Surgical Treatment of Age-Related Cataracts: Milestones and Challenges. Literature Review

Abstract

Cataract (partial or complete violation of the transparency of the lens) is one of the main causes of low vision and reversible blindness in the world. It is a known fact that at present the only effective way to eliminate the clouding of the lens is its surgical treatment. About 18 million cataract-related surgical interventions are performed annually in the world. This literature review is devoted to studies examining important aspects of surgical treatment for age-related cataracts, such as the number and quality of operations performed on a population scale. The paper presents data on the impact of global trends, local territorial and social characteristics on the number of surgical interventions for cataracts. A review of key indicators of monitoring cataract surgery has been carried out, the main factors affecting the target indicators of the cataract surgery frequency on a regional scale (age structure of the population, normative indications for surgical treatment, threshold values for visual acuity indicating the need for surgical intervention, and the proportion of people in need in surgical treatment of cataracts). The main achievements and aspects of the modern technique of surgical treatment of cataracts are described, which can reduce the time of surgery, use more gentle surgery technology, significantly reduce the number of complications and achieve the highest functional results. This review also details the results of the largest epidemiological studies on the causes of low visual acuity after cataract surgery. Literature data on the prevalence of low visual acuity in different populations are reflected, its higher prevalence in countries where most of the operated cataracts were mature or complicated was revealed, the surgical technique of large incisions and a longer operation time prevailed. It was noted that low vision after cataract surgery is most often associated with the elderly patient, concomitant systemic and ocular pathology, surgical complications, inadequate intraocular correction.