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FAKULTAS KEDOKTERAN UKRIDA

(UNIVERSITAS KRISTEN KRIDA WACANA)

Jl.Arjuna Utara No 6, K!on Jru" # Ja"arta $arat

KE%ANITERAAN KLINIK STATUS IL&U %EN'AKIT &ATA

FAKULTAS KEDOKTERAN UKRIDA

S&F IL&U %EN'AKIT &ATA

RU&A SAKIT U&U& DAERA TARAKAN, JAKARTA

Naa a*a++-a A*a/ F"r !n Sa*a" (001201136)

Na/ra* !nt a++an (001204441)

Do"tr 5!!n /r. $a!an r-n/u, S5.&

/r. D7 . %utr, S5.&

888888888888888888888888888888888888888888888888888888888888888888888888888

A. IDENTITAS PASIEN

Naa Tn. KTJ

Jn+ "lan Lla"

Uur 60 ta*un

Alaat Ulu Ja

%"rjaan T/a" !"rja

B. ANAMNESIS

Autoanan++ Tanal 09 No7!r 1203 Ja 02.22 5a WI$

Keluhan utama : &ata "anan !ura +ja" 6 !ulan :an lalu.

Keluhan tambahan : %nl*atan 5a/a ata "anan tra+a !r"a!ut 5ut* +ja" 6 !ulan

:an lalu. %a+n na"u 5nl*atan l!* +lau 5a/a ala *ar +*na t/a" !+a

!a-a +5/a otor +aa +"al 5a/a ala *ar.

1



Riwayat perjalanan penyakit :

%a+n /atan " %ol"ln" RSUD Tara"an /nan "lu*an ata "anan tra+a !ura

+ja" 6 !ulan S!lu &a+u" Rua* Sa"t(S&RS %a/a 6 !ulan :an lalu, 5a+n a+*

!+a l*at !a" /nan ata "anann:a, tta5 +a"n laa 5a+n ra+a"an +u/a*

+u"ar untu" l*at /nan ata "anann:a. Kalau /a*ulu 5a+n a+* !+a nnal

-aja* oran +"tarn:a 5a/a jara" /"at tta5 +"aran 5a+n +u/a* +u"ar untu" l*at

/"at.

%a+n jua na"u /a tra+a +lau 5a/a ala *ar +aat na" +5/a otor

atau5un !rjalan / "a-a+an :an tran. %a+n na"u 5a/a +an *ar "lu*an +aa

t!ul tta5 5a+n a"an tra+a l!* na" a5a!la a"a "a;a ata *ta / +an

*ar. %a+n na"u !lu !ro!at " 5u+"+a+ a*u5un "ln" :an lan "arna

a+* !+a l*at /nan ata "rn:a. Ka/an<"a/an untu" l*at l!* jla+, 5a+n

a"an n;n"an ata "anann:a +u5a:a !+a l*at /nan ata "rn:a.

Ta !ulan S&RS, 5nl*atan 5a+n tra+a +a"n "a!ur +*na tra+a +5rt

a/a !a:anan 5ut* //5an atan:a. %a+n a+* jua t/a" !ro!at untu" atan:a.

%a+n n:an"al a/an:a r-a:at 5a"aan o!at ata atau r-a:at traua 5a/a ata

"anann:a. %a+n na"u !lu 5rna* a"a "a;aata untu" l*at jau* tta5

*an:a a"a "a;aata *ta 5a/a +an *ar +aat na" +5/a otor.

R-a:at +a"t ata /an ata ra* +!lun:a /+an"al ol* 5a+n. R-a:at ata

+rn !rar,!l"an /an r-a:at o5ra+ jua /+an"al ol* 5a+n. Karna 5nl*atan

:an +a"n "a!ur +*na nanu a"t7ta+ +*aran, a"a 5a+n 5r !ro!at

" RSUD Tara"an.

2



Riwayat penyakit ahulu :

%a+n +!lun:a t/a" 5rna* nlu* +a"t +5rt n. %a+n na"u 5un:a

+a"t ula +ja" 4 ta*un :an lalu /an +u/a* "ontrol !ro!at /nan /o"tr 5n:a"t

/ala. R-a:at t"anan /ara* tn jua /a"u ol* 5a+n tta5 +rn turun na" "arna

t/a" !ro!at tratur. R-a:at +rn !r+n<!r+n 5a/a 5a *ar atau na=a+ /nan +uara

n /+an"al ol* 5a+n.

Riwayat penyakit keluar!a :

Dala "luara 5a+n ta/a :an nlu* "lu*an :an +aa +5rt 5a+n

". STAT#S $ENERA%IS

Ka/aan uu Ta5a" +a"t rnan

Tan/a 7tal TD 032>022, N ?2@>, R 12@>, S 46.6 C.

K5ala Noro;5*al, ra!ut !ru!an, /+tr!u+ rata

L*r K$ t/a" tra!a !+ar, JV% B<1

%aru<5aru $un: 5aru 7+"ular,W*n (<><), R*on"(<><)

Jantun $un: jantun I<II rular, urur(<><), allo5(<><)

A!/on Datar, n:r t"an(<), $un: U+u+()

E"+trta+ a"ral *anat, /a(<)

D. STAT#S &P'TA%M&%&$IS

&D &S

3



4

&D PEMERIKSAAN &S

()*++, Pr-yeki baik V+u+ /+)0+ 1/, P'234

T/a" /la"u"an Kor"+ T/a" /la"u"an

ra" !ola ata

Eno5t*alu+ (<)E@o5t*alu+ (<)

Stra!+u+ (<)

$ul!u+ O;ul

ra" !ola ata

Eno5t*alu+ (<)E@o5t*alu+ (<)

Stra!+u+ (<)

N:r t"an (<)

E/a (<)

5r+ (<)

Tr"a++ (<)

$l=aro+5a+ (<)

Lao5t*alu+ (<)

E"tro5on (<)

Entro5on (<)

%+u/o5to++ (<)

%al5!ra

N:r t"an (<)

E/a (<)

5r+ (<)

Tr"a++ (<)

$l=aro+5a+ (<)

Lao5t*alu+ (<)

E"tro5on (<)

Entro5on (<)

%+u/o5to++ (<)E/ (<)

Inj"+ "onjunt7a (<)

Inj"+ +lar (<)

$anunan 5atolo+ (<)

