عینک eyewear

از هر 200 عمل ليزيك چشم در ايران يك عمل منجر به كوري وكاهش ديد در فرد ميشود دكتر هرمز شمش با بيان اين مطلب افزود متاسفانه به دليل ورود بدون كـنترل و محدوديت دستگاههاي گران قيمت ليزيك به داخل كشور و راه اندازي موج بزرگي از تبليغات مثبت بدون آموزش عوارض منفي اين عمل موجب شده تا در ايران بيشترين استـقبا ل از اين عمل نسبت به ساير كشورهاي دنيا وجود داشته باشد وي ابتلا به كوري و كاهش ديد را بهايي سنگين براي خلاصي ازعينك دانست و ادامه داد ا حتمال ابتلا به عوارض جزيي نظير مبدل شدن فرد نزديك بين به دوربيـن -ايجاد لك قرنيه-عفونت چشم- تـنگ شدن شبكيه-انسداد عروق چشمي- بسيار بيش از يك در 200 عمل است كه معمولا بسياري از افراد از اين موارد بي اطلاع بوده و انجام اين عملها را صد در صد موفق و بي عيب مي پندارند.

دكتر شمس افزود تنها كاري كه وزارت بهداشت ميتواند انجام دهد تدوين دستورالعمل مشخصي براي پزشكان است تا انجام اين عمل گران قيمت را براي هر فردي توصيه نكنند و فقط در مواردي كه مطمئن باشندمثبت وكارامد است از اين عمل استفاده شود .وي مدت انجام عمل ليزيك چشم را حدود 3 دقيقه و هزينه آن را بيش از دويسـت هزار تومان عنوان كرد و گفت گران بودن هزينه خريد و نگهداري دستگاههاي ليزيك چشم عمده دليل بالا بودن قيمت اين عملها است و همچنين بعضي از پزشكان براي درامد بيشتر تمايلي به آگاهي بخشي و آموزش عمومي نسبت به عوارض منفي و خطرناك اين عملها در جامعه ندارند.

eResearch by Navid Ajamin -- winter 2009

عوارض عمل لیزیک چشم

• وجود مشکل دید به هنگام رانندگی در شب و سختی مطالعه
• احساس خستگی در چشم
• تاری دید و مه آلودگی دید
• خشکی چشم
• حساسیت به نور
• بازگشت مقداری از عیب انکساری چشم
• ایجاد انواع آستیگماتیسم نا پایدار و نا منظم
• عدم بهبود کامل عیوب چشم ها
• عفونت قرنیه
• هاله بینی مخصوصا در شب
• دوبینی در روزهای ابتدایی بعد از عمل
• حساسیت به نور در هفته های اول که با عینک آفتابی کنترل می‌شود
• نیاز مبرم به عینک آفتابی استاندارد
• نیاز مبرم به عینک های طبی جهت استفاده از گوشی هوشمند و کامپیوتر
• مشکلات دید در شب
• امکان ایجاد آستیگماتیسم ناخواسته
• امکان عفونت قرنیه در صورت عدم رعایت مراقبت‌ها
• ایجاد بیماری های ناشناخته و متقاوت که بیماران گزارش می کنند مثل تغییر در رنگ ها و ...
• ...

عوامل خطرساز جراحی:

تمامی افراد، واجد شرایط انجام لیزیک نمی باشند. شرایط خاص و عوامل آناتومیک می تواند خطر ابتلا به یک نتیجه نامطلوب را افزایش داده

این موارد بدین ترتیب می‌باشند:

• قرنیه های بیش از حد نازک یا نامنظم
• مردمک بزرگ
• عیوب انکساری شدید
• نوسان در بینایی
• خشکی چشم
• سن شما (بیش از 50) و کمتر از 18
• باردار بودن ،پرستاری
• داشتن اختلالات خودایمنی
• ...

Complications that result in a loss of vision are very rare. But certain side effects of LASIK eye surgery are common. These include dry eyes and temporary visual problems such as glare. These symptoms usually clear up after a few weeks or months. Few people consider them to be a long-term problem.

Risks of LASIK surgery include:

• Dry eyes. LASIK surgery causes a temporary decrease in tear production. For the first six months or so after your surgery, your eyes may feel unusually dry as they heal. Dry eyes can reduce the quality of your vision.

  Your eye doctor might recommend eye drops for dry eyes. If you experience severe dry eyes, your eye doctor may recommend additional management, including tear drain plugs or medicated eye drops.

• Glare, halos and double vision. You may have a hard time seeing at night after surgery. This usually lasts a few days to a few weeks. You might notice increased light sensitivity, glare, halos around bright lights or double vision.

  Even when a good visual result is measured under standard testing conditions, your vision in dim light (such as at dusk or in fog) may be reduced to a greater degree after the surgery than before the surgery.

