Fifteen years ago, cataract surgery required cutting open half of the cornea, dragging out the entire cataract, and then closing the cut cornea with sutures. The doctor was touched. Ten years ago, cataract surgery took a quantum leap with the gradual popularization of ultrasound emulsification technology. The target group of cataract surgery has transitioned from patients who are close to blindness to those whose visual impairment affects their lives, and doctors’ pursuit of post-operative vision has changed from seeing to seeing clearly. During this time, there has been a great deal of research on cataract surgery modalities, incision size and location, and these studies have provided much experience for the improvement of cataract surgery. In recent years, cataract surgery techniques have advanced dramatically. Cataract surgery has reached a very high level of speed and safety, but in this case, there are still some patients who do not feel particularly happy after surgery. I often wonder if patients are too demanding or if we have not done our job properly. I would like to share my personal experience here. I think that doctors and patients view and evaluate surgery differently, and this is often overlooked. However, if cataract surgery is to be further improved, a doctor has to think from the patient’s perspective. For the surgeon, the three issues to consider in cataract surgery are safety, speed and quality in order of importance, while for the patient, the three issues should be safety, quality and speed. Safety is always the first priority, and there is a consensus between doctors and patients on this point. But in the perception of speed and quality physicians and patients differ greatly. Many doctors spend a lot of energy and make a lot of efforts to shorten the operation time from 15 minutes to 10 minutes and from 10 minutes to 5 minutes, but they do not spend enough energy to improve the postoperative naked eye vision from 0.6 to 1.0. Although there is a great difference between people, and a considerable number of people who do not have cataracts cannot achieve 1.0 vision, so even if the cataract surgery is perfect, there will be some patients who cannot achieve 1.0 vision. It is undeniable that there will be some patients who cannot achieve 1.0 vision. However, there are some controllable factors in the surgery that can help patients achieve better vision. If there is no glaucoma, fundus disease, or corneal disease, I hope that everyone with simple cataracts will have 1.0 postoperative naked eye vision. Where does better postoperative naked eye vision come from? I think there are several factors that deserve attention: 1. Close to none postoperative reactions: high intraocular pressure, anterior chamber inflammatory reaction, and corneal edema are common postoperative reactions that may affect the vision on the first day after surgery, although these reactions can disappear completely after a few days of medication, but a good surgeon can completely slow down slightly and avoid these conditions through fine and gentle manipulation. From the doctor’s point of view, fast surgery may be more important than fine surgery; however, if we consider the problem from the patient’s point of view, a better postoperative experience can be obtained with close to no postoperative reactions, and fine surgery is more important than fast surgery. 2, as small as possible postoperative astigmatism: postoperative astigmatism is the main factor affecting postoperative naked eye vision, although some patients can get better corrected vision through optometry, but most patients will not wear glasses because of simple astigmatism, so corrected vision is only a psychological comfort to patients, so that patients know they can see clearly. In my personal opinion, the pursuit of the smallest possible postoperative astigmatism requires careful selection in terms of surgical incisions, and the scleral tunnel incision has distinct advantages over the clear corneal incision. The clear corneal incision is characterized by simplicity, speed, and no bleeding, but has a large astigmatism and an increased risk of endophthalmitis. The scleral tunnel incision is time consuming and laborious for the surgeon, but patients can mostly benefit from it. If I were thinking from the doctor’s perspective, I would consider a clear corneal incision, but if I were thinking from the patient’s perspective, a scleral tunnel incision would be a better choice. However, there are patients who cannot accept a conjunctival incision, or where the superior conjunctiva needs to be reserved for other treatments, which is a different story. 3. Lower incidence of posterior cataract: After cataract removal, the retained capsule becomes hard and cloudy causing the patient to lose vision again is called posterior cataract, although it can be solved by simple laser treatment, the process of this change can affect the patient’s experience. Therefore, as a doctor, we cannot ignore this problem just because it is easy to solve. I personally feel that it is necessary to spend some time in the middle of the surgery to deal with the posterior capsule. In addition, through a period of time, I found that it is very effective to give early laser posterior capsulotomy to patients with signs of posterior cataracts, that is, to do this laser treatment when the patient’s vision is quite clear, instead of waiting until some patients have lost vision for months or years because of posterior cataracts. In addition, the patient will not have the unpleasant experience of vision loss. 4. Higher level pursuit: Patients with high myopia can get rid of thick glasses through cataract surgery, patients with astigmatism can have their cataract treated and their astigmatism corrected at the same time, and elderly people can see far and near without glasses after cataract surgery. All these work is being done now, but still needs a lot of exploration to do better. A safe surgery is counted as 60 points, a fast and comfortable surgery is counted as 80 points, a surgery with a very mild postoperative reaction is counted as 90 points, and a clear vision after surgery is counted as 100 points. A surgeon, in every surgery, should think about the best post-operative experience for the patient and work hard for the 100 points of the surgery. Of course, this aspect also requires sincere treatment and open communication between the surgeon and the patient.