I kekahi manawa pono e wehe i ka maka no ka mea he maʻi kona a i ʻole ua pōʻino loa i ka wā ʻeha. Kapa ʻia kēia kaʻina hana enucleation. I ka manawa like, pili ia me ke kau ʻana o kahi implant, kahi e hoʻokipa ai i kahi prosthesis ocular.

ʻO ka enucleation ka wehe ʻana i ka maka, a i ʻole ka ʻoi aku ka pololei o ka maka. No ka hoʻomanaʻo ʻana, ua hana ʻia i nā ʻāpana like ʻole: ka sclera, he enveloppa paʻa e pili ana i ka keʻokeʻo o ka maka, ka cornea ma mua, ka lens, ka iris, ka ʻāpana kala o ka maka, a ma kona waena ka haumāna. . Mālama ʻia nā mea āpau e nā ʻiʻo like ʻole, ka conjunctiva a me ka capsule o Tenon. Hiki i ke aʻalolo optic ke lawe i nā kiʻi i ka lolo. Hoʻopili ʻia ka pōpō maka e nā ʻiʻo liʻiliʻi i loko o ka orbit, kahi ʻāpana puha o ka iwi alo.

Ke kūlana maikaʻi ka sclera a ʻaʻohe lesion intraocular ikaika, hiki ke hoʻohana ʻia ke ʻano hana "table enucleation with evisceration". Hoʻoneʻe wale ʻia ka pōpō maka a hoʻololi ʻia e kahi pōpō hydroxyapatite. Mālama ʻia ka sclera, ʻo ia hoʻi ka keʻokeʻo o ka maka.

Hana ʻia ka hana ma lalo o ka anesthesia āpau.

Wehe ʻia ka pōpō maka, a kau ʻia kahi implant intra-orbital e hoʻokipa i ka prosthesis ocular ma hope. Hana ʻia kēia implant mai kahi dermo-fatty graft i lawe ʻia i ka wā o ka hana, a i ʻole mai inert biomaterial. Ma kahi e hiki ai, hoʻopili ʻia nā ʻiʻo no ka neʻe ʻana o ka maka i ka implant, i kekahi manawa e hoʻohana ana i kahi ʻiʻo e uhi i ka implant. Hoʻokomo ʻia kahi mea hoʻopololei a i ʻole jig (puʻi plastik liʻiliʻi) i ke kali ʻana i ka prosthesis e hiki mai ana, a laila e humuhumu ʻia nā ʻiʻo e uhi ana i ka maka (Tenon's capsule a me conjunctiva) i mua o ka implant me ka hoʻohana ʻana i nā humuhumu hiki ke komo. 

Hāʻawi ʻia ka enucleation inā loaʻa kahi maʻi maʻi o ka maka i hiki ʻole ke mālama ʻia i kahi ʻē aʻe, a i ʻole ka maka ʻeha e hoʻoweliweli i ka maka olakino e ka ophthalmia sympathetic. ʻO kēia ka hihia ma kēia mau kūlana like ʻole:

• ʻeha (ka ulia kaʻa, ulia pōpilikia i ke ola o kēlā me kēia lā, hakakā, a me nā mea ʻē aʻe) kahi i ʻeha ʻia ai ka maka a puhi ʻia paha e kekahi huahana kemika;
• glaucoma nui;
• retinoblastoma (ka ma'i 'a'ai retinal e pili ana i na keiki);
• ophthalmic melanoma;
• ʻaʻa mau o ka maka i kū ʻole i ka lāʻau lapaʻau.

I loko o ka makapō, hiki ke noi ʻia ka enucleation i ka wā e hele ai ka maka i ka atrophy, e hōʻeha ai i ka ʻeha a me ka hoʻololi ʻana i nā mea hoʻonaninani.

Nā keʻena hana

Hōʻike ʻia lākou e ka edema a me ka ʻeha mau 3 a 4 mau lā. ʻO kahi lāʻau analgesic e hiki ai ke kaupalena i nā hanana ʻeha. Hōʻike pinepine ʻia nā kulu maka anti-inflammatory a / a i ʻole nā ​​​​antibiotic no kekahi mau pule. Hoʻomaha hoʻokahi pule ma hope o ke kaʻina hana.

ʻO ke kau ʻana o ka prosthesis

Hoʻokomo ʻia ka prosthesis ma hope o ka hoʻōla ʻana, ʻo ia hoʻi 2 a 4 mau pule ma hope o ka hana. Hiki ke hana ʻia ka hoʻokomo ʻana, ʻeha ʻole a ʻaʻole pono ke ʻoki ʻana, ma ke keʻena ocularist a i ka haukapila. ʻO ka prosthesis mua he manawa pōkole; ua nīnau ʻia ka mea hope i kekahi mau mahina ma hope.

Ma mua i ke aniani (ka "maka aniani" kaulana), aia kēia prosthesis i kēia lā i ka resin. Hana ʻia e ka lima a hana ʻia i ke ana ʻana, kokoke loa ia i ka maka maoli, ʻoi aku ka nui o ke kala o ka iris. ʻO ka mea pōʻino, ʻaʻole hiki ke ʻike.

Pono e hoʻomaʻemaʻe ʻia ka prosthesis ocular i kēlā me kēia lā, hoʻomaʻemaʻe ʻia ʻelua i ka makahiki a hoʻololi i kēlā me kēia 5 a 6 mau makahiki.

Hoʻonohonoho ʻia nā kūkākūkā ma hope o 1 pule ma hope o ka hana, a laila ma 1, 3 a me 6 mau mahina, a laila i kēlā me kēia makahiki e hōʻoia i ka nele o nā pilikia.

Nā pilikia

Kakaikahi ka pilikia. ʻO nā hoʻopiʻi mua e pili ana i ka hemorrhage, hematoma, maʻi maʻi, hōʻeha ʻeha, kipaku ʻia i ka implant. Hiki mai kekahi ma hope - conjunctival dehiscence (haehae) i mua o ka implant, atrophy o ka momona orbit me ka puka ʻana o ka maka, hāʻule ka lihilihi o luna a lalo paha, cysts - a pono e hana hou.