FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to ophthalmology. After performing the main incisions, a dispersive viscoelastic in an amount of 0.1-0.2 ml is injected into the center of the anterior chamber. Further, under the iris, in the direction of the groove of the ciliary body, directly above the Zinn ligament over 360 angular degrees, in three injections, 0.2-0.3 ml each. Once again, the dispersive viscoelastic is introduced into the anterior chamber, while filling its entire volume. Then, the anterior capsule of the lens is opened by the method of continuous circular capsulorhexis. Next, hydrodissection and hydrodelineation of the lens are carried out. Phacoemulsification of cataract is performed. Moreover, if at least one of the following signs of intraoperative irrigation flow deviation syndrome (IIFDS) is noted visually: Prolapse of the posterior capsule of the lens anteriorly or its excessive excursion under the influence of irrigation flow of a balanced saline solution, decrease in the volume of the anterior chamber and/or using intraoperative optical computed tomography (iOCT): complete or partial detachment of the anterior hyaloid membrane of the vitreous body, the presence of microparticles of the lens on its surface and in Berger's space, then proceed to its relief. To do this, a cohesive viscoelastic is introduced into the capsule bag, moving the cannula from the center to the periphery. The entire volume of the capsule bag is filled, dispersed viscoelastic is once again injected under the iris, in the direction of the groove of the ciliary body, directly above the Zinn ligament and above the iris over 360 angular degrees, in three injections, 0.2-0.3 ml each. Then the IOL is implanted intracapsularly, cohesive and dispersive viscoelastics are evacuated from the capsule bag and the anterior chamber, and the operation is completed by sealing the incisions. In the event that none of the signs of IIFDS is noted, both visually and with the help of iOCT, then the IOL is implanted intracapsularly, cohesive and dispersive viscoelastics are evacuated from the capsule bag and the anterior chamber, and the operation is completed by sealing the incisions. In a particular case, with defects of the ligamentous apparatus of the lens up to 90 angular degrees and phacodonese, revealed intraoperatively visually, after removing the nucleus of the lens and replacing the phaco tip with irrigation-aspiration tips, a dispersive viscoelastic is introduced under the iris, in the direction of the groove of the ciliary body, directly above the Zinn ligament defect in one injection in the amount of 0.2-0.3 ml. In a particular case, defects of the ligamentous apparatus of the lens with a length of 90 to 180 angular degrees and phacodonese, revealed intraoperatively visually, after removing the nucleus of the lens and replacing the phaco tip with irrigation-aspiration tips, an intracapsular ring and a dispersive viscoelastic are introduced under the iris, in the direction of the groove of the ciliary body, directly Zinn ligament in the defect zone in two injections in the amount of 0.2-0.3 ml for each.
EFFECT: the method allows reducing the risk of operational and postoperative complications.
3 cl, 6 ex
