Ndiani akakodzera uye chii chaunofanira kutarisira?
Iyo cornea ndiyo yakajeka iri mberi kwejiso rinofukidza iris, mudzidzi, nekamuri rekare. Kushandiswa kweganda, kana keratoplasty (KP), kunosanganisira kubuda muchibvisa chikamu chepachikamu chekonoa uye kuchigadzirisa neicho chakajeka uye chinopa hutachiona chinopiwa nebhino reziso.
Kana iwe uchifunga kana wakamboudzwa iwe unoda kuiswa korneal,
Ndiani Anoda A Corneal Transplant?
Chiratidzo chakanaka chinoda kuti cornea ive yakajeka, inotapira, uye ine utano.
Chiedza hachikwanise kutarisa zvakanaka mukati meziso kana iyo cornea inopera, ichivhuvhuta, kana ichikuvadzwa. Chigumisiro chaicho chiri chiratidzo chisina kujeka kana kuti glare.
Kushandiswa kwegoni kunogona kudiwa kana cornea yako ichikuvara kana isina kunaka. Utano hwakanaka hunowanikwa kubva kumabhanki emaziso mushure mokunge upihwa nevanopa vanhu. Kupiwa korneas kwakanyatsoedzwa kuti uone kuti vakachengeteka uye vane utano hwokushandisa.
I National Eye Institute inofungidzira kuti zvinenge makumi mana makumi mana zvekufambisa kwegungwa zvinogadzirwa gore negore muUnited States. Izvo zvinodiwa kune zvimwe maziso eziso, kusanganisira zvinotevera:
- Keratoconus : Keratoconus inoshandiswa iyo inowanzokomberedza cornea inoonda uye inoita se-cone-like bulge.
- Corneal clouding: Mamiriro akawanda anogona kukonzera kuti cornea itange kuvhuvhuta uye ine makore, zvakadai seFichs 'dystrophy uye pseudophakic bullous keratopathy. Mumatambudziko akaoma, iyo cornea inogona kukura duku, brister inorwadza pamusoro.
- Corneal utachiona: Utachiona hwekorne hungava bhakitiriya, fungal, kana utachiona. Zvirwere zvinokonzerwa nehutachiona zvinogona kukonzera kupera, kuponda, kana kupera kwekonoa. (Herpes simplex inowanzobatwa nehutachiona hunogona kutungamirira kukura.)
- Corneal dystrophy: Mimwe yemararamiro (dystrophies) inogona kukonzera kuti cornea ive yakaoma kana isingaiti.
- Kukuvara kwekakora: Kukuvadza ku cornea kunogona kukonzera kupisa kwekemikari kunogona kukanganisa zvakaratidzwa
Ophthalmologist wako achaona nezvehutano hwako nekunyatsoongorora kudiwa kwako kwekugadziriswa kwegoni.
Aina dzeCorneal Transplants
Mhando mitatu yemapapiro emakona anoshandiswa nhasi. Ophthalmologist wako achasarudza kuti ndeipi nzira yakakodzeresa iwe maererano nemamiriro ako.
Kuzara-Kuyera Korneal Transplant
Kana zvose zviri mberi uye mukati mukati mekudzivirira zvikamu zvakashata, yako yose cornea ingada kuchinjwa. Iyo inozivikanwawo seyakapinda keratoplasty (PK), uzere hwakazara cornea transplant inosanganisira kubvisa kukwana kwakazara kwekaronda kana chirwere chakakanganiswa nekwenyoro inopa cornea.
PK ine nguva yakareba yekudzoka kana ichienzaniswa nemamwe marudzi e-cornea transplants. Zvinogona kutora kusvika pagore kana kwenguva refu kuti chiratidzo chakakwana chidzoke. PK inokonzera ngozi yakawanda kudarika dzimwe mhando dzekugadzirisa kwekodha iyo iyo donor cornea icharambwa. Kurambwa dzimwe nguva kunoitika sezvo muviri wechirwere chemuviri unorwisa hutachiona hutsva.
Kusarura-Kunaka Konneal Kudyara
Dzimwe nguva zvigaro zvepamberi nepakati pekornea zvakakuvara uye chete izvo zvidimbu zvinoda kubviswa. The endothelial layer (yakasara kumashure) yakachengetwa munzvimbo.
Iyi kuiswa kune iyo inonzi yakadzika anterior lamellar keratoplasty (DALK) kana kuti chikamu chiduku chinokonzera kupora.
