Zamućenje stražnje kapsule leće nakon ugradnje različitih modela intraokularnih leća

master's thesis

• Title (english): Posterior capsule opacification after intraocular lens implantation
• Author: Mia Jurilj
• Mentor: Miro Kalauz (mentor)
• Committee member: Damir Katušić (predsjednik povjerenstva)
• Committee member: Tomislav Jukić (član povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Katarakta, odnosno zamućenje leće, može se razviti kao posljedica raznih stanja kao
što je starenje ili bolesti kao što je dijabetes. Zamućenje stražnje kapsule leće
(sekundarna katarakta) nastaje zbog migracije i proliferacije ostatnih lećnih epitelnih
stanica, nekoliko mjeseci ili godina nakon operacije katarakte u do 50% pacijenata.
Rezidualne anteriorne lećne epitelne stanice migriraju s ekvatora uz stražnju kapsulu
leće prema centru zjenice te se opacificiraju diferencijacijom u lećne fibre
(aglomerate globularnih ili fuziformnih Elschingovih perli). Na taj način lećna kapsula
postaje zamagljena.
Na nastanak zamućenja stražnje kapsule utječu dizajn i materijal različitih
intraokularnih leća te njihov smještaj, neke očne bolesti i stanja (retinitis pigmentosa,
glaukom, pseudoeksfolijacijski sindrom, visoka miopija) te dob pacijenta. Kirurška
tehnika također ima veliki utjecaj na sprječavanje nastanka zamućenja.
Simptomi sekundarne katarakte slični su simptomima katarakte. Kod mnogo
pacijenata, prvi znak razvoja zamućenja stražnje kapsule je slabljenje vidne oštrine
te subjektivni osjećaj zamagljenja vida. Promjena vidne oštrine očituje se kao
oslabljena mogućnost čitanja redova na Snellenovoj ploči za ispitivanje vidne oštrine.
Neodymium:YAG laser kapsulotomija je metoda izbora u liječenju zamućenja
stražnje kapsule leće. Tip lasera koji se koristi za ovaj postupak je YAG laser (yttrium
aluminium garnet). Njime se načini mala rupa u kapsuli leće. Cijeli postupak traje
nekoliko minuta te je u potpunosti bezbolan. Indikacija za tretman Nd:YAG laserom
ovisi o gustoći zamućenja, ali i o subjektivnim tegobama koje se javljaju kod
pacijenata. Upotreba farmaceutskih pripravaka za liječenje još je u ekperimentalnoj
fazi.

Abstract (english)

Cataract, the clouding of the lens in the eye, can develop due to multiple reasons
such as aging or diseases such as diabetes. Posterior capsule opacification (PCO or
secondary cataract) is caused by residual lens epithelial cells migration and
proliferation, a few months or a few years after cataract removal surgery in up to 50%
of treated patients. Residual anterior lens epithelial cells migrate from the equator
beside posterior lens capsule towards the pupil centre and they opacificate into lens
fibres by their differentiation (globular aglomerates or fusiform Elsching pearls). In
that way, the capsule that holds the lens in place becomes clouded.
Design and material of different types of intraocular lenses, their accommodation,
some eye conditions or illnesses (retinis pigmentosa, glaucoma, pseudoexfoliation
syndrome) and patient’s age affect the occurrence of PCO. Surgical technique also
has a great influence in preventing the PCO.
Symptoms of posterior capsule opacification or secondary cataracts are similar to
those of cataracts. For many patients, the first sign of secondary cataract
development is a feeling that their vision is cloudy or blurry. A change in visual acuity
shown by decreased ability to read a Snellen eye chart occurs when secondary
cataract develops and is significant enough to consider correction of secondary
cataract with YAG laser.
Treatment for secondary cataracts is the procedure called Neodymium YAG laser
capsulotomy. YAG is a short for yttrium aluminium garnet, the type of laser used for
the procedure. A small hole is made with a laser in the capsule. The procedure takes
only a few minutes and is entirely painless.
Indication for Nd:YAG laser capsulotomy not only depends on opacification density,
but also depends on the patients subjective visual deterioration. Pharmaceutical
substance usage for treating this condition is still in its experimental phase.

• Keywords: katarakta; zamućenje stražnje kapsule; intraokularne leće; Nd:YAG laser kapsulotomija
• Keywords (english): posterior capsule opacification; intraocular lenses; YAG laser; capsulotomy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:746808
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-08-23 08:22:35