MD438Z - Method for treating hypermature senile cataract - Google Patents

Method for treating hypermature senile cataract Download PDF

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Publication number
MD438Z
MD438Z MDS20110095A MDS20110095A MD438Z MD 438 Z MD438 Z MD 438Z MD S20110095 A MDS20110095 A MD S20110095A MD S20110095 A MDS20110095 A MD S20110095A MD 438 Z MD438 Z MD 438Z
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Moldova
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lens
anterior capsule
anterior
hypermature
conjunctiva
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MDS20110095A
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Romanian (ro)
Russian (ru)
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Ion Jeru
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Usmf Nicolae Testemitanu Republica Moldova
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Publication of MD438Z publication Critical patent/MD438Z/en

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Abstract

The invention relates to medicine, particularly ophthalmology, and can be used for the treatment of hypermature senile cataract.According to the invention, the method for treating hypermature senile cataract consists in that it is carried out the local and regional anesthesia, is fixed the superior rectus muscle, is incised the conjunctiva at the limb level, is incised the cornea, is marked the anterior capsule, is performed an incision of the anterior capsule perpendicular to the limb, which corresponds to 18.00 hours of the length of 2…3 mm, are aspirated the lens masses, is introduced a viscoelastic agent under the anterior capsule, then is removed the anterior capsule and the nucleus of lens, is performed the lavage of lens masses, is implanted an artificial lens to the posterior chamber, are carried out two iridectomies which correspond to 11.00 and 13.00 hours, then it is sutured the cornea, is reduced the anterior chamber by introducing sterile saline, is sutured the conjunctiva, is administered an antibiotic and a corticosteroid agent in the subconjunctival space and is released the superior rectus muscle.

Description

Invenţia se referă la medicină, în special la oftalmologie şi poate fi aplicată pentru tratamentul cataractei senile hipermature. The invention relates to medicine, in particular to ophthalmology and can be applied for the treatment of hypermature senile cataract.

Este cunoscută metoda de tratament al cataractei senile, care constă în aceea că se efectuează anestezia locală şi regională, se fixează muşchiul rect superior, se detaşează conjunctiva de la limb, se incizează conjunctiva la nivelul limbului, care corespunde orelor 10°°-14°°, se incizează corneea la nivelul orelor 10°° până la 14°°, se marchează capsula anterioară, se lărgeşte incizia corneei spre nivelul orelor 10°° şi 14°°, se efectuează capsulorexisul anterior prin extracţia cataractei senile cu aplicarea unui implant de cristalin artificial de camera posterioară, apoi se suturează conjunctiva, se aplică un antibiotic şi un preparat corticosteroid, se eliberează muşchiul rect superior şi se aplică un pansament monocular aseptic [1]. The method of treating senile cataract is known, which consists of performing local and regional anesthesia, fixing the superior rectus muscle, detaching the conjunctiva from the limbus, incising the conjunctiva at the level of the limbus, which corresponds to 10°°-14°°, incising the cornea at the level of 10°° to 14°°, marking the anterior capsule, widening the corneal incision towards the level of 10°° and 14°°, performing anterior capsulorhexis by extracting the senile cataract with the application of an artificial lens implant in the posterior chamber, then suturing the conjunctiva, applying an antibiotic and a corticosteroid preparation, releasing the superior rectus muscle and applying an aseptic monocular dressing [1].

Dezavantajele acestei metode constau în diminuarea tensiunii capsulare la efectuarea capsulorexisului anterior în cadrul cataractei senile hipermature, unde cortexul cristalinian se lichefiază în momentul efectuării capsulorexisului anterior, capsula anterioară se poate rupe spre polul posterior cristalinian, determinând un capsulorexis iregulat şi cu o pierdere de corp vitros, iar în perioada postoperatorie se poate declanşa o descentrare a cristalinului artificial cu glaucom secundar, uveită postoperatorie sau o keratopatie edematobuloasă. The disadvantages of this method consist in the reduction of capsular tension when performing anterior capsulorhexis in hypermature senile cataract, where the lens cortex liquefies at the time of performing anterior capsulorhexis, the anterior capsule can tear towards the posterior lens pole, causing an irregular capsulorhexis and a loss of vitreous body, and in the postoperative period, a decentering of the artificial lens with secondary glaucoma, postoperative uveitis or edematobullous keratopathy can be triggered.

