METHOD FOR MICROINVASIVE SURGICAL TREATMENT OF RETINAL DETACHMENT RECURRENCE USING RETINOTOMY AND REPEATED TAMPONADE OF THE VITREAL CAVITY Russian patent published in 2021 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to ophthalmology. A seamless transconjunctival access to the vitreal cavity is performed, the vitreal cavity is revised, a dye is injected to contrast the epiretinal membranes and vitreous remains, and the retina is diathermocoagulated. Retinotomy, aspiration of subretinal fluid, endolaser coagulation of the retina are performed. Repeated tamponade of the vitreal cavity is carried out with silicone oil (SO). At the same time, under local anesthesia, scleral ports with a length of 3.6 mm and a diameter of 0.33 mm are installed through the conjunctiva in the upper-outer, upper-inner and lower-outer segments of the eyeball, retreating from the limb of 3.5 mm, using trocars with a diameter of 0.33 mm through the conjunctiva, respectively. A cannula is installed in the port located in the lower-outer segment to provide irrigation with a balanced saline solution (BSS). At the 6 o’clock point, an additional port is installed for installing a 29 G chandelier in it. In the case of tamponade of the vitreal cavity with SO, it is removed using an endo-illuminator and active aspiration. And if the eye is avitreal, then an audit and evaluation of the vitreal cavity is carried out with the help of a vitreotome and an endo-illuminator. Then, using a cannula, the memraneblue-dual dye is injected into the vitreal cavity in an amount of 0.1 ml. Next, a perfluororganic compound (PFC) in an amount of 1-2 ml is injected into the vitreal cavity through one of the free ports. Simultaneously, aspirating the BSS through another free port, the internal boundary membrane is removed and a bimanual retinotomy is performed using a diathermo coagulator, vitreotome, scissors and tweezers. Next, PFC is brought to the edge of retinotomy, endolaser coagulation of the retinal periphery is performed, as well as restrictive endolaser coagulation of ruptures, zones of chorioretinal dystrophic foci and a retinotomy zone with the capture of completely adjacent healthy retinal tissue in the retinotomy area. PFC is replaced with air, repeated tamponade is performed by introducing 5700 cst SO into the vitreal cavity.

EFFECT: method makes it possible to achieve the highest possible visual functions in the postoperative period, reduce the risk of macular edema, shorten the operation time.

1 cl, 3 ex