METHOD FOR SURGICAL LASER TREATMENT OF PATENCY DISRUPTIONS OF HORIZONTAL AND VERTICAL SECTIONS OF TEAR-DRAINING APPARATUS Russian patent published in 2006 - IPC A61B18/22 

FIELD: ophthalmology, namely, methods for surgical laser treatment of patency disruptions of horizontal and vertical sections of tear-draining apparatus.

SUBSTANCE: in accordance to method, laser light guide is passed along lachrymal channel until it is stopped by bone, then bone tissue is perforated by laser radiation. Tip of cannula with laser light guide on it is passed through tear point, lower or upper lachrymal channel and lachrymal sac hollow until it reaches contact with lachrymal bone or frontal process of maxilla. Nasal hollow is filled with hydrogel. Then, using impulse laser radiation with wave length 1437-1443 nm, frequency 10-30 Hz and laser impulse power 350-450 J with duration 150-250 ms, or impulse-periodic laser radiation with wave length 810-2000 nm, frequency 10-100 Hz and laser radiation power 3-50 Wt or continuous laser radiation with wave length 810-2000 nm and laser radiation power 3-60 Wt, preliminary bone window is made firstly with diameter 0,8-1,3 mm, while moving laser light guide reciprocally with its gradual penetration into bone tissue of lachrymal bone or frontal process of maxilla until penetration into nasal hollow filled with hydrogel. Then, without altering parameters of laser radiation, final dacryostomy is made with diameter 2-5 mm during backward movement of light guide to starting position until laser filament exits dacryostomy. Time consumed by making of dacryostomy ranges from 6 to 120 seconds. Then cannula together with laser light guide is moved into finished dacryostomy until tip exits into nasal hollow filled with hydrogel and, without changing position of cannula tip, laser light guide is removed from it and a stent is inserted into it, which is then moved through dacryostomy into nasal hollow filled with hydrogel, and through vestibule of nose end of stent is let out from nasal hollow and held on facial skin outside the nose of patient. After that tip of cannula is removed from dacryostomy in lachrymal bone or frontal process of maxilla, through tear point of upper or lower eyelid and upper or lower lachrymal channel into nose hollow through dacryostomy Riethling probe is inserted and into its opening under endoscopic control polypropylene conductor of silicon tube is passed into nasal hollow, then Riethling probe is removed from conductor, second end of stent is pulled inside nasal hollow using conductor, let out to holding position of first end of stent and held outside the nose of patient.

EFFECT: possible creation of tear-draining channels from conjunctival hollow into nose with minimal trauma from surgical operation, possible preservation of epithelium of tear routes, reliable endoscopic control, limited thermal damage to surrounding structures, high haemostatic effect, no detachment of soft tissues from bone.

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