Method for surgical management of open-angle glaucoma in patients with pseudophakia

FIELD: medicine.

SUBSTANCE: for complex treatment of glaucoma with Ex-PRESS shunt, drainage "Glautex" is implanted under the superficial scleral flap over the shunt cap. A square flap of scleroplastic material with a size of 33 mm, and thickness, commensurate with the thickness of the superficial scleral flap is laid on a superficial scleral flap. A continuous suture is applied on the conjunctiva over the square flap of scleroplastic material.

EFFECT: method improves the effectiveness of surgical treatment of secondary and primary open-angle glaucoma in patients with pseudophakia, by reducing postoperative complications such as teething and divergence of the conjunctival suture, reducing the risk of the metal Ex-PRESS shunt exposure in the long-term postoperative period, and achieving a prolonged hypotensive effect in the postoperative period.

2 ex

 



 

Same patents:

FIELD: medicine.

SUBSTANCE: implant layers are presented in the form of congruent ellipsoids of rotation consisting of polymers and/or copolymers of glycosaminoglycans, lactic acid and polyvinylpyrrolidone; all drug-saturated layers are alternated with drug-unsaturated layers, while solubility of each implant layer is provided by hydrolysis of cross linkage and directly proportional to their number.

EFFECT: achieving and maintaining the required drug concentration in the vitreal cavity for the required period of time, no risk of damaging the intraocular structures with high-concentrated drug substances, reducing the intraoperative injury.

2 cl

FIELD: medicine.

SUBSTANCE: implant for the revascularisation of a posterior pole of eyeball is a porous composite of polyethylene tetraphthalate or polycarbonate track-etched membranes with the improved medical-biological properties. Improving the medical-biological properties of the track-etched membranes requires additional plasma processing of cyclohexane.

EFFECT: using the given implant enables improving the trophism and mechanical properties of the sclera in the posterior pole of the eyeball that prevents an optic nerve disorder.

2 dwg, 3 ex

FIELD: medicine.

SUBSTANCE: invention can be used for performing a goniopuncture of trabeculo-Descemet's membrane following a non-penetrating deep sclerectomy (NPDS) if observing disturbed transparency of a cornea or fluid flow of an anterior chamber. The trabeculo-Descemet's membrane is micro-perforated from an angle of the anterior chamber within a projection of a postoperative intrascleral cavity by means of a non-traumatic boomerang needle 10-0, needle bend 3/8. The needle is pricked into the cornea at 3-3.5 mm from a limb with its distal end delivered towards an opened portion of the Descemet's membrane. A needle tip is brought through the cornea and further and advanced along a trajectory aligned with its flexion; the needle tip perforates the trabeculo-Descemet's membrane.

EFFECT: method enables achieving the stable normalisation of intraocular pressure following a minimum surgical intervention.

1 ex

FIELD: medicine.

SUBSTANCE: nasolachrymal canal is intubated with a perforated silicone tube with a hole diameter 23G; the holes are staggered at 3 or 4 mm from each other. A distal end of the tube is blocked, whereas a proximal one is fixed in a projection of semilunar fold. A medicinal gel is introduced into a tube lumen every 7 days during the whole period of intubation - up to 3 months.

EFFECT: method provides the prolonged dilation of the lumen of the lachrymal passages and a possibility of the dosed administration of a medicinal preparation around a silicone frame for a long period of time and the recovery of the lachrymal passages patency, and the prevention of recurrent stricture formation, and the lower injury rate.

2 ex

FIELD: medicine.

SUBSTANCE: method involves removing an epithelial layer, exposing a cornea by saturating it through multiple instillations of 0.1% riboflavin followed by the ultraviolet exposure. After the epithelial layer has been removed, a ring made of an ultraviolet-protected contact lens is applied on a surface of the eyeball perilimbally. An outer diameter of the ring covers the limb by no more than 2 mm, whereas an inner diameter of the ring is equal to a basic diameter of the keratoconus. The whole duration of the ultraviolet exposure involves additional instillations of riboflavin on the cornea every 3-4 minutes. The exposure is characterised by wavelength 365 nm, power 3.0 mWt/cm2 at 50 mm for 30 minutes with the ring to be removed after the exposure is completed.

EFFECT: method is easy to implement, involves no difficulties for specialists, providing higher clinical effectiveness by limiting the ultraviolet exposure area, preventing the ultraviolet involvement of the limb and reducing a risk of postoperative complications.

1 ex

FIELD: medicine.

