METHOD OF TREATING PROLIFERATIVE DIABETIC RETINOPATHY Russian patent published in 2012 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention refers to ophthalmology, and may be used for treating proliferative diabetic retinopathy. It involves inserting ports, introducing a light guide, carrying out vitrectomy, detaching a part of an epiretinal membrane (ERM), unbending it, cutting by using a vitreous cutter. It is combined by matching a longitudinal axis of the port for the vitreous cutter directed towards an edge of the ERM with generating a surgical axis (SA), matching a longitudinal axis of the vitreous cutter and a longitudinal axis line of the EMR with generating a surgical plane (SP). An external surface of a vitreous cutter tip is delivered under a retinal surface of the ERM to perform asynchronous oscillatory movements about a centre of oscillation with the positive to negative amplitude ratio within the range 1.5 to 1.0; the centre of oscillation is moved along an external curvilinear surface of the ERM, each stage of discrete movement involves moving the vitreous cutter tip along the SA and in the SP 2-3 mm front, then 1-2 mm; with the vitreous cutter tip advanced along the retinal surface of the ERM to an opposite edge of the ERM, increasing an area of the detached retinal surface of the ERM to start thereby formation of a rectilinear tunnel; in a vacuum mode of 200-300 mm Hg, an upper wall of the ERM tunnel is fixed in a vitreous cutter window while the ERM is pulled upwards; then the vacuum level is dropped to zero, and the vitreous cutter tip is moved along the SA and in the SP again forward to formation of the tunnel 4-5 mm long; the vitreous cutter tip is delivered under an external border of the tunnel; the vitreous cutter window is brought to contact with an upper wall of the tunnel; then the vitreous cutter tip is advanced in a cutting mode along the tunnel in the EMR with dividing the EMR on two equal flaps; the edge of each ERM flap is unbent at an angle of 20-30 degrees in relation of a retinal surface, in the vacuum mode 200-300 mm Hg the edge of each ERM is fixed by the vitreous cutter tip and pulled up with detaching the EMR from the retinal surface; the detached ERM fragment is removed with using the vitreous cutter tip in the cutting mode; the similar procedure is used to remove the rest ERM fragments.

EFFECT: method enables simultaneous reduction of operative injures, IOP variation amplitudes in the eyeball, prevented changes of spatial retinal and epiretinal interposition caused by the IOP variations due to instrument change and eye cavity depressurisation.

2 ex, 2 dwg