METHOD FOR SURGICAL TREATMENT OF VARIOUS ETIOLOGIC FORMS OF GLAUCOMA IN CHILDREN OF YOUNG AGE GROUP Russian patent published in 2018 - IPC A61F9/00 A61F9/07 

FIELD: medicine.

SUBSTANCE: for surgical treatment of various etiological forms of glaucoma in children of the young age group, standard treatment of the operating field is carried out and the upper rectus muscle is taken on the suture holder. A conjunctival flap, a superficial scleral flap (SSF), base to the sulcus, 2/3 of the sclera thickness is formed. Further, a deep scleral flap (DSF) of a triangular shape, base to the sulcus, is cut out, separated from the underlying vascular membrane, exposing the trabeculodescemic membrane (TDM). At that, in children up to four months, the SSF is cut to 3×2 mm and in children over four months - to 3×4 mm, are separated from the underlying sclera to the corneal part of the sulcus, entering the transparent layers of the cornea at 1 mm. The DSF is cut in size 2.5×1.5 mm in children up to 4 months and in size 2.5×3.5 mm in children over four months, separated from the underlying vascular envelope by half of the DSF height, starting from the vertex of the triangle, and when the remaining half of the DSF is separated, a thin network of scleral fibers on the vascular membrane is left. When intraocular fluid (IF) filtration is detected in the exposed TDM zone and the intraocular pressure (IOP) decreases to 10-12 mm Hg, the DSF is excised at the base, leaving the filtering band of the exposed TDM intact, the SSF is fixed by the corners of the free edge by nodal sutures to the adjacent sclera, thus restoring the eyeball integrity. If there is no IF filtration in the exposed TDM zone and the elevated IOP remains, the DSF is excised at the base and the SSF is fixed by the corners of the free edge by nodal sutures to the adjacent sclera, thus restoring the eyeball integrity, then viscoelastic with molecular weight from 1.65 million to 2.4 million Dalton is injected under the SSF. Then the suture is removed from the upper rectus muscle and the eye is drawn into the horizontal plane. A thin spatula is placed under the SSF parallel to the iris plane and perpendicular to the sulcus, pushing the spatula towards the SSF base and opening the anterior chamber, destroying the TDM throughout the inner fistula, extracting the spatula from the SSF and terminating the operation.

EFFECT: group of inventions allows to reduce the risk of development of operational and postoperative haemorrhagic complications, vascular membrane edema and choroid detachment after antiglaucoma surgery, due to surgically formed outflow pathways and to shorten the duration of patient stay in the hospital, prolong the hypotensive effect of the operation.

2 cl, 2 ex