Amapanga intraocular mandala: mitundu, mafakitale, ndemanga

Disolo mu diso disolo amachita mbali. Iwo akhoza kuika kuwala diso. Pamaso pa Kubwera kwa mandala yokumba pambuyo odwala mathithi anavala magalasi ndi yaikulu kwambiri ya magalasi kuphatikiza kapena magalasi kukhudzana.

Pakali pano, kusankha mandala yokumba n'chachikulu kwambiri. The zosiyanasiyana zitsanzo wodziwa ngakhale dokotala aliyense. Pa mitundu ikuluikulu ya mandala ayankhidwa m'nkhaniyi review.

Nthawi zina, amafuna implantation ya mandala yokumba?

The IOL ndi anapatsa m'dera la disolo zachilengedwe anthuwo anasowa ntchito zachilengedwe. Mwachitsanzo, pa opaleshoni kuti mathithi, pamene maso achilengedwe wotaya chilungamo chake, IOL umathandiza kuwukonza myopia, hyperopia ndi astigmatism mkulu.

mandala aikidwa mkati diso, atha kutumikira ngati mandala zachilengedwe ndi kupereka ntchito zonse zofunikira maganizo.

Kutulukira phakic IOL anali yankho woona kwa odwala ndi digiri yapamwamba ya myopia, hyperopia ndi astigmatism. Komanso, zitsanzo izi unakhazikitsidwa kuti odwala amene zifukwa zosiyanasiyana ndi contraindicated khalidwe masomphenya kudzudzulidwa ndi laser.

An zina kukonza laser masomphenya ndi njira refractive mandala m'malo yokumba IOL chitsanzo. Zooneka zida Choncho wotaya umatha malawi (a masomphenya a zinthu pa mtunda osiyana). Pambuyo pa opaleshoni imeneyi wodwala Kwalamulidwa kuvala magalasi kuwerenga ndi kuwona akutsutsa pafupi. Njira imeneyi ndi mmene nkhani unataya malawi zachilengedwe kawirikawiri amabwera kwa zaka odwala pa zaka 45-50

Implantation wa phakic intraocular mandala lasonyeza ndi dzanja kwambiri kukachitika kuti malawi zachilengedwe sanayambebe anatayika n'zotheka akugwira mandala implantation popanda kuchotsa maso achilengedwe. Phakic magalasi kulola odwala kuona zinthu zonse pafupi ndi kutali.

chipangizo IOL

Childs, mandala intraocular limapangidwa Zinthu ziwiri, ndi kutchulidwa kuwala.

Mbali kuwala ndi mandala opangidwa ndi nsalu ya mandala. Iwo pamodzi ndi zimakhala moyo wa diso. Pamwamba pa gawo kuwala ndi zone mapindidwe akuwala kukhala kotheka kupeza momveka la masomphenya. Thandizo gawo disolo ndi udindo fixation otetezeka diso kapisozi.

Kuphunzitsa yokumba intraocular mandala alibe alumali moyo. Imakhala masomphenya wathunthu wa munthu kwa zaka zambiri.

Ubwino waukulu zitsanzo phakic

• Musakhudze Iris ndi diso, pofuna chitukuko cha kusintha osachiritsika.
• Pamodzi ndi biologically ndi diso la munthu.
• Ali ndi chitetezo chapadera kwa diso Mavuto cheza ultraviolet.
• Onetsetsani kubwezeretsa mwamsanga masomphenya.
• Khalani dongosolo corneal.

kusinthidwa zovuta ndi yofewa

magalasi The anawagawa mitundu iwiri chachikulu: mwakhama ndi zofewa. Zochita madokotala diso padziko lonse golide ulamuliro wakhala akunyamula kugwira popanda matabwa - phacoemulsification.