SUBSTANCE: group of inventions refers to surgery. A surgical console comprises a pneumatically operated valve; the first port and the second port connected to the valve configured to feed compressed gas into each of the first port and the second port alternatively; a pressure sensor connected to the ports; and a controller connected to the valve and pressure sensor. The controller is configured to control the time of open and closed state of a valve passage in accordance with the working cycle of the valve. The time of the open state of the valve corresponds to the first port open time, whereas the time of the close state of the valve corresponds to the first port close time. The controller is also configured to receive a measured port pressure differential and to calculate the port pressure differential in accordance with the pressure sensor data, and to modify the working cycle of the valve depending on the difference of the measured or calculated pressure differential and the desired mean pressure differential for reducing a difference of these values. What is disclosed is a method for the valve adjustment.

EFFECT: maintaining the pressure required for the correct operation of the attached instruments.

19 cl, 6 dwg

FIELD: medicine.

SUBSTANCE: conjunctival flap is formed. Surface sclera and deep triangular flaps are formed with base to limbus with exposure of ciliary body. 2 scleral channels are formed on each side of triangular flap, perpendicular to them. External end of sclera channels must project beyond bed of surface sclera flap. Two collagen drainages "xenoplast" 0.8-1.2 mm thick, 1.0-1.5 mm wide, 4.0-5.0 mm long, are sutured to formed sclera bed. Length of collagen drainages must not exceed length of sclera flap. Anterior eye chamber is opened by cut along limbus. Iridectomy is performed. Anterior chamber is fully filled with viscoelastic. Ends of two drainages are introduced into anterior chamber, with formation of window in trabeculo-Descemet's membrane. Root of iris must not overlap ends of drainages. Surface sclera flap is laid into place and fixed with sutures.

EFFECT: method provides activation of intraocular fluid outflow for long term, formation of flat spilled filtration pillow with strong wall, prevention of scarring of created pathways for outflow without application of antimethabolites due to formation of sclera channels, external end of which lies beyond bed of surface sclera flap, application of collagen drainages without their overlapping by iris root and length which does not exceed length of scleral flap.

4 cl, 2 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ophthalmology, and can be used for the removal of silicone oil from the anterior eye chamber. 2 paracenteses are performed. An irrigation cannula of the phacoemulsifier is introduced into one of the paracenteses. Supply of physiological solution is realised. Removal of silicone takes place passively (by gravity) through the second paracentesis.

EFFECT: method makes it possible to remove silicone oil form the anterior eye chamber in a reliable way with low trauma due to the uniform, without differences in pressure, supply of physiological solution by means of an irrigation system and passive removal of silicone oil through the paracentesis.

1 ex

FIELD: medicine.

SUBSTANCE: simultaneous formation of tunnel and installation of lacoprosthesis are carried out. For this purpose disposable intravenous catheter of 20G calibre with guide needle inside, preliminarily modernised, namely by cutting off vanes case, is used. Remaining flexible catheter in form of cylindrical tube is used as lacoprosthesis with placement of guide needle inside it and providing 1.5-2.0 mm protrusion of needle beyond distal end of lacoprosthesis during work. Tunnel formation is realised by puncturing soft tissues with guide needle with access to lachrymal bone. After that, lachrymal bone is punctured under endoscopic endonasal control with further movement of needle with lacoprosthesis into nasal cavity. After that, guide needle is brought out, lacoprosthesis is lowered into common nasal meatus until proximal end of lacoprosthesis, formed in form of "hat" is installed into zone of internal angle of optic fissure.

EFFECT: method makes it possible to create reliably working lachrymal passage with application of permanent lacoprosthesis.

3 cl, 3 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to ophthalmic surgery and concerns intraoperative intraocular pressure regulation (IPR). That is ensured by using a microsurgical system comprising a surgical cartridge, a surgical unit and a computer. The cartridge comprises an infusion chamber containing an irrigation fluid. The pressure is generated and maintained in the microsurgical system by a pressure generator hydraulically connected to the above surgical cartridge and comprising a compressed gas source. The device also comprises an electromagnetic proportional valve and a gas line hydraulically connecting the compressed gas source, proportional valve and surgical cartridge. The surgical unit gets hydraulically connected to the surgical cartridge by an infusion fluid line. The required IPR is specified. The pressure is maintained in the above infusion chamber by gas pressure-fed from the above compressed gas source into the surgical cartridge. The irrigation fluid is supplied into the surgical unit in the infusion fluid line. The irrigation fluid flow is measured in the infusion fluid line; a signal corresponding to the measured irrigation fluid flow is injected into the computer. The estimate IOP is calculated in the computer in response to the received signal. The computer is used to regulate compressed gas pressure by injecting the second signal from the computer onto the proportional valve to maintain the estimate IOP equal to the required IOP.

