Using carbon dioxide luminous tubes to emit high-efficiency light to act on pathological tissues, which can absorb inflammation and destroy tumors. The low-efficiency light can remove freckles and beautify the skin.

The full name of what people generally call "excimer laser surgery" should be "excimer laser refractive corneal surgery", which mainly includes three surgical procedures:

(1) Excimer laser corneal resurfacing (PRK for short) is the earliest method used clinically. PRK is currently considered safe and effective in the treatment of moderate to low myopia, hyperopia and astigmatism. However, it is rarely used due to complications such as postoperative pain and refractive regression.

(2) Excimer laser in situ keratomileusis (LASIK), which is currently the mainstream surgery. It cuts the stromal layer under the corneal flap, keeping the corneal epithelium and Descemet's membrane intact, and can avoid most complications of PRK. The characteristics are that it broadens the scope of myopia correction, there is no pain during and after the operation, the vision recovers quickly, and no nebula is left on the cornea. During the operation, a micro-knife is first used to cut a thin pedicled corneal flap on the cornea, the flap is opened, laser cutting is performed under the flap, and then the flap is restored to its original position. This can be used for low, medium and high myopia. LASIK also has defects caused by the corneal flap, namely corneal flap wrinkles, displacement, epithelial implantation under the corneal flap, astigmatism, and excessive cutting, resulting in corneal ectasia, keratoconus, etc. ASIK is also limited for patients with relatively high corneal myopia who have severe myopia. However, LASIK is still the first choice for patients with high myopia whose corneal flap is thick enough.

(3) Excimer laser subepithelial in situ keratomileusis (LASEK) is an improved procedure of PRK surgery. The corneal surgical area is soaked with laser or low-concentration alcohol to create a corneal epithelial flap. The laser cuts the tissue under the epithelial flap. After the corneal epithelial flap is reset, a contact lens still needs to be covered on its surface. The pain after LASEK surgery is significantly less than that of PRK. With the thin flap, it can be used for patients with relatively thin cornea and large pupils. LASEK does not have the complications of LASIK corneal flap, shortens the corneal epithelial healing time after PRK surgery, and reduces the pain response and corneal haze (haze). However, the corneal epithelial flap damage and edema during the surgery are the same as those of PRK, and after the surgery Vision recovery and refractive stabilization are slower than LASIK. Therefore, it is mainly suitable for patients with thin corneas, occupational characteristics that are prone to eye trauma leading to corneal flap displacement, or other patients who are not suitable for LASIK.

In addition, not long ago, Greek physician Ioannis took the lead in proposing the Epi-LASIK procedure. It is believed that Epi-LASIK can combine the advantages of LASEK and LASIK surgery and better avoid the shortcomings of both. It uses a rotating epithelial knife to "make an active epithelial flap" on the corneal epithelium, with a thickness of only more than 50 μm, unlike LASEK surgery. Soaking in alcohol like this can "save" the corneal thickness to the maximum extent, and at the same time, the postoperative irritation symptoms are also very small, the chance of corneal haze (haze) is less than that of PRK, and the incidence of myopia regression is low.

Not all patients with myopia are suitable for surgery

Generally, only those who meet the following conditions can be considered for eye excimer laser surgery: they are over 18 years old, have a healthy mental state, and have Desire to remove glasses; no active eye disease in the eyes; myopia degree has been relatively stable in the past two years, with the degree of myopia not worsening by more than 50 degrees each year; if you wear contact lenses, soft lenses should be removed for 2 weeks, and rigid lenses should be removed for more than 4 weeks (You can wear glasses before doing a pre-surgery examination); after a doctor's examination, all eye indicators meet the surgical requirements; if it is the second operation, the interval between LASIK is 3 to 6 months, and the interval between PRK is 1 year; wear If you have farsightedness, myopia, or astigmatism after penetrating corneal transplant surgery, the interval should be more than 1 year; there are no diseases that limit the surgery on your body.

People with the following conditions are not suitable for excimer laser surgery: acute and active inflammation of the eye, dry eye syndrome, incomplete eyelid closure, glaucoma, cataracts, uveitis, retinal detachment, lack of Blood eye diseases, viral eye diseases such as herpes simplex, and the following systemic diseases such as: diabetes, collagen diseases (lupus erythematosus, etc.), rheumatoid arthritis, gout, people taking medication for mental illness, AIDS, people with certain diseases that affect wound healing, or People who are eligible for surgery but have concerns about it or have high expectations, as well as pregnant and lactating women.

Safety is the focus of public attention and the first choice is still to wear glasses

There are usually three methods to correct myopia: 1. Lens correction: including glasses and contact lenses; 2. Corneal refraction Sexual surgery: radial keratotomy (RK), excimer laser ablation (PRK), excimer laser in situ keratomileusis (LASIK), etc.; 3. Intraocular refractive surgery: clear lens extraction, phakic surgery Intraocular lens implantation of the eye, etc.

