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眼睛激光手术是怎样进行的?

How does laser eye surgery work? - Dan Reinstein

“我闭上双眼 世界死去 我睁开双眼 世界重生” ——西尔维娅·普拉斯《疯女孩的情歌》
In 1948, Spanish ophthalmologist Jose Ignacio Barraquer Moner was fed up with glasses.
1948年 西班牙眼科医生Jose Ignacio Barraquer Moner受够了戴眼镜
He wanted a solution for blurry vision that fixed the eye itself,
他想直接从眼睛着手来修复视力
without relying on external aids.
而非借助外部的助力
But the surgery he eventually devised was not for the faint of heart.
但他最终设计出的手术却不适合心脏弱的人
Barraquer began by slicing off the front of a patient’s cornea
首先 Barraquer削下患者的角膜前端
and dunking it in liquid nitrogen.
将其浸泡于液化氮中
Using a miniature lathe, he ground the frozen cornea
用微型机床细细研磨冰冻的角膜
into the precise shape necessary to focus the patient’s vision.
将其磨至能精确聚焦患者视力的形状
Then he thawed the disc, and sewed it back on.
随后 他解冻了角膜 缝回患者眼中
Barraquer called this procedure keratomileusis,
Barraquer将此过程叫做角膜磨镶术
from the Greek words for “carving” and “cornea.”
该词源自希腊词语“雕刻”和“角膜”
And though it might sound grisly, his technique produced reliable results.
尽管他的方法听着有些骇人 但结果却颇为喜人
So how did Barraquer’s surgery work?
那么 Barraquer的手术是怎样进行的呢?
Keratomileusis corrects what are called refractive errors:
角膜磨镶术能矫正所谓的屈光不正:
imperfections in the way the eye focuses incoming light.
也就是眼睛不能聚焦进入其中的光线
Ideally, the cornea and lens work together
正常情况下 角膜和晶状体共同作用
to focus light on the surface of the retina,
使光线聚焦在视网膜表面
but several kinds of refractive errors can impair this delicate system.
但是有几种屈光不正情况会损害这个脆弱的系统
In people with myopia, or short-sightedness,
对于近视患者来说
a steep cornea focuses light just short of the retina.
他们过度弯曲的角膜聚焦的光线抵达不了视网膜
Those with hyperopia, or far-sightedness, have the opposite problem:
远视患者则相反
light is focused too far beyond the retina.
其角膜聚焦的光线在视网膜之外
And in people with astigmatism, the cornea has two different curvatures
散光患者的角膜有两种不同的曲率
which focus light at two distances and produce blurry vision.
使光在两处距离上聚焦 导致视线模糊
Even those with perfect vision will eventually suffer from presbyopia, or “aging eyes.”
即使视力极佳的人最终也难逃老花眼
As the proteins in the lens age, they slowly increase its size.
随着晶状体中蛋白质的老化 晶状体会随之慢慢变大
By an adult’s mid-40’s, the lens is too large
人到了45岁左右 晶状体变得太大
to easily change shape and shift focus.
以致于不能轻易改变形状和调整聚焦
Glasses and contact lenses bend light to compensate for these refractive errors.
眼镜和隐形眼镜可以通过弯曲光线来纠正以上这些屈光不正的情况
But, as Barraquer’s procedure shows,
但正如Barraquer手术展示的那样
we can also alter the shape of the cornea itself;
我们也可以改变角膜的形状
moving the focal point backwards, forwards,
来前后移动焦点
or pulling a divided image together.
或者把分开的影像拉到一起
And thankfully, modern eye surgeons can sculpt the cornea with far less invasive tools.
幸运的是 现代眼科医生可以用安全得多的工具雕刻角膜
In corrective laser eye surgery, surgeons rely on excimer lasers.
在激光矫正眼科手术中 医生用的是准分子激光
These tools are accurate enough to etch words into a human hair.
这些工具精确到能在头发丝上刻字
To safely accomplish these ultra-fine incisions,
为了安全完成这些超细切口
they use a technique called photoablation.
医生们使用了一种叫做激光消融的技术
This allows the laser to essentially evaporate organic tissue
这使得激光可以直接蒸发掉有机组织
without overheating surrounding eye tissue.
