Ngo-2030, oyedwa kwabahlanu baseMelika uzoba neminyaka engama-65.1 Njengoba inani labantu base-US liqhubeka nokuguga, siyanda nesidingo sezinketho zokwelapha ze-presbyopia.Iziguli eziningi zibheka izinketho ngaphandle kwezibuko ukuze zilungise umbono wazo ophakathi nendawo naseduze.Badinga ukukhetha okufanelana kalula nezimpilo zabo zansuku zonke futhi ezingagqamisi iqiniso lokuthi amehlo abo ayaguga.
Amalensi okuxhumana amaningi ayisisombululo esihle kakhulu se-presbyopia, futhi ngokuqinisekile ayintsha.Kodwa-ke, abanye odokotela bamehlo basazama ukusebenzisa amalensi okuxhumana amaningi ekusebenzeni kwawo.OKUPHATHELENE: Ukwelashwa nge-lens yokuxhumana kubalulekile ekususeni iminonjana ye-coronavirus Ukuzijwayeza nalokhu kwelashwa akuqinisekisi nje kuphela ukuthi iziguli ziyafinyelela kubuchwepheshe bamuva bokunakekela amehlo, kodwa futhi kukhulisa impumelelo yalo mkhuba ngokombono webhizinisi.
1: Tshala imbewu ye-multifocal.I-Presbyopia iyimakethe ekhulayo.Bangaphezu kwezigidi ezingu-120 abantu baseMelika abane-presbyopia, futhi abaningi babo abaqapheli ukuthi bangagqoka amalensi okuxhumana amaningi.2
Ezinye iziguli zithola ukuthi amalensi aqhubekayo, ama-bifocal, noma izibuko zokufunda ezitholakala ngaphandle kwekhawunta yizo kuphela izinketho zazo zokulungisa eduze nokonakala kombono okubangelwa i-presbyopia.
Ezinye iziguli ziye zatshelwa esikhathini esidlule ukuthi amalensi okuxhumana amaningi awabafanele ngenxa yamanani kadokotela noma ukuba khona kwe-astigmatism.Kodwa izwe lamalensi okuxhumana amaningi selishintshile futhi kunezinketho eziningi zeziguli zayo yonke imiyalelo.Ucwaningo lwakamuva luthole ukuthi abantu abayizigidi ezingu-31 bathenga izibuko zokufunda ze-OTC unyaka ngamunye, ngokuvamile esitolo esikhulu noma ekhemisi.3
Njengabahlinzeki bokunakekelwa kwamehlo okuyisisekelo, odokotela bamehlo (OD) banekhono lokwazisa iziguli ngazo zonke izindlela ezitholakalayo ukuze zibone kangcono futhi zithuthukise izinga lempilo yazo.
Qala ngokutshela iziguli ukuthi ama-contact lens amaningi angaba uhlobo oluyinhloko lokulungiswa kombono noma inketho yokugqokwa kwetoho, okokuzilibazisa, noma ngempelasonto.Chaza ukuthi abathintwayo basebenza kanjani, basebenza kanjani, nokuthi bangena kanjani empilweni yansuku zonke.Ngisho noma iziguli zilahla amalensi okuxhumana amaningi kulo nyaka, zingase zifune ukucabanga kabusha ngenketho yazo esikhathini esizayo.Okuhlobene: Abacwaningi bahlola amalensi okuxhumana aphrintiwe e-3D azimanzisa
Odokotela bamehlo bavame ukuxhumana neziguli ngaphandle kwegumbi lokuhlolwa, okungabanikeza ithuba lokufundisa iziguli ngamalensi okuxhumana amaningi.
2: Landela imiyalelo yokufaka.Kubalulekile ukulandela imiyalelo efanelekile eza nelensi yokuxhumana ngayinye.Lokhu kuyiqiniso ikakhulukazi kumalensi okuxhumana e-multifocal, njengoba izinhlobo ezahlukene zinezindawo zokubona ezahlukene kanye namasu okugqoka.Izinkampani zivame ukuvakashela izincomo zazo zokufakwa kwamalensi okuxhumana njengoba idatha eyengeziwe yelensi yokuxhumana itholakala ngokusetshenziswa kwesiguli.Odokotela abaningi badala izindlela zabo zokwenza ngokwezifiso.Lokhu kungase kusebenze isikhathi esifushane kodwa ngokuvamile kubangela ukwanda kwesikhathi sesitulo kanye nezinga eliphansi lempumelelo ezigulini ezinamalensi okuxhumana amaningi.Kunconywa ukuthi ngezikhathi ezithile ubuyekeze amamanuwali amalensi okuxhumana owagqoka njalo.
