RU2103966C1 - Method for dilatating eye's pupil at ophthalmological operations - Google Patents

Abstract

FIELD: ophthalmology; may be used during surgical operation required eye's pupil dilatation when mydriasis medicamentous is impossible. SUBSTANCE: open ring is inserted into arterior chamber of patient's eye into pupil region. Ring is made of flexible resilient material and has groove all along its outer edge. This groove is adapted to accommodate pupillary edge of iris, groove depth corresponding to thickness of pupillary edge of iris. EFFECT: higher efficiency.

Description

 The invention relates to medicine, namely to ophthalmology, and can be used in surgical operations, the implementation of which requires the expansion of the pupil if it is impossible to achieve drug mydriasis.

 A known method of pupil expansion during ophthalmic operations, including mechanical expansion of the pupil by introducing into the anterior chamber into the pupil region a ring of flexible elastic material (AS USSR N 1258405, class A 61 F 9/007, 1986).

 The objective of the invention is to develop a more effective and safe way to expand the pupil during ophthalmic surgery.

 The technical result is achieved by the fact that in the method of expanding the pupil during ophthalmic surgery in the anterior chamber of the eye, an open ring is made into the pupil region, made of flexible and elastic material, provided with a groove along the outer edge, in which the pupil edge of the iris is fixed, while the dimensions of the groove correspond thickness along its pupillary margin.

 The outer diameter of the open ring is 6.5-8.0 mm (depending on the initial pupil diameter), the thickness is not more than 1.0 mm.

 The method is as follows. After akinesia and anesthesia, a corneo-scleral incision is made with a length of at least 3.0-3.5 mm. An open ring with a groove is inserted into the anterior chamber of the eye with tweezers, in which the pupil edge of the iris is fixed. Under the action of elastic forces, the pupil expands and its diameter becomes equal to the outer diameter of the ring. Cataract extraction is performed and an intraocular lens is implanted, after which the ring is removed from the anterior chamber of the eye, the pupil narrows and sealing sutures are applied.

 Example. Patient N., 59 years old. Diagnosis: OD complicated immature catatact, chronic uveitis. OS is healthy.

 Visual acuity OD - 0.1, OS - 1.0.

Ophthalmometry:
OD 0 - 42.50 D _ptr
90 '- 43.00 D _ptr
Eye length: 24.12 mm. The density of endothelial cells: OD = 2380 cells / mm ² .

 The patient was offered cataract phacoemulsification with implantation of an intraocular lens on his right eye. Due to the presence of fusion of the pupil edge of the iris and the anterior lens capsule, medication mydriasis was not achieved.

After carrying out akinesia and anesthesia with a 2% solution of lidocaine, an eyelid expander was applied and the upper rectus muscle was taken on a stitch-holder. The conjunctiva incision along the limb in the upper half of the eyeball, the conjunctiva is separated towards the upper arch, the sclera is exposed. Hemostasis is carried out by a bipolar coagulator. Section of the sclera by 2/3 of the thickness 1.5 mm from the limbus. The sclera is stratified by a diamond blade towards the center of the cornea with the formation of a “tunnel”. The anterior chamber is opened through the scleral tunnel with a spear-shaped knife. The synechia of the pupil is separated by a spatula, a 1% mesatone solution was introduced into the anterior chamber of the eye, but the pupil did not expand. Through an incision, an open ring with a diameter of 7.5 mm was implanted with a groove along the outer edge, the pupil edge of the iris is fixed in the groove, the pupil has expanded. The front lens capsule was opened with a cystotome, the nucleus was removed with the tip of the phacoemulsifier, the lens masses were aspirated, an intraocular lens with an optical power of 21.0 D _{prt was} implanted. The ring fixing the pupil in the expanded state is removed, the pupil narrowed spontaneously. The incision is stitched. The operation ended with subconjunctival administration of an antibiotic solution.

 Visual acuity without correction on the 1st day after surgery was 0.8. The loss of endothelial cells was 8%, which indicates the safety of this method.

 Using the proposed method for expanding the pupil during an ophthalmic surgery allows you to avoid complications during the operation, such as ruptures of the sphincter of the pupil, bleeding from the iris, incomplete evacuation of the lenses, ruptures of the posterior capsule of the lens, trauma to the corneal endothelium, thereby reducing the number of postoperative complications and lead to more early restoration of visual functions in patients.

Claims (1)

 A method of pupil expansion during ophthalmic surgery, including mechanical expansion, in which a ring made of a flexible, elastic material is introduced into the anterior chamber of the eye, into the pupil, characterized in that the ring is open and provided with a groove along the outer edge in which it is fixed the pupillary edge of the iris, while the dimensions of the groove correspond to the thickness of the pupil edge of the iris.