FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to ophthalmology, and can be used for fixation of capsular sac to sclera in congenital defects of ligamentous apparatus of lens. For this purpose, after gripping the ICR technological element, two loops of two threads preliminarily introduced through the main incision into the anterior chamber are put on it, with subsequent arrangement of loops in 2 points in the middle one-third of the ligamentous defect and ectopia of the lens in the area of the future suturing of the complex of the intracapsular ring-capsular sac of ICR-CS. For trans-scleral suture fixation of the ICR-CS complex, double non-resorbable polypropylene sutures with section of 9-0 are used, which are brought out through a ciliary sulcus according to the ab interno technique. Thereafter, the suture is cut, leaving free ends. Further, a needle is placed on the sclera between the ends of the threads of the first knot to adjust the tightening of the knots. Uniform tension of the capsular sac is monitored by intraoperative optical coherence tomography (IOCT) during filament pull-up. Second guide needle with a double suture in the form of a loop, into which the ends of the cut sutures are threaded after knotting, is carried out intrasclera in a parallel manner for 24 mm by sticking the guide needle into the sclera at the suture exit points. Then they are taken out again through the conjunctiva.
EFFECT: invention provides reliable stabilization of the ICR-CS complex, uniform tension of the capsular sac, the possibility of implantation of a posterior chamber IOL, including EDOF and toric, in case of extensive congenital defects of Zinn ligaments with preservation of anatomic-functional relationships of eye structures, possibility of astigmatism correction using complex toric IOLs.
1 cl, 7 dwg, 3 ex
