Popular Science: Can cataract surgery be performed on only one eye?

Cataract surgery usually starts with one eye and then the other. After surgery on one eye, some patients find that their vision has improved and they can't wait to have surgery on the other eye. However, some patients have good vision recovery after surgery and they think it's no big deal to see with only one eye and live their lives as usual, so they don't plan to have surgery on the other eye.

Is it necessary to perform cataract surgery on both eyes?

This issue needs to be viewed based on different situations.

The first situation: If only one eye has cataracts and the other eye does not have cataracts and has good vision, temporarily only one eye needs cataract surgery.

The second situation: If both eyes have cataracts, the severity of the cataracts is different, and the refractive status after surgery is not much different, you can choose to perform cataract surgery on only one eye.

The third situation: In real life, many patients have similar degrees of cataracts in both eyes, poor vision in both eyes, or large differences in refractive status after cataract surgery. These patients need cataract surgery on both eyes. Only operating on one eye will affect the patient's vision and life.

Will it have any impact if I only do surgery on one eye?

01-Stereoscopic vision will be significantly reduced

Although vision seems to be unaffected, stereoscopic vision will be significantly reduced, which can be simply understood as the inability to see far and near. This visual impairment will cause patients to have unclear vision and step on empty air when going up and down stairs; they may accidentally fall when the road is uneven... These situations are common in clinical practice.

Hua Xia, director of Tianjin University Aier Eye Hospital, said that people can see things because the light from the outside world passes through the lens, reaches the retina and forms an image. However, the retina is a two-dimensional plane, and people can only perceive flat objects with the vision of one eye alone. Only through binocular vision can people have the perception of three-dimensional space with depth, which is depth perception, also known as distance perception or stereoscopic perception.

In clinic, we often encounter patients complaining that their vision in one eye has reached 1.0 after surgery, but they still cannot see clearly and fall down! This is not because the previous surgery was not done well, but because only one eye was operated on for cataract, which will increase the difference in vision between the two eyes. This situation will put the elderly at risk of falling. The reason is due to distance perception or stereoscopic perception disorders. Cataract patients with similar degree of cataract in both eyes and poor vision in both eyes can establish and restore the visual balance of both eyes as soon as possible after surgery on both eyes.

02-Anisometropia in both eyes

For cataract patients with high myopia, after surgery on the first eye, there will be refractive differences in both eyes, such as double vision; inconsistency and incoordination in size and distance; and the risk of falling when walking or going up and down stairs.

03-Causes other complications

If a cataract patient only has one eye operated on and the other eye is delayed for too long, the cataract will be delayed to the late stage and many complications such as secondary glaucoma will occur, and the chance of regaining sight may be delayed or even lost.

Many elderly people think that surgery is too much of a hassle at an old age, and that they can barely live with the vision restored in one eye after surgery. In fact, this is not the case. Cataract surgery "only on one eye" will leave safety hazards, and vision problems caused by "treatable or not" or "temporary incurable" not only affect our normal life, but also increase many health risks. As a common reversible blinding eye disease, senile cataracts deserve everyone's careful prevention and active treatment.