MD835Z - Method for treating senile cataract - Google Patents

Method for treating senile cataract Download PDF

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Publication number
MD835Z
MD835Z MDS20140056A MDS20140056A MD835Z MD 835 Z MD835 Z MD 835Z MD S20140056 A MDS20140056 A MD S20140056A MD S20140056 A MDS20140056 A MD S20140056A MD 835 Z MD835 Z MD 835Z
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Moldova
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clock
anterior chamber
anterior
lens
chamber
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MDS20140056A
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Romanian (ro)
Russian (ru)
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Ион ЖЕРУ
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Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова
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Priority to MDS20140056A priority Critical patent/MD835Z/en
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Publication of MD835Z publication Critical patent/MD835Z/en

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Abstract

The invention relates to medicine, in particular for ophthalmology, and can be used for treating patients with senile cataract.The method, according to the invention, consists in that it is carried out the local anesthesia, is treated the operative site, is applied the blepharostat, is performed a non-invasive corneal incision, corresponding to 10ºº…13ºº o'clock, is opened the anterior chamber at the level of 11ºº and 13ºº o'clock, is introduced sterile air into the anterior chamber, is carried out the anterior capsule marking, and then bimanually, through the performed incisions, in the anterior chamber are concomitantly introduced 2 devices, which consist of a syringe with needle made of two segments, one proximal of a length of 9 mm, bent at an angle of 135° relative to the longitudinal axis of the syringe, and the other distal of a length of 3 mm perpendicular to said axis; with the first device, introduced at 11ºº o'clock, is fixed the lens, and with the second device, introduced at the level of 13ºº o'clock, is performed the circular anterior capsulorhexis towards the hourhand, then is introduced a viscoelastic agent into the anterior chamber, is removed the nucleus, is carried out the lavage of lenticular masses, is implanted the artificial lens to the posterior chamber, is sutured the cornea, is restored the anterior chamber and is sutured the conjunctiva and subconjunctivally is introduced an antibiotic and a corticosteroid drug.

Description

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

Este cunoscută metoda de tratament al cataractei senile, care constă în extracţia cataractei cu implantarea unui cristalin artificial. În cadrul ei, după anestezia topică şi aseptizarea obişnuită a câmpului operator, se aplică blefarostatul, se efectuează o incizie a corneei de la nivelul orelor 10°° până la nivelul orelor 13°°. Camera anterioară se deschide la nivelul orei 11°° şi se introduce aer steril. Se efectuează marcajul capsulei anterioare, se introduce în ea un remediu vâscoelastic şi se efectuează capsulorexisul anterior, se efectuează o incizie a corneei înspre orele 10°° şi 13°°, se înlătură nucleul cristalinian, se efectuează lavajul maselor cristaliniene, se implantează cristalinul artificial. Incizia corneeană se suturează cu fir 10-0 în surget. Se suturează conjunctiva cu fir 8-0 la nivelul orelor 10°° şi 13°°, subconjunctival se introduce un antibiotic şi un preparat corticosteroid şi se aplică un pansament monocular aseptic [1]. The method of treatment of senile cataract is known, which consists in the extraction of the cataract with the implantation of an artificial lens. In it, after topical anesthesia and the usual asepsis of the operating field, the blepharostat is applied, a corneal incision is made from the 10 o'clock level to the 13 o'clock level. The anterior chamber is opened at the 11 o'clock level and sterile air is introduced. The anterior capsule is marked, a viscoelastic remedy is introduced into it and the anterior capsulorhexis is performed, a corneal incision is made towards the 10 o'clock and 13 o'clock levels, the crystalline nucleus is removed, the crystalline masses are washed, and the artificial lens is implanted. The corneal incision is sutured with 10-0 thread in a surge. The conjunctiva is sutured with 8-0 thread at the 10°° and 13°° o'clock positions, an antibiotic and a corticosteroid preparation are introduced subconjunctivally, and an aseptic monocular dressing is applied [1].

Dezavantajele acestei metode constau în faptul că în cazul unei cataracte senile cu subluxare (slăbirea ligamentului Zinn), la efectuarea capsulorexisului anterior se poate amplifica subluxarea sau poate parveni şi luxarea cristalinului în corpul vitros, care pot declanşa ulterior un glaucom secundar, o uveită postoperatorie sau o keratopatie edemato-buloasă. The disadvantages of this method are that in the case of a senile cataract with subluxation (weakening of the Zinn ligament), when performing anterior capsulorhexis, the subluxation may be amplified or the lens may also become dislocated in the vitreous body, which may subsequently trigger secondary glaucoma, postoperative uveitis or edematous-bullous keratopathy.

Problema pe care o rezolvă invenţia dată constă în elaborarea unei metode noi ce ar permite fixarea intraoperatorie a cristalinului subluxat în timpul efectuării capsulorexisului anterior. The problem solved by this invention consists in developing a new method that would allow intraoperative fixation of the subluxated lens during anterior capsulorhexis.

