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关于视网膜退化患者在进行白内障切除手术时要面临的风险的相关问答

本帖最后由 雪山飞狐 于 2010-5-11 08:38 编辑

Cataract Removal for People with Retinal Degenerative Diseases - A Q&A with two Foundation-funded clinicians
People with retinal degenerative diseases are not only at greater risk of cataracts, but also complications due to their removal.

To help people with retinal degenerative diseases better understand issues related to cataracts and their removal, Foundation-funded clinicians Richard Weleber, M.D., of the Casey Eye Institute, Oregon Health & Science University, and Jacque Duncan, M.D., of the University of California, San Francisco, provide the following answers to commonly asked questions:

Why do people with retinal degenerative diseases get cataracts more frequently than the general population?
Researchers don’t know for certain, but they believe that more frequent cataract formation occurs because degenerating photoreceptors cause chronic, low-level inflammation in the eye.  The cataracts are somewhat similar to the type that patients with uveitis get. (Uveitis is swelling and irritation of the uvea, the middle layer of the eye.)


What are the hazards of cataract removal, especially for someone with a retinal degenerative disease?
People with retinal degenerative diseases have increased risk of complications from cataract removal, because of the fragility of their retinas. Some complications include: inflammation of different parts of the eye, macular edema (swelling of central retina), and more difficult management of an existing epiretinal membrane (scar tissue).


How does one reduce their risk of complications?
The surgery should be performed by someone expert at removing cataracts, using as little light as possible and practical. The patient should be treated aggressively for ocular inflammation before and after surgery. Ideally, the surgeon should be familiar with retinal degenerative diseases, and the special considerations that need to be made when performing surgery on these patients.


Does the type or extent of retinal disease impact the decision to have a cataract removed?
Yes. The extent and location of damage to the retina will certainly affect the decision process. The physician(s) will consider the odds that vision will be improved following the surgery, and whether the benefits of surgery outweigh the risks. All people with retinal degenerative diseases should thoroughly discuss the potential risks and benefits of cataract removal with their ophthalmologist
谢谢飞狐大哥。
因为你而坚定
很多病友都并发了白内障,上面一篇文章是美国FFB邀请了美国知名的眼科专家对于视网膜退化疾病并发白内障的问题作出了一些解答,文章都是英语的,论坛风之子版主有空的时候会翻译成中文,让大家做个参考。
谢谢飞狐 风之子版主.
谢谢了两位版主,辛苦了。
严重感谢飞狐哥和几位辛勤的版主,您们辛苦了!
我们不是病人,而是战士!!!
辛苦有什么用,我到了北京你都不请我吃饭!臭小子太假了吧!嘿嘿
汗 嘎嘎,我本来想劫你色来着,可惜被你跑了,嘎嘎~~~这是我一生的憾事哇~~~嘎嘎
我们不是病人,而是战士!!!
本帖最后由 雪山飞狐 于 2010-5-11 08:35 编辑

关于视网膜退化患者在进行白内障切除手术时要面临的风险的相关问答——

视网膜退化患者不仅要面临高于常人的患有白内障风险,而且还要面临白内障切除手术后的一系列并发症风险。


两名由美国抗盲基金会资助的眼科医生:医学博士Richard Weleber(来自美国俄勒冈健康及科学大学Casey眼科学院)和医学博士Jacque Duncan(来自加利福尼亚大学)对相关问题给予了下列回答:


为什么患有视网膜退化疾病的患者比常人更容易患白内障?

现在研究人员还没有十分肯定的答案,不过他们认为视网膜退化患者更容易形成白内障是因为退化中的感光细胞会导致眼睛产生慢性,轻微的炎症。白内障有些类似于葡萄膜炎患者的症状(葡萄膜炎表现为眼球中部的葡萄膜膨胀及发炎)



白内障摘除手术对患者﹑特别是患有视网膜退化疾病的患者有什么影响?

由于患有视网膜退化疾病的患者的视网膜比较“脆弱”,所以如果进行白内障摘除手术则风险要比一般患者风险更大。其中一些并发症包括:眼睛不同部位发炎,黄斑水肿(中央视网膜膨胀),以及更难于控制现有的视网膜前膜(疤痕组织)

应该如何降低并发症的风险?

白内障摘除手术要由擅长此手术的医生进行,尽可能少的使用灯光。术前和术后要对患者的眼部炎症积极治疗。手术医生最好要了解视网膜退化疾病,并知道对这些患者要使用哪些特殊的方法及特殊的注意事项。



视网膜疾病的类型或病情是否会影响白内障摘除手术的进行?

是的。病情及视网膜受损的位置会影响患者是否去做白内障摘除手术。医生会根据患者的情况,对术后视力提高的幅度及患者要承担的风险进行比较,以决定患者是否应该进行手术。所有患有视网膜退化疾病的患者在术前都要与医生全面仔细的探讨手术的潜在风险及视力的提高幅度再做决定。
感谢风之子版主的翻译,辛苦了。
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