Xiao Rou is only 19 years old, but has been suffering from cataracts in her right eye for more than ten years. It turns out that this child was playing with his friends when he was young, and accidentally injured his right eye with a toy gun. After the eye injury was cured, Xiaorou’s vision continued to decline and she was eventually diagnosed with traumatic cataract. For many years, the father of the child has taken her to seek medical treatment everywhere. “But because the child is so young, many doctors tell us that the operation is more difficult and the effect of the operation is uncertain. The child has a long way to go, and it is such an important part of the eye that I dare not perform surgery easily.” In order to treat the child’s eyes , He has done enough homework, the treatment technology and development status in the field of cataract, he will find out if there is any new news. He will go to every eye hospital and ophthalmologist in the mainland to check information. In the end, they chose our Xima Eye Clinic. Dr. Zhan Xingkai was the one who received Xiaorou. After receiving the consultation, Dr. Zhan gave detailed answers to the questions raised by Xiaorou’s father. Xiaorou’s father knew that Dr. Zhan had been in the clinic for nearly 30 years and had more than 10,000 cases of cataract surgery, so he trusted Dr. Zhan very much. After examination, it was found that Xiaorou’s right eye had only 40cm index left, and there was no improvement after correction. The visual acuity of the left eye is 0.5, which can reach 1.0 after correction. Daily life and study mainly rely on the left eye. Dr. Zhan diagnosed: Xiaorou had traumatic cataract in her right eye, the iris root of her right eye had been severed, her right eye had disuse exotropia, and her eyes had refractive errors. After communicating the surgical plan, Dr. Zhan performed phacoemulsification of the right eye + intraocular lens implantation for Xiaorou. After the operation, Xiaorou also needs to cooperate with glasses for vision correction to achieve the best corrected vision. The operation was very successful. On the first day after the operation, Xiaorou’s right eye vision had recovered to 0.1, and her vision could reach 0.2 through glasses. Two weeks after the operation, Xiaorou returned to Xima’s ophthalmology clinic for follow-up, and her corrected visual acuity had reached 0.4 after fitting. Xiaorou’s father finally breathed a sigh of relief, and the smile on her face increased. “We look forward to it, but we are afraid that we will be disappointed if we expect too much. It is not easy for us to restore our vision to 0.4.” As her eyesight slowly recovered, Xiao Rou said that she felt that her quality of life had improved a lot, “I am grateful! I have been treating the disease for so many years. This is also a treatment experience that makes me feel very warm, whether it is a doctor or other medical staff. If there is a problem, I will explain it in detail, and I will take the initiative to follow up on the recovery after the operation, and I feel like a family member. Thank you very much! “Early detection and early treatment, visual function recovery is more likely. When it comes to cataracts, everyone generally thinks this It is a disease that only the elderly get, but it is not. Cataract is a visually impaired disease caused by lens opacity, and the lens is in the liquid environment of the eye. Any factors that affect the environment of the eye, such as aging, physical damage, chemical damage, surgery, tumor, inflammation, drugs, and some systemic metabolism Sexual or immunological diseases can directly or indirectly destroy the tissue structure of the lens, interfere with its normal metabolism and make the lens cloudy, leading to cataracts. In addition, abnormal lens or eyeball development and certain congenital systemic syndromes can cause abnormal lens formation and lead to cataracts. Dr. Zhan also reminded everyone: Pay attention to cataracts caused by eye trauma. Blunt eye injuries, penetrating injuries, radiation injuries and electric shock injuries may cause traumatic cataracts. After the ocular trauma is cured, the eyes have symptoms such as decreased vision, refractive changes (myopia, astigmatism, etc.), decreased contrast sensitivity, double vision or multiple vision, glare, color vision changes, visual field defects, etc., which may be caused by trauma The performance of sexual cataract. Especially when children suffer eye injuries, parents should pay more attention to it. There is a process of human vision development, and the child’s vision development is basically completed until about 7 years old. If during this process, the child’s eyes are injured and the child suffers from traumatic cataracts, it may hinder the development of vision, cause amblyopia, and may be severely blind. If you suffer from cataract in one eye, it may also cause strabismus, which affects the fusion and stereo vision of the two eyes. At present, the only way to improve the obstacles to visual development of children with cataracts is to perform surgery to remove the cloudy lens and implant an intraocular lens, and then assist in glasses correction and visual function training. The child’s vision may be restored. Early detection and early treatment, the younger the child, the greater the chance of recovery of visual function.
The transparent membrane of the anterior segment of our eyes is the cornea. The thickness is about 0.5-1mm. Although it is very thin, it is divided into five layers in structure: epithelial cell layer, anterior elastic layer, stromal layer, posterior elastic layer, and endothelial cell layer. The corneal spotting that I want to talk to you today mainly occurs in the epithelial cell layer. Corneal staining method Among many examinations in ophthalmology, corneal staining is one of the most commonly used methods to check corneal damage, which helps us to accurately judge the degree of corneal inflammation or corneal damage and guide how to use medication and observe the effect.  .After corneal staining, what is the corneal staining that is diagnosed as leukoplakia? That is, after the cornea is stained with fluorescein, punctate staining appears. Corneal staining indicates that the cornea has a punctate defect in the epithelial cell layer. Although corneal epithelial cells have strong self-viability, some mild corneal stains can generally recover on their own, but once corneal stains deteriorate, local corneal epithelial flaky exfoliation and erosion may occur, increasing the hidden danger of corneal infection. If severe corneal stains are not treated in time, complications such as corneal ulcer perforation are more likely to occur, leading to decreased visual function and vision loss. Corneal spotting is a common complication of wearing orthokeratology. Ortho-Keratoplasty is one of the current scientific methods for the prevention and control of myopia in young people. It uses the principle of inverse geometry and is mainly worn at night. It has a squeezing and shaping effect on the cornea. However, when the following conditions occur in the orthokeratology lens, it is very easy to cause corneal staining. 1. Scratches on the lens. In the process of using the orthokeratology lens, due to some reasons (too long nails, excessive force, wrong cleaning methods, etc.), it is easy to cause different degrees of scratches on the lens, which may be scratched. The cornea directly causes damage to corneal epithelial cells. Solution: Trim your nails regularly, use the ring finger to clean the lens radially, do not rotate and scrub; when removing the lens, keep your body close to the edge of the tabletop, and place a towel on the tabletop to cushion the lens to prevent scratches; more scratches In severe cases, it is recommended to replace the lens in advance. 2. The lens is not clean. After a certain period of time, the lens may have grease or protein precipitation. When the lens is not clean, the accumulation of sediment will reduce the oxygen permeability of the lens, resulting in hypoxia of the corneal epithelium, and corneal staining. . Solution: Use care solution to carefully clean the lenses before putting on the glasses and after removing them, and use special hydrogen peroxide, enzyme cleaners and delipidation to enhance the cleaning effect. 3. There is a foreign body under the lens. When the hands are not cleaned or the environment is dusty, eyelashes, cotton wool or dust are likely to adhere to the inner surface of the lens. After wearing the lens, it will cause corneal epithelial friction and corneal damage, causing spot stains. Solution: Check the lens carefully before putting on the glasses, wipe your hands with a paper towel that does not get lint off, and wear the lens in a clean environment. In addition to the reason for the orthokeratology lens, if you wear it improperly, it is easy to cause corneal stains. 1. The method of wearing glasses is wrong. The edge of the lens scratches the cornea due to the unfamiliar movements and inner fear of the initial patient. Solution: First of all, the wearer needs to relax and cooperate. You can put a drop of lubricating fluid or artificial tears on the index finger of the right hand, keep the eyes open, and look forward, try to send the liquid into the eyes, and then change to the lens to bring it into the eyes. Inside. 2. The method of taking the lens is wrong. Ortho-Keratoplasting lens is worn at night. After a night of wearing, the shaping lens is tightly attached to the cornea. Operations such as violent lens removal or vertical lens removal without sufficient lubrication can cause the cornea. damage. Solution: Drop lubricating fluid or artificial tears in the lower eyelid before taking the lens. After normal blinking for 1 to 2 minutes, the lens can be removed with a suction stick after confirming the movement of the lens. When using the suction stick to suck the lens, make the suction stick perpendicular to the edge of the lens to remove it, and do not suck from the middle. After the suction stick sucks the lens, take it out directly without rubbing on the cornea. 3. The left and right lenses are reversed. Most orthokeratological lens wearers have different corneal shapes or degrees, so the parameters of the double spectacle lenses are slightly different. The left and right lenses may have a tight lens while the other lens is loose. This can lead to corneal scratches or hypoxia, causing corneal stains. Solution: Distinguish the color rules of the lens, confirm before wearing, and put the left and right lenses in the designated lens box for next time wearing after taking the lens. Finally, tear quality is also an important cause of corneal staining. When the amount of tear secretion decreases, the cornea remains under pressure for a long time
