1.How to prevent senile cataract
The causes of senile cataracts are not well understood so far. It is especially important for the elderly to take care of their eyes. Many elderly people’s eyes are still crystal bright, and the changes in the lens only increase in density and harden the nucleus, and there is no lamellar or block turbidity, and their vision is also in the normal range.
Preventive measures may include the following.
(1) appropriate increase in nutrition: eat more fruits and vegetables and other foods with high vitamin content, prevent ultraviolet radiation, wear UV-protective sunglasses when going out when the sun is strong, and often use some eye medications or oral medications that are beneficial to lens metabolism. Patients suffering from diabetes or other endocrine – metabolic diseases should be treated promptly and controlled early.
(2) Pay attention to eye care in general: time spent reading, writing and watching TV should be properly controlled. Go outdoors every 1-2 hours to let your eyes rest for a while, and do not read in the dark. If you have refractive errors such as farsightedness, myopia or astigmatism, you should go to the hospital for optometry or to a regular professional optician to wear suitable glasses to avoid eye strain. Do not just go to the stall or irregular optical store, without the correct optometry, buy a pair of glasses to wear, which will bring damage to the eyes.
(3) Life and living should be regular: control your emotions and temper, be cheerful, rest and exercise should be reasonably arranged.
(4) Reasonable arrangement of diet: three meals a day to ensure adequate nutrition in addition, should eat more food rich in vitamin C, vitamin E, less greasy, too salty food, avoid smoking and alcohol, avoid overeating.
2.How to prevent concurrent cataract?
The prevention of concurrent cataract is to actively treat the primary cause of cataract. Actively prevent and treat eye diseases such as iridocyclitis, chorioretinitis, glaucoma and retinal detachment. Once a patient has a complicating cataract, the lens and fundus should be checked regularly for further treatment measures in addition to active treatment of the primary cause. Complicated cataracts are more difficult to treat and operate, have more complications, and have a worse prognosis than senile cataracts, so it is more important to prevent the occurrence of complicated cataracts.
3. Is cataract medication effective?
There is no definite effect of cataract medication, and it is at the stage of exploration and research at home and abroad. For some early cataracts, the development of the disease may be slowed down and the vision may be slightly improved after medication, but this is not necessarily the result of medication, because the early progress of cataract to maturity is a long process, and it may stop at a certain stage of development naturally without seriously affecting the vision. In some patients with intermediate cataracts, neither vision nor lens clouding improves with medication. In near-mature cataracts, drug treatment is even less practical. At present, there are no less than several dozens of drugs commonly used in clinical practice, including eye drops or oral Chinese and Western medicines, but none of them has exact therapeutic effect.
4.Can cataract cause blindness without surgery?
Some patients do not understand cataract disease and do not want to undergo surgery even if they have lost their eyesight after cataract. Some other patients have lost their eyesight in one eye, but they still have some vision in the other eye to maintain their life, so they do not want to have surgery. However, they do not know that cataract disease has to develop and overripe cataract can cause many complications. We already know that cataract medication is ineffective and the only way to see again is through surgery. If cataract is not operated in time, it may cause complications such as secondary glaucoma and uveitis due to overripe cataract, and patients may have headache, eye pain, lacrimation, nausea, vomiting, etc. At this time, if operated again, the effect is poor, and sometimes even lose the opportunity to restore sight. In addition, cataract usually develops in both eyes one after another, and after one eye is blind, the other eye will also be seriously affected by the development of cataract clouding within a certain period of time, so patients who have lost their eyesight when one eye is mature and the other eye still has a little vision should have surgery in time. At the same time, patients may lose the opportunity of surgery due to poor health conditions or changes in eye conditions, which will cause lifelong regret.
5.What are the common surgical methods for cataract?
(1) Cataract intracapsular extraction: This surgery was the most common way to remove cataract. It is relatively simple and can be performed by using carbon dioxide or Freon condenser or surgical forceps to force out the cataract and capsule membrane together. The pupil is also clear in the postoperative area and no posterior cataract occurs. This procedure requires a large surgical incision, and the delivery of the lens has a greater impact on the intraocular tissues, especially on the vitreous. It tends to cause vitreous detachment, pupillary block secondary to glaucoma, macular cystoid edema, retinal detachment, etc. Because the lens capsule is removed together with the surgery, the posterior chamber IOL cannot be implanted at the same time.
