METHOD OF SUTURING COMPLEX INTRAOCULAR LENS - CAPSULAR SAC TO IRIS WITHOUT CAPSULAR SAC PUNCTURES Russian patent published in 2025 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmology, and can be used to attach an intraocular lens-capsular sac (IOL-CS) complex to an iris during ophthalmic operations in cases of complex dislocation. That is ensured by forming corneal paracenteses within the upper and lower haptic elements of the IOL: at 4 o'clock, 6 o'clock, 8 o'clock, and also at 2 o'clock, 12 o'clock, 10 o'clock so that they are directed towards the assembly fixing the IOL-capsular sac complex in a plane parallel to the iris. Mydriatic solution with an anaesthetic is introduced into the anterior chamber and filled with viscoelastic. Viscoelastic is also introduced into the capsular sac under the IOL. Further, holding the IOL-CS complex with the capsulorhexis forceps, it is repositioned to the required position; the IOL-CS complex is fixed starting from the lower haptic element. That is ensured by introducing a needle with a filament of polypropylene 10-00 into an anterior chamber through paracentesis at 8 o'clock. Iris is punctured on right at 1.5-2.0 mm from the edge of pupil and 2 mm away from the projection on the iris of the lower haptic element of the IOL. Needle end is brought out to the edge of the capsulorhexis, bypassing the edge of the anterior capsule of the lens, passing under the base of the haptic element of the IOL and brought out from its opposite side. Further, in the reverse order: bypassing the edge of the capsulorhexis, the needle is used to puncture the iris from its inner side, mirroring the puncture point. Needle is brought out through the corneal paracentesis at 4 o'clock. Suture is pulled so that its free end comes out of the paracentesis. Suture end with the needle is cut at 15 mm from the paracentesis exit point. With the help of the IOL centring hook introduced into the anterior chamber through paracentesis at 6 o'clock, the threads are alternately picked up on both sides of the iris pricks and removed from the eye through paracentesis at 6 o'clock. Similar manipulations are performed to suture the upper haptic element to the iris. If the size of the capsulorhexis does not provide free access of the needle to the junction of the haptic and optical parts of the IOL, it is dilated in this area so that the anterior capsule of the lens does not overlap the junction of the optical and haptic portions of the IOL. Preliminary, vitreal scissors are used to incise a capsulorhexis edge. IOL-CS complex is centred, after which the myotic is introduced into the anterior chamber. Then, starting from below, a triple knot is formed in turn on each side of the withdrawn threads, which is tightened until its immersion into the paracentesis. After that, the formed suture is straightened in the anterior chamber with a spatula, wherein the assembly moves from the paracentesis to the anterior chamber. Basal colobomas are made with a vitreous cutter at 3 o'clock and 9 o'clock.

EFFECT: invention provides reliable fixation of the IOL-CS complex, reduced risk of capsular sac rupture, easier access to the second haptic element of the IOL during its fixation.

2 cl, 2 ex