Ubani okufanelekile futhi yini okufanele ulindele?
I- cornea ingxenyeni ecacile yeso elihlanganisa iris, umfundi, nekamelo langaphakathi. Ukufakelwa kwe-corneal, noma i-keratoplasty (KP), kuhilela ukukhishwa ngokuyinhloko ingxenye yangaphakathi ye-cornea futhi ukuyishintsha ngezicubu ezicacile neziphilile eziphethwe yibhange.
Uma ucabanga noma utshelwe ukuthi udinga ukufakelwa kwe-corneal,
Ubani Okudinga Ukufakelwa Kokunye?
Umbono omuhle udinga ukuthi i-cornea ibe ecacile, elula futhi enempilo.
Ukukhanya akukwazi ukugxila kahle ngaphakathi kweso uma i-cornea ibonakala, ivuvuka, noma iwonakele. Umphumela uba umbono obonakalayo noma ukukhanya.
Ukufakelwa kwe-corneal kungadingeka uma i-cornea yakho ibonakalisiwe noma ingenalo impilo. Ama-corneas enempilo atholakala emaqenjini e-eye ngemuva kokunikezwa ngabanikeli bomuntu. I-corneas enikeziwe ihlolwe ngokuphelele ukuqinisekisa ukuthi iphephile futhi inempilo ukuyisebenzisa.
I-National Eye Institute ilinganisela ukuthi cishe ama-40,000 ukuguquka kwe-corneal kwenziwa minyaka yonke e-United States. Ziyadingeka ngezimo eziningana zamehlo, kufaka phakathi okulandelayo:
- I-Keratoconus : I- Keratoconus yisimo lapho i-cornea ejwayelekile ehlala khona iba yincipha futhi iveza umgqomo onjenge-cone.
- I-corneal clouding: Izimo eziningi zingabangela ukuba i-cornea ivuvuke futhi iguquguquke, njenge-Fuchs 'dystrophy kanye ne-pseudophakic enezinkinga ze-keratopathy. Ezimweni ezimbi, i-cornea ingaba ne-blisters encane, ebuhlungu emkhathini.
- Ukutheleleka kwe- Corneal: Izifo ze-cornea zingaba yi-bacterial, fungal, noma viral. Izifo ezinamandla ezikhukhulayo zingabangela ukonakala, ukuncipha noma ukuguqulwa kwe-cornea. (I-Herpes simplex iyinto ejwayelekile yokutheleleka ngegciwane lengculaza engase iholele ekusweleni.)
- I-corneal dystrophy: Izimo ezithile zokuzalwa (i-dystrophies) zingabangela i-cornea ukuba i-opaque noma ingavamile.
- Ukulimala kwe-corneal: Ukulimala ku-cornea kungabangela ukubola okunamandla okungathinta umbono
Ophthalmologist wakho uzobheka isimo sakho ngokucophelela ukuze ahlole isidingo sakho sokufakelwa kwe-corneal.
Izinhlobo ze-Corneal Transplants
Kunezinhlobo ezintathu zokuguqula izidumbu ezisetshenziswa namuhla. Ophthalmologist wakho uzothola ukuthi iyiphi inqubo efaneleka kakhulu kuwe ngokusekelwe esimweni sakho.
Ukunyathelisa okugcwele ukuqina kwe- Corneal
Uma kokubili izendlalelo zangaphakathi nezangaphakathi zilimazekile, yonke i-cornea yakho ingadinga ukushintshwa. Eyaziwa nangokuthi i-keratoplasty ehamba phambili (PK), ukufakelwa kwe-cornea egcwele ukuqina kuhilela ukufaka esikhundleni sokuqina okugcwele kwe-cornea enezifo noma ezilimazayo nge-donor cornea ecacile.
I-PK inesikhathi sokubuyiselwa eside uma kuqhathaniswa nezinye izinhlobo ze-cornea transplants. Kungathatha isikhathi esingangonyaka noma ngaphezulu ukuze umbono ophelele uphinde ubuyiselwe. I-PK inobungozi obukhulu kunamanye ama-corneal transplants ukuthi i-cornea yomnikeli izokhishwa. Ukwenqaba ngezinye izikhathi kwenzeka njengoba isimiso somzimba samasosha omzimba sihlasela izicubu ezintsha ze-corneal.
Ukunyuka okulinganiselwe Ukufakelwa kwe-Corneal
Ngezinye izikhathi izingqimba zangaphambili nezisemkhatsini ze-cornea zonakalisiwe futhi lezo kuphela izendlalelo zidinga ukususwa. Isendlalelo sokugcina (umcabisho ongenhla) ugcinwa endaweni.
Lokhu kufakelwa kukhonjiswe njenge-deep anterior lamellar keratoplasty (DALK) noma ukufakelwa kwe-corneal yokufakelwa okuncane.
