FIELD: medicine.
SUBSTANCE: invention relates to medicine, specifically to ophthalmology. For treating glaucoma that has developed on the background of iridocorneal endothelial syndrome, a conjunctival flap is formed, with the base to the limb, a superficial scleral flap (PSL) is cut out, size 4×4 mm, base to limb, and separation of that is carrying out from underlying sclera to the corneal part of the limbus, entering 1 mm in transparent layers of the cornea. 3–5 minute application of mitomycin C (MMS) is carried out; as a delivery vehicle of which, a hemostatic sponge is used, cutting it out for scleral application according to the size of the scleral bed, for subconjunctival application – 1–1.5 mm larger than its size. After removing hemostatic sponge, area of application is abundantly washed with saline. Cut out deep scleral flap (GSL) of triangular shape, with base to the limb and separating it from underlying choroid at half its height, starting from the apex, and when separating remaining half of GSL, thin network of scleral fibers is left on the choroid, upon reaching limbal zone, strip of trabeculo-Descemet's membrane (TDM) is exposed. GSL is excised at the bottom, leaving nude TDM intact. From the side edges of the PSL with the help of Vanass scissors form strips – scleral autodrainage 0.7–0.8 mm wide, keeping their connection with the PSL at the base. PSL is laid in place and hemmed to the adjacent sclera with two interrupted sutures in distal corners, a cohesive viscoprotector is inserted under it. Thin spatula is placed under PSL, parallel to plane of iris and normal to limbus, propel it through a layer of cohesive viscoprotector towards the base of the PSL. Passing with spatula into front chamber (PC) and shift it in a horizontal direction, destroying the TDM. Spatula is removed from under the PSL. Scleral autodrainage through viscoprotector layer is charged into anterior chamber.
EFFECT: method provides prolongation of hypotensive effect of surgical intervention due to absence of interstitial adhesions not only in the extrascleral and intrascleral areas of the operation, but also of the intraocular part of the fistula free of adhesions.
1 cl, 1 ex
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Authors
Dates
2018-12-25—Published
2018-01-18—Filed