老花眼：男女的“更年期”

What do you think, how many operations can be done on one eye? A clinical case of one of my patients confirms that more than 20 operations of various kinds are not the limit. Although, no doubt, this case is a record for Russia and the world of ophthalmology.

您如何看待，一只眼睛可以进行多少次手术？ 我的一名患者的临床病例证实，超过20种不同类型的手术不是极限。 尽管毫无疑问，此案是俄罗斯和眼科世界的记录。

In 1978, everything was trivial — there was an 18 year old boy (let's call him “A”) who wanted to become a test pilot like his father. This was hampered by weak myopia of the right eye — only minus 1, it did not interfere with life, but the future pilot needed good vision. He decided to correct the optics of one eye by keratotomy — the old “manual” correction method at the Fedorov Institute (of course, through an acquaintance), but something went wrong. This was the first operation. Then four more in Russia, then seven more — in Switzerland. He did not become a pilot, but he became an oligarch, a man who manages serious business projects, but does not control the situation with his vision.

1978年，一切都变得微不足道了-有一个18岁的男孩(我们称他为“ A”)想要像他的父亲一样成为一名试飞员。 这是由于右眼近视较弱所致-仅减1，不会干扰生命，但未来的飞行员需要良好的视力。 他决定通过角膜切开术来矫正一只眼睛的视力，这是费多罗夫研究所的一种古老的“手动”矫正方法(当然是通过熟人)，但是出了点问题。 这是第一次操作。 然后在俄罗斯再增加4个，在瑞士再增加7个。 他没有成为飞行员，但成为了寡头，一个负责重大商业项目的人，但不能用自己的视野控制局势。

To me, «A» got completely disappointed in the world of ophthalmology, with 10% vision, the impossibility of correction by standard methods and high intraocular pressure. And it was a young 50-year-old businessman, successful in life (this is important — because not everything went further «like that» either). So — the next eight operations are mine. And although we expected that one or two would be enough — we had to go through almost total ophthalmic surgery — all possible types of operations.

对我来说，«A»在眼科学界非常令人失望，它的视力为10％，无法通过标准方法进行矫正，并且眼内压很高。 那是一个年轻的50岁商人，一生成功(这很重要-因为并非所有事物都“像那样”走得更远)。 因此，接下来的八个操作是我的。 尽管我们期望一两个就足够了-我们必须经历几乎完全的眼科手术-所有可能的手术类型。

By the way, instead of keratotomy, there would be a correction of SMILE (ReLEX SMILE) or, at least, Femto-LASIK — there wouldn’t be anything to write about — it’s impossible to do anything like that!

顺便说一下，除了角膜切开术之外，还可以进行SMILE(ReLEX SMILE)矫正，或者至少是Femto-LASIK矫正-没什么可写的，不可能做那样的事情！

不是我的故事 (NOT MY STORY)

So, 1978 — the first operation — radial keratotomy. his is an operation to apply notches manually on the front surface of the cornea. In the 80s, its triumphal procession began — it was widespread in the USSR and in America. If the surgeon's hand trembled — the notch turned out to be a curve or, worse, a through. The middle of the cornea flattened, the optics of the eye became weaker. The number and shape of the notches were calculated by the formulas, but the accuracy was small. «A» got everything at once — the perforation and the curvature of the notch. The cornea «slipped and twisted.»

因此，1978年–首次手术– 放射状角膜切开术 。 他的操作是在角膜的前表面手动施加凹口。 在80年代，它的凯旋游行开始了-在苏联和美国很普遍。 如果外科医生的手发抖-切口原来是弯曲的，或者更糟的是直通。 角膜中央变平，眼睛的视力变弱。 缺口的数量和形状是通过公式计算得出的，但精度较低。 «A»立刻得到所有-缺口的穿Kong和曲率。 角膜“打滑扭曲”。

第二次手术 (The second operation)

is an attempt to trim the astigmatism with notches, but already tangential (longitudinal).

