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中英文对比:有些国外禁止做准分子激光手术的原因

时间:2013-01-28     来源:未知

核心提示:有报道称:英国政府医疗监管部门阻止在国家医疗服务系统进行准分子激光手术。也就是说英国并不是禁止准分子激光手术,而是不允许将准分子激光手术纳入英国国家医疗服务系统,也就是全民医保的范畴。  政...

有报道称:英国政府医疗监管部门阻止在国家医疗服务系统进行准分子激光手术。也就是说英国并不是禁止准分子激光手术,而是不允许将准分子激光手术纳入英国国家医疗服务系统,也就是全民医保的范畴。

  政府承担全民医保"的"英国模式"难度大

  每个国家的国情不同,发达国家实行的是免费全民医保,而我们国家专家称政府承担全民医保"的"英国模式"难度大,所以像眼科的近视、斜视等治疗被划为美容整形范畴,在医保报销范围之外,然而准分子激光手术的安全性和有效性是否因此质疑呢?

  答案当然是:不

  众所周知:威廉王子何以有双英国性感的眼睛

  据英国《每日镜报》报道,虽然继承了母亲“英伦玫瑰”戴安娜那双清澈如湖泊的眼睛,但是威廉王子却曾有着和普通人一样的痛楚——近视。从青少年开始,威廉王子的视力就不断下降,为此,王子还专门咨询了伦敦久负盛名的Moorfields眼科医院的医疗顾问。为了防止自己的余生都伴随着眼镜度过,时年23岁的威廉王子毅然接受了近视手术,以绝后患。

  《每日镜报》称:据皇室内部消息称,当年威廉十分迫切想要做这项手术。除了不想一辈子戴眼镜影响眼睛放电外,威廉王子还想借此更顺利地进入军校。当时,威廉王子即将进入桑德赫斯特皇家军事学院深造,入学时间的紧迫促使他毅然决定接受手术,以便在进入军校之前完全恢复。

  ——事实上,从1985年在美国获批准应用以来,近视手术已经成为全球越来越多公众人物提升视觉和外形的重要方式。

  据悉,英国每年约有10万人接受近视手术,一般人于手术后只需休息一天便可如常工作。尽管英国被公认为世界上医学谨慎的国家,导致近视手术或多或少存在争议。但代表着未来高权利行使者的威廉王子,显然已用现身说法的方式,验证了这一视力矫治方式的安全性和完美效果。

  那么众多发达国家到底是如何对待近视手术(屈光手术)的呢?

  摘自——阿玛仕快讯2012年第1期

  当代欧洲屈光手术指南

  Current European Guidelines for Refractive Surgery

  英国

  患者告知:建议向患者提供书面的术后指导、注意事项以及一个24小时紧急求助电话。还应令患者了解其术前角膜曲、角膜厚度、术前和术后的BCVA、验光度数以及眼压值。

  术后评估:屈光手术医生必须参加患者术后的次随访。

  United Kingdom

  By David P. S. O’Brart,

  MD, MB, BS, FRCS, FRCOphth

  There are no formal guidelines in the United Kingdom for refractive surgery. However, the Royal College of Ophthalmologists published its latest Standards for Laser Refractive Surgery in 2009.1 These guidelines, which are reviewed annually, were developed in response to public concern about safety but are intended only to provide advice and assistance rather than definitive regulations in the following areas.

  Experience and qualifications. Surgeons should be registered with the General Medical Council, maintain professional indemnity insurance, have a broad base of ophthalmic knowledge, ideally hold the Royal College of Ophthalmologists’ certificate in laser refractive surgery, regularly audit their cases, undertake continuing medical education in refractive surgery, and be a member of a national or international refractive surgery association.

  Laser facilities. Laser facilities must be appropriately registered.All equipment within the facility must be correctly maintained and calibrated with documented procedures for use. A back-up power supply for the laser is required. Staff must be adequately trained with demonstrated and documented competence, patient consultations must be conducted confidentially, and information outlining how to make a complaint or offer suggestions about the organization’s services must be displayed.

