Corneal cross linking (CXL) kurapwa kwevanhu vanotambura nekromnea inova isina kugadzikana uye isina simba. Iyo cornea inotanga kuwedzera kana kuputika, ichikonzera kusvibiswa uye kukanganisa maonero, dzimwe nguva kunobatsira zvikuru hupenyu hwehupenyu. Corneal cross linking ndiyo nzira inoshandiswa kuderedza kufambira mberi kwekuchinja kwekwenya. Corneal cross linking inoshandisa UV chiedza kuti kusimbise zvikemikisi zvakasungwa mukati memakona.
Kubva munaFebruary 2012, mutambo wekona wekubatanidza hakusi nzira yeDA-inobvumirwa, uye haisiwanzo-inoitwa muU.S. kunyange zvakadaro.
Chii chinokonzera cornea isina kugadzikana?
Izvo zvikonzero zviviri zvakanyanya zvinokonzerwa nekugadzikana kwekono kunonzi cornea ectasia uye keratoconus. Ndicho chikonzero chechipiri chinowanzokonzera chirwere chekugadzira, uye pamwe chete inofanirwa ne15% yemapurisa ekugadzirwa kwegoni anoitwa muUnited States.
- Corneal ectasia: Corneal ectasia inoratidzika iyo iyo cornea inorasikirwa nekwanisiro yekuchengeta chimiro chenguva dzose, chaiyo, kazhinji kubva ku-cornea kuva yakaonda kwazvo. Iyo cornea inova yakaonda kwazvo zvokuti ziso romukati rinomanikidza rinogona kukonzera kuti cornea iparadzwe kana kuwedzerwa. Nemhaka yekuti cornea inobatsira zvikuru kune simba rose reziso, chiratidzo chinoshandiswa uye chinonyatsopisa. Magirazi emagariro uye mavarai emagetsi havasi kururamisa nguva iyi chiratidzo chakatsauka.
Corneal ectasia inowanzokonzerwa nekuvhiyiwa kunobata, zvakadai seLASIK kana radial keratotomy. Ectasia haisi chiitiko chinowanzoitika mushure mekuvhiyiwa kwekubvumira asi zvinogona kuitika kune vanhu vasiri ivo vakakodzera kutsvaga muitiro. Vamwe vanhu vangave vakave nehana, dzimwe nguva isingaoneki korneal dystrophy yakanga yakaoma kuverenga vasati vavhiyiwa. Ectasia inogonawo kuitika mumamiriro ezvinhu anonzi pellucid marginal degeneration iyo inowanzoputirwa ne keratoconus.
- Keratoconus: Keratoconus chirwere chekromaa. Muchi keratoconus, matinha ekroma uye mabhururi kunze semakona, zvichiita kuti pave nemaonero akatsauka. Sezvo chimiro chekornea chinoshanduka, kutarisa mberi nekuona seastigmatism kunogona kukura. Kuchinja kwekeratoconus kunowanzoitika zvishoma nezvishoma. Kunyange zvazvo keratoconus isingakonzere upofu, inogona kuderedza kukwanisa kutarisa pasina magirazi emaziso kana kuti kuverenga lenzi uye inogona kukanganisa hupenyu hwomunhu.
- Pellucid Marginal Degeneration : Pellucid Marginal Degeneration inofungidzirwa kuti inenge ichinyorwa che keratoconus. Munguva yakapfuura, vanachiremba vazhinji vakafungidzira vakaona kuti Pellucid se keratoconus. Iyo inoratidzwawo nekupenya kwe-corneain chikamu chakashata uye chepakati chekonoa. Izvo zviitiko zvakawanda zvinosanganisa ziso rimwe chete kana ziso rimwe rakaipisisa kupfuura rimwe.
Corneal Cross Kubatanidza Nzira
Corneal cross inobatanidza kuedza kusimbisa zvisungo mukati memakone kuitira kuti ugadzikane. Chiremba wako anotanga kuisa mapepa ekutema anesthetic eye madonhwe. Zvadaro, chiremba wako achabvisa hupamhi hwekornea yako, kana masero epithelial, kuti aratidze zvikamu zvepakati.
