RU2154452C2 - Method for treating the cases of high degree ametropia and astigmatism - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves removing astigmatic component in phakic eye by making conjunctiva incision near limbus in perpendicular to the most marked astigmatism axis. Sclera incision is made in exfoliating it toward the cornea. Exfoliation is continued in the stroma. Anterior chamber is opened. Spherical component is removed by implanting artificial lens in anterior or posterior chamber through the built corneoscleral tunnel. EFFECT: stable refraction result. 1 dwg

Description

 The invention relates to medicine, namely to ophthalmology, and can be used for surgical correction of high degree ametropia and astigmatism.

 A known method of surgical correction of high myopia combined with astigmatism, including laser ablation of corneal tissue on the phakic eye (USSR, Author's certificate No. 1797190). However, when using the known method, the possibility of reducing refractive results in the postoperative period due to the development of incorrect uncorrectable astigmatism or clouding of the surface layer of the cornea is not ruled out.

 The objective of the invention is to provide a method for surgical correction of high degree ametropia and astigmatism on the phakic eye, which allows to obtain a high persistent refractive effect.

 The technical result is achieved by the fact that in the method of treating high degree ametropia and astigmatism on the phakic eye, the astigmatic component is eliminated by conducting a conjunctival incision in the limb perpendicular to the strong axis of astigmatism, then sclera is incised, delaminated in the direction of the cornea, continuing to delaminate in the stroma, open the anterior the camera, and the spherical component is eliminated by implanting an artificial lens in the anterior or posterior chamber of the eye through the formed corneoscleral tunnel .

 The corneoscleral tunnel incision, according to the invention, can weaken the strong meridian of astigmatism, since the proposed surgical approach can perform the function of a tangential incision in the deep layers of the cornea.

 Implantation of an artificial lens into the phakic eye allows eliminating the spherical component both with high degree hyperopia and with high degree myopia combined with astigmatism.

 Implantation of an artificial lens through the corneoscleral tunnel reduces the invasiveness of the operation, allows you to get the highest possible visual functions in the shortest possible time after the operation.

 The method is as follows.

 Under local combined anesthesia after applying a blephostat and frenulum suture to the tendon of the superior rectus muscle, the conjunctiva is cut in the limb perpendicular to the strong axis of astigmatism, the sclera is exposed, 1 mm or 1/2 of its thickness is cut from the limb by 1 mm, for example , 6-8 mm depending on the degree of astigmatism.

 Then the sclera is stratified towards the cornea, continuing stratification in the stroma, the anterior chamber is opened at a distance of 3.5-5 mm from the center of the optical axis of the eye, depending on the degree of astigmatism.

 Then, through the formed corneoscleral tunnel, a positive or negative artificial lens is implanted into the anterior or posterior chambers of the eye, depending on its design. The operation ends with the application of several interrupted sutures.

 The invention is illustrated by the drawing, which shows the conjunctiva 1, limb 2, the scleral part 3 and the core part 4 of the tunnel incision, the optical axis 5 of the cornea.

Example 1. Patient D., 18 years old. Diagnosis: high degree hyperopia, complex hyperopic astigmatism of the middle degree of the left eye. Refractive Amblyopia Visual acuity of the left eye
0.25S sph + 6.0 D, Cyl - 4.0 D ax 175 ^o = 0.5.

Ophthalmometry: 174 ^o - 39.25, 94 ^o - 44.0.

 The operation was performed according to the above method. An artificial lens of +7.0 D was implanted in the posterior chamber onto the natural lens of the eye.

 Stratification of the cornea in the corneoscleral tunnel, according to the invention, was carried out to a level of 3.5 mm from the optical center of the cornea with a length of 6.5 mm.

 On the first day after surgery, the visual acuity of the left eye is 0.3 without correction.

 The result is 5 months after treatment.

Vis OS 0.5-0.6
Ophthalmometry: 70 ^o - 41.75, 160 ^o - 42.0.

 Example 2. Patient K., 37 years old. Diagnosis: High myopia, complex myopic astigmatism of a weak degree of the right eye.

Visual acuity of the right eye:
0.05 sph - 0.8 D, Cyl - 2.0 D ax 177 ^o = 0.9
Ophthalmometry: 178 ^o - 40.75, 87 ^o - 43.0.

 The operation was performed according to the above method. An artificial lens was implanted - 8.0 D in the anterior chamber.

 Stratification of the cornea in the corneoscleral tunnel, according to the invention, was carried out to a level of 4.5 mm from the optical center of the cornea with a length of 6.0 mm.

The postoperative period without complications, on the first day after the operation, visual acuity of the right eye
Vis OD 06 without correction.

Result 5 months after treatment:
Vis OD 0.8-0.9 without correction
Ophthalmometry: 175 ^o - 41.75, 85 ^o - 42.0.

Claims (1)

 A method for treating high degree ametropia and astigmatism, including surgical correction of the astigmatic component on the phakic eye, characterized in that the astigmatic component is eliminated by cutting the conjunctiva at the limb perpendicular to the strong axis of astigmatism, then sclera is incised, and it is layered towards the cornea, continuing to separate into the cornea stroma, open the anterior chamber, and the spherical component is eliminated by implanting an artificial lens into the anterior or posterior chamber of the eye through formed corneoscleral tunnel.