FIELD: medicine; ophthalmology.
SUBSTANCE: anterior circular capsulorexis is performed through valve self-sealing sclera incision. Conjunctiva is dissected along limb of length 3 mm and shifted upwards. Sclera is dissected for 3 mm by 1/3 of its thickness to limb forming semi-oval sclera apron of length 2.5 mm and height 2.0 mm. Then incision is laminated along the full length to transparent layers of cornea. Deep layers of sclera are removed correspondingly to sizes of external apron to inner wall of venous sinus with adjacent juxte-canalicular part of trabecula and uncovering of Descemet's membrane. After penetration to anterior chamber phakoemulsification is combined with IOL implantation. After that phako-needle is covered with branch pipe of diameter 2.5 mm, beyond needle hoop for 1.0 mm, and within 10-30 sec uncovered trabecula and Descemet's membrane is exposed with water jet at pressure 0.05-0.1 atm, ultrasonic activated aw frequency 28.5 kHz and power up to 30 ml W. Then trabecula is actively washed with water supplied through paracentesis to anterior chamber at power 0.05 atm. Intraocular fluid is aspirated from exterior surface of trabecula combined with evacuation of pigment and fine-dispersed material from intertrabecular sheets of filtration areas with vacuum to 10 mm of mercury column by means of aspiration-irrigation system of phakoemulsification using standard steel cannula as aspiration tip with aperture at the bottom. Surgery zone is covered with shifted intact conjunctiva with applied buried purse-string conjunctival suture by limb.
EFFECT: reduced complication number; more rapid recovery process and reduced rehabilitation time.
1 ex, 4 dwg
