If your daily life is difficult due to cataract or reduced vision, surgery is required.

The main cause is aging, which cannot be cured with drugs
It is not allowed to be neglected as it is not an emergency disease
If you are uncomfortable with vision loss, you may need surgery.
Eye supplements don’t help much

Min-kyung Song, an ophthalmologist at Ilsan Paik Hospital, said, “There is no way to completely prevent a cataract as it is a change in the lens that occurs with aging. said

Cataract is the most commonly performed surgery in Korea. It is the undisputed number one from 2016 to 2020. Cataract surgery has been on the rise in recent years. According to data from the National Health Insurance Corporation, the number of cataract surgeries increased by 35.5% from 518,663 in 2016 to 70,261 in 2020. In terms of the number of surgical patients, the number is 455,068. Korea ranks third in terms of overall surgeries. In 2020, the number of cataract surgeries per 100,000 people was 1,329, overwhelmingly the number one. This is more than double the number of cesarean sections (554 cases).

The cost of cataract surgery (excluding non-insurance) ranks second among all surgeries. It increased by 65% ​​from 494.4 billion won in 2016 to 8131 billion won in 2020. The cost of surgery per case increased from 950,000 won in 2016 to 1.16 million won in 2020. The length of hospitalization was 1.1 days, which was the shortest among the surgeries.

By age, the number of surgeries increased with age: 4035 cases under 40, 31,772 cases in 40s, 151,154 cases in 50s, 23633 cases in 60s, 213,566 cases in 70s, and 71,461 cases in 80s or older. also shows an increase. This seems to have risen sharply as the cost of cataract surgery is claimed as an insurance claim for cataract surgery along with an increase in the elderly population.

Major surgeries per 100,000 population in 2020 [자료 = 국민건강보험공단]

Diabetes and UV exposure causes cataracts

Aging is the main cause of cataracts. Usually, after the age of 40, the lens becomes cloudy. Women have a higher prevalence than men. According to data from the Health Insurance Review and Assessment Service, 26,190 women and 193,878 men were among the cataract surgery patients in 2020. The exact cause is still unknown. The higher prevalence of cataracts in postmenopausal women is thought to be due to decreased estrogen. In addition, myopia, diabetes, sun exposure, smoking, and steroid use are known to be major risk factors for cataracts.

Among them, diabetic patients need special attention. Diabetes causes lens edema and opacity. UV rays can also cause cataracts. This is because photosynthetic stimulation can damage the lens cells. In fact, a study in Korea found that the higher the exposure to sunlight, the higher the prevalence of cataracts.

The correlation between smartphone use and cataracts is controversial. It was found in a 2014 Journal of Photochemistry and Photobiology that blue light (blue light) causes cataracts by increasing oxidative stress on the lens. However, the blue light emitted from the screens of electronic devices such as smartphones, TVs, and laptops is about half of store lighting and 1/10 of sunlight, so the risk of cataracts is small.

Professor Song Min-kyung of Ilsan Paik Hospital, an ophthalmologist who specializes in cataract treatment, said, “The amount of blue light emitted from smartphones, TVs, and laptops is small, so it is not dangerous to the eyes. However, active oxygen removed through sleep is not effectively removed and may adversely affect the aging of the lens.”

Morning, vision loss → evening, vision recovery phenomenon

If you compare the eye to a camera, the lens is the lens. A cataract is when the lens (lens) becomes cloudy. The main symptom is loss of vision. As light passes through the lens, it scatters, resulting in monocular diplopia, in which the object appears in two, and the glare increases. In addition, when the central opacity becomes severe, visual acuity deteriorates more during the day when the light is bright, and visual acuity improves in the evening.

Many patients misunderstand that presbyopia and cataract symptoms are similar. In general, presbyopia cannot focus on close objects. On the other hand, in cataracts, not only close objects but also distant objects are not seen, and the symptoms of blurring are added. This is because the lens itself is cloudy. Presbyopia is a condition in which the lens function is impaired, so wearing a magnifying glass will correct your vision. However, the loss of vision caused by cataracts cannot be corrected with glasses.

