SU1544385A1 - Method of surgical treatment of ocular disease due to optic nerve ischemia - Google Patents

Abstract

The invention relates to medicine, namely to surgical ophthalmology. The method allows decompression of the optic nerve in the posterior scleral ring. Due to the transvitreal access, the edges of the posterior scleral ring are cut to a depth of 0.8-1.0 mm.

Description

The invention relates to medicine, namely to surgical ophthalmology.

The aim of the invention is to reduce the trauma and reduce operative and postoperative complications, l

The goal is achieved by decompression of the optic nerve by transvitreal access with incisions of the edge of the posterior scleral ring to a depth of 0.8-1.0 mm.

The method is carried out as follows.

A patient with medicamental mydriasis is placed in a horizontal position, akinesia and retrobulbar anesthesia are performed with a 2% novocaine solution, and the bridle sutures are placed on the upper and lower rectus muscles.

In the meridians of 10 and 14 hours, two cuts of the conjunctiva were made parallel to the limbus of 6 mm, 3-4 mm long from it. Produced local hemostasis. In the meridians of 10 and 14 hours from the limbus, diathermocoagulation is produced in the projection of the flat part of the cylindrical body. At these prepared points, two through-incisions of the sclera are made perpendicular to the limbus 1.5 mm long.

Through one of the incisions penetrate into the cavity of the eye with a thin flat spatula, through the other - with a Sato knife, having a cutting part no longer than 1.0 mm in length, behind which there is a stopper in the form of two small protrusions.

Under the control of biomicroophthalmoscopy with a negative contact lens 60 diopters with immersion medium (methylcellulose) with a spatula, the optic nerve fibers in the avascular zone of the optic nerve disk edge are pushed, the upper edge of the posterior scleral ring is cut and the edge of the scleral ring is cut to a depth of 0.8-1 , 0 mm. Similarly, a second cut is made at the lower edge of the scleral ring on

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depth is 0,8-1,0 mm. Scleral incisions are superimposed on one supra-amide suture. In order to prevent hemorrhage, laser photocoagulation is preliminarily used.

Example. Sick 72 years old was admitted with a diagnosis: far-reaching uncompensated open-angle glaucoma of the right eye, the initial cataract of both eyes.

The described access was performed, the scleral cuts were put on one knot suramid suture. After that, the conjunctival incisions were connected into one and under the flap of the conjunctiva formed, a cumentomy was performed using a standard technique to normalize the intraocular pressure. At the end of the operation, a solution of antibiotic and dexazone was administered under the conjunctiva. Imposed monocular dressing.

The postoperative period was uneventful. At discharge on the sixth day after the operation, the sharpness of the eyesight of both eyes remained the same. The intraocular pressure of the right eye was 14 mmHg. on Goldma-well. The field of view expanded from the nasal side to 15 angular degrees from the point of fixation. In the fundus of the eye, the optic nerve disc became less pale, glaucomatous excavation improved and decreased to 0.8 disc diameter. A year after the operation: intraocular pressure is normal, the field of vision has expanded, the optic nerve disc has a pale pink color, and excavation has decreased.

Claims (1)

Invention Formula A method of surgical treatment of ocular diseases caused by optic nerve ischemia, by means of its decompression, characterized in that, in order to reduce trauma and reduce operative and postoperative complications, tranvitreal access makes two incisions of the posterior scleral ring to a depth of 0.8 -1.0 mm.