I-Corneal cross linking (CXL) yindlela yokwelapha kubantu abahlukunyezwa yi- cornea ehlala engazinzile futhi ebuthakathaka. I-cornea iqala ukukhuphuka noma ukuhamba, ibangele umbono obonakalayo futhi uphambene, ngezinye izikhathi kuthinta kakhulu izinga lokuphila. Ukuxhumanisa kwe-Corneal cross kuyindlela esetshenziselwa ukunciphisa ukuqhubeka kwezinguquko ze-corneal. Ukuxhumanisa kwe-Corneal cross usebenzisa ukukhanya kwe-UV ukuqinisa izibopho zamakhemikhali phakathi kwe-cornea.
Kusukela ngoFebruwari 2012, ukuhlanganiswa kwe-corneal cross akuyona inqubo evunyelwe i-FDA, futhi akuvamile ukwenza eMelika njengamanje.
Yini ebangela i-cornea engazinzile?
Izimbangela ezimbili ezivame kakhulu zokungahlali kahle kwe-corneal yi-cornea ectasia ne-keratoconus. Ziyisizathu sesibili esibangelwa ukuhlinzeka ngokuguqulwa kwama-corneal, futhi ndawonye ku-15% wezinqubo zokuhlinzwa zokuguqula izifo ezenziwe e-United States.
- I-corneal ectasia: i- corneal ectasia yisimo lapho i-cornea ilahlekelwa khona ikhono layo lokugcina isimo esivamile, esivamile, ngokuvamile kusukela e-cornea iba mncane kakhulu. I-cornea iba mncane kakhulu kangangokuthi ingcindezi yeso langaphakathi lingabangela ukuba i-cornea ihlukaniswe noma ikhuliswe. Ngenxa yokuthi i-cornea inomthelela omkhulu kuwo wonke amandla esweni, umbono ubonakala futhi uphazamisa kakhulu. Izibuko zendabuko nama-lens oxhumana naye azilungisi ngaso sonke isikhathi lo mbono ophikisayo.
I-corneal ectasia ivame ukubangelwa ukuhlinzwa okuqhubekayo, okufana ne- LASIK noma i-radial keratotomy. I-Ectasia ayiyona into evamile emva kokuhlinzwa okuqhubekayo kodwa ingenzeka kubantu abangewona abakhethiweyo abakhulu kunqubo. Abanye abantu kungenzeka ukuthi babe ne-dystrophy eyinkimbinkimbi, engabonakaliyo engavamile ukuyihlola ngaphambi kokuhlinzwa. I-Ectasia nayo ingase ibe khona esimweni esibizwa ngokuthi i-pellucid ukuguqulwa okuncane okuvame ukungena ku-keratoconus.
- I-Keratoconus: I- Keratoconus iyisifo se-cornea. Ku-keratoconus, izinhlanzi ze-cornea nama-bulges angaphandle njenge-cone, okuholela ekubonweni okuphambene. Njengoba isimo se-cornea sishintsha, ukubhekwa kwe-nearsight and astigmatism kungakhula. Izinguquko ze-keratoconus zivame ukuhamba kancane kakhulu. Nakuba i-keratoconus engabangeli ubumpumputhe, inganciphisa ikhono lokugxila ngaphandle kwama-eye noma ama-lens futhi lingathinta kakhulu izinga lomuntu.
- Ukuguqulwa Kwama-Pellucid Kwemvelo: I-Pellucid Degeneration ye-Marginal ibhekwa ukuthi iyingxenye ethile ye-keratoconus. Esikhathini esidlule, odokotela abaningi baphowula ngokusobala ukuthi i-Pellucid njengekeratoconus. Ibuye ibonakale ngokugcoba kwe-corneain ingxenye engaphansi futhi ephikisayo ye-cornea. Amacala amaningi kuthinta iso elilodwa noma iso elibi kakhulu kunezinye.
Inqubo yokuxhumanisa i-Corneal Cross
I-Corneal cross ukuhlanganisa imizamo yokuqinisa izibopho ngaphakathi kwe-cornea ukudala ukuzinza. Udokotela wakho uzoqala ukugxilisa amaconsi ejoka elihlosiwe. Khona-ke, udokotela wakho uzosusa ungqimba oluphezulu lwe-cornea yakho, noma amaseli e-epithelial, ukuze aveze izendlalelo eziphakathi.
