Cataracts are a terrible disease in most people’s eyes, and once you get involved, it means saying goodbye to the world of light. According to a survey, cataracts are indeed the most common cause of blindness and visual disability, with about 25% of humans suffering from cataracts.
Do cataracts really mean “blindness”? Does it mean that the patient has to rely on the assistance of others and live on his or her own? Cataracts are not terrible, “This is a kind of curable blindness, cataract removal surgery can let patients see again, especially cataract ultrasound emulsification is more ideal to restore sight.”
Cataracts are currently the leading cause of blindness, with a high incidence after age 50
“Cataracts are currently the number one cause of blindness and occur mainly in older people after the age of 50, i.e., senile cataracts are the most common type of cataract.” The lens is a convex lens in the eye, as big as a lentil grain, with a capsule membrane wrapped around it. It is located behind the pupil and is equivalent to the lens on a camera, which has the function of focusing, and it is transparent under normal circumstances.
The causes of cataracts are complex and varied, and there are various theories on the pathogenesis. “Aging, genetic factors, metabolic abnormalities, eye trauma, radiation, poisoning, and local nutritional disorders of the lens can lead to degeneration of lens proteins and the formation of cloudiness.” And the performance of cataract is mainly vision loss, the patient feels blurred to see things, the degree gradually worsens, and it usually takes months or years for the lens to be completely cloudy, and in the advanced stage, the pupil area can be seen to be white under the naked eye.
Cataracts are curable blindness and only surgery can restore vision
In the past, due to medical conditions, most cataracts would end up in blindness. Therefore, once many people heard that they had cataracts, they were pronounced blind. At present, the effects of various drugs for cataracts are not certain. Some eye drops can be taken in the early stage, but they may only slow down the development of cataracts, and there is no such thing as a special drug.
“Many people are misled by advertisements and think that cataracts can be cured without surgery, so they spend a lot of money on drugs, which results in wasted money and delays the disease.” To use an analogy, a cloudy lens is like a hard-boiled egg, and there is no drug that can restore it to a transparent state.
“So cataract is not terrible, it is a kind of curable blindness. With the advancement of technology and the development of ophthalmic microsurgery, cataract removal surgery is widely carried out, which has brought the gospel to cataract patients”, so far, surgery is the only effective measure to treat cataract.
A 95-year-old man with serious eye disease had a cataract that had turned into a “black cataract”.
Early in the morning of October 18, the doctor uncovered the gauze of the right eye of 95-year-old Lou Dingxiang (a pseudonym) in the ophthalmology ward of the downtown hospital, and the old man felt a brightness in front of him, and the objects in the room were clearly reflected in his eyes. It turns out that the old man’s right eye had cataract removal plus IOL implantation surgery the day before, and after examination, the old man’s vision was restored to 0.6.
Lou Dingxiang, who lives in Jiawang District, had an operation for glaucoma ten years ago. “After the surgery vision recovery is not very good, especially the right eye vision decline very quickly, soon developed to even in front of the human shadow can not see.” According to the children of the elderly, after the eye problem, take her to a number of hospitals for medical treatment, but were rejected, the reason is that the elderly are too old, poor health, the risk of surgery is high, “at that time, a doctor said that the right eye condition is too poor, surgery is difficult, the chances of restoration of sight is small, the left eye situation is slightly better, but if there is an accident will lead to both eyes can not see. “
In this way, the old man’s eye disease has been delayed again and again, into the darkness of the old man also more and more silent. Until October this year, a friend recommended them to the downtown hospital ophthalmology.
A detailed examination was done for the old man, and it was found that his right eye was light-sensitive, with glaucoma surgical follicles, pupil size of about 4 mm, the pupil was dilated to check the pupil was not dilated, the lens was fully mixed and hard, brown-black, and the cataract had turned into a “black cataract”. As for the left eye, the visual acuity was 0.1 and there was also an obvious cataract.
The cataract was successfully removed and the vision of the right eye was restored to 0.6
After a comprehensive analysis of the old man’s situation, it was decided to perform cataract removal and IOL implantation in her right eye first. It is understood that under normal circumstances, the cataract surgery incision is made above the cornea and the surgeon sits on top of the patient’s head for easy operation, while Lou Dingxiang can only make the incision on the outside of the cornea due to her eye condition, so she needs to sit on the right side of the patient’s head to perform the surgery.
The old man’s pupil is small, heavy adhesions, difficult to dilate, lens delivery difficulties, so the operation is difficult, but still with superb medical skills, meticulous operation successfully completed the operation, which took only 15 minutes.
Due to the good recovery of vision in the right eye, the old man saw things clearly, moved freely on her own and no longer needed the care of her family. For this reason, she felt very excited and said, “Now there is such a brilliant medical skill, I want to live to be one hundred and twenty years old!”
It is understood that the family is very relieved to see that the old man is recovering well after surgery, and they are going to ask Director Zhi to do cataract surgery on his left eye again some time later.