Ngifunde lesi sifundo eminyakeni eminingi edlule lapho ngiqala ukugqoka amalensi e-Alcon Dailies Total 1 multifocal.Ngisebenzise indlela yokufaka efana neyamanye amalensi okuxhumana amaningi emakethe axhumanisa amalensi ama-multifocal ubude obugxile kakhulu ekhonweni lesiguli lokwengeza ( ADD).Isu lami lokungifaka alizange lihlangabezane nezincomo ezifanele, okuholele ekwandiseni isikhathi sesitulo, ukuvakashelwa kwamalensi amaningi okuxhumana, kanye neziguli ezinombono we-mediocre contact lens.
Lapho ngibuyela kumhlahlandlela wokusetha futhi ngiwulandela, konke kwashintsha.Kule lensi yokuxhumana ethile, engeza okuthi +0.25 ekulungisweni okuyindilinga futhi usebenzise ivelu ye-ADD ephansi kakhulu ukuze uthole ukulingana okungcono kakhulu.Lezi zinguquko ezilula ziholele emiphumeleni engcono ngemva kokuhlolwa kwelensi yokuxhumana yokuqala futhi kwaphumela ekuncishisweni kwesikhathi sesitulo kanye nokwaneliseka kwesiguli okuthuthukisiwe.
3: Beka okulindele.Zinike isikhathi sokubeka okulindelekile okungokoqobo nokuqondile.Esikhundleni sokuphokophela ukubona okuphelele okungama-20/20 eduze nakude, umbono osebenza eduze nakude uzoba isiphetho esifaneleka kakhudlwana.Isiguli ngasinye sinezidingo ezihlukile zokubuka, futhi umbono osebenzayo wesiguli ngasinye uzohluka kakhulu.Kubalulekile ukwazisa iziguli ukuthi impumelelo ilele ekhonweni lazo lokusebenzisa amalensi okuxhumana emisebenzini yawo eminingi yansuku zonke.Okuhlobene: Izifundo Zokubonisa Abathengi Abawaqondi Ngokujulile Amalensi Okuxhumana Ngiphinde ngeluleke iziguli ukuthi zingaqhathanisi ukubona kwazo namalensi okuxhumana ahlanganisa izinto eziningi kanye nokubona kwazo ngezingilazi ngoba kuqhathaniswa ama-apula namawolintshi.Ukubeka lokhu okulindelekile okucacile kuvumela isiguli ukuthi siqonde ukuthi kulungile ukuthi ungabi u-20/20 ophelele.Kodwa-ke, iziguli eziningi zithola u-20/20 kokubili kude naseduze namalensi okuxhumana esimanje amaningi.
Ngo-2021, uMcDonald et al.ihlongoze ukuhlukaniswa ngezigaba kwe-presbyopia, ehlukanisa isimo ngezigaba ezithambile, ezimaphakathi, neziqinile.4 Indlela yabo igxile kakhulu ekuhlukaniseni i-presbyopia ngokulungiswa kombono eduze kuneminyaka yobudala.Kusistimu yabo, ukuqonda okulungile kokubonayo kwakusukela ku-20/25 kuye ku-20/40 ku-presbyopia emaphakathi, kusukela ku-20/50 kuya ku-20/80 kwe-presbyopia emaphakathi, nangaphezulu kuka-20/80 kwe-presbyopia enzima.
Lesi sigaba se-presbyopia sifaneleka kakhulu futhi sichaza ukuthi kungani ngezinye izikhathi i-presbyopia esigulini esineminyaka engu-53 ubudala ingase ifakwe kusigaba esithambile, futhi i-presbyopia esigulini esineminyaka engu-38 ingase ifakwe kusigaba esilinganiselwe.Le ndlela yokuhlukanisa i-presbyopia ingisiza ukuthi ngikhethe amakhandidethi amalensi okuxhumana amaningi angcono kakhulu futhi ngibeke okulindelwe okungokoqobo ezigulini zami.
