In most cases, it is believed that cataracts should wait until they are “mature” before surgery is performed. This is due to the fact that the medical level and medical equipment were limited in the past and it was considered appropriate to operate at this stage. In recent years, microsurgery has been rapidly developing and popularized in ophthalmology, and modern cataract surgery has been rapidly developed. Then the cloudy and mixed nucleus and cortex are removed, the posterior capsule membrane or capsule bag is preserved, the IOL is introduced, and the posterior chamber type IOL is implanted, which is a leap forward in cataract surgical treatment. Later on, based on the modern extracapsular, ultrasonic emulsification cataract and IOL implantation were performed. In China, if the cause of low vision is cataract, patients with visual acuity around O.3 can undergo surgery. In developed countries, surgery can be done even with vision at 0.5.
For those with systemic diseases such as hypertension and diabetes, which trigger fundus disease and both are accompanied by cataract, the clouded lens should be removed early without contraindication to cataract surgery. It is convenient to provide a glimpse of the occurrence, development and treatment effect of fundus disease. For those who have or will have fundus lesions. After the surgery to “see at a glance”, for timely symptomatic treatment, the protection of useful vision is beneficial. Otherwise, the fundus disease has lost the time for treatment, and it is futile to do surgery again.
People with glaucoma and cataract are interested in long-term drug use to control IOP. When it is too troublesome or the treatment effect is not satisfactory, combined glaucoma cataract surgery is feasible. As far as ultrasonic cataract surgery is concerned, in a sense, the lighter the cataract, the better the surgery is done, and at the same time the surgery has fewer complications. Early surgery is worth advocating if elderly people have high vision requirements and are engaged in delicate work.
In conclusion, there is no longer a uniform standard for cataract surgery. Although there is still some controversy among those in the profession, there is an increasing preference for early surgery. Where cataracts cause vision loss and the vision affects your quality of life in a way that is intolerable to the person, surgery can be performed. This relaxes the time options for surgery and makes it more humane. One thing is for sure, there is no drug in the world that can cure cataract yet, and its surgical method has been developed to be a near-perfect treatment. So the choice of timing for surgery is no longer the view that cataracts need to be mature before surgery is performed.