Chakagadzirwa intraocular gogorosi: mifananidzo, vagadziri, wongororo

The gogorosi iri Ziso izvo rine basa. It anogona kuisa chiedza muna the retina. veMubatanidzwa chakagadzirwa izvo pashure cataract varwere asati vaipfeka magirazi pamwe chaizvo makuru pamusoro ndinoiitawo magirazi kana kuonana lenses.

Pari, pakusarudza chakagadzirwa izvo rakafara chaizvo. The siyana mienzaniso aiziva kunyange chero chiremba. On huru mhando dzose izvo ichakurukurwa munyaya ino ongororo munyaya.

Mune zvimwe zviitiko, zvinoda muchibereko rakagadzirwa nevanhu izvo?

The IOL ari muchibereko munzvimbo yepanyama izvo, akapa kuti vakarasika rechisikirwo. Somuenzaniso, panguva kuvhiyiwa cataract, kana yepanyama izvo anorasikirwa pachena kwayo, IOL inoita rakasungwa myopia, hyperopia uye astigmatism pakukwirira.

The gogorosi anoiswa mukati ziso, inogona dzinongoitika izvo uye kupa zvose zvakafanira mashandiro anoita maonero.

Kugadzirwa phakic IOL aiva mhinduro yechokwadi varwere rurefu mwero myopia, hyperopia uye astigmatism. Uyewo, mienzaniso iyi vakagadzwa kuti varwere nezvikonzero zvakasiyana-siyana zviri contraindicated mufambiro chiono kururamiswa kubudikidza Laser.

Rinogona kutsiva Laser zvakaratidzwa kururamisa nzira refractive izvo yokutsiva chakagadzirwa IOL womuenzaniso. saka Visual midziyo anorasikirwa kukwanisa kwayo kuti pekugara (chiratidzo zvinhu zvakasiyana marefu). Pashure pokuvhiyiwa chino murwere ushandiswe akapfeka kuverenga magirazi uye achiona anoramba akamuka pedyo. Nzira Izvi zvinoratidzwa panyaya vakarasikirwa zvakasikirwa pekugara kuti kazhinji anouya zera wevarwere anopfuura 45-50 Makore

Muchibereko phakic intraocular izvo akaratidza pachayo neruoko vakanakisisa chiitiko kuti dzinongoitika pekugara haisati akarasika uye zvinokwanisika kubata izvo muchibereko pasina kubviswa yepanyama izvo. Phakic lenses kubvumira varwere kuti kuona zvinhu zvose pedyo uye kure.

The mudziyo IOL

Kazhinji, asi intraocular izvo unotora zvinhu zviviri, uye Manyiminya bhuku.

The Manyiminya zvinoriumba iri izvo wakaitwa segirazi zvinhu. Zvinonzi pamwe mupenyu munyama ziso. On pemvura Manyiminya chikamu ari diffraction vematunhu, zvichiita kuti vawane Kujeka wezvakaonekwa. Rutsigiro chikamu izvo zviri kukonzera kuti akachengeteka Kuda kutamba muziso Kamudzira.

Kudyara rakagadzirwa nevanhu intraocular izvo hauna pasherufu upenyu. Rinotibatsira muchiratidzo murume kwemakore akawanda zvakakwana.

The chikuru zvakanakira phakic mienzaniso

• Usabata maziso uye cornea, nokudaro zvichiita kuti pave chinopedza kuchinja.
• Pamwe pakugadzira parutivi munhu ziso.
• Vane chinokosha kudzivirirwa the retina kubva rwakashata zvinokonzerwa ultraviolet mwaranzi.
• Nechokwadi nokukurumidza kudzorerwa wezvakaonekwa.
• Ramba corneal mamiriro.

Hard uye akapfava nadzurudzo

The lenses akakamurwa mhando mbiri huru: zvakaoma uye munyoro. In tsika ziso vanachiremba yose nyika yendarama utongi yave kuita mabasa pasina vazvo - phacoemulsification.