In=ltrat (<)

S"rt (<)

Conju;t7a

E/ (<)

Inj"+ "onjunt7a (<)

Inj"+ +lar (<)

$anunan 5atolo+ (<)

In=ltrat (<)

S"rt (<)

5r+ (<)

N:r t"an (<)

S;lra 5r+ (<)

N:r t"an (<)

$ulat, jrn*

E/ (<)

In=ltrat (<)

S"atr" (<)

Korna

$ulat,jrn*

E/ (<)

In=ltrat (<)

S"atr" (<)

Jrn*

K/alaan ;u"u5

5o5on (<)

=a (<)

Cara O;ul

Antror

Jrn*

K/alaan ;u"u5

5o5on (<)

=a (<)

Kr5ta (<)

Warna ;o"lat

E/a (<)

Sn"a (<)

Atro= (<)

Ir+

Kr5ta (<)

Warna ;o"lat

E/a (<)

Sn"a (<)

Atro= (<)Rulr

%etak entral

Datr 4

R=l"+ 5u5l L>TL (>)

%u5l

Rulr

Lta" +ntral

Datr 4

R=l"+ 5u5l L>TL (>)

Tampak keruh warna

putih paat

Ln+a Jrn*

Ta" /la"u"an

5r"+aan

Vtru+ Ta" /la"u"an

5r"+aan

Ta" /la"u"an

5r"+aan

Fun/u+ R=l"+ Ta" /la"u"an

5r"+aan

Ta" /la"u"an

5r"+aan

Rtna Ta" /la"u"an

5r"+aan

Noral 5r5al5a+ T"anan Intra O"ulr

/tal

Noral 5r5al5a+

Nat= T+ S*a/o- Nat=



E. RES#ME

Subjekti1

$r/a+ar"an anan+a //a5at"an 5a+n la"<la", u+a 60 ta*un, na"u ata

"anan tra+a "a!ur +ja" 6 !ulan S&RS. &ata "anann:a tra+a a/a !a:anan 5ut*

:an +a"n laa +a"n t!al +*na 5a+n +u/a* +ult untu" l*at atau

nnal -aja* oran +"tar 5a/a jara" /"at. %a+n jua na"u a/an:a "lu*an

=oto=o!a. %a+n !lu 5rna* !ro!at /rua* +a"t "arna "lanan 5a/a atan:a

n. %a+n na"u 5un:a r-a:at 5n:a"t /a!t+ lltu+ /an +rn "ontrol

!ro!at untu" ula /ara*nn:a. R-a:at *5rtn+ jua /a"u ol* 5a+n. S"rt,

traua 5a/a ata /an r-a:at o5ra+ 5a/a "/ua atan:a +ja" 6 !ulan :an lalu

jua /+an"al ol* 5a+n.

&bjekti1

%a/a 5r"+aan =+", //a5at"an 7+u+ OD 0>422 /nan 5ro:"+ !a". Ta5a"

""ru*an !r-arna 5ut* 5a/a ln+a OD. T+ +*a/o- nat=.

5. DIA$N&SIS BANDIN$

. Katara" +nl+ atur OD

. Katara" +nl+ atur OD

. Katara" +nl+ *5ratur OD

$. DIA$N&SIS KER6A

Katara" +nl+ atur OD

Da+ar /ano++

5



• Subjekti1 : %a+n !ruur 60 ta*un. %a+n nlu* ata "anan !ura +;ara

5rla*an<la*an. %nl*atan +5rt !r"a!ut. A/an:a "lu*an =oto=o!a. %a+n

l" r-a:at /a!t+ lltu+ +ja" 4 ta*un :an lalu.

• &bjekti1 : V+u+ ata "anan 0>422 /nan 5ro:"+ !a". Ta5a" ""ru*an 5a/a

"+luru*an ln+a, !r-arna 5ut*. T+ +*a/o- nat=.

Klo5o" /ano++ a/ala* ata tnan 7+u+ turun 5rla*an.

'. AN6#RAN PEMERIKSAAN PEN#N6AN$

. %r"+aan +lt la5

. %r"+aan =un/u+"o5

I. PENATA%AKSANAAN

. Kontrol lu"o+a /ara*

. %ro<o5ra+ IOL

6. PR&$N&SIS

OD OS

A/ 7ta a/ !ona a/ !ona

A/ =un+ona a/ !ona a/ !ona

A/ +anatona a/ !ona a/ !ona

6



TIN6A#AN P#STAKA

/.( De1inii Katarak

Katara" !ra+al /ar !a*a+a 'unan "atarr*a"+, Inr+ ;atara;t /an Latn ;atara;ta

:an !rart ar trjun. Dala !a*a+a n/on+a /+!ut !ular, /ana 5nl*atan +5rt

trtutu5 ar tjun. Katara" a/ala* +ta5 "a/aan ""ru*an 5a/a ln+a :an /a5at trja/

a"!at */ra+ (5na!a*an ;aran) ln+a, /natura+ 5rotn ln+a atau trja/ a"!at "/ua<

/uan:a.$a+an:a ""ru*an nna "/ua ata /an !rjalan 5ror+= atau5un /a5at t/a"

nala 5ru!a*an /ala -a"tu :an laa.

/./ Epiemi-l-!i

$r/a+ar"an /ata /ar World Health Organization (WO) 5a/a ta*un 1202, "atara"

ru5a"an "lanan ata :an n:!a!"an "!utaan /an anuan 5nl*atan :an

5aln +rn /tu"an +5rt tr;antu 5a/a a!ar / !a-a* n

7



$ambar (.

anuan 5nl*atan 5a/a 5o5ula+ /una nurut WO ta*un 1202

8



$ambar /.

%n:!a! tr!an:a" anuan 5nl*atan /an "!utaan nurut WO ta*un 1202.

$r/a+ar"an *a+l +tu/ ;ro++ +;tonal, //a5at"an /ata !a*-a an"a 5r7aln+ 5a/a

"atara" +!+ar B2 5a/a u+a 6B ta*un, /an nn"at +"tar 2 5a/a u+a /ata+ B

ta*un. Dan t/a" a/a 5r!/aan !ra"na antara la"<la" /an 5r5uan.

