Introduction: 2012 can be said to be the year of the most rumors, in addition to the doomsday throughout, is closely related to health rumors. The rumors of anesthesia stealing kidneys, the second line of the Rendu, water contraceptives, sperm exhaustion and other alarming rumors frequently appear, but there are also traditional rumors like the heavier the baby, Chinese people are deficient in calcium, Aristolochia Chinese medicine can cure diseases and other rumors were punctured one by one. In this year of rumors, which ones have you believed? Rumor: stop laser surgery to correct myopia In February, Taiwan’s authoritative ophthalmologist Rui-Fang Tsai believes that the sequelae of laser myopia correction surgery are emerging one after another, decided not to do such surgery. And this FDA official website related to the topic of surgery said that because long-term data on the sequelae of surgery is not yet available, its long-term safety and effectiveness is not yet clear. The fact is that as long as the patient is strictly screened and the surgical process is paid attention to, the safety of laser myopia correction surgery is not a problem. [The actual fact is that if you’ve got a lot of people who are not going to be able to get a lot of money, you’re going to be able to get a lot of money. “The safety of laser corrective myopia surgery is not a problem,” he said, “in fact, it is still a pretty perfect surgery.” Taiwanese doctor Rui-Fang Tsai never thought he would become a popular figure in the news across the Taiwan Strait in this way. In a news story that was widely reprinted, the ophthalmologist announced to reporters that he would not perform laser corrective myopia surgery again. This is because, according to his long-term observations, many patients who underwent the surgery back then have experienced significant vision loss after more than a decade. In Taiwan’s medical community, Tsai Ruifang’s status is “quite significant. In fact, it was he who first introduced laser myopia correction surgery to Taiwan 19 years ago, when it was still in the experimental stage. That’s why his declaration caused an uproar on both sides of the Taiwan Strait at the same time: myopic patients anxiously asked on the Internet whether “laser surgery is no longer reliable”, the stock price of an eye hospital suffered a serious setback, and a mainland media commented with emotion that society needs a “Cai Ruifang-style One mainland media outlet commented emotionally that society needed a “Cai Ruifang-style medical conscience”. Cai Ruifang himself did not expect such an outcome. In a telephone interview with reporters, he said that the controversy stemmed from a media misunderstanding and that he did not “take the initiative to announce” that he would stop doing laser myopia correction surgery. “There is no problem with the safety of laser myopia correction surgery,” he said, “in fact, it is still a pretty perfect procedure.” My principle is to pick the best treatment for my patients. What got Cai Ruifang into the whirlwind of public opinion was actually a surgery that wasn’t done. A week ago, a journalist from Taiwan came to Rui-Fang Tsai’s clinic, hoping to introduce his friend to laser surgery for myopia correction. The full name of the surgery is “excimer laser in situ keratomileusis”. According to media reports, since the world’s first laser surgery for myopia was performed in the United Kingdom in 1989, this technology has quickly become a boon to myopic patients, with tens of millions of myopic patients worldwide benefiting from the removal of their glasses. Millions of people have also been treated in mainland China since the technology was introduced in 1995. In Taiwan, the procedure was first introduced by Rui-Fang Tsai in 1993. Publicly available information shows that he was trained at the prestigious Bascom Palmer College of Ophthalmology at the University of Miami in the United States and also served as the director of the Department of Ophthalmology at Chang Gung Memorial Hospital in Taiwan. Later, he founded the Tsai Ruifang Eye Clinic and served as a visiting professor at Taipei Medical University and Fudan University. But this time, faced with a reporter’s request to refer a friend for surgery, he declined. “I haven’t done this hand for a while.” Cai Ruifang told the reporter at the time. But his refusal instead piqued the reporter’s greater interest. On the phone, he asked Cai Ruifang why he no longer performed this surgery, and then came to the clinic to learn more about the situation. Cai Ruifang did not expect that the situation he presented would become news in the next day’s newspaper and occupy a front-page headline. In the heavily reprinted story, the renowned doctor said that he had met half a dozen past patients in recent times who had experienced vision loss more than a decade after the surgery. As a result, he had to “stop prescribing this surgery based on his medical conscience. Cai Ruifang did not agree with the content of the report. Although, it is true that he has not performed this surgery in the past six months. But he has his own explanation: “I have a principle of picking the best treatment for my patients.” He gives the example that if a patient has a cataract, he can only perform surgery on the patient because there is no other treatment. However, myopic patients are different, as they are perfectly capable of correcting their vision by wearing frame glasses or contact lenses, in addition to surgery. So surgery is not their only option, and in many cases, not the best option. “But laser corrective myopia surgery is still an epoch-making medical innovation.” Cai Ruifang said. He believes the procedure is “a pretty perfect procedure” in that it can accurately correct vision, patients can recover