A method of treating retinal detachment

 

(57) Abstract:

The invention relates to ophthalmology, and in particular to methods of surgical treatment of severe forms of retinal detachment complicated by cysts in the posterior pole of the eye. Produce preliminary destruction of the outer cyst wall using a YAG laser. Exercise extrascleral filling defects of the retina with a possible release subretinal fluid. Produce endolaser coagulation zone of the former cysts. The method allows to eliminate the recurrence of the process.

The invention relates to medicine, namely to ophthalmology, and can be used for the surgical treatment of severe forms of retinal detachment complicated by cysts in the posterior pole of the eye.

The known method of prevention restrictive coagulation of the retina when retinoschisis complicated by the development intraretinal cysts (Francis A. L'esperance. Ophthalmic Lasers. Phothocoagulation and Surgery, 1983. P. 202).

However, this method only allows to delimit the area kosteobrazovanie, there is no opening of the cyst and the anatomical fit of the retina in the area of the pathological process. In addition, when othran the parts of the retina.

The technical result of the proposed method is the achievement of the anatomical fit of the retina and exclude recurrence of kosteobrazovanie in the area of the posterior pole of the eye. The technical result is achieved by the fact that the destruction of the outer cyst wall using a YAG laser allows atraumatic to open the cyst, its content gets into the subretinal space formed by the retinal detachment or subretinal (under teanaway capsule and under conjuctiva), and the subsequent conduct of extrascleral interference with drainage of the sclera allows you to extract subretinal fluid and the contents of the cyst. Additional Indrasena coagulation allows to avoid a relapse of kosteobrazovanie.

The method is as follows.

After clinical examination and detection of retinal detachment complicated by cysts in the posterior pole, produce ultrasound examination to exclude secondary nature of the process. Then under pharmacological mydriasis through the lens of Goldman locate the source of the cyst and reveal its outer wall YAG laser, observe the expiry of the contents of the cyst into the subretinal space or cubicle the retinal defects and areas of the former cyst of the retina. Produce extrascleral filling defects of the retina, release subretinal fluid. Access through the flat part of the ciliary body produces endolaser coagulation zone of the former cysts. The strengthening effect of surgical treatment is possible due to additional andrezinho impact zones of retinal defects.

Example. Patient B. 40 years old, was admitted to the Department of traumatology and reconstructive surgery of the eye MNHB them. Helmholtz with a diagnosis of OI - myopia of an average degree, PWHT; OS - detachment of the retina in the posterior pole of the eye.

From the history of decreased vision in his left eye detected by chance during a medical examination at the company. Referred to the Institute.

During examination: visual acuity of the right eye - 0.1 at SF. - 6,0 DV = 1.0, with the examination of the fundus on the periphery zone PWHT limited lazerkoagulyatsii. Visual acuity of the left eye - a 0.02 n/a, fundus - local retinal detachment in the lower outer quadrant. The ultrasonographic examination revealed a cyst of the retina in the posterior pole of the eyeball paramacular.

Produced surgical treatment.

stage 1: under pharmacological mydriasis opened the outer cyst wall set is made of extrascleral filling detachment of the retina in the lower-outer quadrant, release subretinal fluid together with the contents of the cyst Through the flat part ciliarnogo body was vitrectomy according to traditional methods, then endolasercoagulation zone cysts and detachment of the retina. The obtained anatomical fit of the retina, then sealing the wound and binocular headband.

After surgery: visual acuity of the left eye of 0.1 n/a to: eyes calm, the fundus of the eye - the retina is adjoined throughout, the tear-off edge is visible on the shaft of the depressions on the edge - lasercoagulation with the initial pigmentation in the cyst - lasercoagulation with the initial pigmentation.

After 8 months, visual acuity of the left eye - 0.1 at SF. to 8.0 days = 0,8; calm eyes, the retina is adjoined, in the cyst - site lasercoagulation pigmented, the retina is adjoined, the gap is blocked.

The indication of the process are the cases of retinal detachment complicated by cysts in the posterior pole of the eyeball.

The method has no contraindications.

As a result of application of this method it is possible to achieve an anatomic fit of the retina in very advanced cases of retinal detachment with cysts in the posterior pole of the eye. Preliminary YAG LAZ the cysts eliminates receivenowait process kosteobrazovanie. The effect of the operation is provided, extrascleral filling defects of the retina and laser coagulation in the area of defects

The method of treatment of the retina, complicated cysts in the posterior pole of the eye, including retinal laser coagulation, wherein the pre-destroy the outer wall of the cyst using a YAG laser, carry out extrascleral filling, then additionally produce endolaser coagulation zone cysts.

 

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1 dwg

FIELD: medicine; medical engineering.

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