• Keratoplasty — the last option to “fix” the eyes if everything is bad (and something about modern methods)

    • Translation

    Nylon 10/0 (to sew the cornea)

    For the “last chance” operation or cornea transplant, donor tissue is needed. Specifically, we are interested in tissue with a thickness of 500–600 microns for penetrating keratoplasty. Next you need to work with this film with your hands, sew with a thin nylon thread. Then, when the cornea grows together, remove the suture. No biodegradable materials — their decay products will begin to lysing and can cause inflammation, which will exclude a positive result of the operation. Moreover, the transplant is recommended to flash twice around the perimeter — this increases the chances of its correct and uniform fixation. The second layer of nylon is most often not removed at all, because as long as it does not interfere, we don’t touch it.

    But let's start from the beginning. Specifically, from situations where a person may need this difficult for Russia operation, but quite familiar in Germany. It is of three types:

    • PKP, that is, the removal of the entire cornea of ​​the patient, for example, with a diameter of 7 to 8.5 mm and sewing on a new one.
    • DALK, that is, corneal tissue transplantation with the exception of the Descemet's membrane and endothelium.
    • DMEK, that is, the «installation» of only the layer of the Descemet's membrane and endothelial cells instead of the same layer in a patient.
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  • How do doctors do the vision correction themselves

    • Translation


    Of course, “we cannot do it ourselves” —the surgery requires another surgeon whom you trust 100%. Answering the question of who the relatives trust — I use mine myself. I did the operation to my mother, aunt, daughter, husband — who needed something “to fix”. Walter operated on his wife and father-in-law.

    We can usually do this while shooting or tell how it happens, with the consent of loved ones. We do this when we need to “sacrifice” someone for the sake of science. In our clinic already 6 people after laser vision correction. In the network of clinics SMILE EYES also a few people. The last case — we have 7 years of work in the position of operating nurse-administrator girl Anya, she meets and escorts patients for refractive operations. She is experienced with experience: by the age of 35, fifteen she wore soft contact lenses, sometimes she used glasses. The idea of ​​correction lived in her for all 7 years — as it happens, she saw many times in the form of records from the operating rooms. She saw both Lasik and femtoLasik, and only the operation of vision correction ReLEX SMILE (minimally invasive lenticle extraction) instilled in her confidence in safety and painlessness.

    About Anya: I was preparing for the operation as it should be — for a week I honestly took off contact lenses and used glasses. The patients of the clinic were surprised and asked why she was wearing glasses, explaining that she was preparing for a correction. The day was chosen so that she spent the morning in the clinic; in the afternoon, a correction could be made. On this day, I had several SMILE, several SMILE operations — with Walter, who came from Germany. We agreed that Anya will be operated by Professor Sekundo, and I will help camera operators with shooting.
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  • We implant an artificial lens (you will need it after 60 years)

    • Translation


    The lens in your eye can change its optical power: when you focus somewhere on the vision, this is what happens. Payback for the «moving parts of the mechanism» — wear with age. At about 40-45 years old, problems usually begin with age-related visual impairment; in 60-70 years, you need up to three pairs of different points. At the same time, the clarity of view is reduced due to the process of sclerosis and lens opacity — it is worth thinking about replacing the lens, until it becomes dim and becomes completely rigid.

    To date, the technology of replacing the lens is standardized and well developed. Potential risks are generally somewhat higher than with laser vision correction, but at present this type of surgery is performed even on transparent lenses with refractive purpose (when the patient does not like to wear glasses with thick glasses), that is, it is quite a “household” task for ophthalmology.
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  • Cataract: it is waiting for you personally (if you live, of course)

    • Translation

    This is a model of an intraocular multifocal lens from Carl Zeiss. The real size of such a lens is 11 millimeters, the diameter of the optical zone is 6 mm.