It should be pointed out that, considering factors such as safety, simplicity, economy, and practicality, the ophthalmology community believes that for most people, the current preferred method for correcting myopia is still wearing glasses. If a patient is going to choose excimer laser surgery, the most concerning issue is the safety of the surgery.

Objectively speaking, the safety of the current excimer laser surgery is relatively high. Compared with the earliest radial corneal incision surgery for myopia using a diamond knife, its safety has changed qualitatively. This has been fully proven through more than 10 years of extensive clinical practice. It can be said that laser myopia treatment surgery has become relatively mature in my country. However, the success rate of any operation cannot be 100%. Just as contact lenses are prone to infection and harm vision, trauma caused by rupture of glasses lenses is also one of the causes of blindness. As an article in the American magazine "Ophthalmology" pointed out: the failure rate of this type of eye surgery is 1/10, most domestic refractive surgery experts hold different opinions. Of course, good surgical equipment, the surgeon's skillful operation and rich experience, and the patient's good cooperation are the basis for high safety in surgery.

Any surgery has risks, and myopia laser surgery cannot completely avoid complications. The most common complication is over-correction or under-correction, which requires observation for a certain period of time and a second operation as appropriate; some people may experience glare, that is, seeing a light point as a light group or halo at night, which may occur due to postoperative corneal damage. Slight edema reaction between tissues or large pupil at night, and its edge is close to the surgical edge, which gradually reduces with the passage of time after surgery; keratoconus occurs in people with this potential or whose cornea is too thin after surgery; because of poor gaze target , eccentric cutting may occur, or a central island may appear due to the water vortex on the corneal surface; there may be corneal haze (Haze) after PRK and LASEK surgery, as well as steroid-induced high intraocular pressure caused by long-term use of anti-Haze drugs. LASIK has complications related to the corneal flap, such as foreign bodies under the flap, displacement and dissolution of the corneal flap, increased astigmatism, and conscious dryness of the eyes. The most serious thing is the infection of the surgical corneal wound. Although it rarely occurs, it can be the direct cause of blindness. Therefore, a strict surgical disinfection system and good hygiene habits of patients are crucial. Eyes should also be checked regularly after surgery, paying special attention to changes in the macular area and peripheral retina of the eye, so as to prepare for rainy days.

Strict medication and review after surgery are important aspects

Some patients have unsatisfactory results or complications after surgery because they do not strictly follow the doctor’s instructions for medication and review. Therefore, doctors should pay special attention here and remind patients to pay attention to postoperative matters. 1 to 2 hours after LASIK surgery, the eyes will generally have soreness, tears, and foreign body sensation. The symptoms will basically disappear after two or three hours. If the eye pain symptoms are obvious, you must pay attention to distinguish whether it is eye skin pain or eyeball pain. If it is the latter, You should see an ophthalmologist immediately to rule out the possibility of infection and corneal flap displacement. If you have eye symptoms on the day of surgery, you can close your eyes and rest. Do not take off the transparent eye mask at will, and do not squeeze or rub your eyes hard. When you go to the hospital the next day, the doctor will remove the transparent eye patch and check your vision, cornea, and refractive status. Then, you will go for reexamination 3 days, 7 days, 1 month, 3 months, half a year, and 1 year after the operation. Especially in the early postoperative period, the doctor can adjust the medication in time based on the review results, which is also an important part of ensuring the success of the operation. The patient is also instructed to avoid going to places with heavy smoke and dust within a week after the operation, eat less spicy and irritating food, do not wear makeup on the eyes, and avoid getting water and small particles into the eyes. Many people return to normal vision the day after surgery, but their vision fluctuates in the next few days. For some people, their vision gradually returns to normal, mostly stable within two weeks, and the final recovery period is 3 to 6 months. After LASIK surgery, antibiotics can be taken orally for three days to prevent infection; antibiotic eye drops, hormonal eye drops, and eye drops that promote corneal epithelial growth, lubrication, and prevent dryness are also prescribed, generally not more than one month. Within a month, you should use less fine vision at close range (including watching computers and TV). Due to the change in refractive status after surgery, some people may experience difficulty in near vision and fatigue easily in the early stage. If work and study cannot be avoided, you should take more intervals, blink more, and rest more. Generally, the symptoms will gradually disappear over time. Furthermore, be careful not to swim within a month, and avoid diving and intense confrontational sports to avoid impacting the eye, causing eye trauma, displacement or even loss of the corneal flap. If you have glare symptoms, you should wait until the symptoms disappear before driving at night.

Health Economics of Eye Laser Surgery

Different procedures for excimer laser surgery\different hospitals have different prices. For example, the price of LAISK surgery in most hospitals is 6,000 to 8,000 yuan, but some only cost 2,000 yuan, and some even only cost 800 yuan. What needs to be vigilant is that cost reduction is limited. The reason why some hospitals are very cheap is because they use equipment and materials that have long been eliminated from abroad. The technology must be outdated or there are quality problems, and the surgical results cannot be the same. , so be sure to choose a large hospital with guaranteed reputation and technology.