Treatment of Cataract

A. Non-surgical
a. Treatment of cause of cataract
 Control DM
 Remove cataractogenic drugs (corticosterodis, phenothiazenes, strong miotics)
 Remove radiation
 Early and adequate treatment o ocular disease like uveitis
b. Untuk katarak insipient dan imatur
 Koreksi refraksi
 Pengaturan pencahayaan
 Pemakaian dark goggles
 Mydriatics (ex 5% phenylephrine, 1%tropicamide)
B. Surgical
a. Indication
 Visual improvement
 Medical indication
1. lens induced glaucoma
2. phacoanaphylactics endophthalmitis
3. retinal diseases
 cosmetic indication

Preoperative evaluation

1. General medical examination

2. Ocular examination
a. Visual acuity
b. Cover test
c. Pupillary response
d. Ocular adnexa
e. Cornea
f. Anterior chamber
g. Lens
h. Fundus examination
i. Sclera
j. Current refractive status
 Type and choice of surgical technique
1. Intracapsular cataract extraction (ICCE)
 Seluruh lensa katarak + capsulenya dibuang
 Zonule ifber harus lemah dan degenerated  makanya tidak bisa pada pasien muda
 Sekarang sudah ditinggalkan
2. Extracapsular cataract extraction (ECCE)
 Major portion of anterior capsule with epithelium, nucleus and cortex are remoced, leaving
intact posterior capsule
 Bisa dilakukan pada hamper semua pasien katarak muda dan tua
 Kontraindikasi = subluxation of the lens

Kelebihan ECCE disbanding ICCE

 ECCE bisa digunakan untuk semua usia, kecuali zonule yang tidak intak. ICCE tidak bisa untuk usia
<40 tahun
 Posterior chamber IOL bisa implanted after ECCE
 Postoperative vitreous related problem associated with ICCE are not seen after ECCE
 Incidence o postoperative complication (ex endophthalmitis, retinal detachment) are less with
ECCE

Types of extracapsular cataract extraction

 Conventional extracapsular cataract extraction

 Manual small incision cataract surgery
 Phacoemulsification