• Undercorrections. If the laser removes too little tissue from your eye, you won't get the clearer vision results you were hoping for. Undercorrections are more common for people who are nearsighted. You may need another LASIK procedure within a year to remove more tissue.
• Overcorrections. It's also possible that the laser will remove too much tissue from your eye. Overcorrections may be more difficult to fix than undercorrections.
• Astigmatism. Astigmatism can be caused by uneven tissue removal. It may require another surgery, glasses or contact lenses.
• Flap problems. Folding back or removing the flap from the front of your eye during surgery can cause complications, including infection and excess tears. The outermost corneal tissue layer may grow abnormally underneath the flap during the healing process.
• Corneal ectasia. Corneal ectasia, a condition in which the cornea is too thin and weak, is one of the more-serious complications. The abnormal cornea tissue is unable to maintain its shape, which can lead to cornea bulging and worsening vision.
• Regression. Regression is when your vision slowly changes back toward your original prescription. This is a less common complication.
• Vision loss or changes. Rarely, surgical complications can result in loss of vision. Some people also may not see as sharply or clearly as previously.

Conditions that increase risks

Certain health conditions can increase the risks associated with LASIK surgery or make the outcome less predictable.

Doctors may not recommend laser refractive surgery for you if you have certain conditions, including:

• Autoimmune disorders, such as rheumatoid arthritis.
• A weakened immune system caused by immunosuppressive medications or HIV.
• Constantly dry eyes.
• Recent changes in vision due to medicines, hormonal changes, pregnancy, breastfeeding or age.
• Inflammation of the cornea, lid disorders, eye injuries or eye diseases, such as uveitis, herpes simplex affecting the eye area, glaucoma or cataracts.
• Disorders of the cornea, including keratoconus or corneal ectasia.

LASIK surgery is usually not recommended if you:

• Have an eye disease that causes the cornea to thin and bulge, such as keratoconus.
• Have a family history of keratoconus or other corneal ectasia.
• Have good overall vision.
• Have severe nearsightedness.
• Have very large pupils or thin corneas.
• Have age-related eye changes that cause vision to be less clear.
• Participate in contact sports that may be associated with blows to the face.

If you're considering LASIK surgery, talk to your doctor about your questions and concerns. Your doctor will discuss whether you're a candidate for the procedure or other similar procedures.

During the procedure

LASIK surgery is usually completed in 30 minutes or less. During the procedure, you lie on your back in a reclining chair. You may be given medicine to help you relax. After numbing drops are placed in your eye, your doctor uses an instrument to hold your eyelids open.

A suction ring is placed on your eye just before cutting the corneal flap. This may cause a feeling of pressure, and your vision may dim a little.

Your eye surgeon uses a small blade or cutting laser to cut a small hinged flap away from the front of your eye. Folding back the flap allows your doctor to reach the part of your cornea to be reshaped.

Using a programmed laser, your eye surgeon reshapes parts of your cornea. With each pulse of the laser beam, a tiny amount of corneal tissue is removed. After reshaping the cornea, the surgeon lays the flap back into place. The flap usually heals without stitches.

During the surgery, you'll be asked to focus on a point of light. Staring at this light helps you keep your eye fixed while the laser reshapes your cornea. You may notice a distinct odor as the laser removes your corneal tissue. Some people describe smelling an odor similar to that of burning hair.

If you need LASIK surgery in both eyes, doctors will generally do the procedure on the same day.

Special situations

Pregnancy: Hormonal changes associated with pregnancy can lead to changes in the corneal curvature. This change in turn can cause the eye power to fluctuate. So if you are planning to get pregnant in the next 1 year, you should consider postponing the Lasik surgery. The right time is after the pregnancy and period of lactation.

Diabetes: People with diabetes can develop fluctuations in blood sugar levels. This in turn can cause fluctuations in eye power. So for diabetics the rule of thumb is no LASIK unless there is strict control of blood sugar levels for the past several years.

Stability of numbers

Most people tend to achieve a stable eye power by the age of 20-23 years. It is important that eye power is stable prior to considering Lasik. Stable eye power signifies 2 things.

Firstly it signifies that the growth phase of eye has completed and hence the possibility of future increases in eye power is lesser.

Secondly it suggests that the eye is healthy and there are no eye diseases or other external factors like diabetes, hormonal changes etc influencing the eye power.

The truth is, having LASIK doesn't guarantee you'll never have to wear glasses or contacts again. But chances are, you may not need them for a very long time, depending on how old you are when you have your procedure done.

Almost everyone over 40 struggles with at some point, called presbyopia. From the Greek words “presbys” and “opia,” meaning “old man” and “eye” respectively, presbyopia is when the lens in one’s eyes loses flexibility as they age, which affects their ability to focus on things up close. There comes a day when your arm just isn’t long enough — as hard as you might try — to get your phone far enough away from your face so you can actually read your texts. At that point, people typically need reading glasses.

So while LASIK may help correct your vision, it can’t stop the aging process. People who have had LASIK will eventually experience presbyopia too, and may need glasses or contacts.

It is important to realize that presbyopia will eventually affect everyone regardless of LASIK. The age of onset to become presbyopic will not be different if you wear glasses/contacts, have LASIK or are naturally 20/20 at distance.

Reference:

• mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774
• rochestereyecenter.com/blog/cataract-surgery-rochester-ny-0
• dragarwal.com/blog/all-about-lasik/is-lasik-permanent

See also:

• Blurry Vision After LASIK
• Can Myopia Come Back After LASIK?
• Vision Get Worse Over Time After Lasik
• Progression of Presbyopia After LASIK in Early Presbyopia
• Lasek,Lasix or Lasik and PRK side effects ,symptoms ,risks and complications