EFFECT: method provides the IOP regulation, including the compensation function that reduces potential intraoperative hypotension and secondary complications.

2 cl, 4 dwg

FIELD: chemistry.

SUBSTANCE: invention represents a copolymer material for an ophthalmic device produced by polymerising a mixture of arylacryl hydrophobic monomer, silicone macromer, hydrophilic monomer, cross-linking monomer, reactive UV-absorbers and a substance specified in a group consisting of 2-ethylhexylacrylate and n-octylacrylate. The equilibrium water content at 35C in the copolymer material makes at least 4%. The invention also refers to an intraocular lens containing the above copolymer material.

EFFECT: copolymer material is transparent, has low adhesiveness, low surface scattering and good setting experiments.

19 cl, 6 ex, 6 tbl

FIELD: medicine.

SUBSTANCE: implant layers are presented in the form of congruent ellipsoids of rotation consisting of polymers and/or copolymers of glycosaminoglycans, lactic acid and polyvinylpyrrolidone; all drug-saturated layers are alternated with drug-unsaturated layers, while solubility of each implant layer is provided by hydrolysis of cross linkage and directly proportional to their number.

EFFECT: achieving and maintaining the required drug concentration in the vitreal cavity for the required period of time, no risk of damaging the intraocular structures with high-concentrated drug substances, reducing the intraoperative injury.

2 cl

FIELD: physics, optics.

SUBSTANCE: correcting optical lens, adapted to move together with the eye of the user and change the refracting power thereof, comprises a first radial optical area having a first refracting power which, coupled with the refracting power of the eye of the user, results in a first effective refracting power which rises as the radius of the first radial optical area increases, and a second radial optical area having a second refracting power which, coupled with the refracting power of the eye of the user, results in a second effective refracting power which falls as radius of the second radial optical area increases. The first effective refracting power is greater than the second effective refracting power. The dimensions and refracting power of the first and second radial optical areas are intended to weaken visibility of defocused radiation for the user.

EFFECT: eliminating or minimising visibility of ghost images through control of the sign of spherical aberration or other asphericity which depends on a specific area.

20 cl, 9 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medicine. An implant for the introduction into the corneal pocket of the human eye in order to correct refractive errors has a ring-like shape. The implant has a shape of an aspherical ring or its segment and possesses the thickness gradient.

EFFECT: application of the claimed invention will make it possible to perform the correction of irregular refractive errors.

8 ex

FIELD: medicine.

SUBSTANCE: according to the first version of the method, a blind-ended corneal incision is made of two thirds of its thickness. The leukoma is layered along its entire area to form lower and upper flaps. A through hole is cut out in the leukoma with a 3 mm bone trephine. The formed upper leukoma flap is turned away. Three pockets is cut out within the limb in the position of 12, 5 and 7 o'clock in line with a diameter of three arched elastic fixing members of the keratoprosthesis. The keratoprosthesis is laid on the lower leukoma flap. The elastic fixing elements are tucked into the formed limb pockets. The upper leukoma flap with the through hole is laid on an optical cylinder of the keratoprosthesis. The upper leukoma flap is fixed with separate interrupted polypropylene sutures 10.0. According to the second version of the method, a donor's blind-ended corneal incision is made of two thirds of its thickness. It is layered along its entire surface to form lower and upper flaps. A corneal trepanation area is marked with an 8 mm bone trephine. A hole is created in the centre of the cornea in the upper layered flap with the 3 mm bone trephine. The donor's corneal graft is cut out 8 mm in diameter. The lower flap is removed. The upper surface of the keratoprosthesis with three arched elastic fixing elements is covered with the upper donor's corneal flap. They are fixed with three interrupted polypropylene sutures 10.0. A keratoprosthesis and cornea complex is formed. The patient's leukoma trepanation area is marked with the 8 mm bone trephine. The patient's upper leukoma flap is cut out with the 8mm bone trephine. The upper flap is removed. Three pockets is cut out within the patient's limb in the position of 12, 5 and 7 o'clock in line with the diameter of the arched elastic fixing members of the keratoprosthesis. A hole is created in the patient's lower leukoma flap with the 3 mm bone trephine. The keratoprosthesis and cornea complex is laid with its lower surface facing the patient's lower leukoma flap. The optical cylinder of the keratoprosthesis is inserted into the hole of the patient's lower leukoma flap. The keratoprosthesis and cornea complex sutures are removed. The elastic fixing elements are tucked into the formed limb pockets in the position of 12, 5 and 7 o'clock. The keratoprosthesis and cornea complex and the patient's lower leukoma flap are fixed with separate interrupted polypropylene sutures 10.0.

