In the past six months, he felt blurred vision in his right eye, accompanied by symptoms such as photophobia, dark objects and double vision, which obviously affected his efficiency in correcting homework. When he went to the ophthalmology department, the doctor found that Wang’s vision was 0.3 in his right eye and 0.8 in his left eye, which was diagnosed as an immature stage of senile cataract and required surgery. Mr. Wang disagreed, because he always heard others say that cataracts are best operated when the eyes are blind. The cataract specialist did a detailed examination and decided to give him cataract ultrasound emulsification combined with multifocal IOL implantation.
However, Mr. Wang has been wondering after the surgery why he could have the surgery at the immature stage of senile cataract, but isn’t it best to have the surgery at the mature stage of cataract? In fact, as far as the current situation is concerned, the mature stage is only a kind of cataract stage, but not the best indication for surgery.
In the past, cataract surgery was performed by intracapsular extraction and extracapsular cataract extraction with large incisions, which resulted in large postoperative astigmatism and less than ideal efficacy, so we had to wait until the cataract was fully mature and almost invisible to operate. In recent years, with the maturity of ophthalmic microsurgery and the introduction of new types of IOLs, there have been revolutionary advances in cataract surgery methods and surgical results. The most mature method at present is cataract ultrasound emulsion removal combined with IOL implantation, which is operated under a microscope and advanced ultrasound emulsion machines, making the surgery safer and more effective. Therefore, cataract surgery should not wait until the crystal is completely cloudy (mature cataract stage). On the contrary, cataract is not particularly mature, the surgery is more efficient and has fewer complications, therefore, cataract surgeons are more willing to do relatively immature cataract surgery instead. Immature cataract surgery is easier to handle with a capsule membrane and a less rigid cataract nucleus, resulting in a higher surgical success rate and less postoperative inflammatory response. More positively, a relatively perfect cataract surgery can be combined with new functional IOL implantation, for example, multifocal IOLs can make 90% of patients’ life easier after surgery by eliminating the need to wear glasses for distance and near vision. The chances of implantation are relatively small.
Of course, it is not the case that the earlier the cataract is operated, the better. When is the most appropriate time to operate? The choice of surgery can be made at different times depending on the patient’s different needs for work and life. Cataract surgery can be performed when it affects the patient’s study, work and life, or when it affects the treatment of other eye diseases such as retinal disease surgery or causes other complications that threaten eye vision such as possible secondary glaucoma. Generally, surgery can be performed when the corrected visual acuity decreases to about 0.3; while people with higher visual acuity requirements can also be operated when their visual acuity decreases to 0.6.
Of course, there are certain risks in doing cataract surgery. Although most patients recover well after surgery, there are still very few patients who have unsatisfactory recovery of vision after surgery and even some complications. Therefore, if you have cataract, it is best to go to a cataract specialist in a hospital with better surgical conditions and the doctor will recommend the right time for surgery.