FIELD: medicine; ophthalmology.
SUBSTANCE: optical coherence tomography (OCT) of retinal degeneration, photorecording of the retina using scanning laser ophthalmoscopy on a navigation laser unit (NLU) Navilas 577s, installation of safety zones on the fundus image in the area of the optic nerve, macular zone and laser coagulation with application of laser coagulates in 3-5 rows around the degeneration close to each other. Ultrasound biomicroscopy (UBM) is preliminarily performed, during wide-field OCT and UBM retinal degeneration is specifically visualized, localized, and evaluated according to the following parameters: retinal thickness in the area of degeneration and unchanged adjacent retina, localization of thinning zones, areas of hyperpigmentation, presence of vitreoretinal fusion and traction, through and non-through retinal tears, local retinal detachment; and after maximum medicinal mydriasis and epibulbar anaesthesia, a VOLK Super Quad 160 degree contact laser lens is installed on the eye and a fundus photograph is taken on the Navilas 577s NLU. Then, in accordance with the drawn up plan, laser coagulates are applied to the fundus in 3-5 rows close to each other in a checkerboard pattern around the degeneration with the following parameters: power 100-200 mW, spot diameter 200-400 mcm, exposure 0.1-0.2 s. Then, after 10-14 days, if the thickness of the retina in the zone of thinning is more than half the thickness of the intact retina, in the absence of through retinal breaks, in the absence of areas of hyperpigmentation, in the absence of local retinal detachment, in the presence of vitreoretinal fusion along the edge of degeneration without traction, the degeneration zone in the image is covered with patterns consisting of 3-5 applicates located at a distance of two diameters from each other in a checkerboard pattern. Then, using the eraser function, the treatment plan is adjusted so that the adjacent retinal vessels are not affected, then, in accordance with the drawn up plan, laser coagulates are applied to the fundus of the eye with the following parameters: power 80-150 mW, spot diameter 200-400 mcm, exposure 0.05-0.1 s. According to the second variant of the invention, ultrasound biomicroscopy (UBM) is preliminarily performed, while during wide-field OCT and UBM, retinal degeneration is visualized, localized, and assessed according to the following parameters: the thickness of the retina in the area of degeneration and the unchanged adjacent retina, localization of thinning zones, the presence vitreoretinal fusion and traction, through and non-through retinal tears, areas of hyperpigmentation, local retinal detachment; and after maximum medicinal mydriasis and epibulbar anaesthesia, a VOLK Super Quad 160 degree contact laser lens is installed on the eye and a fundus photograph is taken on the Navilas 577s NLU. Then, in accordance with the drawn up plan, laser coagulants are applied to the fundus of the eye in 3-5 rows close to each other in a checkerboard pattern around the degeneration; with the following parameters: power 100-200 mW, spot diameter 200-400 mcm, exposure 0.1-0.2 s. Then, after 10-14 days, if the thickness of the retina in the zone of thinning is less than half the thickness of the intact retina, in the presence of through or non-through retinal breaks, the presence of areas of hyperpigmentation, vitreoretinal adhesions along the edge of degeneration with traction in this area, single applications are placed on the image along the degeneration zone without affecting the adjacent retinal vessels, areas of hyperpigmentation, breaks and areas of thinning of the retina. Then, in accordance with the drawn up plan, laser coagulates are applied to the fundus with the following parameters: power 80-150 mW, spot diameter 200-400 mcm, exposure 0.05-0.1 s, number of laser coagulates 10-50.
EFFECT: group of inventions makes it possible to restore a differential approach to the treatment of peripheral rhegmatogenous retinal degenerations, create strong chorioretinal adhesions during preventive laser coagulation, strengthen and stabilize the retina in the correct anatomical position, prevent the progression of degeneration, reduce the risk of complications, increase the safety of the procedure, minimize pain and discomfort during operations.
2 cl, 4 ex
