MD656Z - Method for treating senile cataract - Google Patents

Method for treating senile cataract

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Publication number
MD656Z
MD656Z MDS20130015A MDS20130015A MD656Z MD 656 Z MD656 Z MD 656Z MD S20130015 A MDS20130015 A MD S20130015A MD S20130015 A MDS20130015 A MD S20130015A MD 656 Z MD656 Z MD 656Z
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MD
Moldova
Prior art keywords
anterior chamber
anterior
clock
suture
iris
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MDS20130015A
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Romanian (ro)
Russian (ru)
Inventor
Ион ЖЕРУ
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Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова
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Priority to MDS20130015A priority Critical patent/MD656Z/en
Publication of MD656Y publication Critical patent/MD656Y/en
Publication of MD656Z publication Critical patent/MD656Z/en

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Abstract

The invention relates to medicine, in particular to ophthalmology and can be used for treatment of patients with senile cataract.The method, according to the invention, consists in that it is carried out the local anesthesia, is processed the operative field, is applied the blepharostat, is performed an incision of cornea which corresponds to 10.00…13.00 o'clock, is opened the anterior chamber at the level of 11.00 o'clock, is introduced sterile air into the anterior chamber, is carried out the marking of the anterior chamber, is introduced a viscoelastic agent in the anterior chamber, is carried out the anterior capsulorhexis, is removed the nucleus, is performed the lavage of lenticular masses, is implanted an artificial lens to the anterior chamber, is sutured the cornea, is reduced the anterior chamber and sutured the conjunctiva, and is subconjunctivally introduced an antibiotic and a corticosteroid drug, at the same time, after lavage of lenticular masses, is performed the anterior vitrectomy, then is implanted the lower leg of the artificial lens in the capsular sac, is fixed the upper leg with a retention suture, with its passage under the iris at the level of 12.00 o'clock, then with its passage in the sclera, afterwards the suture is tightened by raising the iris and is ligatured at the level of 12.00 o'clock.

Description

Invenţia se referă la medicină, şi anume la oftalmologie, şi poate fi aplicată în tratamentul pacienţilor cu cataractă senilă. The invention relates to medicine, namely to ophthalmology, and can be applied in the treatment of patients with senile cataracts.

Este cunoscută metoda de tratament al cataractei senile, care constă în extracţia cataractei cu implantarea unui cristalin artificial de cameră anterioară. În cadrul ei, după anestezia topică şi aseptizarea obişnuită a câmpului operator, se aplică blefarostatul, se efectuează o incizie a corneei de la ora 1000 până la 1300. Camera anterioară se deschide la ora 1100 şi se introduce în ea aer steril. Se efectuează marcajul capsulei anterioare, se introduce în ea un remediu vâscoelastic şi se efectuează capsulorexisul anterior. Se efectuează incizia corneei spre 1000 şi 1300, se înlăturară nucleul, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial de cameră anterioară. Incizia corneeană se suturează cu fir 10-0 în surget. Se suturează cojunctiva cu fir 8-0 la nivelul orelor 1000 şi 1300, subconjunctival se introduce un antibiotic şi un preparat corticosteroid şi se aplică un pansament monocular aseptic [1]. The method of treating senile cataract is known, which consists in the extraction of the cataract with the implantation of an artificial lens of the anterior chamber. In it, after topical anesthesia and the usual asepticization of the operating field, the blepharostat is applied, a corneal incision is made from 1000 to 1300. The anterior chamber is opened at 1100 and sterile air is introduced into it. The marking of the anterior capsule is performed, a viscoelastic remedy is introduced into it and the anterior capsulorrhexis is performed. The corneal incision is made towards 1000 and 1300, the nucleus is removed, the lens masses are washed, the anterior chamber artificial lens is implanted. The corneal incision is sutured with 10-0 suture. The conjunctiva is sutured with 8-0 thread at 1000 and 1300 hours, an antibiotic and a corticosteroid preparation are inserted subconjunctivally and an aseptic monocular dressing is applied [1].

Dezavantajele acestei metode constau în presionarea corpului vitros la introducerea picioruşului superior al cristalinului artificial sub iris în cazurile când extracţia este însoţită de pierdere de corp vitros, fapt care contribuie la instabilitatea cristalinului artificial implantat, cu declanşarea ulterioară a unui glaucom secundar, a uveitei postoperatorii sau a keratopatiei edemato-buloase. The disadvantages of this method consist in the pressing of the vitreous body when inserting the upper leg of the artificial lens under the iris in cases when the extraction is accompanied by loss of the vitreous body, a fact that contributes to the instability of the implanted artificial lens, with the subsequent triggering of secondary glaucoma, postoperative uveitis or of edemato-bullous keratopathy.

Problema pe care o rezolvă invenţia dată constă în evitarea presiunii asupra corpului vitros în timpul introducerii picioruşului superior al cristalinului artificial sub iris cu fixarea ulterioară a acestuia de scleră. The problem that the given invention solves is to avoid pressure on the vitreous body during the introduction of the upper leg of the artificial lens under the iris with its subsequent fixation to the sclera.

Esenţa invenţiei constă în aceea că se efectuează anestezia locală, se prelucrează câmpul operator, se aplică blefarostatul, se efectuează o incizie a corneei ce corespunde orelor 10.00…13.00, se deschide camera anterioară la nivelul orei 11.00, se introduce aer steril în camera anterioară, se efectuează marcajul camerei anterioare, se introduce un remediu vâscoelastic în camera anterioară, se efectuează capsulorexisul anterior, se înlătură nucleul, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial de camera posterioară, se suturează corneea, se reface camera anterioară şi se suturează conjunctiva, iar subconjunctival se introduce un antibiotic şi un remediu corticosteroid, totodată, după lavajul maselor cristaliniene, se efectuează vitrectomia anterioară, apoi se implantează picioruşul inferior al cristalinului artificial în sacul capsular, se fixează picioruşul superior cu un fir de sutură, cu trecerea acestuia sub iris la nivelul orei 12.00, apoi cu trecerea lui pe scleră, după care sutura se tensionează ridicând irisul şi se ligaturează la nivelul orei 12.00. The essence of the invention is that local anesthesia is performed, the operative field is processed, the blepharostat is applied, a corneal incision is made that corresponds to 10.00...13.00, the anterior chamber is opened at 11.00, sterile air is introduced into the anterior chamber, the anterior chamber is marked, a viscoelastic agent is inserted into the anterior chamber, the anterior capsulorhexis is performed, the nucleus is removed, the lens masses are washed, the posterior chamber artificial lens is implanted, the cornea is sutured, the anterior chamber is reconstructed and the conjunctiva is sutured , and an antibiotic and a corticosteroid remedy are introduced subconjunctivally, at the same time, after washing the crystalline masses, the anterior vitrectomy is performed, then the lower leg of the artificial lens is implanted in the capsular bag, the upper leg is fixed with a suture, passing it under iris at the level of 12.00 o'clock, then with its passage on the sclera, after which the suture is tensioned raising the iris and ligated at the level of 12.00 o'clock.

Avantajele metodei constau în faptul că ea este simplă în realizare datorită introducerii ansei picioruşului superior al cristalinului artificial sub iris şi fixării cu un fir de sutură 8-0, astfel se evită declanşarea unor complicaţii, ca: glaucomul secundar, uveita postoperatorie şi keratopatia edemato-buloasă. The advantages of the method consist in the fact that it is simple to perform due to the introduction of the loop of the upper leg of the artificial lens under the iris and fixation with an 8-0 suture thread, thus avoiding the triggering of some complications, such as: secondary glaucoma, postoperative uveitis and edematous keratopathy bullous.

Rezultatul tehnic constă în simplificarea intervenţiei microchirurgicale şi minimalizarea complicaţiilor intraoperatorii. The technical result consists in simplifying the microsurgical intervention and minimizing intraoperative complications.

Exemplu de realizare a invenţiei Example of realization of the invention

Se efectuează anestezia locală, se prelucrează câmpul operator, se aplică blefarostatul, se efectuează o incizie a corneei ce corespunde orelor 10.00…13.00, se deschide camera anterioară la nivelul orei 11.00, se introduce aer steril în camera anterioară, se efectuează marcajul camerei anterioare, se introduce un remediu vâscoelastic în camera anterioară, se efectuează capsulorexisul anterior, se înlătură nucleul, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial de camera posterioară, se suturează corneea, se reface camera anterioară şi se suturează conjunctiva, iar subconjunctival se introduce un antibiotic şi un remediu corticosteroid, totodată, după lavajul maselor cristaliniene, se efectuează vitrectomia anterioară, apoi se implantează picioruşul inferior al cristalinului artificial în sacul capsular, se fixează picioruşul superior cu un fir de sutură, cu trecerea acestuia sub iris la nivelul orei 12.00, apoi cu trecerea lui pe scleră, după care sutura se tensionează ridicând irisul şi se ligaturează la nivelul orei 12.00. Local anesthesia is performed, the operative field is processed, the blepharostat is applied, a corneal incision is made corresponding to 10:00...13:00, the anterior chamber is opened at 11:00, sterile air is introduced into the anterior chamber, the marking of the anterior chamber is performed, a viscoelastic medicine is introduced into the anterior chamber, the anterior capsulorhexis is performed, the nucleus is removed, the lens masses are washed, the artificial lens is implanted in the posterior chamber, the cornea is sutured, the anterior chamber is restored and the conjunctiva is sutured, and a subconjunctival is inserted antibiotic and a corticosteroid remedy, at the same time, after washing the crystalline masses, the anterior vitrectomy is performed, then the lower leg of the artificial lens is implanted in the capsular bag, the upper leg is fixed with a suture, with its passage under the iris at the level of 12:00, then with its passage on the sclera, after which the suture is tensioned, lifting the iris and ligated at the level of 12.00 o'clock.

Exemplul 1 Example 1

Pacientul X., în vârstă de 61 de ani. Diagnosticul clinic: Ochiul Stâng (OS) - cataractă senilă matură. Ochiul Drept (OD) - cataractă senilă incipientă. Patient X., 61 years old. Clinical diagnosis: Left Eye (LO) - mature senile cataract. Right Eye (RD) - early senile cataract.