I often say that cataract is an eye disease that almost everyone will get, as long as you live long enough. Many friends expressed disbelief, saying that this is an ophthalmologist’s strong sense of presence, and there is no disease that everyone has. Some people say that human beings have evolved for so long, there will be no such big bugs. When humans evolved, I really didn’t expect that one day the average lifespan would reach 80 years old, nor that everyone would stare at their mobile phones. When a person is young, the lens is transparent, like a glass ball, light can pass through the lens into our eyes. With age, the lens gradually becomes cloudy and cataracts appear. So why does the lens always become cloudy with age? Why do you get cataracts? The lens is a very unique organ. It has only an entrance, but no exit. In a person’s life, new cells are constantly formed from the periphery and added to the lens, but the old cell fibers are not metabolized, but are slowly squeezed into the core area. Even when people reach old age, the new cells are still being born continuously. This unique physiological structure makes the lens an organ where four generations live together. But here comes the problem, the place is so big, and the more cells come, everyone can only squeeze more. When the crowding is severe, the density increases, and the light transmittance decreases. We will feel myopia (or presbyopia reduction) and dimness. In addition, local areas may be overcrowded, and the order will become muddy. There are more muddy areas, and we can no longer see them. You see, judging from the physiological structure of the lens, it is not intended to work for us for 100 years. Therefore, in the world ranking of blinding eye diseases, cataracts rank first, accounting for almost half of the total! What is the correct way to deal with cataracts? Cataracts can cause blindness, what should be done? Of course it is treatment! As long as you adopt the correct response method, Cataracts are not terrible. It is a pity that more people choose these wrong coping styles: Wrong way 1: Some elderly people are not treated because they do not realize that they have cataracts, lack understanding of cataracts, and only think that they are too old to see clearly. , So the treatment was delayed. Some people think that, anyway, everyone will get cataract, it is not a big deal, and there is no cure. Both of these conditions will cause patients to ignore cataract treatment and allow it to progress, eventually leading to serious problems such as glaucoma, lens dislocation, and uveitis, and doctors are unable to recover. Wrong way 2: applying eye drops Some patients were deceived by the advertisements of unscrupulous merchants and took eye drops to treat cataracts. In fact, no eye drops have a clear effect on controlling the occurrence and development of cataracts. Surgery is the only effective way to treat cataracts. Only by replacing the turbid lens of the human eye with an artificial lens can the cataract patient finally regain clear vision. Wrong way 3: Procrastinating 10 elderly people, there are always three or four people still have this old concept: cataracts can only be done after they are familiar, and they have to be procrastinated. In fact, this statement is actually outdated. In the past, the surgical technique was backward. Cataract surgery needed to remove the cloudy lens as a whole. Therefore, if the lens is not mature enough to a certain thickness, it will shatter with one clip and cannot be removed as a whole. But now the mainstream method of cataract surgery is to make a small incision of 2~3mm. In this way, the harder the lens, the more difficult it will be to break the operation. However, the earlier the lens is easier to break, the operation difficulty is low, and the complications are less. Recovery is also fast after surgery. So cataract surgery does not need to be delayed. What is the correct way to cope with cataracts? Of course, it is to observe closely. If the vision is so low that it affects normal life and work, surgery can be arranged. After all, early surgery can restore vision earlier, there is no need to delay. The current routine operation timing is usually 0.3 to 0.5 vision. Of course, this value is not absolute. You have to consult your doctor’s advice, personal needs and eye conditions.
Four-year-old Xiaoxuan is a child with congenital cataract. About a week after he was born, the child’s mother discovered that Xiaoxuan’s eyes were abnormal: the child’s eyes only chased the light, but did not see objects. The child is always the softest concern of the mother. From the discovery of Xiaoxuan’s eye problems, Xiaoxuan’s mother began to travel to various hospitals. Some hospitals told her to operate as soon as possible, but the possibility of cure is not high, and there will be many complications. Some say that the lens can be implanted only when Xiaoxuan is over 1 year old. After a friend’s recommendation, Xiaoxuan’s mother found our Xima Eye Clinic. In February 2017, Xiaoxuan was diagnosed with congenital cataract in both eyes and nystagmus after an eye examination in our Shenzhen hospital. Because the fundus of Xiaoxuan’s eyes is unclear, considering Xiaoxuan’s condition, I decided to perform eye examination of the child under general anesthesia + phacoemulsification of cataract + intraocular lens implantation. There are also multiple considerations. Assuming that fundus diseases such as retinal detachment are found during eye examination that affect cataract surgery, cataract surgery will not be performed this time, and the treatment plan will be redesigned based on the fundus examination. If the fundus is in good condition, cataract surgery is performed after the eye examination. If eye conditions permit, consider implanting an intraocular lens at the same time. Xiaoxuan was only five months old at that time, and the mother of the child was still very worried, and he ran to many hospitals, and the treatment plans given by each hospital were different. Taking into account the anxiety of the parents, I decided to give a detailed explanation with the parents of the children. For this child’s situation, the only way to improve at present is to have surgery to remove the cloudy lens, implant an intraocular lens, and supplement it with glasses correction and visual function training. After careful consideration, Xiaoxuan’s mother decided to “take a risk” a try. Xiaoxuan underwent surgery the next day. The binocular examination showed that the retina was flat, the optic disc toner, and the macular fovea had clear reflections, which did not affect the performance of eye diseases during cataract surgery. Moreover, the conditions at the time seemed that his eyes were still suitable for implantation of intraocular lenses. If the child does not implant this lens, he will need to wear 1500-2000 degree hyperopia glasses in the future, which may also be a burden. In addition, due to the large postoperative hyperplasia and inflammation in children, when preparing for the second implantation of the intraocular lens after a long period of time, the capsular bag originally reserved for placing the intraocular lens may have been completely adhered due to excessive proliferation of fibers and inflammatory cells It cannot be opened, so the intraocular lens cannot be placed in the capsular bag and can only be placed in other positions, which greatly increases the chance of causing complications.  . After a comprehensive evaluation, we still decided to do phacoemulsification + intraocular lens implantation. Due to the strong ability of tissue proliferation in young children, there is a possibility of subsequent cataracts in the future. We performed binocular posterior capsulotomy + anterior vitrectomy for Xiaoxuan, and the operation was successfully completed. That is, the child needs to wear glasses after the operation and insist on long-term amblyopia training. From the beginning, I didn’t have eyesight, but only the bright spots were seen. Later, my eyesight returned to 0.4, which was sincerely happy for Xiaoxuan and his family. Every time I see the relieved expressions of the patient’s family, I am also very pleased. Every once in a while, Xiaoxuan’s mother would bring Xiaoxuan to Xima for regular review. In August this year, Xiaoxuan came to Shenzhen Xima again for a review. The results of this review were very good and the situation was stable. Last year’s Xiaoxuan still couldn’t see the hair strands, but this year’s Xiaoxuan can accurately twist the hair strands. Because children tend to develop myopia during visual development, if intraocular lenses need to be implanted during cataract surgery in children, they tend to leave some hyperopia. At the same time, the implanted intraocular lens generally only corrects most of the power, and the intraocular lens cannot adjust the distance and near vision. Therefore, it is still necessary to wear low-power glasses to help correct the vision after the operation. In addition, posterior capsule opacity (posterior cataract) may occur after cataract surgery in children and affect vision. This requires consideration of posterior capsule and anterior vitrectomy. Because newborns are not good at expressing, and some of the initial symptoms are relatively hidden, it is difficult for parents to find out in time. Therefore, parents need to pay close attention to their children’s eyes and vision. Once they find that their children have the following symptoms, they should consult a doctor in time. Common symptoms of pediatric cataract: 1. There is a white reflective spot in the center of the pupil; 2. If there is a cataract in one eye, the child may have strabismus; 3. If both eyes have cataract, the child may have symptoms of nystagmus; 4. Cannot look at objects Or can’t follow the light to move your eyes, like squinting, tilting your head to watch TV, or watching things.
