Zusammenfassung
Die Vorstellung der alten Griechen war, dass eine trübe Flüssigkeit über das Auge
herabrinne – daher die vom Verb καταρρηγνυναι = herabfließen hergeleitete Bezeichnung.
Diese Auffassung zur
Pathophysiologie der Katarakt hat sich heute grundlegend geändert.
Abstract
The purpose of this article is a condensed overview of contemporaneous „state of art
and knowledge“ of age-related cataract. As an introduction, some aspects of terminology,
epidemiology,
lens anatomy and pathophysiology of age-related cataract, selected for clinical
interest and relevance, are outlined. Clinical aspects include signs and symptoms:
Objective criteria for
cortical, nuclear and posterior subcapsular cataract are described, followed
by typical symptoms such as decreased visual acuity, contrast sensitivity and foggy
vision, altered colour
perception, decreased mesopic and scotopic vision, glare, myopization and monocular
diplopia. Diagnostic evaluation consists of a general ophthalmic examination, including
history,
refraction and vision testing, tonometry and morphologic examination of anterior
and posterior segment, and is supplemented by special tests and examinations, such
as interference vision
(retinometer), keratometry including corneal topo-/tomography, biometry (ultrasound
and optical), specular microscopy of the corneal endothelium and OCT of the central
retina. Treatment is
exclusively surgical: Evaluating the indication for surgery individually, weighing
chances and risks, determining individual decisions such as anesthesia, surgical technical
options, target
refraction and intraocular lens options is discussed in detail. Finally, some
perioperative considerations for medical treatment and infection prophylaxis are outlined.
The last section
deals with short- and long-term complications and their management – including
early pressure rises, corneal edema, inflammatory response and endophthalmitis, and,
in the longer term,
secondary cataract, refractive problems, cystoid macular edema and retinal detachment.
Schlüsselwörter
Alterskatarakt - grauer Star - Linsentrübung - Kunstlinse
Key words
age-related cataract - basic and clinical aspects - evaluation - treatment - complications
