CATARACT

Dr Arlette SpM
 CLOUDING OF THE LENS

ANATOMY LENS :
- Capsul - AVASCULAR
- Epithelium - 33 % protein, 66 %
- Cortex water  Changes
- Epinucleus and imbalance 
- Nucleus cataract
 TYPES OF CATARACT

LOCATION GRADE
1. CORTICAL 1. INCIPIENT
2. NUCLEAR 2. IMATURE
3. ANTERIOR POLE 3. MATURE
4. POSTERIOR POLE 4. HYPERMATURE
5. SUBCAPSULAR
POSTERIOR

ONSET
1. INFANTILE
2. CONGENITAL
3. JUVENILE
4. SENILE
 CONGENITAL CATARACT
- SINCE BIRTH
- RUBELLA SYNDROME
- LOCATION  WHEN TO INITIATE SURGICAL
TREATMENT
- SYMPTOMS : STRABISMUS, NYSTAGMUS,
POOR RESPON TO LIGHT

-SURGICAL GOALS : PREVENT

AMBLIOPIA
 INFANTILE CATARACT
- FIRST YEAR OF LIFE
- RUBELLA SYNDROME
- LOCATION  WHEN TO INITIATE SURGICAL
TREATMENT
- SYMPTOMS : STRABISMUS, NYSTAGMUS,
POOR DEVELOPMENT

-SURGICAL GOALS : PREVENT

AMBLIOPIA
 JUVENILE CATARACT
- <40 YEARS OLD
- SYSTEMIC, TRAUMA
- SYMPTOMS : DEPEND ON THE LOCATION
AND GRADES

SURGICAL GOALS :
1. RESTORE SIGHT
2. AVOID COMPLICATION
3. POSTERIOR SEGMENT VISUALISATION
 SENILE CATARACT
- THE MOST COMMON TYPE
- Aggregation high-molecular-weigh protein
- Glutathion and potassium reduction, sodium
and calcium increase
- Pigmentation of the lens

SURGICAL GOALS :
1. RESTORE SIGHT
2. AVOID COMPLICATION
3. POSTERIOR SEGMENT VISUALISATION
 OTHER CATARACT
- DRUG INDUCED  STEROID,
PHENOTHIAZIEN, MIOTICS
- TRAUMATIC CATARACT
- RADIATION INDUCED
- SYSTEMIC (DM, GALACTOSEMIA, ETC)
 SPECIFIC SYMPTOMS
- PHOTOPHOBIA PSC
- SIGHT IMPROVES ON DIM LIGHT  PSC/
POSTERIOR POLE
- SIGHT IMPROVE ON BRIGHT LIGHT 
CORTICAL
- FOGGY, SOMKEY  ANY CATARACTS
- DIMINISH COLOR SENSE  BROWN OR
DIABETIC CATARACT
 CATARACT MANAGEMENT

1. Glasses  with good patient

education
2. Eyedrops
3. surgery
 Why we operate? When to operate?
• Restore sight • When the cataract
• Prevent interfere with daily
complications activity
• Prevent
ambliopia
• When complication
• Visusalization of
posterior occur
segment • When dispensing
• Cosmetic lens is not an option
 TYPES OF OPERATION
• ICCE
• ECCE
• SICS
• PHACOEMULSIFICATION

IDEALLY, INTRAOCULAR LENS IS IMPLANTED

DURING THE SURGERY
 INTRAOCULAR LENS
• LIFETIME
• PMMA, ACRYLIC OR SILICONE
• RIGID OR FOLDABLE
• IN AC OR PC
 COMPLICATION OF CATARACT
SURGERY
• HIGH IOP
• CORNEAL EDEMA
• PAIN
• INFECTION
• IOL DESENTRATION
• UGH SYNDROME
 CATARACT SURGERY TODAY
• ONE DAY CARE IS POSSIBLE
• ANESTHESIA
– DROPS (PANTOCAINE 1% OR 2%)
– INFILTRATION
• IOL OPTIONS
• CLEAR LENS EXTRACTION
• POST OP MEDICATIONS  DROPS ONLY ARE
POSSIBLE
THANK YOU