RU2409333C1 - Method of phacoemulsification of traumatic cataract complicated with iridodialysis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to ophthalmology, and may be used in phacoemulsification of traumatic cataract complicated with iridodialysis. Prior to capsulorhexis, pupillary edge of iris are fixed, for this purpose two paracenteses are ensured in zone of iridodialysis, through which irisretractors are inserted into anterior chamber. Iris is pulled towards its root through pupillary edge with the help of irisretractors. Capsulorhexis is ensured, crystalline lens is removed, and intraocular lens is implanted. After removal of irisretractors, iridodialysis is removed, using paracenteses earlier arranged to insert irisretractors.

EFFECT: method makes it possible to simplify process of phacoemulsification of cataract complicated with iridodialysis and to prevent post-operational complications Fixation of pupillary edge of iris towards its root in zone of iridodialysis by irisretractors at initial stage of operation makes it possible to do main stages of phacoemulsification of traumatic cataract with minimum risk of traumatic situations in process of operation.

2 ex

Description

The invention relates to medicine, namely to ophthalmology, and can be used for phacoemulsification of traumatic cataract complicated by iridodialysis.

There is a method of surgical treatment of traumatic cataract complicated by iridodialysis (see the description of the invention to patent No. 2230535 dated July 18, 2002), which consists in performing phacoemulsification of a cataract, including the formation of a corneal two-stage self-sealing tunnel incision and paracentesis for irrigation-aspiration, filling the anterior chamber viscoelastic, capsulorexis, lens removal, and implantation of an intraocular lens, and elimination of iridodialysis.

However, performing phacoemulsification of a traumatic cataract complicated by iridodialysis without fixing the pupil edge of the iris in the iridodialysis zone is associated with a risk of aspiration of the torn edge of the iris with the tip of the phacoemulsifier, may be accompanied by bleeding from the vessels of the iris. In addition, capsulorexis is difficult to perform, in which the risk of damage to the anterior capsule of the lens is not excluded, the process of phakofragmentation of the nucleus and aspiration of the lens masses is complicated. When implanting an intraocular lens due to the presence of a torn edge of the iris, it may be difficult to introduce the supporting elements of the lens and its centering at the installation site due to a decrease in the visibility zone during the operation.

The present invention solves the problem of developing a new method of phacoemulsification of traumatic cataract complicated by iridodialysis. The technical result obtained in this case consists in simplifying the process of performing phacoemulsification of cataracts complicated by iridodialysis and preventing operational complications. The proposed method of fixing the pupil edge of the iris towards its root in the iridodialysis zone with iris refractors at the initial stage of the operation allows you to perform the main stages of phacoemulsification of traumatic cataract with a minimum risk of traumatic situations during the operation. In addition, when eliminating iridodialysis, which is carried out at the final stage of the operation after implantation of an intraocular lens, paracentesis, previously performed for the introduction of iris retractors, is used.

The specified technical result is achieved by the fact that in the method of phacoemulsification of a traumatic cataract complicated by iridodialysis, which consists in performing phacoemulsification of a cataract, including the formation of a corneal two-stage self-sealing tunnel incision and paracentesis for aspiration and irrigation, filling the anterior chamber of the eye with a viscoelastic implant removal, lenses, and elimination of iridodialysis, when performing phacoemulsification of catarrh Before capsulorexis, you fix the pupil edge of the iris in the iridodialysis zone, for which two paracentesis are performed in the iridodialysis zone, iris refractors are inserted through them into the anterior chamber of the eye, which attract the iris through the pupillary edge toward its root, and when eliminating iridodialysis, paracentesis is used, previously made for the introduction of iris tractors.

The method of phacoemulsification of traumatic cataract complicated by iridodialysis is as follows.

After performing a corneal two-stage self-sealing tunnel incision of the cornea and two paracentesis for aspiration and irrigation, the anterior chamber of the eye is filled with viscoelastic. Before capsulorexis, the pupil edge of the iris is fixed, for which two paracentesis in the iridodialysis zone are performed. Through them, iris refractors are introduced into the anterior chamber of the eye, which through the pupillary edge attract the iris towards its root. Capsulorexis is performed, the lens is removed and an intraocular lens is implanted. The iris refractors are removed and iridodialysis is eliminated using paracentesis previously performed for the administration of iris refractors. To eliminate iridodialysis, an iris defect is flashed through paracentesis along the edge of its separation with a needle with a thread of polypropylene 10.0. 4 mm from the limbus in the iridodialysis zone, a scleral incision is made to a depth of 0.5 mm. Two tunnel incisions are made from the incision with exits to the anterior chamber of the eye. Through the tunnel incisions, the ends of the thread suturing the edge of the iris defect are pulled to the sclera surface. The elongated ends of the thread connect, pull the torn edge of the iris to its root. The ends of the thread are tied and laid in a scleral incision. Remove the viscoelastic.

Clinical example

Patient K., born 1954

Received September 10, 2008 with a diagnosis of traumatic cataract, iridodialysis OD. A history of concussion OD in 2006 (domestic injury).

VOD = 0.02 n.k.

IOP = 19 mmHg

OD - calm, the cornea is transparent, the anterior chamber is 3.0 mm, iridodialysis is from 2 to 7 hours, the pupil is 3.0-3.5 mm of irregular shape, in the projection of iridodialysis is planar synechia. The lens is cloudy with swelling elements, fibrosis of the anterior lens capsule in the central optical zone. The fundus is not ophthalmoscopic.

September 11, 2008, the patient underwent surgery in accordance with the proposed method. The first stage was divided planar synechia. The second stage was performed phacoemulsification of cataracts according to standard methods. Before capsulorexis, the pupil edge of the iris was fixed, for which two paracentesis in the iridodialysis zone were performed. Through paracentesis, iris refractors were introduced into the anterior chamber of the eye, which pulled the iris through the pupil edge toward its root and fixed the pupil edge of the iris. Capsulorexis was performed, the lens was removed, and a flexible intraocular lens was implanted in the capsular bag. At the final stage of the operation, iridodialysis using paracentesis previously performed for the introduction of iris tractors was eliminated.

At discharge, September 16, 2008

VOD-0.6 sph - 1.0 = 0.7.

After 6 months VOD = 0.7 sph - 0.75 = 0.8.

Claims (1)

A method of phacoemulsification of a traumatic cataract complicated by iridodialysis, which consists in performing phacoemulsification of a cataract, including the formation of a corneal two-stage self-sealing tunnel incision and paracentesis for aspiration and irrigation, filling the anterior chamber of the eye with viscoelastic, performing capsulorexis, and lens ural lens removal that when performing cataract phacoemulsification before capsulorexis, fixation of the pupillary edge of the iris in the iridodialysis zone, for which two paracentesis in the iridodialysis zone are performed, iris refractors are inserted through them into the anterior chamber of the eye, which attract the iris through the pupil edge towards its root, and when eliminating iridodialysis, paracententses previously performed for administration are used iris tractors.