SU1454454A1 - Method of treatment of macular edema in case of proliferative diabetic retinopathy - Google Patents

Abstract

This invention relates to ophthalmology. The purpose of the invention is to increase the visual acuity and stabilize the pathological process. With vitrectomy, oxygen-enriched air is introduced into the vitreous cavity. After 4-5 weeks, parabasal argonlaser coagulation of the vascular arcades and barrage at the level of second-order vessels is performed. Parabasal coagulation and barrage in the zone of the third-order vessels are carried out 3-4 weeks after the first stage of coagulation. In the third stage, 2-3 weeks after the second stage, the macula at the terminal vessels is performed in the mode: power 150-250 mW, exp of the barrier is 0.05-0.1 s, beam diameter is 50 microns. The method provides resorption of hemorrhages, edema, stabilization of blood supply to the macular area and the optic nerve head. (About SL

Description

The invention relates to medicine, in particular to ophthalmology, and concerns the treatment of macular compartment in patients with proliferative diabetic retinopathy.

The aim of the invention is to improve the visual acuity and stabilization of the pathological process in patients with macular

edema in proliferative diabetic retinopathy.

The method is carried out as follows.

Vitroectomy is performed under local anesthesia with a 1% dicain solution and akenisation with a 2% novocaine 2.0-4.0 retrobulbar solution. A blepharostat is applied to the eyelids, and a provisional suture is applied to the upper muscle. The incision of the conjunctiva is 3 mm long at 11 and 13 hours, 4.5 mm from the limbus. 2 mm long sclera incision in 4 mm

from limb at II and 13 o'clock. The flat part of the ciliary body is opened with a double-edged knife Gref. A vitreotome tip and a light guide are inserted into the incision. Partial vitrectomy of the posterior preretinal layers of the vitreous is carried out, and the preretinal membranes are removed if present. Then, 0.5 ml of air enriched with oxygen (75% air and 25% oxygen) is injected through the infusion system. On the scleral wounds impose two interrupted sutures, on the conjunctiva - a continuous seam. Under the conjunctiva, 0.3 ml of dexamethasone solution + 20 thousand units are injected. kanamycin solution. The first two days in the postoperative period, the patient is laid down face down.

As the clinical adaptation of the eye (4-5 weeks after the operation), we proceeded to the next stage of treatment - 4) SP. 4 01

h

grain coagulation using an argon laser from Coherent Radiation (USA). Under local anesthesia of a 0.5% dicain solution, a Goldman three-mirror lens is applied to the patient's eye, which is used to combine the patient's optical system with the optical system of the slit-lamp binocular microscope and the doctor's eye. First, the fundus is examined under the control of FAG.

the third order in the operation mode: power 150-300 mW, exposure time 0.1-0.2 s, beam diameter 50-100 microns, 300-400 coagulates are applied; in the third stage, after 2-3 weeks after the second stage, the barrage of the macula is performed at the terminal vessels in the mode: power 150-250 mW, exposure time 0.05-0.1 s, beam diameter 50 microns, 20-70 coagulates are applied .

The proposed complex method of treating the zone of supposed coagulation and Yuni macular edema in patients with proliferation. The power parameters of the laser radiation are selected individually in each particular case depending on the characteristics of the disease and the characteristic properties of the retina (severity of retinal edema, transparency of media, degree of pigmentation, etc.). The beam diameter varied from 50 to 200 microns, the exposure time was from 0.05 to 0.2 s, and the radiant power was 150 to 400 mW with an application from 20 to 800

Appropriate diabetic retinopathy leads to the resorption of hemorrhages, edema, stabilization of the blood supply to the macular area and the optic nerve head and an increase in visual acuity.

Claims (1)

Invention Formula A method of treating macular edema in proliferative diabetic retinopoagulants at each stage. As far as 20 by posterior vitrectomy and central coagulation of the arteries of the retinal coagulation, characterized in that, in order to increase visual acuity and stabilization of the pathological process, during the implementation of 25 vitrectomy, air is enriched in the vitreous cavity with oxygen, after 4–5 weeks, paravascular argonlaser coagulation of the vascular arcades and barrage is performed at the level of second-order vessels, after 3-4 weeks of positioning 0.1–0.2 s, the beam diameter is 100 parasalized argonlaser 200 microns, 600-800 coagulates are applied. According to coagulation and barrage in the area of blood vessels In the second stage, the re-reduction of edema in the third stage, 2-3 weeks after 4 weeks after the first stage, paragasal argonlasercoagulation barrage coagulation and barrage in the vascular zone near the terminal vessels are performed. retina is supplemented by pan-retinal or peripheral coagulation. At the first stage, 4–5 weeks after vitrectomy, parabasal coagulation of the vascular arcades and barrage is performed at the level of second-order vessels in the mode: power 300-400 mW, time of extremes in operation mode: power 150-300 mW, exposure time 0.1-0.2 s, beam diameter 50-100 microns, 300-400 coagulums are applied; in the third stage, after 2-3 weeks after the second stage, the barrage of the macula is performed at the terminal vessels in the mode: power 150-250 mW, exposure time 0.05-0.1 s, beam diameter 50 microns, 20-70 coagulates are applied . The proposed comprehensive method for the treatment of macular edema in patients with proliferative diabetic retinopathy leads to the resorption of hemorrhages, edema, stabilization of blood supply to the macular area and the optic nerve head and improve visual acuity. Invention Formula