DALK inowanzoshandiswa kurapa keratoconus kana bulging ye cornea. Nguva yekudzoka mushure mokunge DALK iri shomanana kupfuura mushure mekuzara kwekodhea kuiswa. Kurambwa kwekwenya cornea hausiwo mungozi kupfuura huwandu hwakazara corneal transplant.
Endothelial Keratoplasty
Mune mamwe maziso, zvo mukati-kati remakona (endothelium) zvakashata. Kukanganisa kunokonzera kuti cornea irere, ichikanganisa maonero ako.Endothelial keratoplasty inoberekwa iyo inotsiva ichi chinyorwa che cornea nemhando yezvipo zvinopa utano.
Iyo inozivikanwa sekushandura zvishoma, sezvinongoita mukati mehutachi twamaviri inotsiviwa.
Kune miviri miviri ye endothelial keratoplasty: DSEK (kana DSAEK) uye DMEK. Endothelial transplants inoshandiswa kurapa mamiriro ezvinhu anonyanya kukonzera kumashure kwerineni yakadai sa Fuchs dystrophy uye bullous keratopathy. Iyo inodzivisa maronda makuru ekuvhiya, kuderedza kusvibiswa kunooneka kubva ku-astigmatism, uye inopa kuwedzerwa kwekuona zvakakurumidza kudarika kuputika keratoplasty kune zvimwe zviitiko.
Nhando imwe neimwe inobvisa masero akakuvara kubva mukati memukati wekonoa rinonzi Descemet's membrane. Iyo yakakanganiswa yakasara yakasunungurwa kuburikidza nekukanganiswa kuduku, saka mutsva mutsva unoiswa panzvimbo, dzimwe nguva uchishandisa zvishoma zvishoma. Mazhinji e-cornea akasiyiwa asina kuonekwa, achideredza ngozi yekurambwa kwekornea itsva mushure mekuvhiyiwa.
Pamberi Pokuvhiya
Kana ukasarudza kuva nechigunwe chegoni, ophthalmologist yako achapedza nguva yako newe kuti aronge nzira yose. Rimwe zuva richasarudzwa kuti rivhiwe, asi zive kuti zuva racho rinogona kuchinja kana mupi wemugovera akanaka asina kuwanikwa musi iwoyo.
Ophthalmologist wako achada kuziva nezvemishonga ipi yaunotora, kusanganisira zvose zvinyorwa uye zvisiri izvo. Iwe unogona kunge uchida kumira kwenguva pfupi uchishandisa mishonga usati wavhiyiwa.
Iwewo uchakurudzirwa kuti uite musangano newachiremba wako wekutanga. Iwe uchakumbirwa kuti uite zvinowanzoongorora ma laboratori zvakadai sokuverenga ropa uye EKG kuti uve nechokwadi chokuti une utano hwakakwana zvokuti uite chirwere. Chiremba wako achaongorora maziso ako uye kutarisa miedzo inokosha kuti ave nechokwadi chokuti ziso rako rakagadzirira kuvhiyiwa.
Ramba uchifunga kuti haugoni kukwira motokari mushure mekuvhiyiwa kwekuwedzera. Iwe unofanirwa kugadzirira kuti mumwe munhu akutakure iwe kumba mushure mekuvhiyiwa.
Panguva yekuvhiya
Pose payo kana aneshehesia yakawanda inogona kushandiswa muzviitiko zvakawanda. Chiremba wako achakurukura newe iwe rudzi rwepi anesthesia rwakakunakira iwe. Kana ukangopinda muimba yekushandira, maziso ako achacheneswa uye akafukidzwa nesimbi isina kuchena. Oxygen ichapiwa kwauri neipurasitiki yepurasitiki yakaiswa pedyo nemhino dzako. Chiremba anovhiya achaisa microscope pane ziso rako.
Munguva yehuwandu hunoputika hutachiona hwekeratoplasty, chiridzwa chine chitinha chinonzi trephine chinoshandiswa kubvisa pakati pekonoa. Bhokisi rekupa gorneal tissue rinotemwa kuti rikwanise. Mhuka yezvipo inodonerwa panzvimbo uye ine sutures yakanaka.
Zvimwewo, vanachiremba vakawanda vari kushandisa ikozvino femtosecond laser kuti vape murwere wegoni uye michina yezvipo. Iyo laser inobvumira kuti miviri yacho ichekwe mumagariro e-zig-zag uye pane zvakaderedzwa zvakaderedzwa kuitira zvakakwana zvakakwana. Izvi zvinobvumira kuiswa kwemuviri wemurwere uye mupepeti wegoni kuti akwanise pamwe chete sechinhu chiduku.
