Muraayadaha La Qaban Karo ee Iftiinka Leh waa tiknoolajiyad cusub oo xiiso leh oo hadda loo heli karo bukaanada qaba cataract-ka ee Northwest Eye. Iyadoo qalliinka cataract-ka badankood uu u baahan yahay bukaanada iyo dhakhaatiirtu inay doortaan awoodda muraayadda ka hor qalliinka, muraayaddan cusub waxay bukaanada siinaysaa fursad ay ku habeeyaan aragtidooda. ka dib qalliinka indhaha. Dr. Jesse Doovich, oo ah khabiir ku takhasusay cataract-ka iyo qalliinka qalliinka ee Northwest Eye, ayaa bixiya aragti qoto dheer oo ku saabsan muraayaddan cusub ee loo habeeyey bukaanada cataract-ka.
Muraayadda La Hagaajin Karo ee Iftiinka waxay u shaqeysaa iyadoo adeegsanaysa fallaaraha iftiinka UV si ay u hagaajiso polymer-ka ku jira muraayadda indhaha, taasoo abuurta bartilmaameedyo aragga oo loo habeeyay qalliinka ka dib. Qalliinka cataract-ka laftiisu waa isku mid; cataract-ka waa la saaraa waxaana lagu beddelaa muraayad indhaha cusub. Waxa ka dhigaya Muraayadda La Hagaajin Karo ee Iftiinka mid gaar ah marka loo eego xulashooyinka kale ee muraayadaha waa walxaha polymer-ka ee ku jira muraayadda. Polymer-yadan xasaasiga ah ee sawir-qaadista waxay noo oggolaanayaan inaan ku daabacno qaladka haray ee refractive-ka muraayadda, taasoo kordhin doonta cadaynta masaafada ama aragtida dhow. Tani waxay u oggolaanaysaa muraayadda in la hagaajiyo ka dib qalliin si loo gaaro yoolalka aragtidaada si aad u hesho aragtida ugu cad ee suurtogalka ah.
Ka dib qalliinka indhaha ee caadiga ah (oo leh muraayad indhaha lagu xidho oo caadi ah), bukaanadu waxay u badan tahay inay xidhaan muraayadaha indhaha hawlo badan. Iyada oo la adeegsanayo muraayadaha indhaha ee la hagaajin karo ee fudud, daawada dhakhtarku qoro ayaa loo habeyn karaa ka dib qalliinka iyadoo la raacayo yoolalka aragtida ee bukaanka. Marka isha la bogsado, cabbir dhakhtar ayaa la qaadi doonaa oo lagu dhejin doonaa muraayadda iyadoo la adeegsanayo daaweyn iftiin gaar ah. Inta lagu jiro dhowr kalfadhi, bukaanadu waxay isku dayi karaan dawooyin kala duwan oo ay hagaajin karaan doorbidkooda, ka hor daaweynta "xiritaanka" ugu dambeysa. Awooddan lagu habeyn karo awoodda muraayadda, tijaabinta noocyada aragga ee kala duwan, iyo xulashada aragti kama dambays ah. ka dib qalliinku ma suurtogal ahayn ka hor imaatinka muraayadaha iftiinka ee la hagaajin karo.
Toddobaadyada ka dambeeya qalliinka iyadoo la adeegsanayo Muraayadaha La Hagaaji karo ee Iftiinka, bukaanada waxaa la siin doonaa muraayadaha UV-ga xanniba si ay muraayadda uga ilaaliyaan iftiinka qorraxda. Kuwaas waxaa lagula talinayaa in la xidho dhammaan saacadaha soo jeeda ilaa daaweynta iftiinka ugu dambeysa ay dhammaato. Bukaanka iyo dhakhtarkoodu waxay ka shaqeyn doonaan dhowr kalfadhi oo daaweyn iftiin ah si ay u gaaraan natiijada muuqaalka ee la rabo. Muraayadaha waxaa loo habeyn doonaa kalfadhi kasta oo iftiin ah, taasoo u oggolaanaysa bukaanka inuu go'aamiyo daawada ugu fiican ee iyaga u shaqeyneysa.
Guud ahaan, daaweynta iftiinka bilowga ah waxay dhici doontaa 2-3 toddobaad ka dib marka qalliinka cataract-ka la dhammeeyo. Daaweynta iftiinka ee dabagalka ah waxaa badanaa la qorsheeyaa 3dii maalmoodba mar ka dib daaweynta ugu horreysa, iyadoo bukaanada badankood ay helaan wadarta guud ee 2-4 daaweyn iftiin ah. Marka daawada la rabo la gaaro, dhakhtarku wuxuu isticmaali doonaa daaweyn iftiin ah oo kama dambays ah si uu u xiro muraayadda, si daawada loo qoray aysan waligood isu beddelin.
Maadaama tiknoolajiyadani ay ku darto labadaba cabbiraadda ka hor qalliinka isha iyo bogsashada qalliinka kadib warqadda kama dambaysta ah, baahida loo qabo in dib loo dhigo oo la kala saaro qalliinka u dhexeeya labada indhood ma aha mid muhiim ah. Bukaanno badan oo qorsheynaya inay qalliin ku sameeyaan labada indhoodba waxaa la siiyaa ikhtiyaarka ah in isla maalintaas la sameeyo qalliinka cataract-ka laba-geesoodka ah, si labada indhoodba loogu hagaajin karo daaweynta iftiinka isku mar. Fadlan kala hadal dhakhtarkaaga qalliinka si aad u aragto haddii aad tahay musharrax.
