矯視手術 – 告別眼鏡一族的方法?

0

對於戴眼鏡的人士而言，幾乎所有人都曾想過做手術矯正視力，以從此告別眼鏡一族。當進行視光檢查時，自己是否適合做矯視手術往往是應診者最常發問的問題之一。

在不同的矯視手術當中，以激光矯視(LASIK)手術最廣為人熟悉。另一方面，最近一種名為微笑矯視(SMILE)的新型矯視手術漸被關注。甚麼是激光矯視及微笑矯視? 激光矯視及微笑矯視有甚麼分別? 激光矯視及微笑矯視是否適合所有人? 矯視手術可以矯正老花嗎? 矯視手術的副作用是甚麼?

看畢這篇文章後，您就會找到答案。

激光矯視(LASIK)手術

首先，有部分人將激光矯視的LASIK錯誤串成LASER。LASIK其實是激光矯視手術「laser assisted in-situ keratomileusis」的簡稱，意思是用激光切割角膜矯正視力，但正因該手術使用激光，很多人會誤稱為LASER。

近視病人接受傳統的激光矯視手術時，醫生會先利用微型角膜刀在角膜表面造出角膜瓣，在打開角膜瓣後，醫生便會用激光打磨角膜內層以減低屈光不正，最後蓋回角膜瓣1。

根據美國眼科視光協會顯示，激光矯視較常見的副作用包括眼乾及夜間視力變差，同時亦有機會導致其他後遺症如感染及傷口復原不良等，令視力甚至比激光手術前更差2,3。另一方面，中度至深度近視患者接受激光矯視後會較常出現度數回彈4。不過，近年來激光矯視手術也有所改進，包括使用飛秒激光以減少與角膜瓣相關的後遺症5及用波前技術改善視力1。

微笑矯視(SMILE)手術

最近，另一種跟激光矯視效果相若的微笑矯視(SMILE)手術推出市場。SMILE的完整名稱名為「Small Incision Lenticule Extraction」，意思是從微細切口抽走角膜組織矯正視力。與激光矯視不同的是，微笑矯視過程不需牽涉角膜瓣。

醫生進行微笑矯視手術時，會先用飛秒激光直接在角膜內部切割出碟狀組織，再將之從微細切口中取出6,7。微笑矯視可改善部分激光矯視的副作用，例如眼乾6,7。不過，有時候矯視手術後需要再做增進手術改善效果，激光矯視可進行增進手術但微笑矯視方面目前還沒有標準方法8。另外，微笑矯視面世不久，需要更多長期研究確認效果。

矯視手術的注意事項

成功的矯視手術能矯正屈光不正，但當中當然存在不可忽略的限制。接受激光矯視的理想病人需要度數穩定、21歲以上、少於900度近視和200度散光2,9,11。而接受微笑矯視的理想病人為近視度數100度至800度之間並只有少量散光10。

對於遠視患者，激光矯視和微笑矯視的長遠穩定性目前還不確定12,13。另一方面，以激光矯視和微笑矯視矯正老花不太理想，因為矯視手術過後是無法還原的，以及會增加將來進行白內障手術的難度14。

同時，在年輕時進行矯視手術不能預防老花出現，踏入中年後依然需要配戴老花眼鏡。再者，病人應有心理準備矯視手術後視力未必一定非常清晰，亦有機會伴隨出現眼乾和夜間眩光問題9。

還有一點需要留意的是，矯視手術只是在角膜上掩蓋患者的屈光不正，並不能預防或根治深度數帶來的視網膜問題。因此矯視手術後病人仍需每年進行放瞳視網膜檢查保障眼睛健康。

註冊眼科視光師(第一部份)　陳家豪

以上護眼資訊由瑞士寶視光中心提供

地址 : 香港新界荃灣海盛路11號 One Midtown 23樓全層

查詢/預約電話 : +852 2751 8491

網址: www.swisscoat.com.hk

參考文獻:

  1. R., Steinert, A., McColgin, & S., Garg. (2013, December 11). Laser in situ Keratomileusis (LASIK). American Academy of Ophthalmology. Retrieved June 18, 2017, from https://www.aao.org/munnerlyn-laser-surgery-center/laser-in-situ-keratomileusis-lasik-3
  2. Clinical Practice Recommendations. Optometric Co-Management of Refractive Surgery: Laser Assisted In Situ Keratomileusis, Advanced Surface Ablation, Conductive Keratoplasty For Hyperopia. American Optometric Association. Retrieved from https://www.aoa.org/Documents/optometrists/co-management-of-refractive-surgery.pdf
  3. Bromley, J. G., Albright, T. D., Kharod-Dholakia, B., & Kim, J. Y. (2012). Intraoperative and postoperative complications of laser in situ keratomileusis. Expert Review of Ophthalmology, 7(1), 25-31.
  4. Lim, S. A., Park, Y., Cheong, Y. J., Na, K. S., & Joo, C.-K. (2016). Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia. Korean Journal of Ophthalmology : KJO, 30(2), 92–100. http://doi.org/10.3341/kjo.2016.30.2.92
  5. M., Goel, A., Pathak, & N., Afshari. (n.d.). Femtosecond lasers and laser assisted in situ keratomileusis (LASIK). American Academy of Ophthalmology. Retrieved June 18, 2017, from http://eyewiki.aao.org/Femtosecond_lasers_and_laser_assisted_in_situ_keratomileusis_(LASIK)
  6. J., Harvey, H., Fukuoka, N., Afshari, & B., Feldman. (2015). Small Incision Lenticule Extraction (SMILE). American Academy of Ophthalmology. Retrieved June 18, 2017, from http://eyewiki.aao.org/Small_Incision_Lenticule_Extraction_(SMILE)
  7. Reinstein, D. Z., Archer, T. J., & Gobbe, M. (2014). Small incision lenticule extraction (SMILE) history, fundamentals of a new refractive surgery technique and clinical outcomes. Eye and Vision, 1, 3. http://doi.org/10.1186/s40662-014-0003-1
  8. W., Tullo, & J., Owen. (2016, May 10). Will the SMILE procedure replace LASIK? Small-incision lenticule extraction is new application for femto laser. Optometry Times. Retrieved June 18, 2017, from http://optometrytimes.modernmedicine.com/optometrytimes/news/will-smile-procedure-replace-lasik?page=0,0
  9. Is LASIK for Me? A Patient’s Guide to Refractive Surgery. (2008, October). Retrieved June 18, 2017, from https://www.aao.org/Assets/e890eb55-9bfa-465a-8422-8fdbd828518e/635854347414670000/lasik-patient-guide-pdf?inline=1
  10. VisuMax SMILE Procedure Wins FDA Approval. (2016, October 05). Review of Ophthalmology. Retrieved June 18, 2017, from https://www.reviewofophthalmology.com/article/visumax-smile-procedure-wins-fda-approval
  11. D., Huang, B., Feldman, & N., Afshari (2015). LASIK for Myopia and Astigmatism: Safety and Efficacy. American Academy of Ophthalmology. Retrieved June 18, 2017, from http://eyewiki.aao.org/LASIK_for_Myopia_and_Astigmatism%3A_Safety_and_Efficacy
  12. Jaycock, P. D., O’Brart, D. P., Rajan, M. S., & Marshall, J. (2005). 5-year follow-up of LASIK for hyperopia. Ophthalmology, 112(2), 191-199.
  13. Liu, Y. C., Ang, H. P., Teo, E. P. W., Lwin, N. C., Yam, G. H. F., & Mehta, J. S. (2016). Wound healing profiles of hyperopic-small incision lenticule extraction (SMILE). Scientific Reports, 6.
  14. M., Stephenson. (2015, February 05). The Future of Presbyopia Correction. Review of Ophthalmology. Retrieved June 18, 2017, from https://www.reviewofophthalmology.com/article/the-future-of–presbyopia-correction
We use cookies to personalise content and ads, to provide social media features and to analyse our traffic. We also share information about your use of our site with our social media, advertising and analytics partners.
Cookies settings
Accept
Privacy & Cookie policy
Privacy & Cookies policy
Cookies list
Cookie name Active

Privacy Policy

What information do we collect?

We collect information from you when you register on our site or place an order. When ordering or registering on our site, as appropriate, you may be asked to enter your: name, e-mail address or mailing address.

What do we use your information for?

Any of the information we collect from you may be used in one of the following ways: To personalize your experience (your information helps us to better respond to your individual needs) To improve our website (we continually strive to improve our website offerings based on the information and feedback we receive from you) To improve customer service (your information helps us to more effectively respond to your customer service requests and support needs) To process transactions Your information, whether public or private, will not be sold, exchanged, transferred, or given to any other company for any reason whatsoever, without your consent, other than for the express purpose of delivering the purchased product or service requested. To administer a contest, promotion, survey or other site feature To send periodic emails The email address you provide for order processing, will only be used to send you information and updates pertaining to your order.

