Diabetes What to do about cataracts, how to treat diabetic cataracts, or alleviate them

Beijing reader Mr. Yang.

Mr. Yang: Hello! I'm Wang Yanling, director of the Department of Ophthalmology at Beijing Friendship Hospital, and I'm here for your question.

The cause of vision loss in people with diabetes is usually due to cataracts or diabetic fundus lesions. On the **, both cataract surgery and diabetic fundus lesions should be performed**, but cataract surgery may aggravate the progression of diabetic fundus lesions. If diabetic fundus lesions are not treated in time after cataract surgery, neovascular glaucoma may develop.

Therefore, cataract surgery for diabetic patients should be especially cautious. In clinical practice, it is common for patients to have cataract surgery, but their vision not only fails to improve, but declines, and some even go blind.

The fundus lesions of diabetes are divided into six stages, and different programs are applicable at different stages. Lasers are needed in the period, and vitrectomy surgery is required in the period, especially in the period, which can be said to be a key stage of diabetic fundus lesions. Cataract surgery, with the continuous improvement of the technical level, the indications have been gradually relaxed, and many hospitals can carry out cataract surgery; But for diabetic cataracts**, it is not simply the same as other ordinary cataract patients.

For diabetic cataract patients, depending on the stage of the fundus lesion and the opacity of the cataract lens, the decision should be made whether to undergo cataract surgery first, or fundus lesions first, or both. Even if the vision is not good, do not rush to do cataract surgery, first go to the hospital for a detailed eye examination, mainly dilated pupils to examine the fundus in detail, clarify the stage of the diabetic fundus, if necessary, do fundus fluorescence angiography, if the diabetic fundus has developed to the extent that laser is needed, it is recommended to do laser ** first, and then consider cataract surgery; If a laser** is not yet needed, or if a laser is not possible due to the degree of cataract opacity, cataract surgery is done first.

If cataract surgery is performed first, the surgeon will perform a large continuous annular tear capsule, polish the anterior and posterior capsules of the crystals, and select the appropriate lenses for the patient. This is to prepare for the future laser**, and after the operation, it is necessary to develop a timely fundus fluorescence contrast examination and fundus laser** and other strict follow-up plans.

Through these, diabetic cataract patients can avoid the occurrence of neovascular glaucoma, so that they can have cataract at the same time, fundus lesions can also be avoided. At the same time, an endocrinologist should be asked to adjust the patient's medication to control blood glucose.

Two weeks after cataract surgery, fundus fluorescence imaging can be done in patients with fundus lesions. If the contrast results indicate the need for laser fundus lesions, panretinal photocoagulation is usually completed in time within two months when the anterior and posterior capsules of the lens are not opaque enough to affect the fundus laser**, so as to avoid the further progression of diabetic fundus lesions to neovascular glaucoma. ▲

Hello, the old man's condition still needs to stabilize his blood sugar first, because he is relatively old, and he will normally have a little cataract, but if it is serious, he can control his blood sugar to a normal level, and he can perform cataract surgery. You will be able to see clearly, but the surgery needs to be in line with the surgical correction in all aspects.

All cataracts require surgery**, and diabetic cataracts are no exception. The most common cataract surgery is phacoemulsification combined with intraocular lens implantation, which depends on the condition of the patient's fundus. If there is already diabetes in the fundus, the effect of multifocal lens and trifocal lens cannot be achieved, and monofocal lens can be installed.

During cataract surgery, it is often difficult to operate because of diabetic fundus changes, and corneal edema will occur after surgery, so vision recovery is slow. In addition, eye drops are needed for a longer period of time than regular senile cataracts.

Because diabetic patients have poor immunity, they need antibiotic eye drops. In addition, diabetic patients are also prone to high intraocular pressure after surgery, and intraocular pressure lowering drugs are also needed. Many diabetic patients not only have cataracts, but also fundus changes, so follow-up detection of fundus is also very important.

Diabetic cataract is the clouding of the lens caused by high blood sugar, ** this cataract, in the early stage, through blood sugar control, can make the cloudy cataract transparent, and later on** cataract surgery.

Diabetic cataract is caused by high blood sugar causing the lens to be cloudy, affecting vision, if the blood sugar rises significantly in a short period of time, the lens is cloudy, after controlling blood sugar, the lens opacity can be reduced and vision can be restored. Slow clouding of the crystals occurs due to prolonged blood sugar increases, which requires surgery**.

Diabetes complicated by cataract how to **.

Guo Jia, Deputy Chief Physician.

Department of Ophthalmology, Beijing Anzhen Hospital, Grade 3.

Diabetes complicated by cataract needs to be decided according to the impact of cataract on the patient's vision.

Diabetes complicated by cataract, also known as metabolic cataract, is a very common disease in ophthalmology. If the patient's cataract has a relatively slight impact on vision and does not affect the patient's visual function, it can be temporarily ignored, as long as attention is paid to actively controlling blood sugar, but if the cataract condition is more serious and has affected normal life, such as the patient's vision has been lower, cataract surgery can be considered**. In addition, if the patient needs fundus lesions caused by diabetes, if the cataract affects the observation and ** of the fundus, even if the lens opacity does not meet the indication for cataract surgery, cataract surgery can be carried out in advance.

The surgical method of diabetes complicated by cataract is the same as that of perennial senile cataract, cataract phacoemulsification aspiration combined with intraocular lens implantation can be used, but during the whole operation, we must pay attention to monitoring blood sugar, control blood sugar in a stable state, fasting blood sugar should be at least below 9mmol L, and postprandial blood sugar should be below 14mmol L, only in this way can we get a better recovery after surgery, otherwise it may lead to some complications such as intraocular bleeding or postoperative infection.