Iyo yakajeka cornea ichabva ichishambidzwa nechinangwa chisina kumira riboflavin kwemaminitsi makumi matatu. Ribhoflavin madonhwe anobva abvumirwa kuzadza cornea kwemamwe maminitsi makumi matatu paanenge aine ruzivo rwakananga rwe ultraviolet (UVA) chiedza. IUVA chiedza inokonzera kemikisi yekuita ne riboflavin iyo inobatanidza chibatanidza uye zvisungo kuti zvigadzike mu collageni mukati memakone kuitira kuti zvive zvakasimba. Mishonga inorwisa mabhakitiriya inodonha kana mafuta anoshandiswa kune ziso. Vamwe vanachiremba vachaisa bhanhire rekubatanidza mabhanhire kusvikira masero epithelial akura shure, izvo zvingatora mazuva maviri kusvika ku4.
Iyo nzira inoedza kuita kuti cornea isimbise mukutarisira kudzivirira chirwere ichi kubva pakuipisisa uye mune zvimwe zviitiko, zvinokonzera kuti cornea idzoke pane imwe yemamiriro ayo chaiwo akakomberedzwa.
Corneal Cross Kubatanidza Kudzoka
Mazuva mashomanana mushure mokunge mushure mokuputika korneal, iwe unogona kunge uine humwe unyoro hwekudzivirira. Iwe unganzwa hutsinye hutsinye, hutsva kana huri kunze kwekunzwa kwemuviri kusvikira cornea zvachose ichiporesa. Matsipa emishonga inorwisa mabhakitiriya anowanzotarisirwa kwemazuva mashoma. Kunyange zvazvo vanhu vakawanda vasina matambudziko mushure mekuvhiyiwa, vamwe vari pangozi yekukudziridza zvinyoronyoro zvinyoro zve cornea izvo zvinogona kuderedza zvishoma zvishoma.
Kwemwedzi mitanhatu inotevera, chiremba wako achakuona iwe kazhinji kuti uone maonero ako (kurambidza) uye kuita zviyero, zvakadai sekorneal thickness measurements ( pachymetry ) kana cornea mapping ( corneal topography ) kusvikira cornea yako yakadzikama. Zvakakosha kucherechedza kuti CXL haiti kudzosa magetsi kuti iwe udzoke maonero ako nenzira ipi zvayo. Iyo yakagadzirirwa kusimbisa iyo cornea kunonoka kana kumira kufambira mberi uye kuita kuti cornea inogamuchirwe yekutambira lens kupfeka kana imwe nzira yekuona kururamisa.
Zvaunofanira Kuziva Pamusoro peKorneal Cross Kubatana
CXL iri kuongororwa kuti iende kune "mberi-line" kurapa sarudzo kunze kwechirwere chekare che keratoconus kudzivirira kukura kwakanyanya uye kudiwa kwekugadziriswa kwegoni. Vanotsvakurudza vari kutarisawo muCXL sechinhu chinogona kurapwa nokuda kwehutachiona hwemaziso. Zvirwere zvakanyanya zvinokonzera zvirwere zvinogona kukonzera kupera uye kunyange kunyunguduka kwekonoa. CXL yakaratidzwa kurarisa zvirwere izvi apo maantibioti haashande zvakanaka. Nzira yeCXL inokanganisa maitiro ezvinosvibisa zvokuti mabhakitiriya anobereka uye anodzivisa kukura kwebhakitiriya pachavo.
Zvidzidzo zviri kuongororawo kana CXL inogona kuitwa sechikamu cheimwe nzira yeLASIK kusimbisa iyo cornea uye kuderedza dambudziko rekuvhiya-induced corneal ectasia.
Sources:
Karpecki, Paul M uye Diana Shechtman. A kutarisa ku corneal crosslinking. Kudzokorora kweOptometry, August 2011.
Kabat, Alan G uye Joseph W Sowka. CXL yezvirwere zvinotapukira? Kudzokorora kweOptometry. December 2011.