2011-09-08
激光矯視手術後出現不規則性散光致半盲 青年報考消防員夢碎
激光矯視致半盲 青年消防夢碎
經濟日報
9/08/2011
接受激光矯視可為眼鏡一族帶來便利，但有醫生指手術非人人適合，患有青光眼、角膜有疤、乾眼症等都不適宜。
【經濟日報專訊】激光矯視手術可令眼鏡族重現明眸，甚至有助求職，港男港女趨之若鶩，但手術有風險，非人人適合。
有24歲青年以激光「鏟走」400度近視，以報考消防員，但進行矯視手術後，才發現有先天角膜問題，出現不規則性散光，結果失去一半視力，消防夢碎，並要一世戴硬體隱形眼鏡，倘不能及早發現，嚴重須角膜移植。
http://easss.com/eye/lasik
該名24歲青年之所以決定做激光矯視，是由於計劃投考消防員，卻有400多度近視，故接受手術，不料術後數個月卻發現看東西變矇，就算帶眼鏡仍視力不清，約半年前到公立醫院求診，結果發現有不規則性散光。
先天問題 術前檢查未發現
原來該青年出現角膜變形，即使在進行激光矯視前做檢查，亦未必能找到先天角膜問題，屬隱形病人，結果該名患者其後要長戴硬體隱形眼鏡，視力更僅剩一半，亦無法投考消防員。
公立醫院眼科專科醫生羅智峰說，不規則性散光即角膜表面出現凹凹凸凸，出現不同折射，令影像無法聚焦，看東西會「散晒」，但與一般散光可通過配戴眼鏡及軟性隱形眼鏡矯正不同，該名青年必須戴上硬體隱形眼鏡後，加上淚水分泌填補凹凸位置，才可令影像集中一點，惟視力仍會較正常差5成。羅指，該名青年幸好及早求醫，否則嚴重可能要接受角膜移植。
角膜瓣脫落 急送公院縫合
另外，有17歲少年在做完激光矯視後，角膜瓣移位脫落，結果要緊急到公院求醫用針縫合，「如果角膜瓣掉落地下，便會看得好矇，拿到醫院可以先消毒後再用針縫好，但如找不到，惟有以後都要戴眼鏡﹗」
激光矯視主要由兩個部分組成，手術先以飛秒激光或以傳統方法直接用刀（微型切割器），將角膜向橫切開一個角膜瓣，再以「準分子激光」把角膜磨平，改變角膜屈光能力，當屈光能力變低，影像便會退後，以矯正影像在視網膜面前的近視問題；相反，把角膜磨尖，影像便會走到較前，矯正影像在視網膜後的遠視。
醫生：技術成熟 併發症僅0.3%
養和醫院眼科部視力矯正中心主任張叔銘醫生指，04年10月至07年2月該院對3,009隻進行了飛秒激光矯視的眼睛作出研究，結果0.63%（即19宗）有併發症。
張認為，飛秒激光技術現已相當成熟，去年矯視了1,300隻眼睛，出現併發症的機會已減至0.29%，而這些併發症全部都可以在手術期間發現並及時矯正，亦沒有任何視力損失，今年首半年進行矯視的500隻眼睛，亦沒有一宗出現併發症。
張又說，如發現垂直氣體突破，手術時可即時改用傳統手術刀切割，但會令手術風險推高5倍；而發炎則與激光能量太高有關，術後需要用類固醇消炎。
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