Four-year-old Xiaoxuan is a child with congenital cataract. About a week after he was born, the child’s mother discovered that Xiaoxuan’s eyes were abnormal: the child’s eyes only chased the light, but did not see objects. The child is always the softest concern of the mother. From the discovery of Xiaoxuan’s eye problems, Xiaoxuan’s mother began to travel to various hospitals. Some hospitals told her to operate as soon as possible, but the possibility of cure is not high, and there will be many complications. Some say that the lens can be implanted only when Xiaoxuan is over 1 year old. After a friend’s recommendation, Xiaoxuan’s mother found our Xima Eye Clinic. In February 2017, Xiaoxuan was diagnosed with congenital cataract in both eyes and nystagmus after an eye examination in our Shenzhen hospital. Because the fundus of Xiaoxuan’s eyes is unclear, considering Xiaoxuan’s condition, I decided to perform eye examination of the child under general anesthesia + phacoemulsification of cataract + intraocular lens implantation. There are also multiple considerations. Assuming that fundus diseases such as retinal detachment are found during eye examination that affect cataract surgery, cataract surgery will not be performed this time, and the treatment plan will be redesigned based on the fundus examination. If the fundus is in good condition, cataract surgery is performed after the eye examination. If eye conditions permit, consider implanting an intraocular lens at the same time. Xiaoxuan was only five months old at that time, and the mother of the child was still very worried, and he ran to many hospitals, and the treatment plans given by each hospital were different. Taking into account the anxiety of the parents, I decided to give a detailed explanation with the parents of the children. For this child’s situation, the only way to improve at present is to have surgery to remove the cloudy lens, implant an intraocular lens, and supplement it with glasses correction and visual function training. After careful consideration, Xiaoxuan’s mother decided to “take a risk” a try. Xiaoxuan underwent surgery the next day. The binocular examination showed that the retina was flat, the optic disc toner, and the macular fovea had clear reflections, which did not affect the performance of eye diseases during cataract surgery. Moreover, the conditions at the time seemed that his eyes were still suitable for implantation of intraocular lenses. If the child does not implant this lens, he will need to wear 1500-2000 degree hyperopia glasses in the future, which may also be a burden. In addition, due to the large postoperative hyperplasia and inflammation in children, when preparing for the second implantation of the intraocular lens after a long period of time, the capsular bag originally reserved for placing the intraocular lens may have been completely adhered due to excessive proliferation of fibers and inflammatory cells It cannot be opened, so the intraocular lens cannot be placed in the capsular bag and can only be placed in other positions, which greatly increases the chance of causing complications.  . After a comprehensive evaluation, we still decided to do phacoemulsification + intraocular lens implantation. Due to the strong ability of tissue proliferation in young children, there is a possibility of subsequent cataracts in the future. We performed binocular posterior capsulotomy + anterior vitrectomy for Xiaoxuan, and the operation was successfully completed. That is, the child needs to wear glasses after the operation and insist on long-term training for amblyopia. From the beginning, I didn’t have eyesight, but only the bright spots were seen. Later, my eyesight returned to 0.4, which was sincerely happy for Xiaoxuan and his family. Every time I see the relieved expressions of the patient’s family, I am also very pleased. Every once in a while, Xiaoxuan’s mother would bring Xiaoxuan to Xima for regular review. In August this year, Xiaoxuan came to Shenzhen Xima again for a review. The results of this review were very good and the situation was stable. Last year’s Xiaoxuan still couldn’t see the hair strands, but this year’s Xiaoxuan can accurately twist the hair strands. Because children tend to develop myopia during visual development, if intraocular lenses need to be implanted during cataract surgery in children, they tend to leave some hyperopia. At the same time, the implanted intraocular lens generally only corrects most of the power, and the intraocular lens cannot adjust the distance and near vision. Therefore, it is still necessary to wear low-power glasses to help correct the vision after the operation. In addition, posterior capsule opacity (posterior cataract) may occur after cataract surgery in children and affect vision. This requires consideration of posterior capsule and anterior vitrectomy. Because newborns are not good at expressing, and some of the initial symptoms are relatively hidden, it is difficult for parents to find out in time. Therefore, parents need to pay close attention to their children’s eyes and vision. Once they find that their children have the following symptoms, they should consult a doctor in time. Common symptoms of pediatric cataract: 1. There is a white reflective spot in the center of the pupil; 2. If there is a cataract in one eye, the child may have strabismus; 3. If both eyes have cataract, the child may have symptoms of nystagmus; 4. Cannot look at objects Or can’t follow the light to move your eyes, like squinting, tilting your head to watch TV, or watching things.