  Patient resources. Patient information should be in concise, nontechnical language and include the range of refractive surgery procedures offered along with their eligibility criteria, risks, benefits, and probability of achieving a desired goal. Surgeons’ qualifications and previous substantive positions and a price list that explicitly details what is and is not included in each procedure fee should be available to patients. It is also recommended that all patients receive written postoperative directions with a 24-hour emergency contact number. They should also be given their preoperative keratometry and pachymetry readings, pre- and postoperative BCVA,refraction, and IOPs.

  Informed consent. The consent process should follow General Medical Council and Department of Health guidelines. Written information must be given to patients at least 24 hours before the procedure. Adequate time must be made before surgery to discuss the risks and benefits, to answer questions, and to confirm that patients understand the written and verbal information they have been given. It is recommended that patients have an appointment with a refractive surgeon prior to the day of the surgery. The consent form must reference the elective nature of the procedure and its specific risks and state that spectacles and contact lenses may still be required after the procedure. The surgeon is required to certify on the form that, in his or her opinion, the patient understands the risks and benefits of the procedure and alternative treatments.

  Clinical governance. Surgeons must be responsible for patients’ care and available to assess their suitability for surgery and must provide postoperative follow-up and emergency care (providing appropriate cover when on leave). Surgeons must undertake clinical audits and regularly review the results. They must also investigate, record, and collate all adverse events and report and discuss them with a Medical Advisory Committee or equivalent. There should be documented clinical protocols for all surgical procedures performed, including common variances from the care pathway, which have been made known to and agreed among all clinical staff. All entries in patients’ notes should be clearly readable, signed, and dated.

  Promotional materials. Advertising and marketing literature, which should be legal and adhere to the standards of the UK Advertising Standards Agency, must be factual, not misleading, and drafted and designed to prevent unrealistic patient expectations.

  Postoperative evaluation. The refractive surgeon should be available at the first postoperative visit. He or she is responsible for ensuring that postoperative management is appropriate. Refractive surgeons should be fully trained in the management of postoperative complications and have facilities to provide microbiological and inpatient services if required. The patient’s general practitioners should be informed of all procedures undertaken unless the patient requests otherwise. ■

  德国

  专用术语临床推荐治疗范围(recommended range of application)指的是患者具有接受屈光手术的指征且发生手术并发症几极低。在这个范围内的应用,对患者进行常规的术前沟通教育、并发症的知会与同意。专用语受限制的应用范围(range of limited application)指的是可以开展屈光手术但手术结果的预测性略低且存在发生并发症的可能性。当不得不对这类患者进行手术时,术前的沟通教育必须更为详尽。当患者的情况超出受限制的应用范围或极可能产生严重并发症时,手术医师将不再进行手术。

  表层手术

  PRK、LASEK和EPI-LASIK手术的临床推荐治疗范围在近视-6.00D以内、散光5.00D以内。如果是矫正近视散光,那么球镜与柱镜的度数需要叠加,而不是相减。表层手术受限制的应用范围是近视-8.00以内、散光6.00以内。

  LASIK

  临床推荐治疗范围在近视-8.00D以内、散光在6.00D以内。当矫正近视散光时,球镜与柱镜的度数必须叠加。远视的临床推荐治疗范围在+3.00D以内。LASIK手术受限制的应用范围近视不超过-10.0D,散光则仍是6.00D以内。

  Phakic IOLs

  晶体植入手术临床推荐治疗范围在近视-8.00D以上,远视4.00D以上。如果晶体植入后仍存在部分散光与屈光不正,可再进行准分子激光手术。

  Germany

  By Suphi Taneri, MD,

  and Saskia Oehler, Dipl Ing

  Germany does not have a regulatory agency like the FDA that approves refractive procedures.However,most surgeons in Germany adhere to the evaluation of indications for refractive surgery procedures outlined by the Commission of Refractive Surgery, a combined commission of the German Ophthalmological Society and the Professional Association of German Ophthalmologists.1These guidelines are designed to evaluate and safeguard the quality of refractive surgical procedures performed in Germany.