/.* Eti-l-!i an 5akt-r Riik-

A. %ro++ %nuaan

Sa"n tua ln+a, ln+a a"an nala 5nn"atan !rat /an 5n!alan ln+a

+rta 5nuranan ""uatan a"oo/a+. %a/a la5+an nu"lu+ /ar ln+a a"an nala

"o5r+ /an 5nra+an :an "ta "nal +!aa nu;lar +;lro++. %a/a 5ro++ 5nuaan

jua trja/ ara+ 5rotn 5a/a ln+a :an na"!at"an a/an:a 5n*a!uran ;a*a:a

/an *lann:a tran+5aran+ ln+a. Slan tu 5a/a 5ro++ 5nuaan jua trja/ 5ru!a*an

"a- 5a/a ln+a :an na"!at"an trja/n:a 5na!a*an 5nta+ 5a/a nu;lar

ln+a :an na"!at"an ln+a !ru!a* -arna nja/ "unn atau ;o"lat ++ua /nan

5na!a*an u+a.

9



$. nt"

nt" //ua +!aa =a"tor r+"o :an ;u"u5 !+ar /ala 5n-ar+an "atara".

Dana 5a/a "atara" "ort"al /a5at n-ar+"an l!* /ar B2 "5a/a "turunann:a /an

*al n //ua a/an:a 7ara+ /ala 0 lo;u+ n. %a/a "atara" nu;lar /"ata"an /a5at

n-ar+ on:a"tn:a n +"tar 4B<B2 5n:a"tn:a 5a/a "turunann:a. Fa"tor

"turunan 5ntn +"al untu" "ta "ta*u aar "ta /a5at nuran 5ror+=ta+ /ar

5n:a"t "atara" atau n;a* 5n:a"t "atara" n.

C. O!at<o!atan

%nunaan o!at +5rt "ort"o+tro/, 5*notan, ot;, ao/aron /an +tatn

/"ata"an /a5at na"!at"an a/an:a 5ru!a*an 5a/a ln+a ata /an a/an:a /5o+t

5n 5a/a ln+a. Slan tu, 5nunaan o!at tr+!ut /"ata"an /a5at nn"at"an

""ru*an 5a/a ln+a. %ru!a*an ln+a :an /a"!at"an ol* o!at n trantun /ar

5a"aan +rta /o++ /an /ura+ 5a"aan o!at tr+!ut.

D. Traua

Katara" trauat" 5aln +rn "arna ;/ra !n/a a+n " ln+a atau traua

tu5ul 5a/a !ola ata. %luru +na5an ann /an "!an a5 a/ala* 5n:!a! +rn 5a/a

"a+u+ n. %n:!a! :an "uran +rn a/ala* 5ana*, !atu, ar, o7r@5o+ur 5ana+

(G"atara" la++!lo-rG), /an ra/a+ 5non. S!aan !+ar "atara" trauat" /a5at /;a*.

Dala !/an n/u+tr, u"uran "aanan tr!a" a/ala* +5a+an "a;aata 5naan. Ln+a

/a5at nja/ 5ut* +"t"a "t"a a+u"n:a !n/a a+n, "arna a/an:a anuan /ar

"a5+ul ln+a a"a +anat un"n +"al *uor a"uo+ /an 7trou+ n!u+ " /ala

+tru"tur ln+a.

E. %n:a"t S+t"

Katara" +rn"al /"at"an /nan 5n:a"t ++t" +5rt /a!t+ lltu+,

ala"to+a,*5o"al+a, oton; /:+tro= /an ato5; /ratt+.

/.7 Pat-1ii-l-!i

10



%ato=+olo "atara" +nl+ +anat "o5l"+ /an !lu +5nu*n:a /"ta*u.

D/ua a/an:a ntra"+ antara !r!aa 5ro++ =+olo+ !r5ran /ala trja/n:a "atara"

+nl+ /an !lu +5nu*n:a /"ta*u. Sa"n !rta!a* u+a ln+a, a"a a"an +a"n

t!al /an !rat +ntara /a:a a"oo/a+n:a +a"n la*. Ko5onn tr!an:a"

/ala ln+a a/ala* ar /an 5rotn. Dnan nja/ tuan:a ++oran a"a ln+a ata a"an

""uranan ar /an nja/ l!* 5a/at. Ln+a a"an nja/ 5a/at / !aan tna*n:a,

+*na "a5uan =o"u+ untu" l*at !n/a /"at !r"uran. %a/a u+a tua a"an trja/

5!ntu"an la5+an "ort"al :an !aru 5a/a ln+a :an na"!at"an nu"lu+ ln+a

tr/+a" /an nra+ (+"lro++ nu"lar). %a/a +aat n trja/ 5ru!a*an 5rotn ln+a :atu

tr!ntu"an:a 5rotn /nan !rat ol"ul :an tn /an na"!at"an 5ru!a*an n/"+

r=ra"+ ln+a +*na antul"an +nar a+u" /an nuran tran+5aran+ ln+a. %ru!a*an

"a n jua /"ut /nan 5!ntu"an 5n 5a/a nu"lar ln+a.

%a/a "a/aan noral ln+a ata !r+=at !nn. Srn /nan 5rta!a*an u+a

ln+a ata /a5at nala 5ru!a*an -arna nja/ "unn "ru* atau ;o"lat "ru*.

%ro++ n /a5at n:!a!"an anuan 5nl*atan (5an/anan "a!ur>!ura) 5a/a

++oran. K"ru*an ln+a na"!at"an ln+a t/a" tran+5aran +*na 5u5l !r-arna

5ut* /an a!u<a!u. K"ru*an n jua /a5at /tu"an 5a/a !r!aa lo"al+a+ / ln+a

+5rt "ort"+ /an nu"lu+. Fun/u+ o"ul nja/ +a"n +ult /l*at +rn /nan

+a"n 5a/atn:a ""ru*an ln+a !a*"an ra"+ =un/u+ !+a *lan +aa +"al. &o5a

tn, ro"o", "on+u+ al"o*ol /an 5a5aran +nar UV :an tn nja/ =a"tor r+"o

5r"!anan "atara" +nl+.

/.8 Klai1ikai Katarak

a. Katarak Perkemban!an)pertumbuhan

Katara" "onntal /an ju7nl /+!ut jua "atara" 5r"!anan>5rtu!u*an"arna +;ara !olo" +rat ln+a a+* /ala 5r"!anann:a. K"ru*an

+!aan 5a/a ln+a :an +u/a* //a5at"an 5a/a -a"tu la*r uun:a t/a"

lua+ /an jaran +"al na"!at"an "ru*n:a +luru* ln+a. Lta"

""ru*an trantun 5a/a +aat ana trja/ anuan 5a/a "*/u5an jann.

