EyeWorld China December 2017

ŭ ʃ EWAP ॖෂቤᆫ 9 Views from Asia-Pacific Manish NAGPAL, MD Consultant VR surgeon, Retina Foundation Shahibagh, Ahmedabad, Gujarat, India Tel. no. +919824019850 drmanishnagpal@yahoo.com AMD 患者白内障手术并发症 㑉 わ⒋⒋㑍㢜⊅ㅠ㷳㗐㗯⪹㯧㋲ $0' ⱌ㷝ᱨ☏㗁 $5('6 㫼ⳑゃ 㱸➂㦆⼉㸃⭺▌㵀㑌⧨⻶㥥ᮣ ☕㐹ᱨ$0' 㗁㮥㺸ⱌ㨾㩂⭈⏋ᱨ 㣐⿥㗁⟑㗐㗯ᱨ⛞⶙ㅢ⪹➂㷝ᮣ ⛶㲂⫆⛑㩂㖤㩂 $0' ⪔㸃ᱨ㑥⥗㸡㵀Ⱗ㗖㽂㔠㺰⼒ᱨㅍぼ⍄㩙⢗⳯㽂 㔠㺾㋜⭢㩦⒋⥂ⱌ㨾㽂㔠ᮣ⊅ㅠ㷳㗐㗯⶙㮾⻶⧩㽂㔠➝≦ᱨ⍈オ⛶㮥⢔ ⪔㸃㵜⭩⢚✂㗐㗯␃㾗ᮣ⶙㮾㵀㗐㗯ⰵ㗲㖫ⱌ㨾㽂㔠ᮣ⛶㲂⡳⡳㠞⒱㽂 㔠⼒⒴☨⪔㸃ᱨ⏋㵔⏯⍐⡧ᱨ✚⪔㸃㩖㮔㾖⊅ㅠ㷳㗐㗯ᱨ⛶㲂㸆⹮⪔㸃㮜 㾎⧝ㅢ㵀㗐㗯ⰵ㗲㖫㾖㮥╴㽂㔠ᮣ㸆㺸㎩ⷆ㥲ᱨ㸆⶙ㅢ⶙㮾⮋㔕㙦㺹╲ ⬺⧧⶙ㅢ☨㨰㔶㫖⤸⡒➂ᮣ☏㗁ᱨ㑥⥗⏋㵔㮻ⲿ⡧⼗⧝ⳕᱨㅍぼⳟ⏥㩖㮔 ⻶⧩⊅ㅠ㷳㗐㗯⧧㽂㔠ᮣ 㱎⡡⢖㚱㱸㸆㨗⪔㸃㵀⊅ㅠ㷳㗯㍰㾖㮥⢔⫑㦏 2&7ᱨ㐵⌏⏋㵔⡧⼗ᱨ㴿 㾖ⴈ⛊ᮣ㖼㖯㔋ᱨ㣄わ㮜➂㦆⫆⛑⏋㵔ᱨ2&7 ➂㦆㱸㷗⻸⏍⻳㝛☨ᱨ㱸 㖫⨌⪹㵀⊅ㅠ㷳㗯⨍➂㔶㽴➂⏍⻳㝛㠅⹹ᱨ㐵㖯⶙㮾╿ⱌ⏋㵔ⶼ㚑⍐ ⡧ᮣ☕㐹ᱨ㸆㺸㦆㦣⧶⧋⮑ᱨ㗁ⶏ⏥㽁☨ᮣ ⊅ㅠ㷳㗐㗯㮧㔶㩖㮔㴊⮑☡㴓㥸☨㽂㔠⶙ㅢ⪹㈺☡ⲹ㽔㝛ᮣ⶙ㅢ⪹㱸㮥 㨗㥸㷻ᱨ⺋㑥⨍ㅘㄪ㔋☨⳨⏩⫄㽧⫊⊙㠅㢭ᱨ☕㐹㱸㖫⨌㺾⍋☨㽂㔠㚨 㔇⪹㵀㗯㺲㟯㐹⭩㺺ᮣ☏㗁ᱨ㗍㠬ㄪ㗐㗯㮧㔶ⱌ㨾㽂㔠␃㾗ᱨⲹ㽔㝛㈺ 㔇⫊㩪㑋▞⹹⛱㎩ⷆ⏌⏥⒋⮑ᮣ ⍌⭃㽂ᱶ'U 1DJSDO 㔵タゃ㱸㑌⧨ⲿ⭙⺉㯐⤴㥥ᮣ LEE Mun Wai, MD Medical Director, Lee Eye Centre 44-46 Persiaran Greenhill, 30450, Ipoh, Perak, Malaysian Tel. no. 605-2540095 Fax