FIELD: medicine, ophthalmology.
SUBSTANCE: intra-surgically gonioscopically one should detect Schlemm's canal retrograde filling with blood after cataractous extraction before the stage of liquid introduction into anterior ocular chamber to increase intraocular pressure. Three cases are possible. In the first case one should observe the absence of blood in the lumen of Schlemm's canal - one should diagnose obstruction of intrascleral pathways of intraocular liquid outflow or the combination of intrascleral and trabecular obstruction. In the second case, the blood is observed in the lumen of Schlemm's canal as inproportionally dyed segments with the tendency for fusion - one should diagnose partial obstruction of intrascleral pathways of intraocular liquid outflow or combination of partial intrascleral and partial trabecular obstruction. Moreover, on introducing the liquid into anterior ocular chamber it is necessary to carry out gonioscopic survey of Schlemm's canal once more. In case of decreased dyeing of Schlemm's canal with blood one should diagnose the combination of partial intrascleral and partial trabecular obstruction, and in case of no blood - one should diagnose the availability of trabecular apparatus permeability. In the third case, when Schlemm's canal is filled with blood along the whole circumference as a homogenous line before the stage of increasing intraocular pressure one should diagnose complete permeability of intrascleral pathways of intraocular liquid outflow. Moreover, on introducing the liquid into anterior chamber one should carry out gonioscopic survey of Schlemm's canal once more, and in case of no blood in Schlemm's canal in the course of repeated investigation one should diagnose the presence of trabecular apparatus permeability. The innovation has been based upon decreased ophthalmotonicity during operation on cataractous extraction that develops blood reflux out of epi- and intrascleral veins into the lumen of Schlemm's canal. The technique suggested enables to determine pathogenesis of intraocular liquid retention reliably and simply in the course of operation according to the level and character of Schlemm's canal filling with blood without the necessity for creating negative pressure.
EFFECT: higher accuracy and efficiency of detection.
3 dwg, 4 ex