Representative Lan Fang-Yu Weide, Deputy Chief Physician of the Ophthalmology Center of Ningbo First Hospital, Director of Taixue Ophthalmology Advanced Cataract Center, Chief Young Expert of Taixue Ophthalmology Group Advanced Cataract, Member of the First Committee of the Vision Rehabilitation Professional Committee of Chinese Rehabilitation Medicine Association , Member of the Ophthalmology Professional Committee of China Medical Equipment Association, Youth Member of the Ophthalmology Branch of Zhejiang Medical Association, Gold Medal Consultant of Zeiss Three Focus, Switzerland, EVOVisianICL Surgery Certified Physician from STAAR of Switzerland. Red party representative-Ms. Lu Sanda, fitness coach, graduated from Henan Shaolin Tagou Martial Arts School, won the provincial Sanda competition several times, runner-up in the young women’s 70kg group of the 2013 National Sanda Championships, retired in 2015, has won the national fitness Instructor qualification certificate, national second-level athlete certificate, DFEA senior personal trainer qualification certificate. I heard that Director Yu also studied Sanda for several years when he was a student. Is there any chance of winning? The editor shuddered and quit 10 meters away…Do you think the showdown is like this? Such? Still like this? No, no, it’s not the case. Let’s follow the editor to see how the ophthalmologist defeated Sanda champion —— myopia~ Knowing yourself and knowing Bi Yu Director: When did you start myopia? Ms. Lu: I was nearsighted when I was a teenager, but the degree was not deep at that time, it was only about 300 degrees. After I retired, my degree began to deepen, and it is now 500 degrees. Director Yu: Do you wear contact lenses when you play games? Ms. Lu: You can’t wear contact lenses during training and competitions. They will be shot out, not to mention frame glasses. Director Yu: Then…I don’t wear glasses with myopia of 300 degrees, can you see the opponent clearly when you are playing? Ms. Lu: I can’t see clearly, but it doesn’t affect the game. Director Yu: Did this defeat the opponent by looking at the fuzzy outline of the opponent? Wow! Wouldn’t it be stronger if you could see it clearly at that time! Ms. Lu: Hahaha…the degree was shallow at that time! But now 500 degrees of myopia, not wearing glasses has obviously affected my daily life, especially I want to have myopia surgery, but I have never thought about where to do it, which doctor to look for, whether it is laser or ICL, after all, the current myopia correction There are so many options for surgery, so I just postpone it until now. Weapon selection combat live Step1 Ms. Lv came to Ningbo Taixue Ophthalmology Department (Technical Cooperation of Ningbo First Hospital) and found Director Yu Weide for consultation, and strongly expressed her desire to remove the lens. Before the operation, Ms. Lu had 500 degree myopia and 50 degree astigmatism in the right eye and 525 degree myopia and 50 degree astigmatism in the left eye. Step2 After a series of detailed inspections and professional evaluations, it was confirmed that her corneal conditions were not suitable for laser surgery, and the most suitable treatment for Ms. Lu’s myopia was: ICL lens implantation. Director Yu formulated a personalized surgical plan for her, accurately calculated and customized the most suitable lens. Step3 After receiving the customized ICL lens, Director Yu performed a binocular ICL lens implantation for Ms. Lu. The operation went smoothly and her recovery was very fast. The results are remarkable ☺ More than three hours after the operation: The visual acuity is 1.2 after checking. ☺On the first day after surgery: Without glasses, the visual acuity reached 1.2 for the right eye, 1.5 for the left eye, and 2.0- for both eyes! ☺One week after operation: the visual acuity without glasses is 1.5 for both eyes and 2.0 for both eyes! In this battle, Director Yu relied on his professional skills and rich experience, coupled with teamwork and Ms. Lu’s full trust, and won a great victory! ! ! So… what is ICL? ●ICL lens implantation is also called posterior chamber intraocular lens implantation in phakic eyes. An “ultra-thin micro lens for correcting myopia” is placed in the posterior space of the eye, that is, between the iris and the lens. Good visual quality after surgery. This technology brings another ideal choice to patients who are not suitable for myopia laser surgery, such as myopia, dry eye, thin cornea, and fragile cornea. Correction range: myopia degree is 50 degrees to 1800 degrees, astigmatism is within 600 degrees, and higher degrees can be under-corrected or combined with corneal refractive surgery. ICL procedure ① No injection is required, eye drops are used for anesthesia, and a tiny incision less than 3 mm is made in the limbus. ②Inject the foldable micro ultra-thin lens into the eye through the incision and unfold it. ③After gently planting its four corners on the iris, fine-tune the position to make it stably reside between the iris and the natural crystal. Why choose
On July 29, the first Alcon AcrySof®IQPanOptix® intraocular lens implantation in Taixue Ophthalmology Department was successfully completed! This is also the 200th case of Alcon’s trifocal lens implantation in the country. The implantation of the lens solves the problems of presbyopia and cataracts for patients at one time. Under the condition of ensuring the needs of near and far vision, the middle distance vision is optimized, and the distance, middle and near full vision vision is realized and improved The lens release rate. 65-year-old Aunt Shao is the patient of this operation. Aunty’s daily life is to bring twin grandchildren at home. Taking care of the children is a very tiring task. Coupled with getting older and older, the aunt often feels that her eyes cannot see things. Comfortable and easy to fatigue. Regarding the operation, it was not her who was interested in the operation, but her daughter. Aunt Shao underwent eye examinations in other hospitals and was diagnosed with cataracts, hyperopia, and presbyopia in both eyes. The doctor recommended surgery. The admission procedures were completed, and the operation should be prepared next, but Aunt Shao had no idea. Will the eyes be okay after the operation? Can the operation result be guaranteed by doing it here? Just as the aunt hesitated, her daughter thought of a person, Director Yu Weide of Taixue Ophthalmology Advanced Cataract Center. They had all seen Director Yu’s deeds on public accounts, newspapers, TV and other media. So, accompanied by her daughter, the aunt found Director Yu. After a series of examinations and inquiries, Director Yu found that Aunt Shao had progressive blurred vision in both eyes under no obvious incentives two years ago. The naked vision: 0.4 in the right eye and 0.3 in the left eye. Cataract, hyperopia, and presbyopia in both eyes are undoubted Surgery is also necessary, so what kind of lens to choose has become the main problem at present. The aunt believes that she is old enough to choose ordinary crystals to satisfy daily life, while her daughter believes that she should enjoy life even more when she is older, and insist on giving her good use. After a detailed inspection and professional evaluation by Director Yu, Aunt Shao believed that a high-end intraocular lens could be used. After the mother and daughter discussed, Aunt Shao finally decided to choose Alcon’s three-focus intraocular lens for surgery. The Zeiss microscope OPMI®LUMERA®700 and CALLISTOeye® surgical navigation system were used in the operation to make the operation more precise. Before the operation, Aunt Shao was so nervous that she had insomnia, for fear that the operation would not work well, but now, all these worries are gone. On the first day after surgery, Aunt Shao’s naked eyesight was 1.0 at long distance, 1.2 at middle distance, and 1.2 at short distance! This made Aunt Shao and her family feel very gratified, and the initial waiting and persistence finally had a satisfactory result! The operation was very successful, and the implantation of the triple focal lens will bring more convenience to the aunt’s future life. The first trifocal intraocular lens approved by the US FDA Alcon PanOptix new generation trifocal intraocular lens is the first trifocal intraocular lens approved by the US FDA. It was approved by the US FDA in August 2019 and will be approved in January 2020. It was officially approved by the National Medical Products Administration (NMPA) to enter China in December. AcrySof®IQPanOptix® trifocal intraocular lens is a multifocal intraocular lens that can clearly focus the image to the back of the eyeball (retina), thereby helping patients with cataracts and presbyopia (presbyopia) obtain clear vision after surgery. This product is specially designed to adapt to today’s colorful lifestyles and can meet the needs of high-use eyes in mobile phones, computer screens and a series of dark environment conditions. Its central area can provide better near (reading) and middle (computer) Distance vision performance, which is not provided by single-focal intraocular lenses. Its innovative ENLIGHTEN optical proprietary technology is currently the only three-focal lens designed with four-focal technology, which can bring patients clear full-range vision after surgery, and can obtain continuous good vision at 40-60cm in the middle and short distances. For eyesight, this design is in line with the eye habits of Chinese people. In 2015, Alcon’s new generation of presbyopia correction trifocal intraocular lens AcrySof®IQPanOptix® was approved for marketing in Europe. So far, Alcon trifocal lenses have been used abroad for five years. In the Department of Ophthalmology, National Taiwan University, Alcon’s trifocal lens has been used for two years. The safety is guaranteed and the postoperative effect is trustworthy. Why choose Taixue ophthalmology before the operation, suffering from
