Hloov corneas: hauj lwm, indications, nqi xyuas. qhov muag Microsurgery

Nyob rau hauv hnub no lub ntiaj teb no muaj yog ib tug ceev ceev txoj kev loj hlob ntawm cov tshuaj. Achievements muaj cai nyob rau hauv tag nrho cov cheeb tsam no. Qhov no siv rau kev phais thiab kho txoj kev kho mob, kev kuaj mob, kev discoveries. Tsis tsuas yog, thiab Ophthalmology. Nrog lub advent ntawm microsurgical hom kev kawm qhov muag phais tau ua ntau nyob xeeb dua qub thiab zoo dua. Qhov zoo ntawm niaj hnub Ophthalmology - ib tug ceev thiab tsis mob rov qab pom kev. Hloov ntawm lub cornea, uas yav tas los mag tsis yooj yim sua, yog tam sim no nqa tawm nyob rau hauv tag nrho cov chaw zov me nyuam tshwj xeeb. Raws li ib tug tshwm sim, keratoplasty muaj coob tus neeg rov qab muaj peev xwm mus saib lub ntiaj teb no nyob ib ncig ntawm peb.

Hloov ntawm lub cornea - dab tsi yog qhov no?

Qhov no lub lag luam muaj ib tug scientific lub npe - keratoplasty. Tsis tas li ntawd, nws yog hu ua sib hloov ntawm lub cornea. Vim qhov no hloov khoom nruab nrog ntawm lub xub ntiag twb tsis muaj ntshav mov, nyob rau hauv Feem ntau, nws tau cawm thiab lub lag luam yog muaj kev vam meej. Tom qab keratoplasty pom kev zoo yog paub heev los yog kiag li rov qab los. Mas kuj pub hloov corneas. Hloov ntawm puas qhov chaw los yog lub cev raws li ib tug tag nrho. Nyob rau hauv tej rooj plaub, ua ib co kev hloov khoom. Nyob rau hauv Feem ntau, lub lag luam no yuav siv sij hawm qhov chaw nyob rau hauv kev tshuaj loog. Txawm li cas los, cov tub ceev xwm kom keratoplasty tau siv lub zos tshuaj loog. Lub efficiency ntawm lub lag luam muaj yuav luag yeej ib txwm yog ib tug mob corneal hloov yog tsis tshua muaj tsis tshua muaj. Vim li no, keratoplasty yog ib tug nrov txoj kev kho mob thoob ntiaj teb.

Nyob rau hauv tej rooj plaub, ua corneal transplant?

Lub lag luam los hloov lub cornea yog ua tau tsuas yog nyob rau hauv nruj indications. Nyob rau hauv feem ntau tus neeg mob, qhov ua rau ntawm kev hloov kev puas tsuaj yog kev poob plig thiab inflammatory tus kab mob. Nyob rau hauv ob qho tib si zaum muaj yog ib tug tseem ceeb deterioration ntawm lub zeem muag los sis tag tsi visibility (tsawg feem ntau). Tej zaum keratoplasty yog ua rau kom hniav zoo nkauj hom phiaj. Muaj cov nram qab no yog vim li cas rau koj ua tus lag luam:

1. Eyesore. Yog vim li cas tej zaum yuav muaj ob qho kab mob, thiab hloov khoom nruab nrog kev raug mob ntawm view.
2. Retinopathy. Qhov no yog hais txog cov ntaub ntawv, uas tsis kam txais lawv tus kheej mus kho kev kho mob. Cov no muaj xws dystrophic, bullous retinopathy.
3. corneal raug mob. Tej zaum yuav muaj nyob rau hauv kev sib cuag nrog ntau yam txawv teb chaws lub cev mus rau hauv lub qhov muag.
4. Tshuaj kub yus.
5. Thinning ntawm txheej ntawm lub cornea. Nws cai nyob rau hauv tus kab mob no, raws li keratoconus.
6. Rwj thiab erosive tsis xws luag.
7. Nti.
8. Corneal opacity. Feem ntau qhov tshwm sim ntawm kev kho mob laser.
9. Kom hniav zoo nkauj tsis xws luag.

Contraindications rau keratoplasty

Nyob rau hauv feem ntau tus neeg mob, microsurgery ntawm lub qhov muag - thaj tsam ntawm cov tshuaj uas yog muaj dav. Contraindications rau kev ua hauj lwm nyob rau hauv lub nruab nrog cev uas tsis pom kev tsis tshua muaj. Keratoplasty yog ua rau txhua leej txhua tus, muaj teev tseg tsis xws luag. Muaj hnub nyoog txwv rau lub lag luam no tsis muaj nyob. Cuaj kaum faib 3 lub xeev nyob rau hauv uas keratoplasty yog txwv tsis pub. Cov muaj xws li:

1. Eyesores uas muaj ntshav txaus. Lub xub ntiag ntawm cov hlab ntsha ua rau lub lag luam ntawm corneal transplant ices.
2. Thaum lawv tseem leukomas thiab kom intraocular siab (glaucoma).
3. Concomitant kab mob nyob rau hauv uas lub siab yuav tsis kam graft. Cov no muaj xws immunological kab mob, decompensated mob ntshav qab zib.

