1, high myopia want to remove glasses, what are the surgical methods?
Myopia of more than -6.00D (i.e. 600 degrees) is considered high myopia, and the main surgical methods to correct high myopia are corneal laser surgery (currently represented by full femtosecond smile, which mainly treats myopia below 1000 degrees) and refractive crystal surgery (currently represented by ICL, which mainly treats myopia above 1000 degrees or patients whose corneas are not suitable for surgery). For older myopic patients who already have cataracts, we can consider doing crystal replacement surgery to treat cataracts and correct myopia at the same time.
2. What is femtosecond laser surgery?
Femtosecond is 10-15 seconds, so imagine how short it is! Femtosecond laser is an infrared laser, which acts on the eye tissue with very low energy instantly in a very small space to form a very high energy density, and through photolytic blasting to produce tiny bubbles to separate the tissue, thus achieving corneal cutting. Compared to the traditional knife, it is not only more accurate, but also minimally invasive. Femtosecond laser surgery for myopia is commonly known as using a femtosecond laser to replace the cutting action of a knife to achieve minimally invasive, precise treatment of myopia.
3. Who can get better results with femtosecond laser? Can I get rid of my glasses completely?
Any surgery has its indications, femtosecond laser surgery is no exception, femtosecond laser indications are: 18 years of age or older; myopia is relatively stable, myopia does not exceed -10D, astigmatism does not exceed -5D; the central thickness of the cornea is not less than 480um; the amount of corneal cutting and myopia is proportional, the deeper the myopia, the more corneal cutting, can be completely removed by femtosecond laser surgery. The more myopic you are, the more your cornea will be cut, and whether you can get rid of your glasses through femtosecond laser surgery depends on the thickness of your cornea and the degree of myopia (more than 1000 degrees of patients may be more suitable for crystal ICL surgery).
4.Who can’t do femtosecond laser surgery?
Although the femtosecond laser is minimally invasive and precise, not all myopic patients can do it. The following are not suitable for femtosecond laser surgery: people with other eye diseases, such as tumors; people with systemic autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis; people with corneal abnormalities, such as cone corneas, corneal dystrophy, and myopia, corneal thickness is too high and so on is not suitable for surgery on the cornea or poor results (but choose crystal ICL surgery may good). So the surgery is personalized, not choose the most expensive, but choose the most suitable.
5.What is ICL implantation surgery?
ICL implantation surgery, in layman’s terms, is the equivalent of having a contact lens implanted in the eye. Of course, it is made of different materials than ordinary contact lenses. The full English name is implantable collamer lens, which is a special material, very soft and thin transparent lens, implanted through a tiny incision of less than 3mm, placed in the ciliary sulcus between the iris and its own lens, the operation time is short, vision is improved almost instantly, simply put, it is equivalent to moving the frame glasses or contact lenses into the eye.
Unlike the subtractive principle of keratomileusis, in which a portion of the corneal tissue must be cut with a laser, ICL does not alter the structure of the eye itself. Without cutting the cornea, it is a reversible procedure that can be removed and replaced at any time; and has high-definition visual quality. Minimally invasive, safe, reversible, and high definition are its characteristics.
6.Who can have ICL implantation surgery with better results? Can I get rid of my glasses completely?
Theoretically, ICL surgery can be performed on people with high or low myopia, as long as they meet the requirements of the surgery. Especially for patients with high or ultra-high myopia, or poor corneal shape or thin corneas, ICL has advantages that other surgeries cannot match! Patients are generally between the ages of 18 and 55 and are in good general condition. Most patients with high myopia can get rid of their glasses through ICL implantation and get a clearer world than ever before, after a strict eye examination, excluding other eye diseases and autoimmune diseases.
If the patient’s myopia exceeds -20D, ICL can also be combined with other surgical methods to correct the residual degree, such as ICL + full femtosecond smile surgery, ICL + LASEK surgery, etc., to completely get rid of the bottoms of the bottle!
7.Who can’t do ICL implantation surgery?
