Beauty and Ophthalmology ｜ The "spear" of high myopia and the "shield" of the reinforcement of the posterior sclera

Thinking caused by a photo

A photo of a thick glasses of the bottle bottom of the picture has aroused everyone's discussion. Many people are guessing how much degree can the maximum myopia maximum glasses be matched? Some people say that 500 degrees, some people say 800 degrees, some say 1,000 degrees, tell everyone that this high -degree myopia lens is at least 2500 degrees. How can there be such a large degree of myopia? We started the topic of high myopia glasses and Yu Gangfeng's two deans began a discussion of children's high myopia.

Dean Yu Gang told reporters that this child is not an ordinary myopia. This kind of myopia is a kind of severe eye disease called pathological myopia. The problem is not good or not, but as soon as it exceeds 1500 degrees of myopia, the eyes may be blind, even if it is, even if it is After wearing glasses, the vision is also very poor.

Pathological myopia has become the second approximate blind eye disease in our country

Dean Zhang Feng saw the puzzlement of the editor. He told us that pathological myopia has become the second approximate blind eye disease in our country, and there are no pathological myopia in the top three blind eye diseases in Europe and the United States. The incidence rate is very high, far from the world's first place. Now a large number of myopia for children's pathogenesis is found in large numbers. This is a kind of eye disease that severely damages children's vision.

What is the pathological myopia?

Pathological myopia usually refers to the common blind eye disease of the myopia exceeding 600 degrees, the eye shaft is extremely prolonged, and the posterior sclera becomes thinner, the choroid atrophy and retinal degeneration. It can reach 27%to 33%, and the dean began to tell us the story of the pathogenic myopia baby.

If time can flow back:

It was a particularly beautiful evening in the sun. I went out of the clinic and was standing on the 19th floor of Xizhimen to enjoy the beauty of the sunset. The young man, Xiao Weng, wearing thick glasses, standing in front of me, he was indifferent, I motioned the guy to sit on Next, start looking at his case information. 27 years old, with eyes corrected by 1.0. The right eye of the eye shaft is 32mm, the left eye is 31.mm, the computer optometry shows, the right eye is 2100 degrees myopia, and the left eye is 1950 degrees myopia. The right eye has multiple bottom bleeding. Because of the sharp decline in vision, he went to see many many experts. In the end The vision has returned to 1.0, which is a fortunate. If you bleed again, the vision will not be guaranteed in the future

President Medical Intelligence Assistant Xiao Ai interpretation:

In his OCT report, severe macular lesions have appeared in the right eye macular area, and the outer cnv -like changes in the outer retinal retinal (CNV is just an abbreviation, the full name is the newer vascular disease of the vessel). The color arc spots, pigment epithelium atrophy, leopard -shaped eyes, and the retinal veins are severely atrophy. He is only 27 years old, how good he is. The young man was very anxious, and he was very confused that he didn't know how to face these eyes that may be blind at any time in the future (one eye suffered from CNV, and the risk of CNV in the other eye was greatly improved). If time can be flowed backwards, parents are enough to pay attention to myopia when he was young. If a doctor could give him a suggestion at the time, the sclera reinforcement surgery may not be so anxious today in my outpatient clinic.

He made a special trip to me to do the post -sclera reinforcement surgery. The conditions of his eyes were so bad. Considering that again and again, I still did not agree to his surgical requirements. I could see that he was very disappointed when he left. Regret and regret. Obviously, patients who have already occurred in myopia complications have been too late.

President Medical Intelligence Assistant Xiao Ai interpretation:

From a genetic perspective, scholars at home and abroad believe that pathological myopia has a certain genetic model. The genetic model includes multi-gene genetic and single genetic inheritance. Among them, single-gene genetics is divided into ingredients with algenexuality inheritance, ingredients invisible inheritance, X-chain explicit inheritance, X-chain hidden inheritance, and Y-chain genetic method. Pathological approximation is considered to be single -gene genetic diseases, and there are obvious genetic heterogeneity. Foreign reports are mostly genetic in foreign chromosomes. Domestic reports are mostly hidden inheritance in normal chromosomes.

Isn't it easy to watch 3D movies?