no. 605-2540273 munwai_lee@lec.com.my AMD 患者白内障手术并发症 ⌔ ☠☨㫳㻀☨ㅰ⼰㦐⤴㩂⪞⊍⍐㩂 $0' ⪔⏋⿔▙㴢㢜 ᱨ ⧶▙㮥⏩➶ $0' ⪔㸃▌㵀㖡タ☨⟇㦅ᮣ㱱㲂㸆㺸⭈⏋㗁㮥㺸ㅰ ⼰㦐⤴㩂⭈⏋ᱨⳟ㦡⊅ㅠ㷳ᱨ㣄わ☨⼥╘㺲ᱨタ㦄⊅ㅠ㷳⧩⏌⏥㟠⒴⛪ $0' ☨⪔㸃⏌⏥㔕⮑ᮣ 㸆⹮⪔㸃㽜⌤㾖⊅ㅠ㷳㗐㗯㺐㍰㩖㮔ⶌ⿑㮥⛊☨㯜㚐ᮣ㮔㑁⪔㸃㦐㨳⊅ ㅠ㷳㗐㗯⏥⪹⭩㺺㚳わ☨ $0'ᱷ㖼㖯㔋ᱨ㷎ⓥタ㦄⫄㽧☨⊅ㅠ㷳ㅢ⤗ 㝗⡽⛶⌴ゼ⡮⛪ᱨ㮜⢚㑛㯁⭶␌㚳わ☨⭈⏋ᮣ㗯㍰㽩㫛㮜㮔㍿♛ᱨ$0' 㗁㮥㺸〇㩂⭈⏋ᱨ㚜㐹㾖⼗⊅ㅠ㷳㗐㗯ᱨ⭈⏋㑒㐹⪹ⱌ㷝ᮣ $0' 㺰⼒ 㩛✂ $0' ⪔㸃⶙ㅢ㮻ⲿ㾖⥙ⶉ Ḷ9(*) 㽂㔠ᱨ⊅ㅠ㷳㗐㗯☨㖫⭺≠㈉ ⏥㮔⡧㑃㽂㔠➝≦ᮣ㣄☨⼥╘㺲ᱨ㑥⥗⢗⳯⪔㸃☨㽂㔠➝≦㩖㮔ᱨ㣄㱸 㖫⨌㮜⪹㵀㗐㗯ⰵ㗲㖫⢖㲐ⶉ 9(*) 㽂㔠ᮣ ⹄⤾㾈⛱ Ḷ ▞⪑㗁⏥▞ᱻ $0' ⪔㸃☨ ,2/ 㫍㵗㮥㺓㗁㮥⢔㑆㯓☨⪈㝘ᮣ㵀㖳㱫⹄⤾㾈⛱ ,2/ ➝ ギ▙㝛㱸⼉⢔㯌⮑ ᱨ⛶㲂 $0' ⪔㸃㖳㱫㸆⹮ ,2/ 㠞㐩㐟ⴈ㲂㗐㗯㮧 㔶☨ⴈ⛊ᮣ⛶㲂㣄☨ $0' ⪔㸃ᱨ㣄㮥㺓㖳㱫⹄⤾㾈⛱ ,2/ᱨ㯜㢜㱸㺆⳯ 㦄㖸㸆㺸ⲹ㽔㝛⧶≠㐩ᱨ⛶㲂⛶⌴ゼ⡮⛪⫊㻉㮣Ⱞ⿓ゃ㱸㦄㻚㱘㦜ᮣ⼹ 㠖ᱨ⛶㲂 $0' ⪔㸃ᱨ╹⹻⿥㔋Ⰶᱨ㾈⛱⛮⏒⒌⤾㦏㱎⡡⪹㱸⊝㻜ᱨ㮜㺗 ☧㸆⹮⪔㸃ⶌ⿑ᮣ 㥸ⱌ⭒㗯 ,2/ Ḷ 㱫⪑㗁⏥㱫ᱻ $0' ⪔㸃㖳㱫⹝㗍Ⱇ㸡 ,2/ ⪑▌㵀㸝㯓ᱨ㯜㢜⪹㱸⛶⌴ゼ⡮⛪㥲Ⰹ㮾 ⭆㗍⻲㴊⨍㗖㦎ᱨ㸆⹮⪔㸃⶙ㅢ⏥ㅢⓌ➶㦝㗖㸆⹮ ,2/ ☨⧝╌ᮣ⶙㮾⤠ ⺆⪔㸃㖳㱫➧㎲ギ☉Ⰽ ,2/ᱨ㯜㢜Ⱇ㸡㎲␘㱸⶙ㅢ⪹㝗⡽⛶⌴ゼ⡮⛪ᱨ 㸆⛶ $0' ⪔㸃⶙ㅢ⪹㱸⧝╌ᮣ 㓞⤾ ,2/ 㮜⶙㮾㖳㱫ᱨ☏㗁㵀㗯㍰㽩 㫛Ⱛ⛰㮥⛊㮔ⶌ⿑⭈⏋☨➂㷝Ⱛ⛰ᱨ㋂⭱㗁⟑⧩㗄㺔㑩㓞⤾ ,2/ᮣ ➥▙⤂ㅢ ,2/ ⛶㲂㙣㬇㠡㋜ $0' ⪔㸃 ☼㟰㽔㢠㚭⫊㈐㽔劏⧵ ᱨ㦆㵀㱸㮥㨗㝎㗜 ☨ ,2/ᱨ⶙㮾㱸✐㠖☨➥▙⤂ㅢᱨ㺣㔕⶙㮾㝗⡽㮥㺝㬇☨㺲㬗㗍⻲ᮣ㮥 㨗ⲹ㽔㝛㗁ㅘ▢ㅠ㺔㑩ᱨ⺋㑥 ,PSODQWDEOH 0LQLDWXUH 7HOHVFRSHᱨ ➧⒋▙ᱨ㩖㮔➧⒋㔪☨㍰➟ᱨLRO$0' 㥥㟧ᱨ⏳㱫 +XEEOH 㠯㴜ⳇ☨⡣ ㅴᱨㅘ▢ㅠ㺔㑩㮥⢔⡘ⲹ㝛ᱨⰲ㽔⤑㺔㑩㮥⢔㸡ⲹ㝛ᮣ㋦㚴☨➝➈㱸ⰲ 㽔⤑⤨⛊☨ᱨ⺋㑥 2ULOHQVᱨ㸆㗁㮥㺸ⳇギ㠯㴜ⳇ㺔㑩㣡ᱨ✚ 6FKDULRWK 0DFXODU /HQV 㗁㮥㺸⡛⭩ ,2/ᱨ▞㮥⢔ ' ☨⡽⛪㗷⡛⭩㺲㬗⤾ 㫓㎸ᮣ $0' ⪔㸃☨㺲㬗㗍⻲⶙ㅢ⪹⧶␘ᱨ☏㗁㩛✂㸆⹮⪔㸃⒋⒋㻙㚗⊅ㅠ㷳 㗯⨍㗍⤂ㅢ㱸㻙⤷⡢㔂ᮣ 㸆㨗⡢㔂ᱨ㚜㐹⶝⤷␌⼋㺗⏥⡽ᱨ⛶㲂㸆㨗⪔ 㸃㠭㠭㱸㦄㻚㩂␘㯖ᮣ 参考文献 1. Wong WL, Su X, Li X, Cheung CM, et al. Global prevalence of age related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. Feb 2014;2(2):106–116. 2. Mainster MA, Turner PL. Blue blocking IOLs decrease photorecpetion without providing significant photoprotection. Surv Ophthal. May-June 2010;55(3):272–283. 3. Henderson BA, Grimes KJ. Blue blocking IOLS: A complete review of the literature. Surv Ophthal. May-June 2010;55(3):284–289. ⍌⭃㽂 'U /HH㔵タゃ㱸㦐⤴ⲿ⭙⺉㯐⤴㥥ᮣ “ 应该给所有这些患者在白内障术前做一个基 线 OCT，确保病灶干了，再做决定。事实上，我 们也发现活动病灶，OCT 发现有粘连玻璃体 的，有时候会在白内障术后发生自发玻璃体脱 离，确实可以促进病灶快速变干。 ” - Manish Nagpal, MD “ 要让患者相信白内障手术不会加重他们的 AMD；事实上，摘除明显混浊的白内障能够提 高对比敏感度，也更容易监测他们的疾病。 ” - Lee Mun Wai, MD