SU1152585A1 - Method of conducting operations in case of glaucoma - Google Patents

Abstract

METHOD OF RADIATION OF OPERATIONS IN GLAUCOMA, envisages the formation of a sclera.al flap and laying between the wound surfaces of the graft sclera, which is characterized by the fact that, in order to ensure free flow of intraocular fluid under a co-conjunctiva, the posterior crystal capsule is used as the graft, the back capsule is removed, the graft is perforated, and its size exceeds the size of the scleral los-. kuta.

Description

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This invention relates to medicine, namely ophthalmology.

The object of the invention is to ensure the free flow of intraocular fluid under the conjunctiva,

The method is carried out as follows.

Conjunctival and scleral flaps are formed. After performing a microsurgical intervention on the pshemm channel and trabecula (sinusotomy, trabeculectomy, trabeculostomy, etc. from the donor lens, the graft is cut out 0.5 mm larger than the scleral flap, then from 1 to 3 through holes are formed in the graft with 1 to 3 mm diameter. The graft is transferred onto the scleral bed formed. The scleral flap is placed in the same place. At the edge of the scleral incision, 3-4 knotted sutures are placed (depending on the shape of the cut scleral flap - triangular or trapezium one). The operation is completed by imposing a hermetic suture on the conjunctiva.

In order to study the state of the lens capsule in the sclera layers, experiments were carried out on 15 rabbits of Shimpml breed (15 eyes

The lens capsule is trans-transformed according to the following procedure. The conjunctival flap is cut out with the base to the limb II mm high, for 12 hours with a shaving razor blade and a round knife, the scleral trapezoidal flap is cut out approximately 2/3 the thickness of the sclera, 8 mm wide at the base. Then, a graft is prepared from the posterior casulum of the donor lens, 0.5 mm larger than the scleral flap, and forms trephine from J to 3 through holes in the graft. The transplant transfers to the sclera formed bed. On the edges of the incision of the sclera impose 4 knotted sutures. The edge of the conjunctival incision is sealed with a continuous suture. The control also tested the other paired eyes of animals on which similar surgical interventions were performed, but without placing the lens capsule under the scleral flap (15 eyes, the observation period was 1 - 3 months).

The clinical state in the postoperative period of the eye operated by this technique did not differ.

from the clinical condition of the control eye.

Enucleated eyes were fixed in 2% glutaraldehyde in phosphate buffer, and then cut at the equator. The front segment is embedded in paraffin. Sections were stained with hematoxylin eosin according to Schiff, toluidine blue at pH 7.4 and 4.6, silverized according to Gordon Sweet, examined in polarized light.

- Microscopically (observation period 1-3 months) in the deep sclera layers, the band is differentiated homogeneously

colored capsule. When stained according to Schiff, the substance of the capsule is stained with PAS-positive, which indicates that the polysaccharide complexes are preserved in it. In half-light

birefringence is observed in the capsule zone, indicating the presence of ordered collagen structures in it.

Thus, the absence of any complications during a long stay of the capsule in the sclera layers has been proven: morphologically, no reactive changes are noted in it. There is a positive clinical experience.

use of the developed operation for glaucoma.

Example I. Patient C, diagnosis: secondary (operated) glauka with high intraocular pressure (pos.

leptotransferred keratoveepta j, deep vasculature cornea of the left eye. The intra-ocular pressure of the left eye is 31 mm Hg. IOP measurement was performed on a Bausch and Lombe applanation tonometer.

The operation was performed: cutting out the conjunctival flap with the base to the limbus 8 mm high, for I2 h with

shaving razor blade and round

knife cut out scleral flap

trapezoidal shape 2/3 the thickness of the sclera 5 mm wide and 4 m high at the base. After parallel cuts of the deep layers of filtering gland, the scleral strip formed {along with the trabecula was cut in the middle. The tongues formed in this way were pushed into the anterior chamber so as to push the adjust root away from the anterior chamber angle. Then from the donor lens removed from the patient for senile cataracts, prepared

3I

Grasplant no described method. The graft was transferred to the sclera after treatment. On the edges of the scleral incision A knotted suture was applied. The conjunctival incision edge was sealed with a continuous suture. In the postoperative period, a flat filtration cushion was formed; there was no cylio-choriodal detachment (CTC). 10 days after the operation, the intraocular pressure of the left eye is 18 mm Hg (on the applanation tonometer);

3 months after surgery: IOP of the left eye is 17 mm Hg. on an

planetary tonometer

PRI mme R 2. Sick H., diagnosis: open-angle operated glaucoma 2 In the left eye.

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Operation: conjunctival and scleral flaps were formed. Along the Schwalbe line, the outer wall of the Schlemm's canal is excised.

5 Then, a transplant was prepared from the donor lens removed from the patient for senile cataract according to the described procedure. The graft was transferred to the formed sclera bed. On the edge of the cut

sclera imposed 3 knotted sutures. The conjunctival incision edge was sealed with a continuous suture. In the postoperative period formed

15 flat filter pads, the CEC was not. 10 days after surgery, mm Hg, 35. 6 months after the operation Ro 18 mm Hg, 24.

Claims (1)

METHOD OF OPERATIONS AT GLAUCOMA, which provides for the formation of a scleral flap and placement of a scleral graft between the wound surfaces, which is characterized by the fact that, in order to ensure free outflow of intraocular fluid under the conjunctiva, the posterior lens capsule is used as a graft, and through holes are made in the graft, and its size exceeds the size of the scleral flap.