Surgery is the best way to treat cataract. There are two common misconceptions about the timing of surgery: 1. Cataracts should wait until they are mature. The old view is that cataracts should wait until the vision drops below 0.1 before surgery. This has several disadvantages. First of all, as cataract gets worse, the surgery will cause more damage to several tissues in the eye, such as corneal endothelium, crystal suspensory ligament and iris tissue, and the chance of postoperative complications will increase. Secondly, during the process of cataract expansion, there is a possibility of acute glaucoma attack. Once the acute attack occurs, there will be changes such as iris atrophy, corneal endothelial damage, and post-iris adhesions, which will seriously affect the results of cataract surgery and even lead to permanent loss of vision. Therefore, cataracts should not be operated only when the visual function declines to a very low level.
2. The earlier the cataract is done, the better. Human crystals can see far and near through adjustment. Although artificial crystals have been developed at a rapid pace in recent years, they are far from being comparable to human crystals in terms of adjustment range, adjustment speed and imaging quality. At the same time, in the early stage of cataract, the lens only shows refractive changes due to volume expansion, and simply put, the patient can obtain good vision by wearing glasses. Therefore, it is also undesirable to blindly pursue early surgery while ignoring the possible postoperative disadvantages.
There is no fixed pattern for choosing the timing of cataract surgery. In the past, due to the limitation of medical technology, cataracts had to wait until they were completely “mature” and the affected eye could not see before surgery, and patients had to endure the trouble and pain of low vision for a long time. Patients no longer need to wait until they are completely blind before undergoing surgery, but can receive surgery when cataract medication is ineffective and affects their daily life and work. The risk to experienced surgeons is not increased by early surgery. For different patients, the timing of surgery can vary greatly. At present, it is common in developed countries for patients with visual acuity of 0.5 to receive surgery, and in our clinical work we have done many patients with visual acuity of 1.0, and the visual quality has improved significantly after surgery. In short, when to receive surgical treatment, we must start from the actual requirements of the patient and discuss with the doctor and patient to determine the timing of surgery.