METHOD FOR ELIMINATING THE PARALYTIC AND/OR ATONIC REVERSAL OF THE EYELID Russian patent published in 2018 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to ophthalmology. To eliminate the paralytic or atonic reversal of the lower and/or upper eyelid, the skin is initially cut from the inner to the outer ligament of the eyelids along the edge of the eyelid, receding from the ciliary margin of 2–3 mm. Next, the skin is cut off all over the section from the circular muscle by 5–7 mm towards the orbital margin. Then, retreating 4–5 mm from ciliated edge of the eyelid, they open the circular muscle with scissors stupidly throughout the cutaneous incision. Cutaneous muscle flap is removed towards the orbital rim. Further, in the lateral sections of the eyelid, a pentagonal, through fragment, beginning with its base from the rib margin of the eyelid, is excised, two opposite lateral edges of the fragment are equal in length and perpendicular to the base, and the vertex is facing the orbital edge. Through the top of the formed pentagonal end-to-end defect, from the side of the palpebral conjunctiva, a U-shaped suture is made and taken out to the skin. Next, the lateral edges of the pentagonal end-to-end defect of the eyelid are sutured with each other layer by layer, firstly applying nodal sutures to the tarsal plate in such a way that the nodes are above the tarsal plate, then the gray rim of the costal edge of the eyelid is sutured with three nodal sutures, which are applied to the inner rib, the outer rib and to the center of the gray fringe. Then exfoliate the circular muscle from the tarsal plate to the rib margin. Further to the medial side up to the inner ligament and/or laterally to the outer ligament of the eyelids, forming a tunnel or tunnels above one of the ligaments or over both ligaments, respectively. Then, a polymeric perforated endoprosthesis is placed on the tarsal plate and fixed at the beginning with U-shaped internal nodal sutures to the anterior surface of the tarsal plate, and then to one or both ligaments of the eyelids in the tunnel or tunnel area with an U-shaped suture drawn onto the skin and tied over a compression plate used as a gasket. After this, a nodal suture is applied to the skin in the area of the stitched through defect between the eyelashes and the edge of the longitudinal cut of the eyelid skin. Then the lateral margin of the circular muscle is fixed with an internal U-shaped suture to the outer ligament, if necessary, the excess skin is cut off on the exfoliated musculocutaneous flap of the eyelid. Further, in the region of the outer corner of the eye, a nodal provisional suture is applied, comparing the edges of the longitudinal cutaneous wound and suturing the skin wound with a continuous intradermal suture. Then, U-shaped suture is drawn into the skin at the apex of the pentagonal defect; continuous and provisional sutures are removed for 5–7 days, and the U-shaped sutures removed to the skin and compression plates are removed after 10–14 days.

EFFECT: method allows to restore the anatomical and functional consistency of the century due to its reinforcement and the provision of the carcass function of the tarsal plate.

1 cl, 3 ex, 1 dwg