(2) Cataract extracapsular extraction: It is a common method of modern cataract surgery and requires operation under an operating microscope. The incision is smaller than that of intracapsular extraction, and the cloudy lens nucleus is discharged and the cortex is aspirated, but the posterior lens capsule is left behind. The basic approach is a three-step procedure: an appropriate incision is made in the cornea or sclera, the anterior lens capsule is cut open, the lens core is expelled, and the lens cortex is aspirated. The posterior capsule is preserved and a posterior chamber IOL can be implanted at the same time, allowing immediate restoration of visual function after surgery. Therefore, extracapsular extraction of cataract has become the routine surgical procedure for cataract nowadays.
(3) Cataract ultrasonic emulsification: This is a new type of cataract surgery developed at home and abroad in recent years. Using an ultrasonic emulsification instrument, the lens nucleus is crushed through a 3-5 mm corneal or scleral incision with ultrasonic waves to make it celiac, and then aspirated together with the cortex. The advantages are small incision, less tissue damage, good anterior chamber maintenance, short operation time, fast vision recovery, stable refractive status, and small corneal astigmatism.
6.When is the best time to operate for senile cataract?
This issue needs to be considered according to the patient’s comprehensive situation, such as the degree of lens clouding, visual acuity, the patient’s general condition, and the patient’s working requirements for visual acuity. In the past, surgery for senile cataracts was only done when the lens was fully mature and could not be seen, especially the cataract freeze extraction (intracapsular extraction) that was done in the past. However, with the continuous progress of science and technology, cataract surgery methods have made a qualitative leap. Advances in ophthalmic surgery, the introduction of the artificial lens, and continuous improvements in surgical techniques have led to the adoption of modern microscopic extracapsular cataract extraction and artificial lens implantation. This procedure is safe and has a high success rate. Therefore, it is not necessary to wait until the lens is completely clouded before surgery is performed. Generally speaking, surgery can be considered when the patient feels difficulty in work and life, has difficulty in reading, has vision below 0 or 2, and cannot be corrected with lenses. For those with high vision requirements or difficulties in self-care (such as computer operators, instrument repairers, drivers, etc.), even if the cataract is not mature and the vision is around 0.4, surgery can be performed earlier.
7.Is there an age limit for cataract surgery?
With the development of modern microsurgery, the continuous improvement of surgical methods and the perfection of surgical instruments and microscopes, the success rate of cataract surgery is greatly improved and the complications are significantly reduced. Therefore, the indications and age limits for cataract surgery have been greatly relaxed. Congenital cataracts can generally be operated on 1-2 months after birth. The earlier the surgery, the better the functional development of the retina and macula of infants and children. Traumatic cataracts are generally not age-restricted. Traumatic cataracts of any age group can be considered for surgery if they affect vision. For senile cataracts and concurrent cataracts, even elderly people over 100 years old can still receive cataract surgery as long as their eye condition and general condition allow.
8.What should I pay attention to after cataract surgery?
Modern cataract extracapsular extraction surgery is very delicate, and the incision suture is also very tight, so there are few complications after surgery if proper care is taken.
The following issues should be noted after surgery.
(1) Patients should not squeeze their eyes hard, avoid strenuous activities, and take anti-cough or anti-emetic drugs if they have cough or vomit.
(2) After surgery, the patient should lie flat, relax the head as much as possible, avoid moving the head too much, breathe naturally, and do not hold the breath or sneeze hard. Eating, urinating and defecating can get up, but the movement should be slower and the head should be lowered as little as possible.
(3) The operated eye is generally painless after surgery. If there is obvious pain, attention should be paid to whether there is intraocular infection, elevated intraocular pressure, or blood accumulation in the anterior chamber.
(4) Metal or plastic protective eye shields should be added to the operated eye after surgery to avoid accidental injury to the operated eye, and medication should be changed once a day.
(5) Most of the elderly cataract patients are old and frail, and have a variety of diseases combined with their body, so they need to be treated with appropriate medication, and if necessary, ask for the assistance of a specialist.
(6) Do not eat food that is difficult to chew or too hard for 3 days after surgery, do not eat irritating food, and avoid smoking and alcohol.
(7) Keep the bowel movement smooth and make the habit of defecating once a day.
