Cataract: how to understand when it is time to have the operation and what results to expect

Cataract: how to understand when it is time to have the operation and what results to expect

Cataract surgery is, with 650 thousand operations performed every year, the most practiced surgery of all, so much so that it represents 84% ​​of the volume of services of an entire Italian hospital department. Today, it is possible to correct it using very technologically advanced surgeries which, in a single operation, also make it possible to eliminate other types of vision deficits preceding the cataract itself such as myopia, astigmatism and presbyopia. The reader asks to know how to understand when surgery is necessary and what results to expect.

He replies Stanislao Rizzodirector of the Ophthalmology Unit of the A. Gemelli Irccs University Hospital and full professor of Ophthalmology at the Catholic University of Rome.

Request. I recently experienced a noticeable decline in vision, with symptoms that align closely with what I’ve read about cataracts. Blurring and decreased color intensity have progressively become part of my daily life, affecting my ability to carry out my daily activities. Now I can’t see well even with glasses and so I’m contemplating the possibility of surgery and its implications. Could you please explain how you determine the right time for cataract surgery? Also, what are the possible risks and how do the results generally compare to pre-surgery vision status? How will I see after the surgery? Also, could you recommend lifestyle changes or preventative measures that could slow the progression of cataracts? In the meantime, are there any specific activities or habits I should avoid to prevent further deterioration of my vision? Thank you, Luciana S. (Pisa)

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Answer. Cataracts are the leading cause of reduced vision worldwide. The surgical procedure for cataract treatment involves the removal of the cloudy lens and the insertion of a new intraocular lens. The most common risk factors for its development and evolution include diabetes mellitus, long-term use of topical, systemic, intravitreal, inhaled or oral corticosteroids, previous intraocular surgery, trauma, ionizing radiation, exposure to UVB rays .

As defined by recent national guidelines on cataract surgery, the primary indication is visual function that no longer meets the patient’s needs and for which cataract surgery provides a reasonable likelihood of vision improvement. Therefore, the primary advice is to carry out an eye examination to exclude that your symptoms underlie other ocular pathologies and to evaluate, based on your current visual acuity, the possibility of proceeding with the operation. Although it is considered a routine operation, it is not free from risks and complications which can be mild or serious as in the case of endophthalmitis (eye infection), which is why precautions and careful post-operative checks are necessary. As for vision after surgery, much will depend on the lens implanted (monofocal or multifocal) and the general conditions of your visual system.

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