Yuav ua li cas yog cov ntau ntau yam ntawm keratoplasty

Zoo li feem ntau ua hauj lwm keratoplasty yuav tsum tau nyob rau hauv ntau txoj kev. Nws nyob rau ntawm lub hom hloov (pub los dag cornea), qhov ntau thiab qhov tob ntawm defect. Keratoplasty yuav ua tau tag nrho los yog ib nrab. Nyob rau hauv thawj cov ntaub ntawv, nws ntau xyoo rau tag nrho cov cornea. Nyob rau hauv ib tug thib ob - ib feem ntawm qhov hloov, nyob rau lub graft loj yog 4 mus rau 6 hli. Nyob rau hauv tas li ntawd, tej zaum ua subtotal retinoplastika. Hauv qab no nws yog meant hloov ntawm lub cornea zoo tshaj rau tag nrho cov cheeb tsam, tsuas yog rau ib tug ntug (1-2 hli), nyob ib ncig ntawm lub limb. Nyob rau hauv lub qhov tob ntawm kev puas tsuaj thiab paim ib tug los ntawm lamellar hloov. Nyob rau hauv thawj cov ntaub ntawv, cov kho raws occupies tag nrho thickness ntawm lub cev. Fawm kib retinoplastika tej zaum yuav pem hauv ntej thiab nram qab lub (los yog txheej ntaus lub puab phab ntsa ntawm lub cornea). Raws li siv cadaveric hloov khoom nruab nrog pub cov ntaub ntawv uas nrog rau cov neonates. Dag graft ua nyob rau hauv tshwj xeeb lub chaw soj nstuam.

Yuav ua li cas los npaj rau keratoplasty?

Qhov muag Microsurgery, raws li zoo li lwm hom phais cov txheej txheem, yuav npaj ua ntej ua tau zoo rau txoj kev. Thawj kauj ruam yog mus nqa tawm kho kev kho mob ntawm inflammatory dab. Qhov no siv rau txhua kab mob ntawm lub qhov muag thiab tawv muag daj (conjunctivitis, iridocyclitis). Tom qab kev kho mob, tus kab mob yog nqa tawm ua kom tiav diagnostics ntawm kabmob uas tsis pom kev. Tau ophthalmologic xeem, kuaj kev kuaj (KLA OAM ntshav biochemistry). Nws tseem yog tsim nyog kom paub seb dab tsi yog qhov pathology ntawm tus neeg mob. Qhov no yog qho tseem ceeb heev vim hais tias ib co kab mob tej zaum yuav ua tau ib tug contraindication rau kev phais. "Starvation hom" yuav tsum tau pom nyob rau lub tswv yim ntawm retinoplastiki.

Txheej txheem ntawm corneal hloov

Corneal hloov phais yog tau siv ib tug tshwj xeeb microsurgical khoom. Kom retinoplastiku ua ob tsoos phais thiab laser cov txheej txheem. Nyob rau hauv xyoo tsis ntev los, lub thib ob hom yog suav tias yog preferable vim nws thiaj li postoperative lub sij hawm thiab thiaj li muaj cov uas muaj feem yuav muaj teeb meem. Hloov corneas muaj ib tug meej kev siv cov txheej txheem. Thawj, tus neeg mob yog pw nyob rau hauv lub rooj zaum thiab tsim ua kom loog. Tom qab ntawd txhim kho qhov muag daj thiab lub qhov muag (sclera tshaj lub ntug). Cov theem tom ntej - tshem tawm ntawm lub puas hloov khoom nruab nrog los yog ib feem (qhov no yog ua los ntawm laser los yog phais ntsuas). Ntxiv nqa tawm ib corneal transplant. Cov theem kawg yuav soj ntsuam ntawm welds, soj ntsuam rau lub xub ntiag muaj teeb meem.

Lub postoperative lub sij hawm thaum lub sij hawm keratoplasty

Tom qab lub hloov, lub cornea neeg mob yuav tsum tau muaj yam tsawg ob peb teev nyob rau hauv kev kho mob saib xyuas. Txawm tias muaj tseeb tias tus neeg mob mus tsev, nws yuav tsum tau kuaj los ntawm ib tug ophthalmologist. Nws kuj pom zoo tom qab kev phais yog maj rau lub qhov muag (yam tsawg kawg nkaus load rau hauv lub nruab nrog cev uas tsis pom kev). Yog hais tias kev phais kho sutures raug muab tshem tawm tom qab ib tug ob peb lub hlis (ib xyoos). Tau teeb meem keratoplasty - yog los ntshav, o, hloov rejection. Nyob rau hauv cov zaum muaj tsis xis nyob, photophobia, khaus thiab thiaj li nyob. D. Tej tsos mob ua rau ceev xa mus rau ib tug ophthalmologist.

corneal transplant qhov muag: xyuas tshwj xeeb

Raws li cov kws kho mob retinoplastika yog ib tug muaj kev ruaj ntseg thiab zoo txoj kev rov qab. Nws yog pom zoo rau tag nrho cov neeg uas tsis muaj contraindications. Cov neeg mob yog txaus siab nrog lub lag luam. Vision tsawv rau ntau xyoo tom qab kev sib hloov, thiab teeb meem yog tsis tshua muaj heev. Thaum lub caij, lub nyiam laser yog pom tias yuav hloov lub cornea. Nqi ntawm cov lag luam nyob rau cov kev xaiv ntawm cov chaw kho mob. Qhov nruab nrab nqi yog 50-70 txhiab rubles rau ib lub qhov muag. Thaum xaiv ib tug dag hloov nqi yog ob npaug.