Do I have to wait until I can’t see before I have cataracts? Re. This view is more than a decade old. Due to the limitations of surgical equipment and technology in the past, cataract surgery was performed only when the patient could not see at all after the cataract had matured, and the patient had a high satisfaction rate when a little vision was restored. In fact, with the application of ultrasound emulsification instrument and the maturity of surgical technology in the past 20 years, the success rate of cataract surgery can reach 99.9%, and the incision is small, the recovery is fast, and the vision is well restored after surgery. Timing of cataract surgery: The visual impairment caused by cataract affects the life and work of patients, and surgery can be considered for all visual acuity below 0.5. Perhaps there are still some ophthalmologists in small hospitals who hold this view, probably because there is no local ultrasound emulsification equipment and mature cataract surgery technology. Nowadays, it is advocated to improve the quality of life as early as possible when the conditions for surgery are mature. It is not good to do the surgery early, and you will not be able to see again later anyway? Wrong. Some patients think it is too early because they have heard others say that they will not be able to see again after a few years of cataract surgery. Posterior cataracts occur in 5% of patients after cataract surgery. Posterior cataract is a clouding of the posterior capsule of the lens that holds the IOL. The incidence is very low and is related to age, response to surgery, and the IOL. It is a very low incidence and is related to age, response to surgery, and IOLs. The posterior lens will gradually lose vision and can be treated with the YAG laser at a cost of just over $200 on an outpatient basis. The elderly themselves may also suffer from other eye diseases, most commonly age-related macular degeneration. Diabetes can also cause diabetic retinopathy, and all of these diseases can eventually cause serious visual impairment. As long as one eye can see with cataracts, no longer care about cataracts and vision in the other eye? Wrong. Cataracts are divided into four stages in the development process: early stage, swelling stage, mature stage, and over-ripe stage. Cataracts in the expansion stage and the overripe stage are most likely to cause glaucoma and lead to eye pain, headache and even vomiting. Of course the incidence of glaucoma caused by cataract is not very high. The quality of life with both eyes seeing is much higher than monocular. Monocular vision has no stereoscopic vision, easy to fall, and walking is not as comfortable as binocular vision. The more expensive the IOL implanted during cataract surgery, the better the vision? Wrong. After removing the cloudy lens by ultrasound emulsification during cataract surgery, an IOL must be implanted to replace the removed lens, otherwise you will need to wear 800-1200 degree farsighted glasses to see clearly after surgery, and there will be distortion in the magnification. IOLs have different functions by design, which means there are different price classes. At present, they are divided into: hard crystals (surgical incision 6mm – may have larger medical astigmatism after surgery) and soft crystals (surgical incision 1.8-3.2mm); by function: 1. ordinary monofocal crystals (have better vision at a distance), 2. monofocal aspheric crystals (better vision at a distance, less glare than ordinary monofocal crystals), 3. multifocal crystals and adjustable crystals (better vision at a distance, less glare than ordinary monofocal crystals), 3. Adjustable crystals (better distance vision and better near vision), 4. Astigmatic crystals (for patients with large corneal astigmatism, they can correct corneal astigmatism to obtain better distance vision). Depending on the design and materials as well as different manufacturers is the price difference of IOLs. In simple terms, ordinary monofocal IOLs will give good distance vision in the naked eye, but there is only a slight difference in function in specific circumstances, so it is not related to the price of the IOL chosen. How much vision is restored really depends on the condition of the patient’s own eyes, but of course the surgeon’s skill and surgical details, the function of the IOL, and the material and quality of the IOL are other important supporting factors for good vision. Can’t diabetic patients have cataract surgery? Wrong. Diabetes can lead to complications in two important organs of the body – the kidneys and the eyes. In the eye it can cause eye movement disorders, corneal hyperalgesia, dry eye, cataracts, diabetic retinopathy, and neovascular glaucoma. The most serious one is diabetic retinopathy, which can lead to retinal detachment and neovascular glaucoma in severe cases, and is a very difficult eye disease to