Katara" "onntal tr+!ut /a5at /ala !ntu" "atara" lalar atau onular,

"atra" 5olar+ 5o+tror (5ra/al+ 5o+tror, "utu! 5o+tror), 5olar+ antror

(5ra/al+ antror, "utu! antror), "atra" nt ("atara" nu"lar+), /an "atra"

+utural.

11



• Katarak %amelar atau 9-nular

D /ala 5r"!anan !rolo" 5rulaan tr/a5at 5r"!anan

+rat ln+a a"a a"an trl*at !aan ln+a +ntral :an l!* jrn*.

Ku/an tr/a5at +rat ln+a "ru* /ala "a5+ul ln+a. K"ru*an

!r!ata+ ta+ /nan !aan 5r=r tta5 !nn. Katara" lalar n

5un:a +=at *r/tr /an /tran++ +;ara /onan, "atara"

!a+an:a !latral.

Katara" onular trl*at +ra ++u/a* !a: la*r. K"ru*an /a5at

nutu5 +luru* ;la* 5u5l, !la t/a" /la"u"an /lata+ 5u5l +rn

/a5at nanu 5nl*atan.

anuan 5nl*atan 5a/a "atara" onular trantun 5a/a /rajat

""ru*an ln+a. $la ""ru*an +anat t!al +*na =un/u+ t/a" /a5at

trl*at 5a/a 5r"+aan o=talo+"o5 a"a 5rlu /la"u"an a+5ra+ /an

ra+ ln+a.

• Katarak P-lari P-teri-r

Katara" 5olar+ 5o+tror /+!a!"an nta5n:a +lu!un 7a+"ular ln+a.

Ka/an<"a/an tr/a5at artr *alo/ :an nta5 +*na

na"!at"an ""ru*an 5a/a ln+a !aan !la"an. %no!atann:a

/nan la"u"an 5!/a*an ln+a.

• Katarak P-lari Anteri-r

anuan trja/ 5a/a +aat "orna !lu +luru*n:a l5a+"an ln+a

/ala 5r"!anan !ronal. al n jua na"!at"an trla!atn:a

5!ntu"an !l" ata /5an 5a/a 5r"!anan !ronal. %a/a

"lanan :an tr/a5at / /ala !l" ata /5an :an nuju "orna

+*na 5rl*at"an !ntu" ""ru*an +5rt 5ra/. Katara"

5olar+ antror !rjalan t/a" 5ror+=.

%no!atan +anat trantun "a/aan "lanan. $la +anat nanu

taja 5nl*atan atau t/a" trl*atn:a =un/u+ 5a/a 5r"+aano=talo+"o5 a"a /la"u"an 5!/a*an.

• Katarak Nuklear

Katara" +a;a n jaran /tu"an /an ta5a" +!aa !una "aran.

K"ru*an trlta" / /ara* nu"lu+ ln+a. Srn *an:a ru5a"an

""ru*an !r!ntu" tt"<tt".

anuan trja/ 5a/a -a"tu "*alan 4 !ulan 5rtaa. $a+an:a

!latral /an !rjalan t/a" 5ror+=, !a+an:a *r/tr /an !r+=at

/onan. T/a" nanu taja 5nl*atan.

12



%no!atan, !la t/a" nanu taja 5nl*atan a"a t/a"

rlu"an tn/a"an.

• Katarak Sutural

Katara" +utural ru5a"an ""ru*an ln+a 5a/a /ara* +utura =tal,

!r+=at +tat+, trja/ !latral /an =alal.Karna lta" ""ru*an n t/a" t5at nna /a 5nl*atan a"a

a t/a" a"an nanu 5nl*atan. $a+an:a t/a" /la"u"an tn/a"an.

b. Katarak 6uenil

Katara" ju7nl ru5a"an "atara" :an trja/ 5a/a ana"<ana" ++u/a* la*r

:atu ""ru*an ln+a :an trja/ 5a/a +aat a+* trja/ 5r"!anan +rat<

+rat ln+a +*na !a+an:a "on++tn+n:a l!" +5rt !u!ur /an /+!ut

+!aa +o=t ;atara;t. $a+an:a "atara" ju7nl ru5a"an !aan /ar +uatu jala

5n:a"t "turunan lan.%!/a*an /la"u"an !la "atara"n:a /5r"ra"an a"an n!ul"an

a!lo5a.

Tn/a"an untu" 5r!a" taja 5nl*atan ala* 5!/a*an. %!/a*an

/la"u"an !la taja 5nl*atan +/ua* nanu 5"rjaan +*ar<*ar. a+l

tn/a"an 5!/a*an +anat !rantun 5a/a u+a 5n/rta, !ntu" "atara"

a5a"a* nna +luru* ln+a atau +!aan ln+a a5a"a* /+rta "lanan lan

5a/a +aat t!uln:a "atara", a"n laa ln+a nutu5 /a 5nl*atan

na!a* "un"nan a!lo5a.;. Katarak Senil

%ru!a*an :an ta5a" ala* !rta!a* t!aln:a nu"lu+ /nan !r"!ann:a

la5+an "ort"+ ln+a. S;ara "ln+, 5ro++ "tuaan ln+a +u/a* ta5a" +ja"

trja/ 5nuranan ""uatan a"oo/a+ ln+a a"!at ula trja/n:a +"lro++

ln+a :an t!ul 5a/a u+a /"a/ 3 /ala !nu" "lu*an 5r+!o5a.

D"nal 4 !ntu" "atara" +nl, :atu "atara" nu"lar, "ort"al, /an "u5ul=or.

• Katarak Nuklear

Int ln+a /-a+a +laa */u5 !rta!a* !+ar /an nja/ +"lrot".

Laa "laaan nt ln+a :an ulan:a nja/ 5ut* ""unnan

nja/ ;o"lat /an "u/an nja/ "*taan. Ka/aan n /+!ut

"atara" !run+n atau nra.

• Katarak K-rtikal

%a/a "atara" "ort"al trja/ 5n:ra5an ar +*na ln+a nja/

;!un /an trja/ o5+a+ a"!at 5ru!a*an n/"+ r=ra"+ ln+a.