    The cataract is, simplifying, age opacification and consolidation of a crystalline lens. According to the classical definition, we are talking about the turbidity of any type. First, something gets in the field of view, a general “fog” appears, you want to wipe dirty glasses, then you do not see the letters in the book, then you want to turn on the light brighter or, on the contrary, you hide from the bright light, and then wake up one fine morning and understand that you can not find slippers. And you see nothing at all — only the shadows. This process sometimes stretches for many years, but slippers are still lost. Mention of clouding that develops in the eyeball, there are still thousands of years before our era.

    The treatment procedure has historically been very peculiar — reclination of a cloudy lens. The doctor took the patient with a very dense lens — to that dense stage that the patient is already blind. During the excavations of the settlements of ancient Greece and Rome, the tools used by doctors to remove cataracts were found — sharp needles that pierced the eye and lens, destroying its supporting apparatus. The lens could come off and, by virtue of its gravity, could also fall down from hitting the back of the head with a heavy stick several times. Sometimes the patient died during the emergency eye care, sometimes he had a concussion, and sometimes the lens fell off the ligaments and flew deep into the eye. The patient began to see again — he had a huge lump and vision of about +10 +15 diopters.

    Now two news. The bad — people began to live to cataracts more often, and it is inevitable. Good — we have something better than sharp needles and a heavy stick.
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  • IT specialist's vision: what you personally need to know

    • Translation


    — Which is better: glasses, lenses or laser vision correction?
    It is best to see without any means of correction. If you are completely satisfied with the glasses — keep calm, no other correction is needed. Lenses — this method of correction requires adherence to clear rules of use, which is ultimately more costly and risky, but it is very popular because the main dangers do not appear immediately after the start of wearing, but years later.

    — I decided to stay on the glasses, but I am afraid that the car's pillow will open in my face and they will become contact lenses. What to do?
    In my surgical experience, modern airbags do not injure eyeglasses. Eyes and face are usually damaged by windshield fragments. If you are concerned about the safety of glasses, then think about the modern, with polycarbonate lenses, they are incredibly durable, the car drives on crash tests.

    — Is it true that all eye disease from the computer?
    No, it's not true. The main cause of problems with optics — myopia, hyperopia or astigmatism — is genetics. Adverse environmental conditions, especially during long-term work at close range, are important in childhood, when the development of the organism is not yet complete. And such diseases as cataract, glaucoma, retinal detachment and other diseases occur with the same frequency in those who work at the computer for hours and in those who do not know where the computer has a power button.
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  • «Augmentation» eyes: what do we build into it today, and what else will remain under it

    • Translation

    In surgery, the term «augmentation» is used for a specific type of intervention, for example, hardening (building) the skeleton of an organ. We will talk about the empowerment of biological vision at the expense of implants.

    You can not just take out a piece of tissue from the eye, as during laser correction, but also insert something new there. For example, an implant that allows you to see at night. Or DVR. Or — what is being done now — just an internal contact lens made from a biocompatible polymer.

    Therefore, when you read about new opportunities for contact lenses, remember — all this can be built into a person. Of the most promising technologies — transfer images from your eyes to a computer and vice versa. If you are lucky, in 10 years you will be able to search for a given word in a paper book, as you are now looking for on a web page.

    But let's still go back to the real world and talk about phakic lisch, corrective vision for those who can not help the laser.
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  • FAQ about laser correction ReLEx SMILE: yes, in Russia there is, but no, in Russia there isn’t

    • Translation


    — Are small-invasive laser vision correction operations done in Russia using the Small Incision Lenticule Extraction method?

    Yes, about 10 years already. Every year, more and more at conferences of ophthalmologists, questions arise not at the level of “What is this?”, But at specific practical nuances of technology. VisuMax lasers exist in several clinics in Russia, but it is much less used under ReLEx SMILE than under femtoLASIK. Historically, it happened in Russia that this technology is little used in the central part and is actively used beyond the Urals.

    — What is the story with licenses for specific operations?