Phacoemulsification mathithi intraocular mandala implantation ikukhudza kukhazikitsa kutalika 2.5 mm odulidwa. Disolo ayenera softness. Zimenezi zimathandiza kuti falitsani mu chubu kupyolera mwapadera kwa injector cholinga. Mkati diso, iye anaweramuka ndi kumachita monga mandala a.

Anasiya njira kumafuna kuphedwa gawo mamilimita 12 m'litali ndi suturing kwa miyezi sikisi. Kotero anapatsa okhwima chitsanzo.

Ozungulira ndi aspheric IOLs mtundu

The aspherical IOL amapereka kunyezimira kochepa kwa gwero kuwala masana ndi usiku. Izi zikutanthauza kuti palibe kanthu chimene mfundo zake sanali kuwala, nthawizonse adzakhala pansi refraction, onse pakati ndi pa m'mbali ake. Izi ndi chinthu chofunika kwambiri kwa nthawi mdima wa tsiku pamene mwana wa diso ngati kuli kotheka kukodzedwa.

Mwachitsanzo, palibe glare pa nyali magalimoto. Mundawu Nkofunika madalaivala. Komanso Aspheric mandala mtundu ndi chibadidwe mu akadakwanitsira mtundu kubalana ndi mkulu mosiyana.

Ozungulira mtundu ikukhudza kunyema osiyanasiyana mwamphamvu m'madera osiyana disolo. Izi zimathandiza kuti kupezeka kwa kuunika, amene zoipa zokhudza khalidwe la ntchito zithunzi. Mtundu wa magalasi zingachititse glare ndi kuwala.

Multifocal ndi monofocal lachitsanzo

Monofocal mandala lakonzedwa kuonetsetsa khalidwe la kuzindikira zithunzi nkhani ili patali. Kuwerenga pambuyo opaleshoni chofunika kuphatikiza-mfundo.

Zida intraocular mandala (IOL) ndi mtundu wa multifocal bwino. Izo zimatengera mtengo wake mkulu. Timatha wodwala kuwona zinthu pa mtunda onse. nchito imeneyi amaperekedwa ndi kasinthidwe zovuta za Optics ake. Masomphenya pafupi mtunda pakati kukakumana ndi mabacteria atatu osiyana. Pankhaniyi, wodwalayo sikutanthauza kuvala magalasi. Ndicho chifukwa chake mtengo zipangizo amenewa ndi mkulu.

toric lachitsanzo

zitsanzo Toric yadaikidwa kuti vuto la astigmatism. Astigmatism amatchedwa mawonekedwe osasamba wa diso amene asokoneza fano. Ngati wodwalayo akugwira mathithi kuchotsa ndi kupereka mandala kusinthidwa muyezo wa chosayenerera kusiyiratu. Choncho, pambuyo opaleshoni iye kachiwiri atachitiridwa atavala mfundo cylindrical.

Pamene kuphunzitsa ndi toric mandala chitsanzo wodwala zingakhalepo ndi akulipira chifukwa astigmatism ndi masomphenya machitidwe zinthu. Mu magalasi toric amanga zonenepa kutero. Ndimapereka mandala otero diso mwa zizindikiro zapadera pa mandala, wodwalayo mwina kukwaniritsa akuthwa fano.

Unsembe zitsanzo imeneyi ndi kuwerengetsera yeniyeni asanachite opareshoni. Kwa wodwala aliyense, iwo akutsatiridwa anthu paokhapaokha.

Reviews a odwala matenda astigmatism amasonyeza kuti implantation chitsanzo toric zimabweretsa zotsatira zabwino. odwala ambiri pambuyo opaleshoni akusonyeza kuti masomphenya awo analusa kwambiri moti bwino mmene sanali ngakhale ku unyamata wake.

Multifocal toric mandala

zingapo IOL anamaliza multifocal toric chitsanzo. Ngati wodwala akudwala astigmatism, ndipo akufuna kuona mofanana bwino onse pafupi ndi pa mtunda, ndiye izo zikusonyeza implantation a mtundu umenewu. Ichi chizathandiza mandala kubwezeretsa masomphenya. Pa mfundo yomweyo kuti wodwalayo sufunika. Ndi mtundu mtengo kwambiri disolo.

