FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to ophthalmology. The main corneal incision is made, capsulorhexis (CC), through the incision with the help of an injector, the first polymeric open intracapsular ring (ICR) with a thread is introduced into the capsular bag, at the opposite end of which there is a curved needle (CN). The thread is brought to the outer surface of the sclera through the ciliary sulcus, the capsular sac is centered, the thread is fixed intrasclerally, then the second polymeric open ICC with the thread is implanted into the capsular sac through the main corneal incision, the thread is brought to the surface, similarly to the first ICR. After that, hydrodissection and hydrodelianesis of the lens are performed, cataract phacoemulsification and intraocular lens implantation are carried out. In this case, two identical polymeric ophthalmic ICRs are implanted with a size of 11, or 12, or 13 mm. After performing the main incision and two paracentesis, CC is performed, four additional corneal paracentesis are performed, each of which is equipped with one iridocapsular retractor (ICRr). After removing the lens masses, the capsular bag is filled with a viscoelastic preparation. Then two ICRrs located in the most unstable areas of the ligamentous apparatus of the lens are removed. After that, the end of the thread with CN is cut off, this end is threaded through one of the holes located in the loop of the first ICR, the end of the thread is melted with a thermal cauter until a flange is formed, the size exceeding the hole in the loop of this ICR. After that, this ICR is inserted into the injector so that the loop with the flange is located at the entrance to the injector cavity. Next, this ICR is implanted into the capsular bag in such a way that the loops are located in the most incompetent region of the ligamentous apparatus of the lens. At the same time, the polypropylene thread is left in the main corneal incision, this thread is removed with a hook in the area of the lower paracentesis for calf, forming a loop from the outside. In this case, the end of the thread is left in the anterior chamber. At the next stage, a scleral tunnel is formed in 1/3 of the zone of insolvency of the ligamentous apparatus using a 90° bent needle 27-30G. In this case, the injection is made 2 mm from the limbus, then the needle is passed under the iris into the capsular bag, the second end of the thread is inserted into the needle cavity with the help of microsurgical tweezers and the thread is brought out from the inside out through the sclera. Next, the thread is tightened so that the capsular bag is centered, the thread is cut, leaving 2 mm, and the end of the thread is melted with a thermal cautery, forming a flange, its shape is changed to a “nail head” using microsurgical tweezers, and immersed in the scleral tunnel. Next, the remaining calfs are removed, the second ICR is implanted, a scleral tunnel is formed in 3/3 of the incompetence of the ligamentous apparatus, similarly to the first ICR, the ring is fixed intrasclerally in the region of the ciliary sulcus using a polypropylene thread, passed from the inside outwards with a 27-30G needle bent at 90°.
EFFECT: method enables stabilization of the "IOL-capsular bag" complex in case of violation of the integrity of the ligamentous apparatus of the lens based on the use of a polymeric ophthalmic I ICR CC in cataract surgery.
1 cl, 7 dwg, 3 ex