In the previous article: “Parents ask: Isn’t it said that the eye axis and corneal curvature can be used to know the degree of myopia, why do you need optometry?” It was mentioned: Diopter≈corneal curvature + lens refractive power + eye axis. Generally speaking, the corneal curvature tends to be stable after 3 years of age and does not change much. Therefore, for children, the lens refractive power and the axis of the eye will affect the refractive development, and the relationship between the changes of the two is not linear, but is an independent indicator . Therefore, clinically, there is often an increase in the axis of the eye without an increase in the degree of myopia, and a small increase in the axis of the eye and a rapid increase in the degree of myopia may also occur. The eye axis increases without increasing the degree of myopia. The younger the child, the faster the growth rate of the eye axis, but the refractive power of the lens also decreases to compensate for the myopia caused by the increase in the eye axis. Therefore, when the lens refractive power drops just to compensate for the axial growth, the myopia does not increase. Even if the eye axis grows faster, myopia will not increase much. Namely: myopia is unchanged = corneal curvature (unchanged) + lens refractive power (decrease) + eye axis (growth). The time when children’s eye axis grows fastest is not when myopia occurs, but 1 to 2 years before myopia and myopia 1 year after the occurrence. For example, an 8-year-old child has just been checked for myopia, and his eye axis actually began to grow rapidly when he was 6 to 7 years old, but because the refractive power of the lens is also decreasing to compensate, my myopia is at 6 to 8 years old. The time did not appear. See the previous article for details: Why does the child’s myopia have not increased but the eye axis is still long? A small increase in the axis of the eye and a rapid increase in myopia power does not always have the compensatory effect of the decline in lens refractive power on the growth of the eye axis. Generally, after the age of 12, the development of the lens tends to be problematic, and the compensatory eye is gradually lost Myopia caused by axial growth. At this time, the growth of the eye axis will directly bring about a significant increase in myopia. So there will be: the eye axis does not grow much, but myopia increases rapidly. For example: A 14-year-old child has stabilized refractive development, but if he does not have good eye habits (one punch, one foot, one inch, 20-20-20 rule) because of the pressure of reading at close range (a lot of homework) , The axis of the eye will also increase, but because there is no compensatory effect of the decline of the lens power, it will show a rapid increase in myopia.  .For children of different ages, every 1mm of eye axis lengthening brings about different myopia. The younger the age, the less the amount of myopia growth brought by the eye axis lengthening. Current research believes that every 1mm of eye axis growth for 8-year-old children will bring about 150 degrees of myopia growth; for 14-year-old children, every 1mm of eye axis growth will bring about 250 degrees of myopia growth. Therefore, it is “spread in the world” that an increase of 1mm in the eye axis is equivalent to an increase of 300 degrees in myopia, which is actually inaccurate.  . Periodic measurement of the axis, corneal curvature and cycloplegia refraction can fully monitor the progress of myopia in children. Myopia is mainly determined by the three factors of corneal curvature, lens refractive power and eye axis. The progress of myopia is still not enough. Only by regularly establishing children’s refractive development files, including the measurement of corneal curvature, axial and ciliary palsy refraction, can we comprehensively monitor the progress of children’s myopia, understand the dynamic changes of the three, and provide an objective basis for early warning of myopia and prevention and control of myopia. . Note: The corneal curvature and the axis of the eye can be obtained with eyeball biometric equipment. The results are stable and highly repeatable, and are relatively reliable objective examinations.
Lens removal method for orthokeratology lens (2) Routinely, it is necessary to clean the lens with protein-removing care products once a week. We take AB solution as an example. How to use AB solution: 1. After cleaning the lens daily, put the lens in a special protein removal box (to distinguish the left and right eyes).  .2 Pour one liquid A and one liquid B into the soaking box, close the lid, and soak the lens for 30 minutes. 3. Take out the soaked lens, rinse the lens thoroughly with special care solution, and put it in the special lens box for later use.  . . Tip: If the lens accidentally falls out, the treatment method: . If the lens is facing up, you can directly pick it up with your hands.  .If the back of the lens is buckled on the table, it needs to be sucked up vertically with a suction stick, and then thoroughly rinsed and cleaned with a special care solution to check that the lens is intact and free of scratches or damage.  .
. . . . . .ICL, its full name is ImplantableCollamerLens, also known as “lens lens implantation” or “endocular lens”, which is a new trend in the field of myopia correction.  . . .ICL was approved by the US FDA for application. Global Seiko, made in Switzerland. The emergence of ICL lens implantation has given hope to myopia patients who have a thin cornea, a high degree of power, or who are not suitable for laser surgery, and are suitable for patients who pursue perfect vision after surgery.  . . . To put it simply, you can directly understand ICL as a “contact lens”. The doctor will make a small wound on the edge of your cornea and put the ICL intraocular lens suitable for you into the eye, which is equivalent to giving You wear a contact lens in your eye, and you can carry it for life.  . . .The ICL lens implantation surgery retains the integrity of the physiological structure and physiological function of the eye, and also retains the integrity of the visual field, has a larger range of adaptation, and the refractive index is very stable, and there will be no regression. , The clarity of the visual field obtained after the operation is better than other corneal refractive surgery. This means that if it is the same distance, you will see clearer details after ICL, so the patient’s satisfaction rate is 99.4%.  . . . Reversibility is the unique advantage of ICL which distinguishes it from other myopia correction methods. ICL can be permanently implanted in the eye, but if more advanced technology appears in the future, or other eye surgery is required, the ICL can be removed or replaced at any time, and your eye will return to before the surgery, which means you will have More choices.  . .
.The extraction method of the orthokeratology lens is ready for the preparations before wearing the lens. After the orthokeratology lens can be successfully worn, how can the orthokeratology lens be removed quickly and correctly in the morning next morning? Detailed description. Step 1: Before removing the lens, put 2 to 4 drops of eye drops into the eye first, then blink several times to make the eye drops sufficiently lubricated, and the lens slides on the surface of the cornea. Observe the position of the lens from the mirror to confirm The lens does not adhere to the surface of the cornea. The second step is to start removing the lens: (there are two methods) Method 1: Facing the mirror, place the index fingers of both hands on the upper and lower eyelid margins respectively, gently press the lower index finger against the eyelid margin, and use the upper index finger lightly Lift the lens lightly to remove it. Method 2: Face the mirror, determine the position of the lens, hold the cleaned suction stick in one hand, gently place it on the center of the lens, and suck out the lens. In order to ensure the safety of the lens, a special suction stick must be used for the orthokeratology lens.  .Step 3: Rub the removed orthokeratology lens with the care solution repeatedly until the lens is clean, then rinse it again with the care solution, and finally put it in the special mirror box for the orthokeratology lens and soak it for next use.  .Reminder: The special lens box and suction stick for orthokeratology lens should be disinfected regularly and replaced regularly to ensure cleanliness. When soaking the orthokeratology lens, the lens must be completely soaked in the care solution. To choose care solution products from regular manufacturers.
