SURGICAL METHOD FOR SIMULTANEOUS ACTIVATION OF AQUEOUS HUMOUR OUTFLOW TRACTS IN GLAUCOMA Russian patent published in 2022 - IPC A61F9/07 A61F9/08 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely, to ophthalmology. All aqueous humour (AH) outflow tracts in glaucoma are simultaneously activated. The conjunctiva is incised at the limbus, the conjunctiva and the Tenon's shell are separated from the sclera, bipolar diathermocoagulation of the superficial scleral vessels is performed. Then a superficial scleral flap is cut with the base by the limbus, 4×4 mm in size; a deep scleral flap 4×4 mm in size is cut and removed before dissecting the Schlemm's canal (SC), leaving the scleral tissue on top of the ciliary body. The endothelial lining of the SC is removed, 3-scleral strips 3×1 mm in size are formed perpendicular to the limbus. The two lateral scleral strips are removed, exposing the ciliary body; cyclodialysis is performed using a spatula. A collagen drainage is implanted over the central strip parallel to the limbus, the superficial scleral flap and conjunctiva are sutured with interrupted sutures. After the deep scleral flap and the endothelial lining of the SC are removed, four through incisions are made on the remaining deep scleral layers, retreating from the posterior border of the SC by 0.5 mm, perpendicular to the limbus, so as to create three scleral strips. The lateral strips are then removed, exposing the ciliary body, followed by performing cyclodialysis under the central strip and at the sides under the sclera at the edge of the scleral bed using a spatula. A collagen drainage is herein implanted parallel to the limbus so as to be located over the scleral strip, and so the ends thereof are located under the edges of the scleral bed; then, depending on the IOP level, but not earlier than 7 days after the operation, YAG laser trabeculotomy is performed using a YAG laser and a single-mirror gonio lens, and at least one hole is made in the trabecular apparatus in the area of the primary surgical intervention.

EFFECT: possibility of achieving a consistent hypotensive effect, reducing the number of hypotensive products used, reducing the amount of intra- and postoperative complications, and shorten the duration of hospital stay of the patients due to the simultaneous activation of the trabecular and uveoscleral AH outflow tracts, filtration of AH into the subconjunctival space, and possibility of delayed YAG laser trabeculopuncture.

1 cl, 1 ex