%a/a "a/aan n 5n/rta +a"an<a"an n/a5at"an ""uatan !aru untu"

l*at /"at 5a/a u+a :an !rta!a*.

• Katarak Kupuli1-rm

13



Katara" "u5ul=or /a5at trl*at 5a/a +ta/u /n "atara" "ort"al atau

nu"lar. K"ru*an /a5at trl*at / la5+ "ort"+ 5o+tror /an /a5at

!r"an a!aran 5rn. &a"n /"at lta"n:a tr*a/a5 "a5+ul

a"n ;5at !rta!a*n:a "atara". Katara" n +rn +u"ar /!/a"an

/nan "atara" "o5l"ata.

Katara" Snl /a5at /!aa ata+ 3 Sta/u

(4 Katarak Inipien

K"ru*an :an t/a" tratur +5rt !r;a"<!r;a" :an !ntu" r

/a+ar / 5r=r /an /ara* jrn* !ntu" r /nan /a+ar

/ 5r=r /an /ara* jrn* / antaran:a. K"ru*an !a+an:a

tlta" / "ort"+ antror atau 5o+tror. K"ru*an n 5a/a

uun:a *an:a ta5a" !la 5u5l /l!ar"an.

%a/a +ta/u n tr/a5at "lu*an 5olo5a "arna n/"+ r=ra"+

:an t/a" +aa 5a/a +ua !aan ln+a. $la /la"u"an uj

!a:anan r+ a"an 5o+t=.

/4 Katarak Imatur

%a/a +ta/u :an l!* lanjut, trja/ ""ru*an :an l!* t!al tta5 t/a" atau

!lu nna +luru* ln+a +*na a+* tr/a5at !aan<

!aan :an jrn* 5a/a ln+a.

%a/a +ta/u n trja/ */ra+ "ort"+ :an na"!at"an

ln+a nja/ !rta!a* ;!un. %n;!unan ln+a n

a"an !r"an 5ru!a*an n/"+ r=ra"+ /ana ata a"an

nja/ o5". K;!unan n a"an na"!at"an

5n/oronan r+ " /5an +*na !l" ata /5an a"an l!* +5t.

%a/a +ta/u ntun+n n a"an u/a* trja/ 5n:ult lau"oa. Uj !a:anan

r+ 5a/a "a/aan n 5o+t=.

*4 Katarak Matur

$la 5ro++ /nra+ !rjalan tru+ a"a a"an trja/ 5nluaran ar !r+aa<

+aa *a+l /+ntra+ lalu "a5+ul. D /ala +ta/u n

ln+a a"an !ru"uran noral. Ir+ t/a" tr/oron " /5an

/an !l" ata /5an a"an 5un:a "/alaan noral

14



"!al. Ka/an 5a/a +ta/u n trl*at ln+a !r-arna +anat 5ut* a"!at

5r"a5uran n:luru* "arna /5o+t "al+u. $la /la"u"an uj !a:anan r+

a"an trl*at nat=.

74 Katarak 'ipermatur&ru5a"an 5ro++ /nra+ lanjut ln+a +*na

"ort"+ n"rut /an !r-arna "unn. A"!at

5nr5utan ln+a /an n;arn:a "ort"+, nu"lu+ ln+a

tnla " ara* !a-a* ("atara" oran). Ln+a :an

n;l a"an na"!at"an !l" ata nja/ /ala.

Uj !a:anan r+ !r"an a!aran 5+u/o5o+t=.

A"!at a+a ln+a :an "luar lalu "a5+ul ln+a /a5at n!ul"an 5n:ult

!ru5a u7t+ =a"oto"+" atau lau"o =a"olt".

%r!/aan Sta/u Katara" Snl+

Inipien Imatur Matur 'ipermatur

Kekeruhan Rnan S!aan Sluru* &a+=

"airan %ena Noral $rta!a* Noral $r"uran

Iri Noral Tr/oron Noral Trulan+

Bilik Mata Depan Noral Dan"al Noral Dala

Suut Bilik Mata Noral S5t Noral Tr!u"a

Sha-w Tet Nat= %o+t= Nat= %+u/o5o+t=

Penyulit < lau"oa < U7t+ lau"oa

. Katarak K-mplikata

%n:a"t ntrao"ular atau 5n:a"t / !aan tu!u* :an lan /a5at n!ul"an"atara" "o5l"ata. %n:a"t ntrao"ular :an +rn n:!a!"an ""ru*an

5a/a ln+a ala* r/o+"lt+, lu"oa, a!la+ rtna, o5a tn /an lan<lan.

$a+an:a "lanan tr/a5at 5a/a +atu ata.

%a/a u7t+, "atara" t!ul 5a/a +u!"a5+ul 5o+tror a"!at anuan

ta!ol+ ln+a !aan !la"an. K"ru*an jua /a5at trja/ 5a/a t5at r+

l"at /nan ln+a (+n"a 5o+tror) :an /a5at !r"!an nna

+luru* ln+a.

15



lau"oa 5a/a +aat +ranan a"ut /a5at na"!at"an anuan "+!anan

;aran ln+a +u!"a5+ul antror. $ntu" ""ru*an n !ru5a tt"<tt" :an

tr+!ar +*na /naa"an "atara" 5untata +u!"a5+ular /+nata antror

atau /a5at /+!ut nurut 5nun:a "atara" Vot. Katara" n !r+=at

r7r+!l /an /a5at *lan !la t"anan !ola ata +u/a* tr"ontrol.

A!la+o /an o5a tn jua /a5at n!ul"an "atara" "o5l"ata. %a/a

"atara" "o5l"ata :an nna +atu ata /la"u"an tn/a"an !/a* !la

""ru*ann:a +u/a* nna +luru* !aan ln+a atau !la 5n/rta

rlu"an 5nl*atan !no"ular atau "o+t".

Jn+ tn/a"an :an /la"u"an "+tra"+ lnar atau "+tra"+ ln+a "+tra"a5+ular.

Ir/"to total l!* !a" /la"u"an /ar 5a/a r/"to 5r=r.

Katara" :an !r*u!unan /nan 5n:a"t uu nna "/ua ata,

-alau5un "a/an<"a/an t/a" !r+aaan. Katra" n !a+an:a !t!ul 5a/a u+a

:an l!* u/a. Klanan uu :an /a5at n!ul"an "atara" a/ala*

/a!t+ ltu+, *5o5aratro/, otona /+tro=a, ttan n=antl /an lan<lan.

