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Interview with Professor Chen Weirong: Six Mistakes to Avoid in Cataract Surgery

Posting time:2022-12-02 06:47:15

Interview with Professor Chen Weirong: Six Mistakes to Avoid in Cataract Surgery

"If the eye is compared to a camera, the lens is a zoom lens. When the lens is opaque and cloudy, we can't take a clear view. This is cataract." Cataract is an age-related disease that increases with age. However, in the impression of the elderly, there are still many misunderstandings about cataracts, such as fear of "surgery on the eyes", fear of "recurrence", etc. As a result, the opportunity for cataract surgery is missed. Professor Chen Weirong (first from the left), chief physician of Zhongshan Ophthalmology Center of Sun Yat-sen University, is performing cataract surgery for a patient. Misunderstanding 1: Cataracts are just blurred vision, not a serious disease. influences. Decreased vision or poor vision are only the main symptoms of cataracts. In different periods and in different states, there may also be symptoms such as ghosting, glare, and halos. However, it must be emphasized that "not seeing clearly" will affect intelligence, mood, balance function, etc. Therefore, cataracts will also affect the individual's well-being. For example, some patients have obvious emotional ups and downs, and even cause depression. Both the patient and the family can be physically and mentally tortured. According to our previous research, after the patient suffers from cataract, the connection of the brain and the function of the cortex are obviously degraded, but after the cataract surgery, it can be reconnected again, and the emotional center and the balance center have been well improved. Misunderstanding 2: The cataract has recurred if you can't see clearly after the operation It's like having a cataract come back. The material of the intraocular lens is strongly correlated with the incidence of post-opaque after surgery, while the incidence of post-opaque in the intraocular lens with hydrophobic material is low. Surface modification of intraocular lenses (referring to giving new properties to the surface while maintaining the original properties of the material or product) can also reduce the incidence of post-blockage. For example, the mPEG coating technology adopted by the latest Johnson & Johnson Allergan Smart-LOAD intelligent pre-installed intraocular lens can further reduce the incidence of posterior failure. Generally, there is no need for anxiety after the failure occurs, and vision can be restored within a few minutes through laser treatment. Myth 3: It is very dangerous to operate a knife on the eyes, and it is easy to infect Professor Chen Weirong: With the advancement of technology, cataract surgery is getting easier and easier. For ordinary cataracts, skilled doctors can complete an operation in about 4 to 5 minutes. Only a little topical anesthesia is needed during the operation, and the incision at the edge of the cornea is only 2.2 mm, without bleeding, and you can see the world immediately after the operation. Cataract surgery at Zhongshan Eye Center does not require hospitalization, and you can go home directly after surgery. At present, the mainstream of cataract surgery is phacoemulsification combined with intraocular lens implantation. Femtosecond laser can now be assisted to achieve "surgery-free" surgery. For example, through the Johnson & Johnson femtosecond laser cataract equipment, under the guidance of optical coherence tomography, femtosecond laser is used to make incisions, capsulorhexis, and pre-chopping, making cataract surgery more accurate and safe, and postoperative patients with better visual effects. In addition, the IOL has the latest pre-installed type, which saves the process of implanting and clipping the IOL and adding viscoelastic agent during the operation. The operation is more convenient, the operation time is shortened, the intraoperative pollution is prevented, and the posterior capsule of the patient is reduced after operation. Incidence of membrane opacity. On May 5 this year, Sun Yat-sen University Zhongshan Ophthalmology Center completed the first use of Johnson & Johnson Allergan SmartLOAD intelligent pre-installed intraocular lens. Post complications. Myth 4: Cataract surgery does not need to be rushed. It is too late to do it when you can't see it. Professor Chen Weirong: At present, surgery is the only effective solution for the treatment of cataract. If the cataract has affected the patient's life and work, it is recommended that the patient undergo surgery in time. Some patients have a very severe cataract despite having a visual acuity of 1.0. Although the patient can see through the small clear gap in the middle of the cloudy lens, such vision is not very meaningful. Therefore, doctors will observe the damage of the eye through contrast sensitivity and visual field, rather than using visual acuity as an indication for surgery. It is very important to go to the hospital for cataract treatment as soon as possible. Blindness