Esenţa invenţiei constă în aceea că se efectuează anestezia locală, se prelucrează câmpul operator, se aplică blefarostatul, se efectuează o incizie nepenetrantă a corneei ce corespunde orelor 10ºº…13ºº, se deschide camera anterioară la nivelul orelor 11ºº şi 13ºº, se introduce aer steril în camera anterioară, se efectuează marcajul capsulei anterioare, după care bimanual, prin inciziile efectuate, în camera anterioară se introduc concomitent 2 dispozitive care constau dintr-o seringă cu ac executat din două segmente, unul proximal cu lungimea de 9 mm îndoit sub un unghi de 135º faţă de axa longitudinală a seringei, iar altul distal cu lungimea de 3 mm perpendicular pe axa menţionată; cu primul dispozitiv care se introduce la nivelul orei 11ºº se fixează cristalinul, iar cu dispozitivul al doilea care se introduce la nivelul orei 13ºº se efectuează capsulorexisul anterior circular în direcţia acelor de ceasornic, apoi se introduce un remediu vâscoelastic în camera anterioară, 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. The essence of the invention consists in performing local anesthesia, preparing the operating field, applying the blepharostat, making a non-penetrating incision of the cornea corresponding to 10 o'clock…13 o'clock, opening the anterior chamber at 11 o'clock and 13 o'clock, introducing sterile air into the anterior chamber, marking the anterior capsule, after which bimanually, through the incisions made, 2 devices are simultaneously introduced into the anterior chamber, consisting of a syringe with a needle made of two segments, a proximal one with a length of 9 mm bent at an angle of 135º to the longitudinal axis of the syringe, and another distal one with a length of 3 mm perpendicular to the said axis; with the first device, which is inserted at the 11 o'clock position, the lens is fixed, and with the second device, which is inserted at the 13 o'clock position, the anterior capsulorhexis is performed in a clockwise circular direction, then a viscoelastic remedy is introduced into the anterior chamber, the nucleus is removed, the lens masses are lavaged, the artificial lens is implanted in the posterior chamber, the cornea is sutured, the anterior chamber is restored and the conjunctiva is sutured, and an antibiotic and a corticosteroid remedy are introduced subconjunctivally.

Avantajele metodei constau în faptul că este uşor de realizat datorită introducerii concomitente, bimanuale, a 2 dispozitive menţionate, unul are scopul de a fixa cristalinul, iar al doilea serveşte pentru efectuarea capsulorexisului anterior, astfel se evită declanşarea unor complicaţii cum ar fi: glaucomul secundar, uveita postoperatorie şi keratopatia edemato-buloasă. The advantages of the method are that it is easy to perform due to the simultaneous, bimanual introduction of the 2 mentioned devices, one aims to fix the lens, and the second serves to perform the anterior capsulorhexis, thus avoiding the triggering of complications such as: secondary glaucoma, postoperative uveitis and edematous-bullous keratopathy.

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 embodiment of the invention

Se efectuează anestezia locală, se prelucrează câmpul operator, se aplică blefarostatul, se efectuează o incizie nepenetrantă a corneei ce corespunde orelor 10ºº…13ºº, se deschide camera anterioară la nivelul orelor 11ºº şi 13ºº, se introduce aer steril în camera anterioară, se efectuează marcajul capsulei anterioare, după care bimanual, prin inciziile efectuate, în camera anterioară se introduc concomitent 2 dispozitive care constau dintr-o seringă cu ac executat din două segmente, unul proximal cu lungimea de 9 mm îndoit sub un unghi de 135º faţă de axa longitudinală a seringei, iar altul distal cu lungimea de 3 mm perpendicular pe axa menţionată; cu primul dispozitiv care se introduce la nivelul orei 11ºº se fixează cristalinul, iar cu dispozitivul al doilea care se introduce la nivelul orei 13ºº se efectuează capsulorexisul anterior circular în direcţia acelor de ceasornic, apoi se introduce un remediu vâscoelastic în camera anterioară, 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. Local anesthesia is performed, the operating field is prepared, the blepharostat is applied, a non-penetrating corneal incision is made corresponding to 10 o'clock…13 o'clock, the anterior chamber is opened at 11 o'clock and 13 o'clock, sterile air is introduced into the anterior chamber, the anterior capsule is marked, after which bimanually, through the incisions made, 2 devices are simultaneously introduced into the anterior chamber consisting of a syringe with a needle made of two segments, a proximal one with a length of 9 mm bent at an angle of 135º to the longitudinal axis of the syringe, and another distal one with a length of 3 mm perpendicular to the aforementioned axis; with the first device, which is inserted at the 11 o'clock position, the lens is fixed, and with the second device, which is inserted at the 13 o'clock position, the anterior capsulorhexis is performed in a clockwise circular direction, then a viscoelastic remedy is introduced into the anterior chamber, the nucleus is removed, the lens masses are lavaged, the artificial lens is implanted in the posterior chamber, the cornea is sutured, the anterior chamber is restored and the conjunctiva is sutured, and an antibiotic and a corticosteroid remedy are introduced subconjunctivally.

