EyeWorld Korea September 2014 Issue

39 EWAP CATARACT/IOL September 2014 Views from Asia-Pacific Robert Edward ANG, MD Senior Consultant, Asian Eye Institute 8th Floor Phinma Plaza Rockwell Center, Makati City, Philippines Tel. no. +63-2-898-2020 Fax no. +63-2-898-2002 angbobby@hotmail.com ࠕ ֳણ ௗ ݑ ਁ ೚౸஢ ܩ ઊસ ݴ ೩ത१ె د ؘ ҫ੸ ి ҿીઊ .د ஢Ԟਁ ܩ ઊસ ݴ Ӵ ઒ഡ ࣏܉ ڝ ܾࣳ ટથહ ઊઽ੹ ࡂ ৔Ԟ ߚڹ ਁ ઊ ܟ ഡ ҿી੹ ഡ .د ԓ ܟ ֢ െര ़ીஔ੭൛ी دࡂ ੌਖ਼ട د ؘ ҫઊ ൜ઌ ٻ ଒ ৌ৔Ӌ Ԟीઊ ӆङനࣳ ࠋ ઺ടӋ ઔ੻੹ ੌ ݼ ؘ ্Ӌ ઔৼ .د ௗ ݑ ਁ ઊ ܟ ഡ ३Ԟी੹ ऀӖહ੶ܾ હੋടԞ ੥നؘࣳ ކ ૓നৡ ഢ ૻ੄ഡ ं ૚ ݩ અ ઊനӚӆઘ ઔ .د ൝ઘ ڝ ੸ ઘ३અ ৊઺Ә ௗ ݑ ҿӘ ݴ ૻ੄ടҲ ਉԠ .د અ७ഢ ਉ଒ ৺ઊ ೚౸஢ Ԟीܾ ़ીஔ֮ ઻ґ, ़ીஔ ࡚नी, Ҁ ޅ ઻ґीട޷ થെऀઊ ׬ .د ऽܳ ټ ीઘਁҲؘ ઊ ܟ ഡ Әીઊ ॐ੏ ़ ઔ଒ ކ ीઘѿ ِ ऽܳ ٻ ৼң֢ ࡜৊ીഡ ޾৩ஔघ ڰڰ ,ف ഡ ࠕ ֳણ ؘۙ ৪੸ ઺ ࠒ Ҏઊ ৰܱ੎ ࣛൠਁؘࣳ ೚౸஢ ܩ ઊસ ݴ ࣏ੋട޷ ഥ࠾଑੹ ഗഢ ़ ઔ .د ԓ ݼ Ӌ phaco time ز ஸ੸ ֳഗं೩ घ५ઊ ҆घത੹ ۸ഡ .د ഥ࠾଑ઊ ৺ؘ ीԞઅ ѿ؟ऀ੹ ׬ઊؘ ҫઊ ઊ߸ ࡘف ࡚અ ൝ઘ ڝ ਁҲ ી ؽ ഡ ઊ੭ѿ ٽ ҫઊ .د ԓ ܟ ֢ ੌ ݼ ѿ ઊ߸ Ԟ૔અ ़ીஔ੭൛ीܾ ૝੸ ҿӘ ݴ ৴Ӌ ઔԞ ߚڹ ਁ ً ૝੸ Ӹ઻ ࠃ १ܲ ҿ Ә ݴ ҒӚહ੶ܾ ૂӖടؘ ҫઊ ً ৰܶ .د ࡅ ઌ Ҏ੸ ीઘਁҲؘ ܩ ઊસ ݴ ౿ന ़ીஔ֮, ࠕ ֳણ ߼٩, ޾৩ஔघ ف ౖࣛਭ Ӛӆ৺ ઊ ധࣛ ډ ԗҲ, ૻ७੹ ઠৈ, ਙࣛഡ ఽԞܾ ़ીஔ֮੹ ਍ ़ ઔ د ؘ ҫઊ ѿણ ి અ અѿ ઔ .د ഩ࡚ഢ੸ ࡅ ઌઅ phaco time੹ ز ஸ१ౄӋ ߼٩ѿ ׬੸ ࠕ ֳણ੹ دࡂ ॕҲ ୃґؘ ҫ੹ ٱ ؘ .د Ҁ ޅ ઻ґ Ԟ؟੸ ൝ઘ ڝ ਁҲ ௤ ৺ઊ ઻ґ୺੹ ਍ ़ ઔ٩ܿ ടԞ ؘ ട଒ ކ ௤ܾ٩ ઊ ܟ ഡ ઻ґ ݴ ॕҲ ഢ ़ ઔ .د ࠾੘ਁࣳ ӄૂഠઊ ץ અઅ ి ࡘ ࡚੹ ୱ଒ഡ ܩ .