SU1412780A1 - Method of surgical treatment of detachment of pigmented epithelium of retina of the eye - Google Patents

Abstract

The invention relates to medicine, more specifically to ophthalmology. The purpose of the invention is to prevent the warming up of the disease and shorten the treatment time. To do this, perform a thyroectomy over the area of the detachment, puncture and empty its cavity, remove its contents from the eye and press the detached pigment epithelium to Bruch's membrane with air. The invention allows to cure the retinal pigment epithelium both as a phase in the development of dysciformal macular dystrophies, and idiopathic and traumatic both serous and hemorrhagic.

Description

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The invention relates to medicine, namely to ophthalmology, and can be used in ophthalmologic-ijoft microsurgical practice. ; The purpose of the invention is to prevent the disease from being reduced and to shorten the treatment time. Example. Ill K. R.H. , i2 years old, she was admitted to the 2nd eye department, Hospital No. 52 of Moscow with a diagnosis of detachment of the pigment epi ate of the right eye in the macular area, drusen of the pigment epithelium of the equal eye. The disease developed pontanno 4 years ago. Objective tatus: visual acuity - 0.07 N / Corr. Central positive scotoma, metamorphopsia. Anterior section of the eye without features. In the vitreous body there is a change in the type of filamentous destruction. Just below the upper temporal artery, there is a rounded industrial formation with distinct edges, about 2 RD in size, capturing the foveole. On the fluorescent | angiogram, detachment | of the pigment epithelium is determined, respectively, an ophthalmoscopically visible formation is observed. A more equal medical and laser treatment was unsuccessful. Teach me that the disease did not allow me to rely on independent detachment of the detachment, it was decided to resort to surgical treatment using the proposed method.

Conjunctival incisions were made with a length of 4 mm parallel to the limbus at 10 and 2 hours 5 mm from the limbus. In the same place 2 through cuts of the eye membranes with a length of 1.6 mm each were made. Into the vitreous cavity, the tip of the vitreotome and the illuminator are inserted. A flat-concave lens of 240 D was applied to the cornea. Vitreoectomy was performed over the area of detachment of the pigment epithelium, and the posterior hyaloidoid membrane was separated from the retina. With the Sato's knife tip, a bubble of detachment of the pigment epithelium is punctured at its upper-outer margin. The Sato's blade of the knife, clad in a silicone tube, is viscous, transparent, with a slight yellowish tinge, the contents of the cavity detachment squeezed onto the surface of the retina. Then with the help of the tip of the vitreotom this content is aspirated. AT

The cavity of the vitreous body is introduced about 1 cm of sterile air. On the cuts of the sclera and conjunctiva stitches are applied. Immediately after the patient was taken to the ward, she was bedded face down. After 16 hours she was allowed to walk in the department. On the 6th day after surgery

0 blok was calm. In the vitreous body light fleur. Detachment of the pigment epithelium lay down completely. The place of puncture of the cavity of her ophthalmoscope is not visible. In place of the former detachment, pigment lumps are visible against the depigmentation sites. Visual acuity of 0.2 n / corr., Metamorphopsia disappeared. Central scotoma decreases. sewed twice

0When examined after 4 months, the sharpness

Vision 0.3 N / Corr. The central scotoma decreased to 10 °. Metamorphopia is absent. When ophthalmoscopy under the upper temporal vascular area, there is a depigmentation area with individual pigments on it.

Claims (1)

The application of the proposed method makes it possible to obtain a practical opportunity to eliminate the cavity of the retinal pigment epithelium, to improve the patient's visual functions - to increase the sharpness of vision, to reduce the central scotoma. In addition, metamorphoses disappear, the pathogenetic chain of development of discyform macular dystrophy is interrupted, the most important stage of which is the detachment of the pigment epithelium (both serous and hemorrhagic). For a considerable time it is possible to delay the irreversible loss of the central vision from this age-related disease. Claims. A method of surgical treatment of detachment of the pigment epithelium of the retina by angioprotector drug therapy, anti-sclerotic and vitamin preparations, about m- lichayuschiys in that, for the purpose of preventing disease progression and shortening of treatment, further derivatives trans- t ciliary vitreoectomy over the area of detachment of the pigment epithelium, punktirujut and empty its cavity, ac5 pyrate its contents and inject air into the vitreal cavity, pressing the detached pigment epithelium to the Bru membrane Ha. 0 five Q five 0