At present, there are two kinds of laser myopia surgery. One is called laser keratectomy (PRK), in which the laser repairs the corneal surface. It is only suitable for myopia below 6.00D d. If the myopia degree is too high, PRK will easily cause corneal scar opacity. Another operation is called laser corneal interlaminar inlay (Lasik), which uses a special knife to split the corneal interlaminar to make corneal flap, and uses laser to repair it in corneal stroma. Both high myopia and low myopia are suitable, the operation is difficult, and corneal flap complications are easy to occur. My two daughters and I both had laser myopia surgery, and the results were good, but when asked about our feelings, my sister said, "I don't regret it." My sister said, "I don't regret it. I will never do it again after I die." It can be seen that laser myopia surgery has advantages and disadvantages!
Pro: 1 is the safest and most reliable method to correct myopia at present. Whether it is reported at home and abroad or our own experiments, the long-term stable naked eye vision after surgery is 92%≥0.5 and 70%≥ 1.0 for myopia patients below 6.00D d. For high myopia above 6.00D, the higher the degree of myopia, the worse the long-term effect after operation.
2. Compared with the equipment and technology fees of advanced countries like the United States, Germany and Japan, the domestic surgery fees are very low, only those countries 1/4- 1/6.
3. Domestic doctors have rich clinical experience. According to preliminary estimates, there have been more than 300,000 surgical cases. Because of its high technology and low price, many foreigners have been attracted to China for surgery.
4. Come on. Laser irradiation takes only tens of seconds without hospitalization.
Disadvantages: 1, the surgical effect is not perfect, there are always a few surgical patients with complications, and some patients even have serious complications such as infection and eyeball perforation, resulting in decreased corrected vision or even blindness. Because laser surgery is performed on healthy eyes, the vision of this eye can be completely restored with corrective glasses. If the vision drops due to surgery, it will not be worth the loss. From this perspective, surgical patients are adventurous. Both doctors and patients should think twice before making up their minds to have an operation.
2. At present, the development of laser myopia surgery in China seems a bit excessive. A few units use commercial operation, advertising exaggerates, and do not work hard at the technical level, which increases the possibility of complications.
3. Excimer laser equipment and technology are still developing, and a few units can't keep up with its development, which makes patients suffer undue losses.
Recently, the 6th International (Shanghai) Ophthalmology Academic Conference closed in Shanghai. It is reported that the prevention and treatment of high myopia and the choice of surgical treatment methods for myopia have become one of the hot topics discussed by ophthalmologists in various countries. According to the special report of "The Essentials and Effects of Epi-Lasik Surgery" given by director Hongyi, the chief ophthalmologist of Chengdu Kangqiao, with the further improvement of laser myopia surgery, a new surgical method, Epi-Lasik, appeared, and the cornea consumed during the operation was reduced, so that some people with thin corneas in the past can perform surgery now, and the safety of the operation was further improved due to the increase of corneal thickness after surgery.
Choose the method that suits you.
Jiang Qiao, who had long dreamed of taking off his glasses and showing off his skills in the swimming pool, rushed to the hospital to take off his glasses, but was told that his cornea was thin and not suitable for surgery. A year later, the hospital called again and said that there was a new surgical method called Epi-Lasik, and the cornea used in the operation was reduced. In his condition, he can be operated on now. With the approach of May Day, more and more people want to take advantage of the big holiday to have myopia surgery. Although laser myopia surgery has been carried out in China for more than 10 years, and the number of people undergoing surgery exceeds one million, everyone who is going to undergo surgery is still very concerned about the safety, effect and type of surgery. Especially the choice of surgical methods, there are many people concerned.
It is understood that laser myopia surgery currently carried out in Chengdu mainly includes Lasik, Lasek and the newly launched Epi-Lasik. The differences between the three are as follows:
Lasik is an effective myopia correction operation after PRK, and it is widely used in clinic at present. Under the premise of strict control of contraindications, the effect is good. The main problem of this operation is that a "lamellar flap" with the thickness of 130- 160μm (micron) needs to be made on the patient's cornea, plus laser cutting (the greater the myopia, the thinner the cornea), so it is not suitable for myopia patients with high myopia and thin cornea.
Lasek is an improvement of Lasik. It does not need to make a thick "lamellar flap", but only needs an epithelial flap with a thickness of 60μm, which greatly saves the cornea. However, due to the need for alcohol immersion during the operation, epithelial flap cells are easy to lose their activity, leading to severe irritation symptoms such as glare and tears after the operation.