UV Zosefera IOL chikasu ndi buluu

Disolo zachilengedwe diso ali wapadera luso zoteteza kutchinga cheza zoipa dzuwa. Zimenezi zimathandiza kuwonongeka kwa diso la diso. Modern pochiza matenda a maso kumaphatikizapo kupanga mitundu yonse ya IOLs fyuluta ku cheza ultraviolet.

zitsanzo Special a magalasi ali akuda inki chikasu kukwaniritsa kufanana pazipita ndi mandala achilengedwe. Izi Zosefera kunja zoipa buluu kuwala umene uli mbali yakumwamba ya sipekitiramu wa.

AcrySof IQ

AcrySof IQ wanzeru mandala ndi kukonza ozungulira aberration (pamaso pa glare, kuunika kozungulira mutu, kuunika) mu kuwala. Chotero chitsanzo akhoza kupereka masomphenya wangwiro zinthu aliyense kuyatsa. Izi kopitilira muyeso-woonda mandala (kawiri n'kakang'ono kuposa masiku).

M'chigawo chapakati cha mandala ochiritsira n'kakang'ono kuposa m'mbali. Ndi kupyolera mu kuwala matabwa kuti kudutsa m'dera ake zotumphukira, kuganizira kwa diso ndi cheza chapakati - pa izo. Popeza cheza kuwala kwambiri za osati pa nthawi ina. Chifukwa, ndi fano diso bwinobwino.

Intraocular mandala AcrySof IQ kumatha vutoli. padziko kumbuyo lakonzedwa m'njira kuti amalola onse kuwala matabwa nawo mu mfundo imodzi. Image operekedwa ndi chitsanzo ichi, mkulu mlingo wa quality, Mosiyana ndi momveka nthawi iliyonse tsiku.

M'MALO ndi mathithi mandala opaleshoni

Pakali pano, ndi implantation ya mandala intraocular ndi akupanga phacoemulsification ndi mpheto wa digirii ka chiopsezo cha odwala. Iye ali mkulu mlingo wa dzuwa. Pafupifupi 95% ya mathithi ku Ulaya, United States ndi dziko lathu ndi kuchotsedwa mu njira iyi.

The World Health Organization wakhala anazindikira ntchito kokha mwa njira zonse opaleshoni, amene amasiyanitsa konzanso zonse.

ndicho alowererepo opaleshoni chiyani?

Chifukwa cha opaleshoni mathithi ndi kuchotsa opaque crystalline mandala, amene kumathandiza otaya lowala kwa diso. Amapanga intraocular mandala m'malo ndi zowonongeka zachilengedwe mandala.

Magawo waukulu implantation

Ambiri ntchito phacoemulsification anachita mu zipatala payekha, outpatient. Magawo a pokonzekera opaleshoni ndi pafupi zofanana kulikonse:

• Ola isanayambe opaleshoni wodwala ayenera kubwera ku chipatala.
• Pofuna kuwonjezera mwana wace aikha madontho munali mankhwala ochititsa.
• Wodwala aikidwa pa tebulo ya opareshoni. The dzanzi zimapangitsa mankhwala ochititsa dzanzi.
• Dokotalayo amachotsa mathithi ndi mandala ndi sangafe.
• opaleshoni sikutanthauza stitches.
• Pambuyo pa opaleshoni, wodwalayo ali kunam'sintha kwa House.
• ola pambuyo opaleshoni ya mtima ndi abwelele kunyumba.
• Tsiku lotsatira, wodwala ayenera kubwera pa ulendo kwa dokotala.

