With the development of society and the popularization of electronic products, more and more people are suffering from myopia. Refractive surgery has been carried out in China for more than 30 years, and its safety and effectiveness have been verified by long-term clinical practice, so it has been favored by many myopia patients.
So, how can you get better surgical results? How do I recover after refractive surgery? Here's the answer.
Q: Who is suitable for refractive surgery?
Suitable for:Patients with refractive error over 18 years of age.
Contraindications:
Local ocular diseases: severe dry eye, keratoconus, dilated keratopathy, active ocular infection, glaucoma, severe fundus diseases, etc.;
Systemic diseases: autoimmune diseases or connective tissue diseases (such as rheumatoid arthritis, multiple sclerosis, etc.), hyperthyroidism, etc.;
Mental illness: patients with severe anxiety, depression, hysteria, etc., who are unable to cooperate with the doctor's surgery.
Q: What are the current types of refractive surgery?
Before understanding the types of refractive surgery, it is a good idea to review the anatomy of the eyeball, which is made up of the cornea, iris, lens, vitreous, and nerve layers.
At present, there are two main types of refractive surgery:
One is:Corneal refractive surgeryAs the name suggests, this type of refractive surgery is done in the corneal plane, including full femtosecond surgery, half femtosecond surgery, corneal surface surgery (including lasek, prk, transprk);
The other category is:Intraocular refractive surgery, i.e., intraocular lens implantation, including anterior chamber and posterior chamber types, and the vast majority of posterior chamber types are currently predominant (i.e., ICL lens implantation).
Q: What is the difference between these different types of refractive surgery?
Corneal refractive surgery is done by cutting with femtosecond laser or excimer laser in the corneal plane, which is called "subtractive surgery"; Intraocular refractive surgery is the insertion of a lens with power into the eye without changing any structure of the eye, so it is also called "additive surgery".
Corneal refractive surgery
1.Half femtosecond surgery (FS-LASIK):First, a negative pressure suction loop is used to suction the cornea, a corneal flap is made with a femtosecond laser, and after the corneal flap is lifted, an excimer laser is performed on the stromal bed, and finally the corneal flap is replaced. The corneal flap does not need to be sutured and usually heals in 1-2 weeks. The procedure is very convenient and the patient does not feel any pain during the procedure. Vision recovered quickly after surgery, and there was no pain or discomfort on the first day after surgery.
2.ReLEx Surgery:It's a two-step process. In the first step, a negative pressure suction loop is used to suction on the cornea, and a femtosecond laser is used to make a corneal stromal lens. In the second step, the lens is removed through a small incision of 2-4mm, and the surgery is completed. The whole procedure is very quick, and it only takes 6-8 minutes for both eyes to complete. The postoperative vision recovery is also relatively fast, and it can be completely recovered on the first day after surgery, and there is no pain during and after the operation.
Intraocular refractive surgery
Lens implantation:During the operation, a small incision of about 3mm is made in the limbal area, and the lens is inserted into the small incision through the implanter, placed in the ciliary sulcus between the iris and the natural lens, and the whole operation is completed. This procedure uses a lens to be placed in the optical area to correct myopia, and the surgery is very fast, usually 5-6 minutes to complete the monocular surgery. There was no pain during and after the operation, and the vision returned to normal and clear vision on the first day after surgery.
Q: How do different patient groups choose the right refractive surgery for themselves?
Before refractive surgery, it is necessary to go to a regular hospital for a comprehensive preoperative eye examination, and the expert will make a reasonable recommendation for the surgical method according to the examination results.
Specifically:
ReLEx Surgery:The surgical incision is small, which is suitable for people who have high requirements for exercise intensity after surgery, such as: serving as a soldier, taking the police academy, taking the military academy, etc.;
Half femtosecond surgery:It is suitable for people with high astigmatism or relatively irregular corneal morphology;
Phakic intraocular lens implantation:It is suitable for people who have thin corneal thickness, corneal lesions, or those who cannot be ruled out as having problems at the corneal level.
Q: What are the precautions for the perioperative period (preoperative, intraoperative, and postoperative) of refractive surgery?
According to a multicenter study in China in 2017, 41 of the 1849 patients with refractive error were presentForty-three percent of patients had preoperative dry eye. Preoperative dry eye will affect the stability of the patient's tear film and the morphology of the corneal surface, which will directly affect the design of the surgical plan by the refractive doctor, thus affecting the quality of the operation. For patients with preoperative dry eye, preoperative prophylactic use of artificial tears is recommended to improve ocular surface morphology and tear film stability.
Refractive surgery injures the corneal nerve and changes the corneal curvature, which affects tear film stability and leads to dry eye. At the same time, the use of instruments or negative pressure ring suction can also destroy the conjunctival goblet cells on the ocular surface, which are very important ocular surface structures that secrete the innermost mucin layer of the tear film. Mucin layer deficiency causes mucin-dystotypic dry eye, which is common in clinical practice. Therefore, for patients after refractive surgery, Director Wen Bei of the Refractive Department of Dongguan Huaxia Eye Hospital recommends the use of artificial tears that simulate the function of mucin. It aims to restore the stability of the patient's tear film, alleviate the symptoms of dry eye, improve the patient's surgical satisfaction, and is also a necessary step to ensure the quality of vision after surgery.
· Tip: Dry eye caused by surgery can recover in 3 months, so there is no need to worry too much