Epi-Lasik is a new operation, which combines the advantages of Lasik and Lasek. Unlike Lasik, which needs to make a lamellar flap with a certain thickness on the cornea (wasting the cornea), and Lasek, which uses alcohol to soak the cornea, we use a special precision machine to make epithelial flap, which preserves the corneal thickness to the greatest extent while maintaining good cell activity, and has almost no postoperative irritation symptoms, and the incidence of myopia regression is very low. Of course, Epi-Lasik also has disadvantages, that is, the postoperative visual recovery is slightly slower than Lasik, but faster than Lasek, and the long-term effect is better. It is reported that Cambridge Ophthalmology in Chengdu and Eye, Otolaryngology Hospital affiliated to Fudan University in Shanghai are the first hospitals in China to independently own and use this new technology. The 2006 national Epi-Lasik doctor training course sponsored by the Key Laboratory of Myopia of the Ministry of Health will be held again in Cambridge Ophthalmology in June this year.
In addition, some myopia patients with 1300 degree or even 3000 degree or above, hyperopia of 300 degree or above, thin cornea and inability to perform Lasik series surgery can also choose non-laser ACL (that is, anterior chamber intraocular lens implantation with lens) technology to realize their desire to remove their lenses.
Laser surgery is not suitable for everyone.
Zhang Ming, an eye surgery expert in Chengdu Kangqiao, said that PRK surgery set off the first wave of myopia surgery correction in China in the late 1980s and early 1990s. PRK surgery is to help correct myopia by cutting the corneal surface with excimer laser. This method has a good effect on moderate and low myopia, but it has been replaced by Lasik because of its own defects. But Lasik is not for everyone. The suitable age for operation is between 18-50 years old, and 18-38 years old is the best. /kloc-Teenagers under 0/8 years old are not suitable for surgery. Doctors over the age of 38 must consider the amount of correction and possible presbyopia alone. Patients with cataract, dry eye, scar constitution and other diseases should be strictly examined. For people with high myopia, the operation should be cautious, and careful examination should be carried out before operation, including comprehensive fundus retinal examination. Because people with high myopia often have retinopathy, preoperative examination can find hidden retinal dry holes. Laser sealing the hole in time before laser surgery for myopia can effectively prevent serious complications such as retinal detachment after surgery. If you neglect your work, it will inevitably cause great hidden dangers to patients.
Experts emphasize the final effect of laser myopia surgery, the performance of special equipment, the debugging quality of engineers (including the stability of laser energy, the quality of laser mode, the scientific and reasonable computer program, etc.). ), the doctor's technical level (including the design of surgical plan, the operation and treatment of laser irradiation surface, center positioning, etc. ), and cooperation with patients (including fixation and deviation of eyeball, biological effect of laser, postoperative follow-up, and cooperation with medication).
Myopia is the highest incidence of all ophthalmic diseases, especially among young students. Suffering from myopia is usually corrected by wearing glasses or contact lenses, which is one of the most commonly used, simple and effective correction methods. But wearing glasses brings inconvenience to some professionals, and wearing contact lenses will also add a lot of trouble. At present, there are various methods to treat myopia in the market, such as physical therapy, acupuncture, ultrasound, OK mirror and so on. It is difficult to ensure effective and lasting correction of myopia. Some myopia will rebound quickly after use, and some even have serious complications, resulting in a serious decline in vision.
In recent ten years, scientists have studied high-tech methods to treat myopia and introduced some mature methods. Excimer laser is the most representative method to treat myopia, which has become one of the most common and effective methods to treat myopia. Excimer laser is an ultraviolet laser that can be focused and controlled accurately, and its cutting accuracy is very high. Doctors use this feature to correct myopia.
At present, there are two main methods to treat myopia with excimer laser. One is laser keratectomy (PRK), which is suitable for myopia below 600 degrees. Its advantages are simple operation method and low price, but its disadvantages are obvious pain 3-5 days after operation, which can cause temporary corneal opacity. The other is excimer laser in situ keratomileusis (LASlK), which has a wide treatment range and is suitable for myopia patients with 100-1500 degrees. Its advantages are no obvious pain after operation, rapid recovery of vision, good refractive predictability and stability, no corneal opacity, and no need for long-term use of eye drops after operation. However, this technique is complex and expensive, and a few patients may have some complications during and after operation. But if the doctor is skilled, the complications will be greatly reduced. At present, LASlK has become one of the most mature and effective methods to treat myopia. Around the world, thousands of patients receive this treatment every year.
