RU2020906C1 - Method of treating perforating wounds in eye - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: this method of curing perforating wounds in eye prescribes blanking off through hole by applying biological tissue, positioning source of pressure under Tenon's capsule on opposite side of wound and then building up pressure in eyeball. EFFECT: more sophisticated technique. 1 dwg

Description

 The invention relates to ophthalmic surgery and relates to the surgical treatment of through wounds of the eye.

 Widely known are methods of treating through wounds of the eye by sealing the exit wound with sutures and glue.

 These methods are traumatic, difficult to perform, in addition, intraocular pressure is difficult to regulate, additional hemorrhages and retinal detachment may occur.

 Of the known analogues, the closest is a method of treating perforated wounds of the eye by applying a biological filling to the wound area.

 The disadvantages of this method are the technical complexity of fixation of the fillings, especially when the exit wound is more than 18 mm wide, the possibility of damage to large vessels during hemming of the fillings, difficulties in regulating intraocular pressure, a small degree of indentation and, as a consequence, the likelihood of retinal detachment.

 The purpose of the invention is the reduction of postoperative complications.

 The goal is achieved by the fact that in a method involving closing the exit wound with biological tissue, on the opposite side, a pressure source, for example a balloon of elastic material, is placed under the tenon capsule and a compression is created on the eyeball.

 In this case, an elastic balloon placed above the entrance wound of the sclera serves as a temporary elastic filling that increases the tightness of the wound.

 Creating compression in the main apple while increasing the volume of the container provides a snug fit of the membranes and local compression of the vessels, which in turn reduces bleeding. Indenting the sclera with a balloon reduces traction and the likelihood of retinal detachment.

 In addition, due to an increase in intraocular pressure, the sclera exit wound is sealed by pressing biological tissue with retrobulbar tissue and orbital walls, as well as immobilizing the eyeball.

 The drawing illustrates the method.

 After sealing the entrance wound, the sclera with sutures begin to completely or partially suture the output wound, followed by the application of a biological seal 1. The near end of the seal is sutured to the sclera with sutures, and the distal one is freely filled. On the opposite side, a pressure source - balloon 2 is placed on the protective entrance wound under the conjunctiva and fixed to the sclera. After carefully suturing the tenon capsule and conjunctiva, the balloon is inflated, for example with physiological saline with antibiotics, through catheter 3 until a normotonus or mild hypertonicity is created. A catheter connected to the balloon is discharged onto the skin of the frontal or temporal region and is fixed. If necessary, you can change the volume by introducing or removing its contents, for example using a syringe.

 PRI me R 1. Patient K., 30 years old, was hospitalized with a diagnosis of through corneo-scleral wound with a foreign body in the exit wound of the sclera, traumatic cataract, partial hemophthalmus of the left eye. A foreign body was removed from the exit wound with a SmCo5 magnet with preliminary flux-gate localization, cryopexy, partial vitrectomy in the left eye. After removal of the foreign body from the exit wound of the sclera, partial suturing and filling with the dura mater was performed. Then, on the opposite side, the conjunctiva, the allocation of the sclera, to which a catheter with a balloon is fixed, is opened. The conjunctiva and tenon capsule are carefully sutured with continuous sutures. The balloon is inflated with saline with antibiotics to mild hypertonicity of the eye. The eye is fixed with a balloon in a position favorable for wound adaptation. On the 10th day. after preliminary emptying, the balloon is removed from under the tenon capsule. Lensectomy was performed on the left eye.

 Visual acuity at admission: the correct projection of light.

Visual acuity at discharge: 0.0 s + 10.0 D = 1.0
PRI me R 2. Patient M., 36 years old, was hospitalized with a diagnosis of through sclera-scleral wound about the presence of a foreign body in the exit wound of the sclera, partial hemophthalmus, traumatic cataract of the right eye. PSC of the entrance scleral wound, removal of a foreign body with a permanent magnet SmСо5 with a positive result, cryopexy of the sclera, PSC of the output scleral wound, filling with dura mater was performed. External balloon filling over the entrance wound of the sclera of the right eye (after the PHO of the wounds of the sclera, a balloon was placed over the sutured entrance wound and inflated under a tenon capsule and conjunctiva to moderate hypertonicity of the eye).

 On the 10th day, the balloon was removed. Lens mass was aspirated, anterior mechanical vitrectomy was performed.

 Visual acuity at admission: 0.2 is not corrected.

 Visual acuity at discharge: 0.05 - 10.0 D = 0.8.

 The proposed method, as shown by clinical testing, can reduce the number of surgical and postoperative complications, creates the conditions for faster healing of the wound.

Claims (1)

 METHOD FOR TREATING THROUGH EYE Wounds, including closing the outlet with biological tissue, characterized in that, in order to reduce postoperative complications, a pressure source is placed under the tenon capsule on the opposite side of the wound and a compression is created in the eyeball.

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