د ઊસ ࠕ ֳણ ़ी ؘۙ ௤੹ ࣏ੋട଒ ৌؘ ࠕ ֳણ ़ी੹ ൙ ࡂ ഢ ़ ઔ د ؘ ҫ੸ ބ ௿ವਁ ޓ ੌ ੭ ݼ ടҲ ઙੋഡ .د ԓ ܟ ֢ ણ ࡻ ࣹௗ, ੭଒, घ޾ऀ ߜ ഀਁ ࡻੋ੹ ଒࡜ടؘ ҫઊ ి عࡘ ઊ ٻ ৰ ৊ౌԱҲ٩ ൝ઘਁҲ ઊ ݴ ઺ѿനৡ ഡ ࡅ .د ੘ਁؘࣳ ࠕ ֳણ ़ी ز ӆ, plus/AS,. flaps, Ҁ ޅ ֳ ރ ࣘ઒੹ ੥ഡ ౡ׆ ڝކ Ԟ, Ҁ ޅ ઊ२੹ ޾ ڂ ഢ ़ ઔԞ ߚڹ ਁ 9ictus ೚౸஢ ܩ ઊસܾ ҿીയ .د د ৩ഡ ઺৊ ࡘ Ԟ؟੶ܾ ൞ੋ੹ ׬ઊӋ ಉઘ़ઋ ݬ ੹ ґࣷഢ ़ ઔ .د ҿ݀હ੶ܾ ம३ ଒ҽ੸ ೚౸஢ ܩ ઊસѿ ࠕ ֳણ १ीઅ ৊઺Ә ਙௐѿ؟ऀ੹ ґࣷഡ د Ӌ ૂ१ഡ ࡂ .د ೟હ੶ܾ હੋടؘ ૲੄ ઊ੭ѿ ௤֧ܾ ടؘ /AS,.ਁ ࡻന ҿӘѿ ً ੌ ़ടԞ ߚڹ ੸ ৈ إ ଒ ކ ৊઺ऀઊ ґࣷ ٻ ৰ Ҁ ޅ ഗಹઅ ڂ Ռѿ ԑઍടӋ Ҁ ޅ ഗಹ ഥ࠾ ଑ઊ હৰ ीԞਁ ف ഡ ३݊ѿ ׬ৈ૊ ೚౸ /AS,.੹ ݴگ ़ ઔ .د Editors±note: Dr. Ang is a consultant for %ausch /omE Eut has no financial interests related to his comments. Pannet PANGPUTHIPONG, MD Director, Mettapracharak Hospital and Eye Institute, Department of Medical Services, Ministry of Public Health 52 Moo 2, TambonRaiking, AmpurSampran, Nakornpathom Province, Thailand 73210 Tel. no. +6634-225417 Fax no. +6634-321243 pannetp@hotmail.com ң અ 2 ٳ ך ৊ ௗ ݑ ਁ ೚౸ ܩ ઊસ ݴ ࣏ੋന਴ؘٙ ܩ ઊસѿ ஢ઽઊ ઝ ސ ிଔ ़ી ஔ֮ ઻ґी, ൭Әહઌ ഩ ࡚઻൛, ી൜ഡ Ҁ ޅ ઻ґ ݴ ѿ؟ടҲ ത੹ ࠋ ҽയ .د ઊ ܟ ഡ ࠋ ઺੶ܾ Ӹ઻ ӯી ҿӘѿ ґࣷ ٻ Ӌ ൝ઘઅ ৊઺ઊ ലࣛ ٽ ҫઊ .د ԓ ܟ ֢ ԓ ൭ Ә ી٩ؘ ൝ઘ֢ ीઘਁ ڰڰ .دݱد ܅گ ഡ ഩઊ֢ ޾৩ஔघ ف ന ݼ ਭ Ҏ੸ ഥ࠾଑੹ ࠉٳ ഡ ࠕ ֳણ ൝ઘࢻ ৈ ܅إ ֥१ ؘۙ د ஢ઽ ,2/੹ ࠊ ੹ ൝ઘѿ ೚౸ ܩ ઊસઅ ً ి ൭Ә ݴ ৴੹ ़ ઔ .