Ua nāwaliwali kou cornea? E aʻo e pili ana i ka Corneal Cross-Linking (CXL)!

Ua haʻi aku kāu kauka iā ʻoe he maʻi kou i kapa ʻia ʻo Keratoconus, ka mea e hoʻomāmā ai i ka cornea? A i ʻole ua haʻi aku ʻo ia iā ʻoe e pili ana i kahi lāʻau i kapa ʻia ʻo Corneal Cross-Linking, a i ʻole CXL? E makaʻu iki paha ʻoe ke lohe ʻoe i ka inoa. Akā, ʻaʻohe kumu e makaʻu ai. He lāʻau koʻikoʻi loa kēia a he pono hoʻi e pale i kou ʻike. E kamaʻilio kākou e pili ana i nā mea a pau i kēia lā me ka maʻalahi.

He aha ke ʻano o ka Corneal Cross-Linking (CXL)?

I ka ʻōlelo maʻalahi, ʻo Corneal Cross-Linking (CXL) kahi lāʻau lapaʻau liʻiliʻi e hoʻoikaika a hoʻopaʻa i ka cornea, ka papa lahilahi a moakaka hoʻi ma ke alo o kou maka .

E noʻonoʻo i kou maka e like me ke kāmela. Hana ka cornea o ko kākou maka e like me ke aniani o kēlā kāmela. Komo ka mālamalama i ka maka ma o kēia. No laila, ʻo ke ʻano kūpono o kēia cornea he mea nui ia no ka ʻike maopopo.

I nā kūlana e like me Keratoconus, e lahilahi mālie ka cornea, nāwaliwali, a puʻupuʻu i mua i loko o kahi ʻano cone. Ua like ia me kahi pōpō poepoe e puʻupuʻu ana ma kahi hoʻokahi ke kuʻi ʻia. Kāhea mākou i kēia corneal ectasia. He mea kēia e hoʻonui mālie ana i ka hala ʻana o ka manawa. Ke loli kēia ʻano, hoʻomaka mālie kou ʻike e pōwehiwehi a ʻike ʻia he kikoo (astigmatism).

Hoʻōki ka lāʻau CXL i kēia lahilahi a me ka puka ʻana. Hiki i kēia ke pale i kou cornea mai ka nāwaliwali hou ʻana a pale i ka hōʻino mau ʻana o ka maka.

Pehea e hana ai kēia?

Ua hana ʻia ko kākou cornea me nā olonā protein i kapa ʻia ʻo collagen. Ua like kēia me nā kaula liʻiliʻi i hoʻopili ʻia kekahi i kekahi, e pālahalaha ana e like me ka ʻupena, e hāʻawi ana i ka cornea i kona ikaika. ʻO kēia kaʻina hana o kēia mau olonā e hoʻopaʻa pū ana ua kapa ʻia ʻo "cross-linking."

I ka wā o ka CXL, hoʻohana kāu kauka i kahi kukuna kukui UV kūikawā a me nā kulu maka e loaʻa ana ka huaora B2 i kapa ʻia ʻo riboflavin. Ke hui pū ʻia kēia mau mea ʻelua, hoʻokumu ʻia nā pilina hou a ikaika aʻe ma waena o nā olonā collagen i loko o ka cornea. Ua like ia me nā kaula o kahi mesh nāwaliwali i wili pū ʻia a hoʻoikaika ʻia. Hoʻōki loa kēia i ka lahilahi a me ka puka ʻana o ka cornea.

No wai kēia lāʻau lapaʻau kūpono? A no wai hoʻi i kūpono ʻole?

Inā hoʻoholo kāu kauka ʻo ka lahilahi o kou cornea ke kumu o ka nalowale mau ʻana o ka ʻike, hiki iā ia ke ʻōlelo aku i kēia lāʻau lapaʻau. E nānā kākou i ka papa ma lalo nei e ʻike ai i ka wā kūpono a me ka wā kūpono ʻole.

He ʻoki kino kēia? He aha ka Epi-off?

ʻAe, he ʻoki maka liʻiliʻi ʻo CXL no ka mea hana ʻia e ke kauka maka. Akā, mai hopohopo, ʻaʻole ia he ʻoki nui.

ʻO ka ʻāpana ʻoki kino wale nō o kēia ka wehe ʻana i ka papa lahilahi ma luna o ka cornea, i kapa ʻia ʻo ka epithelium. Ua like ia me ka papa lahilahi ma luna o ko kākou ʻili. Ua wehe ʻia ia e ʻae i ka lāʻau lapaʻau riboflavin a mākou e hoʻopili ai e komo i loko o nā papa hohonu o ka cornea. Ua kapa ʻia kēia ʻano hana ʻo "Epi-off" (ephelium-off). ʻO kēia ke ʻano hana i ʻae nui ʻia a holomua hoʻi ma ka honua.

Pono anei au e hoʻomākaukau ma mua o ka lāʻau lapaʻau?

