RU2581823C1 - Drainage for surgical treatment of glaucoma - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmology. Drainage for surgical treatment of glaucoma consists of acrylic hydrogel. Drainage is designed as a triangular plate shape with gradual reduction of thickness from base to vertex. Thickness of base ranges from 200 mcm to 400 mcm, thickness at vertex ranges from 50 mcm to 150 mcm and a length of 1 to 8 mm, width at base of 0.5 mm to 2.5 mm and has channels filled polycaprolactone and sulphated glycosaminoglycans.

EFFECT: use of present invention improves hydrodynamics of eye, suppresses reparative processes and scarring around drainage.

1 cl, 2 dwg, 2 ex

Description

The invention relates to medicine, more specifically to ophthalmology, and is a drainage for the surgical treatment of glaucoma.

There are various types of drains that are used to treat glaucoma, which help maintain the outflow paths created during surgery, thereby achieving stabilization of the ophthalmotonus.

The closest analogue is drainage, consisting of a hydrogel with a water content of 70-76% and microtubules. Microtubules are inserted into the housing. When performing an antiglaucomatous operation (sinustrabekulectomy), drainage is fixed intrasclerally (RF patent for invention No. 2192821).

However, this drainage does not allow to fully compensate for intraocular pressure in cases of high reparative activity of the sclera in the area of the operation, which can subsequently lead to the formation of a connective tissue capsule around it during postoperative scarring and, accordingly, worsening of the outflow of intraocular fluid in the long-term postoperative period.

The objective of the invention is the creation of drainage for the surgical treatment of glaucoma, containing components that inhibit reparative activity in the area of operation and provide stable and controlled filtration of intraocular fluid.

The technical result is to improve the hydrodynamics of the eye, the suppression of reparative and cicatricial processes around the drainage.

The technical result is achieved by the fact that in the drainage for the surgical treatment of glaucoma, consisting of a hydrogel, according to the invention it consists of an acrylic hydrogel, made in the form of a plate of a triangular shape with a smooth decrease in thickness from the base to the top, while the thickness at the base is from 200 μm to 400 μm, the thickness at the apex is from 50 μm to 150 μm, a length of 1 to 8 mm, a width at the base of 0.5 mm to 2.5 mm and has channels filled with polycaprolactone and sulfated glycosaminoglycans.

The invention is illustrated by drawings (Fig. 1, Fig. 2)

In FIG. 1 shows a top view of drainage.

In FIG. 2 shows a side view of drainage.

Position 1 denotes the top of the drainage, 2 - the base of the drainage, 3 - channels inside the drainage.

Channels 3 are perpendicular to the base 2 of the drainage. Work with drainage is as follows.

After the conjunctiva is cut, a superficial scleral flap is cut out with the base to the limb. Next, from the underlying layers of the sclera, a deep trapezoidal flap is cut out. At the top of this flap, the sclera is excised completely to the surface of the choroid. Then the flap is separated together with the peripheral layers of the cornea and the outer wall of the Schlemm's canal until the trabeculae and descemetic membrane are exposed. A drainage is hemmed into the formed scleral bed, while the base 2 of the drainage is parallel to the limbus without going into the Schlemm canal zone, and the top 1 of the drainage is immersed in the coloboma of the sclera and placed between the choroid and sclera. The superficial scleral flap is returned to its original place without suture fixation. The operation is completed by applying a continuous suture to the conjunctiva.

Drainage implantation can be done with tweezers or an injector.

Example 1

Patient B. 76 years. Diagnosis: OS Primary open-angle 1C glaucoma. Visual acuity with a correction of 0.7. Perimetry: expansion of the blind spot, single scotomas in the Bierrum zone. Glaucomatous excavation of the optic disc 0.3. Tonography: P0 = 32; C = 0.11; F = 0.58; P0 / C = 290.

A microinvasive non-penetrating deep sclerectomy (MNGE) operation was performed using this drainage of the following sizes: thickness at the base 200 μm, at the apex 50 μm, 1.0 mm long and 0.5 mm wide at the base. Drainage was implanted using an injector. Complications during the operation and in the postoperative period were not observed. The patient was discharged on the second day after surgery. At discharge, intraocular pressure is normalized. 6 months after surgery: visual acuity has not changed. According to computer perimetry, changes in the fields of view were not detected. The filter pad is clearly contoured, flat. Tonography: P0 = 16; C = 0.29; F = 1.27; P0 / C = 55. According to ultrasound biomicroscopy (UBM), the filtration zone is actively functioning, there is no excessive proliferation.

Example 2

Patient S. 73 years. Diagnosis: OD Primary open-angle IIIC glaucoma. Visual acuity with a correction of 0.4. Perimetry: the field of view is concentrically narrowed by 30 degrees along the nasal meridian. Glaucomatous excavation of the optic disc 0.9. Tonography: P0 = 36; 00.05; F = 2.76; P0 / C 720.

A microinvasive non-penetrating deep sclerectomy (MNGE) operation was performed using this drainage of the following sizes: thickness at the base 400 μm, at the apex 150 μm, 4 mm long and 2.5 mm wide. Drainage was implanted with tweezers. Complications during the operation and in the postoperative period were not observed. The patient was discharged on the second day after surgery. At discharge, intraocular pressure is normalized. 3 months after surgery: visual acuity has not changed. According to computer perimetry, changes in the fields of view were not detected. The filter pad is clearly contoured, flat. Tonography: P0 = 11.5; C = 0.38; F = 1.56; P0 / C = 30. According to UBM, the presence of an active filtration zone, without excessive proliferation.

Claims (1)

Drainage for the surgical treatment of glaucoma, consisting of a hydrogel, characterized in that it consists of an acrylic hydrogel, made in the form of a plate of a triangular shape with a smooth decrease in thickness from the base to the top, while the thickness at the base is from 200 μm to 400 μm, the thickness is the top is from 50 μm to 150 μm, a length of 1 to 8 mm, a width at the base of 0.5 mm to 2.5 mm and has channels filled with polycaprolactone and sulfated glycosaminoglycans.

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