At present, cataract surgery is the only effective treatment method for all stages of cataract except the initial cataract. Cataract surgery is the most mature and effective surgery in ophthalmology, but still requires pre-surgical examination and preparation, specifically including the following aspects: 1. Control of systemic underlying diseases: cataract is a common and frequent disease in the elderly. According to our statistics, the average age of cataract surgery patients in outpatient clinics is 75 years old, and most of them have such and such systemic underlying diseases.
(1) Diabetes mellitus: blood glucose control is stable in the past two weeks, and fasting blood glucose control is below 8.3 mmol/L before surgery, without ketoacidosis.
(2) Hypertension: blood pressure has been under stable control for the past two weeks, and the preoperative blood pressure is controlled below 160/90mmHg.
(3) Heart disease: cardiac function grade 2 or above, heart rate between 50-100 beats per minute, no serious coronary heart disease, arrhythmia, cardiomyopathy, etc.
(4) Cerebral infarction and cerebral hemorrhage: the original cerebral infarction and cerebral hemorrhage are basically under control, clear consciousness, able to communicate verbally, no fresh cerebral infarction or cerebral hemorrhage occurred in the past 3-6 months.
(5) Renal disease, renal insufficiency or failure: no active renal disease, creatinine is basically normal before surgery, and hemodialysis is required 1-2 days before surgery for renal failure.
(6) Liver disease and liver function: no active liver disease before surgery, basically normal liver function, no jaundice occurrence.
(7) Hematological disease: good control of original hematological disease, no active bleeding, platelets >80*109/L, hematocrit >80g/L, white blood cells >3.0*109/L. (8) Tumor: no newly discovered tumor in the whole body, no appearance of systemic malignant fluid, preferably cataract surgery after 3 months of original tumor surgery, preferably not during the chemotherapy period.
2. Control of local diseases of the eye: no infectious diseases such as ocular surface and tear sac, uveitis under certain control, no fresh hemorrhage of the fundus, retinal detachment and other diseases, no ocular ischemic diseases and active optic neuropathy.
3, systemic examination: blood pressure, pulse, respiration, heart rate, mental and other routine examinations, routine blood and urine examinations, blood antigenology and liver and kidney function examinations, electrocardiogram, chest X-ray and other examinations if necessary.
4.Ocular examination: (1) Routine eye examination: including visual acuity, visual function examination, intraocular pressure, lacrimal apparatus examination, slit lamp, fundus examination, etc.
(2) Ocular biometry and IOL refractive index calculation: ocular length biometry such as eye axis and anterior depth, corneal curvature, corneal diameter and other corneal parameters measurement, preoperative bilateral refractive index examination, and IOL refractive index calculation based on the above results.
(3) Other possible eye examinations: including ocular ultrasound (when fundus examination is not visible), corneal endothelial lens and corneal thickness examination (in patients of advanced age, with keratoconus and glaucoma, and who have undergone internal eye surgery), corneal topography examination (keratoconus), fundus examination such as OCT (when fundus disease such as macula is suspected), visual function and visual effect examination such as laser vision, contrast sensitivity, wavefront phase difference, etc. Visual electrophysiological examination (suspected of having optic nerve and optic pathway system diseases), etc.