RU2123832C1 - Method for creating rest stump and conjunctive vault after operation - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves inserting flexible perforated silicon drain tube coiled into spiral into scleral cavity after implantation. Epithelialization being over, the tube is removed and substituted with cosmetic eye prosthesis. EFFECT: accelerated cessation of inflammation process; prevented symblepharon formation. 2 dwg

Description

 The invention relates to medicine, and more particularly to ophthalmology, can be used to form the musculoskeletal system after evisceration.

 There is a method of forming a supporting stump and conjunctival arches after evisceration, described in the monograph "Tecniques in ophtalmic surgery" published by John Wiley and sons, article N 81, author Albert Homoblass, p. 245 which is taken as a prototype (a copy of the article in the annex to the application).

 The method consists in the formation of a mobile stump after anucleation by introducing elastic silicone implants followed by prosthetics of the conjunctival cavity.

 The disadvantage of this method is that it can be carried out only after anucleation, which is not always possible with an active inflammatory process that requires evisceration. With everation, constant correction of scar formation and simblepharon is necessary.

 The essence of the proposed method is that after implantation in the scleral cavity of an elastic spherical graft between the eyelids and the formed stump, an elastic silicone perforated tube rolled into a spiral is inserted, after epithelization after 7-14 days, the drainage tube is removed and replaced with a cosmetic eye prosthesis.

 As a result of implantation of a perforated silicone tube into the conjunctival cavity, mechanical extension of the cavity is ensured and the possibility of constant irrigation of the cavity with aseptic and therapeutic solutions appears. This contributes to the rapid relief of the inflammatory process, acceleration of epithelialization of wound surfaces and prevents the formation of symblepharon. The silicone drainage tube, coiled into a spiral, provides constant elastic pressure at the border of the conjunctival cavity. The length of the tube is determined by the surgeon by the force of pressure on the conjunctiva.

 The set of essential features is new and meets the criterion of "inventive step".

 In FIG. 1 shows a diagram of the formation of a supporting stump and conjunctiva arches after evisceration; in FIG. 2-silicone drainage tube.

 The method is as follows.

 Initially (Fig. 1), an elastic silicone spherical implant 2 is implanted into the scleral cavity 1. It is fixed by root-scleral flaps 3. Then between the eyelids 4 and the stump 2 a silicone drainage system 5 is inserted, made in the form of a tube 6, coiled (Fig. 2). The outer surface of the silicone tube 6 is perforated 7. After 7 to 14 days, the silicone drainage system 5 is removed, after which a cosmetic eye prosthesis is inserted.

 The method is illustrated by the following clinical examples.

 Example 1. Patient S., 49 years old.

 Diagnosis: Traumatic vascularized corneal thorn, simblepharon of the upper eyelid of the right eye. The upper arch is 2/3 overgrown, significantly limiting the mobility of the eyeball. Evisceration, dissection of simblepharon, formation of the upper arch using the proposed method were performed. After 12 days, the drainage system is removed. A standard cosmetic prosthesis is inserted, after 3 months it is replaced by an individually manufactured one. The depth of the upper arch, the position of the prosthesis and its mobility are satisfactory.

 Example 2. Patient K., 56 years old.

 Diagnosis: Absolute painful operated glaucoma.

 Due to previous surgical interventions, the scleral part of the conjunctiva of the upper arch is tightly spliced with the underlying sclera. When separating it, a significant defect was obtained. Evisceration was performed, and the formation of the upper arch was carried out using the proposed method. After 8 days, the drainage system was removed, a standard cosmetic prosthesis was inserted. The depth of the upper arch is sufficient to use a standard ocular prosthesis.

 The use of this invention allows to reduce postoperative complications (conjunctival chemosis, inflammation, shortening of the arches), to achieve a high cosmetic effect of ocular prosthetics by maintaining or restoring a sufficient depth of the conjunctival arches.

Claims (1)

 A method of forming a supporting stump and conjunctival arches after evisceration, which implies the implantation of an elastic spherical graft in the scleral cavity, characterized in that after implantation between the eyelids and the formed stump, an elastic silicone perforated tube is rolled up, coiled into a spiral, and the drainage tube is replaced after epithelization cosmetic eye prosthesis.

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