SU1680158A1 - Method for preventing the secondary cataract - Google Patents

Abstract

This invention relates to medicine, namely to ophthalmology and, concerns cataract surgery. The purpose of the invention is to reduce the invasiveness of the intervention. The essence of the proposed method for the prevention of secondary cataract is the treatment of epithelial cells of the anterior lens capsule at a temperature of 50-65 ° C to remove the nucleus and lens mass

Description

The invention relates to medicine, namely to ophthalmology, in particular to cataract surgery.

The aim of the invention is to reduce the trauma of the intervention.

The method is carried out as follows.

After anesthesia with novocaine 2% and dykainom 0.25%, the eyelid dilator is placed on the eyelids, not the upper straight muscle — the fixation suture, the mucosa is cut off from the limbus, separated in the direction of the equator of the eye block, a perpendicular incision is made along the limb from 10 to 2 hours, a paracentesis of the cornea is carried out in the deep layers of the incision, 1% mezaton is introduced into the anterior chamber, after expanding the icon the anterior chamber of the eye is opened along the limbus from 10 to 2 hours, the anterior lens capsule is cut from 10 up to 2 h, the working part of the tip is a thermal tool This one, made in the form of an elastic wire loop, is inserted under the front lens capsule through its incision. At the same time, the nearby eye tissue is in contact with the non-working part of the tip and extension cords covered with thermal insulating material. Preliminarily, on the thermoregulator of the device unit, the required temperature of heat treatment of epithelial cells of the anterior lens capsule is established. After that, the device is turned on using an external pedal and the lens anterior capsule is heat treated by gently moving the loop throughout the 50-65 ° C tip temperature. the inner surface of the anterior capsule of the lens. After the heat treatment of the anterior lens capsule is completed, the device is turned off, the working part of the tip is pulled out from under the anterior lens capsule and from the eye. Through an incision in the front capsule of the lens

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the nuclei are washed out, the leftover lens masses are washed out, an intraocular lens is implanted between the sheets of the anterior and posterior lens capsule, fixed, the sutures are cut into the incision in the limbus, the anterior chamber of the eye is restored with saline, the central parts of the anterior lens capsule are removed, the mucosa is removed bend to the limbus and fix with two interrupted sutures for 10 and 2 hours. End the operation with the introduction of antibiotics and corticosteroids sub-conjunctivally.

Example 1. Patient C, 72 years old, was admitted to the clinic with a diagnosis of almost mature age cataract of the left eye. The acuity of the vision of the left eye is equal to the count of the fingers and face. A cataract extraction operation was performed according to the proposed method. After instillation of 20% sodium sulfacyl, 0.2% levomycetin solution, 0.25% solution of dikain into the conjunctival cavity, the surgical field was treated with ethyl alcohol 96 ° and a solution of brilliant green twice. Novocaine 2% - 2.0 ml was introduced retrobulbarno, as well as into the thickness of the eyelids and along the superior rectus muscle. The eye slit is opened by a dilator. A fixation suture is applied to the superior straight muscle. The mucous membrane is cut off from the limbus for 10 to 2 hours and separated in the direction of the equator of the eye block. Hemostasis Perpendicular incision on 1/2 the thickness of the opaque part of the limbus from 10 to 2 hours. In the deep layers, the incision was made in the paracentesis of the cornea with an injection needle for subconjunctival injection. 0.2 ml of methanol 1% was injected into the anterior chamber of the eye. After the pupil is fully expanded with scissors, the anterior chamber of the eye is opened along the notch in the limb from 10 to 2 h. The corneal flap is lifted up. A horizontal incision is made with the blade of the anterior lens capsule from 10 to 2 hours. Sterile holder with a working tip to the thermostat block. Preliminarily, on the thermoregulator of the device unit for carrying out the proposed method, the required temperature value (50 ° C) of heat treatment of epithelial cells of the anterior lens capsule has been established. The working part of the tip of the thermal tool is inserted through the incision so that it is completely covered with the anterior capsule of the lens, and the surrounding eye tissue contacts the non-working part of the tip and extensions covered with thermal insulation material. After that, the device was turned on using the remote pedal, and at the temperature of the working part of the tip 50 ° C, heat treatment of epithelium cells of the lower half of the anterior lens capsule was carried out by smoothly moving the elastic loop from the wire under

front capsule of the lens. After the heat treatment of epithelial cells of the lower parts of the anterior lens is completed, the device is switched off, the working part of the tip is removed from under the anterior

lens capsules and out of the eye. Then another replaceable working tip is installed, the loop of which is bent backwards, by means of which the epithelium cells are heat treated in the same way.

upper half of the anterior lens capsule. The device is turned off, the working part of the tip is removed from the eye. Through an incision in the anterior capsule of the lens, the core of the lens has been removed with a staple,

the residual lenticular masses of the irradiation-aspiration system are washed out. An intraocular lens of the model N.M. Sergienko force of 21.0 D. At the root of the iris

