Ngubani ovumelekileyo kunye nento onokuyilindela?
I- cornea yindawo ecacileyo ephambili kweso elithwala iris, umfundi, kunye nendawo yangaphakathi. Ukutshintshwa kwe-corneal, okanye i-keratoplasty (KP), kubandakanya ukukhangela ngokugqithiseleyo inxalenye ye-cornea kunye nokuyifakela nge-tissue ebonakalayo kunye nephilileyo ephilileyo eyenziwa yibhankini yeliso.
Ukuba ucinga okanye uxelelwe ukuba udinga ukufakelwa kwe-corneal,
Ngubani ofuna i-Corneal Transplant?
Umbono omuhle ufuna ukuba i-cornea ibe icace, ilula kwaye iphilile.
Ukukhanya akukwazi kugxininisa kakuhle ngaphakathi kweso xa i-cornea ibonakala, ikhubekile, okanye ibonakele. Isiphumo sinombono ophazamisayo okanye ukukhanya.
Ukutshintshwa kwe-corneal kuyadingeka ukuba i-cornea yakho ibonakaliswe okanye ayibi. I-corneas ephilileyo ifumaneka kwiibhanki zamehlo emva kokunikezelwa ngabanikeli babantu. I-corneas enikezelwayo ivivinywa ngokupheleleyo ukuqinisekisa ukuba ikhuselekile kwaye inempilo ukuyisebenzisa.
I-National Eye Institute ilinganisela ukuba malunga nama-40,000 ahambayo ahamba rhoqo ngonyaka e-United States. Ziyimfuneko kwiimeko ezininzi zamehlo, kubandakanywa oku kulandelayo:
- I-Keratoconus : I- Keratoconus yimeko apho i-cornea ejikeleza ngokuqhelekileyo iba yincinci kwaye ivelise i-cone-like bulge.
- I-corneal clouding: Iimeko ezininzi zinokubangela ukuba i-cornea ivuvuke kwaye iguquke, njenge-Fuchs 'dysstrophy kunye ne-pseudophakic yolous disease. Kwiimeko ezinzima, i-cornea ingavelisa i-blisters emancinci, ebuhlungu.
- Ukusuleleka kwe- Corneal: Izifo ze-cornea zinokuba yi-bacterial, fungal, okanye viral. Izifo ezithintekayo ezinokubangela izifo zingabangela ukonakala, ukunqunyulwa, okanye ukuguqulwa kwe-cornea. (I-Herpes simplex yintsholongwane ekhoyo yentsholongwane engakhokelela ekubambeni.)
- I-corneal dystrophy: Ezinye iimeko zokufa (i-dystrophies) zingenza ukuba i-cornea ibe yi-opaque okanye ingaqhelekanga.
- Ukulimala kwe-Corneal: Ukulimala kwi-cornea kungabangela ukukhawulwa kwamagciwane okuchaphazela umbono
I-ophthalmologist yakho iya kujonga imeko yakho ngokucophelela ukuvavanya imfuno yakho yokufakelwa kwe-corneal.
Iintlobo zee-Corneal Transplants
Iintlobo ezintathu zokutshintshwa kwe-corneal zisetyenziswa namhlanje. I-ophthalmologist yakho iya kugqiba ukuba yeyiphi inkqubo efanelekileyo kakhulu ngokusekelwe kwimeko yakho.
Ukutshintshwa okupheleleyo kweCoralal Transplant
Ukuba zombini iingqimba zangaphambili nezangaphakathi zonakaliswe, yonke i-cornea yakho ingadinga ukutshintshwa. Eyaziwa nangokuthi i-keratoplasty ehamba phambili (PK), ukuzaliswa kwe-cornea yokutshintshwa kubandakanya ukutshintsha indawo egcweleyo ye-cornea echaphazelekayo okanye eyonakalisiweyo kunye ne-cornea ecacileyo.
I-PK inexesha elide lokubuyisela xa kuthelekiswa nezinye iindidi ze-cornea transplants. Kungathatha unyaka okanye ixesha elide ukuba umbono opheleleyo uphinde ubuyiselwe. I-PK inomngcipheko ophezulu kunokuba nezinye iindidi zokuguquka kwe-cornea eziza kunqandwa ngumnikeli we-cornea. Ukwenqatshelwa ngamanye amaxesha kwenzeka njengoko isistim somzimba sokuzivikela umzimba sihlasela amathambo amasha.
Ukutshatyalaliswa ngokukhethekileyo kweCoralal Transplant
Ngamanye amaxesha iingqimba zangaphambili neziphakathi kwe-cornea zonakalisiwe kwaye kuphela ezo ziqendu kufuneka zisuswe. Umgca wokugqibela (umgca osemva komgca) ugcinwa endaweni.
Olu tshintsho lubhekiselwe njengelinye lamanzi lamellar keratoplasty (DALK) okanye ukutshintshwa kwincinci.