尝试用刻痕修整散光，但已切线(纵向)。

Eye in the process of keratotomy 眼角膜切开术

第三操作 (The third operation)

— thermokeratoplasty — an attempt to get rid of the postoperative farsightedness obtained — by applying thermal burns of the infrared optical range laser on its periphery and the subsequent reduction of collagen fibers. Like this:

-热角膜移植术-试图消除术后远视眼的尝试-通过对红外光学测距激光器的周围进行热灼伤并随后减少胶原蛋白纤维来进行。 像这样：

第四次手术 (The fourth operation)

– 1998, is a

– 1998年，是

LASIK operation. Yes, this method, which is so popular today, was pioneering at that time — they saw in it getting rid of all the problems of eye optics. The patient cut the lid from the top layer of the cornea, an excimer laser of that generation had some thickness of the stroma “evaporated” for the correction of optics, but alas — the cornea was still a curve and the vision was low. How this is done is written LASIK操作。 是的，这种方法在当今非常流行，并且在当时是开创性的-他们看到它消除了光学镜片的所有问题。 患者从角膜的顶层切下盖子，这一代的准分子激光具有“蒸发”的一定厚度的基质，用于矫正视力，但可惜-角膜仍然是弯曲的，视力低下。 如何做到的写 here. 在这里 。

LASIK Operation Scheme LASIK手术方案

And we remember that the cap after LASIK never-never grows — and there is a temptation to lift it again after a couple of months in order to “doze” to the goal. Thus,

而且我们还记得，LASIK手术后的手术帽永远不会增长，而且有诱惑在几个月后再次取消以“打lift”目标。 从而，

第五次手术 ( a fifth operation)

arose — the rise of the “lid” after LASIK and the excimer laser evaporation of some other thickness of the corneal stroma. The result — the cornea is critically thinned and keratectasia occurred. Keratectasia is something that is very similar to keratoconus in its course and symptoms. I wrote about it

出现— LASIK手术后“盖”的上升以及准分子激光蒸发了其他厚度的角膜基质。 结果-角膜严重变薄，发生了角化。 圆锥角膜的病程和症状与圆锥角膜非常相似。 我写过

here. 在这里 。

2012年 (2012)

. By this time, «A» did not become a pilot, he became a wealthy successful man and decided to be treated in Switzerland — it cost him 1 million Swiss francs. The doctor from the French part of Switzerland, who took up the treatment, decided not to touch the cornea anymore, he went the other way (he understood little of the cornea, but knew how to remove the lenses). As a result, it was decided to remove the patient's completely transparent natural lens and replace it with an artificial, complex astigmatic one, which, according to the doctor's understanding, was to compensate for the irregularities of the cornea in the right direction. The idea, in my opinion, could not be successful, since the diseased curve of the exhausted cornea was so irregular that there was no lens that could fix it.

。 到那时，“ A”还没有成为一名飞行员，他成为了一个富有的成功人士，并决定在瑞士接受治疗-这花了他100万瑞士法郎。 来自瑞士法国部分的医生接受了治疗，决定不再接触角膜，而是转而去(他对角膜了解得很少，但知道如何去掉晶状体)。 结果，决定取下患者完全透明的天然晶状体，并用人工的，复杂的散光晶状体来代替，据医生的理解，该镜片是为了补偿角膜在正确方向上的不规则性。 在我看来，这个想法无法成功，因为疲惫的角膜的患病曲线是如此不规则，以至于没有晶状体可以修复它。

第六次手术 (The sixth operation)

is cataract phacoemulsification with the implantation of an individual pre-ordered astigmatic lens. For those who understand something in lenses — its astigmatic part was +7.5 diopters, sphere +21.0. The operation in experienced hands is 5 minutes, in the post

白内障超声乳化术是植入单个预定的散光晶状体。 对于那些了解镜片的人来说，其散光部分为+7.5屈光度，球面+21.0。 在有经验的手中进行操作需要5分钟

您可以阅读 “Implanting an Artificial Crystal Lens” you can read in detail how it is performed. “植入人工晶体透镜”的详细信息。

But something went wrong again — during the operation a rather terrible complication occurred in the form of a rupture of the posterior lens capsule, the surgeon left the peripheral part of his own lens and somehow managed to cope with the implantation. Rupture creates problems for the centering of the lens. The decision was made at the time of breaking the capsule, and the surgeon decided that the gap was not so large as to affect the position of the lens. Ventured and set. The idea was not the best from the very beginning: irregular astigmatism was poorly compensated, and the implant axis did not coincide with the calculated one.