The secret behind the popular OK mirror Many parents have been asking me now, Dr. Zhang, can the OK mirror cure myopia? how much is it? Where can I fit? Is it safe? Whenever I encounter such a problem, I always want to explain the history of OK mirrors and OK mirrors to you. Parents who were still very excited at first, after listening to me chatting for two minutes, it seems that their eyes are not so bright! After two more minutes of nagging, his eyes began to get confused! Are you disappointed to hear this? Obviously many ophthalmologists have been vigorously promoting the OK lens, why is it not good for you here? In fact, any tool has two sides, and there are advantages and disadvantages. OK mirrors are no exception. I personally went to an ophthalmology hospital to investigate OK mirrors, and also consulted various domestic scientific research papers on OK mirrors. The conclusion is that the OK lens is better than the frame lens in preventing and controlling myopia! That’s a good thing! Ha ha. Everyone pay attention to my words, OK is only better than the frame lens in preventing and controlling myopia. It does not say that the OK lens can really prevent the extension of the eye axis, so that the eye axis does not grow at all. Or it can greatly control the dioptric growth. There are some cases where the clinical control is not ideal. The most worrying thing is that some children have a lot of chalazion in their eyes while wearing the OK mirror. That is how the matter? It is not just that everyone agrees with OK mirrors, it is a very good tool for controlling myopia. Why are there so many shortcomings of OK mirror now? The advantage of the OK lens over the frame lens is that it is physically correct, and it is only worn when resting at night. During the day, the hyperopia of the surrounding retina can be avoided. Here is too professional! You can understand that in the frame glasses, the middle is the clearest, but the surrounding is not clear. The OK mirror is removed during the day and will not be affected by the unclear view in the middle and around. Probably understand this point, why OK mirror is better than frame glasses to prevent and control myopia! Treat the OK mirror objectively and fairly! Many OK lens sellers say that the degree of myopia growth controlled by the OK lens is less than 25 degrees every year. This only feedbacks a part of the crowd, and does not represent the effect controlled by the entire group wearing OK mirrors. Not because some people control the effect well, less than 25 degrees, you think that everyone can control so well! After all, after wearing the OK mirror, many parents and children actually spent so much money (every tens of thousands), and they must vigorously control their bad habits with their eyes! This cannot be ignored! OK mirrors are not perfect. Generally, OK mirrors wear myopia less than 600 degrees. Corneal astigmatism cannot exceed 150 degrees. 8 to 18 years old. Corrected vision can reach 1.0. There are no lesions on the surface or fundus. The main complication of OK is that it is easy to cause dry eyes and corneal hypoxia. No matter how breathable this material is, how advanced the material is, how advanced it is. There is always a foreign object covering the cornea. These pairs of words are a kind of foreign body stimulation, which is easy to cause keratitis and conjunctivitis. In particular, if you do not pay attention to eye hygiene and clean, it is easy to cause infection. Over the years, sleeping at night and wearing, it is also easy to cause discomfort. The child rubs his eyes during sleep, which can damage the cornea. Therefore, you should look at the OK mirror objectively and fairly. It is a tool to prevent and control myopia! See how you use it. Nor can it guarantee 100% control of myopia, otherwise, the inventor of the OK lens can not win the international award! Overcome myopia. Haha! 3. Is corneal laser surgery and ICL crystal implant surgery really a life-saving straw for people over 18? Corneal laser surgery and ICL lens surgery have been the earliest corneal refractive surgery for more than 30 years. Countless people have had corneal surgery. The first generation of corneal surgery PRK has brought hope to countless people. It also brought certain complications. Because the operation at that time was not perfect, and there were still certain defects. For example, dry eye syndrome and inflammation of various ocular surfaces appeared after the operation. Even after finishing the vision back. The femtosecond laser is now very advanced. But also need to pay attention to indications. Please have an experienced refractive surgery expert to operate. Don’t try to save money and go cheap, just go to a commercial institution. Refractive surgery is not a one-size-fits-all clinic. I have been in contact with it since the end of corneal surgery. I have been friends for more than 10 years. Vision returned to 0.5, 0.6. There is no way to drive. Later we found us, through the method of physical therapy plus training in traditional Chinese medicine,
Last month, a 70-year-old senior myopic patient walked into Xima Ophthalmology. The patient’s surname is Li. She had performed ICL lens implantation abroad 12 years ago. But as she got older, cataracts “find” her again, which made Aunt Li’s life more troublesome. Auntie Li heard about Xima Ophthalmology through a friend. She was accompanied by her children and went to our hospital. I learned that she had done ICL in the United States before and her eyesight was restored, but now her eyesight is not good, probably lasting for five or six. year. After a professional examination of her, the results showed that the vision of the right eye was 0.1, there was no improvement in the correction, and the lens of the right eye was cloudy.  . . . The ICL done in the past few years has been of no avail for this patient’s cataract. Considering its actual situation, I finally decided to perform intraocular lens extraction + cataract phacoemulsification removal + intraocular lens implantation. The patient itself is still a bit worried because I have performed ICL crystal implantation before, worrying that it will affect his own cataract surgery. I’m also a little bit worried about whether my vision can be restored. ICL intraocular lens diagram . The current actual situation is like this. The current ICL lens implantation has been widely used. The situation of this patient is actually not complicated. ICL and cataract surgery are not complicated, as long as the original ICL intraocular lens is taken out, followed by cataract surgery.  . After about three o’clock in the afternoon, we completed the operation and the operation was very smooth. Aunt Li is very happy, and her family is also very satisfied. I am also heartily happy to see the patient regain a clear vision.  . Under the simple popular science here, we are doing cataract surgery to remove our original lens and put an intraocular lens into the eye. ICL lens surgery to correct myopia does not need to remove the original lens, but put another intraocular lens directly. When the patient has cataract, even if ICL surgery has been performed before, just remove the placed ICL crystal and then perform cataract surgery.  . Illustration of cataract intraocular lens . High myopia is very easy to be complicated with cataract, and has early onset and rapid progress. However, because the patient’s vision is already poor, it is easy to be overlooked. Many people are re-spectacled and still can’t see clearly before they are diagnosed with cataracts.  . Therefore, I usually recommend that patients with high myopia should have an eye examination at least once every six months to prevent serious complications. At the same time, if there is a rapid decline in vision, or the same vision but decreased clarity and other symptoms, we must be alert to the occurrence of cataracts.  . Cataract is the world’s first blinding eye disease caused by lens opacity. Currently, there is no medicine to cure it. Surgery is the most effective method. We should also remind everyone that if they feel that the quality of life is affected by cataract, they can consider surgery without having to wait for the cataract to “mature” before it is done. Cataracts that are too mature may increase the risk of iris inflammation, glaucoma and lens shift. All in all, waiting for the cataract to mature before surgery not only increases the risk, but also has the opportunity to reduce the effectiveness of the operation.  . Illustration of Cataract Surgery