I-DALK isetshenziselwa ukuphatha i-keratoconus noma i-cornea. Isikhathi sokubuyisela emuva kwe-DALK sifushane kunomuva wokufakelwa kwe-cornea ephelele. Ukwenqatshwa kwe-cornea entsha nakho kuyingozi kakhulu kunokwakheka okuphelele kokukhipha okunamandla.
Endothelial Keratoplasty
Kwezinye izimo zamehlo, ingqimba elingaphakathi kwe-cornea (endothelium) limele. Umonakalo ubangela ukuba i-cornea ivule, ifinyelele embonweni wakho.I-keratoplasty ye-endothelial iyindlela yokuhlinzwa eyenza le nsimu ye-cornea ibe nezicubu eziphilile.
Kuyaziwa ngokuthi ukufakelwa okuyingxenye, njengoba nje ungqimba lwangaphakathi lwamathambo luya esikhundleni.
Kunezinhlobo ezimbili ze-endothelial keratoplasty: i-DSEK (noma i-DSAEK) ne-DMEK. Ukuguqulwa kwe-Endothelial kusetshenziselwa ukwelapha izimo ezithinta kakhulu uhlaka olungemuva lwe-cornea njenge-Fuchs dystrophy kanye ne-keratopathy enonya. Igwema isilonda esikhulu sokuhlinzwa, sinciphise ukuhlanekezela okubonakalayo kusuka ku-astigmatism, futhi inikeza ukululama okubukeka kakhudlwana kune-keratoplasty engenayo ngezimo ezithile.
Uhlobo ngalunye lususa amaseli abonakalisiwe avela engxenyeni yangaphakathi ye-cornea okuthiwa i-Descemet's membrane. Umcengezi we-corneal owonakele ususwe ngokuchotshozwa okuncane, khona-ke izicubu ezintsha zifakwa endaweni, ngezinye izikhathi zisebenzisa iziqu ezimbalwa. Iningi le-cornea lishiywe lingasetshenziswanga, linciphisa ingozi yokulahla i-cornea entsha ngemuva kokuhlinzwa.
Ngaphambi kokuhlinzwa
Uma usuqumile ukuba nokufakelwa kwe-corneal, i- ophthalmologist yakho izochitha isikhathi esithile nawe ukuhlela yonke inqubo. Idethi izokhethwa ukuhlinzwa, kodwa qaphela ukuthi usuku lungashintsha uma i-donor cornea enhle ingatholakali ngalolo suku.
I-ophthalmologist yakho izodinga ukwazi nganoma yimiphi imithi oyithathayo, kuhlanganise kokubili kokubhaliswa kanye nokungavunyelwe. Kungase kudingeke ukuba uyeke okwesikhashana ukuthatha imithi ngaphambi kokuhlinzwa.
Uzokhuthazwa futhi ukuba wenze i-aphoyintimenti nodokotela wakho wokunakekela oyinhloko. Uzocelwa ukuba uhlole izivivinyo ze-laboratory ezifana nokubala kwegazi kanye ne-EKG ukuqinisekisa ukuthi unempilo ngokwanele yokuhlinzwa. Udokotela wakho uzohlola amehlo akho futhi aqhube ukuhlolwa okukhethekile ukuqinisekisa ukuthi iso lakho lilungele ukuhlinzwa.
Khumbula ukuthi ngeke ukwazi ukushayela emva kokuhlinzwa kokufakelwa. Kufanele wenze amalungiselelo omuntu okukushayela ekhaya ngemuva kokuhlinzwa.
Ngesikhathi sokuhlinzwa
Kungenzeka ukuthi i-anesthesia yendawo noma ejwayelekile ingasetshenziswa ezimweni eziningi. Udokotela wakho uzoxoxa nawe ukuthi yiluphi uhlobo lwe-anesthesia olungcono kakhulu kuwe. Uma usungena ekamelweni lokusebenza, amajwabu amehlo akho azohlanzwa futhi agubungulwe ngendwangu eyinyumba. Umoya we-oxygen uzonikezwa ithubhu lepulasitiki elibekwe eduze nekhala lakho. Udokotela ohlinzayo uzobe esebeka i-microscope phezu kweso lakho.
Ngesikhathi senqubo egcwele yokungena kwe-keratoplasty, insimbi eyisiyingi okuthiwa i-trephine isetshenziselwa ukususa isikhungo se-cornea. Inkinobho yama-donor corneal tissue nayo iyanqunywa. Izicubu zomnikelo zithunywe endaweni nge-sutures emihle.
