RU12901U1 - MODIFICATION OF THE FLAP FOR CARRYING OUT OF MERIDIONAL SCLEROPLASTY AT PROGRESSING MYOPERNESS - Google Patents

Abstract

Modification of the flap for conducting meridional scleroplasty, characterized in that a two-layer flap of size 8 · 20 mm is modeled, formed from a non-absorbable synthetic material - the canvas of the warp knitted pile medical POVM-30 and the collagen hemostatic sponge, which is located above the flap POVM-30 and is fixed at its edges interrupted sutures, impregnated with a solution of antibiotic and corticosteroid, swollen, hemostatic sponge acts as a "spacer", reliably fixing without suture fixation synthetic a flap to the sclera of the recipient, and a depot of drugs provides an reactive course of the postoperative period.

Description

MODIFICATION OF THE FLAP

FOR MERIDIONAL

ADHESIVE PLASTIC AT PROGRESSING

Myopia

Authors: Aleshaev Mikhail Ivanovich Baulina Galina Nikolaevna Kosarev Sergey Nikolaevich

The proposed utility model is used in medicine, namely in ophthalmology, and can be used in the surgical treatment of progressive myopia during scleroplasty.

It is known that scleroplasgics is the most effective way to treat progressive myopia (Somov E.E. Scleroplasgics. - St. Petersburg, 1995. - P. 123). The most popular method of meridional scleroplasty is the Pivovarov-Pristavko operation (Pivovarov N.N., Pristavko E.F., Shirshikov Yu.K. A simple method for the surgical prevention of progressive myopia // All-Union conference on children's ophthalmology: Tet. M., 1976 .-- S. 141). The material used for scleroplasty in this operation of the homoscler does not always ensure the achievement of a technical result, smacked in a dense planar growth of the flap of the homosklera to the fibrous capsule of the myopic eye, providing a constant banding effect. The effect of biomechanical strengthening is also unstable due to the fact that the used allografts have the property to dissolve quickly without having time to exert a stabilizing effect (Cheglakov Yu.A. et al. // Ophthalmosurgery. - 1996. -. M. 4. - P. 41). B. Curtin noted that a collagenase enzyme is produced at the location of the graft, which takes the sclera of the recipient in disorganization of collagen fibers (Curtin B. J. The Myopias. - Philadelphia, 1985. - 238 p.). T.I. Malysheva also noted the development of ectasia and thinning of the sclera on the operated eye at the site of premature resorption of allografts (Malppeva T.P. Effectiveness of alloscleroplasty in rapidly progressive myopia in children and adolescents. - Author's abstract. Candidate of medical sciences. - M. , 1988 .-- 23 p.).

M.KL.6A61 F9 / 00

A.V. Svirin et al. (1989) used the implant as a duplicate of a hemostatic sponge or collacyl of a three-layer collagen sponge, which includes furatsilin, boric acid and chondroitin sulfate (cit. But: Somov E.E. Skleronlasgika. - St.Pb., 1995. - P. 104 ) The disadvantage of this implant, as well as all biological materials, is the rapid lysis.

Optimal for scleroplasty would be to use syvgeticheskoe material used for implantation in the human body. According to the literature, in ophthalmology it is known to use the following synthetic materials for scleroplasty: lavsan stitches (Klutseva E.I. Surgical treatment of progressive myopia. - Minsk, 1984. - P. 98), lavsan texplant (P) Chkovskaya N.A., Bushueva N.N. - A.S. .NO 767724), silicone rubber (Utkin V.F., 1979 - cited from: Somov E.E. Scleroplasty. - St. Petersburg, 1995.- P. 122). All of these methods require mandatory suture fixation of the transplant to the episclera, without which displacement, formation of folds of the graft is possible.

The proposed utility model is characterized in that a two-layer flap measuring 8 x 20 mm is modeled, made of non-absorbable synthetic material - the canvas of the warp knitted pile medical POVM-30 - and the collagen hemostatic sponge, which is located above the flap POVM-30 and fixed at its edges with interrupted sutures. The formed flap is impregnated with a solution of an antibiotic and a corticosgheroid. Being impregnated with tissue fluid and blood, the collagen sponge swells and acts as a spacer, tightly fixing the synthetic flap to the sclera, so that suture fixation is not required. Thanks to the depot of medicinal substances in the collagen sponge, a reactive course of the postoperative period is ensured. During the lysis of the hemostatic sponge, a synthetic flap sprouts with newly formed vessels and fibrous tissue, tightly fixed to the sclera.

In FIG. 1 shows a general view of a two-layer flap (synthetic material + collagen hemostatic sponge).

In FIG. 2 shows the state of the flap immediately after implantation.

In FIG. Figure 3 shows the formation of a spacer due to swelling of a collagen sponge.

In FIG. Figure 4 shows a sagittal tomographic section of the eyeball after scleroplasty with a two-layer flap in the lower quadrant.

In FIG. 5 shows a frontal tomographic section of the eyeball after scleroplasty with a two-layer flap in the lower quadrant.

The proposed utility model constructively consists of a POVM-30 flap measuring 8 x 20 mm (pos. 1) and a collagenous hemosgmatic sponge of a similar size (pos. 2) located above it, fastened together by four interrupted sutures (pos. 3). This utility model is used in the surgical method for the treatment of progressive myopia of meridional scleroplasgics according to Pivovarov-Pristavko.

Meridional scleroplasgia using a flap formed in the described modification has been performed at the Department of Ophthalmology at the PIUV since October 1998 (rational proposal No. 58 of 10/19/1998) and was performed in 10 patients with 16 eyes. In all cases, stabilization of myopia was achieved. Visually and biomicroscopically, a dense fusion with the sclera (pos. 4) of a synthetic flap (pos. 5) was noted, which is confirmed by computed tomography.

Claims (1)

Modification of the flap for conducting meridional scleroplasty, characterized in that a two-layer flap of size 8 · 20 mm is modeled, formed from a non-absorbable synthetic material - a canvas of the warp knitted pile medical POVM-30 and a collagen hemostatic sponge, which is located above the flap POVM-30 and is fixed at its edges interrupted sutures, impregnated with a solution of antibiotic and corticosteroid, swollen, hemostatic sponge acts as a "spacer", securely fixing without suture fixation synthetic a flap to the sclera of the recipient, and a depot of drugs provides an reactive course of the postoperative period.