SU1599004A1 - Method of treating open angle glaucoma - Google Patents

Abstract

This invention relates to the treatment of open-angle glaucoma. The aim of the invention is to reduce intraoperative complications. To do this, after excision of the Schlemm's external wall under the scleral flap by two meridional loosening cuts from the deep layers of the sclera, a strip about 3 mm long with a base to the equator is marked. The width of the strip is arbitrary within the bed of the superficial scleral flap. The edge of the marked strip, facing the opened Schlemm's canal, is stitched with a thread, and its ends are led through the surface layers of the sclera and conjunctiva beyond the limits of the wound into the conjunctival sac. In the second stage, after the conjunctival wound has healed, the destruction of the trabeculae in the area of operation is carried out by pulling the thread. Such a sequence of operation results in simplification of the method, expansion of its field of application, and provision of a persistent hypotensive effect of the intervention.

Description

The invention relates to mediation, namely to ophthalmology, and can be used in the treatment of primary open-angle glaucoma of all stages of the disease, regardless of the level of intraocular pressure and the hydrodynamic state of the eye, if surgical treatment is indicated.

The goal of the method is to reduce operative complications.

The proposed method is carried out as follows. The xB zone of the excision of the outer wall of the Schlemme canal is forgiven by the scleral lip of the sinus incision with a thread, and its ends through the surface layers of the sclera and conjunctiva are brought out of the surgical wound into the conjunctival sac and tied with a provisional node. After that, stitches are put on the scleral flap and conjunctiva. On the second stage, after the conjunctival wound has healed, the destruction of the trabecula in the area of operation is performed by tensioning the thread.

For a more targeted tension and to facilitate the destruction of the trabeculae, the intervention can be performed in the following modification. After excision of the outer wall of the Schlemm canal under the scleral flap by two meridional loosening cuts from the deep layers of the sclera, a strip about 3 mm long with a base toward the equator is marked. The width of the strip is arbitrary within

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bed of superficial scleral flap. The wider it is, the greater the destruction of the trabecula at the second stage of treatment — the edge of the intended strip, facing the opened Schlemmian canal, is stitched and, as in the first embodiment, is pulled out through the surface layers of the sclera and conjunctiva. limits of operating wounds

PRI m e RO Bol. Bogdanova M. In 76 years old, she arrived with a diagnosis of an open angle developed with high intraocular pressure under the mibtik of right eye glaucoma, myopia of a moderate degree, starting with a cataract. Eye acuity O, 1 with correction sphere - 4.0 D 0.5., The field of view is narrowed to 45 from the nose of the IOP during daily tonometry under 4-fold instilling of myotics -27-34 mm ,, Tonograph: RO - 31.1; C - 0.08; F- 1.7, KB - 389. Gonoscopy: UCP of medium width, moderately pronounced pigment of trabeculae, 26-104,88, the operation was performed - excision of the outer wall of the Schlemmian canal under the scleral loscutoma During the operation within the bed of the superficial scleral glove two meridional cuts and deep layers of the sclera were marked with a strip to the equator 3x3 mm in size. The edge of the intended rush facing the opened Schlemmian canal was stitched, and its ends were pulled out through the surface layers of the sclera and conjunctiva beyond the limits of in the conjunctival sac. In the postoperative period IOP 25-25 mm roost, tonography: RO - 29.9; C - 0.11; F — 1.4; KB - 208. 03.05.8. The trabecula was destroyed in the operation zone by pulling the nitis.

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Onna pillow, gonioscopically, a through defect in the trabecula with a length of about 2.5 mm was determined. 6 days after the second stage of IOP treatment, 15-17 mm of rtsst Tonography: P - 14, C - 0.2; F 1.3; KB - 50. When viewed in 3 months 07/18/88, visual acuity is 0.1 with a correction sphere - 4.0 D 0.5, the field of view is normal. IOP 19 mmHg Tonography: PO - 12.3; C - 0.41; F - 0.3, KB - 87.

Claims (1)

The use of the proposed method ensures safe operation due to disconnection of the moment of excision of the outer and inner walls of the Schlemm canal and ensuring a stable hypotensive effect due to the fact that the destruction of the trabeculae in the operation area is sufficiently long, which reduces the likelihood of overgrowth of the created outflow paths. Invention Formula The method of treatment of open-angle glaucoma by subscleral excision / outer wall of Schlemm's canal and destruction of its inner wall, characterized in that, in order to reduce intraoperative complications due to disconnection of the open-ended inner and outer walls of the Schlemm's canal, the scleral lip of the opened Schlemmian canal is sutured which leads to the flap of the surface layers of the sclera on the surface of the conjunctiva, and the zone of destruction of the inner wall of the Schlemm's canal is metered with two notches of the scleral lips On both sides of the suture, and the destruction of the trabeculae is performed by pulling the thread after conjunctival wound healing. McPitkin Editor Compiled by S.Gluhoded Tehred L. Oliyyyk Proofreader O. Tsiple Order 3102 Circulation 483 VNIIPI State Committee for Inventions and Discoveries at the State Committee on Science and Technology of the USSR 113035, Moscow, F-33, 4/5, Raushsk nab. Subscription