Forwarding cataract FAQ, need to give patients popular science to use

:: Why do I get cataracts?
age. Age is the most important factor. I've always thought of cataracts as biologically evolved bugs, flaws that God deliberately left behind, or gifts to ophthalmologists. A person's lens grows all his life. But the lens is long in the crystalline body sac, suspended by the hanging ligaments in the eyes, so, the surface of the new long lens cells have no other place to go, only to the internal backlog, so the density inside is getting higher and higher, more and more impervious to light. It can be said that older, more or less have cataracts, but only the degree of difference.

:: Is cataract medication effective?
Currently, drugs to treat cataracts do not remove cataracts, but can only slow development at best. Cataract development itself is also very slow, whether or not to use drugs for patients is not much difference. I generally do not recommend that patients use eye medications to treat cataracts. Waste of money. It's uncomfortable to have more eye medicine. The preferred treatment for cataracts is surgery.

:: What extent does cataracts work? Do you need to wait until it matures?
As long as the patient feels that the visual loss caused by cataracts has affected normal life can be operated on. Today's surgical techniques don't have to wait until they're mature to do it. The so-called maturity, is the crystal completely cloudy, at that time generally has basically no vision. A long time ago, about 20 years ago, cataract surgery required the removal of sac-band crystals together, so they needed to wait for maturity so that they could be integrated. Now that type of surgery has long since been eliminated. Now the conventional method is ultrasonic emulsification combined artificial crystal implantation. From transparent crystals to near-mature crystals, the condition of the lens is no longer a factor in the operation, but in the patient's own feelings. If you feel that vision has dropped to affect life you can have surgery. If you think your eyesight is OK, or you can achieve better vision by wearing glasses, you can continue to wait.

:: Is it dangerous to have cataracts, keep them, and not have surgery?
In general cataract progress is very slow, short-term treatment will not make any big difference. Cataracts after maturation may cause inflammation inside the eyes, or may cause the onset of acute closed-angle glaucoma, an eye disease that causes sudden swelling of the eyes and requires immediate treatment. In areas with slightly better general medical conditions, patients who are more concerned about themselves will not allow themselves to develop to this extent.

:: Is cataract surgery at risk? Is it complicated? Is it a major operation?
Any surgery is risky!! note! Any surgery is risky!!

The human eye is not designed and produced by the doctor, the doctor is not responsible for the warranty! Any, attention is anything, no surgery can guarantee recovery, no guarantee of no danger. Only, note, is that doctors can only help patients if they are willing to take the risk of surgery. It's no different from handing over hard-earned money to a fund manager.
People are going to be sick, people are going to die, one day you are going to die in the hands of a doctor. Unfortunately, this is true, without exception. Unless you are not at the hospital.
For cataract surgery, or for any surgery that enters the inside of the eyeball, the most serious and occur is called "explosive bleeding of the vein membrane", also known as "expel bleeding", once this bleeding occurs, everything inside the eyeball may be "evicted" out, rescue can save the shell of the eyeball is good. Fortunately, the possibility of such complications is very small, I have only heard, have not seen, I hope not let me encounter, a such bleeding is enough to destroy the spirit of a general surgeon, so that he can no longer sit in front of the surgical microscope.

In general, cataract surgery is considered a moderate ophthalmology operation. That is, doctors who participate in the third or fourth years of work, hospital conditions vary from place to place, the level of doctors is also different, may vary, some smaller hospitals may not even be able to carry out ultrasound emulsification surgery. Cataract surgery, or ultrasound emulsification, has matured. It will be done in less than half an hour. A cataract specialist typically performs dozens of cataract operations a day.
There are specific risks, and I'll go into more detail later.
Also, if a doctor assures you that the operation is 100% safe, or that a drug is 100% effective, it is either comforting or deceiving you.

:: How much vision can be restored after cataract surgery?
Sorry, I don't know, and I won't tell you.
We often use cameras as metaphors for our eyes. Cataract surgery is equivalent to replacing a lens, so if the other lens is not good or film problems, the photos taken are still unclear. For example, corneal edema, after surgery is very common, generally do hot dressing a few days can go down. For example, late glaucoma affects the central field of vision, that vision is done will not improve. For example, the lesions of the bottom of the eye, especially the lesions of the macular region, affect vision. The trouble is that the general cataract will make it difficult for doctors to examine the bottom of the eye in detail, before surgery can only estimate the situation at the bottom of the eye, whether there is a real problem, need surgery to know later. Conversely, if there is a problem with the bottom of the eye, cataract surgery is often required at the same time.

Since artificial crystal implants are placed in the eye during surgery and undergo a natural healing process, the position of the artificial crystals is not stable at first and may move back and forth. It takes 1-3 months to fully stabilize, so it takes about 3 months for vision to be completely stabilized. Some nearsighted patients, we pre-set is 300 degrees of myopia, but at first may not reach this degree, so at the beginning there is no myopia, no glasses vision can have 1.0, after a period of time into our expectations, without glasses vision may only be 0.5, but the ability to see close has improved.

If a person has no problems with the bottom of his eye and cornea, his optimal corrective vision will be good after cataracts have been done.

:: How artificial crystals(IOL) should be selected
Artificial crystals are things that are surgically placed inside the eyes instead of natural crystals. thin piece. This is equivalent to replacing a lens.
There is a wide variety of artificial crystals.

1. Hard artificial crystals. Incision is about 6mm, such a wound is required stitches, then stitches will cause a certain amount of astigmatism, short-term after surgery reaction is larger, recovery time is longer. Cataracts are nearly mature patients, surgery has been unable to use ultrasound emulsification, had to do ECCE surgery patients, because the incision itself has required 5-6mm.
2. Fold artificial crystals. In Beijing, the majority of patients in Sanjia Hospital (more than 95%) will choose this kind of artificial crystal, it is the first artificial crystal folded, put in a special implant, and then pushed into the eyeball to expand, so the incision is generally 3.2-3.5mm, this incision is not required stitching, astigmatism is relatively small, recovery time faster.

3. Specially treated artificial crystals. For some patients with specific eye diseases, this type of artificial crystal may be needed, such as heparin surface treated artificial crystals, which have a much smaller inflammatory response after surgery.

4. Dual focus/adjustable artificial crystals. These artificial crystals are designed to meet both the far and the near requirements. The previous said several artificial crystals are not able to do, they have only one focus, see far clearly, look close to wear old flower mirror, or vice versa, look close, look far to wear myopia mirror.
Dual-focus artificial crystals are two focal points on an artificial crystal, one for far and one for near. Some patients can adapt, and some complain that when reading, there are ghosts around the text. In principle, two focal points, when one is used, the other must be a state of defocusing, that is, there will be two images on the retina, one is clear and the other is virtual. Double-focus artificial crystals, whether refractive or diffractive, use the reflection of the pupil to change the energy distribution of the near and far focal points, so as to make as much clear energy as possible, less deflated energy. But after all, it is not about eliminating the illusion completely. Whether you can adapt depends on the patient himself.

At present, the design of artificial crystals began to develop towards aspherical and yellow. There are still many academic differences in this part, and the preference to choose artificial crystals depends on the surgeon.

Aspherical artificial crystals can reduce wavefront aberration, simply because the image quality is better.

Now there are artificial crystals that have changed color, the dark environment is transparent, the light is strong after it is yellow.

:: Will you get it again after you've done cataracts?
Cataract surgery will completely remove the lens, then cataracts have no place to go.

:: What do I need to pay attention to after surgery?
Normal life. What do you want to see, TV / books / movies / playing mahjong... But be careful not to get tired. Also, for the elderly, colds are the source of all evils, try to avoid.