I-cornea ebonakalayo izobe ishahwe ngesisombululo se-riboflavin oyinyumba imizuzu engu-30. Amaconsi e-Riboflavin avunyelwe ukugcwalisa i-cornea eminye imizuzu engama-30 ngenkathi evezwa umthamo wokucophelela we-ultraviolet (UVA). Ukukhanya kwe-UVA kubangela ukusabela kwamakhemikhali ne-riboflavin eyenza isixhumanisi nezibopho ukwakha ku-collagen ngaphakathi kwe-cornea ukwenza kube nzima. I-antibiotic iso liyehla noma amafutha isetshenziselwa iso. Abanye odokotela bazofaka i-bandage contact lens kuze kube yilapho amaseli e-epithelial ekhula emuva, okungathatha izinsuku ezingu-2-4.
Le nqubo izama ukwenza i-cornea ibe namandla ngokulondeka ukuvimbela isimo ukuba siphumelele futhi kwezinye izimo, kubangela ukuthi i-cornea ibuyele ekujuleni kwayo kwendwangu evamile.
I-Corneal Cross Ukuxhumanisa Ukubuyisela
Ezinsukwini ezimbalwa emva kokuxhuma kwe-corneal cross, ungase ube nokuvuvukala kwe-corneal. Ungase uzizwe ukucasuka okuncane, ukuvutha noma ukuzwa komzimba wangaphandle kuze kube yilapho i-cornea igula ngokuphelele. Amaconsi okulwa namagciwane ajwayele ukubakwe ezinsukwini ezimbalwa. Nakuba abantu abaningi bengenayo izinkinga emva kokuhlinzwa, abanye basengozini yokuthuthukisa i-clouding emnene ye-cornea engase inciphise umbono kancane.
Ezinyangeni eziyisithupha ezilandelayo, udokotela wakho uzokubona ukuthi ulinganisa njalo umbono wakho (ukukhishwa) futhi wenze izilinganiso, ezifana nezilinganiso ze-corneal (i- pachymetry ) noma i-cornea mapping (i- corneal topography ) kuze i-cornea yakho iqiniseke. Kubalulekile ukuqaphela ukuthi i-CXL ayibuyiseli umlingo wakho ngombono nganoma iyiphi indlela. Yenzelwe ukuqinisa i-cornea ukuyeka noma ukuyeka ukuqhubeka nokwenza i-cornea ibe yamukelekile ukuxhumana nokugqoka i-lens noma enye imodi yokulungiswa kombono.
Okufanele Ukwazi Ngoxhumano lwe-Corneal Cross
I-CXL iyaphenywa ukuze ifinyelele ku-option "yokwelashwa kwangaphambili" ukhetho ngokumelene nokwelapha kamuva keratoconus ukuvimbela ukuqhuma okukhulu kanye nesidingo sokufakelwa kwe-corneal. Abacwaningi baphinde babheke i-CXL njengendlela yokwelashwa okungenzeka kube nezifo ezithinta amehlo. Izifo ezincane ezikhulayo zingabangela ukubola nokuqhakaziza kwe-cornea. I-CXL ikhonjiswe ukuphatha lezi zifo uma ama-antibiotics engasebenzi kahle. Inqubo ye-CXL iphazamisa ama-enzyme ahlambalaza amabhaktheriya akhiqiza futhi avimbela ukukhula kwamabhaktheriya ngokwawo.
Ucwaningo lubheka nokuthi ngabe i-CXL ingenziwa yini njengengxenye yezinqubo ezithile ze-LASIK zokuqinisa i-cornea nokunciphisa ingozi ye-corneal ectasia eyenziwa ngokuhlinzwa.
Imithombo:
UCarpecki, uPaul M no-Diana Shechtman. Ukubheka ukuguqulwa kwe-corneal. Ukubuyekezwa kwe-Optometry, ngo-Agasti 2011.
Kabat, Alan G noJoseph W Sowka. I-CXL yezifo ezithathelwanayo? Ukubuyekeza kwe-Optometry. Disemba 2011.