Every year, the number of children who look at myopia is very large. Miki and Ophthalmology also have a day -to -myopia clinic every Saturday. I often meet various strange myopia babies. One day, after a 7 -year -old child's outpatient optical test, the right eye myopia was 75 degrees long -degree, and the left eye was 1100 degrees myopia. Inquiring in detail, the school's physical examination found that the left eye was myopia. The teacher asked the parents to check it. The eyes can be seen clearly, not serious. With the glasses casually, the child didn't want to wear glasses and didn't wear it. As a result, high myopia eyes grow very fast each year. The gap between the two eyes is getting bigger and bigger. Now the child does not have a three -dimensional view. The loss of three -dimensional vision is that they ca n’t see 3D movies. When they say that they are big, they are also affected. Many high -end occupations cannot be engaged in. This child needs to perform post -sclera reinforcement surgery immediately, but due to the old age, the amblyopia treatment after surgery has no hope of recovery.

There are also Li Zhi and Li Gui with high myopia?

In daily life, many ophthalmologists are also unclear and highly high myopia and simplicity of myopia. The famous classical long novel Water Margin has a true Li Zhi and a fake Li Zhi, called Li Gui. Is Li Zhi or Li Gui who really want to identify high myopia? Children are also 1,000 degrees myopia. The simple high -vision is highly myopia after 20 years of myopia. Pathological myopia is growing every day. Some 40 years old and 50 years old. After the age, you can even reach more than 3,000 myopia. Simpleopia is highly myopia. After 20 years of age, a laser surgery has a vision of 1.2. Pathopathological myopia is not so optimistic. It is best to perform a sclera reinforcement surgery at the age of three or three to prevent the development of myopia. President Medical Intelligence Assistant Xiao Ai interpretation:

There are two types of clinical practice, one is after the body development is completed (about 20 years old), and the axis continues to grow until the end of life and the retractable retinal churchylees caused by the excessive increase of the axis. High myopia for pathological. (Highpathology, also known as high -visual vision of permanent vision, because of the underground lesions, correctional vision is generally lower than normal, and the visual function is poor.

The other is that as the figure is developed (about 20 years old), the degree of eye axis is basically unchanged, and there will be significant lemogenic choroid lesions. Function prognosis is better.

These two high myopia eyes are difficult to distinguish between children and adolescents. It takes a long time to observe and observe the axis. Especially in the first age of children and adolescents is the fastest period of myopia. At this time Missing good opportunities for treatment. Therefore, it is very important to judge whether it is pathological myopia. You must find the right doctor.

Refresh the ultra -high myopia baby we know.

A two -and -a -half -year -old baby came from the clinic one day. The child was about the distance of the palm of the lollipop. I have made a myopia with more than 2400 degrees of optometry, and the eyes of more than 2400 degrees. At such a small age, such a high degree still refreshed our perception of pathogenic myopia. Checking the bottom of the eye found that the entire eye retina has shrunk. The pathological myopia of the child has reached level 5. Considering that the surgery is still very dangerous, the child will be introduced to Professor Chu Renyuan in Shanghai. Later, after reading it after watching it, I felt that the operation was still too dangerous. In the end, the child still failed to perform surgery. This case shows that the degree of high myopia with myopia with high myopia has nothing to do with age. of.

President Medical Intelligence Assistant Xiao Ai interpretation:

The pathogenesis:

The study of pathological myopia and pathogenesis at home and abroad has a history of more than 200 years. It has not been fully clarified so far. It involves the anatomical structure, physiological biochemistry, systemic immune system, endocrine system and nervous system. Micro -morbid development trend.

Reinforcement of the reinforcement -ahead of surgery.

Dean Yu Gang told us that the post -sclera reinforcement surgery was a preventive surgery. Once the child was diagnosed with pathological myopia, this plan is to be planned in the early days. The purpose of surgery is to control the growth of the eye shaft and protect the bottom of the eye, rather than improving the vision of naked eye and reducing refractiveness. This is the most important difference between posterior sclera reinforcement and all other myopic eye surgery. The post -sclera reinforcement has played a basic purpose of delaying or stabilizing the growth of the eye shaft.

Director Yu, you can "kill" me.