  In the following review of these guidelines, the term recommended range of application refers to the range in which a procedure is considered eligible and side effects are rare. In this range, normal standards are sufficient for patients’ education and the informed consent process.The range of limited application is the range in which the surgery may be performed but in which less predictable results and side effects may be anticipated. For procedures in this range, patients’ education must be extensive.Surgeons are discouraged from performing surgery outside of these ranges.

  Surface ablation. The recommended range of application for PRK, LASEK, and epi-LASIK is correction of myopia of up to -6.00 D and correction of astigmatismup to 5.00 D. If myopic astigmatism is to be corrected, the values for myopia and astigmatism must be added,not subtracted. The range of limited application for these procedures is correction of myopia up to -8.00 D and correction of astigmatism up to 6.00 D. If myopic astigmatism is to be corrected, the values for myopia and astigmatism must be added. Up to 4.00 D is the range of limited application for hyperopia. Contraindications include chronic progressive corneal disease, surgery before the age of 18 years, symptomatic cataract, glaucoma with a marked loss of visual field, and exudative macular degeneration.

  LASIK. The recommended range of application is correction of myopia up to -8.00 D and correction of astigmatism up to 5.00 D. If myopic astigmatism is to be corrected,the values for myopia and astigmatism must be added. The recommended range for correction of hyperopia is up to 3.00 D. The range of limited application for LASIK is correction of myopia up to -10.00 D and correction of astigmatism up to 6.00 D. If myopic astigmatism is to be corrected, the values for myopia and astigmatism must be added. Up to 4.00 D is the range of limited application for hyperopia.Contraindications include preoperative corneal thickness less than 480 μm, predicted stromal thickness under the flap after ablation of less than 250 μm, chronic progressive corneal disease and forme fruste keratoconus, surgery before the age of 18 years, symptomatic cataract,glaucoma with a marked loss of visual field, and exudative macular degeneration.

  Phakic IOLs. The recommended range of application for implantation of a phakic IOL is correction of myopia greater than -8.00 D and correction of hyperopia greater than 4.00 D. If astigmatism or ametropia remains after implantation, excimer laser surgery may be performed. The range of limited application is correction of myopia greater than -5.00 D and correction of hyperopia greater than 3.00 D.

  Contraindications include surgery before the age of 18 years, symptomatic cataract, glaucoma with a marked loss of visual field, preexisting corneal disease with a low endothelial cell count, and insufficient anterior chamber depth..

  Conductive keratoplasty. This procedure has never gained popularity in Germany and is almost never performed.

  Refractive lens exchange (RLE). The recommended range of application for RLE is the correction of myopia and hyperopia in presbyopic patients. If astigmatism or ametropia remains after RLE, excimer laser surgery may be performed. The range of limited application is the correction of presbyopia in emmetropic eyes.Patients should be informed of the potential long-term side effect of increased retinal detachment rates, especially in long myopic eyes.

  Saskia Oehler, Dipl Ing, is a research assistant at the Center for Refractive Surgery, St. Francis Hospital, Münster,Germany. She acknowledged no financial interest in the material presented in this article. Ms. Oehler may be reached at [email protected] Taneri, MD, is the director of the Center for Refractive Surgery, Eye Department, St. Francis Hospital, Münster, Germany. He acknowledged no financial interest in the material presented in this article. Dr. Taneri may be reached at +49 251 9877890; fax +49 251 9877898; [email protected]