Cataract ultra-milk surgery to remove cataract is the most ideal
It is understood that with the development of science and technology, cataract surgery methods are constantly being updated and improved. Initially, it was needle dialysis, which was to dial the lens to the vitreous cavity at the back, and later to large incision cataract freezing extraction, both of these surgical methods need to wear 1000 degree farsighted lens after surgery, and the vision recovery is poor; gradually developed to the current extracapsular cataract extraction that retains the posterior capsule membrane, this type of surgery can implant artificial lens.
“The development trend of surgery is that the incision is getting smaller and smaller, the operation time is getting shorter and shorter, and the effect is getting better and better. “The most advanced and ideal operation is cataract ultrasound emulsification plus IOL implantation, and this operation is becoming more and more the first choice for cataract patients.
Cataract ultrasound emulsification surgery is a micro-minimally invasive surgery, which is regulated by microcomputer, and through ultrasound oscillation, together with manual fine operation, the hard lens nucleus is crushed and emulsified, aspirated through a small incision to ensure an intact posterior capsule membrane, and then a folded IOL is implanted, thus enabling patients to recover their vision quickly.
“This surgery has the advantages of short operation time, small incision (only 2.8~3mm), no suture, small postoperative astigmatism, fast vision recovery, fast healing, good results, and it is not easy to tear the posterior capsule during the operation, and low probability of complications such as macular-like edema and retinal detachment after the operation, which is the most advanced and reliable method for cataract treatment at present. “
Cataract removal does not have to wait for “maturity”
“In the past, due to the limitations of medical technology, cataracts had to wait until they were fully ‘mature’ and the affected eye could not see before surgery, and patients had to endure the trouble and pain of low vision for a long time.” Nowadays, with the application and development of cataract ultrasound emulsion aspiration combined with IOL implantation, the safety and effectiveness of cataract surgery have been greatly improved, and patients do not need to wait until they are completely blind before having surgery.
“The whole process of cataract surgery takes only ten to twenty minutes and is painless. Therefore, elderly people should first overcome their psychological fears, and secondly, if they have diseases such as diabetes and hypertension, they should first get their blood pressure and blood sugar under control before coming for surgery.”
For different patients, how early or late they receive the surgery can result in different outcomes. Currently in developed countries patients receive surgery when their vision is 0.5 or higher. We generally consider patients to be considered for surgery when their vision is <0.3 with appropriate glasses.
Since cataract can also cause some eye diseases and inflammation, such as secondary glaucoma, and early surgery can avoid these problems. “Many middle-aged and elderly people are diabetic and hypertensive patients. After surgery, the lens of the eye is clearer, which is better for observing the fundus and better controlling the fundus lesions complicated by high blood sugar and hypertension.”
Senior patients can also receive cataract surgery
In clinical practice, it is found that as China enters an aging society, there are more and more elderly cataract patients, but many feel they are too old and refuse surgical treatment.
“Some patients’ families think that it is too dangerous for people over 80 years old to undergo surgery, but it is not true, because in medicine, there is no uniform limit on the maximum age for cataract surgery.” At present, cataract surgery can be completed by using local anesthesia in the eye, or even by ordering anesthetic eye drops, and the pain is minimal. Many senior citizens are actually able to withstand the surgery because of their own good health and stable blood pressure and heart conditions. She believes that the ability to withstand cataract surgery does not depend on age, but on the patient’s physical condition.
In addition, she reminded that it is wrong to think that “there is no harm in not having surgery when the cataract is mature”. These eye diseases mostly occur in the middle and late stages of cataract, such as expansion and overripe stage, which can not only cause blindness, but also sometimes cause serious inflammation in the eye, resulting in eye atrophy. Some patients can suffer from long-term eye pain that is unbearable and must finally have their eyes removed as a last resort, therefore, she emphasized, “Cataracts must be treated surgically when they develop to a certain extent.”
Health Reminder
What issues should patients pay attention to after cataract surgery?
1. Protect the eye and pay attention to eye hygiene
If you receive cataract ultrasound emulsification surgery, this procedure has a small incision and generally does not restrict normal activities after surgery. However, we should prevent eye trauma, don’t squeeze or collide with the eye, don’t go to dusty places within half a month after surgery, pay attention to avoid water from entering the eyes after surgery when washing the face, and don’t rub the eyes with your hands.
2.Avoid overuse of eyes and prevent eye fatigue
Pay attention to avoid excessive eye use, do not watch TV and computer for a long time, and pay attention to the correct eye posture and ensure sufficient light source, try to avoid reading and working in a dim environment for a long time, and close your eyes or look away for an hour or so to let your eyes rest properly.
3. Refractive correction after surgery
Since most of the implants are hard, non-variable-focus IOLs, in order to compensate for the defects of post-operative refractive adjustment and improve the visual quality of the operated eye, especially for the elderly who need to read and look close, they can generally go for optometry and prescription lenses 3 months after the surgery.
4.Regular follow-up
Early post-operative blurred vision, mild foreign body sensation, and mild redness and blood in the eye are normal reactions. If you experience increased redness and eye pain, tearing, photophobia or blurred vision 2 days to 2 weeks after surgery, you should not take it lightly and go to the ophthalmology department in time to rule out the possibility of intraocular infection.