1.What is cataract?
Cataract is the most significant blinding eye disease in China. Cataract is a condition in which the lens of the eye turns from transparent to opaque, preventing light from entering the eye and thus affecting vision. The initial clouding has little effect on vision, and then gradually worsens until it significantly affects vision or even blindness.
2.What are the clinical manifestations of cataract?
The main symptom is the progressive vision loss without pain or sensation. From blurred vision at the beginning, it gradually progresses to blindness. In addition, it can also manifest as deepening myopia, requiring frequent replacement of glasses, double vision in one eye, fixed black shadows in front of the eyes, grayish and dark vision and photophobia. The onset of cataracts often occurs in both eyes, and the time and degree of onset may vary.
3.How is cataract caused?
The exact cause of cataracts is still unclear, but it may be related to aging, genetic factors, excessive exposure to ultraviolet light, excessive drinking and smoking, high blood pressure, diabetes, high myopia, trauma and certain inflammatory diseases in the eye.
4.What kind of people are prone to cataract?
Cataracts most often occur in elderly people over 50 years old, and the older the age, the higher the incidence. Cataracts appear relatively early in patients with diabetes or high myopia. In addition, cataracts may also occur in some young patients, newborns, and infants.
5.Can cataracts be prevented?
There is no definite prevention method. Those who are active outdoors often wear UV-protective glasses may have a certain effect. Avoiding illness or taking medication during pregnancy can reduce the occurrence of congenital cataracts.
6.How to detect cataract early?
First of all, we should pay attention to the change of vision in one eye. If we find that the vision in the other eye is gradually decreasing when covering one eye, we must go to the hospital in time and have a thorough eye examination to diagnose whether we have cataract. Patients with early cataracts do not feel pain and their eyes are not red, and they only show vision loss.
7. Is cataract medication effective?
There is no drug that can treat cataract in the world so far. Some drugs may only slow down the development of cataract, but cannot cure it completely. Surgery is the only effective way to treat cataract. Nowadays, there are many advertisements claiming that taking medicine can cure cataract, which is extremely irresponsible and misleading to patients.
8. When is it more appropriate to receive cataract surgery?
There is a popular saying that cataract surgery can only be performed when the cataract is fully mature and invisible, which is a wrong view. With the popularization of microsurgery and the improvement of surgical techniques, vision loss is no longer the only indication for cataract surgery. Generally speaking, as long as cataract affects daily life and work, surgery can be considered. In some patients, although their vision is good, they have obvious discomfort such as photophobia or glare, or their contrast sensitivity is significantly reduced, so they should be operated as early as possible so as to improve their quality of life. If you wait until the mature or overripe stage for surgery, not only can secondary glaucoma or uveitis be caused by lens overripening, but also the surgery will be more difficult and there will be relatively more complications.
9.What are the different types of cataract surgery?
There are three main cataract surgery methods: ①. Modern extracapsular cataract surgery is suitable for patients with advanced cataracts that are relatively hard. This surgical method is significantly shorter than the previous incision, which is about 5-6.5mm long, and the surgical astigmatism is reduced and the safety is greatly improved; ②, ultrasonic emulsion cataract extraction, which is the most common surgical method at home and abroad. The incision is no more than 3mm, no suture is needed, the surgery has less astigmatism, and the recovery of vision after surgery is fast; ③, intracapsular cataract extraction, which is to take out the cataract together with the capsular bag, is no longer a routine surgical method because a conventional artificial lens cannot be implanted, and is only applicable to some patients with dislocated lens.
10.Do I need to wear glasses after cataract surgery?
After cataract extraction and implantation of conventional monofocal IOLs, theoretically there will be no adjustment and the best vision will be achieved only at a certain distance. For example, patients with good post-operative distance vision often need “presbyopic glasses” for reading the newspaper. If you do not want to wear a lens after surgery, you can choose a multifocal artificial lens, domestic and foreign research shows that about 90% of patients can complete their daily life and work without glasses.
11.What is an artificial lens?
An artificial lens is an optical lens that replaces a cloudy lens and is implanted in the eye. Its performance is extremely stable and can be tolerated by the eye tissue for a long time, which is equivalent to the “small glasses” in the eye. An eye without an IOL after removal of the cloudy lens is usually highly hyperopic and has poor naked eye vision. A successfully implanted IOL does not need to be replaced for life.
12.How long does an IOL last after implantation?
So far, IOL implantation has a history of more than 50 years. Because of the good biocompatibility of IOL materials, it has been proven to be safe in the eye and can be used for a lifetime.
13.What should I pay attention to before cataract surgery?
①. Eliminate psychological tension. Cataract surgery is a common surgery in ophthalmology. If no complications occur, the surgery is short and less painful, and even there is no special feeling after the surgery.
②. Food and accommodation should be regular.
③. Patients with hypertension, diabetes and respiratory diseases should have the surgery after the disease is controlled and stabilized. If you are taking related medications, please continue to take them both before and after the surgery and on the day of the surgery.
④. Please wash your hair and do not use any eye cosmetics the day before or on the day of surgery.
⑤. A family member must accompany you on the day of surgery.
14.What should I pay attention to during cataract surgery?
①. Do not cough during surgery because coughing will increase the eye pressure, which is not good for the surgery.
②. Do not move your head or chat during surgery, otherwise it will affect the operation of the surgeon. If you have any pain, chest tightness or other discomfort, please inform the surgeon.
15.What should I pay attention to after cataract surgery?
①. Generally, there will be no pain and other reactions on the day of surgery. Some patients have slight eye grinding and eye redness, which are normal.
