SU1405834A1 - Method of treatment of glaucoma - Google Patents

Abstract

The invention relates to medicine, more specifically to ophthalmology. The purpose of the invention is to reduce the postoperative complications of this anti-glaucomatous operation under local (retro-bulbar) anesthesia of 2% p-ra novocaine. At 11 - 1h. from the limbus 8 mm further, a conjunctival flap is formed; a scleral trapezoid flap is cut out to 1/2 its thickness 6x5 in size, with the base to the limb. Sine-trabeculectomy was performed for 12 hours. basal iridectomy is performed, the scleral flap is put in place, fixed on the lateral edges, then a scleral flap is cut 1/3 of the height. The obtained T-o legs are set with a spatula under a fixed portion of the scleral flap, which is inserted in the form of spacers into the intrascleral slit. As a result, two reservoirs are formed. On the conjunctiva imposed a continuous tight seam. 50 thousand units, penicillin and 0.5 ml of dexazone solution were administered under the conjunctiva. The method allows to significantly reduce the number of postoperative complications, in particular the number of postoperative detachments. (L

Description

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The invention relates to medicine, namely to ophthalmology, and can be used in glaucoma surgery.

The aim of the invention is to reduce postoperative complications. The method is illustrated by the following clinical example.

Example. Patient M, 33 years old, was admitted with a diagnosis: open-angle, third-degree glaucoma of the right eye, open-angle I senior glaucoma of the left eye. From the anamnesis it is established that two passed. month, as the patient noticed a deterioration in the vision in the right eye. The condition of the right eye when entering the eye clinic: the visual acuity of the right eye is 1.0, the intraocular pressure is 49.0 mm Hg. (when measured with Maklakov's tonometer) o Objectively: the appendages of the eye are not changed. The mucous membrane is hyperemic, the cornea is smooth, transparent. The front camera is of medium depth, moisture is transparent. Rainbow. the shell is not changed, the pupil is round, of medium width. In the fundus - i glaucomatous excavation of the optic nerve disk. Macular region of the retina i is not changed. Gonioscopy:; the angle of the anterior chamber of the eye is open along

entire goniosphere, wide, trabecula i moderately endogenously pigmented. Data tonography (Nesterov) RO 45.6; C, 0.21; F, 7.48, B 247. An anti- glaucomatous operation was performed on the right eye;

(retro-bulbar) anesthesia of a 2% solution of novocaine. At 11-1 o'clock from the limbus 8 mm further a flap of the conjunctiva is formed, the scleral flap is cut out to 1/2 its thickness of a trapezoidal shape 6x5 in size, with the base to the limbus. A sinusotrabella-ectomy was made, for 12 hours a basal-iridectomy was made, the scleral flap was laid in place, fixed on the lateral edges by submerged supromidous nodal sutures in the amount of 4 by 2/3 from the base, after which the scleral flap was cut to 1/3 heights. The legs thus obtained are set with a spatula under a fixed portion of the scleral flap, which is inserted into the intrasclerole gap in the form of spacers. As a result, two reservoirs are formed. On conjunctiva

superimposed continuous hermetic seam with Virgin silk. Under the conjunctiva introduced 50 thousand units. Pecicillin and 0.5 ml of dexazone solution. In the postoperative period, topical corticosteroids, disinfecting drops. On the 7th day, the patient was placed for outpatient treatment. The acuity at discharge was equal to the preoperative one; the intraocular pressure was 17 mm Hg. (according to Maklakov). Objectively: the right eye is a flat filtration cushion, the conjunctal suture is clean, the cornea is transparent, the anterior chamber is of medium depth. The iris is calm, for 12 hours there is a peripheral coloboma, the pupil is round in the center, in the fundus there is glaucomatous optic nerve head. The molecular region of the retina is unchanged. Gonioscopy: anterior chamber angle open At 12 o'clock there is a small basal coloboma, against which there is a hole in the trabecular zone. The outpatient continued to receive topical corticosteroids. Repeated measurements of intraocular pressure showed stability of the ophthalmotonus within J7-18 mm Hg. Thus, the proposed method significantly reduces the number of postoperative complications, in particular, the number of postoperative detachments was 3.9%, whereas with the use of the prototype method, the percentage of CCO was 15.7%.

Invention Formula

A method for treating glaucoma by forming a conjunctival and superficial scleral flap, removing a portion of the deep layers of the sclera together with trabeculae, followed by fixation of the scleral and conjunctival flaps by sutures, characterized in that, in order to reduce postoperative complications. They gradually reduce intraocular pressure by forming a two-reservoir system of intraocular fluid by cutting a scleral flap from the apex and reducing the resulting legs to the intrascleral fissure of the flap.

Claims (1)

Claim A method of treating glaucoma by forming a conjunctival and superficial scleral flap, removing a portion of the deep layers of the sclera together with trabeculae, followed by fixing the scleral and conjunctival flaps with sutures, characterized in that, with the aim of reducing postoperative complications. In addition, the intraocular pressure is gradually reduced by the formation of a two-reservoir system for the outflow of intraocular fluid through through dissection of the scleral flap from the apex and reposition of the resulting legs into the intrascleral fissure along the lateral sides of the flap.