METHOD OF THE TREATMENT OF COMBINED PATHOLOGY OF THE EARLY STAGE OF PRIMARY ENDOTHELIAL DYSTROPHY OF THE CORNEA FUCHS AND CATARACTS WITH FEMTOLASER SUPPORT Russian patent published in 2023 - IPC A61F9/07 A61F9/08 A61F2/16 

FIELD: medicine; ophthalmology.

SUBSTANCE: main surgical access is formed from the temporal side and additional paracentesis, after which phacoemulsification is performed through the main surgical access and an intraocular lens is implanted into the posterior chamber. Through paracentesis, a cohesive viscoelastic is introduced into the anterior chamber, descemetorhexis is performed, the viscoelastic is aspirated, the anterior chamber is restored with a balanced saline solution, and the incisions are sealed. At the same time, three notches are first applied to the endothelium in the region of the Descemet's membrane and tissue bridges are left between the notches. Notches are applied in such a way as to mark a fragment of the Descemet's membrane with a diameter of 7.5–8.5 mm, capsulorhexis is performed, phacofragmentation is performed and the main surgical access is formed 2.5 mm wide from the temporal side. Then two paracentesis are performed at 90° and 270° each 1.2 mm wide, after which phacoemulsification is carried out through the main incision and an intraocular lens is implanted, a cohesive viscoelastic is introduced into the anterior chamber through one of the paracentesis, and three bridges are cut through one of the paracentesis and the Descemet's membrane is removed through the main access. After that, the main surgical access is expanded to 4 mm, the cohesive viscoelastic is removed from the anterior chamber through paracentesis, an additional paracentesis is performed by 180° and a collet forceps is inserted through it, which is removed through the main surgical access, the donor endothelial material is captured and implanted into the anterior chamber, which is subsequently fixed to the cornea with air, the volume of the anterior chamber during implantation of the material is maintained using a catheter of the irrigation system inserted through paracentesis at 90° and 270°. The incisions are sealed with 10-0 interrupted sutures, while surgical access, paracentesis, descemetorhexis, phacofragmentation and capsulorhexis are performed simultaneously 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.

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