SU1565484A1 - Method of treating open angle glaucoma - Google Patents

Abstract

The invention relates to medicine, namely to ophthalmology. The purpose of the invention is to activate the outflow of intraocular fluid through the corneal portion of trabeculae. For this, after epibulbar anesthesia, an 8-mm-long conjunctival incision is made, the scleral flap 6 is separated ^. 6 mm base to the limbus, the Schlemm canal is opened in layers, its outer wall is removed along with a strip of corneoscleral tissue from the scleral spur to the transparent layers of the cornea, from the Schwalbe anterior borderline to the Descemet's membrane. The outer wall of the Schlemm's canal is separated from the anterior annular ligament, the deep scleral flap of a triangular shape is separated by a base to the limb, and the individual sclera fibers are retained on the surface of the ciliary body. Put two interrupted sutures on the superficial flap and continuous suture on the conjunctiva. 8 il.

Description

The invention relates to medicine, namely to ophthalmology.

The purpose of the invention is to activate the outflow of intraocular fluid through the corneal portion of trabeculae.

FIG. 1 shows the separation of the superficial scleral flap; in fig. 2 - opening and removal of the outer wall of the Schlemm's canal along with a strip of corneoscleral tissue; in fig. 3 - opening of the outer wall of Schlemm's canal along the probe; in fig. 4 - removal of the outer wall of Schlemm's canal together with a strip of corneoscleral tissue to the Descemet's membrane; in fig. 5 - separation of the outer wall of the Schlemm's canal from the front annular ligament; in fig. 6 - separation of the deep scleral flap with preservation of individual fibers of the sclera on the surface of the ciliary body; in fig. 7 - operational field, general view; in fig. 8 - suturing of the superficial scleral flap.

The method is carried out as follows.

Epibulbar anesthesia is performed with a 1% dicain solution, retrobulbar anesthesia with a 2% novocaine solution and akinesia. A conjunctival incision is made 8 mm long, 6-7 mm from the limbus. A scleral flap measuring 6 × 6 mm with a base to limbus 1 is plotted and separated. Then, Schlemm's canal is removed layer-by-layer and its outer wall is removed along with a strip of corneoscleral tissue from the scleral spur to the transparent layers of the cornea 2, 5 - 0.1 mm from the Schwalbe anterior boundary line, depth to the Descemet membrane 3. Separating the outer wall of the Schlemm's canal from the front annular ligament 4. Then cut out and separate. deep scleral flap 5 of a triangular shape based on ate

4- 00 4b

face to limb. Deletion of the deep scleral layer is performed with preservation of individual fibers of the sclera 6 on the surface of the ciliary body 7. Two interrupted sutures are applied to the superficial flap and the continuous suture to the conjunctiva.

Example, Ill, 64 years old, was admitted with a diagnosis of OD-open-angle glaucoma in the Sh-stage. Visual acuity of 0.2 n / k. Field

19 mm. Topography indicators:, 2, 29.

The use of the invention makes it possible to reduce such postoperative complications as hypertension by 90%.

Claims (1)

Invention Formula The method of treating open-angle glaucoma by forming conjunctivalism is narrowed to 10e. The intraocular pressure and surface scleral glossing is 43 mm. Indicators tonography P-40,7, 02. The optic nerve head is gray, glaucomatous excavation. Made operation on the right eye. The postoperative period without complications. 15 The eye is calm. Subconjunctival filtration is mild. The cornea is transparent. Front camera is deep. Iris is calm. Discharged on the second day after surgery. IOP 16 mm. After 1 week IOP To remove a section of the outer wall of the Schlemm canal and a section of the deep layers of the sclera above the ciliary body, then fixing the scleral and conjunctive flaps with sutures, in order to activate the outflow of intraocular fluid through the corneal portion of the trabecula, transition to the cornea up to 1 mm from the anterior borderline 20 mm. After 1 month IOP of 21 mm. After 6 months. 20 Schwalbe, and after removing the deep layers after the operation, the eye is calm, the subconjunc- tive sclera above the ciliary body is left no tival filtration. Sharply detached scleral fibers on the surface view, field of view, unchanged. IOT the last. 19 mm. Topography indicators:, 2, 29. The use of the invention makes it possible to reduce such postoperative complications as hypertension by 90%. Invention Formula The method of treatment of open-angle glaucoma by forming conjunctival and superficial scleral gloss foot and surface scleral gloss To remove a section of the outer wall of the Schlemm canal and a section of the deep layers of the sclera above the ciliary body, then fixing the scleral and conjunctive flaps with sutures, in order to activate the outflow of intraocular fluid through the corneal portion of the trabecula, transition to the cornea up to 1 mm from the anterior borderline Schwalbe, and after removing the deep layers 1 Fig.Z 2 FIG. FIG. five 6 Phage.7 FIG. eight