Nezvipfeko zvemaitiro zvinowanikwa ne trephine, zvinogona kutora kubva pamwedzi matanhatu kusvika kumwedzi gumi nembiri kuti ugare uye uwane zviratidzo zviri nani. Zvisinei, nekadzi femtosecond laser, zvakananga incision inoporesa nekukurumidza, zvichibvumira kushandiswa kwekukurumidza nekukurumidza nekuona zviri nani.
MuK EK kana kuti endothelial keratoplasty nzira, chete iyo yakasara yekornea inotsiviwa. Murwere anowanzopora nekukurumidza zvakadai nenzira iyi, sezvo iyo cornea yose isingatsiviwa. Mushure mokunge nzira yacho yakwana, nhoo yeziso ichashandiswa kuchengetedza ziso. Iwe uchazoendeswa kunzvimbo yekudzikinura kuti ugare musati wasunungurwa.
Mushure mekuvhiya
Ziso rinowanzotariswa chero kupi zvako kubva kune rimwe zuva kusvika kune matatu. Chiremba wako weziso achawanzokuona iwe zuva rakatevera chaipo uye kubvisa chigadziko cheziso. Iye achaongorora kuvhiyiwa kuti aone kuporesa uye kutarisa kurambwa kwezvivara, achishandisa shanduro RSVP semutungamiri:
- R edness - Ruvara rwekutsvaga kwemaziso nekukurumidza chiratidzo chekuramba.
- S kushanda - Kurambwa kunowanzoita kuti munhu ave nechiedza chikuru.
- V ision - Kurasika kunogona kukonzera kusvibiswa, foggy kana maziso masikati.
- P ain - Kuwedzera kamwe kwekunzwa kweziso kana kutorwa kwekunze kwemuviri kunogona kuva chiratidzo chekuramba.
Mushure mokutanga kana zuva repiri mushure mekuvhiyiwa, unogona kudzokera kumabasa ezvakadai sekusunungura meno ako, kushambidza, kupfugama, kuverenga, kufamba kana kutarisa TV. Kushandisa ziso rako hakugoni kukuvadza ziso rako kana kukanganisa kuporesa, asi kunofanira kudzivisa mitambo yakashata kana kushamwaridzana kusangana nechiso kana ziso. Inogona kukurudzirwa kuramba uchipfekedza ziso nhoo yevhiki yekutanga kana maviri mushure mekuvhiyiwa kungochengetedza ziso rako usiku iwe uchirara.
Iwe unofanirwa kuva wakashingaira zvikuru pakuita kuti ziso rako ridonhedze sezvinoitwa nachiremba. Chimwe chezvinhu zvinonyanya kukosha zvekuchengetedza kwako mushure mekushandira ndeyekuchengetedza dhigirii wako wese. Chiremba wako achada kuziva kana mhuka yacho inotanga kurambwa. Mumwe kubva kune mumwe nomumwe wevatori vemazuva mana anogamuchira kuregererwa kwemafurati. Kana akabatwa nokukurumidza, zvisinei, inogona kuchinjwa nemishonga.
Pashure pemwedzi mishomanana, cornea ichasimbiswa zvakakwana kuti ienzaniswe magirazi emaziso matsva. Mune zvimwe zviitiko, astigmatism kana kuswedera pedyo zvingaita, asi magirazi emaziso anogona kugadzirisa nyore nyore dambudziko racho. Mune dzimwe nguva, kambani yepamusoro inoshandiswa inogona kudiwa kuti ivhare chero kusanganisa kwakasara pa cornea.
Shoko Rinobva
Kutarisana nekuti iwe unoda kuiswa korneal kunogona kuva kwakaoma. Kushandiswa kwekodhi ndiko kushanda kukuru kwemaziso uye iwe unofanirwa kuva nehanya nazvo. Zvisinei, nemichina yezuva ranhasi, vanhu vazhinji vanowanikwa mukugadzirisa kwekugadzirisa ruzivo kunenge kusina kukwanisa kuita. Kudzidza zvakawanda pamusoro pezvinobatanidzwa mukugadzirwa kwemakona kuchaisa zvizhinji zvezvinetso zvako zviri nyore.
Kunobva:
Boyd, Kierstan. About Corneal Transplantation. American Academy of Ophthalmology. Sep 2017.