Monga opaleshoni

Kuti apeze mwayi kwa diso imachitika tosaoneka ang'ambe thupilo wa 1.8 mm m'litali. Ndimitambo mandala ali anasintha mwa ultrasound ndi adziwonetsa emulsion ndi, amene achoka diso. kapisozi umayamba kudzera injector kusintha intraocular mandala. Amakambirana diso mu mawonekedwe a timachubu, kumene iye akutembenuka ndi mwabata.

Tosaoneka ang'ambe thupilo mtsogolo losindikizidwa popanda chopinga kunja. Choncho, suture mu nkhani iyi si koyenera. Masomphenya kwa wodwala akubwerera monga ulamuliro, mu chipinda cha opareshoni.

Nthawi ntchito mphindi 10-15. Pomwe ichi ntchito kukapanda kuleka mankhwala oletsa ululu umene mosavuta analekerera ndipo sachita khama katundu pa zotengera mtima ndi magazi. Pambuyo pa opaleshoni ya mtima yatsala anazimitsa kayendedwe zimachitika pa moyo. Zoletsa ndi kochepa. Iwo makamaka ikukhudzana bwanji ndi ukhondo.

nthawi konzanso

Pambuyo opaleshoni, dokotala n'kukulemberani wodwala madontho wapadera diso kudziŵa pafupipafupi ntchito zawo. Komanso anaika tsiku chavuta ndi zina ngati muyeso prophylactic. Wodwalayo ali ololedwa kusunga moyo wake zonse, kuwerenga, kulemba ntchito pa kompyuta, kapena kuonera TV, amasamba, kukhala ndi pansi udindo omasuka. Zofunikila pa chakudya komanso kulibe.

ndi zovuta za opaleshoni?

The implantation ya mandala intraocular ali Kuvuta ena kuti lagona amafuna okwezeka ndi lolondola mawerengedwe ndi kusankha chitsanzo mandala, ndi ntchito akatswiri a maso a. N'chifukwa chake chikhalidwe zofunika kwambiri ntchito ndi matenda wathunthu. Only kafukufuku zambiri amachitika ndi mitundu yosiyanasiyana ya zipangizo zamakono, limachititsa kupeza cholinga Poona mmene alili.

ubwino

Akupanga phacoemulsification mathithi amasiyana ungwiro anakhala pa luso zaka. opaleshoni imagwiridwa mu nthawi yochepa. Wodwala angamasuke ndi wotetezeka. Komabe, lingaliro loterolo cha mpheto ndi ofunika mkulu luso la woyendetsa ndi lumo lakuthwa ndondomeko bungwe.

Ubwino waukulu wa opaleshoni imeneyi ndi monga:

• ufulu mtheradi kuchokera ng'ala;
• kukwaniritsa makhalidwe mkulu zithunzi;
• kuchira mofulumira wodwalayo;
• pakalibe zofunikila pa thupi ndi zithunzi zikomo katundu njira wopanda msoko;
• kupweteka chifukwa mandala alibe mathero mitsempha;
• kudutsa ndi kusintha mwamsanga, pambuyo pa sabata, mukhoza kupita ku ntchito;
• zoletsedwa ndi malamulo a mwezi;
• ndi chiphaso mandala mtundu ndi Mosiyana.

Zikuonetsa kuti Khwelero

Zikuonetsa kuti alowererepo opaleshoni akhale pa siteji iliyonse ya mathithi. Njira ndi kuchita opaleshoni mu mawonekedwe mwana wa mathithi, limalola ntchito popanda chiopsezo.

Wodwalayo, kumakhalanso kuphatikiza lalikulu: si koyenera kudikira mpaka maso wathunthu khungu, monga momwe analiri poyamba. Kuchotsa turbidity mu magawo koyamba matenda kuchepetsa mavuto onse pa opaleshoni ndipo pambuyo pake.

zosokonezeka kutheka pambuyo opaleshoni

Mu ambiri ananena phacoemulsification implantation a magalasi intraocular imene ikuchitikira madokotala akatswiri ndi zotsatira zabwino. Ngati dokotala ndi oyamba, mu 10-15% milandu amafotokozedwa zosokonezeka.

