1.What is cataract?
The human eye is like a camera, light passes through the cornea and lens and is projected onto the retina for imaging, and then passes through the optic nerve to the brain, so that people can see the colorful world. The normal lens is transparent, just like the lens of a camera. Once it is cloudy, it will affect the light entering the eye and make the vision decrease and blurred.
2.Causes of cataract?
There are many causes of cataracts, the most common one is senile cataracts, which increases with age, for example, the incidence rate is 60-70% at the age of 50-60 and 80% at the age of 70 or above. It is usually bilateral, but the onset and course of the disease are different in the two eyes. There are also congenital cataracts, traumatic cataracts, etc. Diabetes, intraocular inflammation and hemorrhagic diseases can also lead to cataracts.
3.What are the manifestations of cataract?
Take the symptoms of senile cataract as an example.
In the early stage, there may be no symptoms, sometimes a fixed black spot appears in front of the eyes.
The obvious manifestation is blurred vision, which may be accompanied by photophobia, darker or yellowish color of seeing objects, distortion or double vision, etc. In severe cases, there is only a sense of hand movement or light.
Cataract is the main cause of blindness, so once cataract is found, you should go to the hospital for treatment in time.
4.Can cataracts be treated with medication?
Since the cause of cataract formation is still unclear, no breakthroughs have been made in drug development, and there are no drugs that can cure cataract or completely stop or delay its development.
5. What is the best surgery method?
Cataract surgery involves removing the clouded lens and implanting an IOL.
Ultrasound emulsion surgery: It is the most advanced and reliable cataract treatment method recognized internationally. The advantages are as follows.
Short operative time and mild pain.
Small surgical incisions, no sutures, and rapid recovery of vision.
a mild inflammatory response and a low dose and short duration of postoperative medication
less astigmatism due to the small incision.
You can receive this surgery even if your symptoms are mild, without waiting until you are completely blind or it affects your work and life.
6.Why do I need to implant an IOL?
When the lens is removed surgically, it is like a camera without a lens, so you cannot see clearly. If there is no fundus disease or other eye diseases that affect vision, the IOL implantation can almost reach the pre-catar vision level.
7.How to choose an IOL?
IOLs are divided into rigid IOLs and soft (folding) IOLs. Folding IOL is the current trend of international development because it requires smaller surgical incision (only 2.8-3.5mm), less post-operative astigmatism and faster recovery. However, foldable IOLs are more expensive and patients can choose according to their financial situation.
The material and process of IOL are closely related to the post-operative results, mainly in terms of.
(1) Post-operative inflammatory reaction
(2) The incidence of “posterior cataracts”.
Posterior cataract” is the clouding of the posterior capsule caused by IOL implantation, which manifests as the patient’s visual impairment; the time and the chance of occurrence of “posterior cataract” vary greatly among IOLs; if “posterior cataract” is serious, laser surgery is required. “If it is serious, laser surgery will be required.
8.What other factors affect the results of surgery?
Any surgery will cause certain trauma, because the human cornea is very fragile, it is difficult to recover after the damage, moreover, serious damage to the cornea will cause blindness, so the ophthalmologist attaches great importance to the protection of the patient’s cornea during the surgery, if the economic conditions allow, the doctor will recommend you to use better products, during the surgery, the eye is completely immersed in the liquid; after the surgery for a period of time, the liquid will still remain in the eye, so that the eye is not only good, but also good. Therefore, the good or bad liquid can not only directly affect whether the surgery can be carried out smoothly, but also affect the degree of inflammatory reaction and the speed of vision recovery after the surgery, and even affect the vision situation after years or decades after the surgery, so it is very important to choose the special perfusion liquid for eye surgery.
The choice of viscoelastic is also important because it can act like a transparent lid that always attaches to the inner surface of the cornea during surgery, resisting damage to the cornea from various operations.
9.How long does the surgery take?
Ultrasonic emulsification surgery: general cataract takes about 10 minutes, and if you start from the pre-operative preparation, you can walk out of the operating room and see the light again in about 30-40 minutes.
10.How can I choose in the face of different price levels of surgery?
The cost of ultrasound emulsification surgery has the following main parts: instrument wear and tear, technical fees, disposable consumables such as IOL and viscoelastic.
The performance of the ultrasonic emulsification instruments ranges from 100,000 to 800,000, which directly affects the safety factor of the surgery; the imported and domestic viscoelastic vary greatly in terms of purity, safety and protection of the cornea; there are differences between domestic and imported IOLs, and between folded and non-folded ones, while products without FDA or SDA certification will be very cheap.
11.What preparations do I need to make before surgery?
Pre-operative routine examination: visual acuity, visual function, intraocular pressure, tear duct flushing.
Special examination: A, B ultrasound and corneal curvature, corneal endothelial cell and corneal topography if necessary.
Systemic health status examination: blood routine, urine routine, electrocardiogram. Inpatients should have blood tests for liver and kidney function and surface antigen, and diabetic patients should have blood glucose tests, and if necessary, internal medicine consultation. Generally, the preoperative blood pressure should not be higher than 180/90 mmHg and fasting blood glucose should not be higher than 8.3 mmol/L.
Routine anti-inflammatory eye drops, such as Topaz eye drops or Colistin eye drops 3-6 times a day, should be administered to the operated eye 1-3 days before surgery.
If the patient is under general anesthesia, he/she should abstain from food and water for 8 hours before surgery.
12.How should the patient cooperate during surgery?
After entering the operating room, the patient should put on shoe covers, explain to the nurse which eye is to be operated on, and wait for the pupil to dilate.
After getting on the operating table, check your name and eye with the doctor.
During surgery, please overcome your nervousness and relax your mind. Keep your head, hands and body still, and inform the doctor of any discomfort at any time.
If surface anesthesia is used, the patient’s cooperation will be very important and you should adjust the position of your eyes according to the doctor’s instructions.
13.What should I pay attention to after the surgery?
On the day of surgery, you should rest as much as possible and avoid lowering your head and coughing.
After the surgery, you do not need to avoid eating, all daily life is normal, but do not smoke and drink. If you have dry stools, take laxatives; avoid excessive force and lifting heavy objects.
Come to the hospital for review on the first day, the third day and one week after discharge after surgery, and determine the medication to be used at home and the next follow-up date according to the doctor’s prescription.
After medication change (discharge), go home and order anti-inflammatory eye drops such as Demerol eye drops or Parsol eye drops 4-6 times a day and Putnam Pulmonary eye drops 4 times a day. Some patients use pupil dilating medicine to dilate the pupil every night, and the pupil is usually dilated three times with an interval of 5 minutes between each time.
Post-operative blurred eyes, mild foreign body sensation, and orbital bruising are normal. If you experience significant eye pain, nausea, vomiting or sudden loss of vision, please do not be nervous and go to the hospital immediately.
A small number of patients have symptoms such as eye redness, photophobia and tearing after surgery, please go to the hospital for examination and early treatment.
Do not allow dirty water or soap water into the operated eye for two weeks after surgery, do not apply pressure (rubbing the eye) to the operated eye for four weeks and prevent trauma.
If necessary, a pair of low-degree glasses should be used to adjust the distance or near vision in order to achieve the best results.
Some patients need laser treatment for post-operative cataracts.
If no IOL is implanted after cataract surgery for young children, they need timely prescription of glasses and amblyopia training and regular review.