Of course, each patient needs to undergo a thorough examination to determine if they are suitable. For those who are <18 years old, the refractive state of the eye has not yet reached stability, the myopia may further increase, and the eye structure is not yet fully developed, so it is not recommended for the time being (except for treatment of special cases). For those who are >55 years old, the patient may have already developed cataract, at this time, ICL myopia surgery will have a shorter duration of postoperative effect, and cataract surgery can be performed.
In addition, ICL surgery is generally not recommended for women during pregnancy and breastfeeding. It should be emphasized that it is also not recommended for people with psychological abnormalities who have not been allowed to have surgery by a psychologist or psychiatrist, such as patients who cannot understand the risks of surgery, are overly anxious or have unrealistic expectations.
8.Who is IOL replacement suitable for? What is the effect?
Lens replacement is a cataract-like surgery, which is based on the principle of taking out one’s own lens and replacing it with an artificial lens. It is mainly suitable for people with high myopia or hyperopia who are older and have developed a cloudy lens (i.e. cataract). Since IOLs do not have the adjustment function of their own crystals (equivalent to a camera without zoom function), seeing far and seeing near cannot be satisfied at the same time, although there are also multifocal IOLs, but they are relatively lacking in visual quality.
9.Is it true that after high myopia is cured, the chances of retinal detachment and other fundus diseases will be less?
All myopia surgeries only correct the patient’s myopia, but not change the nature of myopia and the condition of the fundus. Therefore, the fundus is unchanged after surgery for high myopia, and some of the possible fundus risks that exist in high myopia itself (such as the possibility of retinal detachment and other fundus diseases) remain unchanged and have nothing to do with ICL surgery, which neither decreases the risk of fundus disease nor, of course, increases that risk.
The following chart shows the comparison between ICL implantation surgery and laser surgery
10. What is the significance of posterior scleral reinforcement for patients with high myopia? How is it different from femtosecond laser surgery and ICL surgery?
Posterior scleral reinforcement is a procedure that uses biologic or non-biologic materials to strengthen the weak area of the posterior pole sclera. The reinforcement material is fixed to the posterior scleral surface, which acts as a mechanical reinforcement to stop the axial growth of the eye and reduce the scleral cavity, while thickening the scleral tissue at the posterior pole and improving the local blood supply, thus stopping the progression of pathological myopia and related fundus diseases.
Posterior scleral consolidation controls axial lengthening or myopia deepening, especially posterior scleral constriction (improved posterior scleral consolidation) treats macular degeneration in high myopia, which is different from boson peeling silicone oil filling surgery, has less damage, does not require special body position after surgery, generally does not cause cataract, glaucoma, corneal endothelial loss and other serious complications, and is not easy to recur.
The main treatment items are: high myopia deepening control in children and adults, macular splitting reset in high myopia eyes, macular fissure reset in high myopia eyes, macular detachment reset in high myopia eyes, macular hemorrhage treatment in high myopia eyes, macular fissure and retinal detachment reset in high myopia eyes, recurrent retinal detachment reset after high myopia biosurgery, silicone oil dependence and high intraocular pressure treatment after high myopia biosurgery, etc.
It can be used clinically for patients with myopia above -8.00~-10.00D and progressive myopia progressing at least 0.50~2.00D per year, the presence of posterior scleral chylomalacia and the development of fundus pathology and vision loss. The specific situation should be analyzed according to the patient’s own situation.
Femtosecond laser surgery, ICL surgery and IOL implantation aim to change the refractive status of patients by cutting the cornea and implanting lenses, so that patients can have a good visual experience. However, they do not control the progression of myopia or treat fundus lesions.
The main purpose of posterior scleral reinforcement surgery is to control the lengthening of the eye axis, the deepening of myopia, and the treatment of fundus pathology. Therefore, for some patients with high myopia who have rapid growth and fundus lesions, posterior scleral augmentation can be considered as a priority to control the prolongation of the eye axis and myopia and treat the fundus lesions, and then choose to have femtosecond laser surgery, ICL surgery, IOL implantation or a combination of surgeries according to the patient’s own situation. In this way, we can control the lengthening of the eye axis and the deepening of myopia, treat the fundus pathology, and let the patient say goodbye to the thick glasses and have a better vision and visual experience.