However, it should also be emphasized that PRK and LASIK only change the refractive index of the patient's cornea, have no therapeutic effect on the fundus complications caused by myopia, and will not prevent them. In other words, at present, this kind of laser surgery is just a method of "treating the symptoms rather than the root cause". The myopic intraocular lesions will not be changed by PRK or LA5lK surgery. Therefore, myopia patients, especially those with high myopia, need to go to the ophthalmology department for examination according to the doctor's instructions, treat possible intraocular diseases and complications in time, and avoid serious complications such as retinal detachment.
Since laser treatment of myopia is safe and effective, are all myopia patients suitable for laser treatment? The answer is no, the eyes are very accurate visual organs. Whether it is suitable for laser surgery, you must go through a doctor's careful examination to determine whether you are a suitable object before you can do laser surgery. Generally speaking, people aged 18-50 have been stable myopia for more than two years, and the myopia degree is between 100-1500. It is better to wear glasses to correct vision. There are no other eye diseases and systemic diseases that affect wound healing, and laser surgery can be considered for those with normal mental state. Of course, if you have serious eye diseases, such as keratoconus, severe dry eye, exophthalmos, scar constitution, etc., it is not suitable for laser treatment.
Many patients wrote and called to ask whether this laser surgery was safe. Are there any complications in the operation? Generally speaking, laser treatment of myopia is safe and has few surgical complications. Of course, this does not mean that there are no complications-no medication can guarantee this. However, with the cooperation of advanced instruments and doctors' skilled surgical techniques, the complications of myopia laser surgery have dropped to a very low level (about 0. 1%). These complications include insufficient or excessive correction, decreased best corrected vision, corneal opacity, glare and corneal epithelial implantation, corneal flap dissolution and so on.
In short, the lower the degree of myopia, the better the curative effect of laser treatment of myopia, and the higher the degree. The curative effect is relatively poor: the curative effect of correcting good eyesight is higher, and the curative effect of correcting poor eyesight is worse. Up to now, our eye center has performed PRK or LAStK surgery on more than 14000 patients. According to statistics, among myopia patients with 600- 1000 degrees, 94% of them have a visual acuity above 0.5, and 86% have a visual acuity above 1.0. The long-term effect is relatively stable after follow-up. This result shows that laser surgery is an ideal method to treat myopia.
Laser correction of vision misunderstanding
Myth 1: excimer laser myopia correction surgery can cure other eye diseases.
Myopia is caused by ametropia. The purpose of myopia laser correction surgery is to correct vision by cutting corneal diopter. It can't be used to treat other eye diseases. Therefore, the recipient's eyes must be free from other eye diseases.
Myth 2: Excimer laser surgery can improve vision to the extreme.
Laser surgery can only make the subject's vision close to the corrected vision of optical glasses, but it cannot exceed it. If the vision corrected by laser surgery exceeds that corrected by optical glasses, it will destroy the natural system of the eyes, which is not worth the loss.
Myth 3: Any myopia can be treated by laser surgery.
/kloc-Teenagers under 0/8 years old should never undergo excimer laser surgery, because their visual system is not well developed, which will affect the effect. Although there is no limit to the upper age of surgery, the effect of surgery will be affected by presbyopia, cataract and other problems over 55 years old.
Myth 4: The cheaper the price, the more cost-effective.
Price is not the most important index to measure excimer laser surgery. The effect of excimer surgery is highly dependent on the level of equipment (including auxiliary equipment) and operators, who decide the operation price, so the price cannot be the dominant factor in the selection.
Myth 5: Laser myopia surgery is always available.
Excimer laser surgery for myopia is a perfect systematic project, which should be strictly controlled and the best treatment effect should be selected. Excimer laser irradiates the cornea of eyeball, which produces photochemical effect, cuts the cornea a little and changes the refractive power of cornea, thus achieving the purpose of correcting vision. The data that determines the surgical method and the amount of incision depends on strict preoperative examination. Therefore, mydriasis optometry before operation and re-examination optometry the next day are very necessary. In addition, we should also check the fundus, if there are lesions, it is not suitable for surgery. In addition, intraocular pressure should be measured to exclude glaucoma patients. Therefore, patients who do excimer laser treatment for myopia need to go to the hospital one day in advance, and don't believe in "computer optometry".