FIELD: medicine.
SUBSTANCE: invention relates to medicine, specifically to ophthalmology. For conducting ultrasonic cross-linking in progressive keratoconus in patients with initial corneal thickness at apex of cone ≤ 400 mcm after deepithelialization, a patient's corneal thickness is measured by intraoperative optical coherence tomography (OCT). Corneal protector solution used is dextralink, which is instilled onto the patient's cornea for 30 minutes. After that, in the course of repeated OCT, the corneal pachymetry is determined in the thinnest place and the protective cornea protective flap thickness is calculated as difference between 400 mcm and the minimum pachymetry value of the patient's cornea according to the repeated OCT data. At that, to obtain a protective flap of a layer of the anterior donor stroma of the native donor cornea, which is resected with a femtolaser, of the required thickness with diameter of 9.4 mm, a donor sclerotic strain disc is used, isolated by means of a femtoscopic laser from a native cadaver's eye, pre-used in parallel to femtoscopic posterior layer keratoplasty or Descemet's membrane transplantation on one operation day. After the femtosecond resection of the native donor corneal stroma layer and obtaining a protective flap, it is separated from the underlying tissues, laid on the patient's corneal surface and centered. That is followed by the control intraoperative OCT of the "patient's cornea - donor cornea stroma flap" complex to confirm the total thickness of at least 400 mcm. Then ultraviolet irradiation is carried out patient procedure through the protective corneal stroma of a donor cornea flap wavelength 370 nm capacity of 9 mW/cm2 for 10 minutes with parallel dextralink instillation every 2 min. After irradiation, a protective flap of donor cornea stroma is removed.
EFFECT: method provides the safe procedure of ultraviolet cross-linking by replenishing the corneal thickness deficiency of the patient to the required value taking into account individual values of patient's thin corneal pachymetry, absence of intra- and postoperative complications, strengthening of strength properties of the cornea, stopping and absence of keratoconus progression in the remote postoperative period.
1 cl, 1 ex
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Authors
Dates
2020-07-30—Published
2019-07-26—Filed