9.How to correct the vision of senile cataract surgery?
We already know that cataract surgery is equivalent to removing a high number of convex lenses, if we want to correct the vision, we need to add another high number of convex lenses.
At present, there are three methods commonly used in clinical practice.
(1) Wearing glasses: This is the simplest method, but there are many troubling optical disadvantages. For example: image magnification, the degree of magnification is about 20%-30% of the original, the field of view becomes smaller, the peripheral field of view is missing, only the center of the scene can be seen clearly, while the surrounding blurred, object image distortion, etc.. In addition, the glasses have high prescription and heavy weight. Patients need a period of adaptation to wear these cataract glasses, and they are not suitable for patients who have undergone cataract surgery on one eye only, as they can cause double vision, dizziness and dizziness.
(2) Wearing corneal contact lenses (contact lenses): Wearing contact lenses provides better results than lens-free glasses. It can have good peripheral vision, and although the image release is about 7% or so, it is not easily noticeable to the patient. It can be suitable for monocular cataract patients. However, it is important to know the correct way to wear contact lenses and to clean them daily to prevent corneal and conjunctival infections caused by lens dirt. Patients with dry eyes or those who are not dexterous with their hands are not suitable for wearing contact lenses. Elderly cataract patients are mostly elderly, so it is not easy to accept.
(3) Implantation of an artificial lens: An artificial lens made of a special polymer material is surgically implanted into the eye to replace the original cloudy lens that was removed. Because it is implanted in the anatomical location of the original lens inside the eye, you can have very good vision after surgery and do not need to wear glasses anymore. For an elderly person, it is an indescribable joy to wake up every morning and be able to see clearly. The refractive index of the implanted IOL must be measured by highly sophisticated instruments, such as A ultrasound to measure the length of the eye axis and keratoconus to measure the curvature of the cornea, and then input into the computer to calculate the exact number of IOLs.
10.Can all elderly cataract surgery patients be implanted with IOLs?
Due to the continuous improvement of cataract surgery technology and the significant improvement of IOL quality, most elderly cataract patients want to have IOL implanted at the same time to obtain satisfactory vision at an early stage and to avoid the trouble of wearing glasses after surgery. However, IOL implantation has its own indications and there may be some postoperative complications. Therefore, whether or not to implant an IOL in the operated eye after cataract removal depends on the ocular and systemic conditions and vision requirements of each cataract patient. In addition, the medical conditions in the patient’s region, the surgeon’s surgical skills, the patient’s financial status and psychological state are all factors to be considered. Generally, if the patient has no other important eye diseases (such as vitreous, retina, optic nerve and iris lesions) and no serious systemic diseases (such as serious heart disease and diabetes), implantation of IOL can be considered.
11.What should I pay attention to after IOL implantation?
Elderly cataract patients who have undergone modern microscopic extracapsular cataract extraction surgery and implanted an IOL at the same time can immediately recover their vision and “see the light again”, which makes them very happy.
The following issues should generally be noted.
(1) Ideologically, we should not relax our vigilance and think that everything is fine after surgery. The IOL implantation is after all a foreign body in the eye, and sometimes it can produce certain complications, so we should strengthen our observation and pay attention to protection so as not to lead to serious consequences.
(2) After IOL implantation, attention should be paid to any pain in the operated eye, any deviation or dislocation of the IOL position, any inflammatory exudation in the anterior segment of the eye, and any adhesion of the iris and pupil.
(3) After surgery, the eye should be checked once a week, including visual acuity, anterior segment, IOL and fundus. 1 month later, the eye should be rechecked regularly according to medical advice.
(4) Avoid strenuous exercise, especially low head movement, overexertion and cold for 3 months after surgery.
(5) Hormonal and antibiotic eye drops should be administered several times a day for 1 month after surgery, and weaker pupil-dilating eye drops should be administered as prescribed by the doctor to prevent pupil adhesions. For long-term use of hormonal eye drops, attention should be paid to intraocular pressure to avoid hormonal glaucoma.
(6) Keep the bowel movement smooth, eat less stimulating food, avoid smoking and alcohol, and eat more fruits and vegetables.
(7) 3 months after surgery should go to the hospital for routine examination and refractive examination, and those who have refractive changes can be corrected by prescription lenses after experience. Generally, you can participate in normal work and study after 1 month.