Eye Issues and Treatment in Marfan Syndrome, Stickler Syndrome, and Other Related Conditions
19:12-22:19
Now on to a cataract. This is a typical age-related cataract, as I said, everyone gets it. That's just a part of the normal aging change. Lens becomes cloudy. That's the definition of a contract.
では、白内障についてお話します。一般的に加齢により発症し、先ほども言ったように誰でもかかる眼疾患です。通常の加齢による変化の一部であり、レンズが濁るのが白内障です。
What do we do? Easily can be easily taken care. Actually it's a very fun surgery, we do this, this is that the most commonly performed eye surgery in our field and then you can see this and this is the illustration how the surgery works.
どのように治療するかというと、単純です。非常に楽しい手術で、眼科では最も多く行われています。図を使って、白内障の手術を説明します
Again this is partially just a front part, the, the part of the eye, the back is, is behind. Now you make a incision in the clear cornea, which doesn't contain any blood vessels at all. The incision is so small. Right after the surgery, those patients, other than the fact those patient can see, and you don't see anything, there's no bleeding because corneas is clear. There's no blood vessel.
先ほどと同じく、前半分のみの眼の図です。まず、透明な角膜に非常に小さな切れ込みを入れます。角膜に血管はありません。手術直後に見えるようになります。視野に何かが見えるということもありません。角膜に血管はなく透明なので出血もありません。
You make incision. You put instrument inside eye after the pupils dilated. Remember Marfan patients they have a poorly dilated the pupil. If the pupil doesn't dilate well, that alone can make surgery difficult. Okay? There are ways to take care of this but if your eye surgeon has to be aware of this. So if you can dilate the pupil well and that this would allow you to use this instrument to reach the lens.
瞳孔を開いた後で器具を眼の中に入れます。マルファン患者さんは瞳孔の開きがよくありません。瞳孔がしっかり開かないというだけで、手術は難しくなります。対処法はありますが、担当医がそのことを知っておくひつようがあります。瞳孔がきちんと開けば、器具をレンズまで到達させることができます。
When you reach the cloudy lens, you literally break into small pieces and this instrument has aspiration portal, so you basically break it down using the energy, ultrasound the energy, suck it in to the this same instrument and get the lens out.
濁ったレンズに器具が到達したら、レンズを細かく砕きます。器具には吸込口があります。超音波を使ってレンズを細かく砕いたあとで、破片を吸引します。
And so you, some patients would ask me, say that "Now, when you remove my cataract, can I have it as a souvenir?" I said, "No, you don't, you don't want to have it. I'm gonna break down." That's a baby and they're just, you know, you're not deliver the whole baby out. When you have that, this is what's the old way to do the surgery. We didn't have this instrument. We have to make a large incision, deliver the whole baby out, basically. You can imagine the surgery was a whole different way to perform. Now we don't have any souvenir for patients at all.
一部の患者さんから「取り除いたレンズをお土産に持って帰りたい」と言われることがあるのですが、それはできません。細かく砕いてしまうからです。昔は今のような器具がなく、大きく切開してレンズを取り除くという今とは全く違った手術法でした。今は患者さんにお土産を差し上げることはできなくなりました。
After the cataract is removed, we use the same incision putting another instrument, which is a delivery system. On the right is the artificial lens. You put artificial lens in the eye. It's just a piece of plastic, very soft. You can fold it up and put into this delivery system. When you get inside, when the lens gets inside eye, because this is very soft and guess unfold it on your own, gets suspended in this capsular bag, which is just the wrapping of the lens. We call a capsule. So that's how the standard a contract is performed.
濁ったレンズを取り除いた後、同じ切れ込みから別の器具を差し込みます。右の画像にあるのが人工レンズです。非常に柔らかく、プラスチックで出来ています。人工レンズは折りたたんだ状態で器具に乗せ、眼の中に入れます。眼の中に入った人工レンズは自然と広がり、カプセル状の膜（砕いたレンズを包んでいた膜）に収まります。以上が標準的な白内障の手術です。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
