SU1297851A1 - Method of keratoplasty - Google Patents

Abstract

The invention relates to medicine, in particular to ophthalmology, and improves the cosmetic effect and its durability. Trephine do notch the surface layers of the wallet. Turbid layers are removed prior to the formation of a bed for transplantation of the iris and cornea. The corneal graft (T) is placed in the bed of the recipient's eye and fixed with sutures. The homo-graft of the iris with the pigment epithelium of the medial axis fixed on it is placed between the corneal T and the thorn. Part of the vascular tract of the homotransplant, corresponding to the diameter of the pupil T of the iris, is placed in the region of the pupil with the pigment epithelium outwards. Cover with corneal T and fIsiruyut. € (L with tsD CO 00 SP

Description

4 O.

The invention relates to medicine, namely to ophthalmology.

The purpose of the invention is to improve the cosmetic effect and increase its durability.

The goal is achieved by placing an iris homotransplantation with the pigment epithelium fixed on it between the thorn and corneal translantal pigment epithelium of the medial intestine, and the central part of the astrophe is covered with the pigment apithelium outwardly with a part of the vascular tract of the homotransfer.

The method is carried out as follows.

Prior to surgery, an iris transplant is prepared. For this, 24 hours before the operation, the cornea of the eye is cut off and the remaining part of the glae is immersed in a 10% clear formalin solution, placed in a refrigerator at the temperature used for storing grafts (2 - As a result, optimal stability of the graft and its pigment layer is achieved .

 After processing, the head of the donor, immediately before the operation, excises the iris (at the root) from the canned eye of the donor around the entire circumference, placing it on the moistened paraffin support with the pigment surface up. Trephine diameter less than the diameter of the cornea of the recipient 0.5 - 1.0 mm excised graft iris cut out the flap trephine with a diameter corresponding to the diameter of the pupil of the iris graft. The resulting transplant material is washed in albucide and placed in sterile saline. A layered corneal transplant is prepared from the other eye of the donor.

The patient's eye is prepared for surgery as usual (for layered keratoplasty). Trephins of the desired diameter make the notching of the surface layers of the wallet. Turbid layers are removed prior to the formation of a bed for transplantation of the iris and cornea. The corneal graft is placed in the bed of the recipient's eye and the edges are fixed (overlapped with preliminary seams) by four seams (at 12 "

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3-6-9 hours). At 6 hours, the seam is tied tightly. Stratified corneal graft and is folded between them cataract ukladgoayut homograft iris with fixed thereon retinitis, epithelium inwards a portion of a vascular tract gomotrans- plantata corresponding to the diameter of the pupil of the iris of the graft is deposited in the region of the pupil pigment epithelium outwards, closing the remainder of cataracts, corneal Coat graft and avaluvia previously applied sutures. The corneal graft is finally fixed with a continuous suture. Disinfectant drops are put into the conjunctival cavity. This operation is completed.

Example. The patient, was admitted with the diagnosis: right eye - superficial corneal clouding: visual acuity 1.0; the left eye is a complete vasculature of the cornea: the visual acuity is equal to the wrong projection of light. The field of view could not be removed.

In connection with the inexpediency of the production of optical keratoplasty, a cosmetic procedure was recommended to the patient.

The patient undergoes transplantation of the iris under the layer corneal transplant. Treatment of the operative field is usual; after arkinesia, retrobulbar anesthesia, bridle stitches are placed on the upper and lower side; a ventricle is inserted into the eye slit, trepane W.-U 8.5 mm is used to incise the surface turbid layers of an animal to a depth of 0.25 ML, using a scraper and a round knife to exfoliate the cornea and remove its cloudy layers.

After preservation of the donor's eye, the cornea is removed for 24 hours in a 10% formalin solution. The iris is excised completely around the entire circumference, and placed on a moisturized paraffin base with pigment; tri-jiaHOM cutting crown diameter 7.5 mm and dissection of the iris graft by pressing. The graft is washed in 30% albumin solution and placed in sterile saline. From the foro donor eyes cut corneal layered

transplant trepan with cutting core diameter 8.5 mm. Corneal transplant; in the bed on the eye of the recipient, four premature plots are laid 6–9–3–3 h. At 6 h the seam is tightly closed, the horn graft is turned off, and the homo-graft of the iris is pigmented inwardly between the stump and the graft. In the area of the pupil, a graft is placed (with a pigment of outside) 3 mm in diameter, cut out from the choroid of the same donor, corneal layered graft is punctured, and the previously applied sutures finally terminate. A corneal graft is fixed with a continuous suture. Disinfectant drops are instilled into the conjunctival cavity, making binocular belt applied.

The postoperative period was uneventful. In the postoperative period, the patient received anti-inflammatory and desensitizing

Editor And Derbak Order 838/6

Compiled by M.Pozn to Tehred M.Hodanich

Corrector

Circulation 596 Subscription

VNIIPI USSR State Committee

for inventions and discoveries 113035, Moscow, Zh-35, Raushsk nab., 4/5

Production and printing company, Uzhgorod, Projecto st., 4.

therapy. Continuous suture removed on day 25. At discharge the eyes are almost calm, cosmetic effect is good. After three years, the eye is calm, there is a slight depigmentation of the rainbow transplant, the cosmetic effect is good.

Claims (1)

Invention Formula A keratoplasty technique by excision of the anterior layers of corneal leucoma and transplantation of a layer-by-layer graft, characterized in that, in order to improve the cosmetic effect and increase its durability, between the eyes and the layered corneal graft the pigment epithelium of the inside is placed a homotranslated irradiation membrane of the anterior membrane of the anterior membrane. with the epithelium and the central part of the lemme is covered with a part of the vascular tract of the homotransplantation with pigment epithelium outwards. Proofreader A.T. sko