Geriatric cataracts are not considered emergency surgery and therefore can be operated on “electively”. When is the best time to operate? Generally, cataract surgery can be considered when cataracts are causing vision deterioration and affecting daily life and work.
However, each person has different needs for vision. Therefore, even for cataracts of the same degree, there are individual differences in the timing of surgery. If vision must be expressed in terms of visual acuity, surgery is generally indicated when it is below 0.1 to 0.3 affecting daily life and work. For nuclear cataracts with urgent vision needs, vision below 0.3 to 0.5 can also be operated. In a few cases where secondary glaucoma or crystal-derived uveitis is induced by cataract, or where cataract affects the diagnosis and treatment of fundus lesions (e.g. diabetic retinopathy), cataract surgery is sometimes performed even if there is better vision.
As for other types of cataracts, the timing of surgery can be early or late, depending on discretion. For congenital cataracts, surgery should be performed as early as possible to prevent the occurrence of form deprivation amblyopia. For complication cataract caused by uveitis, in order to avoid aggravating the inflammation by surgical harassment, in principle, conservative treatment should be given first, and surgery is appropriate only after the inflammation has subsided for 3 to 6 months. Diabetic cataracts require a certain level of blood sugar control before surgery.
Some patients are unable to operate for some reasons (such as serious heart disease), so it is appropriate to postpone cataract surgery and actively treat related systemic diseases. Patients who are considered by their physicians as “waiting” should not be impatient and should cooperate with their treatment carefully. Under the supervision of ophthalmologists, cataract will not become a serious disease or an incurable disease.