Phacoemulsification cataract intraocular izvo muchibereko hunosanganisira Implementation ane chekawo kureba 2.5 mm. The gogorosi kuva softness. Izvi zvinobvumira kuti kumonera ndokuita chubhu kuburikidza zvikuru akagadzirirwa chinangwa ichi injector. Mukati ziso, iye yakagadzirisa uye anoita somunhu izvo.

Legacy chidobi kunosanganisira kuurayiwa chikamu 12 mm pakureba uye suturing kwemwedzi mitanhatu. Saka akaita omarara womuenzaniso.

Idenderedzwa uye aspheric IOLs mhando

The aspherical IOL anopa usingashandi vakapfeka kubva chiedza kupi masikati nousiku. Izvi zvinoreva kuti pasinei zvayo pfungwa asiri chiedza, iye achagara kuti pasi refraction, zvose pakati uye pamusoro wayo kumicheto. Ichi chinhu chinokosha zvikuru nokuda rima nguva zuva apo mboni ziso rukuru sezvinobvira kuwedzerwa.

Somuenzaniso, hapana kudzvokora kubva headlights motokari. pfuma iyi inokosha zvikuru vatyairi. Uyewo Aspheric gogorosi mhando tinoberekwa ari optimum ruvara kubereka uye yakakwirira musiyano.

Idenderedzwa mhando kunosanganisira nepakumedura kunosiyana kuchinyanya dzakasiyana nzvimbo izvo. Izvi zvinobatsira kuti kupararira chiedza, izvo isakarurama kunokanganisa unhu kuona basa. Izvi mhando lenses kunogona kukonzera kudzvokora uye hwihwinyara.

Multifocal uye monofocal muenzaniso

Monofocal gogorosi akagadzirirwa nechokwadi nokunaka kuona maonero nyaya iri kure. Kuverenga pashure pokuvhiyiwa inodiwa ndinoiitawo-pfungwa.

Midziyo intraocular gogorosi (IOL) ndiyo mhando multifocal akavandudzika. It anosarudza kudhura kwayo. Kunoitawo murwere kuona zvinhu panguva marefu ose. basa iri inopiwa kunzwisisa configuration pamusoro optics ayo. Nokuti pedo dzengerere kure pakati uzosangana zvikamu zvitatu zvakasiyana. Panyaya iyi, murwere haana zvinoda kwokupfeka magirazi. Ndokusaka mutengo vakadai mano zvakakwirira chaizvo.

toric womuenzaniso

Toric mhando akagadzirirwa kugadzirisa dambudziko astigmatism. Astigmatism anonzi mugari Maumbirwe cornea inokanganisa mufananidzo. Kana akadaro murwere rokubata cataract kubviswa uye izvo zvisingasviki mureza nadzurudzo, ari abnormality nokupera. Saka, pashure pokuvhiyiwa achaita zvakare kuratidzwa akapfeka cylindrical pfungwa.

Kana kudyara munhu toric izvo muenzaniso kuti murwere anogona inopiwa compensating kuti astigmatism uye nokugamuchira zvakasiyana zviratidzo zvinhu. In toric lenses vakavaka zvakakodzera sepombi. Nokugadzirira izvo kwakadaro kupinda ziso kuburikidza inokosha mavanga pamusoro izvo, murwere anogona kuzadzisa mufananidzo rakapinza.

Kuisa mhando yakadaro inosanganisira chaiwo Masvomhu pamberi kuvhiya. Nokuti mumwe murwere, vari kunze nomunhu.

Reviews wevarwere kutambura kubva astigmatism, anoratidza kuti muchibereko toric muenzaniso kunounza migumisiro yakanakisisa. Varwere vakawanda pashure pokuvhiyiwa zvinoratidza kuti chiono chavo akava saka pachena sei hazvina kunyange mumakore ake ouduku.