Ngaphandle kwalokho, odokotela abaningi abahlinzayo manje basebenzisa i-femtosecond laser ukusika isiguli se-cornea kanye nezicubu zomnikelo. I-laser ivumela ukuthi izicubu zinqunywe emaphethini we-zig-zag nasezindlini ezijulile ezilawulwayo ngokucacile okukhulu. Lokhu kuvumela ukuchotshozwa kwezicubu zesiguli kanye ne-donor cornea ukuvumelanisa ndawonye njengesiqeshana se-puzzle.
Ngezingxenyana zendabuko ezenziwe nge-trephine, kungathatha izinyanga eziyisithupha kuya kweziyishumi nambili ukuzinza nokuthola umbono ongcono. Kodwa-ke, nge-laser femtosecond, ukucubungula okuqondile kuphulukisa ngokushesha, okuvumela ukukhishwa kakhudlwana kwe-suture nombono ongcono.
Esikhathini senqubo ye-EK noma i-endothelial keratoplasty, kuphela uhlaka lwangemuva lwe-cornea olushintshwayo. Isiguli sigcina ukuphulukisa kakhulu ngale nqubo, njengoba yonke i-cornea ingasetshenzisiwe. Ngemuva kokuthi inqubo iphelele, isihlangu somzimba sizosetshenziswa ukuvikela iso. Uzobe usuthathwa ekamelweni lokutakula ukuze uhlale ngaphambi kokukhishwa.
Ngemuva kokuhlinzwa
Iso livame ukuchotshwa noma yikuphi kusukela ezinsukwini ezilodwa kuya kwezintathu. Udokotela wakho weziso uyovame ukukubona ngosuku olulandelayo futhi asuse i-punch eye. Uzohlola ukuhlinzwa ukuqapha ukuphulukiswa nokubuka ukulahla izicubu, usebenzisa i-RSVP njengesiqondiso:
- Ukubukeka - Ukubomvu kweso isobala kuyisibonakaliso sokwenqaba.
- Ubuqotho buka- S - Ukwenqatshwa ngokuvamile kubangele ukuzwela okukhulu.
- V ision - Ukulahlwa kungabangela ukuzwakala okubuhlungu, okufisa noma okufiphele.
- P ain - Ukwanda okungazelelwe kobuhlungu beso noma ukuzwa komzimba kwangaphandle kungaba uphawu lokulahlwa.
Emva kosuku lokuqala noma lwesibili emva kokuhlinzwa, ungabuyela emisebenzini evamile njengokuxubha amazinyo, ukugeza, ukuguqa, ukufunda, ukuhamba noma ukubuka i-TV. Ukusebenzisa iso lakho ngeke kulimaze iso lakho noma kuthinte ukuphulukiswa, kodwa kufanele ugweme noma yikuphi ukugijima kwezemidlalo noma ukuxhumana okunamandla ubuso noma iso. Kungase kuphakanyiswe ukuthi uqhubeke ugqoke isihlangu somlenze wesonto lokuqala noma amabili emva kokuhlinzwa ukuze uvikele iso lakho ebusuku uma ulele.
Kumele ube nokukhuthele kakhulu ngokugxilisa amehlo akho phansi njengoba udokotela echaza. Enye yezingxenye ezibaluleke kakhulu zokunakekelwa kwakho kokuthutha ukugcina zonke izinkampani zakho zokuqashwa. Udokotela wakho uzodinga ukwazi ukuthi izicubu ziqala ukwenqatshwa. Omunye kwabayisishiyagalombili abamukeli bezitshalo zokufakelwa bahlangabezana nokulahlwa kwamagrafu. Uma kubanjwe kusenesikhathi, kungase kuguqulwe imithi.
Ngemuva kwezinyanga ezimbalwa, i-cornea izozinza ngokwanele ukuze ilinganiswe ngama-eyeglass amasha. Kwezinye izimo, i-astigmatism noma i-nearsightedness ingase ikhule, kodwa izibuko zesola zingakwazi ukulungisa kalula inkinga. Kwezinye izimo, kungadingeka i-lens yokuxhumana ekhethekile ukumboza noma yikuphi ukuphazamisa okusele ku-cornea.
Izwi elivela
Ukubhekana nokuthi udinga ukufakelwa kwe-corneal kungaba nzima. Ukufakelwa kwe-corneal ukuhlinzwa okukhulu kweso futhi kufanele ukhathazeke ngakho. Kodwa-ke, ngobuchwepheshe banamuhla, iningi labantu abahlangabezana nokuhlangenwe nakho kwe-corneal ukufakelwa inqubo enhle kakhulu. Ukufunda okwengeziwe ngalokho okuhilelekile ekufakweni kwe-corneal kuzofaka okuningi kokukhathazeka kwakho kalula.
Umthombo:
Boyd, Kierstan. Mayelana nokufakelwa kwe-Corneal. I-American Academy of Ophthalmology. Sep 2017.