my country is a big country of myopia. The population of myopia in China has reached 600 million, ranking first in the world, and the number of myopia increases by more than tens of millions every year. In addition to spectacles, keratoplasty is currently recognized internationally as a method for delaying the increase of myopia in young people. In recent years, with the prevalence of orthokeratology in China, many parents want to equip their children with a “weapon” that can delay the growth of myopia. 1. What is keratoplasty? Keratoplasty is achieved by wearing a series of specially designed rigid and breathable contact lenses with geometric shapes that are opposite to the anterior surface of the cornea. The central area of the lens is flat and the central area is steep. The shape of the cornea is reshaped so that the curvature of the central area There are flat and regular changes in a certain range, which can temporarily reduce the refractive power of myopia and improve the visual acuity of the naked eye. The reversible non-surgical physical orthopedic treatment method can also obtain a clinical effect that significantly slows down the development of myopia. The OK lens is a medium for orthokeratology. 2. What is an OK mirror? The OK lens is actually a common name (introduced into the country in the last century, the name is still used today), the original name is Orthokeratology, the English name is Orthokeratology. If understood literally, Ortho- means “positive position”, “-keratology” means “corneal”, and together it is to make the cornea upright. Taking the first letter of two words, you get the well-known name OK mirror. The OK lens is a hard material that can shape the cornea when worn. Many people wear contact lenses, most of them wear them during the day and take them off at night. The OK lens is just the opposite of contact lenses, worn at night and removed during the day. Corneal shaping uses special contact lenses. 3. Sight correction ability Wear orthokeratology lens, suitable for young children with myopia less than 600 degrees, no age limit, but 8-18 years old students are the most ideal. Although there is no specific age limit for the wearing of orthokeratoscopes, there are other adaptation requirements, including the patient’s eye health, refractive status, corneal curvature, etc. There are very specific requirements, as well as the compliance and immunity of wearing glasses Strength, hygiene habits, etc. Therefore, before wearing it, you must go to a professional ophthalmologist to do a comprehensive “physical examination” of the eyes. 4. Can the OK lens cure myopia? Will it rebound if it is stopped? Of course not! Although people wearing OK glasses can get rid of the trouble of the frame mirror during the day, this does not mean that myopia is cured. Objectively speaking, this is a reversible, delayed, non-radical treatment of myopia, and it cannot completely eradicate myopia. But at the same time, according to many years of experience of foreign patients wearing it, if it is worn for several years, if it is stopped, there will be no serious rebound. We consulted the relevant doctors, and the effect varies from person to person. Of course, there are some other ways to deal with myopia, such as laser surgery, using low-concentration atropine. Whether it is OK mirror, myopia laser surgery, eye drops, only certain corrections and repairs can be made, and the changes in the eye axis or corneal curvature cannot be completely restored. 5. The principle of treatment The lens used for keratoplasty is a specially designed contact lens with a flat middle and a steep peripheral edge. After wearing this lens, the lens will gently contact the cornea and slowly cooperate with the blinking action of the eyelid Change the cornea shape, so that the central part of the cornea is compressed and flattened, so that the light from the outside enters the eye and refocuses on the retina, so as to achieve the effect of 降low myopia度 or astigmatism. Corneal orthopaedic treatment achieves the purpose of correcting myopia and astigmatism by using special lenses to change the curvature of the cornea. The OK lens was approved by the US FDA for the treatment of myopia in 2002. Today’s new corneal orthopaedic lenses are made of new high-oxygen permeability materials and are manufactured according to precision design. Changes in thickness can also reduce myopia while correcting myopia. Gas-permeable materials used in lenses can help improve oxygen permeability and reduce corneal complications. 6. Before the patient undergoes orthokeratology treatment, an ophthalmologist or optometrist will examine the eyes in detail, including vision, myopia and astigmatism, corneal curvature, etc. In addition, it is necessary to check to determine whether there is an eye disease (such as Corneal inflammation, damage, etc.) are not suitable for treatment. After the examination is completed, the optometrist will customize special lenses according to the individual eye refractive power, corneal curvature and corneal characteristics.
“Often parents ask: the corneal curvature of the child is 43.00D, the axis of the eye is 23.2mm, and the refraction is -2.50D. Is this result right? Why the corneal curvature and the axis of the eye are normal? Why is myopia? Is the refraction wrong? Many parents It is believed that the measurement of the axis of the eye and the curvature of the cornea allows the doctor to estimate the myopic degree of the child… It is actually very difficult.” Diopter ≈ corneal curvature + lens power + eye axis The total refractive power of the eye is determined by a series of refractive tissue parameters Of, including: posterior vertex diopter of frame mirror (refraction result), corneal vertex diopter, first principal plane diopter of cornea, corneal diopter, anterior chamber depth, lens thickness, eye axis, vitreous cavity depth, lens diopter, aqueous refractive index, Glass refractive index, lens refractive index, lens front surface curvature radius, lens back surface curvature radius, lens front surface to lens first principal plane distance, lens back surface to lens second principal plane distance… and so on.  . If you ignore the effects of some physiological constants and subtle differences, let’s simplify it: the refractive power of the eye is mainly determined by the corneal curvature, lens refractive power and lens position, and the length of the eye axis. For ease of understanding, it can be considered: dioptre ≈ corneal curvature + lens power + eye axis (note that it is “approximately equal to”, ≈, not equal). In this formula, if we only have corneal curvature and eye axis measurement results (and no lens measurement results), this is a binary linear equation. Both myopic power (diopter) and lens refractive power are variables that cannot be solved. . So, this answers the question of parents: why measuring corneal curvature and eye axis is not enough, or optometry is still needed. Why measure the refractive power of the lens? Modern research believes that the reduction of lens power is a compensating factor in the process of myopia, and can largely neutralize the process of myopia caused by the growth of the eye axis. The sooner myopia occurs, the sooner the lens power drops. That is, the decrease in lens power compensates for the early growth of the eye axis-this explains why some children do not have myopia, but the axis of the eye still grows very quickly, because its lens power decline compensates. But when the refractive power of the lens drops to a certain degree and cannot continue to compensate for the growth of the eye axis, myopia manifests. After 12 years of age, the refractive power of the lens tends to be stable, and can no longer compensate for the myopia caused by the growth of the eye axis. (For details, see the previous article: Why does my child’s myopia not increase and the axis of the eye is still long?) . Therefore, we believe that the refractive power of the lens is the same as the axis of the eye, which is also an important factor for predicting the occurrence and development of myopia. Is there a way to measure the refractive parameters of the lens? For example, the observation that the refractive power of the child’s lens drops rapidly means that the process of myopia is fast, and myopia control must be strengthened.  . There are already mature and simple methods for measuring lens refractive power, such as measuring ocular axis, corneal refractive power, anterior chamber depth and other ocular biological parameters. Unfortunately, we have no effective, fast and accurate method for measuring the refractive power of living lens. This is why there is no large-scale epidemiological investigation on lens power. At present, most of the detection of the lens power is calculated indirectly through the formula. That is, in the above formula dioptric corneal curvature + lens refractive power + eye axis formula, the refractive power of the lens can be calculated only after measuring the corneal curvature, eye axis and other parameters and refraction.  . For example, the more commonly used is the Bennett formula (Figure 1). The study believes that the lens power calculated by Bennett’s formula is the closest to the true lens power. PL . Lens refractive power .n Aqueous refractive index . .SCV . Corneal vertex diopter K . Corneal diopter ACD anterior chamber depth c1T .Distance from lens front surface to lens first principal plane c2T . Lens posterior surface to lens Plane distance V glass cavity depth Figure 1 Bennett formula & nbsp. Note: Bennett needs the lens thickness parameter to calculate the distance c1T, c2T from the lens surface to the main plane. (The lens is a thick lens, so there are 2 principal planes) If there is no lens thickness value, you can also use the stenstrom formula, Benn
#你不知道的医学小常识# Astigmatism is the difference in the refractive power of the eyeball on different meridians. When the parallel light rays are refracted by the eyeball, the imaged image is not a focal point, but the two focal lines in different positions in space and the smallest circle of confusion. Light state. To put it simply, astigmatism is related to the two refractive media of the cornea and lens of our eyes. Our cornea is not a perfect sphere, so everyone will have some physiological astigmatism. If the astigmatism is within 100 degrees, don’t worry too much. If the astigmatism exceeds 100 degrees, which affects vision, or if the astigmatism suddenly becomes high in a short period of time, it is necessary to cause vigilance and promptly go to the hospital for examination. Some astigmatism is born, and some astigmatism is acquired. Acquired astigmatism is caused by many factors. Eye trauma, keratoconus, cataract, corneal inflammation, trichiasis, pterygium, and other eye diseases that endanger the cornea and lens may cause astigmatism. Many people ask questions about astigmatism, but most people are a little too nervous. If the degree is not high, you don’t have to pay too much attention to this issue.