د ऽܳ ټ ीઘؘ ৈ૲ ૒ԙઊ܅٩ ً ґࣷ੹ ടԞ ੥നࣳ ܩ ઊસ ࣹ ીਁ ஷѿܾ १ҁ੹ অৡ ഡ د ؘ ҫ੹ ࠋ ҽഢ ҫઊ ࠉ .د ޷ਁ ஢ ࡂ ઘ ڝ ੸ ೚౸ ܩ ઊસѿ ௗ ݴݑ ً ॕҲ ടӋ ன ़ी १ҁ੹ ૵ਉ૴ د Ӌ ࣥҀഢ ҫઊ ܅گ .د ࣳ ೚౸ ܩ ઊસ Ԟ ी੸ ઺ ߚ ѿਭ ஢ ࡂ ઘઅ һୱ ݴ ૘ට .د ކ ৢ ࡘف ࡚અ ஢ ࡂ ीઘѿ ೚౸ ܩ ઊસਁ ଒֢ௗҲ અ૔ഡ د ޷ ৰܱ੎ ࣛൠઊ֢ ੾Ԛ ࣛ ൠਁ ف ஋ടؘ ച़હઌ ीԞ ݴ ࣛ५ടؘ ؽ ڢ ਌ഡ ߚ ૂѿ ઔ੹ ҫઊ .د ৗ੶ܾ ൓్ Ҁ ,ޅ Әऽ ࠕ ֳણ, ؘۙ ޾৩ஔघ ف ന ݼ ਭҎઊ ֥നഡ ଑ܺਁ ف ஋ഢ ़ ઔؘ ӄભܲ ઔؘ ीઘѿ ૵ৰ ڝ ҫઊ .د Ԟӆਁ ଒֢ௗҲ અ૔ട଒ ৌ٩ܿ ૲અനৡ ഡ .د ӖӖ ߚࡘ ਁࣳ ઍട޵ ી୽ ҿીਁ ୶ਉ ഢ ࡅ ,ڹ ઌ੸ ࡻੋ-೟ઋઅ ம ف ൛ ݴ ѿણ ૻ੄ ടҲ ࣥҀഡ .د ಶ ܩ ౸ ࠩ௘ ؘۙ 80-20 Ԑ௘੸ ੌ ݼ ਁҲ ಉ઒ઊ֢ ף ܲઅ ஋੻ 20%ѿ ࣒஺ ܞ ؘۙ ҿӘઅ 80% ݴ ҿીഡ د ؘ ҫ੹ މ ന૴ )(د igure 1). െര ೵૴ ࠕ ֳણ ़ी ઌ ز ஢ઽ ાඩ ઌӖ़ીஔ ݴ ࣏ੋടؘ ஢੻ಶ ݴ ઊੋഡ ़ીஔ੭൛ीؘ ઊ߸ ઊࣛહ ҿ Әઅ ৢ 90%ਁ ٩ ش ന ઔ .د மࣷઅ ҿӘ ݴ ৴Ԟ ੥ന ף ܲടӋ ઔԞ ߚڹ ਁ ֙Ԫ଒ ૒ ԙઊ܅٩ ґࣷടԞ ੥നؘࣳ ࣛ ؽ ഡ ઘ੘੹ घࡻടҲ ٽ ҫઊ .د ೚౸ ܩ ઊસਭ ഑ ߸ݼ ৸ ܫ ଊ(֥१, د ஢ઽ, ૒઻ ,2/)ઊ ބ ଒ ޅ 10% ݴ ୼ੌ٩ܿ ף ܲടӋ ઔؘٙ ़ीࡻؘ 2 ࠔ ਁࣳ 3 ࠔ ѿ ٽ ҫઊ .د ґ ࠋ ٩ࣛӵઅ ૂഡ ټ ઘ੘੶ܾ ޾ ڛ ઊ ڝ ਁҲ மࣷઅ ࣳࡻफ़ ݴ ૂӖടؘ ҫઊ ৈ ف ا ࡘ ࡚અ ࣏܉੹ ੥ന ޓ ੌ ૝੸ ௗ ݴݑ ടؘ ҫ੹ ܈ࠅ ़ ࠇ ਁ ৺ .د ԓ ܟ ֢ ഥ࠾଑੹ ٳ ࠉ ഡ ࠕ ֳણਁ ف ഡ ೚౸ ܩ ઊસઅ ൭Ә ݴ ઒଑ടؘ ԕңѿ ா࡚ട د ޷ ી୽઒৊ઘ ڝ ੸ Ӌ੥സӶਁ ف ഡ ࡂ ࣛਁ ೚౸஢ ܩ ઊસ ݴ ೩തഢ ҫઊ .د ԓ ܨ ଒ ৌ੶޷ ൝ઘ ڝ ઊ ઘ३ અ ٫੹ ଒࡜നৡ ഢ ҫઊ .د ഑ ߸ݼ ৸ ,2/ ൝ઘ ڝ ੸ ҿӘ ݴ ґࣷടԞ ੥ന ೚౸ ݴ ࣷ౗ ടӋ ஷѿ ࡻੋ੹ ଒࡜ഢ ҫઊ .د ೚౸஢ ܩ ઊસܾ ً ૝੸ ҿӘ ݴ ৴੹ ़ ઔ଒ ކ ੌ ݼ ؘ ѿһઊ ֳ ݼ Ԟ ݴ Ԟ ݼد Ӌ ઔ .د Editors±note: Dr. Pangputhipong has no financial interests related to his com- ments.