又不会使眼部组织过热
So how does laser eye surgery actually work?
那么究竟激光眼科手术是怎么进行的呢?
The first step is to separate a thin layer from the front of the cornea.
第一步就是从角膜前端分离出薄薄的一层角膜
This can be done with either a flat, wide blade, or a femto-second laser
工具可以用一个又平又宽的刀片 或者飞秒激光
that produces millions of tiny plasma bubbles
飞秒激光会产生数百万个等离子体气泡
to create a plane beneath the corneal surface.
在角膜表面下形成一个平面
Surgeons then lift the flap to expose the inside of the cornea.
然后医生揭开上面那层角膜 露出里面的角膜来
Guided by the refractive error and the shape of the cornea,
根据屈光不正和角膜形状
the excimer laser robotically sculpts the exposed corneal bed
准分子激光自动对暴露的角膜床进行雕刻
into the correct shape.
将其刻成能正常聚焦的形状
This process usually takes less than 30 seconds for each eye.
此过程每只眼睛一般不超过30秒
Finally, the flap is closed,
最后 将上层角膜盖上
and its edges reseal themselves in just a few hours.
它的边缘会在几个小时内重新合上
Because the lasering is done on the eyeball itself,
因为激光是在眼球上作业的
it’s described as “in situ,” or “on site.”
所以此法也叫做“原位法”
Its complete name is “laser in-situ keratomileusis”
全名叫“准分子激光原位角膜磨镶术”
but you probably know it as LASIK.
但你大概对LASIK比较熟悉
Essentially, this technique carves a patient’s contact lens prescription onto their cornea.
本质上 这项技术是将患者的隐形眼镜刻在他们的角膜上
Like any surgical procedure,
像任何外科手术一样
LASIK comes with certain risks.
LASIK手术也有一定的风险
Some patients experience slightly blurred vision that can’t be corrected by glasses.
有些患者的眼睛度数较低 不适合戴眼镜矫正
But the technique is currently about as likely to damage your eyes
但目前这项技术对眼睛的伤害
as wearing daily disposable contact lenses for one year.
和持续戴一年的日抛隐形眼镜差不多
Today, a technique called enables surgeons to
如今一种叫做“SMILE”的技术使得外科医生
sculpt the cornea through even smaller incisions –
能够通过更小的切口来雕刻角膜
further reducing recovery time.
大大减少了角膜的恢复时间
And lasers aren’t just correcting the three types of refractive errors –
激光技术不仅仅能矫正三种屈光不正
this technology can also restore aging eyes.
还能修复老花眼
In a technique called Laser Blended Vision,
通过一项叫Laser Blended Vision的技术
surgeons adjust one eye to be slightly better at distance vision
医生先调整一只眼睛 使其在远距离视觉上稍好一些
and the other to be better at close range vision.
再调整另一只眼睛 使其在近距离视觉上好一些
The difference between the two eyes is small enough
两只眼睛的差异极小
that most patients can merge their vision,
因此大多数病人都能合并双眼视力
allowing both eyes to work together at all distances.
使得双眼能看清任何距离的事物
Advances in laser technology continue to make vision correction surgery
激光技术的进步使视力矫正手术
more effective and accessible.
更有效 更容易
One day soon, Barraquer’s vision of a world without glasses
不久的将来 Barraquer设想的没有眼镜的世界
may finally come true.
最终或成现实
Did you know that you’re crying right now?
你知道你正在哭泣吗?
Our eyes are constantly producing tears,
我们的双眼一直在分泌泪液
we go through 30 gallons of tears a year.
每人每年可以产生30加仑泪水
But not all tears are same,
但眼泪并非只有一种
get to know the three different types with this video.
观看本视频了解三种不同的眼泪类型

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视频概述

本视频详细介绍了激光眼科手术的发展史。

听录译者

收集自网络

翻译译者

蜗牛姑娘

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审核员YY

视频来源

https://www.youtube.com/watch?v=XPDVmBg5DeE

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