treat, and it is difficult to restore vision in advanced stages. Therefore, cataract surgery for diabetic patients has two purposes: to restore some of the vision of the removed cataract as much as possible; and to see the fundus after surgery for further observation and treatment of fundus lesions. Controlling blood sugar and controlling and treating fundus is the key to treating diabetic fundus. Timing of cataract surgery for diabetic patients: surgery for cataract is considered when crystal clouding affects observation and treatment of diabetic retinopathy. Fasting blood sugar control below 9mmol/l can be operated. After surgery, the fundus should be reviewed regularly for a long time, and if necessary, fundus fluorescence imaging and retinal laser treatment should be performed. In severe cases, vitreous surgery is performed. As long as there is cataract, you should operate? Wrong. Generally, clouding of the lens (i.e. cataract) begins after the age of 50-60 years, and early cataracts usually do not require surgery. Surgery is only considered when the visual impairment caused by cataract affects life and work, depending on the type of cataract, the degree of visual impairment caused, the patient’s requirements for quality of life, refractive status (myopic or farsighted), and other factors. Cataract is a minor surgery, and you should regain the vision you had when you were young after the surgery? Wrong. After decades of development, the invention of cataract surgery equipment (ultrasound emulsifier) and the continuous maturation of surgical skills, cataract surgery is a very mature surgery. Cataract surgery is quick and can be completed in just a few minutes to ten minutes for a mature cataract surgeon. The post-operative recovery is quick and the treatment is effective, and many hospitals do not require hospitalization. However, there can be risks associated with any surgery – intraoperative and postoperative complications. Especially serious complications such as infection (endophthalmitis) and severe intraocular hemorrhage can lead to non-recovery of vision or even failure to keep the eye. Only the incidence of these complications is very low, about 0.01-0.03%. Therefore, preventive medication before surgery, intraoperative disinfection, surgeon skills, postoperative medication and follow-up, control of the patient’s systemic condition, and the patient’s eye hygiene care all have equally important roles to play and should all be taken seriously. While the amount of surgical vision restored really depends on the condition of the patient’s own eyes, of course, surgeon skill and surgical details, IOL function, IOL material and quality are other important supporting factors for good vision. Most of the patients choose to implant ordinary monofocal IOLs, so after the surgery, they can see clearly in the distance and blurred in the near, and need presbyopic glasses after 3 months. The reason why IOLs are white, bright, blue, and brightly colored is because IOLs only absorb ultraviolet light and cannot be equivalent to the function of the human eye’s own crystal. Therefore, it is impossible to fully restore the visual function of a young eye. Can cataracts be effectively controlled and cured with medication? No. There are no specific medications that can control and cure cataracts. Currently there are some eye drugs and oral medications on the market for cataracts. In theory, these drugs may have the effect of slowing down the development of cataracts in the early stage of cataracts, but the exact efficacy of these drugs cannot be clinically confirmed, firstly, there are large individual differences, secondly, cataracts themselves develop slowly, and thirdly, cataracts will eventually develop and 100% of cataracts occur by the age of 80, and the surgery rate is also high. The most definitive treatment for cataracts at present is cataract surgery, and the most common way is cataract ultrasound emulsification + IOL implantation. As you get older, presbyopia disappears? Wrong. Cataract development can lead to myopia, hyperopia and astigmatism of crystalline origin. Presbyopia usually starts to appear after the age of 45, but some patients gradually get better vision in the near and presbyopia slowly disappears in their 60s or 70s, while vision in the distance gradually decreases. In fact, it is just a manifestation of senile cataract (nuclear cataract), which leads to myopia, and this myopia will gradually become more and more serious, up to about 2000 degrees, but the patient’s eye axis is normal, and there will be no myopic fundus lesion. In a certain period of time, seeing far and near has a relatively good life vision, and it shows light to moderate in the degree of cataract, but as the cataract develops, the worse the vision in seeing far and the deeper the near degree will affect the quality of life, and then surgery can be considered.