METHOD FOR COMBINED TREATMENT OF SECONDARY NEOVASCULAR GLAUCOMA Russian patent published in 2022 - IPC A61F9/07 A61F9/08 A61K39/395 A61P27/02 A61F2/04 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ophthalmology. The anti-VEGF drug ranibizumab is injected into the anterior chamber before the proposed operation. 10 days after the administration of the drug in the upper temporal quadrant of the eyeball, free from previous operations, at the site of the proposed implantation of the drainage tube, sectoral iridoplasty is performed - with a laser with a power of 850 mW, a wavelength of 532 nm, a spot diameter of 100 μm along an arc of a circle 30 angular degrees cause 35 appliques. Next, the Ahmed drainage model FP7 is implanted - a conjunctival incision is made at 12 o'clock along the normal to the limbus 4 mm long, then the incision is continued along the limbus 10 mm long in the upper temporal zone and the conjunctiva is separated, exposing the scleral zone. Then the drainage is activated by introducing a syringe with a 27 G cannula into the drainage tube, followed by the supply of physiological saline into the drainage under pressure. After that, viscoelastic "Provisk" is introduced into the drainage until the viscoelastic comes out from the opposite side. Then the drainage body is sutured with a thread 9-10 mm from the limbus with two interrupted sutures behind the holes in the drainage body, coagulation of the scleral vessels is carried out in the area free from previous surgical interventions, and a scleral flap is cut out with the base to the limbus measuring 4×4 mm in half the thickness of the sclera. Next, a part of the drainage tube is measured, equal to 2.0 mm from the limbus into the anterior chamber, and the tube is cut at an angle of 30 degrees. After that, paracentesis is formed at 6 o’clock, then under the scleral flap, retreating 2 mm from the limbus, a 23 G needle is punctured into the anterior chamber parallel to the iris and 0.2 ml of Provisk viscoelastic is injected, creating ophthalmohypertension equal to preoperative IOP, which is determined by palpation, and implant the drainage tube into the anterior chamber so that the opening of the distal end of the tube with the cut end faces the cornea. After implantation, the tube is covered with a scleral flap and sutured to the sclera with three interrupted sutures; the operation is completed by sealing the conjunctiva.

EFFECT: method allows preserving visual functions, reducing or eliminating further neovascularization and fibroplastic activity, reducing the likelihood of intraoperative bleeding during antiglaucoma surgery, maintaining an optimal level of intraocular pressure in the early and late postoperative period.

1 cl, 2 ex