4: Thola izinketho ezintsha zokwelashwa kwe-adjuvant.Ngisho noma okulindelekile okulungile kusethiwe futhi kulandelwa izincomo ezifanele, amalensi okuxhumana amaningi angeke abe yifomula efanelekile yaso sonke isiguli.Enye indlela yokuxazulula inkinga engiyithole iphumelela ukusebenzisa i-Vuity (Allergan, 1.25% pilocarpine) kanye namalensi okuxhumana amaningi eziguli ezingakwazi ukuzuza incazelo efiswayo endaweni emaphakathi noma eduze kwayo.I-Vuity umuthi wokuqala osekilasini ogunyazwe yi-FDA wokwelapha i-presbyopia kubantu abadala.Okuhlobene: Ukubhekana Nokulahlekelwa Kwelensi Yokuxhumana Ne-Presbyopia Uma kuqhathaniswa ne-pilocarpine, ukugxiliswa okulungiselelwe kwe-pilocarpine okungu-1.25% kuhlanganiswe nobuchwepheshe be-pHast obunelungelo lobunikazi kwenza i-Vuity ihluke futhi isebenze kangcono ekuphathweni komtholampilo kwe-presbyopia.
I-Vuiti iyi-agonist ye-cholinergic muscarinic ene-double mechanism of action.Ivula i-iris sphincter kanye ne-ciliary smooth muscle, ngaleyo ndlela yandise ukujula kwensimu futhi ikhulise ububanzi bendawo yokuhlala.Ngokunciphisa umfundi, njengaku-pinhole optics, ukubona eduze kuyathuthukiswa.
I-Vuity iqedele uhlolo lwemitholampilo olu-2 oluhambisanayo lweSigaba sesi-3 (i-Gemini 1 [NCT03804268] ne-Gemini 2 [NCT03857542]) kubahlanganyeli abaneminyaka engu-40 kuya kwengama-55 ngokuqonda kokubukwa okulungiswe ibanga phakathi kuka-20/40 no-20/100.Ukuhlolwa kwemitholampilo kubonise ukuthi ku-myopia (ukukhanya okuphansi) kube nokuthuthuka okungenani kwemigqa emi-3, kuyilapho ukubona ibanga akuzange kuthinte umugqa ongaphezu ko-1 (izinhlamvu ezi-5).
Esimeni sesithombe, ababambiqhaza abangu-9 kwabangu-10 bathuthuke eduze nombono kangcono kuno-20/40 esimweni sesithombe.Ngokukhanya okukhanyayo, ingxenye yesithathu yabahlanganyeli bakwazi ukufeza i-20/20.Izivivinyo zemitholampilo nazo zibonise ukuthuthuka embonweni ophakathi.Imiphumela emibi evame kakhulu nge-Vuiti kwakuyi-conjunctival hyperemia (5%) kanye nekhanda elibuhlungu (15%).Ngokuhlangenwe nakho kwami, iziguli eziphathwa yikhanda zibika ukuthi ubuhlungu bekhanda buthambile, buthatha isikhashana, futhi kwenzeka kuphela ngosuku lokuqala lokusebenzisa i-Vuity.
I-Vuiti ithathwa kanye ngosuku futhi iqala ukusebenza kungakapheli imizuzu eyi-15 ngemuva kokufakwa.Iziguli eziningi zibika ukuthi lokhu kuthatha amahora angu-6 kuya kwangu-10.Uma usebenzisa i-Vuity ngamalensi othintana naye, amaconsi kufanele afakwe emehlweni ngaphandle kwamalensi okuxhumana.Ngemuva kwemizuzu eyi-10, i-lens yokuxhumana ingafakwa esweni lesiguli.Ama-Vuiti amaconsi kadokotela ongawathenga kunoma yiliphi ikhemisi.Nakuba i-Vuity ingazange ifundwe ngokuhambisana namalensi okuxhumana amaningi, ngithole ukuthi kwezinye izimo le ndlela ehambisanayo ehlangene ivumela iziguli ezinamalensi okuxhumana amaningi ukuze zithole ukuthuthukiswa okufisayo ekuboneni eduze.
Isikhathi sokuthumela: Sep-11-2022