EFFECT: more effective treatment and rehabilitation of the patients by creating the stable position of the keratoprosthesis, reducing a probability of the keratoprosthersis rejection and a risk of developing tissue necrosis by the keratopsrosthesis structure adjusted to the leukoma shape and a minimum pressure of the elastic support portion of the keratoprosthesis structure on the leukoma stromal layers.

2 cl, 3 ex

Intraocular lens // 2551239

FIELD: medicine.

SUBSTANCE: intraocular lens comprises an optical portion in the form of a cylinder with flat back and convex front surfaces, support elements in the form of projections on its end faces. The lower support element represents two diametrical segments that lengthen the back surface of the lens integrally with the same. The lower support elements and the back surface of the lens lie in the same plane and are perpendicular to the optic axis of the lens. The upper support element is elliptically shaped 7.0-8.05.5 mm in diameter. One of the segments of the lower support elements is rounded, whereas the other one is radially equally parted in two.

EFFECT: using the given invention enables reducing postoperative complications by a possibility to implant the intraocular lens by means of an injector, reducing a risk of dislocation to the back pole of the eyeball.

2 dwg

Intraocular lens // 2550002

FIELD: medicine.

SUBSTANCE: invention refers to ophthalmosurgery. An intraocular lens comprises an optical part consisting of two lenses with two securing flanges, and a haptic part with grooves. Each flange of the optical part represents a segment of a flat curvilinear figure, while curvilinear elements of the haptic part represent parabolic segments with a focal parameter of 5.0-12.0. Light refraction coefficients of each lens are different.

EFFECT: using the given invention enables reducing ocular tissue injuries, reducing chromatic aberrations, provides more reliable lens fastening in the IOL structure with the graduated intraocular variation of the optical force, and increases conservation.

4 dwg

FIELD: medicine.

SUBSTANCE: invention refers to ophthalmology. An intracorneal lens comprises an optical portion having front, back surfaces, an optical axis and a non-optical axis concentric with an optical portion outside the optical portion. The lens is made of a transparent material biocompatible with the corneal tissue. It is demountable. The non-optical portion has a central hole the diameter of which corresponds to the diameter of the optical portion, while an inner portion of the non-optical portion is congruent with an end surface of the optical portion.

EFFECT: using the given invention enables reducing the rate of undesired visual postoperative effects, such as light scattering circles, gating, and enabling recurrent surgical intervention for the correction of presbyopia progression, as well as promotes extending the range of intracorneal lenses.

5 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: invention refers to a hydrated silicone hydrogel contact lens. The lens has a layered structural configuration. A hydrogel core of the lens has the low water content and is completely covered with a layer of a water-rich, e.g. the water content more than 80%, hydrogel totally or substantially free from silicone.

EFFECT: hydrated silicone hydrogel contact lens possesses high oxygen permeability for maintaining the corneal health and a soft, water-rich smooth surface for wearing comfort.

47 cl, 9 dwg, 11 tbl, 33 ex

Multifocal lens // 2538935

FIELD: physics.

SUBSTANCE: multifocal lens with the amount of main focal powers n>2 includes the first part of the lens having, at least, one first ring-shaped band and, at least, second part of a lens having, at least, one second ring-shaped zone. Each of zones has, at least, one basic subzone and, at least, one phase subzone. For creation of n main focal powers maximum n-1 parts of the lens is combined which differ, at least, by one optical parameter, and the average focal power of the zone refraction of the first part of the lens is equal to the average refractive power of the zone of the second part of the lens.

EFFECT: improvement of vision both in near and in intermediate range, and, in particular, in a long-distance range.

14 cl, 18 dwg

FIELD: medical engineering.

SUBSTANCE: implant is manufactured from porous polytetrafluoroethylene produced by pressing thermostatically controlled polytetrafluoroethylene powder fraction of 0.25-1.60 mm at 30±10°C and having structure composed of polymer elements and empty space elements with elements joined into three-dimensional network possessing empty space element volume share of 15-40%, specific space element surface of 0.25-0.55 mcm2/mcm3, mean distance between empty spaces in a volume of 25-50 mcm and mean spatial chord of 8-25 mcm.

EFFECT: high heat resistance properties; reliable integration into connective eye tissue.

6 dwg

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