METHOD FOR FEMTOSECOND PENETRATING KERATOPLASTY IN PATIENTS WITH KERATECTASIA WITH SIGNIFICANT THINNING OF THE CORNEAL PERIPHERY Russian patent published in 2022 - IPC A61F9/07 A61F9/08 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ophthalmology. The corneal graft is cut out and placed in the recipient's bed. Preliminarily, the required primary diameter of the main part of the graft is determined in the recipient - 7-8.5 mm, the corneoscleral flap is placed in the artificial anterior chamber of the Ziemer LDV Z8 femtosecond laser (Switzerland), the corneal graft disk is cut out by laser cutting in stages. First, the disk is cut out along a circular arc for the entire thickness of the graft over 180 angular degrees along a given radius of 3.5-4.25 mm. The rest of the graft along the arc of a circle over 180 angular degrees is formed in three steps. First, a disk is cut to a thickness of 200 µm along the same given radius. Then, in the second stage, a protrusion with a radius of 5.5-6.25 mm is formed by a planar cut with a thickness of 200 microns. At the third stage, the end-to-end trepanation of the remaining thickness of the corneal graft disk is completed along the initially specified radius, the residual sections of the stroma are separated at the site of the laser cut, and the formed corneal donor graft is separated from the corneoscleral flap. The formation of the transplant bed in the recipient is also carried out using a femtolaser. First, a disk is cut out around the entire circumference for the entire thickness of the recipient's cornea with a diameter of 7-8.5 mm. Then, by a circular planar cut in the residual peripheral ring of the recipient's cornea, a tunnel is formed in the zone of its maximum thinning from 3 to 9 hours, along a circular arc of 180 angular degrees, congruent to the cut protrusion of the graft, to a depth of 200 mcm from the anterior epithelium, 2 mm towards the limbus. The cut corneal disk of the recipient is separated from the residual sections of the stroma and the formed tunnel is opened. After that, the graft is placed in the recipient's bed in such a way that its protrusion is inserted into the tunnel of the recipient's corneal ring. The operation ends with the imposition of a continuous suture or interrupted sutures.

EFFECT: method provides reducing the frequency of such complications as progressive thinning of the recipient's residual cornea periphery, as well as incongruent comparison of the tissues of the donor's corneal graft and the recipient's peripheral residual ring of the cornea.

1 cl, 3 ex, 3 dwg