VIII. SPECIAL CASES

  • 14/06/2021
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A. Monocular Patients

Cataract surgery outcomes for monocular patients have not been formally assessed in large studies. For patients without good visual potential in the fel- low eye, careful assessment of subjective visual function is especially critical to help patients and surgeons balance the risks of proceeding with surgery versus the risks of deferring intervention. Recommendations for the surgeon include taking extra time with the decision-making and consent processes and being realistic about the surgical skills and resources necessary for a good outcome. Many surgeons consider referring monocular patients for a subspe- cialty consult to assess any additional ocular pathology that could influence the outcome of surgery.

B. Patients With Low Visual Potential

Many low-vision patients are very satisfied with the results of cataract sur- gery if they understand in advance the goals of the surgery and have realistic expectations. Therefore, even when the visual potential is limited by factors other than cataracts, it is reasonable to consider surgery if the cataract is ad- vanced and if the patient is well informed and motivated to undergo surgery. In these cases it can be useful to focus on functions related to peripheral vi- sion, improved colors, and brightness, rather than on central visual acuity. It is important to consider the increased threat of surgical complications posed by other pathology, as well as the potential need to remove the cataract in order to diagnose and treat other ocular disorders. Finally, it is critical to evaluate carefully and optimize treatment of disorders such as glaucoma and diabetic retinopathy prior to surgery.

IX. CONCLUSION

Cataract surgery is an appropriate option to consider whenever a patient has decreased ability to perform needed or desired activities due to cataract. In addition, patients who are not aware of subjective visual deficits may ben- efit from surgery if they have reduced vision from cataract and have elevated risks for falls, motor vehicle accidents, or other injuries. Patients with cataract obscuring the view of the posterior segment may also benefit from cataract surgery. Appropriate decision making for cataract surgery is a collaborative effort between the patient and the surgeon and requires an understanding of the patient’s vision-related quality of life and visual function.




*Dikutip dari Buku Essentials Of Cataract Surgery 2nd Ed, halaman 5-6

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