  意大利

  在意大利,屈光手术被看作是美容外科手术。政府提供的大众医疗保障体系仅仅覆盖对各类疾病的治疗费用。很多想做屈光手术的患者在发现大众医疗保险不承担屈光手术费用后就放弃了这一手术。政府的医保体系仅在一种情况下将负担屈光手术费用:即患者双眼屈光参差超过4.00D。例如,某位患者右眼为-8.00D、左眼为-4.00D,则右眼可被矫正成-4.00D。

  角膜厚度必须足以满足矫正屈光不正的需求。若要安全的开展屈光手术(LASIK和PRK),无论近视度数是多少,术后角膜厚度应不少于430—450微米。若患者术前角膜厚度不足480微米,我们不推荐为其进行屈光手术,即使患者仅仅只有-0.75D的近视。

  在进行LASIK或PRK手术之前,考虑患者的术前角膜曲同样非常重要。当矫正近视时,我们希望患者术后角膜曲不低于40.00—41.00D,而当矫正远视时,则希望术后角膜曲不超过48.00—49.00D。医生必须考虑到手术导致的角膜曲变化,因为术后高阶像差对其视觉质量至关重要。

  LASIK vs PRK

  我们选择飞秒激光LASIK或PRK手术方式主要取决于患眼的解剖结构特点、屈光不正的种类与程度及患者的期望。若患者不希望出现术后疼痛或者患者是个繁忙的专业人士,同时术眼的生理条件满足要求,那么我将选择femto-LASIK手术。对于年轻人,我更倾向于选择PRK,因为PRK几乎不存在术中并发症风险。无论是PRK还是femto-LASIK,术后均能获得很好的视觉质量。

  Italy

  By Simonetta Morselli, MD,

  and Antonio Toso, MD

  Refractive surgery in Italy is considered aesthetic surgery. The government fully reimburses the health insurance system only for procedures that address diseases.Many patients who ask for refractive surgery abandon the idea when they discover that public insurance will not cover the cost. The government health system will reimburse refractive surgery on one condition: if the patient has a difference in refractive error of more than 4.00 D between his or her two eyes. Italy’s health care system will cover expenses for the patient to correct anisometropia. For instance, if the patient’s right eye is -8.00 D and left eye is -4.00 D, the right eye could be corrected to -4.00 D.

  Although there are no official guidelines for refractive surgery in Italy, some refractive and anatomical considerations serve as guidelines in this country for practical purposes.

  Corneal thickness. The corneal thickness must be sufficient to allow correction of the refractive error. If the indication is a corneal refractive procedure, whether LASIK or PRK, the postoperative residual pachymetry should not be less than 430 to 450 μm, regardless of the amount of myopia targeted. If the preoperative pachymetry is less than 480 μm, we do not recommend corneal refractive surgery for any amount of myopia, even -0.75 D, because this can be a sign of developing keratoconus.1 Some surgeons perform corneal collagen cross-linking in conjunction with PRK or LASIK.2 For the reasons listed above, the amount of myopia is not a determining factor for performing PRK, LASIK, or other corneal refractive surgical procedures.

  Corneal curvature. It is important to consider preoperative corneal curvature before performing PRK or LASIK. We would like to obtain a postoperative curvature no flatter than 40.00 to 41.00 D when correcting myopia and no steeper than 48.00 to 49.00 D when correcting hyperopia. These guidelines must be taken into consideration because postoperative higher-order aberrations are important for the patient’s quality of vision. The shape of the cornea is also important; PRK or LASIK is relatively contraindicated if the patient has keratoconus.Some surgeons perform collagen cross-linking at the time of PRK to correct refractive errors associated with keratoconus.2 In these cases, the patient must be informed that the correction may not be permanent.

