Since cataracts cannot be solved by conservative treatment, sooner or later they have to face surgery, and when should surgery be done? In the past, cataract patients had to wait until their cataracts matured before they could have surgery due to the limitations of cataract surgery methods. However, with the innovation of cataract surgery, it is no longer affected by the occurrence and development of cataract, and surgery can be performed at all stages of cataract. Choosing the timing of cataract surgery is considered from several aspects.
One is the state of accommodation. Adjustment is the ability of the eye to see far and near. When cataract occurs, the ability to adjust is basically lost. In general, presbyopia starts to appear at the age of forty and cataracts start to appear at the age of sixty, and the adjustment ability starts to decline at the age of forty.
Another is the physical state. Although cataract is a very mature surgery with high safety and success rate, it is after all an intraocular surgery and there are various surgical risks. For example, in patients with hypertension, due to increased vascular fragility, explosive choroidal hemorrhage may occur during surgery due to fluctuations in intraocular pressure, and once this happens, the surgery cannot even be completed and needs to be terminated urgently; in patients with diabetes, because they often develop posterior subcapsular cataracts, it takes years to develop blindness.
Some patients just wait until they become blind before deciding to have surgery, and several years later their diabetes has worsened, and it is difficult to control their blood glucose before surgery to reach the standard range, and even if they barely reach the standard before surgery, they still cannot maintain stability after surgery. Such patients are prone to inflammatory reactions, corneal edema and macular edema after surgery due to high blood glucose and slow wound healing.
The early physical condition of hyperlipidemia patients is still good, but some patients do not control their blood lipids well unconsciously and need surgery after a few years due to cataract blindness, but at this time, high blood lipids have already caused damage to blood vessels and coronary heart disease and stroke follow, which may become a contraindication for elective cataract surgery, and even if the surgery is done, the incidence of cerebrovascular accidents after surgery is high. The incidence of postoperative cerebrovascular accidents is also high.
Then there is the vision status. In general, cataract surgery is recommended for cataract patients with visual acuity down to 0.3 in China, while cataract surgery is recommended for those with visual acuity below 0.5 in foreign countries. This difference is partly because foreign countries have good economic conditions and high requirements for visual acuity.
Some patients require better post-operative naked eye vision than before surgery, and sometimes this is affected by the post-operative refractive state, and it is more certain if the vision is 0.3 or less. For patients who often go out to play or work, cataract can be done earlier, for example, some people need to drive, 0.5 vision is not only a threat to public safety, but also irresponsible to themselves; patients with posterior subcapsular cataract often have 0.8 or 1.0 vision when measuring vision, but in bright places vision is often less than 0.3 or even worse, in this case wait until the measurement of vision In this case, it is not necessary to wait until the vision test is less than 0.3 before doing the surgery.
Once the above issues are sorted out, it will be easier for individuals to grasp when to choose surgery. If my family members are suffering from cataracts, those with vision below 0.5 and those older than 60 years old will consider having surgery.
If you have high myopia, the lens can be hardened easily. The harder the cataract surgery, the more damage and the longer the surgery, so it is better to do it sooner rather than later. After all, these chronic diseases will accompany the rest of your life and will become increasingly difficult to control, and the risk of surgery in the early stage is definitely lower than in the later stage.
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