FIELD: medicine; ophthalmology.
SUBSTANCE: main operating access from the temporal side and additional paracentesis is formed. After that, phacoemulsification is performed through the main surgical access and an intraocular lens is implanted into the posterior chamber, and a cohesive viscoelastic is introduced into the anterior chamber through paracentesis, descemetorhexis is performed, the viscoelastic is aspirated, the anterior chamber is restored with a balanced saline solution, and the incisions are sealed. Three incisions are made on the endothelium in the region of the Descemet's membrane and tissue bridges are left between the incisions, while the incisions are applied so as to mark a fragment of the Descemet's membrane with a diameter of 7.5–8.5 mm. Then, capsulorhexis is performed, and after phacoemulsification, the main surgical access is performed with a width of 2.5 mm. Then two paracentesis at 90° and 270° are performed through which the residual masses are removed using an aspiration-irrigation system remaining after phacoemulsification, after which an intraocular lens is implanted through the main incision and a cohesive viscoelastic is introduced into the anterior chamber through one of the paracentesis. Three bridges are cut through one of the paracentesis, and the Descemet's membrane is removed through the main access. After that, the cohesive viscoelastic is removed from the anterior chamber through paracentesis. Then, a cartridge for corneal endothelial implantation with donor material is passed through the main surgical access, and the donor corneal graft straightens itself. After that, the instruments are removed and the incisions are sealed with 10-0 interrupted sutures, while the surgical access, paracentesis, descemetorhexis and capsulorhexis are performed using a femtolaser. In a particular case, notches are applied at 110°, and bridges are left 10°.
EFFECT: method allows to increase the accuracy of manipulations and reduce the risk of tissue injury.
1 cl, 5 tbl, 2 ex
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Authors
Dates
2023-08-17—Published
2022-08-24—Filed