Many elderly people who go to hospitals for medical checkups find themselves diagnosed with senile cataracts, which are actually due to the clouding of the lens, a transparent and elastic “lens” inside the eye, as we age, preventing light from entering the eye. Patients generally do not feel any discomfort other than the progressive increase in blurred vision. Cataracts are the most common blindness-causing eye disease, and the prevalence of cataracts among the elderly over 60 years old is rising steeply. 100% of the elderly over 80 years old will get cataracts, which not only seriously affects the vision and quality of life of elderly patients, but also causes a great burden to families and society. Nowadays, China has entered an aging society, and the number of elderly cataract patients has also increased significantly. Therefore, it is a major issue for the whole society to pay attention to the health of the elderly, especially the timely treatment of elderly cataract. The most common question that ophthalmologists hear when facing elderly cataract patients is: Can cataract be cured by eye drops? Is it possible to take medicine? The answer is no. There is no eye drop or oral medication that can cure cataracts, and eye drops used for cataract patients only slow down the progression of the disease in the early stages of cataracts and serve to relieve related symptoms (e.g., visual fatigue). Surgery is the only effective way to treat cataracts. The purpose of surgery is to remove the clouded lens and implant a clear lens so that it can function as a normal “lens” for light transmission. When should I have surgery for cataracts? Older people may often hear the words, “Your cataract is not ripe yet, so come back for surgery when it is.” In fact, with the rapid development of surgical technology in recent years, this view has been eliminated as ultrasound emulsification has become a routine cataract surgery method. Now, ophthalmologists advocate that cataract surgery should not wait until maturity, but should be performed promptly when it affects the patient’s daily work or life. This is because as cataract develops, if surgery is not performed in time, it may cause serious complications such as glaucoma and uveitis; at the same time, the more mature the cataract is, the longer the ultrasound emulsification surgery takes, the greater the surgical risk, and the slower the recovery after surgery. The general clinical standard is that surgery can be performed when the visual acuity drops below 0.5. Certain patients with high vision requirements such as painters, photographers, drivers, etc. should also undergo surgery early, although their vision is above 0.5, but the degree of cataract has affected their daily activities. Among other ophthalmic diseases, cataract surgery should also be performed on patients with diabetic fundus lesions that are affected by cataracts, as well as patients with acute angle-closure glaucoma. When it comes to the word “surgery”, some elderly patients are inevitably worried about the safety of cataract surgery for the elderly. It is safe to say that the current surgical method, ultrasonic cataract aspiration combined with IOL implantation, is very safe. The procedure involves entering the eye with an instrument through an incision as small as 3.2 mm in length or even smaller, and using the vibrational energy of ultrasound to break up the cloudy lens and aspirate it out, and then implanting an IOL. The entire procedure is usually completed in less than half an hour, and only a drop of surface anesthetic is needed to achieve anesthesia. The surgical incision does not require sutures, and the postoperative response is mild with a low complication rate. Crucially, the patient’s vision is restored to a satisfactory state within a few days or even the same day after surgery. Although cataract surgery is safe, ophthalmologists recommend that the surgery can be performed smoothly and with more desirable results if patients cooperate with their surgeons in the following ways First, it is important to consider the systemic and local conditions of the eye before undergoing surgery for senile cataracts. Because elderly people often suffer from many chronic systemic diseases such as hypertension, diabetes and heart disease, cataract patients should consider surgery only when they are in good general condition, with normal heart function, blood pressure and blood sugar controlled within the normal range and infectious diseases such as pneumonia cured. For the eye, it must be confirmed that there is no active inflammation of the eye such as acute or infectious conjunctivitis, lacrimal sacculitis, and mydriasis. Secondly, in addition to a rigorous general and ocular examination, patients should be psychologically prepared before surgery. Patients should fully understand their condition and the general procedure of surgery, and should fully trust their surgeon, eliminate any worries about the procedure, and prepare for the surgery as instructed by the medical staff. Stay relaxed on the operating table and cooperate with the surgery as instructed by the surgeon. Both eyes are usually not operated on the same day, as this increases the risk of surgery. On the day after surgery, some patients may feel discomfort such as tingling, tearing and foreign body sensation in the eyes. This is a painful irritation from the surgical incision after the surface anesthetic has worn off and can be relieved after a few hours of rest. Many patients feel dry eyes after surgery, which is due to the need to constantly flush the eye surface during surgery, thus damaging the tear film. This can be treated with artificial tears after removal of the eye shield and is usually recovered in about one month after surgery. Patients should also be aware that antibiotic and hormonal eye drops should be administered to the operated eye for about one month after discharge to prevent infection, and that the eye should be reviewed at the time agreed upon by the doctor. If there is a significant decrease in vision compared to when they were first discharged, sudden eye pain, double vision, etc., they need to return to the hospital immediately. The operated eye may not adapt to the strong light at first, so you can wear sunglasses to block the strong light. Do not overuse the eye in the early postoperative period, and avoid strenuous exercise and collision with the operated eye to avoid incision cracking or even dislocation of the IOL. Avoid eating spicy and stimulating foods. The recovery of visual quality after surgery is the most important concern of cataract patients. First of all, it must be understood that for patients who already have various fundus pathologies, cataract surgery cannot restore their vision to a normal state and treatment of related fundus diseases is required after cataract surgery. Secondly, most patients are currently implanted with monofocal IOLs, which do not have the adjustment function of the natural human lens and can only improve the patient’s distance vision or near vision, but cannot achieve the ideal state of both distance and near vision. Cataract surgery changes the refractive state of the eye, and it takes some time for the operated eye and the IOL to adapt to each other, usually stabilizing three months after surgery, at which time if the patient needs more perfect vision results, optometry can be performed to meet further needs. Cataract is the most common eye disease of the elderly. And with the development of technology and social progress, cataract ultrasonic emulsion aspiration combined with IOL implantation has become one of the most common eye surgeries. We hope that the knowledge about cataract surgery can be similarly popular among the elderly, so as to eliminate many previously existing misconceptions and allow them to easily undergo cataract surgery and obtain normal vision smoothly. We wish all our senior citizens to have healthy and bright eyes!
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