There are many outpatient clinics, and there are always some impressive cases. This day is another day of diagnosis. A small patient is very young, but the degree is not small. The mother's face is sad. Director, you see that my child's myopia rises, and the axis can not be controlled. I don’t show my children at home. I don't know what the child is going on. Many years of medical experience,

This may be a pathological myopia baby. He immediately asked the medical history: "Who is your family highly myopia? Including the previous generation", "We are all good. Without high myopia, his dad will be two hundred degrees." I looked at Dad in a blink of an eye, and his eyes flickered. I seemed to smell a little clues. "Nurse, please give your child a few inspections. By the way, you can also take an eye photo for his dad and stick to the child's medical record." The father who just went out for a long time returned to the clinic while his mother was not here: "Director Yu, you can kill me." "Director, my left eye is highly myopia, and I can hardly see it, but the child and his mother never know. But my right eye is good."

Later, the child was inspected the standard of the myopia in accordance with the pathogenic myopia, and there were genetic factors. We had a postplane reinforcement surgery for the child. The postoperative control effect was very good. This dad and I became good friends.

What are the reinforcement surgery in the domestic post?

Left Figure: Four -piece surgery Positive view Right: Four -piece surgery after surgery

Left: Positive surgery Positive view Right: Belt surgery back

[Improved four -piece post -scleral reinforcement]: It has an exact treatment effect on delaying children's high -level myopia development. The operation is simple, the damage is small, ignoring the risk of injury of the macular injury, and it is suitable for patients with high myopia for children.

[Improved pocket pocket post -routing sclera reinforcement surgery]

The operation is difficult, the surgical effect is long -lasting, and it is suitable for all pathological myopia.

[Small incision quickly restores tunnel -type post -scleral reinforcement]

This is a new type of surgery in our beauty and ophthalmology. After surgery, the trauma is small. Patients do not need to be hospitalized, recover quickly, have light response after surgery, and have good postoperative effects. Compared with traditional surgery, it is necessary to lose a monthly hormone. It is precisely because of this minor trauma that the children have reduced the risk of postoperative complications with hormones. We have done hundreds of patients, the youngest child is two years old, the maximum age is 47 years, and the number of myopia is the smallest. 600 degrees, the maximum number of myopia is 2500 degrees. We find that the younger the age, the faster the postoperative recovery, and the better the effect of myopia control. [Post -sclera shortening]

This surgery is only for adult pathological myopia, and patients with lesions with advanced macular and vision are less than 0.1. He also needs to pierce many water from the eyeballs. The sclera should be shortened during the operation. Surgical surgery is not suitable for children, and it is only suitable for advanced pathological myopia adults with severe underground lesions.

Will high myopia really inherit?

Once as a doctor just live broadcast online, a two -and -a -half -year -old baby mother asked for help. The child's eyes were highly myopia at 1200 degrees, and my myopia increased by more than 200 degrees every six months. Beijing, Guangzhou, and Shenzhen visited famous doctors. In the end, they were very short due to their small children, and the foreign sclera materials were very short. You need to observe the rejection of surgery. Now there are 5 old people in the baby's family who have lost usefulness because of the pathological high myopia. Dad Now one eye is blind, and the other eye has only 0.04 vision. Dr. Yu Gang had a linked wheat with him in the video. For this congenital ultra -high myopia child, the surgery was in every second. When the child was three years old, the parent of Xinjiang made a special trip to Beijing Meihe Ophthalmology. Dean Zhang Feng urgently allocated the heart valve reinforcement material for him from other places. He successfully performed the post -sclera reinforcement surgery. After surgery It has been wearing a lockest soft mirror. Now it has been three years of operation. It is worthy of being happy that the number of children's number of annual growth is only 25 degrees. After the operation of Dad, I sent us a video. Thank you for saving the child. Now every 4 months, we Dad will report to Dean Zhang through remote video consultation.

No one has me, people have me new, people have changed

Left: Dr. Zhang Feng Right: Dr. Yu Gang

In recent years, there are many major breakthroughs in Midea and Ophthalmology. Due to the introduction of heart valve materials, the reduction of surgical age, the improvement of surgical technology, and the successful research and development of minimally invasive tunnel -type surgery. The sclera is reinforced, and no longer need to wait until the age of 18 years of the eye lesions. The tragedy that causes the blindness of some children. Today, the pathological high -myopia of Midea and Ophthalmology can accept new, minimally invasive, and modified tunnel reinforcement surgery. The earlier the reinforcement surgery, the more valuable vision can be saved by the child. After the operation, the children will immediately wear the high -tech "separation soft mirror" of myopia and the videos of the videos of the vision. The free myopia prevention and control training is arranged, and the combination of boxing control myopia. During the child's most valuable visual physiological development period, the child's valuable vision is saved.

