FIELD: medicine; ophthalmology.
SUBSTANCE: reconstruction of the epithelial layer of the cornea is performed in patients with limbal insufficiency syndrome. A 360-degree peritomy of the conjunctiva is performed, exfoliating it by 5–10 mm from the limbus, excision of the fibrovascular pannus from the surface of the cornea of the affected eye is carried out. Then the vacuum ring is fixed with the head of the femtosecond laser. Next, the cornea is scanned using the optical coherence tomography laser built into the handle, the location, depth and configuration of the incisions are specified. Then the laser is activated and 8–10 tangentially or radially located corneal tunnels are performed. Next, the grafts are implanted into the resulting tunnels, followed by the application of the amniotic membrane and its fixation with sutures outside the limbus. In patients with bilateral SLN, a rectangular fragment of the mucosa from the lip or cheek 5–10 mm long, 2–3 mm wide and 0.5 mm thick is used as an autograft. The length of the vertical part of each tunnel is 1.0 mm, the length of the inclined part is 300–1,000 µm, the depth of the tunnel is 250–500 µm. When forming each tunnel with a laser, first a vertical cut is made, perpendicular to the surface of the cornea, and then an oblique cut at an angle of 10–15 degrees to a plane parallel to the aligned surface of the cornea.
EFFECT: method allows to reduce the number of intraoperative complications, restore the epithelial layer of the cornea, reduce subjective complaints, disability and improve the patient's quality of life.
1 cl, 3 ex, 1 dwg
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METHOD FOR RECONSTRUCTION OF THE CORNEAL EPITHELIUM IN THE SYNDROME OF LIMBAL INSUFFICIENCY BY SIMULTANEOUS FEMTOLASER-ASSISTED ANTERIOR LAYERED KERATOPLASTY AND TRANSPLANTATION OF LIMBUS FRAGMENTS | 2021 |
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Authors
Dates
2023-08-09—Published
2023-04-21—Filed