Mchinji wa Corneal (CXL) ndi mankhwala kwa anthu omwe amavutika ndi cornea omwe amakhala osakhazikika ndi ofooka. Kornea imayamba kuphulika kapena kusuntha, kuchititsa masomphenya olakwika komanso osokoneza, nthawi zina zimakhudza kwambiri khalidwe la moyo. Mtanda wa Korneal ukugwirizanitsa ndi njira yogwiritsira ntchito kuchepetsa kukula kwa kusintha kwa nyamakazi. Mtanda wamtunduwu umagwiritsa ntchito kuwala kwa UV pofuna kulimbitsa mgwirizano wa mankhwala mkati mwa cornea.
Kuyambira mu February 2012, mtanda wamtunduwu umagwirizanitsa si njira yovomerezeka ya FDA, ndipo kaŵirikaŵiri imachitidwa ku US monga kale.
Kodi chimayambitsa cornea chosakhazikika?
Zifukwa ziwiri zomwe zimayambitsa kusakhazikika kwa thupi ndi cornea ectasia ndi keratoconus. Ndilo chifukwa chachiwiri chomwe chimayambitsa opaleshoni yowonongeka , ndipo palimodzi ndikuwerengera 15% ya ma opaleshoni opangira opaleshoni ku United States.
- Etheasia ya Corneal: Etheasia ya Corneal ndi yomwe imapangitsa kuti cornea isalowetse mphamvu yake yosunga, nthawi zonse, kuchokera ku cornea kukhala woonda kwambiri. Kornea imakhala yochepa kwambiri moti diso la mkati limapangitsa kuti cornea isokonezedwe kapena kuwonjezeka. Chifukwa chakuti cornea imathandizira kwambiri ku mphamvu yonse ya diso, masomphenya amasokonezedwa ndi kusokoneza kwambiri. Magalasi achikhalidwe ndi makina ojambulira sizimasintha nthawi zonse masomphenya awa.
Mazira a Corneal amayamba chifukwa chochitidwa opaleshoni, monga LASIK kapena radial keratotomy. Ectasia sizochitika mwachibadwa pambuyo pochita opaleshoni ya opaleshoni koma ikhoza kuchitika mwa anthu omwe sali abwino koposa omwe angapite. Anthu ena ayenera kuti anali ndi vuto linalake losadziwika, lomwe nthawi zina silinali lodziwika bwino lomwe linali lovuta kuyeza asanachite opaleshoni. Ectasia imatha kupezeka mumtundu wotchedwa pellucid m'mphepete mwa madzi omwe nthawi zambiri imakhala ndi keratoconus.
- Keratoconus: Keratoconus ndi matenda a cornea. Mu keratoconus, mitsempha ya cornea ndi ziphuphu zakutali ngati khonje, zomwe zimayambitsa masomphenya osokonezeka. Monga momwe mawonekedwe a cornea amasinthira, kuyang'ana kwapafupi ndi astigmatism kungakhalepo. Kusintha kwa keratoconus kumawoneka pang'onopang'ono. Ngakhale kuti keratoconus siimachititsa khungu, imatha kuchepetsa kulingalira popanda magalasi a maso kapena kukhudzana ndi lens ndipo ingakhudze kwambiri khalidwe la munthu.
- Pellucid Pakati pazigawo Zomwe zimapangidwira : Pellucid Pakati pazinthu zowonjezeredwa zimaganiziridwa kuti ndizochepa keratoconus. M'mbuyomu, madokotala ambiri anapeza molakwa kuti Pellucid ndi keratoconus. Amadziwikanso ndi kupatulira kwa corneain mbali yochepa ya pang'onopang'ono. Nthawi zambiri zimakhudza diso limodzi kapena diso limodzi loposa lina.
