Glaucoma and cataract simultaneously. The operation to remove, treatment of folk remedies

Age-related changes in the body due to aging, form the basis on which appear and progress rapidly various diseases affecting major organs. Examples of such diseases include glaucoma and cataracts.

Glaucoma and cataract eyes simultaneously. The peculiarity of the disease

Glaucoma and cataracts affect both the human eye is quite common, in spite of the differences in etiology and some clinical signs.

Detection of the manifestations of these diseases requires action on serious and immediate treatment. Diagnosing the simultaneous manifestation of the situation translates into the category of critical.

Glaucoma

Glaucoma is an irreversible damage to the optic nerve under the influence of a number of factors, The main of which is the increase in intraocular pressure (IOP). This disease - one of the most common causes of blindness. According to experts, about 17% of the blind in the developed countries - victims of glaucoma.

A feature of the disease is asymptomatic. In the early stages it can manifest itself sluggishly following subjective symptoms:
• overly rapid fatigue of eyes;
• the emergence of black flies flitting in the field of view;
• periodic appearance of fog, scouring the visible contours of objects;
• appearance of the rainbow halo surrounding light sources;
• head and light eye pain.

The incidence of these symptoms is so small that they are affected other explanations, not associating with glaucoma symptoms. And only when the disease reaches its climax, accidentally covering one eye, the patient notes the complete loss of the second eye. In this case, return the lost is no longer possible, and the only task of the doctor is to keep the state of the patient from further degradation.

Cataract

The occurrence of cataracts is uniquely determined by pathologic changes occurring in the lens of the human eyeAssociated with age-related changes in the human body. These changes give rise to degradation of the structure of matter, which consists of the lens, its turbidity and appearance of subjective sensations turbid appearance of the film covering the eye.

According to WHO, the disease affected 75% of people aged over 65 years. And recently there has been a steady shift towards disease rejuvenation.

cataracts, as well as glaucoma, is slow. Formation signs of disease at an early stage lasts for years, the person can not sense an impending danger.

Possible symptoms that warn of cataract development are:
• loss of image sharpness that can not compensate for the points;
• the progress of myopia, sometimes leading to compensation age farsightedness that temporarily improves vision;
• appearance of the rainbow halo surrounding light sources;
• deterioration of color;
• split contours observed objects;
• headaches and light eye pain.
In lesions in the central part of the lens characteristic symptom of cataracts is also an improvement in night vision with simultaneous deterioration of vision in normal conditions.

The reasons for the defeat of both eyes with glaucoma and cataract

The reason for the simultaneous defeat of eyes with glaucoma and cataract is determined by the course of several internal biological processes that accompany its normal functioning.

The central element of the eye is an optical system - a biconvex lens of vitreous biological material called lens.

The lens contains blood vessels and nerve endings. The chemical composition it contains protein compounds, water and some minerals. The lens is an elastic, transparent degree inscribed Zinn ligaments ring ciliary body providing production of intraocular fluid by filtration of blood flowing through the capillaries.

Intraocular fluid first fills the cavity formed by the rear lens surface and the outer side of the vitreous (posterior cavity) and then flows through the pupil into the cavity formed by the outer surface of the iris and the cornea (anterior chamber).

Pupillary edge of the iris valve performs the function of preventing reverse flow of intraocular fluid. The area of ​​corneal compound and iris intraocular fluid through a complex drainage system returns to the ophthalmic venous blood. The chemical composition of the intraocular fluid similar to that of cerebrospinal fluid.

Processes permanent formation and intraocular fluid absorption lead to the creation of the laminar flow of washing the lens, which ensures its nutrition and removal of waste products.

defined static pressure is created inside the ocular cavities, the magnitude of which determines volume ratio intraocular fluid produced by the source and drain absorbed system. This option is called HDV.

The increase in IOP in glaucoma may be due to the occurrence of tumor in the posterior cavity of the eye on the rear side of the lens, or decreasing the outflow of intraocular fluid, associated with disturbances in the drainage system.

With increasing IOP lens can move closer to the back surface of the iris and pupil tightly close (lock pupil). Wherein the rear and front cavity will be isolated, which intensifies the IOP rise in the rear plenum.

pressure transmission through the vitreous to the optic nerve will cause its gradual atrophy and then complete loss of capacity for the transmission of nerve impulses to the brain.

If the development of these processes will be stretched over time, possible that the increase in IOP will cause stagnation of intraocular fluid from the surface of the lens. Substance lens deprived of food and removal of waste products, begin to degrade, leading to the appearance of cataract.

In the case of cataracts, as the disease progresses, degraded compacted lens, its thickness increases, which reduces the volume of the eye cavities increases IOP and there is a classical picture of glaucoma is already described above, which complements the clinical signs of lens opacity.

Is it possible to operate with glaucoma and cataract together

Considered a simplified model of the biological processes of the human eye clearly shows that glaucoma and cataracts constitute an inseparable tandem and their simultaneous manifestation is not an accident, but rather regularity.

An indicator of the irreversibility of the pathological eye changes is the degree of atrophy of the optic nerve. Until recently, the operation of replacing the lens with IOP greater than 25 mm Hg. Art. and at the same time defeat the eye with glaucoma is strictly prohibited.

This operation served as the starting point for further growth IOP stimulated further progress of glaucomatous lesions and complete atrophy of the optic nerve.

