2012.11.10(六) 台灣醫學週 近視手術後的注意事項


2012.11.10(六) 台灣醫學週

              近視手術後的注意事項

1.    年紀40歲以上  

   Regression在度數愈多愈會，每年0.06D?10年100度
   40歲以上要留一眼一點度數，或手術後會引起一些high order aberration,看 

   近會較好，遠不行，尤其是spherical ab >0.4uRMS
   Constrast 下降
2. 高度近視手術前、手術後要追蹤
3.  PreLASIK,有small break,lattice 要先預防性雷射治療。
4. 近視雷射手術後13mmHg就有點高標,或&>10 mmHg就要注意
5.  Suction ring 60-70mmHg及LASIK対視神經不會有傷害。不管是對 青光眼或非青光眼的病人, Suction ring 60-70mmHg較怕是會發生CRAO、CRVO

6. 利用OCT可以做青光眼較好的評估
7.  Arcuate scotoma
   Double Arcuate scotoma
8. RNFL loss 在color相片會暗暗的
9. Aspheric IOL 負球面像差會較適合手術後的病人,因為術後會有正   
       球面像差
10. RK病人、尤其高度近視近視雷射手術後會較算不準IOL
11. 年紀大，瞳孔小，做RK矯正軽度近視
12. 高度近視放Toric 眼壓低些較不転
13. YAG laser0.5mj,長差不多好再打，復發性角膜糜爛。打在ant.  
         Stroma
14. OCT有double hump好的，視野最可靠，雷射前做VF評估. VF正常就安心做，因為若現在有青光眼，以後也2-3年才會VF defect.


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