METHOD FOR DETERMINING DIFFERENTIATED INDICATIONS FOR SELECTING METHOD OF TREATING PROGRESSIVE KERATOCONUS USING FEMTOSECOND LASER Russian patent published in 2019 - IPC A61F9/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmology, and can be used for determining differentiated indications for selecting a method of treating progressive keratoconus using a femtosecond laser. In progressing keratoconus of stages I-III, with central arrangement of its apex and minimum thickness of cornea more than 400 mcm, patient's satisfaction with spectacle or contact correction is transopithelial intrastromal cross-linking with formation of intrastromal pocket by means of femtosecond laser with diameter of 9.0 mm at depth of 150–300 mcm, passing through the central optical zone of the cornea. If the keratoconus vertex is located in a peripheral position, local circular cross-linking is performed with the help of the FSL of an intra-gastric tunnel with an internal diameter of 4.0–5.0 mm and an external diameter of 8.0–9.0 mm at depth of 150–300 mcm. In progressing keratoconus I-III stage and intolerance of spectacle and contact correction in patients with a minimum corneal thickness of more than 400 mcm, Ksr less than 56.0 D, implantation of intrastromal segments or MyoRing rings by technology with an intrastromal pocket diameter of 8.0 mm, depth of location - 85 % of minimum thickness of cornea with application of FSL. If the cornea has a minimum thickness of more than 400 mcm and Ksr is more than 56.0 D and (or) secondary and high degree myopia is present, only MyoRing rings are implanted according to the technique with an intra-stromal pocket diameter of 8.0 mm, depth of 85 % of the minimum thickness of the cornea using FSL. If progressing keratoconus II-III stage and intolerance of spectacle and contact correction in patients with a minimum corneal thickness of 400 to 350 mcm, Ksr more than 56.0 D, implantation of MyoRing rings by technology with an intra-stromal pocket diameter of 8.0 mm, depth of location - 85 % of minimum thickness of cornea with application of FSL. If the cornea has a minimum thickness of less than 350 mcm and no stroma opacity, deep anterior keratoplasty is performed using the FSL. In keratoconus IV stage - through keratoplasty with application of FSL.

EFFECT: method provides reducing the risk of intra- and postoperative complications, achieving high functional results, reducing the length of patient rehabilitation and improving quality of life by assessing the complex of the most significant parameters.

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