RU1801427C - Method for extraction of solid-nucleus cataract - Google Patents

Abstract

Usage: in medicine, namely in orthalmology. Essence: the lensectome tip is withdrawn, the lens core is rotated with an additional instrument, the lens masses are removed, the previously made incision in the flat part of the ciliary body is extended to a value equal to the diameter of the lens core, and the core is removed with a fixing tool through the formed incision. Positive effect: eliminates the need for an additional surgical incision in the corneoscleral region and the possibility of a number of associated surgical operations after surgical complications.

Description

The invention relates to medicine, and more particularly to ophthalmology, and can be used in the surgical treatment of patients with cataract and dense core.

The aim of the invention is to reduce surgical and postoperative complications. while reducing the time of surgery, if possible, aspiration or fragmentation of the nuclear substance.

The method is carried out as follows. In the flat part of the ciliary body, a conjunctiva 4.5–5 mm long and sclera, choroid 2–2.5 mm long are cut parallel to the limbus in the upper-outer segment of the ocular block. A double-edged knife is inserted through the incision and a canal is formed in the area of the equator of the lens towards its center. Then, the tip of the lensectome is inserted into the formed channel and the removal of the nuclear

lens substances. If there is a dense core that is not succumb to aspiration and excision, it is fragmented using additional instruments inserted through the same surgical incision. If the core does not lend itself to additional fragmentation and lensectomy, the tip of the lensetome is temporarily removed from the eye cavity, a Sato knife is inserted, the core is rotated and its diameter is measured. Then, the lensectom tip is again inserted through the surgical incision, the lens masses are removed. After removing the tip of the lensectom, the incision of the sclera and choroid is prolonged to the value necessary to remove the lens nucleus in accordance with its Diameter. The nucleus of the lens is captured with a fixing tool and removed through an incision in the flat part of the ciliary body. The operation ends with suturing the scleral incision and a continuous suture on the conjunctiva.

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PRI me R 1. Patient G., 45 years old, was admitted to the hospital 07.12.87 with a complete traumatic cataract of the right eye, with the effects of nuclear sclerosis. Visual acuity of 0.01 is not corr. Ophthalmologists: 90 ° - 42.5 D, 180 ° - 41.75 D. The patient underwent surgery - cataract removal through an incision in the flat part of the ciliary body. The operation and the postoperative period without complications. At discharge, visual acuity 0.6 s corr. sphere + 11, OD. When viewed after 0.5 years, visual acuity from corr. 0.8 ,. Ophthalmometers: 90 ° - 42.25; 180 ° -41.5.

PRI me R 2. Patient D., 49 years old, was admitted to the hospital of the Institute 11.11.87, with a diagnosis of complicated cataract of the left eye. On examination, pronounced effects of nuclear sclerosis. Visual acuity -0.01 not corr., Ophthalmometric cornea - 4 ° - 43.0; 94 ° - 43.5.

An operation was performed - removal of the lens through the approach in the flat part of the ciliary body. During the operation and in the postoperative period, no complications were noted. On discharge, visual acuity with aphakic correction of 0.4, at the fundus of the appearance of macular degeneration. After 10 months, visual acuity with corr. amounted to 0.6, the effects of postoperative astigmatism are practically absent - 90 ° - 42.75 D: 90 ° -43.25 D.

The indications for the treatment method proposed by the authors are various in etiology — traumatic, complicated, age-related, with a dense lens nucleus.

The proposed method, compared with the basic version, allows to reduce the number of operating and postoperative

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complications by 40% and reduce surgery time by 50%.

This positive effect of the proposed method is achieved by the fact that the lens nucleus is removed through the surgical approach in the flat part of the ciliary body, eliminating the need for an additional surgical incision in the corneoscleral region and the possibility of a number of related surgical and postoperative complications: the occurrence of postoperative horn is completely eliminated - primary astigmatism, the corneal endothelial injury is significantly reduced, corneal dystrophy is excluded, because the anterior surgical incision and removal of the nucleus through it are removed, and all manipulations are performed in the posterior chamber of the eye far from the corneal endothelium.

Claims (1)

SUMMARY OF THE INVENTION A method for extracting cataracts with a dense nucleus by transciliary lansectomy and subsequent removal of the nucleus with the help of additionally introduced instruments, characterized in that, in order to reduce surgical and postoperative complications while shortening the operation time when aspiration or fragmentation of the nuclear substance is impossible, the tip is withdrawn Lensectomy, 4 an additionally introduced instrument rotates the lens core, removes the lens masses, prolongs the previously made incision in a flat part ciliary body to a value equal to the diameter of the lens core, and the core removal is carried out through the tool formed by the fixing section.