FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to ophthalmology. The corneal graft is cut out and placed in the recipient's bed. At the same time, the required initially specified 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). Cutting out the corneal graft disk by laser cutting is carried out in three stages. First, a disk is cut out along the entire circumference to a thickness of 200 microns according to a given diameter of 7-8.5 mm. Then, in the second stage, a ledge with a diameter of 11-12.5 mm with a rectangular cross section is formed by a planar cut with a thickness of 200 mcm. At the third stage, the end-to-end trepanation of the remaining thickness of the corneal graft disk is completed according to the initially specified diameter, the residual sections of the stroma are separated at the laser cut site, and the formed corneal donor graft is separated from the corneoscleral flap. The formation of the graft bed in the recipient is also performed using a femtolaser. First, a disk is cut out along 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 along the entire circumference, 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 reduces 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 peripheral residual ring of the recipient's cornea.
1 cl, 3 ex, 3 dwg
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Authors
Dates
2022-05-31—Published
2021-10-08—Filed