SU822820A1 - Method of revascularization of choroid - Google Patents

Description

This invention relates to medicine, namely ophthalmology.

The known method of revascularization of the choroid by invagination of the vascular-tissue flap into the supraoririal zone is f,

However, the known method does not. provides visual acuity and increased field of view.

The purpose of the invention is to increase visual acuity and increase the field of vision.

This goal is achieved by introducing a vascular episcleral flap on the pedicle and a surgical zone with a kidney fibrous capsule homograft into the suprachoroidal space through a scleral incision.

The method is carried out as follows.

Under local anesthesia, an incision of the conjunctiva of the ocular block is made in the corresponding sector that is closest to the pathological focus. With the defeat of the entire retina, which is usually observed with tapetto-retinal abiotrophies, the lower sector of the ophthalmic block is the most convenient for surgical intervention. After the conjunctiva has been separated, the adjacent direct ocular muscle is taken on a suture holder and cut off, after which the episclera with the main blood vessels visible on it is exposed. One of the vascular bundles and the corresponding region of its blood supply is surrounded by an incisal incision. With the aid of a fragment of an angular blade, the flap is separated from the underlying sclera. Vessels with a flap remain unaffected and at the base of it the episclera will pass to the surrounding tissue. At the base

5 of the flap, they make a through linear incision of the sclera to the suprachoroidal space, where the flap of episclera is carefully inserted using a spatula. Thus, the blood supply region of these vessels moves

0 under the sclera on the surface of the choroid. The base of the flap is fixed with the 2nd 3rd microsurgical suture to the opposite lip of the scleral incision. At the same time, stitches are placed between Cro-5 venous vessels. The homotransplant of the fibrous capsule of the kidney is rectangular in shape and 4-5 mm wider than the width of the flap is moistened with physiological solution and placed on the sclera through the incision through the superimposed microsurgical sutures, after which the corners are fixed with additional sutures. The trimmed muscle is sewn on its own, stitched to the conjunctiva.

The homotransplant of the fibrous capsule of the kidney used in the operation is taken from the corpses of people in the morgue. The capsule of the kidney is easily separated from the parenchyma, after which it is stretched on glass slides and preserved in 70–9 hours of sleep with ethanol. Ranplants preserved for a period of 3 days to 2–3 years are used. Material taken from the corpse of one person is enough to produce 100 or more operations.

Disinfectant drops are instilled in the postoperative period, the suture from the conjunctiva is removed for 4-5 days. Patients observe bed rest and wear a binocular belt for 2 days. Immunosuppression therapy is not used. The patient is discharged from the hospital after 7-10 days after the operation.

When examining the fundus in the area of the displaced flap for the first 5-12 days, weak retinal edema is observed. Choroida and retinal vessels become hyperemic. There are no complications (for example, detachment, vascular or retinal membranes). Already at discharge of the patient from the hospital, a noticeable expansion of the visual fields is noted, the visual acuity improves, a positive shift is noted in the data of electrophysiological studies of the eye. In the long-term observation period, the achieved expansion of the visual fields is maintained, and in most cases, even greater expansion is observed, and visual acuity also improves.

A comparative analysis of the results of the operation of revascularis of the hlorioidea in various ways in patients with pigmentary retinal abiotrophy is shown in Table 1.

From Table 1 it can be seen that in the near term of observation, the efficiency of the proposed method is noticeably higher than the known one. Thus, an increase in visual acuity when performing operations with the proposed method is noted in .88.3% of cases, while with the known method this figure ranges from 60-83.8%. Expansion of the visual fields in the operations performed by this method is noted in 96.6% of cases, and in the known operation it is 52.5-83.8%.

A comparative analysis of the long-term results of choroidal revascularization surgery in various ways in patients with pigmentary taporetotinal abistrophy is presented in Table 2.

From Table 2 it can be seen that in the long-term observation period, the effectiveness of the proposed method is noticeably higher than the known. Thus, when performing operations using this method, an increase in visual acuity is noted in 77.1% of cases in relation to the original data, while for a known method this figure is 36.4-57, 0%. Even greater advantages are observed in relation to the field of view, when using the proposed method the expansion is achieved in 85.4% of cases, while for the known method this figure is 40.9-62%. In no case of the operation by the proposed method is there a decrease in visual acuity and a narrowing of the visual fields, while for the known method the number of such cases is a significant number.

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invention formula

The method of recharacterizing the choroid by invaginating the vascular-tissue flap into the suprahoriodal space, characterized in that, in order to increase visual acuity and increase the visual field, the vascular-episcleral flap is inserted into the suprachoroidal space through the incision through the sclera and the area of the working area through the sclera and the area of the working area through the sclera and the area of the working area through the sclera and the area of the working area through the sclera and the area of the working area through the sclera and the area of the working area through the sclera and the area of the working area through the sclera to the pedicle and the area of the operative scleral incision through the sclera through the incision through the sclera, the vessel and the area of the working area enter the area and the area of the working sclera through the incision through the sclera, introduce the vascular-episcleral flap into the area and the area of the operative - homotransplant of the fibrous capsule of the kidney.

Sources of information taken into account in the examination

1. Ophthalmological journal, No. 3, 1978, p. 224-227,

Claims (1)

Claim Method of choroidal revarcularization 'by invagination of a vascular-tissue flap into the suprachoriodial space, characterized in that, in order to increase visual acuity and increase the field of view, a vascular-episcleral flap on the peduncle and an operative area are introduced into the suirochoroid space through a through incision of the sclera cover the kidney fibrous capsule with a homograft. Sources of infopamation taken into account during the examination 1. Ophthalmological journal, No. 3, 1978, p. 224-227.