SU1426579A1 - Method of treatment of glaucoma - Google Patents

Abstract

This invention relates to ophthalmology. The purpose of the invention is a persistent reduction in intraocular pressure without opening the anterior chamber. A continuous circular suture is placed on the sclera in the projection of the trabecular binding and the outer wall of the scleral sinus. The needle is punctured by at least 3/4 of the thickness of the sclera without damaging the trabecular binding, and the ends of the suture are tied up with tension and immersed under the conjunctiva. The method provides for stretching the trabecular binding, increasing the lumen or opening the scleral sinus during its collapse throughout the whole bore.

Description

The invention relates to medicine, namely to ophthalmology, and concerns microsurgical methods of treating glaucoma.

The purpose of the invention is a persistent reduction in intraocular pressure without opening the anterior chamber.

; Example, Bolna A., 72 years old, born on 09/03/86 with a diagnosis of open angle According to the glaucoma of the left eye, open angle Pv glaucoma of the right BJoro eye, the initial cataract of the eyes. The condition of the left eye upon admission: visual acuity of 0.4 n / cor ophthalmometric: 90 ° - 46 diopters, radius of curvature 7.35 mm; 180 - 45 diptrium, radius of curvature 7.5 mm. The depth of the anterior chamber of the pachymetry slit lamp firm Wholesale and echo- graphically 2.6 mm, anterior-posterior. JDCb echographically 22.8 mm. Tonogra-: phi, 0; , TO, 8; Ro / C 1 280; IOP of Maklakov 32mm Hg | Field of view: nasal depression iso-: pters up to 30 from the point of fixation. Objectively: the accessory apparatus of the eye is not changed, the cornea is transparent, the iris is subatrophic, the pupil in the center, medical miosis, the lens with initial opacities, the optic disc in the fundus of the eye, glaucoma excavation of 0.8 of the disk diameter. Goniscopy: anterior chamber angle of medium width, moderate to exogenous pigment trabecular binding.

09.09.86 the operation of the left eye was performed. According to the proposed method: after local anesthesia, akinesia with a solution of novocaine, the bridle stitches were put on the upper and lower right muscles of the eye. The intraocular pressure on the operating table is 32 mmHg. according to Maklakov. An indentation of 1 mm from the border of the transparent part of the limbus in the projection on the sclera of the trabecular binding and the outer wall of the scleral sinus was placed with a circular continuous suture with 8/00 nylon by Etikon, and the needle was injected into 3/4 of the sclera under gonioscopic control puncture the outer wall of the scleral sinus without damaging the trabecular lining. The seam pitch was on average 2 mm. Stitches were started from the meridian for 12 hours and finished there. After some tension with the end of the scar, the intraocular pressure on the operative table was measured with a Maklakov tonometer, which was after 23 minutes 23 mm Hg, i.e. decreased by 9 mm Hg The ends of the suture were tied up with tension and immersed under the mucosa to avoid eye irritation. 0.3 ml of gentamicin and dexazone were injected under the conjunctiva. A small gauze curtain was glued to the eye with adhesive tape. Immediately after surgery, the patient was allowed to walk. On the first day after the operation, the left eye was calm, the suture plunged into the mucous membrane for almost the entire duration. The intraocular pressure according to Maklakov is 21 mmHg. Instillations of dexamethasone and 20% albucid 3 times a day were prescribed. On the second day after the operation, the patient was discharged for outpatient monitoring. Anterior to the front: the left eye is calm, the suture is immersed in the mucous membrane all the way through and is well visible through it, the cornea is smooth, transparent, shiny, the anterior chamber depth is 3,03 mm echographically and echographically. The rest of the eye status is the same as in the admission. Front-rear axle 22.5 mm. Ophthalmometers: 90 - 46 diopters, radius of curvature 7.35 mm; 180 - 45 diopters, radius of curvature 7.5 mm. Visual acuity, 5 n / Corr. The intraocular pressure according to Maklakov is 21 mmHg, tonography, 8 ;. , 23; , 04; without a drug regimen. The field of ereni is unchanged. Subsequently, during a 2-month observation, the intraocular pressure did not exceed 21 mm Hg. according to Maklakov without a miotic regime, i.e. there was a rack normalizing intraocular pressure.

Compared with the prototype, the proposed method provides for stretching the trabecular binding and increasing the lumen or opening the scleral sinus during its collapse over its entirety, which causes a permanent decrease in intraocular pressure. Performing the operation without opening the anterior chamber avoids the complications that are typical of traditional surgical methods of treating glaucoma.

31426579

Claims (1)

The claims of the invention, the sclera in the projection of the trabecular method of treating glaucoma by reproducing and the outer walls of the scleralisation of the suture, stretching the trabecular sinus, and injecting the needle with an osulary binding that differs by no less than 3/4 puls that, in order to sustain a stable sclera without damaging the trauma of the intraocular pressure, without binding, and the ends of the suture over the front of the chamber, overlap with tension and immerse There is a continuous circular suture on the conjunctiva.