ʻAʻole kēia he hana ma waho o ka haukapila. ʻO ia hoʻi, hiki iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi ma hope o ka mālama ʻana. ʻAʻohe hoʻomākaukau kūikawā e pono ai. Eia nō naʻe, no ka mea ʻaʻole hiki iā ʻoe ke hoʻokele ma hope o ka mālama ʻana, he mea nui e loaʻa iā ʻoe kekahi e lawe iā ʻoe i ka home.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

Ma kahi o 60 mau minuke ka lōʻihi o ka mālama ʻana.I kēia manawa, e moe ana ʻoe ma luna o kahi moe. E hana ke kauka i kēia mau hana ma ke kaʻina hana:

1. Hoʻomānoʻo maka: ʻO ka mua, hoʻopili ʻia nā kulu maka anesthetic i ka maka i ʻole e ʻeha.

2. Ka wehe ʻana o ka Epithelium: ʻO ka mea aʻe, ua wehe mālie ʻia ka papa luna o ka cornea, ʻo ia hoʻi ka epithelium.

3. Ke kau ʻana i ka lāʻau lapaʻau: A laila, e kau i nā kulu maka melemele i kapa ʻia ʻo riboflavin (vitamin B2) i loko o ka maka a waiho no kahi o 30 mau minuke e komo maikaʻi.

4. Kukui UV: A laila, ua kuhikuhi ʻia kahi kukuna kukui UV kūikawā i kou cornea no kahi o 30 mau minuke. ʻO kēia ka manawa e hana ai ka hana kilokilo, e hoʻoikaika ana i nā pilina collagen.

5. Ka hana hope loa: ʻO ka mea hope loa, hoʻohana ʻia nā lāʻau antibiotic e pale aku i ka maʻi, hoʻohana ʻia nā kulu maka steroid e hōʻemi i ka pehu ʻana, a hoʻohana ʻia kahi lens hoʻopili bandage manawa pōkole e pale aku i ka maka.

ʻO ia wale nō. A laila hiki iā ʻoe ke hoʻi i ka home.

He aha nā pōmaikaʻi a me nā pilikia o kēia?

ʻO ka pōmaikaʻi nui o kēia lāʻau lapaʻau, ʻo ia wale nō ka lāʻau lapaʻau i loaʻa i kēia manawa e hiki ai ke hoʻōki i ka lahilahi a me ka puka ʻana o ka cornea. E pale aku kēia i kou ʻike mai ka ʻino ʻana. Hiki iā ia ke pale aku iā ʻoe mai ka hana ʻana i ke ʻoki kino nui, e like me ka hoʻoili ʻana o ka cornea, ma hope aku.

ʻOiaʻiʻo, e like me nā lāʻau lapaʻau āpau, aia kekahi mau pilikia liʻiliʻi loa. Akā he mea nui e hoʻomanaʻo he mea kakaikahi loa kēia.

• Ka maʻi ʻana.
• Ka ʻōpala.
• ʻIke pohihihi mau loa (noe corneal).

E kamaʻilio kāu kauka me ʻoe e pili ana i kēia mau mea.

Pehea ka manawa ho'ōla ma hope o ka lā'au lapa'au?

Pono ka wā hoʻōla ma hope o ka lāʻau lapaʻau i kahi ahonui iki.

ʻO ka mea mua, pono ʻoe e komo i kahi aniani hoʻopili bandage no hoʻokahi pule . ʻO kēia ka manawa no ka papa epithelium a mākou i wehe ai e ulu hou. I loko o kēia manawa, pono nō hoʻi ʻoe e hoʻohana i nā kulu maka steroid a kāu kauka e kuhikuhi ai.

ʻEha: Ma hope o ka mālama ʻana, hiki iā ʻoe ke ʻike i kekahi ʻeha a i ʻole ka wela i kou mau maka. Hiki i kekahi poʻe ke manaʻo nui loa. E hāʻawi kāu kauka iā ʻoe i nā kulu maka e hoʻomaha ai i ka ʻeha no kēia. Inā ʻaʻole e emi ka ʻeha ma hope o ka hoʻohana ʻana i kēia mau lāʻau lapaʻau, mai makaʻu e haʻi i kāu kauka.

ʻIke: ʻO ka mea nui loa, i nā lā mua ma hope o ka mālama ʻana, e ʻike ʻia kou ʻike he ʻoi aku ka pōwehiwehi ma mua o ka wā ma mua.Ua kapa ʻia kēia he corneal haze. He mea maʻamau kēia, mai hopohopo no ia mea. E hoʻomaka mālie ana kou ʻike e hoʻomālamalama.

Aia ma ka papa ma lalo nei nā mea āu e ʻike ai i ka wā e hoʻōla ai.

He 2-3 mahina paha e paʻa pono ai kou ʻike. Ma hope o kēlā, pono ʻoe e hoʻohana i nā aniani maka hou a i ʻole nā ​​​​​​aniani hoʻopili.

Āhea ʻoe e pono ai e kamaʻilio me ke kauka?

Inā ʻike koke ʻoe i kahi loli o kou ʻike i kou wā e hoʻōla ai (e laʻa, ka pohihihi nui koke ʻana, ka ʻike ʻana i nā kiko ʻeleʻele) a inā ʻaʻole i kāohi ʻia ka ʻeha e ka lāʻau lapaʻau a kāu kauka i kauoha ai, e hoʻomaopopo koke i kāu kauka.