Metabolic cataract is an endocrine disorder, also known as diabetic cataract, which is caused by the rise in blood sugar caused by diabetes and causes the formation of cataracts, which is more common in the case of congenital metabolic abnormalities.

Presenting symptoms include loss of color vision, visual disturbances, corneal opacity, and diplopia.

**Methods: Diabetes can be actively controlled first, and cataract phacoemulsification combined with intraocular lens implantation can be performed after the condition is stabilized. The prognosis is good in the absence of severe ocular and complications after surgery.

To actively control diabetes, you can often drink konjac herring soup to stabilize blood sugar, and konjac glucomannan inhibits the abnormal rise of blood sugar in diabetic patients and prevents hyperlipidemia.

Selenium has a strong antioxidant effect, which can remove excessive free radicals and prevent cataracts and diabetes.

Selenium is the active ingredient that makes up glutathione peroxidase, which can prevent the oxidative destruction of pancreatic islet cells, make them function normally, promote sugar metabolism, reduce blood sugar and urine glucose, and improve the symptoms of diabetic patients.

Physis Selenium Weikang Chewable Tablets can help improve the symptoms in this regard, which is natural, hormone-free, safe and non-toxic***. High activity, high absorption rate, easy to be absorbed and utilized by the body. It can give full play to the role of selenium in the body, which is of great help to metabolic cataracts.

The increase in blood sugar changes the osmotic pressure of the aqueous humor, which affects the metabolism of the lens, leading to the occurrence of cataracts, which are called metabolic cataracts. **Metabolic cataract is to lower blood sugar first, and then perform surgery after blood glucose vatarization**Cataract.

You must first ** cataract and stabilize blood sugar at the same time You can try the gray douba of Mount Emei, which can regulate blood sugar stability.

General**: All diabetic patients must be popularized with diabetes knowledge, so that they can learn to measure blood glucose (peripheral blood glucose meter method), urine glucose, insulin injection technology, application of diet, exercise, and knowledge and methods of hypoglycemic drugs.

Cataract surgery can only be done.

Surgery is selected on the basis of glycemic control**

Diabetic cataracts can be divided into two categories: one is true diabetic cataracts. It is mainly caused by excessive osmotic moisture in the lens, which is relatively rare in clinical practice. It is more common in adolescents with severe diabetes. The second is accompanied by diabetic patients.

Onset of senile cataracts. Age-related cataracts are generally considered to be more common in people with diabetes than in non-diabetic patients, at an earlier age, and that cataracts mature more quickly, but there is no other difference.

For cataract patients with diabetes, according to the stage of the fundus lesion and the degree of cataract lens opacity, the ** plan should be chosen, whether to do cataract surgery first, or **fundus lesion first, or both at the same time**:

If diabetic fundus lesions are the main problem, fundus lesions should be done first, and patients who have progressed to the point where laser is needed can be treated first. If the degree of cataract opacity is severe and affects the laser**, cataract surgery can be done first. If cataract affects fundus viliscotomy, cataract surgery and fundus laser can be combined**.

Diabetes has a very large impact on the eyes, and in severe cases, it can lead to blindness. In order to avoid cataracts caused by diabetes, when diabetes occurs, it is necessary to take reasonable precautions, actively control blood sugar, and avoid unnecessary complications.

Phacoemulsification surgery can be done.

If it is fundus hemorrhage complicated by cataract, and it has not yet reached the stage of retinal detachment, the vision can be restored to a large extent after surgery, which is a little worse than the original situation without cataract, and it will not affect the vision, but if it is said that it is at the stage of retinal detachment, then the recovery after surgery will be very poor, it can only be said that the vision is preserved, and you can see things, but it is still blurry after surgery.

As for whether it will affect the other eye, if you are referring to surgery, it will not affect it. But my opinion is that because one of your grandmother's eyes has fundus bleeding accompanied by cataracts, the other eye must also be examined, because I estimate that the eye over there must also be a lesion, and maybe there is a slight fundus hemorrhage, but because there are very few, the fundus can absorb on its own, so I didn't notice it. I would say this because the fundus lesions of diabetes are not special, and generally if there is a problem, both eyes will have symptoms, so while there is no major problem with the eyes now, check it in time and prevent it as soon as possible.

Another point is that your grandma's blood sugar control is not very good, it must be strengthened, and it is very important to monitor blood sugar regularly, because if blood sugar is not well controlled, complications will develop.

This is because the lack of insulin in the body or the decrease in the activity of certain enzymes in the body increases the blood sugar concentration, which leads to an increase in the osmotic pressure of the aqueous humor in the eye, and the swelling of the crystal fibers, which then breaks and disintegrates, and finally leads to the clouding of the crystals. The most typical symptom of diabetic cataract is that before the cataract forms, the blood sugar concentration rises, and it becomes myopia; When the blood sugar concentration decreases, it becomes normal again. It should be noted that there are no signs of cataract in the early stage, and as the disease progresses, patients may experience symptoms such as blurred vision, changes in color vision, excessive sensitivity to sunlight or lights, frequent changes of glasses, double vision, and short-term improvement in near vision in patients with farsightedness.

Therefore, if a patient has vision problems, it is important to see an ophthalmologist in time to find out the cause. Eating more foods rich in lutein and zeaxanthin such as corn, kiwifruit, and broccoli can prevent the occurrence of cataracts. When lutein and zeaxanthin enter the body, they accumulate in the light-sensitive tissues at the back of the eye.

These tissues then protect the eyes by filtering harmful blue light, preventing the occurrence of cataracts and delaying vision loss. However, the absorption and utilization rate of food is too low, so it is more recommended to take Leyi Lutein Chewable Tablets directly, one tablet a day, which is simple and convenient to absorb and good, and can easily supplement lutein for the body, prevent the occurrence of cataracts, and protect binocular vision.