Left: Dr. Zhang Feng Right: Dr. Yu Gang

President Medical Intelligence Assistant Xiao Ai:

Research on genetic epidemiology in the past showed that pathological myopia has obvious family aggregation and is a single -gene genetic disease with a genetic degree of 100%. Many studies at home and abroad have shown that pathological myopia is hardly affected by environmental factors and is determined by genetic. Hu Xuanning and Chu Renyuan had studied two large -scale myopia twice studies, and found that the myopic consistency rate of pathological myopia and oval twins was 100%, and the genetic degree was 1%.

President Medical Intelligence Assistant Xiao Ai:

The posterior scleral reinforcement surgery has been followed up for more than 10 years. Ophthalmologists have found surgery. There are few CNVs after surgery, which is far lower than the incidence of high myopia CNV. It has a certain effect on protecting high myopia and preventing CNV. Polyclastic reinforcement surgery has directly reinforced the scleral membrane, which improves the weakness of the high myopular posterior sclera, and improves the micro -ring in the ischemic and hypoxic area of ​​high myopia macular area. Because the operation is to reinforce and support the rear part of the eyeball to achieve the purpose of preventing the number of myopia from further increase and further visual function.

Mom unexpectedly surprised after surgery?

The mother of Pingping (pseudonym) is an engineer, grandfather, mother, two uncle family. The grandfather is a pathological myopia. There are 11 elders who have more than 1,000 degrees myopia. After Pingping was born, the mother was one year old. At the time, he checked his eyes and screened it. I didn't want to. The child was still recruiting. The doctor told his mother that the child's 400 myopia is likely to be a pathological myopia. At the age of 4 The growth rate exceeded 200 degrees, and her vision of her glasses was only about 0.3. Uncle Zhang Feng performed a reinforcement surgery for him. Due to the epidemic relationship, he came to the hospital for an examination. The miracle occurred. Only 50 degrees long, and there are even more surprising results. Ping Ping's vision has reached 0.7. We had surgery at the age of two. " President Medical Intelligence Assistant Xiao Ai:

In this regard, Dean Zhang Feng checked a large number of literatures, and the effect was related to sclera factors. Studies such as Hayashi and others found that the thickens of the polar elevation can affect the best correction vision. After high myopia, the polar scleral film is thinner than positive eyes. After the reinforcement of animal -derived materials, the sclera becomes thicker, which provides a scientific basis for the improvement of the vision after the stamina. The most intuitive change of the posterior scleral reinforcement surgery is to increase the thickness of the post -polar sclera,

Dean Zhang patiently told his mother that many young children's vision can increase after surgery, but not all children can change so. It is difficult for adults to increase vision after surgery. This is why we emphasize that once the pathological myopia is diagnosed, the post -scorch reinforcement should be done as soon as possible. At that time, I saw that you were particularly anxious and not as optimistic as the surgical effect. After listening to Dean Zhang's words, his mother broke his nose.

President Medical Intelligence Assistant Xiao Ai:

Medical interpretation: McBrien and others found that the sclera becomes thinner due to the substantial reduction of the sclera, not just because of the mechanical pull. In high myopia, the elevation metabolism changes, and the high expression of the conversion factor causes abnormal collagen structure. The diameter of collagen fibers is reduced, the collagen fiber synthesis decreases, and the decomposition increases and the thinning of the sclera finally causes the eye axis to prolong.

High myopia is too much harmful?

Pathological myopia will bring a lot of harm, including: retinal detachment, macular crack holes, retina, veins atrophic, postplane grape swelling, restricted internal strabismus, glaucoma, cataract.

Left: Pathological close -up retinal cracks. Right Figure: Retinal laser laser closure

Professor Chu is a senior consultant of Mimi and Ophthalmology.

