SU1063415A1 - Method of plasty of defects of the eye iris - Google Patents

Abstract

METHOD FOR PLASTICS iris defect by administering donor iris in corneal incision and stitching to the edges of the defect, characterized in that in order to eliminate the post-operative complications, pre-surface layer of the sclera cut out flap base to the limb flap donor iris fixed to the inner surface of the scleral flap , and the defect of the iris is covered with a sclera flap with a donor iris.

Description

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The invention relates to medicine, and the estate and ophthalmology.

Previously, plastic iris was reduced to the application of tightening seams and loosening notches, provided that the iris remains elastic with limited defects.

The known method of plastic surgery of the iris, which consists in using the autoscler of the patient 1 as the graft.

The disadvantage of this method is the lack of a sufficient cosmetic effect, since a white sclera flap stands out sharply against the background of the iris, as well as the possibility of damaging the anterior capsule of the lens with the rough surface of the flap cut from the middle layers of the sclera, which can lead to clouding of the lens.

The closest in technical essence and the achieved result to the present invention is a method of plasty of iris defects by inserting a donor iris into a corneal incision and stitching to the edges of the defect. The procedure for performing iridoplasty is as follows: the anterior chamber is opened with a blade, the corneal incision is extended to 3 and 8 h, respectively, coloboma iris. In the corpse eye cut out the flap of the iris in shape, corresponding to the defect in the patient's eye and 1 mm larger in size from the sides. The cut graft is applied to the defect of the iris, the edges of the graft are spread with a spatula and compared with the edges of the dial. Nodal grooves on the edge of the graft and coloboma. Suture on the cornea. The anterior chamber is reduced with saline. In the postoperative period, the course of injections of pinicillin with strep thomycin, oral prednisone according to the scheme (only 500 mg), dexazone 0.3 ml under the conjunctiva 10 injections 2.

However, after 6 months there is wrinkling and a decrease in the size of the graft. When biomicroscopy visible atrophy of the stroma and the pigment leaf of the transplanted iris.

The purpose of the invention is the elimination of postoperative complications.

The goal is achieved by the method of plasty of iris defects by inserting a donor iris into a corneal incision and stitching to the edges of the defect, preliminarily cutting a flap from the surface of the sclera by the base to the limb, the donor flap of the donor iris is fixed on the inner surface of the scleral flap, and the defect is irradiated shells are covered with a sclera flap with a donor iris.

The method is carried out as follows.

Cut out the sclera flap from the surface layers 1/3 the thickness of the sclera, larger in size than the required size, with the base to the limb. On the inner surface of the formed flap is laid and fixed with sutures from supramid 10: 0 prepared on the eve of the graft from cadaveric homoraduzhki. After the anterior chamber is opened with a corneal size, the flap prepared and previously modeled is placed into the lumen of the iris defect with a smooth conjunctival surface to the anterior lens capsule and strengthened with six nodal sutures from 10: 0. The graft and iris are spread with a spatula. Air into the front chamber. The suture of the supramid on the corneal incision. Continuous schov on conjunctiva.

Example I. Patient I., 53 years old, was admitted to the clinic with a diagnosis: postoperative aphaki, extensive full of coloboma of the iris of the right eye. Extraction of the right eye cataract was performed in 1979. Acuity of vision was 0.02 with spn + 10.0 D 0.5 with a stenopic opening 1.0. 1/14/28 g. Operation was performed: iris plasty with auto sclera and donor iris. After retrobulbar anesthesia with 2 ° / this solution of novocaine, a section of the conjunctiva, 3.5 mm from the limbus for 3-9 hours, a sclera flap 1/3 sclera thick with a base to the limb, the size of the iris coloboma, is formed on the inner surface of the formed of the flap is laid and fixed with schva.mi from the supramid 10: 0 prepared graft from cadaver gomorazhuzhki. After opening the anterior chamber with a corneal incision, the modeled flap with the gomorad is placed in the iris defect lumen with a smooth conjunctival surface to the anterior lens capsule and strengthened with six knots of Supermid 10: 0. The graft is straightened with a spatula, the air in the anterior chamber. The suture of the supramid on the corneal incision, continuous schov on the conjunctiva. In the postoperative period, gentamicin intramuscularly 1-2 times a day number 10. Prednisolone according to the scheme 500 mg). Deksazon 0.5 ml subconjunctival number 10.

After 6 months of patient observation, the operated eye is calm, the transplant autosclers with donor iris occupy the same position. Intraocular pressure is normal.

Example 2. Patient K., 66 years old, was admitted to the hospital with a diagnosis of postoperative aphaki, secondary cataract, coloboma of the iris, iridocorneal adhesions of the right eye. Cataract extraction was performed in 1978. Acuity of vision is 0.02; correction does not improve. 12.25.81 g. Operation was performed: plastic iris by autosclerosis and donor iris, removal of secondary cataract, dissection of iridocorne adhesions. Retrobulbar anesthesia with a 2% solution of novocaine, incision of the conjunctiva for 3-9 hours, 4 mm indent from the limbus. The flap of the sclera is cut out with the base to the limbus in size larger than the iris coloboma. On the inner surface of the formed flap is laid and fixed with sutures from supramid 10: 0 prepared graft from cadaveric homoraduzhk. The anterior chamber is opened with a corneal incision. The modeled scleral flap with the Homo-iris is laid in the lumen of the iris of the iris of the conjunctival surface to the anterior lens capsule and strengthened with six interrupted sutures from Supermid 10: 0. The graft is straightened with a spatula. Removed secondary cataract, dissected iridocorneal adhesions. Air is introduced into the anterior chamber. The suture of the supramid on the corneal incision, a continuous suture on the conjunctiva. In the postoperative period, gentamicin intramuscularly 1-2 times a day number 10. Prednisolone PO scheme (5000 mg). Dexazon under conjunctiva number 10. After 5. Months after surgery: the eye is calm, the transplant autosklery with donor iris takes the same position, intraocular pressure normal In total, six people were operated on. After 6 months, the patients were examined in the clinic. The absence of a process of wrinkling and rejection of the graft has been established. When biomicroscopy of the donor eye, the iris and sclera flap occupy the same position. The main advantage of the invention is the elimination of postoperative complications, as well as the achievement of a cosmetic effect by using a donor iris placed on a reliable bed formed from autosclerae, which gives a stable position to the iris and pupil graft, as well as eliminating the possibility of damage to the anterior capsule of the conjunctival lens. flap. It is natural to achieve an optical effect.

Claims (1)

METHOD OF PLASTIC OF IRAID DEFECTS by introducing a donor iris into the corneal incision and suturing to the edges of the defect, characterized in that, in order to eliminate postoperative complications, the sclera is first cut from the surface layers with a base to the limbus, the donor iris flap is fixed on the inner surface of the scleral lobe and the defect of the iris is covered with a sclera flap with a donor iris.