METHOD OF ELIMINATION AND PREVENTION OF INTRAOPERATIVE BLEEDING IN SURGERY OF PROLIFERATIVE DIABETIC RETINOPATHY Russian patent published in 2012 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention relates to field of ophthalmology. Ports are installed, LEDs and instruments are introduced, vitrectomy is performed, section of epiretinal membrane (ERM) is detached, bent aside, cut and ablated by means of vitreotom. Longitudinal axis of port for vitreotom is matched with direction at ERM edge, forming axis of surgical impact (ASI). Longitudinal axis of vitreotom is matched with line of longitudinal symmetry of ERM, with formation of plane of surgical impact (PSI). External surface of vitreotom tip is brought under retinal ERM surface, asynchronous fluctuating movements around fluctuation centre are realised with ratio of positive amplitude to negative amplitude within the interval from 1.5 to 1.0; centre of fluctuating movement is moved along external curved ERM surface; during each stage of discrete movement vitreotom tip is moved along ASI and in PSI 2-3 mm forward, then 1-2 mm backward; vitreotom tip being moved on retinal ERM surface to the opposite edge of ERM, increasing area of detached retinal surface of ERM, thus starting formation of rectilinear tunnel. In mode of 200-300 mm Hg vacuum fixation of upper wall of ERM tunnel in vitreom window and pulling ERM upwards are performed, after that, level of vacuum is reduced to zero and vitreom tip is moved again along ASI and in PSI forward, until 4-5 mm long tunnel is formed. Vitreom tip is brought under external border of tunnel, window of vitreom tip is brought into contact with upper wall of tunnel, then in mode of cutting vitreom tip is moved along tunnel in ERM, dividing ERM into two equal flaps, angle of flap bending aside constituting 20-30 degrees. Point bleeding from newly formed vessel of retina surface is covered with silicone tip of introduced into eye cavity extrusion needle, forming in 300-400 mm Hg vacuum mode convex surface of retina, facing with convexity posterior capsule of crystalline lens, then vacuum is released, extrusion needle is removed from eye cavity, diathermocoagulator is introduced and precision diathermocoagulation of newly formed vessel of retina surface on apex of formed in vacuum mode convex surface of retina is carried out with diathermocoagulator tip.

EFFECT: method makes it possible to increase accuracy of diathermocoagulation, reduce area of burn, ensure efficient hemostasis after single impact, reduce risk of intraoperative complications.

2 dwg, 1 ex