caused by cataract is a curable blindness. However, once an overripe cataract occurs in the elderly, it will not only cause vision loss, but also cause a series of complications such as glaucoma pain and uveitis, which may lead to permanent blindness. Therefore, early diagnosis and early treatment of cataracts are now encouraged. Misunderstanding 5: Intraocular lenses cannot see as naturally as their own eyes. Professor Chen Weirong: It is analogous to a camera that needs to focus clearly to take pictures, and the human eye also has a "zoom function". In the past, monofocal intraocular lenses had only a single focal length and could not zoom, so the purpose of cataract surgery at that time was only to "see". In recent years, the development and innovation of intraocular lenses has been rapid. For example, continuous vision intraocular lenses can allow patients to have full vision after implantation. Not only can they see clearly in the distance, middle, and near, but they can also see comfortably and naturally. Therefore, cataract surgery has also developed from the past vision restoration surgery to the current refractive surgery. In addition, the life of the elderly is more colorful now, such as dancing square dance, traveling by car, browsing information from mobile phones at any time, etc., so they have higher and higher requirements for visual quality, and have needs for far, medium and near vision. Correspondingly, the intraocular lens is becoming more and more "smart", and it can make every point between different focal points can see more clearly, like a "stepless zoom" lens, which can provide a continuous range of vision, and it can also be seen at night. Glare or halo can be invisible, especially at night to reduce the dependence on glasses. Misunderstanding 6: One type of intraocular lens is suitable for everyone. It is right to listen to a friend's recommendation. Professor Chen Weirong: The classification of intraocular lenses is very complicated. They are divided into hard and soft, hydrophobic and hydrophilic. In addition to monofocal, multifocal and new stepless continuous visual range, astigmatism correction intraocular lens and so on. The choice of intraocular lens still has to listen to the doctor, and communication is very important. First of all, you need to combine your physical condition. If there are other eye diseases, fundus surgery is required in the future, and try to choose some safe materials, such as hydrophobic acrylic materials. Some data show that the inflammatory reaction after the operation of the hydrophobic acrylic intraocular lens is milder. Secondly, it is necessary to meet the needs of personal life. Some elderly people need to use mobile phones and also need to drive, so that they can see both far and near, so it is more appropriate to choose a new stepless continuous vision intraocular lens; if they only look at mobile phones, then bifocal intraocular lenses can meet his needs. . Personal life habits must be fully communicated with the doctor. In addition, communication during the postoperative adaptation period is also important. Previous studies have shown that after the multifocal intraocular lens is implanted, the brain has a process of neural adaptation for 3 to 6 months, that is to say, the brain is also learning to use the new intraocular lens. Therefore, there is a little discomfort after surgery. anxiety. Expert Profile Professor Chen Weirong Chief Physician, Doctoral Supervisor Director of the Chinese Medical Association, Member of the Ophthalmology Branch of the Chinese Medical Association, Deputy Head of the Cataract Group of the Ophthalmology Branch of the Chinese Medical Association, Member of the Ophthalmology Branch of the Chinese Medical Doctor Association, Director of the Ophthalmology Branch of the Guangdong Medical Association Member, winner of the APACRS Certified Educator Award, and the latest "Expertise in Cataract: Worldwide" in 2022 announced by the famous "Expertscape" institutions in Europe and the United States, that is, "Global Cataract Experts" The international ranking ranks 44th. He has won honorary titles such as National March 8 Red Banner Bearer, Good Man in China, Good Doctor in China, the Most Beautiful Doctor in the Country, Model in Southern Guangdong, Model Worker in Guangdong Province, etc. He presided over a number of projects such as the National Natural Science Foundation of China, a sub-project of the National Key R&D Program, and a key project of the Guangzhou Science and Technology Plan. He has obtained 3 invention patents in the United States and China. He is the first author or corresponding author in Science, Ophthalmology, Advanced Science, Small , EbioMedicine, IOVS, AJO, JCRS and other famous journals published nearly 70 medical papers included in SCI. He is the chief editor of "Ophthalmology Handbook for Primary Physicians", the chief translator of ≪Pediatric Lensology≫, the deputy editor of ≪Phakology≫, and the deputy chief translator of ≪Cataract Surgery≫.

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