SU1537243A1 - Method of selecting the volume of explant at forming postenycleating stump - Google Patents

Abstract

This invention relates to ophthalmology. Using the method with high accuracy, it is possible to determine the parameters of the required explant, which reduces the time of the operation, eliminates the need for repeated surgical interventions, reduces the number of complications after enucleation, increases the cosmetic effect of the subsequent main prosthesis. For this purpose, a series of axial computed tomograms of the orbits is carried out, by which the volumes of the orbits and the healthy eye are determined, these volumes are compared. The dimensions of the explant are determined by the difference between the volumes of the eye block and the unified eye prosthesis, if the volumes of the orbits are equal. If the volumes of the orbits do not match, this value is reduced or increased.

Description

The invention relates to medicine, namely to ophthalmology, and is intended to enhance the cosmetic effect of ocular prosthetics.

The aim of the invention is to improve the accuracy.

The method is carried out as follows.

The patient is given a series of axial computed tomograms, which determine the volumes of the orbits and the healthy eye block, which are equal to the sum of the volumes indicated, the structures on each tomographic slice passing through the orbits. With an equal volume of orbits, the size of the required explant for the formation of a stump during primary enucleation or delayed infusion is determined from the difference in the volumes of the healthy eye block, as determined by computer tomography, and the unified eye prosthesis, whose parameters are constant (2.2 cm). If the volume of a healthy orbit is greater than the volume of the orbit

enucleation side, the size of the explant should be reduced by the magnitude of this discrepancy. If the volume of a healthy orbit is less, then respectively the volume of the explant is increased by the value of this inequality.

Example I. Patient D. Diagnosis: left anophthalmus, recession of the prosthesis. Enucleation in 1983 due to post-traumatic pathology.

When computed tomography, the volume of a healthy eye block was 6.025 cm, the volumes of the orbits are the same 15.8 cm 1. The volume of the explant is equal to: 6.025 cm, the volume of the unified prosthesis is 2.2 cm. From 3.85 cm.

Delayed stump formation was performed with infusion of a cartilage explant of the indicated sizes. The postoperative period was uneventful. The cosmetic effect of the subsequent prosthesis was evaluated by the following parameters: retraction of the upper eyelid 0.2 mm.

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opem3.

enophthalmos was absent, the total mobility of the prosthesis was 105 °.

Example 2. Patient G. Diagnosis: OS - penetrating corneoscleral spa scar, fusion and fusion of the pupil, iris rubeosis, post-traumatic in uteritis, fibrosis of the vitreous body, retinal detachment, subatrophy II Art. History of explosive injury in 1984. Computed tomography was performed before enucleation. The volume of a healthy eye block is 5.81 cm, 3 volume of the right bit is 15.52 cm, volume of the left orbit is 15.1 The volume of the explant is 5.81 cm1 minus the volume of the prosthesis 2.2 cm, minus the difference of the volumes of the orbits (0.32 cm ), i.e. 3.29 cm:

Enucleation was performed with fixation of extraocular muscles to the cartilage explant of the specified volume.

Cosmetic effect of prosthesis: there is no retraction of the upper eyelid, 0.5 mm enophthalmos, total prosthesis mobility 115 °.

Example 3. Patient P. Diagnosis: anophthalmos, recession of the upper eyelid on the left. Enucleation was performed in 1985 for secondary glaucoma.

When computed tomography is determined

volume of the right eye 5.28 cm howl of orbit 16.62 cm, right orbit

The volume of the le-16.21 cm. Thus, the volume of the explant is equal to:

5.28 cm minus the volume of the prosthesis (2.2 cmj

five

0

plus the difference between the volumes of the orbits (0.41 cm), i.e.3.49 cm.

The delayed stump formation with a cartilage explant of a given volume was made.

Cosmetic effect of prosthetics: retraction of the upper eyelid 1.2 mm, enophthalmos 0.7 mm, the total mobility of the prosthesis 95 °.

Claims (1)

The use of the method allows to determine the true required size of the explant for each particular patient, both during primary enucleation and with delayed stump formation, which will make it possible to increase the cosmetic effect of ocular prosthetics. Invention Formula The method of selecting the volume of the explant during the formation of the postenucleation stump, characterized in that, in order to increase the accuracy, the volume of the healthy eye block and orbit volumes are determined and if the orbit volumes are equal, the volume of the explant is determined by the difference of the volume of the healthy eye block and the unified eye prosthesis, with the orbits of a healthy eye are larger than the volume of the orbits of the eye on the enucleation side, the volume of the explant as a difference between the volume of the healthy eye block and the unified ocular prosthesis is reduced, and Otherwise, increase the volume by the difference orbits.