  Presbyopia. Some patients with presbyopia are convinced that lasers must be able to correct their problem.Although some software has been designed for this purpose,we currently do not have a standardized refractive surgical procedure to offer to presbyopic patients.3-5

  Hyperopia and hyperopic astigmatism. When treating these conditions, we take into consideration the patient’s pachymetry, corneal curvature, and amount of hyperopia.For cases with up to 3.00 D spherical equivalent, PRK is suitable. For more than 4.00 D, we recommend LASIK with femtosecond laser flap creation (femto-LASIK). In our experience,PRK is not stable for more than 4.00 D of hyperopia; the cornea tends to revert to its original shape, causing a postoperative hyperopic shift that requires an enhancement.

  Astigmatism. In the presence of more than 2.50 D of myopic or hyperopic astigmatism, we prefer to perform femto-LASIK to obtain good postoperative stability.

  Age. For patients older than 40 to 45 years, we recommend femto-LASIK for reasons related to reepithelialization and dry eye. These two conditions are related to the risk of postoperative infection and the delay of visual recovery.

  LASIK versus PRK. We choose to perform femto-LASIK or PRK depending on the anatomy of the eye, the degree and type of refractive error, and the desire of the patient. If the patient does not want to feel pain after surgery or if he or she is a busy professional, then I recommend femto- LASIK if the anatomy of the eye is suitable for this procedure. For young patients, we recommend PRK because in Italy it is cheaper than femto-LASIK and it is free of intraoperative complications. The postoperative quality of vision is the same with PRK and femto-LASIK.6 If the anatomy of the eye does not match the requirements for a corneal procedure, we consider phakic IOL implantation for myopic prepresbyopic patients. In this case, we measure anterior chamber depth, endothelial cell count, and white-to-white distance. If these are appropriate, we implant the Acrysof Cachet IOL (Alcon Laboratories, Inc., Fort Worth, TX; not availabe in the United States), a foldable anterior chamber angle-supported IOL. We have been using this lens for 10 years and have not encountered any complications. Iridectomy is not needed, and the IOL is implanted through a 2.6-mm corneal incision. If the anatomy of the eye is not suitable for this IOL, we consider the Artisan phakic iris-supported IOL (Ophtec BV, Groningen, Netherlands; in the United States, Verisyse; Abbott Medical Optics Inc., Santa Ana, CA). If the endothelial cell count is not high enough in relation to the patient’s age, we consider implanting a posterior chamber phakic IOL (toric if appropriate). If the patient is presbyopic, we consider performing clear lens extraction, especially in those with hyperopia. In some special cases, when early cataract is present, we consider implanting multifocal or bifocal IOLs.

  France(中文缺失)

  By Damien Gatinel, MD, PhD

  The practice of refractive surgery is accessible to any ophthalmic surgeon in France. In theory,no special certification is required besides an ophthalmology specialty diploma. Conversely, ophthalmologists are the only physicians who are qualified to perform refractive surgery.Ophthalmologists learn theory and gain surgical experience through daily hospital practice. Lectures given as part of the teaching residency program cover the entire field of ophthalmic pathology. Although refractive surgery represents a significant proportion of ocular surgical activity in France, this field is taught only in specific units and may not be available to some residents. As the field of medical knowledge widens, especially in ophthalmology, it is difficult for teaching units to remain versatile and provide as much emphasis on elective and, some would say, cosmetic procedures as on vision-threatening diseases.Additionally, public hospitals cannot always afford the heavy financial burdens of the costs and maintenance of the lasers used in refractive surgery. The complexity of refractive surgery requires surgeons to possess specific skills to master several types of specialized laser units. To learn these skills, it is recommended that surgeons, particularly those interested in laser refractive surgery, including LASIK and PRK, follow specific courses, such as the Inter-University Diploma offered in partnership by the Université de Bordeaux, the Université de Toulouse,and the Université de Besançon.