Dean Yu Gang told us the relationship between him and the post -sclera reinforcement surgery: "I started to engage in the research on pathogenic myopia in 1992. At that time, I also visited the Micro Surgical Center in Fedlov, Russia. Coincidentally, Professor Chu Renyuan also went to Russia to do academic visit and exchanges. Professor Chu Renyuan was dedicated to the treatment of children's pathogenesis. Three years ago, we also specially hired Professor Chu Renyuan to teach as Beijing Meihe Ophthalmology Children's Pathopathy Myopia. Senior consultant at the surgical center, professors often go to Beijing Meihe Consultation for surgery.

Do you need other treatments after the stamina reinforcement surgery?

After surgery, we should also wear a separate soft mirror as soon as possible to do network amblyopia training for children as soon as possible, amblyopia training, and desktop automatic reversal mirror training to help them improve their vision and restore visual functions. After child surgery training.

Is the posterior scleral reinforcement big or disadvantage?

Many parents have insufficient understanding of the harm of high myopia, or they have missed the best opportunity for surgery, which eventually led to the broken holes, departure, bleeding, and severe vision damage, and parents regret it. Dean Yu Gang reminded repeatedly here: The litage of surgery is far greater than the disadvantages.

President Medical Intelligence Assistant Xiao Ai:

Some scholars have proposed that the surgery of the posterior sclera reinforcement has a positive effect on preventing the occurrence of retinal splitting and visual prognosis. About 3 weeks after surgery, neonatal blood vessels have grown between implant and sclera, and the growth of new blood vessels grows at the peak at 12 weeks. The increase in postoperative blood vessels improved the nutritional status of the post -eyeballs, which helps improve the patient's visual function. At the same time, the enhancement of the "new sclera" resistance relieved the tension of the retinal veins vascular vascular vascular vascular. It also helps improve blood circulation. A few patients have no change in refractiveness after surgery but increased vision. closely related.

Left: Dr. Zhang Feng Right: Dr. Yu Gang

What kind of material is better for the reinforcement of the reinforcement?

This problem is the most concerned on ophthalmologists and mothers. In the past 50 years, ophthalmologists have made countless attempts. With the continuous development of ophthalmology technology in recent years, the materials of the reinforcement of postplane film have also been optimized and improved. The material with the reinforced film can be divided into biological materials and synthetic materials. Among them, biological materials mainly include pericardial membrane, foreign scleral film, umbilical cord, ductilular, dehogenetic leather, etc. Non -biological synthetic materials mainly include polyester Fiber network is polyester tablet, gelatin sponge and plasma chemical improvement,

The ideal reinforcement material should be biocompatible, sufficient sources, easy to cut, easy to save, and can survive with the eyeballs for a long time. It is easy to be "degraded". It is easy to integrate new blood vessels with the surface of the surface, which can improve the blood supply of the vessel. It is also necessary to consider the rigidity, elastic modulus and fracture strength, calcification and other properties of the material. From the above perspective, although non -biological materials cannot be degraded, it does not blend with the surface sclera, and the new blood vessels are not easy to grow, so that the blood supply to the veins cannot be improved, so the application is limited.

Dean Yu Gang said: "The answer is yes, animal -derived materials, and heart valve materials are the most ideal choice of surgical materials."

The skill of heterogeneous sclera materials is slightly insufficient.

Dean Zhang Feng explained that most of the domestic hospitals are used by foreign scleral materials. Although the albumous sclera is good, the source is insufficient, and the conditions of the materials are unstable (different ages and different development status), and it is easy to be absorbed or calcified. Lost the effect of reinforcement surgery. Simple popular science, the materials are implanted for three to five years, and some of the foreign scleral membranes are gradually absorbed. The effect of the surgery is gone. The eyes of the child will grow crazy like before. It is the fundamental reason for the recurrence of myopia after surgery.

Niu Xinbao material is also called animal -derived material

Medical Intelligence Assistant Xiaoai:

Fresh bull -hearted bags have almost completely removed the cell components in the tissue after the cell treatment and further cross -linking of the cells. The ability to implant tissue and resist stretching deformation significantly enhances significantly. After the cross -linking, the bull -hearted bag material not only greatly improves the mechanical strength, but also has a light inflammatory response and good resistance to degradation. It can be stored in the human body for a long time without being degraded and absorbed, and the biocompatibility is good. The pericardial supplement is used for myopia surgery. The doctor observed that this material is not absorbed and can form a solid "marriage relationship" with the sclera. We have used both materials. In contrast, it is found that the medium -alverly cross -linking cattle heartbag materials are better than [Alien sclera] in terms of rigidity, elastic film, fracture strength, and long -term effects.