Problema pe care o rezolvă invenţia propusă constă în obţinerea unui capsulorexis anterior circular regulat. The problem solved by the proposed invention consists in obtaining a regular circular anterior capsulorhexis.

Conform invenţiei, metoda de tratament al cataractei senile hipermature constă în aceea că se efectuează anestezia locală şi regională, se fixează muşchiul rect superior, se incizează conjuctiva la nivelul limbului, se incizează corneea, se marchează capsula anterioară, se efectuează o incizie pe capsula anterioară, perpendicular pe limb, ce corespunde orei 18°° cu o lungime de 2…3 mm, se aspiră masele cristaliniene, se introduce un remediu viscoelastic sub capsula anteroară, după care capsula anterioară şi nucleul cristalinului se înlătură, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial de camera posterioară, se efectuează două iridotomii ce corespund orelor 11°° şi 13°°, după care se suturează corneea, se reface camera anterioară prin introducere de ser fiziologic steril, se suturează conjunctiva, în spaţiul subconjunctival se introduce un antibiotic şi un remediu corticosteroid şi se eliberează muşchiul rect superior. According to the invention, the method of treating hypermature senile cataract consists in performing local and regional anesthesia, fixing the superior rectus muscle, incising the conjunctiva at the limbus level, incising the cornea, marking the anterior capsule, making an incision on the anterior capsule, perpendicular to the limbus, corresponding to 18°° with a length of 2…3 mm, aspirating the lens masses, introducing a viscoelastic remedy under the anterior capsule, after which the anterior capsule and the lens nucleus are removed, washing the lens masses, implanting the artificial lens in the posterior chamber, performing two iridotomies corresponding to 11°° and 13°°, after which the cornea is sutured, the anterior chamber is restored by introducing sterile physiological serum, suturing the conjunctiva, introducing an antibiotic and a corticosteroid remedy into the subconjunctival space and releasing the superior rectus muscle.

Rezultatul constă în simplificarea intervenţiei microchirurgicale şi profilaxia complicaţiilor intra- şi postoperatorii. The result is the simplification of microsurgical intervention and the prevention of intra- and postoperative complications.

Metoda de tratament al cataractei senile hipermature se realizează în modul următor: se efectuează anestezia locală şi regională, se fixează muşchiul rect superior, se incizează conjuctiva la nivelul limbului, se incizează corneea, se marchează capsula anterioară, se efectuează o incizie pe capsula anterioară, perpendicular pe limb, ce corespunde orei 18°° cu o lungime de 2…3 mm, se aspiră masele cristaliniene, se introduce un remediu viscoelastic sub capsula anteroară, după care capsula anterioară şi nucleul cristalinului se înlătură, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial de camera posterioară, se efectuează două iridotomii ce corespund orelor 11°° şi 13°°, după care se suturează corneea, se reface camera anterioară prin introducere de ser fiziologic steril, se suturează conjunctiva, în spaţiul subconjunctival se introduce un antibiotic şi un remediu corticosteroid şi se eliberează muşchiul rect superior. The method of treatment of hypermature senile cataract is performed as follows: local and regional anesthesia is performed, the superior rectus muscle is fixed, the conjunctiva is incised at the limbus level, the cornea is incised, the anterior capsule is marked, an incision is made on the anterior capsule, perpendicular to the limbus, corresponding to 18°° with a length of 2…3 mm, the lens masses are aspirated, a viscoelastic remedy is introduced under the anterior capsule, after which the anterior capsule and the lens nucleus are removed, the lens masses are lavaged, the artificial lens is implanted in the posterior chamber, two iridotomies are performed corresponding to 11°° and 13°°, after which the cornea is sutured, the anterior chamber is restored by introducing sterile physiological serum, the conjunctiva is sutured, an antibiotic and a corticosteroid remedy are introduced into the subconjunctival space and the superior rectus muscle is released.