Iwo akhoza zimayamba ndi:

• kufooka kwa Mitsemphayi disolo;
• kuphatikiza ashuga mathithi, khungu ndi myopia;
• pamaso pa matenda ofala diso.

Zovuta za opaleshoni monga:

• kuwonongeka corneal mwa ultrasound;
• kuswa umphumphu wa Mitsemphayi mandala;
• chophukacho wa mandala kapisozi, kuchititsa imfa ya vitreous;
• kuchepetsa mandala yokumba, etc ..

Tikumbukenso kuti mavuto onse akuwuka opaleshoni, kungabweretse mavuto aakulu. Chithandizo Pankhaniyi adzakhala mosalekeza, ndipo zotsatira zake sizingakhale zabwino kwambiri.

Kuchotsa mandala

Nthawi zina pa ndondomeko yotupa kapena njira pathological mu diso amafuna kuchotsa mandala intraocular. Zikatero, okwana vitrectomy anachita IOL. Disolo akagwidwa awiri tweezers ndi chitsogolo. Sclerostomy kwa oyamba endo-chounikira ali ndi kapu ya. Madokotala kuchita ndi ang'ambe thupilo mu diso njira lumo ndi ❖ kuyanika diamondi. IOLs akhoza intercepted ndi dokotala ku forceps ena 25G Mwachitsanzo, 20g forceps ndi diamondi-adagadabula.

Pambuyo kuchotsa mandala ang'ambe thupilo sutured olimba kapena X woboola pakati nayiloni suture № 10-0. Kugwiritsa ntchito zinthu n'kakang'ono kwa msoko ndi zochepa kuonekera kwa astigmatism, koma pamafunika kusamala changu monga chiopsezo kutayikira kudzera msoko pa mpheto.

Nthawi zina, IOL atachotsedwa pamaso pa Kakhungu fibrovascular lomwe ndi zotsatira za kuchuluka fibrovascular kutsogolo zochokera vitreous chifukwa zoopsa, kapena uveitis. Chotero ndondomeko angathe ankaipembedza ndi shuga.

Pankhaniyi, zigawo zikuluzikulu haptic intersect ndi lumo, koma kuti asunge kuya zapambuyo chipinda, ntchito viscoelastic.

Haptics akhoza kusungidwa M'mimbamo ocular ngati amacheza ndi kapisozi fibrous ndipo si kuchotsedwa ndi tweezers. Kuonjezera zikayamba wa bala umagwiritsidwa ntchito matabwa angapo X woboola pakati. Ntchito monoiflemnaya ulusi chiwerengero 9-0 kapena 10-0.

Kodi IOL opanga adalipo?

Kodi kusankha magalasi intraocular? Opanga kuimira osiyanasiyana a zanyengo ndi makhalidwe osiyana. Pakali pano, ambiri kusinthidwa wa phakic mandala ICL (STAAR, CIBA Masomphenya) ndi kamera kumbuyo.

zitsanzo izi ndi phunziro kwa implantation disolo kutsogolo kwa Iris ndi kuonetsetsa mkulu kuwala ntchito. Ngati n'koyenera, magalasi akhoza kuchotsedwa diso popanda kusokoneza mmene thupi lake lilili.

Reviews

magalasi Intraocular, amene ndemanga zabwino kwambiri, akhala kwa anthu ambiri, ndi njira yokhayo yodalirika achire otaika masomphenya.

Feedback kwa odwala, ultrasound mathithi phacoemulsification ndi IOL implantation ndi kwambiri zothandiza, otetezeka ndipo sabweretsa chisoni njira kuti akhoza tichotse mathithi zonse ndi kuonetsetsa masomphenya angwiro. The IOL anali yojambula weniweni mankhwala a maso.