I-DALK isetyenziswa ngokuqhelekileyo ukuphatha i-keratoconus okanye i-bulge ye-cornea. Ixesha lokubuyisela emva kwe-DALK lifutshane kunokuba emva kokufakelwa kwe-cornea epheleleyo. Ukwenqatshelwa kwe-cornea entsha kungaphantsi komngcipheko kunokuba ukutshintshwa kwe-corneal epheleleyo.
Endothelial Keratoplasty
Kwezinye iimeko zamehlo, i-cornea (endothelium) eyona nto yangaphakathi iyonakaliswe. Umonakalo ubangela ukuba i-cornea ivule, iphazamise umbono wakho.I-keratoplasty e-endothelial yindlela yokuhlinzwa eyenza le ndawo yoluhlu lwe-cornea kunye nezicubu eziphilileyo.
Iyaziwa ngokuba yinto yokutshintshwa okuyingxenye, njengokuba kuphela isalathisi sangaphakathi seethambo.
Kukho ezimbini iintlobo ze-endothelial keratoplasty: i-DSEK (okanye i-DSAEK) ne-DMEK. Ukuguqulwa kwe-Endothelial kusetyenziswa ukunyanga iimeko ezichaphazela kakhulu umqolo ongemva kwe-cornea ezifana ne-Fuchs dystrophy kunye ne-bulleropathy. Inqanda inxeba enkulu yokupanda, iyanciphisa ukuphazamiseka okubonakalayo kwi-astigmatism, kwaye inika ukufumana kwakhona ngokukhawuleza kunokuba i-keratoplasty engena kwiimeko ezithile.
Uhlobo ngalunye luyakususa iiseli ezilimele ukusuka kwinqanaba langaphakathi le-cornea ebizwa ngokuba yi-Descemet membrane. Ubume obunobungozi obunobungozi buyasuswa ngento encinci, ngoko ke izicubu ezintsha zifakwa endaweni, ngamanye amaxesha zisebenzisa izicatshulwa ezimbalwa. Ininzi ye-cornea ishiywe ingafunyanwanga, iyanciphise umngcipheko wokugatya i-cornea entsha emva kokuhlinzwa.
Ngaphambi ko kutyanda
Xa unqumle ukuba ulungele ukufakelwa, i- ophthalmologist yakho iya kuchitha ixesha kunye nawe ukucwangcisa inkqubo yonke. Umhla uya kukhethwa ukuba kwenziwe utyando, kodwa qaphela ukuba umhla ungatshintsha ukuba uncedo olungumniki-mpahla olungileyo alufumaneki ngaloo mhla.
I-ophthalmologist yakho iya kufuneka ikwazi malunga nayiphi na imithi oyithathayo, kubandakanya zombini umyalelo kunye nokungagunyazisiyo. Unokufuna ukuyeka okwethutyana ukuthabatha imithi phambi kokuhlinzwa.
Uya kukhuthazwa ukuba wenze i-aphoyintimenti kunye nogqirha wakho oyintloko. Uyacelwa ukuba ufunde iimvavanyo zelabhoratri ezifana nesibalo segazi kunye ne-EKG ukuqinisekisa ukuba unempilweni ngokwaneleyo ukuba utyunye. Ugqirha uya kuhlolisisa amehlo akho kwaye aqhube iimvavanyo ezizodwa ukuqinisekisa ukuba iso lakho likulungele ukuhlinzwa.
Gcina ukhumbule ukuba awuyi kukwazi ukuqhuba umqhubi emva kokuhlinzwa okutshintshwayo. Kufuneka wenze amalungiselelo omntu ukuba akuqhube ekhaya emva kokuhlinzwa.
Ngethuba loPhando
Ingaba i-anesthesia yendawo okanye jikelele ingasetyenziswa kwiimeko ezininzi. Ugqirha wakho uya kuxoxa nawe uhlobo luni lwe-anesthesia elona lungcono kuwe. Emva kokuba ungene kwigumbi lokusebenza, iinqwelo zakho ziza kuhlambuluka kwaye zigutyungwe ngumbumba ongezantsi. I-oksijeni iya kunikwa ityhubhu yeplastiki ibekwe kufuphi neempumlo zakho. Ugqirha uza kubeka i-microscope phezu kweso lakho.
Ngethuba le-full-thickness inkqubo engena kwi-keratoplasty, isixhobo setyhula esibizwa ngokuba yi-trephine sisetyenziselwa ukususa i-cornea. Iqhosha le-donor corneal tissue liyakunqunywa. Izicubu ezixhasayo zitshintshwe endaweni kunye ne-sutures emihle.
