{"id":8091,"date":"2016-01-21T10:57:07","date_gmt":"2016-01-21T09:57:07","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/?page_id=8091"},"modified":"2021-06-23T14:38:00","modified_gmt":"2021-06-23T13:38:00","slug":"cataracte-glaucome-et-greffe-de-cornee","status":"publish","type":"page","link":"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/cataracte-glaucome-et-greffe-de-cornee\/","title":{"rendered":"Cataracte, glaucome et greffe de corn\u00e9e"},"content":{"rendered":"<p style=\"text-align: right;\"><a href=\"https:\/\/www.chu-poitiers.fr\/page-consultations\/?CodeConsult=Nom%20de%20votre%20m%C3%A9decin...&amp;CodeSpe=25\" target=\"_blank\" rel=\"noopener\"><strong>Nos consultations<\/strong><\/a><\/p>\n<h3>La cataracte<\/h3>\n<figure style=\"width: 257px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"zoom filet\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/Cataracte.jpg\" alt=\"cataracte\" width=\"257\" height=\"168\" align=\"right\" hspace=\"10\" vspace=\"2\" \/><figcaption class=\"wp-caption-text\">Cataracte<\/figcaption><\/figure>\n<p>La cataracte est due \u00e0 l\u2019opacification progressive du cristallin, en g\u00e9n\u00e9ral due \u00e0 l\u2019\u00e2ge. Le diab\u00e8te, la myopie et la prise de cortico\u00efdes au long cours sont aussi des facteurs de risque.<\/p>\n<p>Le cristallin est la lentille situ\u00e9e dans l\u2019\u0153il, \u00e0 l\u2019arri\u00e8re de l\u2019iris qui permet de faire la \u201cmise au point\u201d c\u2019est \u00e0 dire de focaliser les rayons lumineux sur le centre de la r\u00e9tine. Autour de l&rsquo;\u00e2ge de 45 ans, le cristallin commence\u00a0\u00e0 perdre son \u00e9lasticit\u00e9 : la vue de pr\u00e8s est floue : c&rsquo;est la presbytie<\/p>\n<p>Normalement, le cristallin est transparent. Sa perte de transparence, ou opacification, emp\u00eache la lumi\u00e8re de le traverser correctement. La vision se trouble, c\u2019est la cataracte.<\/p>\n<p>La cataracte est g\u00e9n\u00e9ralement li\u00e9e au vieillissement naturel du cristallin apr\u00e8s l\u2019\u00e2ge de 65 ans mais peut \u00e9galement \u00eatre li\u00e9e au diab\u00e8te, \u00e0 un traumatisme oculaire et plus rarement \u00eatre cong\u00e9nitale.<\/p>\n<p><u>Les signes\u00a0:<\/u><\/p>\n<p>Une baisse de vision touchant la vue de loin ou de pr\u00e8s appara\u00eet, \u00e9galement un l\u2019\u00e9blouissement ou un d\u00e9doublement d\u2019images.<\/p>\n<p><u>Le traitement\u00a0<\/u>:<\/p>\n<p>Il est chirurgical. Le but de l\u2019intervention est de retirer le cristallin opaque pour le remplacer par un cristallin artificiel. L\u2019op\u00e9ration de la cataracte\u00a0 se d\u00e9roule en g\u00e9n\u00e9ral en ambulatoire sous anesth\u00e9sie locale.<\/p>\n<div style=\"width: 352px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-8091-1\" width=\"352\" height=\"288\" poster=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/carton_noir.jpg\" preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/film-cataracte.mp4?_=1\" \/><a href=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/film-cataracte.mp4\">https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/film-cataracte.mp4<\/a><\/video><\/div>\n<p>Vid\u00e9o du traitement chirurgical de la cataracte (attention, ce sont des images de chirurgie !).<\/p>\n<h3>Le glaucome<\/h3>\n<figure id=\"attachment_8887\" aria-describedby=\"caption-attachment-8887\" style=\"width: 252px\" class=\"wp-caption alignright\"><a href=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/nerf-optique-normal-et-glaucomateux.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"zoom filet wp-image-8887\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/nerf-optique-normal-et-glaucomateux.jpg\" alt=\"Nerf optique glaucomateux en haut et normal en bas\" width=\"252\" height=\"374\" \/><\/a><figcaption id=\"caption-attachment-8887\" class=\"wp-caption-text\">Nerf optique glaucomateux en haut et normal en bas<\/figcaption><\/figure>\n<p>Le glaucome est une maladie oculaire <strong>grave<\/strong>. Il est le plus souvent li\u00e9 \u00e0 une trop forte tension oculaire conduisant \u00e0 la perte de la vision irr\u00e9versible par une d\u00e9g\u00e9n\u00e9rescence des fibres optiques.