Metoda revendicată are unele avantaje: este simplă în realizare şi prin introducerea remediului viscoelastic sub capsula cristaliniană anterioară se evită diminuarea tensiunii sacului, ce permite efectuarea unui capsulorexis anterior circular cu evitarea unor complicaţii, ca glaucomul secundar, uveita postoperatorie şi keratopatia edematobuloasă. The claimed method has some advantages: it is simple to perform and by introducing the viscoelastic remedy under the anterior lens capsule, the reduction of the bag tension is avoided, which allows performing an anterior circular capsulorhexis while avoiding complications such as secondary glaucoma, postoperative uveitis and edematobullous keratopathy.

Exemplul 1 Example 1

Pacienta X., în vârstă de 77 de ani. Diagnosticul clinic: OD - cataractă senilă hipermatură, OS - cataractă senilă incipientă. Patient X., 77 years old. Clinical diagnosis: OD - hypermature senile cataract, OS - incipient senile cataract.

Visus OD = l/u prL certa Visus OD = l/u prL certa

OS = 0,4 nu corijează (internare) OS = 0.4 does not correct (hospitalization)

S-a efectuat intervenţia conform metodei revendicate la OD, după care The intervention was carried out according to the method claimed at the OD, after which

visus OD = 0,4 nu corijează visus OD = 0.4 does not correct

OS = 0,4 nu corijează (externare). OS = 0.4 does not correct (externalization).

La un an de la intervenţie la OD la biomicroscopie semne de descentrare a cristalinului artificial şi procese inflamatorii sau procese patologice corneene nu s-au depistat. One year after the intervention at OD, biomicroscopy showed no signs of decentration of the artificial lens and no inflammatory or pathological corneal processes.

Exemplul 2 Example 2

Pacientul G., în vârstă de 80 de ani. Diagnosticul clinic: OD - cataractă senilă incipientă, OS - cataractă senilă hipermatură. Patient G., 80 years old. Clinical diagnosis: OD - incipient senile cataract, OS - hypermature senile cataract.

Visus OD = 0,6 nu corijează Visus OD = 0.6 uncorrected

OS = l/u pr L certa (internare) OS = l/u pr L certa (hospitalization)

S-a efectuat intervenţia conform metodei revendicate la OD, după care The intervention was carried out according to the method claimed at the OD, after which

visus OD = 0,6 nu corijează visus OD = 0.6 does not correct

OS = 0,7 nu corijează (externare). OS = 0.7 does not correct (externalization).

La un an de la intervenţie la OS la biomicroscopie semne de descentrare a cristalinului artificial, procese inflamatorii şi procese patologice corneene nu s-au depistat. One year after the OS intervention, biomicroscopy showed no signs of decentration of the artificial lens, inflammatory processes, or corneal pathological processes.

Metoda a fost aplicată la 48 de pacienţi, în cadrul catedrei Oftalmologie ISMP SCR. La un an de la intervenţia microchirurgicală nu s-au depistat descentrări ale cristalinului artificial implantat. The method was applied to 48 patients, within the ISMP SCR Ophthalmology Department. One year after the microsurgical intervention, no decentrations of the implanted artificial lens were detected.