The treatment of complex pathologies such was carried out in two stages, separated in time by at least a month. The first step consisted in carrying glaucoma surgery, normalizing IOP, or at least reducing it to acceptable limits. The second stage was dedicated to the fight against cataract: the removal of degraded lens and implantation of an artificial.

In some cases, during the initial stage of glaucoma, some surgeons solved disrupt established taboo. But this happened only when the increased IOP was due to a significant thickening of the lens degraded. Removing it and implantation of an artificial, without any additional measures to combat glaucoma, led to normalization of the IOP and the restoration of sight.

Modern international practice surgical ophthalmology based on the simultaneous method of surgical treatment of the disease in question.

What are the advantages of the complex operation to remove a cataract and glaucoma

Treatment of the patient with a history of glaucoma and simultaneous destruction of the eye during cataract two successive spaced time operations, has always presented a difficulty, for both the physician and for the patient.

The doctor was forced to plan their time taking into account the need to organize a second operating phase, the time of which to a large extent determined by the state and the willingness of the patient.

For the patient with such an approach increases significantly the terms of postoperative rehabilitation as a social and visual. Stress two consecutive operations and the need to pass twice preoperative studies cycle inhibitory effect on its psychophysical state.

And, considering his age and the list of concomitant diseases, the period of treatment turned into a tough test, both for patients and for the relatives.

Cardiovascular and heart diseases, diseases of the musculoskeletal system, diabetes diabetes and the like, can not simply adjust the plan of medical actions, but it completely disavow.

As is the operation to remove the cataract and glaucoma

Modern international practice surgical ophthalmology based on the simultaneous method of surgical treatment of these diseases.

The algorithm of this technique is constructed as follows:
• removing degraded lens;
• antiglaucoma activity;
• implantation using the minimum number of cuts of an artificial lens.
Using this approach, low-traumatic, and has been shown to safely and effectively.

Widespread complex techniques, using phacoemulsification cataract in collaboration with non-penetrating glaucoma surgery.

Their use prevents a sharp drop in IOP in the first stage of the operation, and provides a controlled reduction of IOP in the second. This approach reduces the possible risk of complications both during the operation and in the postoperative stage.

The techniques used in the first two phases of operation, together with a minimally invasive surgical access technology used in the implantation of artificial lenses, provide recovery of a patient immediately upon completion of the action and the anesthesia, when the period of rehabilitation requirements remain sufficiently long term.

It should be noted that the stated methods are well tested and has long been widely used ophthalmic clinics RF in the treatment of various eye diseases such as:
• detachment of the retina;
• cataracts;
• glaucoma;
• simultaneously cataracts and glaucoma;
• myopia;
• farsightedness;
• vitreous hemorrhage.

Contraindications to complex operations

Like any surgery, complex surgery to remove cataracts and glaucoma has a number of contraindications:
1. First of all, the absence of light perception, indicating atrophy of the optic nerve. In this case, the operation does not make sense.
2. The presence of infectious inflammatory ocular lesions of the choroid, iris and conjunctiva. In this case, you need to take a course of treatment with antibiotics and anti-inflammatory agents, thus reducing the risk of possible postoperative complications.
3. The presence of decompensated somatic diseases (diabetes mellitus; a progressive development of multiple sclerosis; recent stroke or heart attack; oncology).
4. Some neuropsychiatric nature of the disease.
5. Pregnancy or lactation, preventing the use of antibiotics, sedatives and anesthetics required for medical support of operational activities.

In the latter case, the operation should be postponed until the child breast-feeding process is complete.

Recovery and rehabilitation after removal of glaucoma and cataracts

The patient's behavior in the postoperative period is a key factor in securing the success of the operation.

Since, for the most part, glaucoma surgery to remove and replace the lens are performed on an outpatient basis, under the local anesthesia, the patient leaves the medical center wall already after a few hours after the end procedure.

At the same time it receives a brochure, which is governed by its behavior in the next 30 days, a list of medicines needed in the future, the order of their receipt and the date of the next consultation doctor.

The main responsibility of the patient becomes the precise performance requirements of a doctor in this period, careful related to the operated eye and implementation of hygiene requirements, the possibility of warning infection. The daily routine, restriction of physical activity and minimizing stress on the visual apparatus (reading, TV, computer).

How you fit for the complex operation?

If you suspect a disease of the eye under consideration, above all, should apply to the your doctor, therapist, who will send the sick to hold consultations to ophthalmologist.

Upon confirmation of a presumptive diagnosis, the physician draws to a survey of other specialists: cardiologist, endocrinologist and a neurologist. On the recommendations of the last consultation round commission can be extended.

Simultaneously physician directs the patient to carry out general medical research laboratory. The Commission of experts, led by therapist, decides whether the direction of patient for surgery in a specialized ophthalmologic center.

The commission is guided by the existing list of contraindications, in which the age limit is not provided.

After selecting a particular patient ophthalmic center is determined by the action recommendations received in consultation with an expert of the center. If necessary, the patient can ask for help in other specialized medical organization.

It should be borne in mind that the average cost of commercial operations for the treatment of glaucoma and lens replacement in Russia is 75,000 rubles.

The decision to conduct simultaneous operations in the affected eye with glaucoma and cataract should be a conscious move the patient to the need to preserve vision. This operation is quite possible and does not require a long rehabilitation period.

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