<\/p>\n<p>C\u2019est une maladie <strong>fr\u00e9quente<\/strong>, elle repr\u00e9sente la deuxi\u00e8me\u00a0cause de c\u00e9cit\u00e9 au niveau mondial et touche 1 \u00e0 3 % de la population au-del\u00e0 de 50 ans.<\/p>\n<p>&nbsp;<\/p>\n<p><u>On distingue diff\u00e9rents types de glaucomes :<\/u><\/p>\n<ul>\n<li>le glaucome chronique \u00e0 angle ouvert, forme la plus fr\u00e9quente, indolore,<\/li>\n<li>le glaucome par fermeture de l\u2019angle de forme aigu\u00eb ou subaigu\u00eb, forme plus rare et douloureuse,<\/li>\n<li>les glaucomes cong\u00e9nitaux, infantiles, juv\u00e9niles (tr\u00e8s rare).<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Les facteurs de risque sont : <\/u><\/p>\n<ul>\n<li><strong>l\u2019hypertonie oculaire,<\/strong><\/li>\n<li><strong>l\u2019\u00e2ge: <\/strong>Le glaucome est souvent d\u00e9crit comme une maladie li\u00e9e \u00e0 l\u2019\u00e2ge, m\u00eame si un glaucome peut survenir \u00e0 tous les \u00e2ges de la vie,<\/li>\n<li><strong>les ant\u00e9c\u00e9dents familiaux: <\/strong>Le terrain familial repr\u00e9sente un facteur de risque de survenue de glaucome, ce qui impose une sensibilisation et une surveillance orient\u00e9e des patients rapportant des cas de glaucome dans leur famille,<\/li>\n<li><strong>les prises m\u00e9dicamenteuses: <\/strong>les cortico\u00efdes,<\/li>\n<li><strong>le terrain vasculaire: <\/strong>Les facteurs de risque vasculaire sont \u00e0 rechercher en cas de glaucome.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Les signes :<\/u><\/p>\n<p>C\u2019est une maladie insidieuse, sans douleur ni perte de la vision centrale. Et c\u2019est donc seul l\u2019examen chez l\u2019ophtalmologiste qui permet de le d\u00e9pister. Le d\u00e9pistage du glaucome se fait par la prise de tension oculaire et sur de nombreux examens : champ visuel, analyse des fibres optiques (tomographie en coh\u00e9rence optique\/OCT).<\/p>\n<p>&nbsp;<\/p>\n<p><u>Le traitement :<\/u><\/p>\n<p>Le traitement consiste \u00e0 faire baisser la pression de l\u2019\u0153il afin d\u2019emp\u00eacher la maladie d\u2019\u00e9voluer. Actuellement, le traitement repose sur :<\/p>\n<ul>\n<li>des collyres hypotonisants,<\/li>\n<li>du laser SLT\u00a0 ou YAG (iridotomie),<\/li>\n<li>la chirurgie de filtration (scl\u00e9rectomie ou trab\u00e9culectomie),<\/li>\n<li>la cyclodestruction par cryoth\u00e9rapie des corps ciliaires ou par une nouvelle technologie les ultrasons focalis\u00e9s de haute intensit\u00e9 sur les corps ciliaires.<\/li>\n<\/ul>\n<div id=\"wpfp_a67d9bc1d25bac21603f9dec881e58be\" data-item=\"{&quot;sources&quot;:[{&quot;src&quot;:&quot;https:\\\/\\\/www.chu-poitiers.fr\\\/specialites\\\/ophtalmologie\\\/wp-content\\\/uploads\\\/sites\\\/7\\\/2018\\\/04\\\/sclerectomie-glaucome.mp4&quot;,&quot;type&quot;:&quot;video\\\/mp4&quot;}]}\" class=\"flowplayer no-brand is-splash is-paused skin-slim no-svg fp-slim fp-edgy\" data-fv-embed=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/cataracte-glaucome-et-greffe-de-cornee\/fvp\/\" style=\"position:relative; max-width: 640px; max-height: 360px; \" data-ratio=\"0.5625\">\n\t<div class=\"fp-ratio\" style=\"padding-top: 56.25%\"><\/div>\n\t<div class=\"fp-ui\"><noscript>Please enable JavaScript<\/noscript><div class=\"fp-play fp-visible\"><svg class=\"fp-play-sharp-fill\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 100 100\"><defs><style>.fp-color-play{opacity:0.65;}.controlbutton{fill:#fff;}<\/style><\/defs><title>play-sharp-fill<\/title><path class=\"fp-color-play\" d=\"M49.9217-.078a50,50,0,1,0,50,50A50.0564,50.0564,0,0,0,49.9217-.078Z\"\/><polygon class=\"controlbutton\" points=\"73.601 50 37.968 70.573 37.968 29.427 73.601 50\" filter=\"url(#f1)\"\/><\/svg><\/div><div class=\"fp-preload\"><b><\/b><b><\/b><b><\/b><b><\/b><\/div><\/div>\n<div class='fvp-share-bar'><ul class=\"fvp-sharing\">\r\n    <li><a class=\"sharing-facebook\" href=\"https:\/\/www.facebook.com\/sharer\/sharer.php?u=https%3A%2F%2Fwww.chu-poitiers.fr%2Fspecialites%2Fophtalmologie%2Fcataracte-glaucome-et-greffe-de-cornee%2F\" target=\"_blank\"><\/a><\/li>\r\n    <li><a class=\"sharing-twitter\" href=\"https:\/\/twitter.com\/intent\/tweet?text=Ophtalmologie+&url=https%3A%2F%2Fwww.chu-poitiers.fr%2Fspecialites%2Fophtalmologie%2Fcataracte-glaucome-et-greffe-de-cornee%2F\" target=\"_blank\"><\/a><\/li>\r\n    <li><a class=\"sharing-email\" href=\"mailto:?body=Check%20out%20the%20amazing%20video%20here%3A%20https%3A%2F%2Fwww.chu-poitiers.fr%2Fspecialites%2Fophtalmologie%2Fcataracte-glaucome-et-greffe-de-cornee%2F\" target=\"_blank\"><\/a><\/li><\/ul><div><a class=\"sharing-link\" href=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/cataracte-glaucome-et-greffe-de-cornee\/\" target=\"_blank\">Link<\/a><\/div><div><label><a class=\"embed-code-toggle\" href=\"#\"><strong>Embed<\/strong><\/a><\/label><\/div><div class=\"embed-code\"><label>Copy and paste this HTML code into your webpage to embed.<\/label><textarea><\/textarea><\/div><\/div>\n<\/div>\n\n<p style=\"text-align: center;\">Vid\u00e9o d&rsquo;une\u00a0scl\u00e9rectomie\u00a0(attention, ce sont des images de chirurgie !)<\/p>\n<div style=\"width: 384px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-8091-2\" width=\"384\" height=\"288\" preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2018\/04\/istent.mp4?_=2\" \/><a href=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2018\/04\/istent.mp4\">https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2018\/04\/istent.mp4<\/a><\/video><\/div>\n<p>Vid\u00e9o d&rsquo;une pose d&rsquo;istent apr\u00e8s\u00a0une op\u00e9ration d&rsquo;un glaucome\u00a0(attention, ce sont des images de chirurgie !)<\/p>\n<h3><\/h3>\n<h3>Maladies de la corn\u00e9e<\/h3>\n<p>La corn\u00e9e est la premi\u00e8re lentille transparente de l\u2019\u0153il. Elle recouvre la partie ant\u00e9rieure de l\u2019\u0153il devant l\u2019iris et la pupille. Elle doit garder sa transparence.<\/p>\n<p>Les maladies de la corn\u00e9e peuvent avoir de multiples origines : traumatiques, infectieuses, g\u00e9n\u00e9tiques, inflammatoires, allergiques ou toxiques.<\/p>\n<p>Dans les suites de traumatismes physiques ou chimiques, au cours de maladies h\u00e9r\u00e9ditaires (dystrophies corn\u00e9ennes), d\u2019infections ou d\u2019inflammations, la corn\u00e9e peut perdre sa transparence. Ces opacit\u00e9s peuvent\u00a0 avoir des retentissements variables sur la fonction visuelle de l\u2019\u0153il atteint.<\/p>\n<div id=\"metaslider-id-8056\" style=\"max-width: 500px; margin: 0 auto;\" class=\"ml-slider-3-114-0 metaslider metaslider-responsive metaslider-8056 ml-slider ms-theme-default\" role=\"region\" aria-label=\"Pathologies de la corn\u00e9e\" data-height=\"500\" data-width=\"500\">\n    <div id=\"metaslider_container_8056\">\n        <ul id='metaslider_8056' class='rslides'>\n            <li aria-roledescription='slide' aria-labelledby='slide-0'><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2015\/11\/carton_noir.jpg\" height=\"500\" width=\"500\" alt=\"\" class=\"slider-8056 slide-8035 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Diaporama de diff\u00e9rentes pathologies de la corn\u00e9e : pt\u00e9rygion (2), br\u00fblure oculaire chimique (3), conjonctivite virale (4), cornea guttata d\u00e9compens\u00e9e en dystrophie de Fuchs (5) et k\u00e9ratite herp\u00e9tique (6). Attention, certaines images sont difficiles \u00e0 regarder.<\/div><\/div><\/li>\n            <li style='display: none;' aria-roledescription='slide' aria-labelledby='slide-1'><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2015\/11\/pterygion-500x500.jpg\" height=\"500\" width=\"500\" alt=\"\" class=\"slider-8056 slide-8070 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Pt\u00e9rygion<\/div><\/div><\/li>\n            <li style='display: none;' aria-roledescription='slide' aria-labelledby='slide-2'><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2015\/11\/brulure-oculaire-chimique-500x500.jpg\" height=\"500\" width=\"500\" alt=\"\" class=\"slider-8056 slide-8071 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Br\u00fblure oculaire chimique<\/div><\/div><\/li>\n            <li style='display: none;' aria-roledescription='slide' aria-labelledby='slide-3'><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2015\/11\/conjonctivite-virale-500x500.jpg\" height=\"500\" width=\"500\" alt=\"\" class=\"slider-8056 slide-8072 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Conjonctivite virale<\/div><\/div><\/li>\n            <li style='display: none;' aria-roledescription='slide' aria-labelledby='slide-4'><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2015\/11\/cornea-guttata-decompens\u00c3\u00a9e-dystrophie-de-Fuchs.jpg\" height=\"500\" width=\"500\" alt=\"\" class=\"slider-8056 slide-8073 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Cornea guttata d\u00e9compens\u00e9e en dystrophie de Fuchs<\/div><\/div><\/li>\n            <li style='display: none;' aria-roledescription='slide' aria-labelledby='slide-5'><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/wp-content\/uploads\/sites\/7\/2015\/11\/keratite-herpetique-500x500.jpg\" height=\"500\" width=\"500\" alt=\"\" class=\"slider-8056 slide-8074 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">K\u00e9ratite herp\u00e9tique<\/div><\/div><\/li>\n        <\/ul>\n        \n    <\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_8897\" aria-describedby=\"caption-attachment-8897\" style=\"width: 197px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"zoom filet wp-image-8897\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/photo-greffe-transfixiante.png\" alt=\"Greffe de corn\u00e9e transfixiante\" width=\"197\" height=\"156\" \/><figcaption id=\"caption-attachment-8897\" class=\"wp-caption-text\">Greffe de corn\u00e9e transfixiante<\/figcaption><\/figure>\n<p>Lorsque les opacit\u00e9s sont trop \u00e9paisses, ou lorsque toutes les couches de la corn\u00e9e sont concern\u00e9es, on peut recourir \u00e0 une\u00a0<strong>greffe de la corn\u00e9e<\/strong>. La grande avanc\u00e9e chirurgicale de ces derni\u00e8res ann\u00e9es r\u00e9side dans le remplacement s\u00e9lectif des parties malades de la corn\u00e9e en respectant les parties saines : il s\u2019agit de\u00a0<strong>greffes lamellaires<\/strong>. Cependant, lorsque toute la corn\u00e9e est pathologique, on r\u00e9alise des greffes de pleine \u00e9paisseur: il s\u2019agit des <strong>greffes transfixiantes<\/strong>.<\/p>\n<p>&nbsp;<\/p>\n<div style=\"width: 352px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-8091-3\" width=\"352\" height=\"288\" poster=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/carton_noir.jpg\" preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/greffe_cornee.mp4?_=3\" \/><a href=\"https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/greffe_cornee.mp4\">https:\/\/www.chu-poitiers.fr\/wp-content\/uploads\/2014\/09\/greffe_cornee.mp4<\/a><\/video><\/div>\n<p>Vid\u00e9o d&rsquo;une greffe de corn\u00e9e (attention, (attention, ce sont des images de chirurgie !).<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nos consultations La cataracte La cataracte est due \u00e0 l\u2019opacification progressive du cristallin, en g\u00e9n\u00e9ral due \u00e0 l\u2019\u00e2ge. Le diab\u00e8te, la myopie et la prise de cortico\u00efdes au long cours sont aussi des facteurs de risque. Le cristallin est la lentille situ\u00e9e dans l\u2019\u0153il, \u00e0 l\u2019arri\u00e8re de l\u2019iris qui permet de faire la \u201cmise au [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-8091","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cataracte, glaucome et greffe de corn\u00e9e - Ophtalmologie<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.chu-poitiers.fr\/specialites\/ophtalmologie\/cataracte-glaucome-et-greffe-de-cornee\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cataracte, glaucome et greffe de corn\u00e9e - Ophtalmologie\" \/>\n<meta property=\"og:description\" content=\"Nos consultations La cataracte La cataracte est due \u00e0 l\u2019opacification progressive du cristallin, en g\u00e9n\u00e9ral due \u00e0 l\u2019\u00e2ge. Le diab\u00e8te, la myopie et la prise de cortico\u00efdes au long cours sont aussi des facteurs de risque. 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