Older adults with cataract eye disease often have problems such as presbyopia, farsightedness, or myopia and astigmatism. The simple effect of cataract restoration, i.e. “seeing”, can no longer meet their needs for texting, Internet access, fishing, mahjong and other activities. How can cataract be restored and refractive error be corrected at the same time?
Cataract surgery has undergone a revolutionary change in the concept of cataract surgery from sight restoration to refractive correction. In the past 20 to 30 years, cataract surgery has undergone rapid development in terms of surgical techniques, instruments and equipment. In terms of the use of materials, the birth and application of IOLs have replaced the human organ, the artificial lens. This is the first revolutionary leap in the history of cataract surgery development.
In terms of surgical methods, the application and promotion of ultrasound emulsification has changed the traditional injection anesthesia and large incisions, minimizing the complications of surgery and the pain of patients, which can be called the second revolutionary development in the history of cataract surgery development.
And the change of concept is now the most striking. According to President Hongjian Zhou, the purpose of traditional cataract surgery is to restore sight, so that patients can see light and the shadow of people and objects after surgery is considered successful. Now, with the improvement of people’s demand for quality of life, cataract surgery is no longer just about restoring sight, but about maximizing post-operative visual quality and being able to see in and near, not only in the daytime, but also at night.
This change in concept directly requires the introduction of the concept of “refraction” in surgery.
President Zhou Hongjian introduced that refraction and cataract were originally two different groups in the field of ophthalmology, namely the refraction group and the cataract group. In order to achieve better refractive effect in cataract surgery, some countries in Europe and America have combined the refractive and cataract groups and established the Cataract and Refractive Surgery Association. China is gradually following suit and forming its own cataract refractive surgery association. The change in the concept of refractive cataract surgery has pushed cataract surgery to a humane direction, which can be regarded as the third revolution in the history of cataract surgery.
The ideal refractive surgery strives to achieve normal eye function: Refractive cataract surgery requires patients to see clearly after surgery, to have good vision throughout the entire process of seeing at a distance, in the middle and near, and to have good vision in both bright and dark places. What are the differences between this procedure and traditional cataract surgery that requires only “seeing”?
Compared to traditional cataract surgery, refractive cataract surgery is more focused on using every aspect of the surgery and adopting the best measures to achieve the best refractive results together.
(1) Precise calculation of IOL prescription before surgery is an essential step to achieve refractive cataract surgery. If the IOL prescription is not precise, postoperative hyperopia and myopia will occur, and one or two pairs of glasses will still be required after surgery.
(2) Skilled use of ultrasound emulsification. The smallest incision in the eye can be 1.8-2.2 mm, which can reduce the degree of astigmatism and ensure the effect of refractive cataract surgery. In order to achieve perfect refractive results, the surgeon is required to pursue “ultra-low occurrence” of complications during the surgery, and each step of the surgery is required to be not only successful, but perfect.
(3) Selecting the right IOL, a new multifocal lens that provides full vision as much as possible when conditions permit. Of course, aspheric astigmatic multifocal IOLs can be used now to correct refractive errors throughout.
Old-sightedness and myopia, say goodbye together with cataracts In our life, we often meet such elderly people: they usually don’t wear glasses, but once they read books and newspapers, they immediately put on glasses. Dr. Zhou said that this is a typical old-sighted patient. Old vision and cataracts are the most common diseases of the elderly, so there are many elderly people who suffer from old vision and cataracts at the same time.
In addition, some elderly people not only suffer from presbyopia, but also myopia, and usually need two glasses to replace in order to see objects at different distances. Can cases like these be removed at the same time as cataract surgery? Dr. Zhou’s answer is, “Yes, it can.”
Like cataracts, the problems of presbyopia and myopia are mainly manifested in the lens, so clinically, both can be solved by replacing the lens together.