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Abstract: High myopia complicating cataract is a complex cataract with high risk of blindness and is the leading cause of visual impairment in people aged 45-59 years in China. This case is an elderly female patient with 5 years of progressive vision loss in both eyes, self-consciousness of blurred vision and plastic film obscuring sensation, diagnosed with ultra-high myopic cataract in both eyes, and removed her glasses in half a month by admission for cataract surgery with good surgical results, fast recovery and significant improvement of vision.
Basic information】Female, 62 years old
Disease Type】High myopia (both eyes), cataract (both eyes)
Hospital】The First Hospital of Harbin Medical University
Date of Consultation】March and April 2022
Treatment plan】Surgical treatment (cataract ultrasonic emulsion aspiration + IOL implantation) + medication (levofloxacin eye drops + pralophine eye drops + tobramycin dexamethasone eye drops + sodium glassate eye drops)
[Treatment Period] 1 day of inpatient treatment, half month of outpatient review
The effect of the treatment is that the visual acuity is significantly improved and the quality of life is significantly improved by removing high myopia glasses.
I. Initial consultation
The patient lives in a remote village and has not been seen for 5 years for vision loss with dry eyes and increased discharge from the corners of the eyes in the morning, has high myopia in both eyes, has worn heavy glasses all his life, and has hypertension and cerebral infarction.
He had a high degree of myopia in both eyes, had worn heavy glasses all his life, and had a hypertensive cerebral infarction. Optometry was not performed in the right eye because of heavy lens clouding and 1225 degrees of myopia in the left eye. OCT of both eyes showed high myopic retinopathy in the fundus. After the above examination, the patient was diagnosed with high myopia complicating cataract and was recommended to be admitted to the hospital for surgery.
II. Treatment history
The patient was admitted to the hospital on the morning of the second day. Before surgery, the IOL Master was used to measure the personalized parameters of the eye, and the surgeon selected the most suitable IOL and the number of degrees according to the patient’s condition and need for vision. The number and quality of endothelial cells were checked by endothelioscopy to see if they could tolerate the procedure. The patient was also given a full eye irrigation before surgery to prevent infection and stabilize blood pressure and blood sugar. On the same day, the cataract ultrasound aspiration combined with IOL implantation in the right eye was performed. The surgery went smoothly for 5 minutes, and the patient felt no pain during the surgery with local anesthesia, and the incision was small without sutures.
III. Treatment effect
On the day of surgery, gauze was used to protect the operated eye. On the second day, the doctor saw that the patient’s visual acuity improved significantly from the preoperative corrected visual acuity of FC/50cm in the right eye and 0.1 in the left eye to the postoperative bare eye visual acuity of 0.4 in the right eye and 0.3 in the left eye. After surgery, the patient was instructed to take a combination of levofloxacin eye drops, pralofene eye drops, tobramycin dexamethasone eye drops, and sodium vitreous acid eye drops for 1 month. The patient was reviewed at the outpatient clinic half a month after the surgery and recovered very well, and the quality of life was significantly improved. The right IOL was checked to be in place, and the patient could be admitted for surgery on the left eye. The patient was then admitted to the hospital and underwent the same surgery and postoperative procedure as the right eye, and the recovery of the left eye was also better in the postoperative examination.
IV. Precautions
The patient was able to remove the thick glasses she had been wearing for so many years through active surgical treatment, so I am very happy for her, but she should not relax her vigilance in her daily life after surgery, and needs to pay attention to the following matters.
1, it is recommended to pay attention to drink more water and maintain a light and easy-to-digest diet after discharge.
2.Avoid direct glare on the eyes or seeing in bright light, such as when going out when the sun is highly strong, it is recommended to wear sunglasses, pay attention to the condition of the eyes at all times, and seek medical attention if dry eyes occur again.
3, pay attention to the reasonable use of eyes, more rest, to avoid eye fatigue, causing more pressure on the eye nerve.
V. Personal insight
The patient’s high myopia can lead to early onset of cataract and make the disease progress more rapidly. Fortunately, cataract surgery is now a mature technology with features such as painless, small incision and fast recovery, which can effectively improve surgical results and enhance people’s quality of life. If patients experience a gradual loss of vision without obvious causes, they should come to the eye hospital as soon as possible, just like the case patients, for early detection and treatment. In particular, patients who also have high myopia should strengthen the prevention of this disease, pay attention to eye hygiene and habits in daily life, do not overuse the eyes, and seek medical attention promptly when symptoms such as dry eyes and increased secretions occur.