Prior to the 1980s, it was common knowledge that cataracts should wait until they were “mature” before surgery, as this was considered appropriate due to the limitations of the medical level and medical equipment at the time. The modern extracapsular surgery (only a small piece of the capsule is removed from the center of the anterior surface of the lens. Soon after, IOLs were introduced and posterior chamber IOLs were implanted, which was a quantum leap in cataract surgery treatment. Later, on the basis of modern extracapsular, ultrasonic emulsification cataract and IOL implantation was a major breakthrough in the field of ophthalmology in the 1990s. Thus, the so-called “maturity” of cataracts has long since become obsolete. Now, in the United States, even a vision of 0.5 can be operated, but of course, their elderly people have higher vision requirements, such as driving their own cars and operating computers. In our country, patients with visual acuity of O.3 or corrected visual acuity below 0.6, if the cause of low vision is related to cataract, can have surgery.
For highly myopic patients who do not want to wear heavy frame glasses and those with systemic diseases such as hypertension and diabetes, which cause fundus lesions and both are accompanied by cataract, the clouded lens should be removed early if there is no contraindication to cataract surgery. Implantation of IOL. One is to remove the heavy glasses and eliminate the trouble of taking them off: the other is to provide convenience for peeping at the occurrence, development and treatment effect of fundus disease. Of course, the post-operative vision of such patients is definitely not as good as that of simple age-related cataracts, and there are many complications. But then again, for those who have or will have fundus lesions. It is beneficial for the timely treatment and protection of useful vision. Otherwise, the fundus is lost to treatment, and then surgery is also futile.
People with glaucoma and cataract are interested in long-term drug use to control IOP. When it is too troublesome or the treatment effect is not ideal, combined glaucoma cataract surgery is feasible to achieve the purpose of treating two diseases with one knife.
As far as ultrasonic cataract surgery is concerned, in a sense, the more “raw” the cataract is, the better it is and the fewer the complications of surgery. If elderly people have high vision requirements and are engaged in delicate work with O.5 vision, why not have surgery earlier?
In conclusion, there is no unified standard for cataract surgery. Although there is still some controversy among people within the profession, which is normal, a consensus will eventually be reached as time goes by and practice raises awareness. Where cataracts cause vision loss, depending on the degree to which the vision affects your quality of life and is intolerable to the person, surgery may be performed. This relaxes the choice of surgery time and makes it more humane. One thing is for sure, there are no drugs in the world that can cure cataracts yet, and its surgical method has evolved to become a near perfect treatment .