Multifocal toric gogorosi

A anoverengeka IOL anogumisa multifocal toric womuenzaniso. Kana murwere anotambura astigmatism, uye anoda kuona zvakafanana zvakanaka zvose pedyo uye kure, zvino zvinoratidza muchibereko kwaiita. Izvi zvinoita izvo rokudzorera zvaakaratidzwa. Panguva iyoyowo pfungwa murwere haumbofaniri. Ndicho kupfuura kudhura mhando izvo.

UV filters IOL yeyero uye zvitema

The kwomuzvarirwo gogorosi ziso rine yakasiyana inodzivirira mano, rakavhara mwaranzi inokuvadza zuva. Kanoita kuvadza the retina ziso. Modern ophthalmology kunosanganisira kugadzirwa mhando dzose IOLs Sefa kubva ultraviolet nemwaranzi.

Special yemashoko lenses vari mavara yero pigments kuti vabudirire kunonyanyisa Kufanana ne yepanyama izvo. filters izvi chiedza yebhuruu inokuvadza, riri chisingaoneki chikamu chakarondedzera.

AcrySof IQ

AcrySof IQ Intelligent izvo nokuda kururamisa idenderedzwa aberration (kuvapo kudzvokora, halos, chiedza) inopenya chiedza. muenzaniso kwakadaro kunogona kupa chiratidzo chakakwana chero okuvimba ezvinhu. Izvi Ultra-matetetete izvo (kaviri wakawondereiko kudai mazuva ose pane dzose).

Nechepakati chikamu kwakajairika izvo wakawondereiko kudai mazuva ose pane panhivi. Zviri kuburikidza chiedza ichi matanda kuti vadarike dzayo peripheral nharaunda, ita kuti the retina uye nechepakati mwaranzi - pamusoro payo. Sezvo chiedza mwaranzi vari pfungwa kwete pane imwe nguva. Somugumisiro, mufananidzo pamusoro the retina vari kujeka.

Intraocular gogorosi AcrySof IQ anobvisa dambudziko iri. musana pamusoro wayo akagadzirirwa nenzira inoita kuti zvose chiedza matanda kusangana chete pfungwa. Image inopiwa wokuenzanisira ichi, mukuru azvipire yepamusoro, kusiyana uye zvakajeka chero nguva yezuva.

Kuzvitsinhanisa pamwe cataract izvo surgically

Pari, muchibereko ane intraocular izvo maererano ultrasonic phacoemulsification ndiyo kuchinja duku mwero ngozi varwere. Iye ane mukuru azvipire kunyatsoshanda. Vanenge 95% kuti cataract muEurope, kuUnited States uye nyika yedu hwabviswa saizvozvi.

The World Health Organization vakacherechedza chete anoita zvose maoparesheni, izvo chinosiyanisa zvizere vapore.

Chii ndiwo kuvhiya kupindira?

Hwaro cataract Kuvhiya ndiwo kubviswa opaque crystalline izvo, izvo kunotadzisa uzere chokubuda chiedza the retina. Chakagadzirwa intraocular gogorosi unotsiva hunenge dzinongoitika izvo.

The chikuru zvokukura muchibereko

Ruzhinji phacoemulsification remapazi anoitwa toga makiriniki, outpatient. Zvokukura kugadzirira kuvhiyiwa rinenge chete kose:

• An awa pamberi kutanga oparesheni murwere vauye kukiriniki.
• Kuti awedzere mudzidzi wake vakaviga Madonhwe ane rufimbi.
• Murwere anoiswa patafura uchishandisa. The anesthesiologist anoita yokutindivadza.
• The chiremba anobvisa cataract uye izvo zviri kwomwoyo.
• The oparesheni hakurevi stitches.
• Pashure pokuvhiyiwa, murwere redirected kuna House.
• An awa mushure kuvhiyiwa murwere anotumwa kumba.
• Zuva rakatevera, murwere vauye kuzoshanya kuti chiremba.