Many parents asked: doctors said that they should wear the OK mirror for 8 hours, otherwise the shaping effect would not be achieved. However, my child has a lot of homework, and sleeps less than 6 hours a night. It turned out that the children started wearing glasses 3 hours before going to bed. They wear OK glasses to do their homework, which can make up for the time of wearing glasses. But after reading your article “Can children wear OK glasses to read and do homework?” When it comes to wearing OK glasses to do homework, it will weaken the effect of myopia control. What should we do? Will it cause the child’s naked eyesight to reach 1.0 during the day? ?  . 1. The night-wear sculpting mirror mainly “maintains” the shape of the cornea, not “scratching” once a day! I understand that many parents think that “OK glasses should be worn for 8 hours, otherwise it will affect the shaping effect.” In fact, this statement is incorrect. Today’s corneal orthopaedic lens design is very mature, and the efficiency of shaping is very high. Under normal circumstances, a reasonable lens fit can completely maintain clear vision throughout the day. For example, for low myopia (100 degrees myopia), during the fitting process, we only give the child a 30-minute closed eye try-on (not to mention wearing a mirror overnight for more than 8 hours) to achieve the shaping effect. Mirror vision can be increased to 1.0.  . In the early stage of corneal shaping, the corneal curvature changes from a steep state to a flat state. Shaping requires a process, which depends on the corneal curvature (high curvature shaping fast / low curvature shaping slow), e value (high e value The effects of factors such as fast shaping/low e-value shaping slow), myopia (low degree shaping fast/degree high shaping slow) and other factors. Generally, wearing glasses for one night can achieve more than 60% of the effects, and wearing glasses for one week can achieve more than 90% of the effects. And the lower the degree will be much faster, under normal circumstances, myopia within 200 degrees, generally wear OK lens on the first night, after taking the lens the next day can achieve 1.0 vision.  . After the cornea has been stabilized, the cornea has formed a flat central shape with a steep mid-periphery shape. In the future, when you wear a mirror every night, you only need to “maintain” this shape instead of “starting from scratch”, and then remove the cornea from the original The state is shaped once. This means that wearing corneal shaping mainly maintains the shape after shaping, and this process can be achieved without wearing for a long time. So there is no need to wear more than 8 hours per night. Although there is no specific literature research in this area (for example, only letting children wear glasses at night for 4 hours and 6 hours to study the shape of the day, this is not ethical, there is no such research), but we believe that this kind of ” Shaping for the purpose of “maintenance” only takes a relatively short time (maybe 4 hours) to achieve the effect.  . Second, some children do not wear glasses for long enough for daytime vision, and why? However, there are actually some special cases, which may cause poor vision of the naked eye after daytime lens removal due to insufficient wearing time, including: myopia is too high (more than 400 degrees), the curvature is too flat, and the e value is too small. In these cases, the cornea is not easily shaped in place, and even after shaping, the diopter rebound will be faster. If it is due to the above-mentioned special reasons, it will indeed happen that the naked eye vision in the daytime is easy to decline, fluctuate, and unstable. You can also try to increase the wearing time of the lens to improve (but even so, the effect is not necessarily good). These factors can be found before the shaping and fitting, and the optometrist should explain and communicate to the parents based on the relevant examination results. 3. The main factor that determines the shaping effect of the cornea is the lens fit, not the length of wearing the lens. If the lens is not fitted properly and the shaping power is not enough, the cornea cannot achieve the ideal post-shaping state, which is the naked eye vision during the day. Fluctuations are large, and naked eyesight is poor after taking off the lens.  . For an example: Figure 1A is a corneal topography map of a child with insufficient shaping ability encountered in our clinic. The main complaint is: poor vision after taking the lens, and the parent said that his orthopedist added a lot of shaping to her When the lens is lowered (flat BC), the effect is still not good, and the eyesight during the day is still poor. Just picking up the lens is OK, and the vision will obviously decrease after 2 hours. This situation is more obvious if the lens is not worn for a long time.  . Figure 1 .A Insufficient shaping force, the effect of wearing a mirror for a day after B modified the parameters . We analyzed her fitting data, adjusted the parameters, changed the lens, and only worn it for one day, the topographic map was improved ( Figure 1B), naked eyesight is enough
Today, the head of the family wears a child to come back to see the orthokeratoscope. For the first time last night, the mother wore mirrors for the children. The mother did 30 minutes of psychological counseling and persuasion work, and then spent an additional 40 minutes to wear the mirrors for the children. The process of wearing the mirror is “complex”, repeated wearing, picking, wearing, picking … exhausted a whole box of saline for washing. Parents ask, the physiological saline used for special flushing is too expensive, can it be replaced with cool white boiling water? & nbsp. According to experience, it is not easy to wear a mirror on the first day. It is not how difficult it is to wear a mirror, but the child is psychologically difficult to accept. Therefore, often from the next day, the speed and efficiency of wearing glasses will be greatly improved. A week later, the child will be able to accept this kind of lens that “wearing a mirror can improve vision” when sleeping. Parents will also wear and remove the lens smoothly, and they can complete the lens wearing action once (within a few seconds). Within 5 minutes, you can complete all the work from preparing tools and lenses-wearing glasses-picking up tools and mirror boxes. & nbsp. The first “difficult” lens wearing process, because of the long operation time, repeated wearing and removing of the lens, is likely to cause micro damage and infection of the ocular surface tissue. Therefore, we particularly emphasize the importance of wearing glasses at the beginning. Including: first order artificial tears without preservatives, rinse out possible foreign objects, such as missing eyelashes and secretions. Drop the high-viscosity moisturizing liquid on the concave surface of the lens before wearing the lens, which can reduce the discomfort and foreign body sensation of wearing the lens and reduce the bubbles entering the lens. Rinse the lens with sterile saline or special flushing solution. Before removing the lens, drip low-viscosity artificial tears without preservatives to make the artificial tears enter under the lens, and the lens is separated from the cornea for easy removal. & nbsp. (We generally use 0.1% sodium hyaluronate artificial tears without preservatives.) For details, see the previous article: How to wear glasses safely? & nbsp. How to safely remove the cornea? Why is it recommended to drop artificial tears instead of eye drops before orthokeratology? Therefore, parents should pay special attention to the lens operation and care during the first stage of wearing glasses. In the early stage, because the operation is not smooth, it is easy to cause corneal micro-damage. It should emphasize standard operation and rinse the lens with sterile saline or special irrigation solution. On the contrary, after a period of time, the child can accept the orthokeratology, and after the operation is proficient, the possibility of corneal injury and infection caused by the operation is greatly reduced, and the cool white opening can be used again (saving some costs).