quickly and the cornea does not scar from the surgery. “We have evaluated laser surgery for myopia in the past and there is no doubt about its safety; to date, it remains unproblematic.” Cai Ruifang stressed. Compared to other surgeries, laser myopia correction surgery has relatively few problems, but there are still some possible side effects. Patients will experience glare when exposed to bright light and reduced vision at night, all reactions that will be clearly communicated before the surgery. For most people who undergo the procedure, these side effects are well within the tolerable range. It was the “corneal flap” that raised Cai’s alarm. When the surgeon re-covers the lifted “orange peel”, the laser-cut portion of the eye is completely repaired within two days, but the re-covered cornea is no longer able to connect to the surrounding cornea and heal, but remains in the patient’s eye forever, like a petal. Most of the time, such a “flap” does not have much effect and is not dangerous even if the eye is rubbed hard. But in the past ten years, Cai Ruifang met five or six patients, because the eye suffered an external impact and the phenomenon of corneal flap displacement. Such a displacement can be recovered, but it may cause the corneal epidermal cells to invade the flap, causing great pain to the patient and making surgical treatment more difficult, according to Rui-Fang Cai. On the other hand, the presence of a corneal flap can alter the clinical presentation of other conditions in these patients. Rui-Fang Tsai once met a patient with herpes keratitis who did not have the dendritic ulcers common to this condition, but had edema throughout the cornea. Cai Ruifang spent a long time considering many possibilities before finally arriving at the correct diagnosis. He deduced from this that if the patient had a chronic inflammatory disease, such as allergic conjunctivitis or dry eye syndrome, and had not been effectively treated for more than a decade, the inflammatory cells could have been deposited in the spaces of the corneal flap, causing the patient’s vision to recur. However, Rui-Fang Tsai also emphasized that the probability of these problems is not high. In 19 years of treatment, Cai Ruifang has performed nearly 10,000 surgeries in total, and today there are only 10 patients who experience vision loss to about 0.5. “I just want to make an appeal.” Cai Ruifang said. In his opinion, today, the number of people around the world who have had laser treatment for myopia is large enough to form a community, and their corneal structure is different from that of people who have not had surgery. “We should address such a structural shift because it affects the pathological mechanisms of some diseases.” Cai Ruifang said. Laser myopia correction surgery is safe as long as patients are strictly screened and the procedure is attended to. In contrast to these complex explanations, the reaction of ordinary people to this news is very intuitive. Last week, a doctor documented in a tweet an incident in which a female patient with 300 degrees of myopia in both eyes wanted laser treatment, but was willing to undergo surgery in only one eye. “There will be uneven vision in both eyes after this surgery, there will be a sense of imbalance, and it’s not as comfortable as continuing to wear glasses.” The doctor said. “One doctor in Taiwan said that laser corrective myopia surgery can have complications after 20 years.” This woman said, “I’m tempted to have the surgery, but I still want to leave one eye behind as a precaution.” This struck the doctor as unbelievable. He tweeted that he would rather endure the uneven vision in both eyes for the next 20 years because of a news story. “Taiwan’s Cai Ruifang’s comments are seriously misleading to patients and are indeed questionable.” In the medical community, the news also caused an uproar. The Taiwan Society of Ophthalmology told the media that the rate of side effects or complications of laser myopia surgery in Taiwan is less than one percent, and that as long as attention is paid to the surgical procedure and patients are strictly screened, it is a “fairly safe surgery”. In fact, in the pre-operative examination of laser surgery, keratitis, dry eye, cone cornea and diabetic patients are prohibited to receive the surgery, and for people with fragile retina, the surgery is also risky. The most serious problem is that some medical institutions deliberately weaken the possible problems of the surgery in order to make a profit. Yao Xiaoming, director of the Department of Ocular Surface and Corneal Diseases at Shenzhen Eye Hospital, told the media that he had seen 12 patients who had suffered keratoconus after undergoing laser corrective myopia surgery. Some of these patients had severe post-operative vision regression, others had serious corneal infections, and even others needed corneal transplants because of the post-operative elevated intraocular pressure, which led to severe vision loss in the cone cornea. According to the patients, most of them were gullible to the advertisement of some irresponsible medical institutions and underwent the surgery without undergoing strict examination. However, in Cai Ruifang’s opinion, laser myopia correction surgery is still an option for most ordinary people to correct their vision as long as they undergo a complete pre-operative examination. Yuan Yue, a journalist in science reporting, underwent laser surgery to correct myopia 10 years ago, and today, he still considers it “the best money spent on him”: “After the surgery, vision in low light will deteriorate and the time of presbyopia will be earlier, but for someone who likes sports and travel, the benefits of not wearing glasses are too obvious. The benefits of not wearing glasses are just too obvious.”