但是又出了点问题–手术中，后晶状体囊破裂的形式发生了相当可怕的并发症，外科医生离开了自己晶状体的外围部分，并设法处理了植入。 破裂会产生透镜居中的问题。 该决定是在胶囊破裂时做出的，外科医生认为间隙不大到影响晶状体位置的程度。 冒险创业。 这个想法从一开始就不是最好的：不规则散光的补偿很差，并且植入物的轴与计算出的轴不一致。

The problem was that the previously ordered complex astigmatic lens could no longer be placed in a defective bag, since correct orientation would be impossible. But the lens was set, as the surgeon was hoping for a «miracle.» The miracle did not happen — the optics became even more crooked.

问题在于，先前订购的复杂散光镜片无法再放置在有缺陷的袋子中，因为不可能正确定位。 但是镜头已经安装好了，因为外科医生希望获得“奇迹”。 奇迹没有发生-光学器件变得更加弯曲。

Optics scheme with irregular astigmatism 具有不规则散光的光学方案

Мы помним, что этот хирург не занимался роговицами, а умел делать только катаракту и менять хрусталики. И он предложил пациенту добавить еще один хрусталик (!) поверх уже поставленного, сделать такой «бутерброд» из них, заказав астигматический с альтернативными осями сфера -7,5 цилиндр +11,0.

Мыпомним，чтоэтотхирургнезанималсяроговицами，以及умелделатьтолькокатарактуиеленятьхрут。 Ионпредложилпациентудобавитьещеодинхрусталик(！)поверхужепоставленного，сделатьтакой«бутерброд»изних，заказавастигматическийсальтернативнымиосямисфера-7,5цилиндр+11,0。

We remember that this surgeon did not deal with the corneas, but was able to do only cataracts and change lenses. And he suggested to the patient to add another lens (!) On top of the already set, to make such a “sandwich” of them, ordering a cylinder -7.5 astigmatic with alternative axes +7.0.

我们记得这位外科医生没有处理角膜，但只能做白内障和更换晶状体。 他建议患者在已设置的镜片上再加上一个镜片(！)，以制成这样的“三明治”，并订购-7.5散光的圆柱体，以及+7.0的替代轴。

第七次手术 (The seventh operation)

is the implantation of this additional lens on top of the former. More precisely, he was afraid to get a lens-lens and put in its place a new one: this is a rather complicated and risky operation. As you can guess — the optics became even more crooked…

是在前者顶部植入此额外的晶状体。 更确切地说，他害怕拿到镜头，然后放一个新的镜头：这是一个相当复杂且危险的操作。 您可以猜到–光学元件变得更加弯曲……

This is what ultrasound biomicroscopy with two artificial lenses in the eye looks like. 这就是在眼睛中带有两个人工晶状体的超声生物显微镜。

By the way, I often use such additional lenses (lenses) — they really help out in certain cases. They have a great ability — they can be rotated — rotated if necessary.

顺便说一句，我经常使用这样的附加镜头(镜头)，在某些情况下它们确实有帮助。 它们具有很大的能力-可以旋转-必要时可以旋转。

This is how clockwise or counterclockwise you can “twist” the IOL in the eye. 您可以顺时针或逆时针“旋转”眼睛中的IOL。

Thus,

从而，

行动八 (operation eight)

— in fact, this is not one, but three operations — attempts to rotate the accessory lens to bring the optics to zero. Should I write that all attempts were unsuccessful. And my colleague from the French part of Switzerland sent a patient to the German part of Switzerland to help solve the problem.

(实际上，这不是一个操作，而是三个操作)，尝试旋转辅助镜头以将光学元件归零。 我应该写所有的尝试都不成功。 我来自瑞士法国部分的同事将患者送至瑞士德国部分，以帮助解决问题。

My colleague number two from the German part of Switzerland did not deal with cataracts and lenses, he was engaged only with corneas — he transplanted them and made laser corrections. And so

我来自瑞士德国的第二名同事没有处理白内障和晶状体，他只从事角膜手术-他将它们移植并进行了激光矫正。 所以

第九次行动 (the ninth operation)

happened — the surgeon honestly decided to fix the cornea in a simple safe way — tightening sutures. But they did not help.

发生了-外科医生诚实地决定以一种简单安全的方式修复角膜-收紧缝合线。 但是他们没有帮助。

And we remember that the specialization of this colleague is cornea transplantation. Therefore, «A» was performed tenth anniversary operation — anterior layered keratoplasty — transplanting the anterior wall of the cornea, which restored the thickness of the cornea.