Da!t+ ltu+ n!ul"an "atara" :an !r"an a!aran "*a+ :atu

""ru*an :an tr+!ar *alu+ +5rt t!aran "a5a+ / /ala a+a ln+a.

%a/a *5o5aratro/ a"an trl*at ""ru*an :an ula 5a/a /ataran !la"an

ln+a, +/an 5a/a 5n:a"t uu lan a"an trl*at tan/a /nra+ 5a/a ln+a

:an nna +luru* la5+ ln+a.

%no!atan 5a/a "atara" "o5l"atan /la"u"an !la +u/a* nanu

5"rjaan +*ar<*ar.

Katara" 5a/a 5a+n /a!t+ lltu+ /a5at trja/ /ala ta !ntu" :atu

< %a+n /nan /*/ra+ !rat, a+/o++ /an *5rl"a :an n:ata. %a/a

ln+a a"an trl*at ""ru*an !ru5a ar+ a"!at "a5+ul ln+a !r"rut. $la

/*/ra+ laa a"an trja/ ""ru*an ln+a, ""ru*an a"an *lan !la

trja/ r*/ra+ /an "a/ar ula noral "!al.

< %a+n /a!t+ ju7nll /a tua t/a" tr"ontrol. Katara" a"antrja/ +rnta"

5a/a "/ua ata /ala 3? ja, !ntu" /a5at +no- =la" atau !ntu" 5rn

+u!"a5+ulr.

< Katara" 5a/a 5a+n /a!t+ /-a+a. a!aran +;ara *+tolo" /an

!o"a +aa /nan "atara" 5a+n non /a!t".

Katarak Diabete Sejati

16



%a/a /a!t+ ju7nl :an 5ara* "a/an<"a/an t!ul "atara" !latral +;ara a"ut.

Ln+a un"n nja/ o5a" total +laa !!ra5a nu.%a/a ln+a a"an trl*at

""ru*an t!aran +alju +u!"a5+ulr :an +!aan jrn* /nan 5no!atan.

Katarak Senilli paa Paien Diabete

%a/a 5n/a5 /a!t+, +"lo++ nu"lar +nll+, "lanan +u!"a5+ulr 5o+tror, /an

""ru*an "ort"+ trja/ l!* +rn /an l!* /n.Tra5 :an /!r"an 5a/a

5a+n /a!t+ ltu+ /nan "o5l"a+ "atara" a/ala* "ontrol "a/ar ula /ara*

/an !/a* "atara". $/a* "atara" !rtujuan untu" nan"at ln+a /nan 5ro+/ur

ntra"a5+ular /an "+tra"a5+ular.

e. Katarak Sekuner

Katara" +"un/r atau +rn /+!ut a=tr ;atara;t :atu "atara" :an t!ul

!!ra5a !ulan +tla* "+tra"+ "atara" "+ta"a5+ular atau +tla* ul+="a+

=a"oH !ru5a 5n!alan "a5+ul 5o+tror 5rol=ra+ +l<+l ra/an 5a/a ++a<++a

"ort"+ :an trtnal. $la nanu taja 5nl*atan 5n!alan tr+!ut

/!u"a /nan +a:atan +nar la+r, a"a alat N/. 'A la+r.

1. Katarak Trauma

K"ru*an ln+a a"!at ru/a 5a"+a atau "atara" traua/a5at trja/ a"!at ru/a

5a"+a tu5ul atau taja. Ru/a 5a"+a n /a5at n"!at"an "atara" 5a/a +atu

ata atau ono"ular "atara".

%no!atan 5a/a "atara" traua !la t/a" tr/a5at 5n:ult /a5at /tunu

+a5a ata nja/ tnan. %n:ult :an /a5at trja/ /a5at /ala !ntu"

lau"oa ln+a :an n;!un atau u7t+ a"!at ln+a "luar lalu "a5+ul

ln+a.

/.0 Mani1etai Klini

%nl*atan :an !ran+ur<an+ur !uru" atau !r"uran /ala !!ra5a !ulan

atau ta*un ru5a"an jala utaa /ar "atara". $!ra5a oran *an:a ra+a"an

5nl*atan r/u5 5a/a +atu ata. Da5at +aja "lu*an n +a"an<a"an l*at lalu =l

(ta!r) :an nutu5 ata, "lu*an !ru5a +lau / t5at tran, atau 5nl*atan "uran

!la nn/ara "n/araan n*a/a5 +nar :an /atan / ala *ar.

S;ara uu /a5at /a!ar"an jala "atara" a/ala* +!aa !r"ut

17



a. %nl*atan "a!ur /an !r"a!ut

!. Foto=o!a

;. %nl*atan an/a

/. K+ultan l*at / -a"tu ala

. Srn !rant "a;aata

=. %rlu 5nranan l!* tran untu" !a;a

. S5rt a/a tt" la5 //5an ata

/.< Penatalakanaan

&+" tla* !an:a" u+a*a :an /la"u"an untu" 5rla!at 5ror+7ta+ atau

n;a* trja/n:a "atara", tatala"+ana a+* tta5 /nan 5!/a*an. T/a" 5rlu

nunu "atara" nja/ atan. Dla"u"an t+ untu" nntu"an a5a"a* "atara"

n:!a!"an jala 7+ual +*na nurun"an "ualta+ */u5. %a+n un"n

nala "+ultan /ala nnal -aja*, !a;a, atau nu/. $!ra5a 5a+n

+anat tranu ol* ra+a +lau. %a+n /!r"an n=ora+ nna 5rono++ 7+ual

r"a /an *aru+ /!rta*u 5ula nna +ua 5n:a"t ata :an trja/ !r+aaan

:an !a+ 5naru* *a+l 5!/a*an "atara".

A. N-n Meikament-a

0. Tra5 %n:!a! Katara"

%nontrolan /a!t+ ltu+, n*nt"an "on+u+ o!at<o!atan :an !r+=at

"atara"ton" +5rt "ort"o+tro/, =nota+n, /an ot" "uat, n*n/ar

ra/a+ (n=ra ra* atau +nar<) /a5at 5rla!at atau n;a*

trja/n:a 5ro++ "atara"ton++. Slan tu 5nananan l!* a-al /an a/"uat

5a/a 5n:a"t ata +5rt u7t+ /a5at n;a* trja/n:a "atara"

"o5l"ata.