  Anterior segment and cataract surgeons already perform lens-based refractive surgery, using toric and multifocal IOLs to correct blurred vision, astigmatism, and presbyopia. In fact, many surgeons who perform lensbased refractive surgery regularly are now also mastering laser-based techniques. The introduction of femtosecond laser technology to the field of crystalline lens surgery will probably continue to strengthen this trend toward refractive lens surgery. Damien Gatinel, MD, PhD, is a cataract, corneal, and refractive surgery specialist. He is an assistant professor and head of the Anterior Segment and Refractive Surgery Department at the Rothschild Ophthalmology Foundation,Paris. Dr. Gatinel is a member of the CRSToday Europe Editorial Board. He acknowledged no financial interest in the material presented in this article. Dr. Gatinel may be reached at +33 1 48 03 64 82; [email protected]

  西班牙

  目前西班牙在屈光手术领域的发展趋势显示出:,表层手术比例呈现上升趋势,特别是优化的表层切削术和PRK手术;第二,有晶体眼人工晶体植入术所占比例也有上升,目前已占接受屈光手术年轻患者总数的4%—5%;第三,越来越多医生采用飞秒激光制作更薄的角膜瓣。

  屈光晶体置换术(RLE)已经逐渐成为50岁以上年长患者的选,这得益于现在手术技术极大地安全性、更加精确的生物测量技术以及高端人工晶体的不断改善。

  准分子激光手术被认为是矫正-7.00D以下近视的金标准。表层手术近年来越来越受到西班牙医生青睐,约占准分子激光手术量的1/3,主要是针对近视度数不超过-4.00D的患者。丝裂霉素C广泛使用,主要用于切削深度较大的患者、近视合并散光的治疗以及增效手术。

  对于近视度数超过-7.00D的患者,选择应当是有晶体眼人工晶体植入术,要求术前内皮细胞计数超过2000个/mm2,前房深度大于2.8mm。在西班牙,80%的有晶体眼人工晶体植入术是后房型,仅20%为前房型。

  Spain

  By Daniel Elies, MD

  Although Spain does not have defined guidelines for refractive surgery, there is a general consensus that surgeons follow regarding preoperative workup, indications, and follow-up for various procedures. It is important to take into account that my country is covered by both public and private health services. The public health care system, which is universal and free, is responsible for approximately three-quarters of the cataract surgeries performed in Spain. The standard public coverage does not include premium IOLs or excimer lasers. Private ophthalmic centers have access to the leading technology in refractive surgery, such as lasers (excimer and femtosecond) and premium IOLs, and they offer a wider range of treatments than public centers.

  Current refractive surgery trends in Spain show an increase in the use of surface ablation techniques, particularly advanced surface ablation and PRK; a rise in phakic IOL implantation, which makes up 4% to 5% of the total refractive surgery procedures performed on young patients; and an increase in the use of femtosecond lasers to create thin LASIK flaps. Refractive lens exchange (RLE) is becoming the technique of choice in patients older than 50 years. This may be due to the safety of the surgical technique,more accurate biometry, and the development of premium IOLs. In Spain, premium lens implantation represents approximately 10% to 12% of the 400,000 lenses implanted per year; of that, of those 40,000 to 48,000 premium lenses, 70% to 80% are multifocal, and 20% to 30% are toric IOLs (data on file with Alcon Laboratories, Inc.,Fort Worth, TX, and Abbott Medical Optics, Inc., Santa Ana, CA). The percentage for premium IOLs is much higher if we consider only patients treated in the private setting.

  The preoperative regimen for patients scheduled for refractive surgery requires a complete ophthalmic evaluation after discontinuation of contact lens use for at least 1 to 2 weeks. The evaluation includes subjective refraction under cycloplegia, slit-lamp examination with emphasis on the ocular surface and the quality of the tear film, mesopic and scotopic pupillary diameter, IOP, fundus examination, and corneal topography and pachymetry. In some cases, corneal hysteresis is also highly recommended. In Spain, the increasing use of customized laser surgery with aspheric

  ablations has made the pupillary diameter less relevant,provided that it exceeds 7.5 mm under scotopic conditions.Examining the tear film and the ocular surface has become more important, because it helps surgeons to decide whether the patient is a candidate for corneal refractive surgery.