我们还记得，这个同事的专业是角膜移植。 因此，“ A”手术进行了十周年纪念手术-前层角膜移植-移植了角膜的前壁，从​​而恢复了角膜的厚度。

Schematically, the operation looks like this 从原理上讲，该操作如下所示

After corneal transplantation, the optics, of course, did not become correct — after all, the transplanted cornea had the curvature and refraction of the donor (that is, the deceased person, from whom it was transplanted). To make it clear — a cornea transplant from a donor is like transferring a breast from one woman to another — when transplanting, we don’t understand the right or left eye, where the top is and where the bottom is, the curvature is not considered at all. But the surgeon expected that later he would make a femtolaser correction and correct at least the corneal component. Let me remind you that he was not an expert on lenses and he was not tormented by the question of two lenses in the eye with rather extraordinary optics.

角膜移植后，视力当然没有变好-毕竟，移植的角膜具有供体(即，已从其移出的死者)的曲率和屈光度。 明确地说-从供体进行角膜移植就像将乳房从一个女人转移到另一个女人上-移植时，我们不了解右眼或左眼，顶部在哪里，底部在哪里，曲率不是考虑过的。 但是，外科医生希望他以后能做飞秒激光矫正，至少矫正角膜组件。 让我提醒您，他不是镜片专家，他对两个镜片具有非凡光学特性的问题也没有感到困扰。

第十一次手术 (Eleventh operation)

— femtoLASIK on the transplant — the 1st time. It did not work out — probably, at this time, the lenses in the eye moved and everything was squinting. How is the operation femtoLASIK written here.

— femtoLASIK移植–第一次。 它没有解决问题-可能在这个时候，眼睛的镜头移动了，所有东西都quin起了眼睛。 femtoLASIK的操作如何写在这里。

第十二次行动 (The twelfth operation)

— re-femtoLASIK transplant. Again it did not work, and it could not happen. But the cornea thinned to 130 microns in its thinnest part (!), Although it remained fairly regular in the optical zone. This was the keratotopogram:

—重新进行femtoLASIK移植。 再次，它不起作用，并且不可能发生。 但是，角膜的最薄部分变薄至130微米(！)，尽管在光学区域中角膜保持相当规则。 这是角膜地形图：

When the patient asked the Swiss surgeon — “What are we going to do next?”, He replied — “we will replant the cornea again, and then sharpen it again with a laser.” Realizing that the circle closed, «A» returned to Moscow.

当病人问瑞士外科医生时，“接下来我们要做什么？”他回答：“我们将再次植入角膜，然后用激光再次将其削尖。” 意识到圈子已经关闭，«A»回到了莫斯科。

我的故事 (MY STORY)

So, the patient came to me after

所以病人来找我

12次 (12 operations)

, with a thinned irregular cornea, the outer part of which was transplanted from the donor, low protective properties of the inner wall (endothelium), two curved lenses in the eye, high intraocular pressure — this is a complication of everything experienced and a desire to see.

角膜变薄，不规则的角膜变薄，其外部部分是从供体移植而来，内壁(内皮)的保护性较差，眼中有两个弯曲的晶状体，眼压高-这是经历过的一切的复杂性和渴望查看。

Nowhere in Moscow and the world did they want to see him for several reasons:

他们不想在莫斯科和全世界看到他的原因有几个：

1) To solve his problem, it was necessary to start with the removal (explantation) of two curves that cause complication of the lens — no one took it up, because the rupture of the posterior capsule, which took place during the operation, made this operation extremely risky and very jeweler.

1)为了解决他的问题，必须从导致晶状体复杂的两条曲线的切除(移出)开始-没有人拿起它，因为在手术过程中发生了后囊破裂此操作极具风险且非常珠宝商。

2) It was difficult to calculate the optics of the new necessary lens — a vast experience of calculations and surgical intuition were needed.

2)很难计算出新的必要镜片的光学元件-需要大量的计算经验和手术直觉。

It looked like the topography of the cornea of ​​the patient «A» 看起来像是病人«A»的角膜地形图

And something had to be done. Firstly, because high intraocular pressure would destroy the optic nerve. Secondly, the patient, as you already understood, loves to be operated on. That is, so simply such people do not give up, and since they begin to fight for their vision, they finish the job.

并且必须要做的事情。 首先，因为高眼压会破坏视神经。 其次，正如您已经了解的那样，患者喜欢接受手术。 就是说，这样的人根本不会放弃，并且因为他们开始为自己的愿景而奋斗，所以他们完成了工作。

第十三行动 (The thirteenth operation)

(I don’t believe in prejudices, but still) — removing both lenses from the eye and implanting a monofocal aspheric IOL with emmetropia (we call it “zero”). The operation went great, technically managed to complete all the planned and the new lens was in the right place. I and the patient were happy — but early. There was a complication that could negate all efforts and lead to a fatal end.