Njira Yogwirizanitsa Konneal Cross
Mtanda wa Corneal umalumikiza kuyesera kulimbitsa mgwirizano mkati mwa cornea kuti ukhazikitse bata. Dokotala wanu adzayamba kuyika madontho a m'maso a m'maso. Ndiye, dokotala wanu amachotsa chotsatira cha cornea yanu, kapena maselo a epithelial, kuti awulule zigawo za pakati.
Komwe khungu la cornea lidzasambidwe ndiye lidzasambitsidwa ndi yankho lopanda kanthu la riboflavin kwa mphindi 30. Madontho a Riboflavin amaloledwa kudzaza mchere wina kwa mphindi makumi atatu pamene akuyang'anitsitsa mlingo wa ultraviolet (UVA). Kuwala kwa UVA kumayambitsa mankhwala ndi riboflavin yomwe imapanga mgwirizano ndi zomangira kupanga mu collagen mkati mwa cornea kuti zikhale zovuta. Diso la antibiotic limadumpha kapena mafuta amagwiritsidwa ntchito pa diso. Madokotala ena amapanga lenti yothandizana nayo mpaka maselo a epitheli akule kumbuyo, omwe angatenge masiku 2-4.
Ndondomekoyi imayesetsa kulimbikitsanso kuti matendawa asapitirire ndipo nthawi zina amachititsa khunyu kubwerera ku mawonekedwe ake ozungulira.
Mphuno ya Corneal Yogwirizanitsa Kubwezeretsa
Patangotha masiku angapo mutayika mtanda, mukhoza kukhala ndi kutupa kochepa. Mwinamwake mungamve kupwetekedwa pang'ono, kutentha thupi kapena kunja kwa thupi mpaka cornea ikachiza kwathunthu. Madontho a antibiotic amalembedwa kwa masiku angapo. Ngakhale kuti anthu ambiri alibe vuto pambuyo poti opaleshoni, ena ali pachiopsezo chokhala ndi chimbudzi chofewa cha cornea chomwe chingachepetse masomphenya pang'ono.
Pa miyezi isanu ndi umodzi yotsatira, dokotala wanu adzakuwonani nthawi zambiri kuti muyese masomphenya anu (kutsutsa) ndikuchita miyeso, monga corneal mapangidwe ( pachymetry ) kapena mapu a cornea ( mapiritsi owonetsera ) mpaka cornea yanu ikhale yolimba. Ndikofunika kuzindikira kuti CXL sichibwezeretsa masomphenya anu mwanjira iliyonse. Zapangidwira kulimbikitsa cornea kupititsa patsogolo kapena kuyima kupita patsogolo ndikupangitsa kuti cornea iyambe kuvomereza kuvala kwa lens kapena njira yowonetsera masomphenya.
Zimene Mukuyenera Kudziwa Pokhudza Mtanda wa Korneal Kugwirizana
CXL ikufufuzidwa kuti isamuke ku chithandizo cha "kutsogolo" kusiyana ndi chithandizo cham'tsogolo cha keratoconus pofuna kupewa kupititsa patsogolo kwakukulu ndi kufunika kwa kuika magazi. Ochita kafukufuku akuyang'aniranso ku CXL ngati mankhwala othetsera maso. Matenda akuluakulu amtunduwu angayambitse kapenanso kusungunuka kwa cornea. CXL yasonyezedwa kuti iwachiza matendawa pamene maantibayotiki samagwira ntchito bwino. Njira ya CXL imalepheretsa mavitamini owononga omwe mabakiteriya amabala komanso amalepheretsa kukula kwa mabakiteriya okha.
Kafukufuku akufufuzanso ngati CXL ingathe kuchitidwa ngati mbali ya njira zina za LASIK zolimbitsa cornea ndi kuchepetsa chiopsezo cha opaleshoni ya odwala opaleshoni.
Zotsatira:
Karpecki, Paul M ndi Diana Shechtman. Kuwonekeratu kuwonongeka kwamtundu. Ndemanga ya Optometry, August 2011.
Kabat, Alan G ndi Joseph W Sowka. CXL ya Matenda Opatsirana? Ndemanga ya Optometry. December 2011.