[Age-related Cataract].
[Age-related Cataract].
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DOI：
10.1055/a-1758-3451
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发表时间：
2022-02
影响因子：
0.8
通讯作者：
I. Neuhann;Lukas Neuhann;T. Neuhann
中科院分区：
文献类型：
--
作者：
I. Neuhann;Lukas Neuhann;T. Neuhann
这篇文章的目的是对当代老年性白内障的“技术和知识”进行简要的概述。作为导言，概述了年龄相关性白内障的术语、流行病学、晶状体解剖学和病理生理学的一些方面，这些方面是出于临床兴趣和相关性而选择的。临床方面包括体征和症状：描述了皮质型、核型和后囊膜下白内障的客观标准，其次是典型的症状，如视力下降、对比敏感度和视力模糊、色觉改变、中间视力和暗视视力下降、眩光、近视和单眼复视。诊断评估包括一般眼科检查，包括病史、屈光和视力检查、眼压计和前后节的形态检查，并辅之以特殊的检查和检查，如干涉视力(视网膜计)、角膜屈光度测量(包括角膜地形图/断层扫描)、生物测量(超声和光学)、角膜内皮的镜面显微镜和中央视网膜的OCT。治疗完全是手术：详细讨论了单独评估手术适应症，权衡机会和风险，决定个人决定，如麻醉、手术技术选择、靶点屈光和人工晶状体选择。最后，概述了围手术期内科治疗和感染预防的一些注意事项。最后一节涉及短期和长期并发症及其处理--包括早期压力升高、角膜水肿、炎症反应和眼内炎，以及较长期的继发性白内障、屈光问题、黄斑囊样水肿和视网膜脱离。
The purpose of this article is a condensed overview of contemporaneous "state of art and knowledge" of age-related cataract. As an introduction, some aspects of terminology, epidemiology, lens anatomy and pathophysiology of age-related cataract, selected for clinical interest and relevance, are outlined. Clinical aspects include signs and symptoms: Objective criteria for cortical, nuclear and posterior subcapsular cataract are described, followed by typical symptoms such as decreased visual acuity, contrast sensitivity and foggy vision, altered colour perception, decreased mesopic and scotopic vision, glare, myopization and monocular diplopia. Diagnostic evaluation consists of a general ophthalmic examination, including history, refraction and vision testing, tonometry and morphologic examination of anterior and posterior segment, and is supplemented by special tests and examinations, such as interference vision (retinometer), keratometry including corneal topo-/tomography, biometry (ultrasound and optical), specular microscopy of the corneal endothelium and OCT of the central retina. Treatment is exclusively surgical: Evaluating the indication for surgery individually, weighing chances and risks, determining individual decisions such as anesthesia, surgical technical options, target refraction and intraocular lens options is discussed in detail. Finally, some perioperative considerations for medical treatment and infection prophylaxis are outlined. The last section deals with short- and long-term complications and their management - including early pressure rises, corneal edema, inflammatory response and endophthalmitis, and, in the longer term, secondary cataract, refractive problems, cystoid macular edema and retinal detachment.