Visus OD = 1L 0,3 nu corijează Visus OD = 1L 0.3 does not correct

OS 1/u prL certa (la internare). OS 1/u prL certa (on admission).

Efectuarea intervenţiei microchirurgicale la OS conform metodei revendicate: Carrying out the microsurgical intervention at the OS according to the claimed method:

Visus OD = 0,3 nu corijează Visus OD = 0.3 does not correct

OS 0,4 nu corijează (la externare). OS 0.4 does not patch (on discharge).

La un an de la intervenţia microchirurgicală la OS, în cadrul biomicroscopiei, semne de decentrare a cristalinului artificial implantat nu s-au depistat. One year after the microsurgical intervention at the OS, during biomicroscopy, no signs of decentration of the implanted artificial lens were detected.

Exemplul 2 Example 2

Pacientul Y., în vârstă de 73 de ani. Diagnosticul clinic: OD - Cataractă senilă matură. OS - cataractă senilă incipientă. Patient Y., 73 years old. Clinical diagnosis: OD - Mature senile cataract. OS - early senile cataract.

Visus OD = 1/u L certa Visus OD = 1/u L certa

OS 0,5 nu corijează (la internare). OS 0.5 does not correct (on admission).

S-a efectuat intervenţia microchirurgicală la OD conform invenţiei. Microsurgical intervention was performed at OD according to the invention.

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

OS 0,5 nu corijează (la externare). OS 0.5 does not patch (on discharge).

La un an de la intervenţia microchirurgicală la OD, în cadrul biomicroscopiei, semne de decentrare a cristalinului artificial nu s-au depistat. One year after the microsurgical intervention at OD, during biomicroscopy, no signs of decentration of the artificial lens were detected.

Metoda a fost aplicată la 18 pacienţi, în cadrul catedrei Oftalmologie, IMSP SCR, care au fost inspectaţi la un an de la intervenţia microchirurgicală şi nu s-a depistat decentrarea cristalinului artificial implantat. The method was applied to 18 patients, within the Department of Ophthalmology, IMSP SCR, who were inspected one year after the microsurgical intervention and no decentration of the implanted artificial lens was detected.

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

Claims (1)

Metodă de tratament al cataractei senile, care constă în aceea că se efectuează anestezia locală, se prelucrează câmpul operator, se aplică blefarostatul, se efectuează o incizie a corneei ce corespunde orelor 10.00…13.00, se deschide camera anterioară la nivelul orei 11.00, se introduce aer steril în camera anterioară, se efectuează marcajul camerei anterioare, se introduce un remediu vâscoelastic în camera anterioară, se efectuează capsulorexisul anterior, se înlătură nucleul, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial de camera posterioară, se suturează corneea, se reface camera anterioară şi se suturează conjunctiva, iar subconjunctival se introduce un antibiotic şi un remediu corticosteroid, caracterizată prin aceea că, după lavajul maselor cristaliniene, se efectuează vitrectomia anterioară, apoi se implantează picioruşul inferior al cristalinului artificial în sacul capsular, se fixează picioruşul superior cu un fir de sutură, cu trecerea acestuia sub iris la nivelul orei 12.00, apoi cu trecerea lui pe scleră, după care sutura se tensionează ridicând irisul şi se ligaturează la nivelul orei 12.00.Senile cataract treatment method, which consists in applying local anesthesia, processing the operative field, applying the blepharostat, making a corneal incision corresponding to 10.00...13.00, opening the anterior chamber at 11.00, inserting sterile air in the anterior chamber, mark the anterior chamber, insert a viscoelastic agent in the anterior chamber, perform the anterior capsulorrhexis, remove the nucleus, wash the lens masses, implant the artificial lens of the posterior chamber, suture the cornea, redo the anterior chamber and the conjunctiva is sutured, and an antibiotic and a corticosteroid remedy are inserted subconjunctivally, characterized by the fact that, after washing the lens masses, the anterior vitrectomy is performed, then the lower leg of the artificial lens is implanted in the capsular bag, the upper leg is fixed with a suture thread, with its passage under the iris at 12:00 o'clock, then with its passage over the sclera, after which the suture is tensioned, lifting the iris and ligated at 12:00 o'clock.
MDS20130015A 2013-02-04 2013-02-04 Method for treating senile cataract MD656Z (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
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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* Cited by examiner, † Cited by third party
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MD722Z (en) * 2013-07-12 2014-08-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for treating 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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MD9Z (en) * 2008-11-21 2009-10-31 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Method for treating the 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
MD437Z (en) * 2011-03-04 2012-06-30 Usmf Nicolae Testemitanu Republica Moldova Method for treating senile cataract
MD438Z (en) * 2011-05-23 2012-06-30 Usmf Nicolae Testemitanu Republica Moldova Method for treating hypermature senile cataract
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
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MD438Z (en) * 2011-05-23 2012-06-30 Usmf Nicolae Testemitanu Republica Moldova Method for treating hypermature senile cataract
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
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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