    Zeiss sells cones with licenses. A cone — a replacement part adjacent to the eye — is purchased with a license to use a laser procedure, usually in batches of 10 or 100 operations. For example, 10 cones and 10 licenses are received. Licenses are driven through the laser menu, and it allows you to use the appropriate cones for the appropriate program types. Licenses for SMILE separately, for femtoLASIK separately, for FLEX, rings and additional corrections are also separate licenses. Most manufacturers of femtosecond and some excimer lasers have a similar situation. Licenses for excimer operations are not needed, perhaps, except on models of about 5 years old and older.

    — And you can not get such a license for SMILE?

    Easily. Firstly, this module in the laser is as an expensive option, so the device itself without the SMILE option is cheaper. Secondly, if this option is available, then licenses to carry out the operation ReLEx SMILE can be acquired only after conducting 5–10 test runs on pig eyes, then performing at least 10 femtoLASIK operations on patients, then 50 FLEX operations, and only after that Buy a SMILE license for a specific surgeon.
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  • AdBlock has stolen the banner, but banners are not teeth — they will be back

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  • A couple more unobvious things that you might not be told before laser vision correction

    • Translation

    Today, without the «tin», as you asked

    There is already a post about how the laser cuts by creating millions of cavitation bubbles in the cornea layer of the eye, and analyzing telemetry from the real operation in seconds with comments of the surgeon's actions.

    Now FAQ about various related things


    — If I look away while the laser is running, what will happen?

    You simply will not work. In fact, immediately after anesthesia, the eye is pressed against a special pneumocapture. To blink at you too will not leave because of fixing (it is not long and not for long). The only moment where it is possible to seriously disrupt the course of the operation is to pull the head down strongly, pulling it out of the headrest by a serious willed effort. In this case, the operation will instantly stop. More precisely, it will stop even before the loss of capture (details below).

    — How should an operating room be prepared?

    In general — as a normal operating room, that is, a room with a clean area (air filtration, overpressure to prevent contamination from the outside after cleaning). It is important for the procedure that microparticles of dust flying in the air do not fall between the laser lens and the eye.
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  • Laser telemetry for vision correction: a complete operation with comments (not for the faint of heart)

    • Translation
    Now I will show what doctors usually never show to patients. More precisely, it shows everything in the form of a beautiful render, from which it does not follow at all that a piece of metal will stick up in your cornea for a couple of minutes. Fortunately, you will not feel this because of the anesthetic premedication, you will not know and do not remember, because the piece of iron will be out of focus.



    So, watch the video, and I will show the frames with comments. This is a real operation on a patient in a German clinic, the recording was made on a device like the “black box” of the VisuMAX device. In this case, the patient has agreed to use the recording for training purposes, usually access to such records is strictly limited.
    Read more →
  • Laser that cuts inside the cornea: ReLEx procedure at the physical level

    • Translation
    The idea — to take and cut a lens in a transparent cornea — is not new. At first it was done manually, with a scalpel directly on the surface (difficult and very rough, with a sea of side effects). The first laser was used in 1979, then it was a pulsed infrared emitter with an effective pulse length of 4 nanoseconds.


    Step 1: creating a plasma bubble, in fact — a microburst. Step 2: expansion of the shock and heat waves. Step 3: cavitation bubble (plasma expansion). Step 4: the formation of a parallel slice at the expense of several adjacent laser focus points.

    Read more →
  • Blood sugar and COVID-19

      Novel pandemic is very new for science, often it takes years before scientists prove connection of risk factors and replicate their findings in experimental setups, but it is not the case to wait. I have been observing different facts about COVID-19 and propose “Hypothesis for connection between blood sugar levels and infection”. The only reason I do this now with so many controversies is that I genuinely believe it can save lives. Lives of my friends, and their relatives.

      In the article below I summarise my knowledge on infection and immunity, back it up by links to COVID observations of doctors and scientific papers.
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    • Research in rejuvenation biotechnology – where are we now?



