白内障幻灯片上课讲义.pptVIP

Complicated cataract并发性白内障 Develop as a direct effect of eye diseases upon the physiology of the lens,such as ： glaucoma，青光眼 iritis，虹膜炎 eye tumors，眼部肿瘤 retinitis pigmentosa，视网膜色素变性 retinal detachment，视网膜脱离 常有眼部原发病的表现。 眼前段炎症疾病所致的由前皮质开始混浊。 临床表现 眼后段炎症所致 在晶体后极部囊膜下皮质、晶体核中心部和周边部呈放射状，玫瑰花样混浊。 Drug-induced /toxic cataract药物或中毒性白内障 ????????Steroids： 糖皮质激素全身较局部使用发生率高 ?????Chlorpromazine： 氯丙嗪 ??????Metals： 金属（铜、铁、汞等） Miotics： 缩瞳剂 Trinitrotoluene： 三硝基甲苯 After Cataract 后发性白内障 Opacifacation of the posterior capsule due to partially absorbed traumatic cataract or following extracapsular cataract extraction. Persistent subcapsular lens epithelium may favor regeneration of lens fibers. 晶状体外伤后或白内障囊外摘出（包括超声乳化）手术 后，残留的皮质或晶状体上皮细胞增生，形成混浊。 After-cataract treatment Unlike a cataract, an after-cataract is treated with a technique called laser capsulotomy. 后发性白内障的治疗不同于其他类型白内障， 激光囊膜切开是有效的方法。 The neodymium: YAG laser provides a noninvasive method for discission of the posterior capsule. Nd : YAG激光囊膜切开术是一种后囊切开的非侵入性方法。 Pulses of laser energy creat a small hole in the posterior capsule in the pupillary axis. 激光能量瞬间传入靶组织引起小的“爆发”，于瞳孔轴心的后囊内造成一个小洞。 Cataract Treatment Surgery is the only way to remove the cataract. However, if symptoms from a cataract are mild, a change of glasses may be all that is needed for you to function more comfortably. Cataract surgery should be considered when cataracts cause enough loss of vision to interfere with daily activities. 手术适应症 ◆视力的原因 ◆医疗的原因 ◆美容的原因 术前准备 What happens before surgery? A week or two before surgery, some tests should be done, including: 　Visual acuity,intraocular pressure, slit lamp, ophthalmoscope To measure the curve of the cornea and the size and shape of the eye. systemic exam: hypertension, diabetes and other disorders 术前检查 ◆全身检查 三大常规、心电图、胸透、血压、血糖、肝功能、肾功能。 ◆局部检查 视功能、眼压、冲洗泪道、角膜曲率、A/B超 散瞳查晶体 结膜囊细菌培养 角膜内皮计数 眼电生理检查(EOG、ERG、VEP) 白内障手术 成熟期 Hypermat