Case #12: Woman in her 60s from Suginami (posterior subcapsular cataract: monofocal lenses)

She had posterior subcapsular cataracts with a soft nucleus of about grade 1, and the surgery was performed safely without much ultrasound. Posterior subcapsular cataract, in which the center of the back of the lens (posterior capsule) becomes cloudy, is common in people with diabetes or using steroids, progresses quickly, and causes very strong symptoms such as haziness. She was relatively young for cataract surgery, in her early 60s, but her lenses had already lost their accommodation, so we explained that replacing them with monofocal intraocular lenses would have almost no disadvantage. She was also originally hyperopic and used reading glasses, so we predicted she would be highly satisfied just to see far without glasses; considering her wishes and lifestyle, she agreed to monofocal lenses focused for distance, and as a result she was very satisfied. Someone who has lost accommodation, that is, whose presbyopia is complete, effectively has a cloudy monofocal lens already, so replacing it with a clear monofocal intraocular lens of the right power seems to have no disadvantage. Having surgery early rather than putting up with it means less invasive surgery and a lower chance of complications, so if you are wondering whether it is still too early (especially if you are strongly hyperopic), please feel free to consult us first.