How to choose the type of surgery for myopic patients ?

In recent years, the number of myopic people has been increasing. According to foreign statistics, the prevalence of myopia is 23%, of which 0.4% is high myopia. Among the myopic people, the proportion of high myopia is 2%. China is a big country with myopia, and the incidence of myopia among college students has reached 60%-75%. With the continuous improvement of people’s understanding of myopia and the rapid development of science and technology, there are more and better treatment methods for myopia besides the traditional glasses. In recent years, surgery has become the choice of more and more myopic patients. However, many people are not sure how to choose a suitable surgery for themselves. Myopia is categorized as low myopia (below 300 degrees), moderate myopia (300-600 degrees), high myopia (600-1000 degrees) and ultra-high myopia (above 1000 degrees). Surgical treatments for myopia are broadly categorized into: scleral surgery, corneal surgery, and lens surgery. Scleral surgery is commonly used for the treatment of progressive myopia in adolescents and is no longer commonly used due to its high trauma and poor predictability. Corneal surgery is the current laser surgery. Laser (PRK, LASIK, LASEK) surgery can achieve very satisfactory results for the treatment of low to moderate myopia, of which LASIK and LASEK also have better results for some high myopia, but for patients with ultra-high myopia (myopia greater than 1,000 diopters), some patients may experience postoperative regression of visual acuity after laser surgery, corneal irregularity and increase in aberration, which affects the postoperative visual quality. Therefore, laser surgery is not the best choice for hyperopia. Lens surgery is a new method emerging in recent years, which is suitable for patients with ultra-high myopia who cannot undergo laser surgery and some patients with high myopia who cannot undergo laser surgery due to thin cornea thickness. It is categorized into refractive lens replacement, iris-clamp IOL implantation in crystalline eyes, atrial angle-support IOL implantation in crystalline eyes and posterior chamber IOL implantation in crystalline eyes. Refractive Lens Replacement (RLR) is a procedure that removes the lens of the myopic eye and implant a specific IOL to treat hypermetropia, and is mostly used for hypermetropic myopic patients with cataracts. Iris Clamp IOL implantation in crystalline eyes, Atrial Angle Support IOL implantation in crystalline eyes and Posterior Chamber IOL implantation in crystalline eyes are used to implant IOLs of a specific power at different locations in the eye through a small incision while preserving the crystalline lens of the eye. It is also known as an implantable “contact lens”. This is a high-precision surgery, which has more than 10 years of successful experience in Europe and the United States, has performed 60,000 successful surgeries, and has been certified by the FDA and CE. It is a safe and effective treatment method and is one of the most recommended surgeries abroad. The biggest advantage of this kind of surgery is that it does not change any structure of the eye, does not damage any tissue of the human body, and can significantly improve the quality of the patient’s vision, is not limited by the degree of myopia, and is reversible (can be taken out and restored to its original state.) In March 2007, our hospital has successfully carried out iris-clamping IOL implantation in crystalline lens eyes for ten cases of ultra-high myopia with myopia of more than 1500 degrees, and the visual acuity reached 1.5 degrees after surgery. After the surgery, the visual acuity reached 1.0 and 0.8, which is equal to and exceeds the best corrected visual acuity obtained with ordinary glasses. This surgery is the first of its kind in the city, and only a few hospitals in the province have done it, providing another safe and effective treatment for patients with ultra-high myopia. Finally, I would like to warn all myopic patients that the treatment of myopia should not be based only on advertisements, nor is it the more expensive the better. Choose a large hospital with good conditions and an experienced, responsible doctor to find a surgical method that best suits your needs.