Ngaphandle koko, abaninzi oogqirha ngoku basebenzisa i-laser femtosecond ukusika isigulane sesigulane kunye nezicubu. I-laser ivumela ukuba izicubu zinqunywe kwimizekelo ye-zig-zag kunye neendawo eziphantsi ezilawulwayo ngokuchanekileyo. Oku kuvumela ukufakwa kwesigulane sesigulane kunye ne-cornea abaxhasiyo ukuba bahlangane kunye njengengxube yepuzzles.
Ngeemveli eziqhelekileyo ezenziwe nge-trephine, kunokuthatha iinyanga ezintandathu ukuya kwezilishumi elinesibini ukuzinzisa nokufumana umbono olungcono. Nangona kunjalo, kunye ne-femtosecond laser, ukuchaneka ngokuchanekileyo kuphulukisa ngokukhawuleza, ukuvumela ukuba kususwe ngokukhawuleza kweso suture kunye nemibono engcono.
Kwi-EK okanye inkqubo yokuphelisa i-keratoplasty, i-back row of cornea iyatshintshwa kuphela. Isigulane sivame ukuphulukisa ngokukhawuleza kule nkqubo, njengoko yonke i-cornea ingasetyenziswanga. Emva kokuba inkqubo iphelele, ikhuselo leso liya kusetyenziswa ukukhusela iso. Emva koko uza kuthathwa kwigumbi lokubuyisela ukuphumla ngaphambi kokukhutshwa.
Emva koBuloyiko
Iliso livame ukubethelwa kuyo yonke indawo ukusuka kwimihla ukuya kwiintsuku ezintathu. Ugqirha lakho liso liyakuthi likubone ilanga elilandelayo kwaye lisuse iqhosha lemehlo. Uya kuhlola ukuhlinzwa ukubeka iliso ukuphulukisa nokujonga ukulahla izicubu, usebenzisa i-RSVP njengesikhokelo:
- Ulungelelwaniso - Ubomvu obusenyameko ngumbonakaliso wokulahlwa.
- Ububungqina bobugqwetha - Ukugatywa kaninzi kubangele ukuqonda okukhulu.
- I- ision - Ukulahlwa kungabangela ukubonakala okuphazamisayo, okugubungelayo okanye okunamafu.
- P ain - Ukunyuka ngokukhawuleza kwentlungu okanye isohlwayo lomzimba lwangaphandle luba ngumqondiso wokuchaswa.
Emva komhla wokuqala okanye wesibini emva kokuhlinzwa, ungabuyela kwimisebenzi eqhelekileyo njengokutshiza amazinyo, ukuhlamba, ukuguqa, ukufunda, ukuhamba okanye ukubukela iTV. Ukusebenzisa iliso lakho akuyi kubuhlungu iso lakho okanye kukuchaphazela ukuphulukiswa, kodwa kufuneka ugweme nayiphi na imidlalo ebalulekileyo okanye udibaniselwano olunobunzima ubuso okanye iso. Kungacetyiswa ukuba uqhubeke ugqoke ikhuselo leso ngeveki yokuqala okanye ezimbini emva kokuhlinzwa, ukukhusela iso lakho ebusuku xa ulala.
Kumele ube nokukhuthele kakhulu ngokugxilisa iliso lakho lihla njengokuba ugqirha echaza. Enye yezona zinto zibalulekileyo kunonophelo lolondolozo lwentlalo kukugcina zonke iinkqubo zokuqeshwa kwabagqirha bakho. Ugqirha wakho uya kufuneka azi ukuba izicubu ziqala ukulahlwa. Omnye kwabafundi abane abafake izicelo zokutshintshwa kweentlobo. Ukuba ibanjwe kusenokwenzeka, kunjalo, iyakuthi iguqulwe ngamachiza.
Emva kweenyanga ezimbalwa, i-cornea iya kuzinza ngokwaneleyo ukuba ilinganiswe ngeeklasi zokukhanya. Kwezinye iimeko, i-astigmatism okanye i-nearsightedness ingahlakulela, kodwa iziglasi zamehlo ziyakwazi ukulungisa lula ingxaki. Kwezinye iimeko, i-lens ekhethekileyo yoqhagamshelwano ingadingeka ukukhupha nayiphi na into ephazamisayo ekhoyo kwi-cornea.
ILizwi
Ukujongana nelokuba udinga ukutshintshwa kwe-corneal kunokuba nzima. Ukutshintshwa kwe-corneal kuyindlela enkulu yokuhlinzwa kwaye ujongene nokuxhalaba ngako. Nangona kunjalo, ngekhnoloji yanamhlanje, abaninzi abantu abafumana ithuba lokutshintshela i-corneal inkqubo engabonakaliyo. Ukufunda okungakumbi malunga nento echaphazelekayo ekutheni ukufakelwa kwamanzi kuyakubeka ezininzi iinkxalabo zakho ngokukhululeka.
Umthombo:
Boyd, Kierstan. Malunga neCorneal Transplantation. I-American Academy ye-Ophthalmology. Septemba 2017.