I would like to thank all my patients for their trust in me. Patients often ask me what treatments are available for cataracts, when they should have surgery and the cost of surgery, and what they should pay attention to before and after surgery.
General knowledge of cataract
What are cataracts and their clinical manifestations?
Cataract is the most common eye disease that causes blindness. The clouding of the tissues in the eye called the lens, which leads to vision loss, is called a cataract. The main symptoms are a shadow in front of the eye and a progressive, painless loss of vision. Monocular diplopia and hyperopia may occur, as well as photophobia and glare.
Treatment of cataract
Drug treatment: There are no specific drugs available. Clinical drugs used to slow down the development of cataract can be used for the treatment of early cataract.
Surgical treatment: It is the most effective method to treat cataract. The most common method is ultrasonic cataract extraction combined with IOL implantation. Non-emulsification surgery, i.e., small incision cataract extracapsular extraction combined with IOL implantation, is also the treatment method for cataract in a large number of primary care hospitals.
Features of cataract ultrasound emulsification technique.
Ultrasonic cataract surgery requires high requirements for surgical instruments as well as technology, but it has many advantages over traditional cataract extracapsular extraction surgery: small surgical incision: 1.8mm-3.0mm, small postoperative corneal astigmatism, light postoperative reaction, fast healing incision, fast and good vision recovery. The surgery time is short and can be completed in a few minutes.
Timing of cataract surgery?
With the maturity of cataract ultrasound emulsification technology, the previous view that cataracts should be operated only when they are mature (completely blind) has changed. Mature or overly mature cataracts increase the difficulty and risk of surgery and also predispose to secondary glaucoma or crystalloid glaucoma caused by cataracts. And mature or overmaturing cataracts lead to a lower quality of life for patients over a long period of time. It is now considered that surgery can be considered for cataracts resulting in vision loss to 0.4 or less, and even for some patients with cortical cataracts who have better vision. In conclusion, as long as the visual impairment caused by cataract affects life and work, while the timing of surgery is chosen according to the patient’s requirements for vision and quality of life.
Why is it necessary to implant an IOL after cataract removal?
After cataract removal, the important structure of the lens is missing in the eye, so the vision is still unclear and requires farsighted glasses of about 1,000 degrees to correct, and the visual field is limited, distorted and inconvenient to use. An IOL is implanted in the eye to replace the lens of the human eye to restore vision and visual field to normal.
Introduction to IOLs
The IOL prescription is determined by the doctor based on the patient’s refractive data and eye habits. The type of IOL is chosen according to the patient’s eye condition and his or her financial situation. The cost of cataract surgery differs depending on the material and function of the IOL implanted in the eye.
1. Ordinary IOLs
Rigid IOL, made of PMMA, 5.5mm-6mm in diameter, with a surgical incision of about 6mm. the incision is relatively large and may lead to a larger corneal astigmatism after surgery.
2.Ordinary Folding IOL
Silicone material or acrylic material. The best is acrylic material. It can be folded and implanted intraoperatively, and the surgical incision is 2.8-3.0mm. The surgical damage, postoperative reaction and astigmatism are small, and recovery is fast.
The following are all folding IOLs, and the cost varies according to the IOL design to postoperative visual function improvement
3.Aspheric IOL
Aspheric IOL design reduces the spherical phase difference of ordinary IOLs, resulting in clearer vision and better visual quality, especially in the evening and under dark light. The incision is 1.8mm-2.8mm.
4.Astigmatism IOL
The IOL is designed with astigmatism axis recognition, and the surgical incision, IOL implantation degree and implantation angle are precisely calculated. It can achieve the purpose of correcting corneal astigmatism at the same time. Better visual quality is achieved. It is suitable for patients with corneal astigmatism greater than 1D.
5.Adjustable IOL
The specially designed IOL can automatically change its focus under the action of the lens capsule and ciliary muscle, so that it can obtain a better effect of farther and closer viewing.
6.Multifocal IOL
The multifocal IOL with step progressive diffraction combined with aspheric design to obtain ideal far and mid-near vision enables post-cataract surgery patients to achieve the purpose of seeing near off the lens and get ideal visual effect.
What are the precautions for cataract patients before surgery?
1. Pre-operative antimicrobial eye drops and non-steroidal eye drops should be used.
2. Patients with hypertension and diabetes should control their blood pressure and blood glucose, and continue to take medication as prescribed by the internist before and after surgery, as well as on the day of surgery.
3.The day before surgery, do a good job of personal hygiene.
4.Practice cloth sheet to cover the patient’s mouth and nose.
5. Try to eat easily digestible food and keep bowel movements smooth a few days before surgery.
Cataract postoperative care and follow-up
1. Mild eye pain on the day of surgery is a normal reaction. If eye distension or pain is obvious, you should immediately return to the hospital and inform the doctor on duty for emergency treatment.
2. On the day of surgery, you should rest as much as possible, do not rub your eyes, and control coughing and sneezing.
3.The next day after surgery, open the eye patch for examination, and follow the doctor’s instructions to apply antibacterial eye solution, hormone eye solution and non-steroidal eye solution.
4.Postoperatively, if there is a sudden loss of vision, accompanied by eye stinging, redness and increased secretions quickly return to the hospital for examination. Especially within 1 week after surgery.
5.Avoid heavy physical labor, forceful head swinging, strenuous exercise, eye rubbing, and external force touching the operated eye for 1 month after surgery. You can eat more vegetables, bananas, easy to digest food to keep the bowel movement smooth.
6.Eye mask cleaning: once a day, clean and dry with warm water and use it when sleeping. 2 weeks later, stop using it.
7. 1 month after surgery, wash your hair and face to avoid sewage entering your eyes. It is recommended to wash your hair in the supine position.
8.Revisit on time, routinely 1 day, 3 days, 1 week, 2 weeks, 1 month and 3 months after surgery at the outpatient clinic, and follow the doctor’s instructions if there is any change.
9.Generally, the vision can be examined in 3 months after surgery, and lenses can be chosen according to the need to achieve the best effect. For non-multifocal IOL implanters, they can see clearly in the distance and blurred in the near after cataract surgery, and they need to wear presbyopic glasses to see near after the vision stabilization in 3 months.