Auntie Min has been suffering from high myopia since she was a child, and her vision has been deteriorating in the past six months, with her myopia increasing from a few hundred degrees to more than 1,000 degrees. However, the doctor told her that because of the macular degeneration in her highly myopic eyes, her cataract surgery would not work well and her symptoms would worsen. After coming to our hospital for treatment, the author examined her fundus in detail and found that her fundus was indeed extensively atrophied, but a well-functioning retina still existed in the central region of the visual axis, and it was expected that her vision could be significantly improved after surgery. Sure enough, her visual acuity was corrected to 0.8 at the 1-week postoperative review after cataract ultrasound emulsion extraction and simultaneous implantation of an aspheric, UV-protected IOL. The following author will analyze this case and why such a good result could be obtained after surgery.
Can cataracts produce or deepen myopia Cataracts are clouding of the lens, which acts as a lens in the eye to focus and image light on the retina. In cataracts caused by high myopia, the clouding occurs mainly in the nucleus of the lens. As the cataract develops, the lens changes its role in focusing light, and light cannot be focused on the retina, leading to myopia in people who are not originally myopic and to a deepening of myopia in people who are nearsighted.
Indications for surgical cataract treatment Surgical cataract treatment is the safest, efficient, fast and painless method nowadays. Most elderly people can receive this surgery except for some elderly patients with poor general condition. Moreover, cataract surgery has entered the refractive era, which is far from what it used to be. High myopia with cataract has become an indication for surgery, and the surgical results are quite good. Many patients who have undergone the surgery say, “If I had known it was so easy, I wouldn’t have had to endure it for so long! The results are quite good. The concept of waiting until the cataract is fully mature before surgery is out of step with the times, which not only greatly increases the patient’s pain of low vision, but also easily causes various complications and leads to irreversible blindness. In the majority of grassroots areas, patients and even some doctors still have the same understanding of cataract as in the past decades, or they mistakenly believe in false advertisements that they can be treated by medication, thus missing the good time for treatment, which is a pity.
Can high myopia be operated when the fundus is broken? The statement “the fundus is broken and cannot be operated” is a statement I often hear. It is true that high myopia is mostly accompanied by retinal macular lesions, but most of the lesions are not serious and it is still possible to restore most of the vision or even normal vision through cataract surgery. With this misconception, many patients with high myopia easily and stubbornly refuse surgery and give up the opportunity to improve their quality of life.
The best cataract treatment The most advanced and mature cataract ultrasound emulsion surgery, with a surgical incision of less than 3 cm, can not only shorten the post-operative recovery time, but also reduce tissue damage and the chance of post-operative astigmatism and complications; the invention of functional IOLs, including the ability to filter harmful blue light and reduce the chance of retinal degeneration due to exposure to blue light; the aspheric design can reduce the aberration of the eye system and protect night vision. The aspheric design reduces aberrations in the eye system to ensure the quality of night vision; the multifocal design simulates the natural lens adjustment function, allowing for comfortable distance viewing and astigmatism correction, and other artificial lenses to meet the different vision needs of patients and provide the best visual quality. Patients can choose the right functional IOL according to their individual needs.