Kwesinye isikhathi kuyaye kudingeke ukuthi kukhishwe iso ngenxa yokugula noma lonakele kakhulu ngesikhathi sokuhlukumezeka. Le nqubo ibizwa ngokuthi i-enucleation. Ngesikhathi esifanayo, kuhlotshaniswa nokubekwa kokufakelwa, okuzogcina kufake i-ocular prosthesis.

I-Enucleation ihilela ukukhishwa kweso ngokuhlinzwa, noma ngaphezulu inhlamvu yeso. Njengesikhumbuzo, yakhiwe izingxenye ezihlukene: i-sclera, imvilophu eqinile ehambisana nomhlophe weso, i-cornea ngaphambili, i-lens, iris, ingxenye enemibala yeso, futhi phakathi kwayo umfundi. . Yonke into ivikelwe izicubu ezahlukene, i-conjunctiva kanye ne-capsule ye-Tenon. I-optic nerve ivumela ukudluliselwa kwezithombe ebuchosheni. Inhlamvu yeso ixhunywe imisipha emincane ngaphakathi kwe-orbit, ingxenye engenalutho yohlaka lohlaka lobuso.

Uma i-sclera isesimweni esihle futhi singekho isilonda se-intraocular esebenzayo, inqubo "ye-table enucleation with evisceration" ingasetshenziswa. I-eyeball kuphela ekhishwayo futhi ithathelwe indawo ibhola le-hydroxyapatite. I-sclera, okusho ukuthi umhlophe weso, uyagcinwa.

Ukuhlinzwa kwenzeka ngaphansi kwe-anesthesia jikelele.

Inhlamvu yeso iyasuswa, bese kufakwa i-intra-orbital implant ukuze kufakwe i-ocular prosthesis kamuva. Lokhu kufakelwa kwenziwa kusuka ku-graft ye-dermo-fatty ethathwe ngesikhathi sokuhlinzwa, noma nge-inert biomaterial. Lapho kungenzeka khona, imisipha yokunyakaza kwamehlo ixhunywe kulokho okufakelwayo, ngezinye izikhathi kusetshenziswa i-tissue graft ukuvala lokho okufakelwayo. I-shaper noma i-jig (igobolondo lepulasitiki elincane) lifakwa ngesikhathi kulindwe ukufakelwa kwesikhathi esizayo, bese izicubu ezimboze iso (i-capsule ye-Tenon kanye ne-conjunctiva) zithutshulwa phambi kokufakelwa kusetshenziswa izitishi ezimuncwa. 

I-Enucleation inikezwa uma kwenzeka isilonda esishintshayo seso esingeke siphathwe ngenye indlela, noma lapho iso elihlukumezekile libeka engozini iso elinempilo nge-ophthalmia enozwela. Lokhu kunjalo kulezi zimo ezahlukene:

• ukuhlukumezeka (ingozi yemoto, ingozi empilweni yansuku zonke, ukulwa, njll.) lapho iso kungenzeka ukuthi libhobozwe noma lishiswe umkhiqizo wamakhemikhali;
• i-glaucoma enzima;
• i-retinoblastoma (umdlavuza we-retina othinta kakhulu izingane);
• I-melanoma ye-ophthalmic;
• ukuvuvukala kweso okungapheli ukumelana nokwelashwa.

Kumuntu oyimpumputhe, i-enucleation ingahlongozwa lapho iso lisenqubo ye-atrophy, okubangela ubuhlungu nokuguqulwa kwezimonyo.

Amasudi wokusebenza

Zibonakala nge-edema kanye nobuhlungu obuhlala izinsuku ezi-3 kuya kwezi-4. Ukwelashwa kwe-analgesic kwenza kube nokwenzeka ukunciphisa izenzakalo ezibuhlungu. Amaconsi e-anti-inflammatory kanye / noma ama-antibiotic eye avame ukunikezwa amasonto ambalwa. Kunconywa ukuphumula kwesonto ngemuva kwenqubo.

Ukubekwa kwe-prosthesis

I-prosthesis ifakwa ngemva kokuphulukiswa, okungukuthi amasonto ama-2 kuya kwangu-4 ngemva kokuhlinzwa. Ukufakwa, okungenabuhlungu futhi okungadingi ukuhlinzwa, kungenziwa ehhovisi le-ocularist noma esibhedlela. I-prosthesis yokuqala ingeyesikhashana; owokugcina ubuzwa ezinyangeni ezimbalwa kamuva.

Ngaphambilini engilazini ("iso lengilazi" elidumile), lesi sitho sokufakelwa sise-resin namuhla. Yenziwe ngesandla futhi yenziwe ukukala, iseduze ngangokunokwenzeka neso lemvelo, ikakhulukazi ngokombala we-iris. Ngeshwa, ayikuvumeli ukubona.

I-ocular prosthesis kufanele ihlanzwe nsuku zonke, ipholishwe kabili ngonyaka futhi ishintshwe njalo eminyakeni emi-5 kuya kwemi-6.

Ukubonisana kokulandelela kuhlelwa isonto eli-1 ngemuva kokuhlinzwa, bese kuthi ezinyangeni ezi-1, ezi-3 nezi-6, bese kuthi njalo ngonyaka ukuze kuqinisekiswe ukungabikho kwezinkinga.

Izinkinga

Izinkinga azivamile. Izinkinga zakuqala zihlanganisa ukopha, i-hematoma, ukutheleleka, ukuphazamiseka kwezibazi, ukuxoshwa kokufakelwa. Ezinye zingase zenzeke kamuva - i-conjunctival dehiscence (ukudabuka) phambi kokufakelwa, i-atrophy of the orbit fat enokubonakala kweso elingenalutho, ukuwa kwejwabu leso eliphezulu noma eliphansi, ama-cysts - futhi kudinga ukuhlinzwa kabusha.