SU1535542A1 - Method of treating secondary graucoma - Google Patents

Abstract

This invention relates to medicine, in particular to ophthalmology. The purpose of the invention is to reduce postoperative complications. The method consists in the fact that after the formation of a conjunctival flap, scleral dissection in the area of the limb, removal of the deeper layers of the sclera, two strips of the autochral ear are inserted into the layers of the sclera. The free ends of these strips are placed in the front chamber.

Description

This invention relates to median, namely eye surgery.

The purpose of the invention is to reduce postoperative complications.

This goal is achieved by the fact that in the treatment of secondary glaucoma involving the formation of a conjunctival flap, scleral dissection in the limb area, trepanning of the sclera deep sheet, and implantation, two implants of the thoracic ear, which are placed in the sclera layers, are used as an implant. loose ends are inserted into the anterior chamber,

The method is carried out as follows.

Under local infiltration anesthesia with a solution of novocaine (0.5-1.0%), an ear skin is cut on the posterior surface with a 10 mm long shell. The tissue of the cartilage of the ear for the entire thickness of 7x4 mm is dissected with a splinter of the blade. On the wound of the skin of the ear impose

silk stitch (continuous). Kra wounds smeared with brilliant green solution. From the graft, the cartilage is cut with a blade by two strips with an approximate size of 7.0 x 0.5 mm and a thickness of 0.3-0.4 mm. Such dimensions of cartilage strips are determined experimentally in order to better adapt them in the opening of the sclera for the subsequent formation of outflow routes of intraocular fluid,

Next, eyelid akinesia and retrobulbar anesthesia are performed in the usual manner, the conjunctiva is cut in the upper or outer quadrant 10 mm long parallel to the limb and 6 mm indented, the U-shaped area is marked with 3x5 mm uneven incisions (the larger size corresponds to the crossbar P, free ends facing the limb). The sclera is stratified within the delineated area. At the bottom of the exfoliated area of the sclera, excise a strip of deep sclera 1x4 mm in size. If a rainbow falls (L

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ka, then the battleship iridum cell carcass is dissected into the sclera at the same depth, only in the opposite direction by 2 mm. Two strips of cartilage of the ear with one end are inserted into the cavity of the eye, and the other end is placed in the layers of the sclera and impose 2 knotted sutures on the free corners of the scleral flap. The anterior chamber is filled with saline. The conjunctival incision is sutured with a continuous silk stitch. An antibiotic solution with dexazone is administered under the conjunctiva.

In the proposed method, two strips of ear cartilage form a channel through which fluid flows from the eye cavity from the eye cavity under the conjunctiva.

An example. Patient R, with a diagnosis of secondary uncompensated glaucoma, corneal ulcer, penetrating keratoprosthesis, aphaki of the left eye

At admission: visual acuity of the right eye 1.0, visual acuity of the left eye 0.2 and / K. OD - healthy

OS is calm. The arches of the average depth. In the center of the cornea is an optical cornea optical cylinder through keratoprosthesis. Vitreous humor is transparent. The fundus of the eye: sulfur glaucomatous excavation of the optic nerve head, IOP 36 mm hg. (measurement of intraocular pressure on a pneumotonograph).

Surgery: scleroectomy with anterior chamber drainage with strips of cartilage of the ear and basal iridectomy of the left eye

The operation was performed according to the following scheme. Under local infiltration anesthesia with a solution of novocaine (0.5-1.0%), an incision was made in the skin of the ear on the posterior surface of the auricle 10 mm long. The cartilage was excised with a fragment of the blade with the entire thickness of the cartilage 7x4 mm in size. A continuous silk show was applied to the wound on the skin of the ear. The wounds were smeared with brilliant green solution. Two strips of size 7 were cut out from the cartilage graft

Editor A. Dezhnina

Compiled by E.Ga Techred M. Dndyk

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хО, 5 mm and thickness 0,3-0,4 mm. Next, eyelid akinesia and retrobulbar anesthesia were performed according to the usual procedure, the conjunctiva was cut in the upper quadrant with a length of 10 mm parallel to the limbus and 6 mm indented, marked with a U-shaped section with non-through cuts 3x5 mm in size (the larger size corresponds to the crossbar, free ends turned to limbu). The sclera was stratified within the delineated area. At the bottom of the exfoliated area of the sclera, a strip of deep sclera 4x1 mm in size was dissected. The iris fell into the wound and was produced by basal iridectomy. The sclera was layered at the same depth, only in the opposite direction by 2 mm. Two strips of the ear cartilage were placed with one end into the cavity of the eye, with the other end into the layers of the sclera and 2 nodal stitches were put on the free angles of the scleral flap. The anterior chamber was filled with saline. A continuous silk suture was applied to the incision of the conjunctiva. Under the conjunctiva, dexazone 1 was injected with gentamicin. Complications during surgery and in the postoperative period were not observed,

The proposed method allows one to achieve consistent compensation of intraocular pressure in patients with secondary glaucoma.

Claims (1)

Invention Formula A method for treating secondary glaucoma by forming a conjunctival flap, scleral dissection in the limb area, trepanning a deep sclera sheet, and inserting an implant, characterized in that, in order to reduce postoperative complications, two strips of autochral ear are used as an implant, which are placed in sclera layers, and the free ends are inserted into the anterior chamber. Proofreader I. Muska