2 point iridotomies were made, where the supporting elements of the artificial lens were inserted. On the section of the cut in the limb imposed 8 nodes of nylon. Front camera restored physiological

solution. Scissors, inserted between the seams, excised the central part of the anterior lens capsule, located in the projection of the pupil. The mucous membrane is pulled to the limb and fixed with two interrupted nylon sutures for 10 and 2 hours. Under the conjunction, 0.5 ml of dexazone and 0.1 ml of gentamicin are injected. Monocular aseptic dressing. The postoperative course is smooth. The patient was discharged from the clinic

after 14 days. after operation. The visual acuity of the left eye with correction is 0.6. With careful biomicroscopy, signs of proliferation of the epithelium of the remains of the anterior capsule of the crystalline lens do not

detected. The patient was re-examined on 10.03.89. The visual acuity with correction is 0.9. Horn cover is transparent. The position of the IOL is correct. With careful biomicroscopy of the signs of proliferation of epithelial cells, no residues of the anterior lens capsule were detected. Zadkg. the lens capsule remains uniformly transparent. The fundus of the eye without pathological changes.

PRI mme R 2. Patient 3., 19 years of the history of the disease No. 15204, operation 16.07.88, was admitted to the hospital with a diagnosis of congenital unripe cataract of the right eye. Keenness

the view of the right eye is 0.1 not corrects. A cataract extraction operation was performed according to the proposed method. After instillation of 20% sodium sulfacyl, 0.2% levomycetin solution, 0.25% solution of dicainum, and 96% ethyl alcohol and brilliant green solution into the conjunctival cavity. Novocaine 2% -2.0 ml was injected retrobulbarno, as well as into the thickness of the eyelids and along the superior rectus muscle. The eye slit is opened by a dilator. A fixation suture is applied to the superior straight muscle. The mucous membrane is cut off from the limbus for 10 to 2 hours and separated in the direction of the equator of the eye block. Hemostasis. Perpendicular incision on 1/2 the thickness of the opaque part of the limb from 10 to 2 hours. In the deep layers of the incision, the paracentesis of the cornea is made with an injection needle for subconjunctive injection. 0.2 ml of mezaton 1% is injected into the anterior chamber of the eye. After the pupil is fully expanded with scissors, the anterior chamber of the eye is opened along the notch in the limb from 10 to 2 h. The corneal flap is lifted up,

A horizontal incision was made with the blade of the anterior lens capsule from 10 to 2 hours. A sterile holder with a working tip made in the form of an elastic wire loop is connected to the thermostat unit. Preliminarily, on the thermoregulator of the device unit for carrying out the proposed method, the required temperature value (65 ° C) of heat treatment of epithelial cells of the anterior lens capsule is established. The working part of the tip of the thermal tool is inserted through the incision under the front capsule of the lens so that it is completely covered with the front capsule of the lens, and nearby eye tissues contact with the working part of the tip and extension cords covered with heat insulating material. After that, the device was switched on using the remote pedal and, at the temperature of the working part of the tip 65 ° C, the epithelium cells of the lower half of the anterior capsule of the lens were heat treated by smoothly moving the elastic loop from the wire under the anterior lens of the lens. After heat treatment of epithelium cells of the lower parts of the anterior lens capsule is completed, the device is turned on, the working part of the tip is pulled out from under the anterior lens capsule and from the eye. Then another replaceable working tip is installed, the loop of which is bent backwards, by means of which the epithelium cells of the upper half of the anterior lens capsule are heat treated in the same way. The device is turned off, the working part of the tip is removed from the eye. Through a slit in the anterior capsule of the lens, the lens core was removed with a spatula, the residual lens masses were washed with an irrigation and aspiration system. An intraocular lens of the model NM is implanted into the capsular bag. Sergienko force of 21.0 D. At the root of the iris made 2 point iridotomy, which introduced the supporting elements of an artificial lens. The area of the cut in the limb imposed 8 knotted nylon seams.

Front camera restored saline. Scissors, inserted between the seams, excised the central part of the anterior lens capsule, located in the projection of the pupil. The mucous membrane is pulled to the limb and fixed with two interrupted nylon stitches for 10 and 2 hours. 0.5 ml of dexazone and 0.1 ml of gentamicin are injected under the conjunctiva. Monocular aseptic dressing. The postoperative course is smooth. The patient was discharged from the clinic after 14 days after surgery. The visual acuity of the right eye is 0.5 not corrosive. With careful biomicroscopy signs of proliferation of the epithelium remnants of the anterior lens capsule is not detected. Re-patient examination 24.02.89. Visual acuity is 0.6 with a correction of +1.0 D 0.8. Horn cover is transparent. The position of the IOL is correct. With careful biomicroscopy signs of proliferation of epithelial cells of the remnants of the anterior capsule of the lens is not detected. The posterior lens capsule remains uniformly transparent. The fundus of the eye without pathological changes.

Compared with the prototype of the proposed method reduces the invasiveness of the intervention.

Claims (1)

Claims A method for preventing secondary cataracts by thermally processing a lens capsule during cataract extraction, characterized in that, in order to reduce the traumatic intervention, the epithelial cells of the anterior lens capsule are treated at 50-65 ° C.