Exemplul 1 Example 1

Pacientul X., în vârstă de 62 de ani. Diagnosticul clinic: ochiul stâng (OS) - cataractă senilă. Ochiul drept (OD) - cataractă incipientă legată de vârstă. Patient X., 62 years old. Clinical diagnosis: left eye (OS) - senile cataract. Right eye (OD) - incipient age-related cataract.

Visus OD = 0,4 nu corijează (la internare) Visus OD = 0.4 uncorrected (at admission)

OS 1/Ω pr L certa OS 1/Ω pr L certa

Efectuarea intervenţiei microchirurgicale la OS conform metodei revendicate: Performing microsurgical intervention on the OS according to the claimed method:

Visus OD = 0,4 nu corijează (la externare) Visus OD = 0.4 uncorrected (at discharge)

OS 0,4 nu corijează OS 0.4 does not fix

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 on the OS, during biomicroscopy, no signs of decentration of the implanted artificial lens were detected.

Exemplul 2 Example 2

Pacientul I., în vârstă de 74 de ani. Diagnosticul clinic: OD - cataractă senilă. OS - cataractă incipientă legată de vârstă. Patient I., 74 years old. Clinical diagnosis: OD - senile cataract. OS - incipient age-related cataract.

Visus OD = 1/Ω pr L certa (la internare) Visus OD = 1/Ω pr L certa (at admission)

OS 0,6 nu corijează OS 0.6 does not fix

Visus OD = 0,6 nu corijează (la externare) Visus OD = 0.6 uncorrected (at discharge)

OS 0,6 nu corijează OS 0.6 does not fix

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

Metoda dată a fost aplicată la 23 de pacienţi din cadrul catedrei Oftalmologie a IMSP SCR. La un an de la intervenţia microchirurgicală pacienţii au fost inspectaţi şi nu au fost constatate cazuri de decentrare a cristalinului artificial implantat. This method was applied to 23 patients from the Ophthalmology Department of IMSP SCR. One year after the microsurgical intervention, the patients were inspected and no cases of decentration of the implanted artificial lens were found.

1. Краснов М., Беляев В. Руководство по глазной хирургии. Москва, Медицина, 1988, p. 266-324 1. Krasnov M., Belyaev V. Guide to eye surgery. Moscow, Medicine, 1988, p. 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 nepenetrantă a corneei ce corespunde orelor 10ºº…13ºº, se deschide camera anterioară la nivelul orelor 11ºº şi 13ºº, se introduce aer steril în camera anterioară, se efectuează marcajul capsulei anterioare, după care bimanual, prin inciziile efectuate, în camera anterioară se introduc concomitent 2 dispozitive care constau dintr-o seringă cu ac executat din două segmente, unul proximal cu lungimea de 9 mm îndoit sub un unghi de 135º faţă de axa longitudinală a seringei, iar altul distal cu lungimea de 3 mm perpendicular pe axa menţionată; cu primul dispozitiv care se introduce la nivelul orei 11ºº se fixează cristalinul, iar cu dispozitivul al doilea care se introduce la nivelul orei 13ºº se efectuează capsulorexisul anterior circular în direcţia acelor de ceasornic, apoi se introduce un remediu vâscoelastic în camera anterioară, 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.Method of treatment of senile cataract, which consists in performing local anesthesia, processing the operating field, applying the blepharostat, making a non-penetrating incision of the cornea corresponding to 10 o'clock…13 o'clock, opening the anterior chamber at 11 o'clock and 13 o'clock, introducing sterile air into the anterior chamber, marking the anterior capsule, after which bimanually, through the incisions made, 2 devices are simultaneously introduced into the anterior chamber consisting of a syringe with a needle made of two segments, one proximal with a length of 9 mm bent at an angle of 135º to the longitudinal axis of the syringe, and another distal with a length of 3 mm perpendicular to the aforementioned axis; with the first device, which is inserted at the 11 o'clock position, the lens is fixed, and with the second device, which is inserted at the 13 o'clock position, the anterior capsulorhexis is performed in a clockwise circular direction, then a viscoelastic remedy is introduced into the anterior chamber, the nucleus is removed, the lens masses are lavaged, the artificial lens is implanted in the posterior chamber, the cornea is sutured, the anterior chamber is restored and the conjunctiva is sutured, and an antibiotic and a corticosteroid remedy are introduced subconjunctivally.
MDS20140056A 2014-04-25 2014-04-25 Method for treating senile cataract MD835Z (en)

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Publication number Priority date Publication date Assignee Title
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
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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
  • 2014

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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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