The artificial cornea is an artificial device used to replace the diseased cornea and play its optical role, providing hope for the restoration of vision for patients with cicatricial pemphigus, Stevens Johnson syndrome, multiple corneal transplant failures, severe dry eye disease, eye chemical burns and other patients who cannot be treated by traditional surgery.
However, due to its difficult operation, long recovery period and high incidence of postoperative complications, some serious complications may also directly lead to complete loss of vision.
So, what do patients need to do to avoid complications after surgery? What needs to be done with the nursing staff to ease their anxiety and psychological burden and improve their quality of life?
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As we all know, there is more than one complication after artificial cornea transplantation. Therefore, the observation and nursing methods are different. Here are some examples.
glaucoma
Glaucoma is one of the serious postoperative complications, which can cause permanent visual impairment. Because of the serious damage of cornea, some patients had secondary glaucoma before surgery. Although the intraocular pressure was controlled by drugs or ciliary cryotherapy before surgery, the intraocular pressure of some patients would still rise again after surgery.
In addition, the surgical inflammatory reaction can make some patients have a transient increase in intraocular pressure after surgery, or even have uncontrollable glaucoma. Therefore, it is very important to observe intraocular pressure regularly after operation. Due to the poor ocular surface conditions of patients undergoing keratoplasty, it is impossible to measure intraocular pressure with conventional methods. An experienced doctor is required to measure intraocular pressure to assess the level of intraocular pressure.
Nurses will explain the common symptoms of glaucoma to patients, often ask patients about their self feelings, and guide patients to ensure adequate sleep every day to maintain emotional stability.
In general, glaucoma patients often have eye pain, eye swelling, headache, nausea, vomiting, etc., but different from traditional glaucoma symptoms, glaucoma symptoms of patients after artificial cornea implantation are not typical, and vision loss of unknown causes is the most common manifestation of glaucoma after artificial cornea implantation.
Patients and their families should be familiar with the characteristics of glaucoma after artificial cornea implantation. In case of unexplained vision loss, they should seek medical advice in time to eliminate the possibility of glaucoma and achieve early diagnosis and treatment. Remember to review the fundus and visual field regularly, which is of great significance for monitoring whether there is glaucoma damage and progress.
Anterior membrane formation of artificial cornea
Anterior membrane formation of artificial cornea is one of the common complications, which affects vision temporarily and can be improved after treatment. The main reason is the reactive proliferation of the surrounding tissues to the foreign body stimulation of the artificial corneal column, and the other reason is the low height of the column exposed to the eye surface. For patients with mild reactive hyperplasia, wash them with antibiotic eye drops, or gently wipe them with cotton swabs dipped in edible vinegar.
We should know that the formation of anterior membrane of artificial cornea is a common phenomenon after surgery, which is beneficial to the stability of artificial cornea, and can be improved after treatment without affecting vision.
For patients with severe reactive hyperplasia, it may be necessary to restore visual function through laser or surgical treatment of the anterior segment. After surgery, patients should closely observe whether the eyes are dry, painful, and foreign body. They need to drop artificial tears as instructed by the doctor to keep the eyes moist, promote corneal epithelial repair, and stabilize the artificial cornea.
Keratolysis and corneal leakage
This is a kind of complication that seriously threatens the stability of artificial cornea. If the treatment is not timely and delayed, the artificial cornea will come out, and even the eyeball will be lost. The treatment often adopted by doctors is autologous ear cartilage implantation. The patient's autologous ear cartilage is taken to reinforce the anterior tissue of the artificial cornea, promote local corneal fiber vascularization and tissue proliferation, so as to stabilize the corneal stent, thus preventing the artificial cornea from prolapse and leading to the failure of the operation.
Due to the complexity of keratoprosthesis surgery, it will impose a great burden on the psychology and economy of patients. Patients and their families should understand that keratoprosthesis surgery is not a single operation that can be successful. They should be prepared for long-term medical treatment and multiple operations, and should deal with related complications in a timely manner.
The patients and their families should pay attention to: no matter whether there is any clinical symptom, they should be ensured to have a follow-up visit every 3 months to half a year after the operation. Do a good job of nursing after autologous ear cartilage implantation. After the operation, antibiotic eye drops are dropped into the eyes 3 to 4 times a day. Patients with high intraocular pressure are given local drops of intraocular pressure lowering drugs, and ofloxacin or aureomycin eye ointment is applied before bed. In the case of eyelid fissure closure, eye drops are dropped from the sutures to slowly penetrate into the conjunctival sac.
Observe the eyes for redness, swelling and abnormal secretion, and change the dressing in time. Attention shall be paid to the disinfection and treatment of the wounds at the cartilage removal site of the ear, and the suture and wound healing shall be observed. The wounds shall be disinfected with povidone iodine every day in a gentle manner to keep the wound dressings dry and clean, and strict aseptic operation shall be carried out to prevent infection.
Infective endophthalmitis
Infectious endophthalmitis is a very serious complication. Inflammatory reaction quickly spreads to ocular tissues and fluids, mainly caused by bacterial or fungal infection. The patient should pay attention to whether there are abnormal conditions such as eye redness, swelling, pain, increased secretion, etc. At ordinary times, we should eat more food with high protein and vitamin, eat more fresh vegetables and fruits, and not eat spicy and other stimulating foods.
The occurrence of various complications after artificial cornea surgery will seriously endanger the stability and visual function of artificial cornea, and even affect the whole eyeball.
Once complications occur, it will bring heavy physiological, psychological and economic burden to patients, especially glaucoma, keratolysis, corneal leakage and other complications can lead to artificial cornea excretion, intraocular infection, which needs to be paid close attention to by patients. At the same time, patients should be familiar with the importance and necessity of timely treatment of complications, receive treatment and nursing in a peaceful manner, and extend the service life of artificial cornea.