1. Краснов М.Л., Беляев В.С. Руководство по глазной хирургии. Москва, Медицина, 1988, с. 266-324 1. Krasnov M.L., Belyaev V.S. Guide to eye surgery. Moscow, Medicine, 1988, p. 266-324

Claims (1)

Metodă de tratament al cataractei senile hipermature, care constă în aceea că se efectuează anestezia locală şi regională, se fixează muşchiul rect superior, se incizează conjuctiva la nivelul limbului, se incizează corneea, se marchează capsula anterioară, se efectuează o incizie pe capsula anterioară, perpendicular pe limb, ce corespunde orei 18.00 cu o lungime de 2…3 mm, se aspiră masele cristaliniene, se introduce un remediu viscoelastic sub capsula anteroară, după care capsula anterioară şi nucleul cristalinului se înlătură, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial de camera posterioară, se efectuează două iridotomii ce corespund orelor 11.00 şi 13.00, după care se suturează corneea, se reface camera anterioară prin introducere de ser fiziologic steril, se suturează conjunctiva, în spaţiul subconjunctival se introduce un antibiotic şi un remediu corticosteroid şi se eliberează muşchiul rect superior.Method of treatment of hypermature senile cataract, which consists in performing local and regional anesthesia, fixing the superior rectus muscle, incising the conjunctiva at the limbus level, incising the cornea, marking the anterior capsule, making an incision on the anterior capsule, perpendicular to the limbus, corresponding to 18:00 with a length of 2…3 mm, aspirating the lens masses, introducing a viscoelastic remedy under the anterior capsule, after which the anterior capsule and the lens nucleus are removed, washing the lens masses, implanting the artificial lens in the posterior chamber, performing two iridotomies corresponding to 11:00 and 13:00, after which the cornea is sutured, the anterior chamber is restored by introducing sterile physiological serum, suturing the conjunctiva, introducing an antibiotic and a corticosteroid remedy into the subconjunctival space and releasing the superior rectus muscle.
MDS20110095A 2011-05-23 2011-05-23 Method for treating hypermature senile cataract MD438Z (en)

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Cited By (6)

* Cited by examiner, † Cited by third party
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MD581Z (en) * 2012-07-20 2013-08-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method of treatment of senile cataract associated with pseudoexfoliative syndrome
MD612Z (en) * 2012-11-14 2013-10-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for treatment of senile cataract
MD656Z (en) * 2013-02-04 2014-02-28 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating senile cataract
MD722Z (en) * 2013-07-12 2014-08-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for treating senile cataract
MD835Z (en) * 2014-04-25 2015-06-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating senile cataract
MD870Z (en) * 2014-06-25 2015-08-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating senile cataract

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MD500Z (en) * 2011-11-29 2012-11-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for treatment of hypermature senile cataract
MD994Z (en) * 2015-03-16 2016-08-31 ОП ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ И ФАРМАЦЕВТИЧЕСКИЙ УНИВЕРСИТЕТ им. НИКОЛАЯ ТЕСТЕМИЦАНУ РЕСПУБЛИКИ МОЛДОВА Method for treating cataract complicated with anterior uveitis
MD1017Z (en) * 2015-07-07 2016-10-31 ОП ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ И ФАРМАЦЕВТИЧЕСКИЙ УНИВЕРСИТЕТ им. НИКОЛАЯ ТЕСТЕМИЦАНУ РЕСПУБЛИКИ МОЛДОВА Method for treating senile cataract

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MD3247G2 (en) * 2006-09-06 2007-09-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method of senile cataract treatment
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MD3676G2 (en) * 2008-02-21 2009-03-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method of treating the senile cataract
MD9Z (en) * 2008-11-21 2009-10-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating the senile cataract
MD142Z (en) * 2009-08-28 2010-09-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for the treatment of senile cataract
MD292Z (en) * 2010-07-01 2011-07-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method of treatment of senile cataract
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MD292Z (en) * 2010-07-01 2011-07-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method of treatment of senile cataract

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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
MD581Z (en) * 2012-07-20 2013-08-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method of treatment of senile cataract associated with pseudoexfoliative syndrome
MD612Z (en) * 2012-11-14 2013-10-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for treatment of senile cataract
MD656Z (en) * 2013-02-04 2014-02-28 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating senile cataract
MD722Z (en) * 2013-07-12 2014-08-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for treating senile cataract
MD835Z (en) * 2014-04-25 2015-06-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating senile cataract
MD870Z (en) * 2014-06-25 2015-08-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating senile cataract

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