FIELD: ophthalmology.
SUBSTANCE: invention relates to medicine, namely to ophthalmology. The formation of corneal paracentesis is carried out and the IOL is sutured through the flat part of the ciliary body. Previously, 2.5 mm from the limbus, diametrically opposite, two through punctures of the sclera and ciliary body are made in the projection of the haptic elements with a needle. Accordingly, one limbal corneal paracentesis is formed above the puncture sites and two more diametrically located limbal corneal paracentesis are formed in the perpendicular meridian. Through one of the scleral punctures - the first puncture - a needle with a thread in the form of a loop is passed with the back part forward over the IOL, without touching it. Then the back of the needle is taken out through the paracentesis of the cornea, located at 90 angular degrees from the first puncture. After that, a guide needle is inserted into the first puncture under the IOL-capsular bag complex, in the region of the near haptic element, and the IOL is centered. The cutting part of the needle with the thread is passed through the guide needle and brought out through the first puncture. Then a “noose” loop is formed from the outside, which is tightened on the IOL haptic element, the needle with the thread is injected into the first puncture and passed intrasclerally and intracorneally through both lips of the paracentesis closest to this puncture, the needle with the thread with the back side is removed from the paracentesis to the outside, an “anchor” knot is formed, the rest of the thread with the needle is cut off, and the knot is immersed in paracentesis, the same surgical actions are performed on the opposite side through the second scleral puncture. At the same time, punctures of the sclera and ciliary body in the projection of the haptic elements are performed with a 29 G needle. After the formation of the “noose” loop and before it is tightened, at the base of one of the haptic elements of the IOL, perpendicular to its lateral side, a notch is made with endovitreal scissors for 1/3 of the width of the base this element. The “noose” loop is pulled and immersed in the notch, the same actions are performed on the opposite side, with another haptic element.
EFFECT: method makes it possible to stably fix the IOL in the area of the flat part of the ciliary body, achieve a stable anatomical and functional result, reduce the risks of postoperative complications, prevent the need for repeated surgical interventions, and eliminate the need to replace the IOL during surgery.
1 cl, 1 ex
