Cataract surgery is a surgical procedure used to treat lens opacification, primarily aimed at restoring the patient's vision and improving quality of life. The surgery involves removing the cloudy natural lens and replacing it with an artificial intraocular lens (IOL) to address issues such as blurred vision and decreased color perception caused by cataracts. This procedure is regarded as a safe and effective standard treatment in ophthalmology worldwide, suitable for patients of all ages.
The surgery is typically performed under local anesthesia, with a short recovery time, and can significantly enhance daily activities such as reading, driving, or performing fine motor tasks. Advances in technology have further improved surgical precision, making it one of the most common minimally invasive procedures in modern ophthalmology.
The main types are “Phacoemulsification” and “Femtosecond Laser-Assisted Cataract Surgery.” Phacoemulsification uses ultrasonic probes to break up the cloudy lens, which is then aspirated out, followed by implantation of an artificial lens. This method is well-developed and broadly applicable.
Femtosecond laser technology allows for precise corneal incisions, lens nucleus disassembly, and reduces damage to surrounding tissues. It is especially suitable for hard cataracts or patients requiring highly customized IOLs. Both techniques require careful selection of the IOL to meet different needs such as myopia, hyperopia, or astigmatism correction.
Primarily indicated for severe lens opacification that affects daily life, such as visual acuity below 0.3 or interference with routine activities. Other indications include significant anisometropia causing stereo vision abnormalities or cataracts complicated by glaucoma. Some patients may require surgery due to congenital or traumatic cataracts.
However, not all cataracts require immediate surgery; ophthalmologists will evaluate the degree of visual impairment and the patient’s subjective needs. For example, early-stage cataracts may initially be corrected with glasses, with surgery considered when the condition begins to impact daily functions.
The procedure lasts approximately 30 to 60 minutes, performed under topical anesthetic eye drops, with the patient awake but painless. The steps include creating a corneal incision, emulsifying the lens, implanting the IOL, and closing the incision. The IOL power is precisely measured preoperatively based on corneal curvature and axial length.
Postoperative care involves using antibiotics and corticosteroid eye drops to prevent infection and inflammation, typically for several weeks. Patients should avoid rubbing their eyes, strenuous activities, and should attend regular follow-up visits. The choice of surgical method and IOL should be customized based on corneal condition, intraocular pressure, and visual needs.
Main benefits include:
Additionally, surgery can reduce the risk of falls caused by visual impairment, especially improving quality of life for elderly patients.
Although the risk of complications is low, potential issues include:
Emergency symptoms such as severe pain or sudden vision loss require immediate medical attention. Regular follow-up can help detect and manage issues early.
Contraindications include:
Preoperative examinations should include corneal topography, intraocular pressure, and fundus assessment. Patients should avoid eye makeup or chemical substances three days before surgery and follow the doctor’s instructions regarding preoperative medications.
Surgical planning should coordinate with other ocular treatments, such as choosing specially designed IOLs for glaucoma patients. Postoperative steroid eye drops should be used with awareness of interactions with systemic corticosteroids.
Patients on anticoagulant therapy should consult with their hematologist to adjust medication to reduce bleeding risk. IOL calculations should consider corneal refractive power, and patients who have undergone laser refractive surgery should inform their ophthalmologist of their previous correction status.
Clinical studies show that over 90% of patients achieve visual acuity of 0.5 or better postoperatively, with some recovering to 1.0 or higher. The National Eye Institute (NEI) reports that surgery can reduce fall risk in the elderly by up to 30% and significantly improve cognitive function.
Femtosecond laser technology enhances surgical precision, reducing posterior capsule opacification to below 10%. Long-term follow-up studies indicate that modern IOLs have a 98% survival rate over ten years, demonstrating good biocompatibility.
Non-surgical options include enhanced lighting, high-refractive index glasses, or contact lenses, but these only provide temporary symptom relief. Pharmacological treatments such as antioxidants or traditional Chinese medicine currently lack sufficient evidence to reverse cataracts.
Laser treatment for lens opacification remains experimental; surgery remains the definitive treatment. Alternatives are only suitable for patients who cannot undergo surgery due to health reasons, but visual recovery is limited.
What examinations are necessary before surgery? How do these tests affect the procedure?
Preoperative assessments include intraocular pressure measurement, corneal topography, and fundus examination to evaluate eye structure and health. These tests help determine the appropriate IOL power and rule out complications such as glaucoma or retinal disease, ensuring safety and effectiveness of the surgery.
What should I do if my vision suddenly becomes blurry or I experience glare after surgery?
Initial postoperative blurry vision or glare may be due to corneal edema or adaptation to the IOL, usually improving within 1-2 weeks. If symptoms persist or worsen, immediate follow-up is necessary. The doctor may adjust medications or recommend further treatment.
Are there activity restrictions after surgery, such as reading or using electronic devices?
It is recommended to avoid strenuous activities and bending over in the first week. Light reading and using electronic devices are generally safe. Patients should avoid rubbing their eyes, swimming, or exposure to dirty water to prevent infection. Normal activities can gradually resume after two weeks, but prolonged eye use should be avoided to prevent fatigue.
What is the long-term success rate and complication rate of cataract surgery?
Modern phacoemulsification has a success rate of over 95%. Complications such as posterior capsule opacification occur in about 20% of cases but can be treated with laser. Regular follow-up allows early detection and management of issues, with most patients experiencing significant long-term vision improvement.
What is the correct way to use antibiotics and corticosteroid eye drops after surgery?
Follow medical instructions carefully. Usually, antibiotics are used for about a month to prevent infection, combined with corticosteroids to reduce inflammation. When applying eye drops, wash hands thoroughly, avoid contact between the bottle tip and the eye, and space different medications by 5-10 minutes to ensure efficacy and prevent contamination.
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