RU2397742C1 - Method of immature cataract extraction - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to ophthalmological surgery and can be sued in surgical treatment of soft cataracts. After formation of "cross" in crystalline lens nucleus, canules are introduced into remaining crystalline lens masses until pink reflex appears. Viscoelastic is pumped between posterior capsule and crystalline lens masses. By means of viscoelastic fragments of crystalline lens nucleus are lifted and broken by cuts. Further phacoemulsification and aspiration are performed.

EFFECT: method allows to ensure prevention of rupture of Zinn ligaments, capsulorexis edges, to preserve integrity of posterior capsule.

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Description

The invention relates to medicine, in particular to ophthalmic surgery, and can be used in the surgical treatment of soft immature cataracts.

A known method for the surgical treatment of soft cataracts of I and II degree of hardness (Lucio Buratto "Cataract Surgery. The transition from extracapsular cataract extraction to phacoemulsification", p. 364 onwards), involving the fragmentation of the nucleus by ultrasonic formation of a "cross" in the lens nucleus, breaking the nucleus along cuts, phacoemulsification and aspiration of the lens masses (prototype).

The disadvantages of this method are the difficulties arising from the fragmentation of nuclei due to their viscosity:

- mechanical destruction of the edges of the core fragments during a break with the help of choppers, as a result of which the support points for the instruments disappear;

- the power of ultrasound increases;

- the possibility of injuries to the edges of capsulorhexis and zinc cords.

The objective of the invention was to develop a safe and effective method for the destruction of immature cataracts.

The essence of the invention lies in the fact that a cannula with viscoelastic is inserted into the center of the “cross” formed by the core (according to Shepheld) and the lens substance is pushed with a tip until a pink reflex appears, then under the pressure of viscoelastic the core remains are separated from the back capsule, the fragments are lifted and exposed phacoemulsification.

The technical result obtained from the invention is expressed in the following:

- provides prevention of ruptures of the zinc ligaments and the edges of capsulorexis;

- the duration of the surgical intervention is reduced;

- the integrity of the posterior capsule is maintained;

- the method can be used for extraction of subluxated lens.

The proposed method is as follows. After premedication, treatment of the surgical field, anesthesia and dilated pupil at 2 and 8 hours, paracentesis is performed. At 10-11 hours in the corneal part of the limb produce a tunnel incision 2-2.5 mm long. A viscoelastic solution is introduced into the anterior chamber. After a circular anterior capsulorexis and hydrodissection of the lens, a phacoemulsifier tip is inserted into the anterior chamber of the eye. Two mutually perpendicular grooves are cut in the lens nucleus. Then the remains of the lens nucleus and lens masses in the center of the formed “cross” are carefully pushed apart by the cannula of the syringe with viscoelastic. After the appearance of the pink reflex, viscoelastic is injected under pressure into the space between the posterior lens capsule and the lens, the core remains are separated from the posterior capsule, they are raised using viscoelastic and the raised fragments are removed in turn with the tip of the phacoemulsifier. Then proceed with the implantation of an intraocular lens. The operation is completed by sealing the surgical wound.

The proposed method is illustrated by the following clinical examples.

Example 1

Patient S., 57 years old, a.k. No. 235679.

Diagnosis: OS - posterior capsular cataract.

Vis OD = 0.08 n / a.

Vis OS = 1.0.

10.28.08, the patient underwent surgery according to the proposed method with the implantation of Iol.

Ultrasound use time 36 sec, power 20%. The amount of irrigation fluid is 100 ml. The postoperative period was uneventful.

At discharge: Vis OS = 1.0.

Example 2

Patient T., 49 years old, a.k. No. 206135.

Diagnosis: OD - immature cataract; OS is the initial cataract.

Vis OD = 0.1 n / k.

Vis OS = 0.7 + 0.75 = 0.8.

The patient underwent surgery OD - cataract extraction according to the proposed method with IOL implantation. The time of using ultrasound is 28 seconds, the power is 30%, the amount of irrigation fluid is 125 ml. The postoperative period was uneventful.

At discharge: Vis OD = 0.9.

Claims (1)

A method for the extraction of immature cataracts, which involves ultrasonic formation of two mutually perpendicular grooves in the lens nucleus - a “cross” and phacoemulsification of the lens, characterized in that a cannula with viscoelastic is inserted into the center of the “cross” and the lens substance is expanded with a tip until a pink reflex appears, and then under pressure viscoelastics separate the central fragments from the posterior capsule, lift them and complete phacoemulsification, while the pressure of the viscoelastic is created by pumping it between the back th capsule and lens.