Management
Prevention
Î Smoking is associated with nuclear sclerosis and demonstrates a
dose-response effect. Smoking is also associated with an increased
risk for PSC and, to a lesser degree, cortical cataract. The risk may
persist for decades in heavy smokers. Thus, patients should be
warned of this risk and counseled to stop smoking. (II+, G, S)
Î Cumulative lifetime exposure to ultraviolet-B radiation has been
associated with lens opacities. Therefore, brimmed hats and
ultraviolet-B blocking sunglasses are reasonable precautions to
recommend to patients. (II-, G, S)
Î There is an increased risk of cataract with blunt and penetrating
trauma. Therefore, recommending safety eyeglasses in high-risk
activities at work or recreation is reasonable. (III, G, S)
4
Nonsurgical Management
Î Ophthalmologists should advise patients that at this time there is
insufficient evidence to support the use of pharmacological treatments
for cataract. (III, G, S)
Î Patients who are long-term users of oral and inhaled corticosteroids
should be informed of the increased risk of cataract formation. (II+, M, S)
Surgical Management
Î The predominant method of cataract surgery in the developed world
is sutureless small-incision phacoemulsification with foldable IOL
implantation. (I+, G, S)
Î Ideally, the operating ophthalmologist should perform the
preoperative evaluation, because this will allow the surgeon to
formulate the surgical plan and establish a relationship with the
patient prior to surgery. (III, G, S)
Î Patients undergoing cataract surgery should have a preoperative
medical evaluation, including history and physical examination
with consideration of the risk factors for undergoing the planned
anesthesia. (III, G, S)
Î Routine preoperative laboratory testing in association with the history
and physical examination is NOT indicated. (I+, G, S)