Sezvo ari oparesheni

Kuti tiwane kuwana cornea inoitwa nemaziso incision kuti 1,8 mm pakureba. Zvikanganiswe gogorosi iri kuzochinja pachishandiswa Ultrasound uye kuva chinhu emulsion, riri vakabviswa ziso. The Kamudzira kutaurwa kuburikidza injector kusanduka intraocular izvo. Iye achipinda ziso muchimiro sepombi, apo iye kwaanoda uye makachengeteka.

Nemaziso incision mune ramangwana chakaputirwa pasina kwokunze kupindira. Naizvozvo, suture muchiitiko ichi hachisi zvakakodzera. Vision murwere anodzoka sechipiriso mutemo, muna uchishandisa mukamuri.

Duration kushanda iri maminitsi 10-15. Kana iri parinoshandiswa donhwe yokutindivadza iyo nyore akashivirira uye asingauyi nesimba mutoro pamusoro mwoyo uye ropa midziyo. Pashure pokuvhiyiwa murwere akakurumidza dzava kushandisa chakaipa mutinhimira upenyu. Kurambidzwa zvishoma. Ivo ainyanya chokuita utsanana.

vapore nguva

Pashure pokuvhiyiwa, chiremba prescribes murwere inokosha madonhwe ziso uye anosarudza kakawanda avo kushandiswa. Uyewo akagadza musi okuwedzera inspections somunhu prophylactic nechiyero. The murwere akabvumira kuti arambe achiita mararamiro, verenga, nyora, basa iri kombiyuta, tarisai TV, tora nemvura, gara uye pasi hwomutambarakede chinzvimbo. Kurambidzwa zvokudya uyewo haako.

Chii kunzwisisa kwakaita oparesheni?

The muchibereko ane intraocular izvo ane imwe kunzwisisa kuti iri dzakakwirira zvinodiwa kuti rakarurama dzemaitirwe uye kusarudzwa zviri izvo womuenzaniso, uye basa nyanzvi yacho ophthalmologist. Ndokusaka chinokosha ezvinhu pamberi oparesheni ndiyo zvokuongorora zvakakwana. uwane ongororo yakaitwa neboka rose zvakawanda midziyo ano chete, inoita kuti tikwanise kuwana chinangwa maonero murwere ezvinhu.

zvakwakanakira

Ultrasonic phacoemulsification cataract akasiyana pakukwana apedza mumakore ano. The oparesheni rinoitwa munguva pfupi. Murwere anonzwa kugadzikana uye akachengeteka. Zvisinei, chakadaro yokuti evanhu ndewe yakakwirira unyanzvi opareta uye chisvo unopinza sangano rikurumidze.

The chikuru zvakanakira Kuvhiya ichi zvinosanganisira:

• Mhedziso rusununguko kubva tsanga;
• kuwana yakakwirira ziso unhu;
• nokukurumidza kupora murwere;
• kusavapo kurambidzwa mumuviri uye kutarisana mutoro nekuvongwa musono nzira;
• hapana marwadzo nokuti izvo haana tsinga harinzwi;
• kupfuura kukurumidza kupora, pashure pavhiki, unogona kubuda basa;
• zvaidiwa mitemo kwemwedzi;
• bhora gogorosi ruvara uye musiyano.

Zvairatidza kuti Step

Zvairatidza kuti kuvhiya kupindira kungava chero padanho cataract. Yakanaka kuita kuti kuitisa kuvhiyiwa zvine saibva muchimiro cataract, rinobvumira kushanda pasina ngozi.

Nokuti murwere, asiwo ndinoiitawo guru: hakusi zvakakodzera kumirira kusvikira wakakwana upofu mumaziso, sezvo asati. Nokubviswa turbidity iri kutanga nzendo chirwere kuderedza matambudziko zvose pakuvhiya uye pashure.

Possible yematambudziko pashure pokuvhiyiwa

In ruzhinji phacoemulsification muchibereko intraocular lenses, ayo dzaidzidziswa vanovhiya unyanzvi vane zvakanaka mugumisiro. Kana chiremba ari beginners, muna 10-15% kuti zviitiko akashuma matambudziko.

