METHOD OF CATARACT EXTRACTION AND INTRAOCULAR LENS IMPLANTATION DURING SIMULTANEOUS PENETRATING KERATOPLASTY WITH PARTIAL FIXATION OF TREPANNED CORNEA (VERSIONS) Russian patent published in 2023 - IPC A61F9/07 A61F2/16 A61K8/63 A61P27/12 

FIELD: medicine, ophthalmology.

SUBSTANCE: according to the first variant, the recipient's cornea is trepanned, the remaining bridges are dissected with scissors. Extracapsular cataract removal is performed, the donor graft is placed in the recipient's bed and partially fixed to the recipient's cornea remaining after trepanation, leaving a clearance for the passage of the injector with an elastic intraocular lens (IOL). The anterior and posterior chambers are filled with viscoelastic, the IOL is implanted into the capsular bag, the viscoelastic is removed and the graft is fixed. When cutting the remaining bridges, the bridge is kept at 6 o’clock position and a ligature is applied at 12 o’clock position, and if the clouding of the cornea makes it possible to visualize the anterior chamber, the ligature is fixed to the cornea remaining after trepanation (CRAT). The recipient's trepanned cornea (RTC) is fixed at two points, after which mezaton and viscoelastic are injected into the anterior chamber. Next, circular capsulorhexis, hydrodissection, hydrodeletion are performed, phacofragmentation and aspiration of the lens masses are performed using the phaco-tip. All the instruments for the above manipulations are introduced into the anterior chamber through the space between the two fixation points of the RTC and the operation is completed by removing the viscoelastic and fixing the graft to the CRAT. According to the second option, when dissecting the remaining bridges, the bridge is kept at 6 o’clock position and a ligature is applied at 12 o’clock position, and if the corneal opacification is diffuse and makes it impossible to visualize the anterior chamber, the RTC is lifted by the ligature, creating an angle of 40 degrees between the RTC and the iris, to visualize the structures anterior chamber, after which mezaton and viscoelastic are introduced. Next, circular capsulorhexis, hydrodissection, hydrodeletion are performed, phacofragmentation and aspiration of the lens masses are performed using the phaco-tip, all the instruments for the above manipulations are inserted through the space between the elevated RTC and CRAT, and in the absence of intraoperative complications, after cataract extraction, the operation is completed by removing the viscoelastic and fixing the graft to the CRAT.

EFFECT: group of inventions makes it possible to reduce the number of intraoperative complications, in particular, vitreous prolapse, expulsive hemorrhage, trauma to the posterior lens capsule and anterior hyaloid membrane, which is achieved due to the fact that cataract extraction and IOL implantation are performed in the presence of a relatively sealed anterior chamber or it is possible to control the tightness when presence of diffuse corneal opacity.

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