How do we protect your information?

We implement a variety of security measures to maintain the safety of your personal information when you place an order or enter, submit, or access your personal information. We offer the use of a secure server. All supplied sensitive/credit information is transmitted via Secure Socket Layer (SSL) technology and then encrypted into our Payment gateway providers database only to be accessible by those authorized with special access rights to such systems, and are required to?keep the information confidential. After a transaction, your private information (credit cards, social security numbers, financials, etc.) will not be kept on file for more than 60 days.

Do we use cookies?

Yes (Cookies are small files that a site or its service provider transfers to your computers hard drive through your Web browser (if you allow) that enables the sites or service providers systems to recognize your browser and capture and remember certain information We use cookies to help us remember and process the items in your shopping cart, understand and save your preferences for future visits, keep track of advertisements and compile aggregate data about site traffic and site interaction so that we can offer better site experiences and tools in the future. We may contract with third-party service providers to assist us in better understanding our site visitors. These service providers are not permitted to use the information collected on our behalf except to help us conduct and improve our business. If you prefer, you can choose to have your computer warn you each time a cookie is being sent, or you can choose to turn off all cookies via your browser settings. Like most websites, if you turn your cookies off, some of our services may not function properly. However, you can still place orders by contacting customer service. Google Analytics We use Google Analytics on our sites for anonymous reporting of site usage and for advertising on the site. If you would like to opt-out of Google Analytics monitoring your behaviour on our sites please use this link (https://tools.google.com/dlpage/gaoptout/)

Do we disclose any information to outside parties?

We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information. This does not include trusted third parties who assist us in operating our website, conducting our business, or servicing you, so long as those parties agree to keep this information confidential. We may also release your information when we believe release is appropriate to comply with the law, enforce our site policies, or protect ours or others rights, property, or safety. However, non-personally identifiable visitor information may be provided to other parties for marketing, advertising, or other uses.

Registration

The minimum information we need to register you is your name, email address and a password. We will ask you more questions for different services, including sales promotions. Unless we say otherwise, you have to answer all the registration questions. We may also ask some other, voluntary questions during registration for certain services (for example, professional networks) so we can gain a clearer understanding of who you are. This also allows us to personalise services for you. To assist us in our marketing, in addition to the data that you provide to us if you register, we may also obtain data from trusted third parties to help us understand what you might be interested in. This ‘profiling’ information is produced from a variety of sources, including publicly available data (such as the electoral roll) or from sources such as surveys and polls where you have given your permission for your data to be shared. You can choose not to have such data shared with the Guardian from these sources by logging into your account and changing the settings in the privacy section. After you have registered, and with your permission, we may send you emails we think may interest you. Newsletters may be personalised based on what you have been reading on theguardian.com. At any time you can decide not to receive these emails and will be able to ‘unsubscribe’. Logging in using social networking credentials If you log-in to our sites using a Facebook log-in, you are granting permission to Facebook to share your user details with us. This will include your name, email address, date of birth and location which will then be used to form a Guardian identity. You can also use your picture from Facebook as part of your profile. This will also allow us and Facebook to share your, networks, user ID and any other information you choose to share according to your Facebook account settings. If you remove the Guardian app from your Facebook settings, we will no longer have access to this information. If you log-in to our sites using a Google log-in, you grant permission to Google to share your user details with us. This will include your name, email address, date of birth, sex and location which we will then use to form a Guardian identity. You may use your picture from Google as part of your profile. This also allows us to share your networks, user ID and any other information you choose to share according to your Google account settings. If you remove the Guardian from your Google settings, we will no longer have access to this information. If you log-in to our sites using a twitter log-in, we receive your avatar (the small picture that appears next to your tweets) and twitter username.

Children’s Online Privacy Protection Act Compliance

We are in compliance with the requirements of COPPA (Childrens Online Privacy Protection Act), we do not collect any information from anyone under 13 years of age. Our website, products and services are all directed to people who are at least 13 years old or older.

Updating your personal information

We offer a ‘My details’ page (also known as Dashboard), where you can update your personal information at any time, and change your marketing preferences. You can get to this page from most pages on the site – simply click on the ‘My details’ link at the top of the screen when you are signed in.

Online Privacy Policy Only

This online privacy policy applies only to information collected through our website and not to information collected offline.

Your Consent

By using our site, you consent to our privacy policy.

Changes to our Privacy Policy

If we decide to change our privacy policy, we will post those changes on this page.
Save settings
Cookies settings