The etiology, diagnosis, and treatment
of cataract, The clouding of the lens caused by various reasons is collectively referred to as a cataract. There are many causes of cataracts, the most common one is senile cataract, which is a normal physiological phenomenon that appears with the increase of age. The incidence rate increases with age, especially in people over 60 years old. Cataracts can also be caused by other factors, and young people, infants, and young children can also be affected. Cataracts that are present after birth or that occur at a young age are called congenital cataracts; traumatic cataracts are called traumatic cataracts due to rupture of the lens caused by trauma to the eye. In addition, diabetes, intraocular inflammation, and bleeding disorders can also lead to cataracts. A cataract is a common eye disease and one of the main causes of blindness.
The main symptom of cataracts is blurred vision, which may be sensitive to light, dark, or yellow in color, and even diplopia (double vision) and deformation of objects.
Diagnosis of cataracts is not difficult, and if the above signs and symptoms are present, the diagnosis can be confirmed by a doctor through a dilated eye examination. Cataracts are sometimes accompanied by other ophthalmic diseases and may cause other complications, so you must be diagnosed and treated by an ophthalmologist. Once a cataract is diagnosed, it must be checked regularly to keep an eye on its progress.
Because the mechanism of cataract formation is still unclear, so far no breakthrough has been made in drug therapy. So far, no drug has been able to cure cataracts, or completely prevent or delay the development of cataracts, and the only effective treatment for cataracts is surgery, which removes the cataract (the cloudy lens).
Surgery is the most effective way to treat cataracts, and thousands of cataract patients have achieved good vision through this safe and effective procedure.
The cataract extraction procedure mainly consists of two parts:
1. Removal of the cataract (cloudy lens)
2. Implantation of an intraocular lens
Modern cataract Surgery incorporates today’s most advanced surgical equipment and sophisticated cataract surgical techniques. The characteristics of modern cataract extraction and intraocular lens implantation are as follows:
1. The size of the surgical incision is about 8-10mm
2. Pull out the cloudy lens nucleus and aspirate the lens cortex
3 . 4. Implantation of rigid PMMA intraocular lens
. Suture incision
phacoemulsification and foldable intraocular lens implantation, the characteristics are as follows:
1. The size of the surgical incision is 2.8-3.5mm
2. Emulsify the cloudy crystal nucleus and aspirate the lens cortex
3 . 4. Implantation of foldable intraocular lens
. No need to suture the incision
Timing of cataract surgery and postoperative vision correction
In the past, due to the limitation of concept and medical technology, cataract patients had to wait until they were completely invisible (commonly known as “long maturity”) before surgery. Now with the development of modern technology, cataract surgery has been significantly improved in both medical equipment and technology. In particular, the application of phacoemulsification technology, short operation time, small incision, less astigmatism, and good postoperative vision recovery, greatly improves the success rate and postoperative effect of cataract surgery. Therefore, when cataract affects daily life or work, cataract surgery can be decided. In addition, some patients have better vision due to work or life needs, and they can also take surgery early.
Cataract surgery is to remove the cloudy lens. The lens is a high-power convex lens. Therefore, another convex lens must be used after surgery, such as wearing cataract glasses and implanting intraocular lenses to correct vision, so that patients can see objects. If you wear cataract glasses (usually 1000-1200 degrees), due to the magnification of the object image by 25%-30 %, the field of view becomes smaller; especially if only one of the eyes has undergone cataract surgery, diplopia and dizziness will occur, and the patient is very uncomfortable to wear. , so it is rarely used at present.
An intraocular lens is an artificially designed and manufactured replacement for the lens that is implanted in the eye during cataract surgery and requires no wearing or maintenance. Intraocular lens implantation can restore good vision to patients without fundus diseases and other eye diseases that affect vision. By implanting intraocular lenses, the normal vision level before cataract can almost be achieved. After inputting into the computer, it calculates the degree of intraocular lens that needs to be implanted.
The IOL of Choice for Cataract Surgery An
IOL is a permanent, clear, artificial replacement for the lens that approximates natural normal vision. To achieve better postoperative visual acuity after implantation of an intraocular lens after cataract extraction, a very important point is the patient’s choice of the intraocular lens.
Commonly used intraocular lenses are the following materials: polymethyl methacrylate (PMMA), acrylates, silicone gels, and hydrogels. The former is a rigid intraocular lens, and the latter three are foldable intraocular lenses. PMMA material intraocular lens has been used in the clinic for more than 50 years; the foldable intraocular lens is a new type of intraocular lens developed in the past ten years. The best postoperative safety and stability; excellent biocompatibility, the lowest postoperative inflammatory response; in addition to senile cataracts, clinical indications for surgical contraindications such as diabetes, glaucoma, uveitis, congenital cataract, traumatic cataract The patient is the first choice; the postoperative short-term and long-term complications are the least, and it is currently the most widely used foldable intraocular lenses in the world.
Different intraocular lenses have different prices due to different materials and different production processes and bring different benefits to patients. The patient can choose the intraocular lens that suits him according to his situation and at the same time seek the advice of the doctor.
Instructions after cataract surgery
According to different hospital treatment routines and patients’ conditions, the postoperative treatment medication and precautions are different, as follows:
1. Rest as much as possible on the day of surgery to avoid bowing and coughing.
2. There is no need for taboos after surgery, all daily life is normal, but do not smoke or drink. People with dry stools should take bowel medicine; avoid excessive exertion and heavy lifting.
3. The next day after the operation (or one week after discharge), come to the hospital for review, cooperate with the doctor to check, and determine the medication status and the next follow-up date according to the doctor’s order.
4. After the dressing change (discharge), go home and order anti-inflammatory eye drops, 4-6 times a day. Some patients use mydriatic drugs to dilate their pupils every night. When the pupils are dilated, the drugs are usually ordered three times, with an interval of 5 minutes between each time.
5. Dizziness, mild foreign body sensation, and orbital congestion are normal phenomena after surgery. If you have obvious eye pain, nausea, or vomiting, please do not be nervous and go to the hospital immediately.
6. A small number of patients have red eyes, photophobia, tearing, etc. 5-7 days after the operation. Please go to the hospital for inspection and early treatment.
7. Do not let dirty water or soapy water enter the surgical eye for two weeks after surgery, do not apply pressure (rubbing) to the surgical eye for four weeks, and prevent trauma.
8. If the visual acuity is unstable within 3 months after the operation, the refractive power is usually checked after 3 months.
9. Postoperative cataracts in some patients require YAG laser surgery.
10. If the patient with congenital cataract is not implanted with an intraocular lens after cataract surgery, it is necessary to wear glasses in time, do amblyopia training, and regularly review.