If children's amblyopia caused by refractive error cannot be effectively corrected and improved with glasses, adults will face the reality of amblyopia all the time without other effective measures. Professor zhouyuehua pioneered the "laser correction of children's refractory ametropic amblyopia" in China, and successfully helped many desperate families bring hope. It not only gave these children a clear vision when they grew up, but also opened up a new research direction for the academic circle of Ophthalmology.

1、 Professor zhouyuehua pioneered the surgical correction of refractory ametropic amblyopia in children

In the field of Ophthalmology, minors are usually regarded as the "forbidden zone" of refractive surgery. However, Professor zhouyuehua keenly observed that "children's refractory ametropic amblyopia" is silently devouring the future of many children. If conventional means are ineffective, will these children be allowed to grope in the dark for a lifetime? "Nothing is absolute in the world. Innovation requires courage and rigorous verification." he is not a believer in evil, and has been collecting cases and concentrating on research for many years. Instead of simply copying adult surgery, he has strictly limited the indications according to the characteristics of children's development, improved the design of the operation scheme, and put forward high requirements for doctors' surgical skills.

Finally, he pioneered the "laser correction of refractory ametropic amblyopia in children" in China and successfully performed the first operation in China. This breakthrough not only brought hope to countless desperate families, but also opened up a new research direction for ophthalmology academia.

2、 Surgical correction of refractory ametropic amblyopia

For the development of our vision, we need normal light to stimulate the macular region, so that the macular region can be well developed. For children with refractory ametropic amblyopia, conventional frame glasses can only correct low-order aberrations such as myopia, hyperopia, astigmatism, but cannot correct high-order aberrations such as coma, so they cannot form a clear image in the retina. Therefore, in order to correct this situation, we must correct the low-order aberrations such as myopia, hyperopia, astigmatism and other high-order aberrations at the same time, so that the retina can be stimulated and developed normally.

For children with refractory ametropic amblyopia, the influence of higher-order difference on visual quality accounts for 5% - 10%. In this case, if only myopia, hyperopia and astigmatism are corrected, it is equivalent to only 90-95% correction. Even with amblyopia training, 5% - 10% due to higher-order aberration can not be corrected, so these children's amblyopia training to a certain extent, vision can not be improved.

According to the pre-operative examination data, myopia surgery can simultaneously carry out personalized point-to-point correction for diopter and higher-order aberrations, so that all light forms a normal stimulus to the macular region, and the visual system can get the normal development needs. Then through amblyopia training, we can get a good training effect, and fundamentally solve amblyopia.

3、 What age should we choose for the surgical correction of children's refractory ametropic amblyopia?

Under normal circumstances, myopia laser correction surgery is suitable for people older than 18 years old, and it is not recommended for children and adolescents who are too young to accept such surgery. The main reason is that teenagers' eyeballs are still in the growth and development period, and the diopter is unstable. Through surgical correction, it is very likely to cause myopia again due to their own diopter instability after surgery.

According to the experience of the operation for several years, it is generally recommended that children around 6 years old can be considered for surgery, first of all, because the age of 6-12 is the sensitive period of visual development, especially before the age of 6 is the fastest stage of development and the key period that needs intervention most. Surgery should be carried out in time during the golden period of children's visual development, and then visual training and other measures should be taken to stimulate visual development and improve visual function, so as to obtain good results.

Secondly, the reason is that children who are too young can not cooperate well with the operation, while most of the children around 6 years old have strong understanding ability and cooperate with the requirements of the doctor. Before the operation, the doctor will patiently communicate with the child, narrow the distance with the child, relieve the tension of the child, observe the cooperation degree of the child in the examination stage, and evaluate the feasibility of the operation. Professor zhouyuehua's team has rich experience in psychological nursing of children's surgery. By breaking through barriers, rewards and other forms, the children's surgery has a certain interest, enhances the children's confidence and eliminates tension. The whole operation can be accompanied by parents, alleviating the children's fear in an unfamiliar environment.

Therefore, the age of surgery is set at about 6 years old, mainly from two aspects: first, to grasp the most important stage of visual development for timely intervention, and second, the operation cooperation for children around 6 years old is relatively ideal.

Professor Zhou reminded parents that for children and adolescents with ametropia and amblyopia, surgery should not be performed easily. We must find a professional doctor for consultation and examination. Before the operation, the doctor will conduct a comprehensive examination and evaluation. It is very important for children to strictly control the indications and the best operation period.