事件记录
播音员: Access to our experts with in-depth information about the biggest health issues facing you today. 专家与博士. Tom Miller在范围报道.
Dr. 米勒: 嗨，我是博士. 我和米勒博士在一起. 马克》. He's the Professor of Ophthalmology and his practice includes refractive surgery, 也被称为LASIK手术.
Now if we go to the operative day where they're going to have the procedure, is that a fairly involves surgery or is it fairly straightforward, 局部麻醉下完成, 还是需要全身麻醉? 再多描述一下这个过程.
Dr. 》: Yeah, the actual procedure itself is outpatient and pretty user-friendly. 我喜欢这样想. 令人惊讶的是, 大多数现代眼科手术, 至少在眼睛的前部是这样, 这包括激光视力矫正手术, is done with what's called topical anesthesia which means we just actually numb the eye with several eye drops, 大概三到四剂麻药. 令人惊讶的是，这可以导致无痛的手术. ,通常, 视力矫正手术没有镇静剂, 没有四世, and it's done in kind of a clean setting in a laser room but the person doesn't have to change into a hospital gown or anything like that.
Dr. 米勒: So patients coming in for the surgery might be anxious on the operative day. Some people are very concerned about having their eye touched, and I can understand that. 这给人一种神经质的感觉. 你如何让来做手术的病人平静下来? 显然他们会醒着. You mentioned that you're going to use a topical anesthetic so they're going to know pretty much what's going on during the surgery, 我怀疑很多人会感到焦虑. How do you calm them and how do you get them through the surgery so that you have a really good outcome?
Dr. 》: The day of surgery is actually a culmination of a long process of teaching the patient and kind of letting them know what the whole experience is going to be like, 不仅仅是术前, 但在手术过程中以及恢复阶段. 其实对大多数人来说都很容易通过. 大发娱乐真的握着. 大发娱乐的激光室大约有三到四个人. We have nurses and technicians who have been doing this for decades, some of them. So anything from gentle coaching by the surgeon in which there is constant verbal interaction. 有些人甚至称它为“声音本地”, meaning kind of calming the patient by talking to the patient and coaching them and kind of telling them what to expect.
Dr. 米勒: 直言不讳的地方. 这很好. So I'm assuming that they've got to be completely still while that laser is performing the procedure, 做出改变, 在镜头上雕刻.
Dr. 》: 有趣的是 . . . 你完全正确. 这是病人焦虑的一大来源. Not only, number one, we have really strong reflexes to keep things away from our eyes. 这是大发娱乐根深蒂固的想法. The concept of somebody doing something to your eye is unpleasant, 但是再一次, through the educational process and also a very stepwise process where we kind of ease in to the surgery, 令人惊讶的是，几乎每个人都能忍受它.
Part of that process again is the fact that it is pain-free and the laser technology actually tracks the eye just like a weapons technology laser or something would track a target. 这就是激光技术的工作原理, so even though the patient is a little bit worried about not looking in the right place . . .
Dr. 米勒: The laser is sophisticated enough to be able to do that automatically.
Dr. 》: 完全正确. 病人看着一个目标. 外科医生正在调整激光, and then the laser has a camera and/or lasers in it that is tracking the pupil. Between those things, I've never seen one of these laser tracker fail. 它非常非常准确. So if the patient should look away more than about a half a millimeter the laser automatically quits firing.
The actual sculpting or laser ablation typically would last between 5 and 20 seconds per eye, 非常快. In LASIK手术 surgery the initial stage of the surgery is cutting a flap and that takes about maybe 30 seconds, so the actual time under the laser where they are really kind of critical things going on is really usually less than a minute per eye.
Dr. 米勒: 你通常每次只做一只眼睛还是两只都做?
Dr. 》: 非常早期的, we recognized that this was extremely reliable technology and by doing one eye at a time it was mostly just inconveniencing the patient. 很少, we still see patients that are a little bit uncomfortable with the thought of doing both eyes and we offer that option. 大多数人都害怕做这个手术, but by the time we have finished educating them and get them to the day of surgery they are very comfortable.
The other fear that patients have is that they are able to do something to cause a bad outcome, 但事实并非如此. It is such a safe surgery and we have such a low tolerance for risk in an elective eye surgery like this that we have literally made it risk-free in terms of anything the patient can do to cause a bad outcome.
The patient can put themselves at risk by being non-compliant with postoperative care. 有药物，处方眼药水是必需的. There are certain protective and common sense things that are required during the healing period. 除非这, it's almost risk-free and that really boils down to having a good conservative screening process that steers away people who are better served by wearing glasses or contact lenses.
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