Haa, Muraayadaha La Hagaajin Karo ee Iftiinka leh waxay noqon karaan ikhtiyaar aad u fiican bukaanada lagu ogaaday inay qabaan astigmatism. Bukaanada badankood ee qaba wax ka yar saddex diopters oo astigmatism ah ayaa noqon doona musharixiin aad u fiican muraayaddan. Waxay si gaar ah waxtar ugu leedahay bukaanada leh taariikh hore oo qalliinka LASIK ah, maadaama ay leeyihiin rajooyin sare oo ku saabsan aragti wanaagsan, mararka qaarkoodna awoodda lagu hagaajin karo aragtida iyadoo la adeegsanayo tignoolajiyada muraayadaha indhaha ee cataract-ka ayaa xaddidan marka la sameeyo kubbadda indhaha kadib LASIK maadaama qalliinka LASIK uu keeno isbeddello aan la saadaalin karin oo ku dhaca inta badan indhaha.
Wonderful vision! Patients with the Light Adjustable Lens can see far enough to drive, read the dashboard of their car, and then pick up items in the grocery store to read the labels. While patients may prefer a light pair of reading glasses when reading very fine print, most daily activities will be free of glasses or contacts for Light Adjustable Lens patients. In addition, this technology does not use trifocal rings to generate sweet spots in the vision, so the Light Adjustable Lens has minimal risk of post-surgical glare and halos.
Musharax wanaagsan waa qof kasta oo doonaya aragtida ugu ballaaran ee shaqaynaysa iyadoo leh ugu yaraan iftiin iyo halos qalliinka ka dib. Bukaanno badan oo LASIK ah oo loo sheego inaysan ahayn musharrixiin aad u fiican oo ku jira Trifocal Lens Technologies, ama Tiknoolajiyada kale ee Xidhmada Sare, ayaa laga yaabaa inay u tartamaan Muraayadaha La Hagaaji karo ee Iftiinka leh, maadaama ay magdhabi karto isbeddellada ay keento LASIK ee ka dhasha cornea inta lagu jiro qalliinka LASIK.
- This is usually used for both eyes at, or around, the same time as the maximal benefit comes when targeting the dominant eye for distance and the non-dominant eye for near. That said, I have had great patient satisfaction for some patients using LAL technology unilaterally in their dominant eye to target distance vision. Both eyes start off slightly hyperopic, and the process of adjusting the polymers induces some positive spherical aberration, which maximizes the depth of focus and truly blends the two eyes together. I have many patients that are 20/20 J3+ dominant and 20/25 J1+ non-dominant, essentially capturing 80%+ of the visual range in each eye with a very wide zone of overlapping vision. Unlike traditional mono-vision, with a tight band of focus at distance and another at near, these LAL patients feel comfortable, adapt quickly, and do not report an imbalance between the eyes. If a patient is requesting mono-vision with Toric IOLs I am always cautious to confirm they have experienced mono-vision in the past (either with LASIK or CTL use), and if not, I have them do a trial as patients have flexibility after surgery to adjust their prescription to their liking. Some patients enjoy bilateral distance targets; others prefer mini-mono or mono-vision. We target functional outcomes, such as “reading your phone, working on a computer, or seeing violin sheet music” to make sure they are thinking in terms of functional vision optimization during the post-surgical light treatments.
- Commonly, this is used in both eyes; however, this technology can be placed in only one eye (ex: if the first eye is already pseudophakic and the patient is now undergoing their second eye surgery) in scenarios where the patient has a primary target, like distance, in mind before the surgery. In fact, one of my patients has severe POAG in her right eye and mild POAG in her left eye. She was convinced she wanted the LAL in her worse eye to do everything possible to maximize her chances of having the best vision, but she could not afford the technology in both eyes. After extensive conversations with her to confirm her selection, we proceeded as she requested with LAL in the right eye and traditional surgery in the left eye. She now reports the highest vision satisfaction outcome in the most severe glaucoma eye as her other eye has a mild amount of post-operative astigmatism.
- I have used this, with good benefit, for patients with an 8-cut RK incision and slightly irregular post-LASIK corneas. I explain upfront, that the traditional technologies are not able to compensate for the post-surgical changes. Patients are informed that this technology will give them their best chance of optimizing their vision, even though it may be slightly unpredictable with irregular corneas. Patients are happy knowing they’ve done everything possible with modern technology to optimize their outcomes, and if a light prescription is needed for various visual tasks, patients are still highly satisfied.
- Patients with prior iritis, pseudoexfoliation, or other organic reasons for poor pupillary dilation, h/o Flomax usage, or any iris trauma or pathology may not be a great candidate for the technology as you need at least 7mm dilation on exam for the UV treatment process to be successful.
- To explain the concept of “adjustments” to the patients and how the treatment process works for the lens polymers, I ask the patients to think about a sheet of bubble wrap. When we first discover bubble wrap in a shipping package, none of the bubbles have been popped. This is similar to the LAL; all of the adjustable polymers are naïve and ready to be manipulated by UV light. Once we start imprinting the prescription into the eye, we begin a process akin to “popping bubbles on the bubble wrap.” This allows us to adjust the vision two or three times prior to the final lock-in. The final treatment is a process that “pops the remaining bubbles” so the IOL becomes extremely stable and will not optically shift in the future when exposed to UV light from the environment. Therefore, we can induce the largest magnitude of change in the prescription during the first lock-in treatment, with diminishing amounts of prescription changes with each subsequent treatment. Most patients are highly satisfied with their vision after the first treatment and request a “final lock-in.”
- Recently, I have ex-planted the PanOptix IOLs from a patient who could not tolerate the glare or halos generated by the trifocal technology and replaced her lenses with Light Adjustable Technology. She is currently healing and about to start the imprinting process. I will be extremely interested in how she describes the difference between the two technologies, as she will have first-hand experience with both.
Referring a patient to Northwest Eye has never been easier with our new Online Referral Form. Click halkan to refer online or call (763) 416-7600.