Ivo zvinogona kukonzerwa:

• kusava nesimba nemarunda ari izvo;
• Kubatana chirwere cheshuga cataract, yemaziso uye myopia;
• Kuvapo zvirwere zvakajairika ziso.

Matambudziko Kuvhiya dzinosanganisira:

• corneal kukuvadzwa achishandisa Ultrasound;
• kutyora kuvimbika izvo nemarunda;
• atsamwira pamusoro izvo Kamudzira, kukonzera kurasikirwa vitreous;
• zvaizopedza chakagadzirwa gogorosi, etc ..

Zvinofanira kucherechedzwa kuti vose matambudziko kunobva vavhiyiwa, kungakonzera zvinetso zvakakomba. Treatment muchiitiko ichi chichava chinoenderera, uye mugumisiro angasava akanaka chaizvo.

Dzichibvisa gogorosi

Dzimwe nguva panguva kushoma kana pathological pezvakaitwa ari the retina kunoda kubviswa intraocular izvo. Muzviitiko zvakadaro, zvachose vitrectomy akaita IOL. The gogorosi akabatwa peya tweezers uye kuenderera mberi. Sclerostomy nokuti pakatanga endo-zvivheneko akazadza chivharo. Vanachiremba kuita chinhu incision ari cornea achishandisa chigero pamwe nedhaimani unhani. IOLs kunogona intercepted nachiremba nemamwe forceps 25G Somuenzaniso, 20G forceps pamwe nedhaimani ane miromo yesimbi.

Mushure nokubvisa izvo incision sutured yakasimba kana X-zvakaumbwa zvinhu zvenaironi suture № 10-0. Kushandiswa zvinhu wakawondereiko kudai mazuva ose nokuti musono kushoma kuratidzwa astigmatism, asi kunoda nokungwarira chaizvo sezvo mukuru mukana leakage kubudikidza musono panguva evanhu.

Dzimwe nguva, vakuru IOL chinobviswa pamberi fibrovascular Kamudzira iri migumisiro fibrovascular kuwanda ari mberi vachishandisa vitreous nokuda kunotevera, kana uveitis. mumwe muitiro kwakadaro kunogona naro uye chirwere cheshuga.

Panyaya iyi, iyo haptic zvinoriumba piringisha pamwe chigero, asi kuti tirambe kuti Anterior kamuri udzamu, kushandisa viscoelastic.

Zvinhu zvinofadza zvinogona kusara muziso reziso kana zvikakomberedzwa ne-capsule ye-fibrous uye haigoni kubviswa nemaoko. Kuti uwedzere huwandu hwehutano pamaronda, huwandu hwema X hunoumbwa hunoshandiswa. A mono-flemic string No. 9-0 kana 10-0 inoshandiswa.

Ndezvipi zvinogadzirwa neIOL zvinosarudzwa?

Ungasarudza sei intraocular lenses? Vagadziri vanomiririra huwandu hwakawanda hwevatungamiri vane maitiro akasiyana. Kusvika iye zvino, zvakashandiswa kushandiswa kwephakic lenses ICL (STAAR, CIBA Vision) nekamberi kamera.

Izvi zvinotarisirwa kuiswa mumashure meiyo pamberi pe lens uye inopa maitiro akakwirira. Kana zvichidiwa, lenzi dzakadai dzinogona kubviswa kubva muziso pasina kuvhiringidza maitiro ake.

Ongororo

Intraocular lenses, kuongororwa kwazvo ndiko kwakanyanya kunaka, kwave kune vanhu vazhinji nzira yakarurama uye yakarurama yekudzorera zviratidzo zvakarasika.

Maererano nemhinduro dzevarwere, ultrasonic phacoemulsification ye cataract neIOL implantation inobatsira zvikuru, inotendeseka uye inorwadza nzira inogona kurwisa cataract nokusingaperi uye inopa maonero akanaka. Ita yemazino inonzi intraocular yave yakagadzikana chaizvo mumunda wekurapa kwekataract.