What is a cataract and what symptoms does it show?
Cataract, especially senile cataract, is one of the most common eye diseases and is the first blindness-causing eye disease in third world countries. As a common metaphor, the human eye is like a camera, and the light-transmitting and light-sensitive part of the eye is like the lens and film of the camera. When the lens becomes cloudy or even white and cannot transmit light for various reasons, the patient gradually becomes unable to see and becomes blind, which is called cataract. The main symptoms of cataracts are gradual loss of vision, blurred vision, sometimes photophobia, and in severe cases, blindness.
How cataracts occur
There are many causes of cataracts, such as age-related changes, excessive exposure to ultraviolet light, intraocular inflammation, drugs, trauma, metabolic diseases, etc., and aging is the most common cause. Age-related cataracts are an inevitable phenomenon of human aging. With the progress of aging, the incidence of cataracts increases, and 100% of the elderly over 80 years old have cataracts.
How to treat cataracts
Until today, there is no real effective drug to stop the development of cataract, except for surgery. Surgery is the only effective method.
Nowadays, many advertisements in the society advertise that they can cure cataracts, and there are also some secret ancestral recipes and new special drugs, which are often very expensive. Many patients often go to the hospital only after they have tried various medications and spent a lot of money but the treatment is ineffective.
When is cataract surgery and do all cataracts need surgery?
Not all cataract patients need surgical treatment. In principle, surgery is only considered if the cataract has an impact on life and work. The specific decision is usually based on the patient’s level of vision needs, the surgeon’s surgical experience, and the hospital’s equipment, and there is no need to wait until you are completely blind or the cataract is mature before surgery. Some overly mature cataracts can cause complications such as glaucoma and uveitis, so it is not advisable to wait until the cataract is overly mature before surgery.
Can I have cataract surgery at an older age?
There is no uniform age limit for cataract surgery. Some patients’ families think that it is too dangerous for the elderly to have surgery and cannot do it. In fact, some elderly people are in good health, with stable blood pressure and heart condition. Moreover, most cataract surgeries nowadays use local anesthesia in the eye and the surgery time is short, so most of them can bear the surgery.
When can cataract surgery not be done immediately?
If you have high blood pressure, diabetes, hyperthyroidism or cough, you should consult an internist for diagnosis and treatment, and wait until your condition is stable before cataract surgery; if you are taking anticoagulant drugs such as aspirin orally, it is better to stop taking anticoagulant drugs for 1 week before surgery; if you have acute conjunctivitis with red eyes and a lot of eye stools, you need to operate after treatment; if you have chronic dacryocystitis, you need to operate to deal with dacryocystitis before cataract surgery.
What preparations should be made before cataract surgery
Before cataract surgery, general examination and special eye examination should be done: corneal curvature, A/B ultrasound, corneal endothelial lens, IOL measurement, etc. Routine antibiotic eye drops 1-3 days before surgery, 3~4 times a day. Adequate pupil dilation with pupil dilator before surgery. Eat according to your usual diet before surgery. To keep your face clean, you can wash your hair and take a bath a day in advance, and keep a relaxed mental state to wait for the surgery. Take special care not to catch a cold or cough.
What is cataract ultrasound emulsification?
It uses ultrasound instruments to shock and emulsify the cataract and then aspirate it. Finally, an artificial lens is implanted into the original lens to replace the original cloudy lens. The procedure uses a small incision without sutures, which minimizes the possibility of post-operative astigmatism and allows patients to obtain optimal vision in the shortest possible recovery time.
Will cataracts regenerate after surgery?
At present, cataract surgery preserves the original posterior capsule for implantation of an artificial lens. The posterior capsule may grow thicker and blur vision after a few months or years due to the growth of epithelial cells, which is called posterior cataract. In this regard, patients can come to the hospital for laser treatment, and their vision can be restored after a small hole is made in the posterior capsule with a laser.
Why is it necessary to implant an IOL after cataract surgery?
The main function of the lens is to focus light on the retina. After surgery to remove the lens (cataract), the patient becomes highly farsighted, and only with the implantation of an IOL can the eye see clearly.
How to choose an IOL for cataract patients before surgery
Patients can choose a crystal according to their economic situation and needs. Currently, most patients choose soft crystals (foldable), which are implanted in the eye through an incision of less than 3.2mm in diameter and have the advantages of small post-operative astigmatism and fast recovery. Among them, patients with more outdoor activities and frequent ultraviolet radiation should choose color-changing crystals or photochromic crystals that can filter harmful blue light and ultraviolet light; for patients who have the requirement to see clear vision throughout the distance, middle and near after surgery, they can choose multifocal IOLs; patients with astigmatism can choose Toric IOLs specially designed for them, etc.
Rigid IOLs are less expensive. It needs to be implanted through an incision of about 6mm, has a large post-operative astigmatism, and has a larger reaction and longer recovery time in the short term after surgery. A portion of patients with slightly difficult families will choose it. A small percentage of patients who are not suitable for an IOL because the incision itself already needs to be 5-6mm can also be implanted with a rigid IOL.
How long can an IOL be implanted in the eye?
The IOL material is stable and has good tissue compatibility and can last for more than 50 years in the eye.
Precautions after cataract surgery
Modern cataract surgery is sutureless, with small incisions and quick recovery time, and you can usually resume your normal life after the next day. There are some matters that still need to be paid attention to, such as don’t squeeze your eyes hard, rest as much as possible on the day of surgery, avoid strenuous activities as well as bending hard, don’t hold your breath or sneeze, avoid dirty water into your eyes for 2 weeks after surgery and prevent trauma. If you have any eye discomfort after discharge from the hospital, consult a doctor promptly.
What is the reason for the lack of improvement in vision after cataract surgery?
If the eye only has a cataract, the vision can be restored better after surgery; however, if the eye has other eye diseases in addition to cataract, the vision can only be improved after cataract surgery, but not restored to normal. In other words, cataract surgery only relieves the part of vision loss caused by cataract, while the vision loss caused by other eye diseases still exists. For example, corneal leukoma, optic nerve atrophy, retinitis pigmentosa, retinal detachment, macular degeneration, etc. all affect vision improvement. Other conditions such as astigmatism and refractive error also affect the improvement of visual acuity.
Why do some patients have black shadows in front of their eyes after cataract surgery?
In medical terms, it is called vitreous opacities or “flying mosquitoes”. It is very common for the elderly and highly myopic patients to have cloudiness after vitreous degeneration. Before surgery, some patients do not feel the presence of large dark shadows in front of their eyes because of the cataract cover, but after the cataract is removed, the dark shadows also appear immediately after the vision is improved. Some patients feel the black shadows in front of their eyes before surgery, but they still exist and become more obvious after surgery, and these phenomena are not related to cataract extraction in any way. These phenomena are not related to cataract extraction. A small amount of floating black shadow has no effect on vision and usually does not deteriorate further.