Post-RK近視手術後的客製化微創白內障定位手術--- Customized Phacoemulsification for post-RK with VERION™ 20160831新眼光眼科診所 скачать в хорошем качестве

Post-RK近視手術後的客製化微創白內障定位手術--- Customized Phacoemulsification for post-RK with VERION™ 20160831新眼光眼科診所

在20至30年前曾接受過近視手術的患者，許多到這年紀已經有白內障了，要做白內障手術的這類患者免擔心！本診所計算人工水晶體的經驗豐富，您一樣可以達到一次矯正白內障、近視、遠視、散光、老花五合一的治療喔！ 需要請洽詢+886-2-23460266 email : [email protected] 蕭裕泉醫師 潘怡文醫師 新眼光眼科診所 http://www.asianewvision.com.tw Tel: +886-2-234650266 高階五合一近視遠視散光老花眼白內障矯正手術 患者是一位大約48歲的許先生，二十多年前接受過近視矯正手術，二十多年前的近視矯正手術不同於現在的近視雷射，此種手術無法精準矯正度數，是醫師經由經驗使用鑽石刀將角膜做放射狀的切開手術 (Radial Keratotomy)，使前、後角膜皆變平以達到降低近視度數的目的，但術後視力大多不穩定，且隨著年齡增長、老花眼度數增加而視力會顯得更加模糊並影響日常生活。 許先生的職業是外勤郵務人員，他表示在投遞郵件時，常常因為老花度數越來越增加，造成視力模糊而看不清楚郵件上的地址，尤其在騎樓底下或光線昏暗時更是看不清楚，這狀況造成他工作非常有壓力。於是經由郵局同事介紹新眼光眼科診所，恰巧許先生他多年前也曾到我們診所給蕭醫師看診過，於是滿懷信心來到我們診所，希望蕭醫師盡快幫他解決這惱人的問題。 Dr. Masket firmly believes the post-RK eye "is such a moving target, a multifocal lens should not be considered—it will fail unless we achieve absolute or near emmetropia." He noted that the refraction can change from morning until evening and there may be progressive hyperopic shift over time. Barbara Bowers, MD, in private practice, Innovative Ophthalmology, Paducah, Ky., disagrees—she'll bring these patients in at several different times throughout a day "and if the vision is fluctuating a little bit, I'll consider a multifocal. If they're fluctuating drastically between the morning and afternoon readings, I'll tell them point-blank a multifocal lens will make them miserable." Dr. Masket uses four or five devices to find the flattest Ks, and those are the readings he'll use for IOL calculation. Astigmatism is an essential component to evaluate in these eyes, said Barry Schechter, MD, in practice, Florida Eye Microsurgical Institute, Boynton Beach, Fla. "We've had some very nice results with toric IOLs in RK patients who have varying amounts of regular astigmatism," he said. "You want to look for wound gaping. If the wounds have healed nice and tight, you're more likely to get a very stable postop refraction after time, but if you see some gaping, you've got the potential for refractive surprises." If there's "very irregular astigmatism," Dr. Schechter advises against a toric—"you just have to go with a plain monofocal aspheric lens. I've been surprised with the results obtained and with the range of vision possible due to the spherical equivalent." Dr. Masket avoids toric lenses in some post-RK patients "for fear they may someday need a corneal transplant" and because it's rare to have regular astigmatism in these eyes. In general, he advises adding "about a half diopter" of measured IOL power for a patient with four incisions, between 1-1.5 D for those with eight incisions, and 2 D for those with 12 or more incisions. While intraoperative aberrometry may be very useful in eyes having prior laser vision correction, it is less accurate in the post-RK eye, as corneal curvature changes during cataract surgery in these eyes, he added. http://www.eyeworld.org/article-calcu...