Song Min-kyung, an ophthalmologist at Ilsan Paik Hospital, said, “The diagnosis of cataract can be made by an ophthalmologist by magnifying the structure of the eyeball and using a slit lamp microscope to see the turbidity of the lens. If you feel cataract symptoms such as inability to see teeth, you need to take action after an accurate diagnosis.”

Number of cataract surgery patients by age in 2020 [자료 = 국민건강보험공단]

Increased risk of glaucoma and optic nerve damage if left unattended

To cure a cataract, surgery is required. To date, there is no way to treat cataracts with drugs. Prescribing eye drops or pills is a drug with an antioxidant effect, which inhibits the progression of turbidity.

So, when should I have surgery? Most cataract surgeries are not emergency. However, if a person who needs cataract surgery is left without surgery, his eyesight deteriorates severely. The difficulty of the operation itself also increases. Secondary optic nerve damage may occur due to glaucoma. If you have cataracts, it is recommended to have regular checkups and get surgery at an appropriate time.

Conversely, if you do not have a cataract, undergoing surgery is generally more for the purpose of correcting your vision by replacing it with an intraocular lens instead of for the purpose of treating cataracts. Because the surgical procedure is the same, there are no additional complications and side effects.

If life is difficult due to reduced vision due to cataract, surgery is recommended. Vision can be restored by replacing the cloudy lens with an artificial lens. There are several types of artificial lenses. A typical intraocular lens is monofocal. It only focuses on one thing, either far or near. In other words, if you have operated to see far away areas clearly, you need to use a magnifying glass for near distances. A multifocal intraocular lens was developed to solve this inconvenience. It can see both far and near, such as bifocal, trifocal, and extended focal length. It’s called ‘presbyopia cataract surgery’.

Multifocal intraocular lenses are not without their advantages. Professor Song Min-kyung said, “Because the multifocal IOL disperses the focus, the sharpness may be lower than that of the monofocal IOL, and there may be side effects such as glare and shadows. We have to be more careful,” he said.

The number of cataract surgeries by year [자료 = 국민건강보험공단]

Patients with dry eye syndrome should undergo surgery after treatment for dry eye syndrome.

Cataract surgery is performed through a small passage of 2-3 mm in the eye due to the development of technology. It is relatively safe compared to other surgeries. However, all surgeries can have complications or side effects. The most common side effect complained of is dryness. Dryness may occur due to changes in the corneal nerve after surgery. For patients with severe dryness, it is necessary to undergo surgery after receiving adequate treatment for dryness in advance.

In addition, ▲intraocular infection caused by bacteria in the eye ▲intraocular lens dislocation where the intraocular lens is out of position ▲corneal failure due to damage to the darkened cornea.

To prevent intraocular infection after cataract surgery, do not wash your face or wash your hair for 1 to 2 weeks after surgery. It is recommended to avoid bathing and swimming pools for 4 weeks after surgery. Eye drops prescribed after surgery are used to prevent infection and reduce inflammation, so use them according to the intended use.

Most patients try to avoid surgery in the summer because they can’t wash, but there is no difference in the surgical results depending on the season. Cataract can only be treated with surgery, so it is advisable to consider surgery if you feel uncomfortable even in summer.

You don’t have to wear sunglasses right after cataract surgery. A cataract that was cloudy can become sensitive to light as it transforms into a clear intraocular lens. You can wear sunglasses if they help you adapt to the light. It is recommended to wear sunglasses to protect the retina, etc., because the UV protection effect of the transparent intraocular lens decreases outdoors.

Commercially available eye supplements contain vitamins and various substances that help prevent macular degeneration or improve dryness, so they are not very helpful in preventing cataracts.

Professor Song Min-kyung said, “Diabetes increases the prevalence of cataracts among the underlying diseases, so sugar management can help prevent cataracts. We recommend wearing a hat or sunglasses to block the sun.”

Professor Song also emphasized, “There is no way to completely prevent a cataract because it is a change in the lens that occurs with aging. did.