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National clinical guideline on the diagnosis and treatment of age-related cataract updated in Denmark
In early January 2020, the Danish Health Authority (Sundhedsstyrelsen) has updated the national clinical guideline on the diagnosis and treatment of patients with age-related cataracts.
The age-related (senile) cataract is a vision-impairing disease characterized by gradual progressive clouding and thickening of the lens of the eye. It is the leading cause of treatable blindness, with about 50,000 surgeries performed per year in Denmark. As the proportion of older people in the population increases, the annual number of cataract operations is also expected to increase.
In the updated guideline, it is recommended that patients with age-related cataracts, with visual acuity greater than 0.5 decimal, corresponding to the visual requirement for a driver's license, are not routinely offered surgery.
The surgery for age-related cataracts comprises replacing the eye's natural lens with an artificial lens that corrects vision. For patients who at the same time have astigmatism of more than 2 diopters, it should be considered using implantation of toric artificial lenses that more effectively reduce glasses dependence. Toric artificial lenses are not as effective in reducing glasses dependence in patients with minor astigmatism.
A new recommendation has been added to the guideline allowing the patient to make an informed choice regarding multifocal rather than monofocal artificial lenses. Multifocal artificial lenses provide lesser glasses dependence as well as better uncorrected vision. However, the disadvantage of them is that they can cause an increased incidence of complications. Therefore, the recommendation is to offer multifocal lenses only after careful consideration.
The guideline also includes an update on the evidence to use eye drops with nonsteroidal anti-inflammatory drugs (NSAIDs) rather than steroids to prevent inflammation after surgery and swelling of the retina.
The full details in Danish can be found here.
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