        Certainly this event is an example of some of the people in our longevity community coming in and just taking over a little bit of somebody else's conference to talk about longevity… but really exposing the rest of the community to it. I'm finding that at every event I go to, I'd really love to have conference presentations where I get to talk about some interesting thing about the longevity industry, because there are a lot of really interesting things going on.

        But every presentation turns out to be «hey, we exist, please notice us — because this is really, really important.» Everything that you guys think that you are doing in medicine is about to be up-ended, because suddenly we're going to be actually able to stop people from getting sick and incapacitated and debilitated in old age. This is happening right now, the first rejuvenation therapies exist. But nobody notices.
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      • COVID YAAA! or Yet Another Analyze Attempt

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          Hello, Habr!


          About a month ago, I had a feeling of constant anxiety. I began to eat poorly, sleep even worse, and constantly read to a ton of news about the pandemic. Based on them, the coronavirus either captured, or liberated our planet, was either a conspiracy of world governments, or the vengeance of the pangolin, the virus either threatened everyone at once, or personally me and my sleeping cat…


          Hundreds of articles, social media posts, youtube-telegram-instagram-tik-tok (yes, I sin) content of varying degrees of content quality did not lead me to anything but an even greater sense of anxiety.


          But one day I bought buckwheat decided to end it all. As soon as possible!

          What did you do?
        • How HealthTech Startups Are Leveraging Tech To Combat COVID19?

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            Source: Google Images

            The world has taken aback through the global pandemic of Novel Coronavirus or Covid19. With the spontaneous outbreak of the coronavirus pandemic worldwide, most of us are self-quarantined and taking precautionary measures. The situation is further amplified with an ongoing economic slowdown.

            However, our healthcare industries, startups and front-line medical professionals & staff haven't taken a step back in dealing with the pandemic through innovative healthcare measures that can effectively combat and procure ailing patients from Coronavirus outbreak.
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          • Everything you always wanted to know about human memory (but were afraid to ask)

              Having a good memory is advantageous, even as people stay home amidst the pandemic. Our memories help us maintain an intellectual connection to the world, and keep us from mentally deteriorating.

              Today, we’re launching a new series of articles on memory enhancement, starting with a short overview of how our memory works and the basic training you can undergo to improve it.


              Read more →
            • Turns out internet businesses are sustainable during pandemics. Why? Home Office DNA

                “In 1665, Cambridge University closed because of the plague. Issac Newton decided to work from home. He discovered calculus & the laws of motion.”

                We live in a truly remarkable moment. With the year 2020 and the COVID-19 outbreak employees all over the world are staying home for quarantine, trying their best to sustain the normal flow of life, which means continue working. And this is something new compared to all the previous infectious pandemics humanity has survived through — this time we have the Internet.

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              • Novel Coronavirus nCOV/2019-nCoV/NCP/COVID19: Forecasts, Statistics, Protection, News,[4th reprint, 06.03|

                • Translation

                Translated by authorNovel Coronavirus nCOV/2019-nCoV/NCP/COVID19: Forecasts, Statistics, Protection, News, World: ~2500 [4th reprint, 28.02]



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                In Chinese
                https://hmp.me/cxq9


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                Incomplete data from December 31 to February 19

                imageIncomplete data for the entire period


                New news
                Updated Charts for 2019-nCov

                I started creating my own site, everything new will be on it.

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              • Top 20 Apps that a Healthcare Provider can't Miss

                  • Are you searching for the best healthcare apps?
                  • Want to use a healthcare app that is best in features and functioning?
                  • Looking for the best app for healthcare providers?


                  Here, in this blog, you will get answers to all such questions. Let’s start with some stats and facts related to apps for healthcare providers.

                  1. The mHealth technology market is predicted to grow by 33% to USD 60 bn by 2020 (Marketsandmarkets)
                  2. 93% of physicians find value having a mobile health app connected to Emergency Health Services. (Great call)
                  3. 70% of surveyed doctors use mobile devices in 2016 to manage in-patient data, up from just 8% in 2013 (Black Book Market Research)

                  Read more →