1. &5rla!at %ror+7ta+

$!ra5a 5r5arat :an nan/un "al+u /an "alu /una"an 5a/a

"atara" +ta/u /n untu" 5rla!at 5ror+7ta+n:a, naun +a5a

+"aran "an+ "rjan:a !lu jla+. Slan tu jua /+!ut"an 5ran

7tan E /an a+5rn /ala 5rla!at 5ro++ "atara"ton++.

4. %nlaan tr*a/a5 %r"!anan V+u+ 5a/a Katara" n+5n /an Iatur

a. R=ra"+H /a5at !ru!a* +anat ;5at, +*na *aru+ +rn /"or"+.

!. %naturan 5n;a*a:aanH 5a+n /nan ""ru*an / !aan 5r=r ln+a

(ara 5u5l a+* jrn*) /a5at /n+tru"+"an nuna"an 5n;a*a:aan

18



:an tran. $r!/a /nan ""ru*an 5a/a !aan +ntral ln+a, ;a*a:a

ran :an /t5at"an / +a5n /an +/"t / !la"an "5ala 5a+n

a"an !r"an *a+l tr!a".

!. %nunaan "a;aata la5H 5a/a 5a+n /nan ""ru*ann ln+a / !aan

+ntral, *al n a"an !r"an *a+l :an !a" /an n:aan a5anla

!ra"t7ta+ / luar ruanan.

;. &/ratlH /lata+ 5u5l a"an !r"an =" 5o+t= 5a/a lataral a"+al

/nan ""ru*an :an +/"t. &/ratl +5rt =nl=rn B atau tro5"a/

0 /a5at !r"an 5nl*atan :an jla+.

B. &perati1

%!/a*an "atara" a/ala* 5nan"atan ln+a natural ata (ln+a "r+taln) :an

tla* nala ""ru*an, :an /+!ut +!aa "atara". Inikai

In/"a+ 5natala"+anaan !/a* 5a/a "a+u+ "atara" n;a"u5 n/"a+ 7+u+,

/+, /an "o+t".

0. In/"a+ 7+u+H ru5a"an n/"a+ 5aln +rn. In/"a+ n !r!/a 5a/a ta5

n/7/u, trantun /ar anuan :an /t!ul"an ol* "atara" tr*a/a5

a"t7ta+ +*ar<*arn:a.

1. In/"a+ /+H 5a+n !+a +aja ra+a t/a" tranu /nan ""ru*an 5a/a

ln+a atan:a, naun !!ra5a n/"a+ /+ /la"u"an o5ra+ "atara" +5rt

lau"oa !a+ ln+a (lens-induced glaucoma), n/o=talt+ =a"oana=la"t",

/an "lanan 5a/a rtna +aln:a rtno5at /a!t" atau a!la+o rtna.

4. In/"a+ "o+t"H 5a+n /nan 7+u+ nol nta "+tra"+ "atara"

(+"5un ta/a *ara5an untu" n!al"an 7+u+), untu" 5rol* 5u5l

:an *ta.

Jeni3jeni -perai katarak :

(. Pha;-emuli1i;ati-n 2Pha;-4

L"u="a+ ln+a nuna"an 5ro! ultra+onora= :an /a+u""an

lalu n++ :an l!* ";l / "orna atau +"lra antror (1<B ) /nan

nuna"an taran<taran ultra+on". $a+an:a t/a" /!utu*"an

5nja*tan. T"n" n !ran=aat 5a/a "atara" "onntal, trauat", /an

"!an:a"an "atara" +nl+. T"n" n "uran ="t= 5a/a "atara" +nl+

:an 5a/at, /an "untunan n++ l!u+ :an ";l aa" !r"uran "alau

a"an /a+u""an ln+a ntrao"ulr, +"5un +"aran l!* +rn

/una"an ln+a ntrao"ulr =l"+!l :an /a5at /a+u""an lalu n++

";l +5rt tu. &to/ n ru5a"an to/ 5l*an / Nara $arat.

19



/. Small In;ii-n "atara;t Sur!ery 2SI"S4

In++ /la"u"an 5a/a +"lra /nan u"uran n++ !r7ara+ /ar B<? .

Naun tta5 /"ata"an SICS +ja" /+n ar+t"n:a tan5a ja*tan,

%nutu5an lu"a n++ trja/ /nan +n/rn:a (+l=<+aln). T"n" o5ra+

n /a5at /la"u"an 5a/a +ta/u "atara" atur, atur, /an

*:5ratur. T"n" n jua tla* /la"u"an 5a/a "a+u+ lau"oa =a"olt"

/an /a5at /"o!na+"an /nan o5ra+ tra!"ul"to.

*. E=tra;apular "atara;t E=tra;ti-n 2E""E4

In++ lua+ 5a/a 5r=r "orna atau +"lra antror (!a+an:a 02<01 ),

!aan antror "a5+ul /5oton /an /an"at, nu"lu+ /"+tra"+, /an

"ort"+ ln+a /!uan /ar ata /nan ra+ /nan atau tan5a a+5ra+,

+*na n:+a"an "a5+ul 5o+tror. In++ *aru+ /ja*t. &to/ n

/n/"a+"an 5a/a 5a+n /nan "atara" :an +anat "ra+ atau 5a/a

"a/aan /ana a/a a+ala* /nan =a"oul+="a+. %n:ult :an /a5at

t!ul a/ala* tr/a5at "ort"+ ln+a :an /a5at n:!a!"an "atara"

+"un/r.

7. Intra;apular "atara;t E=tra;ti-n 2I""E4

%ro+/ur n l" tn"at "o5l"a+ :an +anat tn +!a!

!utu*"an n++ :an lua+ /an t"anan 5a/a 7trou+. Tn/a"an n +u/a*

jaran /una"an trutaa 5a/a nara<nara :an tla* l" 5ralatan

o5ra+ "ro+"o5 /an alat /nan t"nolo tn lann:a.