②. Some patients will have numbness in their fingers after taking the medicine, please do not worry.
③. On the day of surgery, please do not open the bandage by yourself, and try to rest quietly.
④. Pay attention to eye hygiene, do not rub your eyes, move lightly after surgery, reduce bending down, do not cough and keep your bowels open.
⑤. Avoid spicy food, do not smoke or drink.
(6) Wash your face and shower gently and do not let water run into your eyes.
(7) Observe the follow-up time, order medication on time, and see a doctor if you feel unwell.
Please wash your hands first when ordering eye drops. When more than two kinds of eye drops are used, they should be separated by 10-15 minutes, and they should not be ordered at night.
16.What are the main risks and complications of cataract surgery?
Cataract surgery is a surgery for restoration of vision, and the surgical method is relatively mature, and most of the surgeries are safe and effective. However, individual patients may suffer from anesthesia and cardiovascular accidents, infection, explosive choroidal hemorrhage, lens dislodgement into the vitreous cavity, inability to successfully implant an IOL, retinal detachment and other problems. Once the above complications occur, patients should maintain a good attitude and actively cooperate with the treatment, and most of them can be controlled by medication or re-operation.
17.Does the season affect the recovery effect of cataract surgery?
Cataract surgery has small incisions and good closure. As long as medical advice is followed, infection rarely occurs, so the seasonal constraint on surgery is broken and surgery can be performed all year round.
18. Is the more expensive IOL the better the implantation effect?
Different IOLs are suitable for different groups of people, for example, the most expensive multifocal IOL is not suitable for every patient, it has strict indications; the more expensive adjustable lens may not work well for patients with aging ciliary muscle. Therefore, when choosing an IOL, you should not just look at the price, but choose according to your doctor’s recommendations.
19.How many types of IOLs are available now?
There are various ways to classify artificial lens.
From the perspective of soft and hard, they are divided into hard crystals and soft folding crystals. Hard crystals are cheaper because they cannot be folded and the surgical incision needs 5.5-6.0mm; folding crystals are more expensive because they are softer and foldable and can be implanted in the eye through an incision of less than 3.5mm.
In terms of material, it can be divided into polypropyl methyl acrylate, hydrophilic acrylate, hydrophobic acrylate, silicone, hydrogel, etc.
From the focal point perspective, it can be divided into monofocal IOLs, multifocal IOLs and adjustable IOLs. The former is mainly used for distance viewing and is cheaper, while the latter two provide full vision in different degrees and are expensive.
From a spherical perspective, they are divided into spherical and aspheric lenses. The latter is closer to the natural human eye lens, which can effectively reduce postoperative visual aberration, improve imaging clarity and image quality, enhance contrast sensitivity, and is more expensive.
Special types include heparin surface modified crystals, blue light filtered crystals (yellow crystals), and crystalline eye IOLs, which can be used under the guidance of doctors.
20.Is it dangerous to have surgery at an older age?
Therefore, before eye surgery, the doctor should give the patient a general examination to determine whether the patient can tolerate the surgery. If the patient is in good condition, there is no need to worry. The entire cataract surgery is performed under local anesthesia and takes only a few minutes, and the patient does not feel any pain.
21.Will cataract grow or recur?
Some patients say, “I just had good vision after surgery, but after a few months, my vision gradually decreases again”, thinking that the cataract has recurred again. In fact, this is not true. In the current cataract ultrasound emulsification surgery, the lens capsule is preserved to facilitate the implantation of an artificial lens. The so-called “recurrence” of cataract is actually a clouding of the preserved capsule, which is medically known as “posterior cataract”. With the improvement of IOL design and surgical techniques, the incidence of posterior cataracts is about 2% to 5%. Once the posterior cataract occurs, there is no need to be too worried and nervous, generally no need to operate again, you can use the YAG laser to cut open the cloudy posterior capsule, as long as a few dozen seconds, vision can be restored without any pain, safe and effective.
22. Can diabetic patients have cataract surgery?
Many people think that diabetic patients with cataract cannot have surgery, but it is not true. The main damage of diabetes to the eyes is to produce cataract and fundus bleeding. Early fundus bleeding can be treated by laser, while late stage can only be operated and the result is not good. Therefore, if the cataract affects the doctor’s observation of the fundus, cataract surgery should be performed as soon as possible, and the treatment of fundus lesions should be continued about 2 weeks after surgery.
23.Does the disappearance of presbyopia mean that my eyes are well?
Presbyopia will gradually appear when people reach old age, which is a normal physiological change for the elderly. If cataract occurs at the same time, the lens fiber degeneration, swelling and clouding, so that the central part of the refractive power increases, the vision of near objects instead of clear, can be changed to a lower degree of presbyopic glasses, or even do not need to wear glasses; if the lens clouding does not affect the pupil area, the distance vision can not be greatly affected. Therefore, the disappearance of presbyopia may be the precursor of cataract, which does not mean that one’s eyes are good, and one should go to hospital for detailed examination.
24.Is 1.0 vision after cataract surgery the most ideal?
The monofocal IOL implanted in conventional cataract surgery has no adjustment power itself, so if the post-operative distance vision is 1.0 or above, the near vision may not be good enough, causing many inconveniences such as difficulty in reading. If the post-operative distance vision is between 0.5 and 0.8, it may be more desirable to have good distance vision while also taking into account a certain amount of near vision, which can mostly meet the basic needs of daily life. Individualized treatment plans are currently advocated and require communication between the doctor and patient.