(我不相信偏见，但仍然如此)-从眼睛上移开两个晶状体并植入具有正视眼的单焦点非球面IOL(我们称之为“零”)。 操作非常顺利，从技术上讲，它可以完成所有计划的工作，因此新镜头在正确的位置。 我和病人很高兴-但很早。 并发症会否定所有努力并导致致命的结局。

As a result of multiple prior surgery, an eye reaction occurred in the form of inflammation. Not just a small one — but stormy, with a large number of cells, with thick haze and loss of vision.

由于进行了多次先前的手术，眼睛React以发炎的形式发生。 不只是一小部分，而是暴风雨，有大量的细胞，浓雾和视力丧失。

It looks like an ultrasound picture of inflammation in the posterior segment of the eye. 它看起来像是在眼后段的炎症超声图像。

That was how the eye looked under a microscope. 那就是在显微镜下眼睛的样子。

After a couple of days, he stopped seeing objects — only light, and I stopped distinguishing anything in his eye. Unfortunately, this development is possible after numerous operations, when we have to go into the cavity of the eye. There is no vision. Consilium with colleagues did not add optimism — the general opinion that there would be one end — “eye in the basin”. It's time to give up.

几天后，他停止看到物体-只有光线，而我也停止区分他的眼睛。 不幸的是，当我们不得不进入眼腔时，这种发展是可能的。 没有远见。 Consilium与同事并没有增加乐观情绪-人们普遍认为会有一个终点-“流域内的眼睛”。 是时候放弃了。

It was impossible to delay. The following operation followed.

不可能拖延。 进行以下操作。

第十四次行动 (The fourteenth operation)

is the introduction of drugs into the anterior chamber of the eye. We took seeding for the presence of microbes (then received a negative response). In most cases it helps, but in this case the fifteenth operation was needed.- the introduction of drugs into the posterior chamber of the eye — into the vitreous cavity, since such inflammation is dangerous for the retina and can destroy it. All this, of course, against the background of general therapy.

是指将药物引入眼前房。 我们为微生物的存在进行了播种(然后收到了负面React)。 在大多数情况下有帮助，但在这种情况下需要进行第十五次手术。-将药物引入眼后房-玻璃体腔内，因为这种炎症对于视网膜是危险的并且会破坏视网膜。 当然，所有这些都是在一般疗法的背景下进行的。

The struggle went on day and night — we became allies in this battle. But by the third day it became clear that one could not avoid another volumetric operation.

斗争日以继夜进行着-我们成为这场斗争的盟友。 但是到了第三天，很明显一个人无法避免进行另一次体积操作。

第十六次行动 (The sixteenth operation)

— vitrectomy — is a deep, serious operation — removal of a turbid vitreous body, which, like a sponge, absorbs all inflammatory cells, microbes (if any) and their decay products. If you do not do this operation in time — the eye will die. The operation is very complicated, “visibility is zero”, but I managed to do it. She brought relief, a gradual improvement in the patient’s vision and a 60% vision by the end of the month. We celebrated the victory. Early.

玻璃体切除术是一项深层的，严肃的手术，要去除浑浊的玻璃体，像海绵一样，吸收所有的炎症细胞，微生物(如果有的话)及其腐烂产物。 如果您不及时执行此操作，则眼睛将死亡。 操作非常复杂，“可见性为零”，但是我设法做到了。 她带来了缓解，患者的视力逐渐改善，到月底视力达到60％。 我们庆祝了胜利。 早。

After 2 months, «A» again had a recurrence of inflammation and vision decreased to light perception.

2个月后，«A»再次出现炎症，视力下降至光线感知。

第十七次行动 (The seventeenth operation)

and

和

第十八次行动 (the eighteenth operation)

, the introduction of medical preparations into the vitreous cavity, have gone the same way.

将药物制剂引入玻璃体腔的方法与此相同。

And six months later, when everything calmed down, another problem was found that interfered with vision and caused distortion.

六个月后，当一切都平静下来时，又发现了另一个干扰视力并导致变形的问题。

The patient saw six lines. But there were complaints of distortion. The reason for this was the formed epiretinal membrane (similar to the cellophane film covering the retina) in the center. At the same time, the new lens was excellent, and the cornea was stable.

