”This is the description of cataract treatment by previous generations. With the development of medical technology, cataract surgery has been perfected day by day, from the earliest “golden needle plucking” through cataract intracapsular extraction, cataract extracapsular extraction, modern cataract extracapsular extraction, small incision cataract extracapsular extraction to the most commonly used cataract ultrasound emulsification combined with IOL implantation surgery today. The most common cataract surgery today is the cataract ultrasound-emulsification combined with IOL implantation. Due to the short surgery time (usually completed in about 7 minutes), small incision without sutures, high safety and quick recovery, ultrasonic cataract surgery has become a mature eye surgery. Ms. Xiao loves calligraphy, but within six months, she had monocular diplopia in both eyes and could not write calligraphy. In August this year, she came to our clinic. The right eye has 0.25 distance vision, corrected -0.25DS=-0.75DCX120o→0.3, near vision jr7/30cm; the left eye has 0.3 distance vision, corrected -0.50DS=-0.50DCX80o→0.4, near vision jr7/30cm; 33cm reflective light orthoptics; both eyes have clear corneas, lens right eye NC2C5P2, left eye NC2C5P1, no fundus abnormalities seen in both eyes. Diagnosis: bilateral age-related cataracts (cortical). The current cause of Ms. Xiao’s monocular diplopia was due to the change in refractive index caused by morphological changes in the lens cortical fibers. The irregularity of the lens clouding and the inconsistency of the order of occurrence caused a disruption of the refractive state, resulting in monocular diplopia. So I explained to her that her monocular diplopia was crystalline in origin and could not be solved by lens prescription, but by cataract surgery. Ms. Xiao was puzzled and asked, “I always thought that cataracts could only be done when I was old and blind, but can I do it with my eyesight?” I patiently explained to her, “In the past, cataract surgery was required to be done at a more mature level because the entire cloudy lens was delivered through a large incision, so mature cataracts were relatively easy to operate. requires more ultrasound energy and time to complete the surgery, which causes more damage to the intraocular structures, especially the corneal endothelium, so immature cataracts have less intraocular loss and surgical complications relative to each other, and have better postoperative results.” Ms. Xiao understood the mechanism of the ultrasound emulsification surgery and asked, “I heard that I have to put a mirror in my eye, what kind of mirror should I put?” . I explained, “IOL implantation is the finishing touch to a complete cataract surgery, and the good or bad vision after surgery is not only related to the surgery itself, but also to the type and quality of the IOL. In addition to non-foldable hard crystals, there are more foldable soft crystals, which make the incision of ultrasound emulsification surgery reduced from 6mm to 3mm or even smaller. Patients can recover their vision faster and have less astigmatism after surgery. There is a difference between multifocal and monofocal IOLs. Multifocal IOL implantation can generally solve the need of seeing things at far and near distances, while monofocal IOL implantation can only solve the need of seeing far or near.” Since Ms. Xiao likes to work at close distances, I suggested her to choose multifocal IOL implantation, which can solve the need of long-medium and near distance vision, and the patient gladly accepted my suggestion. Before the surgery, I performed systematic systemic and ocular examinations, such as blood pressure control, fasting blood glucose of 8 mmol/l, discontinuation of anticoagulants, etc. After making sure that there was no infection in her body, she was given regular antimicrobial eye solution 3 days before the surgery to prevent infection; one hour before the surgery, she was given compound tropicamide to fully dilate her pupil. Surgical procedure: Part I: Ultrasonic cataract aspiration 1. Surface anesthetic 0.4% Benoxyl is ordered 2-3 times in the operated eye. 2.Routine disinfection of the operative eye to spread the towel, paste protective film, and simple lid opener to prop up the operative eye. 3.Incision: The location of the main incision and the type of incision (clear corneal incision, corneoscleral rim incision, scleral incision) are selected according to the operator’s habit or corneal curvature. 3mm main incision is made at the corneoscleral rim for this operation. 4.Inject viscoelastic into the anterior chamber and make a lateral incision 90 degrees or more away from the main incision. 5.Circular tear capsule: tear capsule forceps to make a centered, continuous circular tear capsule of about 5mm in diameter. 6.Water separation and aqueous layer: The lens cortex is separated from the capsule membrane (water separation) and the lens cortex is separated from the lens nucleus (aqueous layer) with balanced salt solution. 7.Ultrasonic emulsification: The ultrasonic emulsification machine is adjusted to the ultrasonic emulsification program, and the ultrasonic needle is inserted into the autonomous incision, and the cloudy, hardened lens nucleus is divided into small pieces with the cooperation of the splitting knife, and the nucleus is broken up by ultrasonic vibration, and then these small pieces are sucked out by negative pressure suction, and this process is called ultrasonic emulsification. 8. Cortical removal: The ultrasound emulsification machine is adjusted to the injection-suction procedure, and the injection-suction needle is inserted into the autonomous incision to remove the residual cortex. Part II: IOL implantation is performed by feeding the IOL into the lens capsule through the implant, adjusting the IOL position, replacing the viscoelastic, and closing the mouth with water. After the operation, he was instructed not to shake his head violently, lower his head, rub his eyes as much as possible; control coughing and sneezing; keep the bowels open, prevent constipation, and eat more coarse fiber food; strictly follow the doctor’s requirements for eye drops, pay attention to keep the hands hygienic when dropping eye drops, and do not squeeze the eyeball. On the first day after the surgery, the patient’s monocular diplopia disappeared, her binocular distance vision was 0.8 and her near vision was jr2/33cm; Ms. Xiao was very satisfied and happy with the surgery result, because she could continue her favorite calligraphy work again.