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Presbyopia: «menopause» of the eyes in men and women

Время на прочтение9 мин
Количество просмотров922

What do you think, how many operations can be done on one eye? A clinical case of one of my patients confirms that more than 20 operations of various kinds are not the limit. Although, no doubt, this case is a record for Russia and the world of ophthalmology.

In 1978, everything was trivial — there was an 18 year old boy (let's call him “A”) who wanted to become a test pilot like his father. This was hampered by weak myopia of the right eye — only minus 1, it did not interfere with life, but the future pilot needed good vision. He decided to correct the optics of one eye by keratotomy — the old “manual” correction method at the Fedorov Institute (of course, through an acquaintance), but something went wrong. This was the first operation. Then four more in Russia, then seven more — in Switzerland. He did not become a pilot, but he became an oligarch, a man who manages serious business projects, but does not control the situation with his vision.

To me, «A» got completely disappointed in the world of ophthalmology, with 10% vision, the impossibility of correction by standard methods and high intraocular pressure. And it was a young 50-year-old businessman, successful in life (this is important — because not everything went further «like that» either). So — the next eight operations are mine. And although we expected that one or two would be enough — we had to go through almost total ophthalmic surgery — all possible types of operations.

By the way, instead of keratotomy, there would be a correction of SMILE (ReLEX SMILE) or, at least, Femto-LASIK — there wouldn’t be anything to write about — it’s impossible to do anything like that!
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Всего голосов 3: ↑3 и ↓0+3
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FAQ about laser correction ReLEx SMILE: yes, in Russia there is, but no, in Russia there isn’t

Время на прочтение9 мин
Количество просмотров2K


— Are small-invasive laser vision correction operations done in Russia using the Small Incision Lenticule Extraction method?

Yes, about 10 years already. Every year, more and more at conferences of ophthalmologists, questions arise not at the level of “What is this?”, But at specific practical nuances of technology. VisuMax lasers exist in several clinics in Russia, but it is much less used under ReLEx SMILE than under femtoLASIK. Historically, it happened in Russia that this technology is little used in the central part and is actively used beyond the Urals.

— What is the story with licenses for specific operations?

Zeiss sells cones with licenses. A cone — a replacement part adjacent to the eye — is purchased with a license to use a laser procedure, usually in batches of 10 or 100 operations. For example, 10 cones and 10 licenses are received. Licenses are driven through the laser menu, and it allows you to use the appropriate cones for the appropriate program types. Licenses for SMILE separately, for femtoLASIK separately, for FLEX, rings and additional corrections are also separate licenses. Most manufacturers of femtosecond and some excimer lasers have a similar situation. Licenses for excimer operations are not needed, perhaps, except on models of about 5 years old and older.

— And you can not get such a license for SMILE?

Easily. Firstly, this module in the laser is as an expensive option, so the device itself without the SMILE option is cheaper. Secondly, if this option is available, then licenses to carry out the operation ReLEx SMILE can be acquired only after conducting 5–10 test runs on pig eyes, then performing at least 10 femtoLASIK operations on patients, then 50 FLEX operations, and only after that Buy a SMILE license for a specific surgeon.
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Всего голосов 3: ↑3 и ↓0+3
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«Augmentation» eyes: what do we build into it today, and what else will remain under it

Время на прочтение10 мин
Количество просмотров1.2K

In surgery, the term «augmentation» is used for a specific type of intervention, for example, hardening (building) the skeleton of an organ. We will talk about the empowerment of biological vision at the expense of implants.

You can not just take out a piece of tissue from the eye, as during laser correction, but also insert something new there. For example, an implant that allows you to see at night. Or DVR. Or — what is being done now — just an internal contact lens made from a biocompatible polymer.

Therefore, when you read about new opportunities for contact lenses, remember — all this can be built into a person. Of the most promising technologies — transfer images from your eyes to a computer and vice versa. If you are lucky, in 10 years you will be able to search for a given word in a paper book, as you are now looking for on a web page.

But let's still go back to the real world and talk about phakic lisch, corrective vision for those who can not help the laser.
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