Management of Senile

and
Complicated cataract
Introduction:
*To review management of senile and
complicated cataract, highlighting the
latest in the field.
* Cataract is derived from a Greek word that
describes rapidly running water tuning
white.
*Cataract accounts for around 40%
of global blindness representing
about 16 million people.
:How we did it
I-Diagnosis:
A-Clinical picture: Management

-Symptoms:
*Cloudy, fuzzy, foggy, or filmy vision.
Diagnosis Treatment

*Problems with glare from lamps or the sun.

*Frequent changes in his/her eyeglass
C/P Investigation Pre-
operative
Surgery Post-
Operative
prescription. Check Visual
Rehabilitation

*Double vision.
B-:Pre-operative Tests
*We must know the type of cataract we are
dealing with whether: -Age related
-Complicated
-So we do these examinations:
*Cover test. *Intraocular pressure
*Pupillary responses. *Fundus
*Ocular adnexa. *Snellen visual acuity.
*Cornea
*Anterior chamber.
* Lens.
*Newer techniques for evaluating visual dysfunction
caused by cataract include contrast sensitivity and
glare testing.
*Predicting postoperative visual acuity:
(Potential Vision Testing (
-Maddox rod test.
-laser interferometer
-potential acuity meter
-critical flicker frequency.
A recent study concluded that the potential acuity meter and
the laser interferometer showed a limited clinical capability
in predicting postoperative visual acuity, particularly with dense
opacities. The critical flicker frequency shows the most
promise as a potential vision test; particularly with dense
cataract .
 II-TREATMENT:
The indications are:
1-Visual improvement 2- Medical indications
*Types:
a- Conventional extracapsular cataract extraction.
b- Phacoemulsification.
c-Intracapsular Extraction.
d-Cryosurgery.
N.B. Complicated cataract is managed firstly by
treating the cause.
:Recently
Pulsed electron avalanche knife
a new electrosurgical device, which has
recently been introduced for ‘‘cold’’ and
traction-free dissection of tissue in liquid
medium.
 :Complications
*Posterior capsule opacity, treated by YAG laser.
*Edema (swelling) of the cornea.
*Uveitis *Rupture of the posterior capsule
*Malpositioning of the IOL
*Endophthalmitis
Recently, The gatifloxacin (GFLX) concentrations
found in aqueous humor samples were sufficient to kill
bacteria other than S. epidermidis, P.aeruginosa, and
MRSA in vitro.
III-Visual Rehabilitation
The choices are:
1-Cataract eyeglasses
2- Contact lenses
3- Intraocular Lens (IOL):
a- Monofocal IOLs.
b-Multifocal IOLs.
c-Toric IOLs.
d-Accommodative IOLs
:Prevention of Senile cataract*
( Inhibition of Crystallin Ascorbylation by
Nucleophilic Compounds in thehSVCT2
Mouse Model of Lenticular Aging).
A title of a recent study that resulted in a pharmacologically
blocking protein ascorbylation with absorbable guanidino
compounds is feasible and may represent a new strategy for
the delay of age-related nuclear sclerosis of the lens .