Ngokunyuka kwe-myopia kwihlabathi jikelele kwiminyaka yakutshanje, akukho kunqongophala kwezigulana ezifuna ukunyangwa.Uqikelelo lokuxhaphaka kweMyopia kusetyenziswa uBalo lwase-US luka-2020 lubonisa ukuba ilizwe lifuna iimviwo zamehlo ezingama-39,025,416 kumntwana ngamnye one-myopia ngonyaka, kunye neemviwo ezimbini ngonyaka.Nye
Koogqirha bamehlo abamalunga nama-70,000 kunye neengcali zamehlo kuzwelonke, ingcali nganye yokhathalelo lwamehlo (ECP) kufuneka ijonge abantwana abangama-278 rhoqo emva kweenyanga ezintandathu ukuhlangabezana neemfuno zangoku zokhathalelo lwamehlo kubantwana abane-myopia e-United States.1 Ngumndilili ongaphezulu kwe-1 myopia yobuntwana efunyaniswe kwaye ilawulwe ngosuku.Yahluke njani indlela osebenza ngayo?
Njenge-ECP, injongo yethu kukunciphisa umthwalo we-myopia eqhubekayo kunye nokunceda ukukhusela ukukhubazeka okubonakalayo kwexesha elide kuzo zonke izigulane ezine-myopia.Kodwa izigulane zethu zicinga ntoni ngezilungiso zabo kunye neziphumo?
Xa kuziwa kwi-orthokeratology (i-Ortho-k), impendulo yesigulane kumgangatho wabo wobomi obunxulumene nombono uphezulu.
Uphononongo olwenziwa nguLipson et al., Ukusebenzisa iZiko leSizwe leZifo zeLiso ngeRefractive Error Quality Questionnaire, xa kuthelekiswa nabantu abadala abanxibe iilensi zoqhagamshelwano ezithambileyo ezinombono omnye kunye nabantu abadala abanxibe iilensi ze-orthokeratology.Baye bagqiba ukuba ukwaneliseka ngokubanzi kunye nombono wawuthelekiseka, nangona kunjalo malunga ne-68% yabathathi-nxaxheba bakhetha i-Ortho-k kwaye bakhetha ukuqhubeka beyisebenzisa ekupheleni kwesifundo.Izifundo ezi-2 zinike ingxelo yokukhetha umbono wemini ongalungiswanga.
Nangona abantu abadala benokukhetha i-Ortho-k, kuthekani ngokujonga kufutshane ebantwaneni?UZhao et al.ivavanywe abantwana phambi nasemva kweenyanga ezi-3 zokunxitywa kwamathambo.
Abantwana abasebenzisa i-Ortho-k babonise umgangatho ophezulu wobomi kunye neenzuzo kwimisebenzi yabo yemihla ngemihla, babekwazi ukuzama izinto ezintsha, babenokuzithemba ngakumbi, bekhuthele ngakumbi, kwaye banomdla wokudlala imidlalo, nto leyo eyakhokelela ekubeni bachithe ixesha elingakumbi kwimidlalo. unyango.esitratweni.3
Kungenzeka ukuba indlela epheleleyo yonyango lwe-myopia inokunceda ukuqhubeka nokubandakanya izigulane kunye nokunceda ngokufanelekileyo ukulawula ukubambelela ixesha elide kwirejimeni yonyango efunekayo kunyango lwe-myopia.
I-Ortho-k yenze ukuqhubela phambili okubonakalayo kwilensi kunye noyilo lwezinto ezibonakalayo ukususela ekuvunyweni kwe-FDA yokuqala ye-ortho-k contact lens ngo-2002. Izihloko ezibini ezibalaseleyo kwiinkqubo zekliniki namhlanje: iilensi ze-Ortho-k ezinomahluko obunzulu obunzulu kunye nokukwazi ukulungisa ububanzi bezowuni yombono wangasemva.
Ngelixa iilensi zemeridian orthokeratology ziqhele ukumiselwa kwizigulana ezine-myopia kunye ne-astigmatism, ukhetho lokuzifakela lungaphezulu kakhulu kwezo zokulungisa i-myopia kunye ne-astigmatism.
Umzekelo, ngokuhambelana neengcebiso zomenzi, ngokweempirically kwizigulane ezine-corneal toricity ye-0.50 diopters (D), umahluko wobunzulu bezowuni enye unokwabelwa ngokusemthethweni.
Nangona kunjalo, inani elincinci le-toric lens kwi-cornea, edityaniswe ne-Ortho-k lens eqwalasela ukuhlukana kobunzulu be-meridional, iya kuqinisekisa ukuchithwa okufanelekileyo kweenyembezi kunye nokugxilwa ngokufanelekileyo phantsi kwe-lens.Ngaloo ndlela, ezinye izigulane zinokuzuza ngokuzinza kunye nokulungeleka okugqwesileyo okubonelelwa ngolu yilo.
Kulingo lwakutsha nje lwezonyango, i-orthokeratology 5 mm iilensi zombono ongasemva zone idayamitha yezone (BOZD) izise izibonelelo ezininzi kwizigulane ezine-myopia.Iziphumo zibonise ukuba i-5 mm VOZD yandisa ukulungiswa kwe-myopia nge-0.43 diopters kwi-1 yokutyelela usuku xa kuthelekiswa noyilo lwe-6 mm VOZD (i-lens yokulawula), ukubonelela ngokukhawuleza ukulungiswa kunye nokuphuculwa kwezinto ezibonakalayo (Amanani 1 kunye ne-2).4, 5
Jung et al.kwakhona kwafumanisa ukuba ukusetyenziswa kwe-5 mm BOZD Ortho-k lens kubangele ukunciphisa okubonakalayo kububanzi bendawo yonyango ye-topographic.Ngoko ke, kwii-ECPs ezijolise ekufikeleleni kwimithamo emincinci yonyango kwizigulane zabo, i-5 mm BOZD ibonakalise ukuba luncedo.
Ngelixa ii-ECPs ezininzi ziqhelene nokufaka iilensi zoqhagamshelwano kwizigulane, nokuba zixilongwa okanye zinamandla, ngoku kukho iindlela ezintsha zokwandisa ukufikeleleka kunye nokwenza lula inkqubo yokufaneleka kweklinikhi.
Yaziswa ngo-Okthobha ngo-2021, i-Paragon CRT Calculator app mobile (Figure 3) ivumela oogqirha bexakeka ukuba bachaze iiparameters kwizigulane ezineParagon CRT kunye neCRT Biaxial (CooperVision Professional Eye Care) iinkqubo ze-orthokeratology kwaye uzikhuphele ngokuchofoza nje okumbalwa.Umyalelo.Ukufikelela ngokukhawuleza izikhokelo zokulungisa iingxaki zibonelela ngezixhobo eziluncedo zeklinikhi nanini na, naphi na.
Ngo-2022, ukuxhaphaka kwe-myopia ngokungathandabuzekiyo kuya kwanda.Nangona kunjalo, i-ophthalmic profession ineendlela eziphambili zonyango kunye nezixhobo kunye nezixhobo zokunceda ukwenza umahluko kubomi bezigulane zabantwana abane-myopia.