RU2506937C2 - Method for intraocular lens reposition and fixation in cases of no lens capsule on eyes with traumatic iris defects - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to ophthalmosurgary and may be applicable for the IOL reposition and fixation in cases of no lens capsule on the eyes with traumatic iris defects. Two threads brought in parallel through a flat portion of a ciliary body behind an optical portion perpendicularly to an axis of haptic elements at 2 mm from edges of the optical portion; the threads are knotted on a sclera with using a thread with two needles on both ends.

EFFECT: method enables providing the normal position of the IOL.

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Description

The invention relates to medicine, in particular, to ophthalmic surgery and can be used to eliminate the dislocation of posterior intraocular lenses (hereinafter IOL) in the absence of a lens capsule in the eyes with previous traumatic damage to the iris.

One of the complications arising from the implantation of IOLs, including in the postoperative period, is the violation of their position in the posterior chamber to varying degrees, both in the presence of the lens capsule and in its absence. (S.N. Fedorov, E.V. Egorova "Errors and complications in the implantation of an artificial lens", M., 1992).

With traumatic injuries of the iris (mydriasis, aniridia) and the absence of capsular support, the IOL can retreat right up to a 90 ° rotation along the axis of the haptic elements, which leads to a sharp deterioration in vision.

Known methods for eliminating the displacements of posterior chamber IOLs provide for the possibility of their reposition in the presence of a capsular bag (S. D. Stebnev, B. B. Stebnev “Modern technologies of cataract and refractive surgery” M., 2007, pp. 237-243; B.E. Malyugin, A .V. Golovin RF patent No. 2375996, dated August 14, 2008 dated December 20, 2009, “A method for reposition of an intraocular lens deployed or decentered together with a capsular bag”; B.E. Malyugin, Rakhim Fayez, S.K. Demyanchenko- Shulga "Modern technologies of cataract and refractive surgery - 2005", M., 2005, p.196-203).

However, the known methods cannot be used for traumatic injuries of the iris.

The objective of the invention was to develop an effective method of reposition and fixation of IOL in the absence of a lens capsule in the eyes with traumatic injuries of the iris.

The inventive rotated IOL is repaired by two threads held behind the optical part, parallel to each other through the flat part of the ciliary body at a distance of 2 mm from the edges of the optical part of the IOL. The threads are pulled and knotted on the sclera in the projection of the flat part of the ciliary body, thereby reliably fixing the IOL (see. Fig.).

The technical result is as follows:

- under the influence of tightly stretched threads, the IOL takes a normal position,

- fixation of threads is carried out at 4 points of the sclera,

- eliminates the need for reimplantation of the IOL and additional trauma to the tissues of the eye.

The proposed method is as follows: after the necessary examination and anesthesia, prepare the thread 10: 0 with needles at both ends. The sclera is pierced at the limb (1), a thread is drawn behind the optical part at a distance of 2 mm from the edge of the optical part of the IOL (2) perpendicular to the axis of the haptic elements and a needle is punctured at the limbus on the opposite side of the sclera (3). The second needle is pierced in the same way at a distance of 2 mm on the other side of the optical part of the IOL (4) parallel to the first thread, punctured in the same way (5), the ends of the threads are pulled and tied with a knot (6) on the sclera in the projection of the flat part of the ciliary body.

The method of reduction and fixation of the IOL is illustrated by the following clinical examples:

Example 1

Patient K., b. 1956 Amb. cards - 210688.

On admission: post-traumatic mydriasis 9.0 mm. Artifakia: a previously implanted IOL, hemmed by the haptic elements to the sclera in the projection of the flat part of the ciliary body, is rotated 90 ° along the axis of the haptic elements.

Objectively: the eye is calm, the cornea is transparent, the anterior chamber is deep.

Vis OD-0.05 n / a

The patient underwent surgery in accordance with the proposed method.

At discharge: IOL position is stable.

Vis OD-0.2-1.0 = 0.3

Example 2

Patient R., born in 1948 Amb. Cards 220646.

On admission: post-traumatic mydriasis and partial aniridia, dislocation of the IOL into the anterior chamber together with the capsular bag, pinching it with blood elements in the pupil.

Objectively: the cornea is transparent, the fundus is not visible, the anterior chamber is uneven.

Vis OS = pr.l.certae.

The patient underwent surgery: anterior vitrectomy (removal of a deformed capsule bag, blood fragments and vitreous body), the movement of the optical part of the IOL into the posterior chamber, reposition and fixation of the IOL in accordance with the proposed method.

At discharge:

Vis OS - 0.04 n / a, the position of the IOL is correct.

Claims (1)

The method of reposition and fixation of the IOL in the absence of the lens capsule in the eyes with traumatic defects of the iris, characterized in that two strands are pulled parallel to each other at the distance of 2 mm from the edges of the optical part of the IOL behind the optical part, passing through the flat part of the ciliary body, knotted on the sclera, using a thread equipped with needles at both ends.

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