8. %ena Intra-kular

Stla* 5nan"atan "atara", ln+a ntrao"ular (IOL) !a+an:a

/5lanta+"an " /ala ata. K"uatan 5lan IOL :an a"an /una"an

/ala o5ra+ /*tun +!lun:a /nan nu"ur 5anjan ata +;ara

ultra+on" /an /nan "ln"unan "orna (a"a jua ""uatan o5t")

+;ara o5t". K"uatan ln+a uun:a /*tun +*na 5a+n t/a" a"an

!utu*"an "a;aata untu" 5nl*atan jau*. %l*an ln+a jua/5naru* ol* r=ra"+ ata "ontrolatral /an a5a"a* tr/a5at "atara" 5a/a

ata tr+!ut :an !utu*"an o5ra+.

/.> K-mplikai

Ko5l"a+ o5ra+ /a5at !ru5a "o5l"a+ 5ro5rat=, ntrao5rat=, 5o+to5rat=

a-al, 5o+to5rat= lanjut, /an "o5l"a+ :an !r"atan /nan ln+a ntra o"ular (intra

ocular lens, IOL).

A. K-mplikai pre-perati1

20



0. An+ta+H !!ra5a 5a+n /a5at nala ";a+an (an+ta+) a"!at

"ta"utan a"an o5ra+. An anxiolytic +5rt /a5a 1<B /a5at

5r!a" "a/aan.

1. Nau+a /an a+trt+H a"!at =" o!at 5ro5ra+ +5rt a+taola/ /an>atau

l+rol. Ka+u+ n /a5at /tanan /nan 5!ran anta+/a oral untu"

nuran jala.

4. Konjunt7t+ rtat= atau alrH /+!a!"an ol* tt+ ant!ot" to5;al

5ro5rat=, /tanan /nan 5nun/aan o5ra+ +laa 1 *ar.

3. A!ra+ "ornaH a"!at ;/ra +aat 5r"+aan t"anan !ola ata /nan

nuna"an tonotr S;*ot. %nananann:a !ru5a 5!ran +al5

ant!ot" +laa +atu *ar /an /5rlu"an 5nun/aan o5ra+ +laa 1 *ar.

B. K-mplikai intra-perati1

0. La+ra+ . r;tu+ +u5rorH /a5at trja/ +laa 5ro++ 5nja*tan.1. %r/ara*an *!atH /a5at trja/ +laa 5r+a5an conjunctival fla atau +laa

n++ " !l" ata /5an.

4. C/ra 5a/a "orna (ro!"an !ran D+;t), r+, /an ln+aH /a5at trja/

a"!at n+trun o5ra+ :an taja +5rt "rato.

3. C/ra r+ /an r/o/al++ (trl5a+n:a r+ /ar a"arn:a)

B. L5a+> *lann:a 7trou+H ru5a"an "o5l"a+ +ru+ :an /a5at trja/

a"!at ru5tur "a5+ul 5o+tror (accidental ruture) +laa t"n" ECCE.

". K-mplikai p-t-perati1 awal

Ko5l"a+ :an /a5at trja/ +ra +tla* o5ra+ tra+u" *=a, 5rola5+ r+,

"rato5at +trata, u7t+ antror 5o+to5rat=, /an n/o=talt+ !a"tral.

D. K-mplikai p-t-perati1 lanjut

!ystoid "acular #dema (!"#), $elayed !hronic %ostoerative endohtalmitis,

%seudoha&ic 'ullous eratoathy (%'), a!la+o rtna, /an "atara" +"un/r

ru5a"an "o5l"a+ :an /a5at trja/ +tla* !!ra5a -a"tu 5o+t o5ra+.

E. K-mplikai yan! berkaitan en!an I&%

I5lanta+ IOL /a5at n:!a!"an "o5l"a+ +5rt uveitis-glaucoma-hyhema

syndrome (*H syndrome), al5o++ IOL, /an +n/ro ln+a to"+" (toxic lens syndrome).

/.? Pen;e!ahan

Katara" /a5at /;a*, /antaran:a /nan njaa "a/ar ula /ara* +lalu noral

5a/a 5n/rta /a!t+ lltu+, +nanta+a njaa "+*atan ata, n"on+u+

a"anan :an /a5at ln/un "lanan /nrat7 5a/a ata /an anto"+/an +5rt

!ua*<!ua*an !an:a" :an na/un 7tan C, n:a" +a:uran, +a:uran *jau, "a;an<

"a;anan, a"anan :an na/un 7tan E.

21



Vtan C /an E /a5at 5rjla+ 5nl*atan, /ana "/uan:a ru5a"an

anto"+/an :an /a5at nal+a+ "ru+a"an o"+/at= 5a/a ata, :an ru5a"an

+ala* 5n:!a! "atara". a+l 5nltan :an /la"u"an tr*a/a5 4.222 oran /-a+a +laa

la ta*un nunju"an, oran /-a+a :an n"on+u+ ult7tan atau +u5ln lan

:an nan/un 7tan C /an E +laa l!* /ar 02 ta*un, trn:ata r+"o tr"na

"atara" 62 l!* ";l.

a+l 5nltan lann:a :an /la"u"an ol* =ar/a (099?<0999) nunju"an,

a+:ara"at :an 5ola a"ann:a "uran r!o=la7n ($1) !r+"o tn tr+ran "atara".

&nurut =ar/a, r!o=la7n 5naru* a"t7ta+ n glutation redu&tase. En n

!r=un+ n/aur ulan glutation tro"+/a+ nja/ lutaton tr/u"+, aar tta5

ntral"an ra/"al !!a+ atau o"+n.

/.(+ Pr-!n-i

Dnan t"n" !/a* :an uta"*r, "o5l"a+ atau 5n:ult nja/ +anat jaran.

a+l 5!/a*an :an +anat !a" /a5at n;a5a 9B. %a/a !/a* "atara" r+"o n

nja/ +anat ";l /an jaran trja/. K!r*a+lan tan5a "o5l"a+ 5a/a 5!/a*an

/nan ECCE atau =a"oul+="a+ njanj"an 5rono++ /ala 5nl*atan nn"at

*na 1 ar+ 5a/a 5r"+aan /nan nuna"an +nlln ;*art.

DA5TAR P#STAKA

0) Kan+" JJ, $o-ln $. Cln;al o5*t*alolo: a +:+t; a55roa;*. t* /.

Unt/ Kn/o El+7rH 1200.

1) E7a %R, W*t;*r J%. Vau*an A+!ur:M+ nral o5*t*alolo:. 0t* /.

Unt/ Kn/o &;<ra- llH 122.

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