How long can Niu Xinbao material grow in the eyes?

This kind of bull -hearted material was first born in the British hospital. The earliest patients who have accepted Niu Hexbao materials. Patients who have been transplanted by heart valve have been 47 years. Patients are patients with severe heart disease. Before surgery, there was almost no work ability due to heart disease. He changed his heart valve through the cow heartbag material. After changing the valve, his heart disease was completely cured. This person still lives healthily and works. Our beauty and ophthalmology are used to moderate to cross -linking bull -hearted materials. He is more suitable for the growth needs of the child's eyes to strengthen the child's eyes.

The stones of other mountains can attack jade.

In the field of medicine, every industry has its own implant materials. We use the best materials in the heart field for the posterior scleral reinforcement surgery of the ophthalmology. In fact, pathological myopia is an innovation and revolution. You can imagine that the heart surgery is more delicate, and the heart valve is the key organs of human life. Can heart surgery be used? Isn't it more advanced to use it?

What are the stories of Niu Xinbao Materials?

Several experts have specially went to the "explore class" to produce special bull farming bases for cowbon -producing materials and biological factories that produce cattle heartbag materials. This kind of beef dedicated to heart valve transplantation is a special breeding cow. There are special persons raised, professional archives record, each part of the cow heart package has special files after the material is taken, which is convenient for real -time tracking. This material is specially biochemically, physical treatment, medical testing. Strict biomedical testing standards stipulated in the state, and then through a series of scientific processing of biomaterials factories, testing, can only enter clinical use after performance testing. You say how good the new animal -derived materials are, and the foreign body, and the foreign body After the sclera is removed from the eyes of the donor, it does not have such a high treatment. After simple treatment, it is used clinically.

At present, there are very few doctors who use heart valve materials to make thick sclera. Many children have lost their best treatment age in the process of waiting for materials.

Is children's pathogenesis waiting or treating?

Watching these highly pathological myopia children grow every year. At present, domestic and foreign countries do not have a solution to solve the cause of the cause. There are very few children's ophthalmologists who engage in the reinforcement of sclera. Waiting for the child's eyes to have a problem, and even on the verge of blindness, we came to seek medical treatment, and what our doctor can do is so limited. For example, the pathological myopia has a crack hole and the retina. If glaucoma is issued, then we can only perform glaucoma surgery. As doctors, they all understand that these dead sheep's surgery can only try to maintain the status quo to slow down the worsening of the condition and delay the time of blindness. So is there a way to plan ahead? The answer is yes. The reinforcement surgery of the posterior scleral film is a kind of prevention surgery. Domestic ophthalmologists have formed a consensus. They have increased by 100 degrees each year. Reinforcement surgery to prevent children from developing to deterioration.

Yu Gang's expert team obtained the brand doctor team left: Dr. Zhang Feng right: Dr. Yu Gang

You are not alone in the battle

Dean Yu Gang said that because pathological myopia is a hereditary eye disease, some children will still increase myopia after the pyrumine reinforcement surgery is performed. Beijing Meihe Ophthalmology has carried out a new method of controlling myopia after surgery. For children who meet the conditions of use after the surgery of the surgery in our hospital, the use of the lighting instrument to combine the progress of myopia under the strict supervision. This is us. A caring public welfare project made with [Three Generations] Yuguang instrument manufacturers, a fertile instrument of 1,1800 yuan. Children who have done surgery here are free. Surgery combined with the effect of lighting instruments is satisfactory, and the child's growth rate is significantly slowed down from the surgery. I hope that more caring companies will participate in this public welfare project. Two hours of interviews quickly passed. Next, the two deans still have surgery. Children with congenital pathological myopia are unfortunate, but they are lucky because there are so many doctors who are working hard to work hard Studying this genetic disease, and modern and high -tech surgical methods can treat this disease. We sincerely wish the two doctors. I can help more highly myopia children through this new surgery and new treatment technology.

(Finally, I would like to thank the Meihe Smart Assistant Xiao Ai -Director Guo Lili of Ophthalmology for consulted a large number of literatures and provided various ophthalmology theoretical support for the technical views of this article!)

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