FIELD: medicine, ophthalmology.
SUBSTANCE: cataract extraction is performed with intraocular lens implantation in patients after the second stage of keratoprosthetics. Viscoelastic is introduced, circular capsulorhexis, hydrodissection, hydrodelineation and implantation of an intraocular lens into the capsular bag are performed. The newly formed vessels are coagulated in the projection of the limbus in the area of the planned incisions. Further, in the projection of the limbus at 11 o’clock position, a main incision of 2.2 mm in size and two paracentesis in the projection of the limbus of 1.5 mm in size at 2 and 9 o’clock position, respectively, are made, after which a cohesive viscoelastic is introduced into the anterior chamber, which during the operation as it exits from the anterior chamber is added, replenishing its volume. Then, using collet tweezers, a circular capsulorhexis is performed, the diameter of which corresponds to the diameter of the optical cylinder, that is 3.5 mm. Hydrodissection and hydrodelineation are performed by supplying saline with a flat cannula, after which the lens nucleus is crushed using a phaco needle and cataract phacoemulsification is performed using a sparing regimen: the height of the irrigation tank is 50 cm or less; vacuum less than 100 mm Hg; ultrasound — 80 pulses per minute with a fractional feed and a power of less than 30%. Next, the removal of the epinucleus and residual cortical masses is performed using an irrigation-aspiration system and a Simcoe cannula, after which a cohesive viscoelastic is introduced into the capsular bag and an intraocular lens is implanted into the capsular bag using a manual injector, centered and the residual viscoelastic is washed out, after which all incisions are sealed by placing interrupted sutures.
EFFECT: method allows to reduce the risk of intraoperative complications by maintaining a sealed anterior chamber.
1 cl, 1 ex