病人看了六行。 但是有人抱怨扭曲。 原因是中央形成了视网膜前膜(类似于覆盖视网膜的玻璃纸膜)。 同时，新晶状体非常出色，并且角膜稳定。

НOn a CT scan, you can see the correct position of the new lens under the iris. Н在CT扫描上，您可以看到新镜头在光圈下的正确位置。

I do a lot of operations on the retina, including this type. But I can not say that I then wanted to do another operation. On the one hand, there are risks of recurrence of inflammation, on the other hand, there is a great temptation to help the patient, to get rid of distortions, this is impossible without surgery. We decided together what we will do!

我在视网膜上做了很多手术，包括这种手术。 但是我不能说我当时想做另一种手术。 一方面，存在炎症复发的风险，另一方面，存在极大的诱惑来帮助患者，摆脱扭曲，如果没有手术，这是不可能的。 我们共同决定了我们将做什么！

第十九次行动 (The nineteenth operation)

— removal of the epiretinal and internal border membranes — looks like this:

-去除前视网膜和内部边界膜-如下所示：

vitrectomy + work in the vitreous cavity with special tweezers for manually removing cellophane. Again, when seen bad. But everything worked out — the result of 80% of view, and the correction is all 90-100% (nevertheless, corneal astigmatism interferes). 玻璃体切除术 +用特殊镊子在玻璃体腔中工作，以手动去除玻璃纸。 再次，当看到不好。 但是一切都解决了– 80％的视线结果，并且矫正率全部为90-100％(尽管如此，角膜散光会干扰)。

The pressure is good, without drops. The position of the lens is normal. The cornea is still irregular, the density and quality of the endothelium is not very high. But transparency is good and allows you to see 100%.

压力好，无滴落。 镜头位置正常。 角膜仍然不规则，内皮的密度和质量不是很高。 但是透明度很好，可以让您看到100％。

This is a tomogram of the membrane that causes distortion of the relief of the retina. 这是引起视网膜缓解变形的膜的断层图像。

Tomogram of the retina after the 19th operation 第十九次手术后的视网膜断层扫描

第二十次行动 (The twentieth operation)

— blepharoplasty — is already aesthetic ophthalmology. The result — the patient began to see and looks younger by 10-15 years.

眼睑整形术已经是美容眼科。 结果-病人开始看到并且看起来年轻了10-15岁。

美满结局 (HAPPY END)

My patient and I are best friends. He periodically asks the question: “Or maybe I still have a cornea transplanted? After all, I can see even better. ” From what I, for the time being, naturally discourage him. The eye under the microscope looks like this:

我和我的病人是最好的朋友。 他定期问这个问题：“或者也许我还有角膜移植？ 毕竟，我可以看到更好的结果。 ”从我暂时来看，自然使他灰心。 显微镜下的眼睛如下所示：

Fortunately, everything ended well.

幸运的是，一切顺利。

最后 ( Finally)

: the eye is not a designer, which can be disassembled in parts and made a replacement, it has a complex structure, all structures are interconnected. Although, the further we go in the development of ophthalmology, the more we can do: something to make out, something to change.

：眼睛不是设计者，可以分解成一部分然后进行替换，它具有复杂的结构，所有结构都相互关联。 尽管，我们在眼科学的发展上越走越远，我们可以做的越多：可以做出改变，可以做出改变。

This should be done in experienced hands, choosing specialists not of a “narrow” profile, but of those who see the eye as a whole, knowing all its departments. A clinic — with a full range of surgical operations and equipment for their operations, so that the “professional outlook” is sufficient, without limiting the choice of methods.

这应该由经验丰富的人员来完成，选择的专家不是“狭义”的，而是从整体上了解眼睛并知道其所有部门的专家。 诊所-具有各种手术操作和用于其操作的设备，因此“专业视野”足够，而不会限制方法的选择。

And also — a good doctor can fix a lot, but it's good if you turn to him right away.

而且-一位好医生可以解决很多问题，但是如果您立即向他求助，那就太好了。

Yes, the main thing is if it were our day and the patient was corrected using the method ReLEX SMILE — the story would not have taken place.

是的，最主要的是如果今天是我们的一天，并且使用ReLEX SMILE方法对患者进行了矫正-故事就不会发生。

翻译自: https://habr.com/en/company/klinika_shilovoy/blog/510704/