory with the conventional approaches in patients with monocular congenital cataract, there is a tendency to implant an intraocular lens in every eye that is anatomically suitable regardless of the age of the patient in an attempt to help amblyopia treatment or to obviate the need for a second operation. Prevention of posterior capsule opacification is more important in children than in adults since it prevents an effective amblyopia treatment. In children posterior continuous curvilinear capsulorhexis and anterior vitrectomy is critical and in some age groups it is more important than the lens material for prevention of posterior capsule opacification.

Anahtar Kelime:

Konular: Göz Hastalıkları

Belge Türü: Makale Makale Türü: Editoryal Erişim Türü: Bibliyografik

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APA	Agca A, ELTUTAR K, DOĞAN M, altan t, GÜRKAN S (2011). Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. , 135 - 142.
Chicago	Agca Alper,ELTUTAR Kadir,DOĞAN Mustafa,altan tugrul,GÜRKAN Sedat Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. (2011): 135 - 142.
MLA	Agca Alper,ELTUTAR Kadir,DOĞAN Mustafa,altan tugrul,GÜRKAN Sedat Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. , 2011, ss.135 - 142.
AMA	Agca A,ELTUTAR K,DOĞAN M,altan t,GÜRKAN S Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. . 2011; 135 - 142.
Vancouver	Agca A,ELTUTAR K,DOĞAN M,altan t,GÜRKAN S Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. . 2011; 135 - 142.
IEEE	Agca A,ELTUTAR K,DOĞAN M,altan t,GÜRKAN S "Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür." , ss.135 - 142, 2011.
ISNAD	Agca, Alper vd. "Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür". (2011), 135-142.

APA	Agca A, ELTUTAR K, DOĞAN M, altan t, GÜRKAN S (2011). Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. Glokom Katarakt, 6(3), 135 - 142.
Chicago	Agca Alper,ELTUTAR Kadir,DOĞAN Mustafa,altan tugrul,GÜRKAN Sedat Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. Glokom Katarakt 6, no.3 (2011): 135 - 142.
MLA	Agca Alper,ELTUTAR Kadir,DOĞAN Mustafa,altan tugrul,GÜRKAN Sedat Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. Glokom Katarakt, vol.6, no.3, 2011, ss.135 - 142.
AMA	Agca A,ELTUTAR K,DOĞAN M,altan t,GÜRKAN S Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. Glokom Katarakt. 2011; 6(3): 135 - 142.
Vancouver	Agca A,ELTUTAR K,DOĞAN M,altan t,GÜRKAN S Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür. Glokom Katarakt. 2011; 6(3): 135 - 142.
IEEE	Agca A,ELTUTAR K,DOĞAN M,altan t,GÜRKAN S "Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür." Glokom Katarakt, 6, ss.135 - 142, 2011.
ISNAD	Agca, Alper vd. "Konjenital kataraktlar: Etiyoloji, hastaya yaklaşım ve cerrahi prosedür". Glokom Katarakt 6/3 (2011), 135-142.