METHOD FOR ENDOMETRIALLY REMOVING CHOROIDAL MELANOMA Russian patent published in 2018 - IPC A61F9/00 A61F9/07 A61N5/67 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to ophthalmology. Method for treatment of choroidal melanoma (CHM) by endometrially removing it, comprises subtotal vitrectomy, retinotomy, endocoagulation, endolaserphotocoagulation (ELC), retinopexy, adjuvant brachytherapy (BT). Wherein subtotal vitrectomy is performed using instruments 25 G. Diathermocoagulation of the retina and choroid is performed around the macroscopically visible CHM base in the medium of perfluororganic compounds (PFOC) under conditions of increased IOP to 50 mm of mercury. In addition to retinotomy, retinectomy is performed over the CHM, after removal of the CHM to form surgical coloboma with the capture of 1 mm of a layer of surrounding tissues, the sclera is partially excised within the macroscopically visible boundary of the CHM base. Further, a narrow layer of surrounding tissues is excised in two zones: first zone – a zone of surrounding tissues closer to the macular zone and optic nerve disk – is excised by a width of up to 0.5 mm; second zone – a zone of surrounding tissues occupying peripheral departments, – is excised by a width of up to 1 mm. Resulting portions of material, having the numbering corresponding to the zone, are sent by cito to the laboratory for histological or cytological examination. Normal IOP is restored by partially removing PFOC. If the CHM cells are not detected in the portions of material from the first and second zone, the ELC is performed using a laser with a wavelength of 532 nm at a power of 150–250 mW at the edge of the coloboma for retinopexy and at the surface of the scleral bed to prevent recurrence of the CHM. Then, the PFOC are replaced by gas, followed by the replacement of gas with silicone oil. After endometrially removing the CHM, BT is performed by binding to the episclerus on the projection of the surgical coloboma of the beta applicator with radionuclide Ruthenium-106, with absorbed radiation dose on the inner surface of the sclera of at least 150 Gy. If at least one of the two portions of the material of the CHM cells are detected, a narrow layer of surrounding tissues is further excised in the corresponding zone and further actions are performed as described above, until the CHM cells miss in the material, and the operation is completed as described above.

EFFECT: treatment of choroidal melanoma by endometrially removing it is proposed.

1 cl, 2 ex, 1 dwg