  Indications for surgical techniques vary according to the patient’s age. In Spain, refractive surgery is not approved in children, except in cases that cannot be managed with standard treatments such as high amblyopic anisometropia. Individuals must be at least 18 years of age to undergo corneal refractive surgery or phakic IOL implantation; however, surgeons generally prefer patients to be

  at least 20 years old. Corneal refractive surgery is the gold standard for all patients younger than 45 years who meet the accepted dioptric range. In older patients, the surgery of choice is RLE. Some exceptions can be made in terms of age limits. For example, RLE can be offered to younger

  (40-42 years old) high hyperopes and later (±50 years) in high myopes .

  Excimer laser techniques are considered the gold standard for myopic refractive errors up to -7.00 D and are widely used in this country, with approximately 180,000 procedures performed per year (data on file with Alcon Laboratories, Inc., and Abbott Medical Optics Inc.). Surface ablation procedures have recently become more popular among Spanish surgeons, now accounting for almost one-third of excimer laser procedures, mainly in patients with myopia up to -4.00 D. Mitomycin C is widely used, mostly in deep ablations, compound myopic astigmatism treatments,

  and enhancements. For patients with myopic errors greater than -7.00 D, the first option usually is implantation of a phakic IOL. A preoperative endothelial cell count of greater than 2,000 cells/mm2 and an anterior chamber depth greater than 2.8 mm from the endothelium to the lens are required for phakic IOL implantation. In this country, 80% of phakic IOLs are posterior chamber models, and 20% are anterior chamber models.

  In patients with hyperopia of up to 4.00 D, my first option is LASIK using an optical ablation zone of greater than 6.5 mm. When the hyperopic defect is greater than 4.00 D, implantation of a phakic IOL or, if presbyopia is present, a multifocal IOL is recommended.

  The main surgical options for managing astigmatism in young patients include excimer laser ablation or implantation of toric phakic IOLs in those who are not LASIK candidates. For older, presbyopic patients, toric pseudophakic IOLs are the preferred approach. Incisional astigmatic surgery,such as limbal relaxing incisions, has practically been abandoned by surgeons in Spain; it is used only in patients undergoing cataract surgery with monofocal IOLs.

  Intracameral cefuroxime is the intraoperative treatment used for infection prophylaxis in all intraocular refractiveb procedures (whether cataract surgery, phakic IOL implantation,or RLE). Topical antibiotics are prescribed postoperatively for 1 week and topical steroids for 2 to 4 weeks. For LASIK, I prescribe a combination of antibiotic and steroid drops three times daily for the first week and artificial tears five times daily for at least 2 months.

    济南爱尔眼科医院院长,博士生导师、主任医师李镜海教授具有20多年近视手术临床经验:1991年,李镜海教授做了山东省内例近视RK手术;1994年,完成了省内例准分子激光PRK手术;1996年,他施行了省内例LASIK手术……迄今为止,李镜海教授已成功实施近视手术5万例,成为近视治疗领域国内知名专家、教授。

  李院长说:激光近视手术,并非人人适合

  事实上,任何医疗技术都有因人而异的前提。激光近视手术“快速、安全、完美”的特性,亦非在每个人身上尽善尽美。“一般来说,对于度数700度以下,眼部结构正常,角膜厚度足够(因为激光手术需要切削角膜)的近视者而言,如无其他禁忌问题,激光手术可呈现良好效果。”眼科医生介绍,但对度数过高、角膜薄、瞳孔大、曲大的近视者而言,激光手术并不合适。 “当然,这需要通过术前18项详细全面的检查,来确定是否适合手术。”眼科医生告诫想摘掉眼镜的近视朋友:“不可盲目听信广告宣传,要选择大型的正规专业眼科机构,谨遵医嘱,切不可执意而为”。

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