Shadow chasing the wind, persevering: Professor Wang Yan talked about the development and trend of refractive surgery

Editor's Note

In the middle of summer, the sea breeze is cool. On July 9-10, the 21CSCRS conference was held in the beautiful coastal city of Dalian, and wonderful content came pouring in. During the conference, Professor Wang Yan from Tianjin Eye Hospital was interviewed by The International Ophthalmology News, professor Wang highly recognized and endorsed the holding of the conference, and spoke and shared the development and indications of refractive surgery, as well as the latest scientific research achievements of Professor Wang's team.

Refractive surgery develops rapidly, and the four major directions must be firmly grasped

At present, there are many classifications of refractive surgery, and the surgical methods of laser or non-laser treatment are not the same. According to the different surgical sites, it is divided into surface surgery and plate surgery, and the more classic representative methods of surface surgery are PRK, LASEK, TransPRK and so on. Lascopic surgery generally refers to LASIK surgery, LASIK surgery is now representative of femtosecond LASIK, there are new surgical methods are SMILE surgery, SMILE surgery also belongs to lamellar surgery, which is characterized by surgery in the corneal matrix. Professor Wang stressed that no matter which surgical method, the purpose is to allow patients to obtain better visual correction results. At this stage, the development of refractive surgery is very rapid, and Professor Wang summarized the four directions of its development:

First, minimally invasive. From the very beginning of the operation requiring safety and efficacy, to the current minimally invasive surgery, patients are expected to suffer minimal damage. At present, many new surgical procedures have emerged, among which SMILE surgery is one of the representatives of minimally invasive surgery.

Second, diversity. There are many refractive patients, different individuals have different needs, patients can choose different surgical methods according to their own situation, so as to achieve better visual effects.

Third, personalization. In the past, doctors developed different surgical methods according to the needs of different professions, which was a generalized personalization. Now the personalization is more specific, different eye physiological structure has different characteristics, such as corneal thickness, pupil size, Kappa angle size, in order to achieve more accurate surgery, wavefront aberration guidance surgery, corneal topographic map guidance surgery, Kappa angle correction and Q value guidance surgery.

Fourth, intelligence. Intelligence is the development direction of refractive surgery in the future, because the amount of data in refractive surgery itself is very large, and it is hoped that intelligence can integrate preoperative, intraoperative and postoperative data, and further analyze and operate around preoperative screening, intraoperative design and postoperative treatment. Intelligence can go deep into many aspects of surgery, and Professor Wang and his team have also carried out a lot of work and research in the use of intelligence to participate in refractive surgery.

The team strives to engage in scientific research, and the progress is rapid and visible

Over the years, Professor Wang's team has focused on scientific research in three major directions:

One is research around visual science. At present, whether it is refractive surgery or other surgeries on the eye, the ultimate goal is not only to improve vision, but also to improve visual quality. In terms of improving visual quality, Professor Wang's team cooperated with the physical optics team of Nankai University to do a lot of research around vision science and theoretical applications, and achieved certain results.

The second is the study of biomechanics. At present, biomechanics is a hot topic in medical research, including tumor direction and other fields, but ophthalmology has relatively little research on mechanics. Many eye diseases, especially corneal-related diseases, its occurrence and development are related to mechanics, Professor Wang did a lot of research in the early days, from a macroscopic point of view to observe the changes after the organs are stimulated by the level of mechanics; the later in-depth study, from the microscopic point of view, including the cellular level, molecular level observation, after giving mechanical stimulation on the apoptosis, cell proliferation, cell protein degradation and so on What are the effects.

The third is the research of artificial intelligence. At present, artificial intelligence runs through many aspects of ophthalmology, and the artificial intelligence studied by Professor Wang can not only carry out preoperative screening, for example, for refractive surgeons, the screening of keratoconus is a difficult point, and early keratoconus diagnosis can be carried out with the help of artificial intelligence; but also the design of surgery can be carried out, and the surgical accuracy integrated into AI design is significantly improved, and the current level of artificial intelligence even exceeds that of some experienced doctors. This study was rated as one of the top ten advances in ophthalmology, and was called "an alpha dog that can beat refractive surgery" by experts, and the integration of artificial intelligence into refractive surgery is also the future development direction of refractive surgery. Professor Wang said that in the future, artificial intelligence will be integrated into more details, including big data integration, which is used to find problems that doctors are not easy to find in the clinic and promote the development of ophthalmology.

Cross-integration is the trend, and we work together to promote development

The focus of the 21CSCRS conference is cross-fusion, as mentioned by Professor Yao Ke, the president of the conference, cataract and refractive surgery cross-fusion is an international development trend. The cataract field and the refractive surgery field are cross-integrated, and there are many identical parts, but also many different parts.

The same is that they are all doing surgery on refractive interstitials, pursuing visual quality, and even the development trend of surgery is very close. For example, in the field of refractive surgery and cataracts, related surgeries are performed with femtosecond lasers. In addition, there are academic similarities, and many academic papers are published in the same journal. Professor Wang pointed out that refractive surgery and cataract surgery have a lot in common, which is an inevitability of cross-fusion.

Of course, there are many different places: the surgical site is different, refractive surgery is mostly in corneal surgery, cataract surgery is in lens surgery; the purpose of surgery is different, cataract surgery is mainly restorative surgery, it is charcoal in the snow, and refractive surgery is not restoration surgery, it is the icing on the cake, in order to make patients pursue more perfect vision and visual effects.

The development direction of refractive surgery and cataract surgery is becoming more and more consistent, both in pursuit of better visual quality. Professor Wang stressed that refractive surgery and cataract surgery cross-fusion is very necessary, for example, the structure of the eye has a cornea, a lens, they belong to different parts, have different structures, but the cornea and lens must compensate each other, the anterior surface of the cornea and the posterior surface are compensated for each other, and the aberration between the cornea and the lens is also compensated for each other. Therefore, the two majors should do that you have me, I have you, and the cross-integration of the two majors will promote the better development of the entire ophthalmology career.

With the advancement of medicine, cataract surgery has also changed from simple restorative surgery to refractive surgery, "low astigmatism, low spherical aberration, no presbyopia", improving the rate of desuphroscopy and improving postoperative visual quality has become the common goal of ophthalmologists and cataract patients. The original heart is like a rock, and the hard work is committed. The fusion of cataract and refractive surgery has promoted the development of ophthalmology and provided better treatment options and postoperative results for more ophthalmic patients.