Method and device for fixing retina edges

FIELD: medicine; medical engineering.

SUBSTANCE: method involves introducing device for fixing retina rupture edges into vitreous cavity after having done subtotal vitrectomy. The device has a pair of microsurgical needles connected to each other with surgical thread. Required number of needle pairs is introduced in succession to have required number of straight segments for fixing rupture edge. Needle ends are brought out in pairs together with thread to external sclera surface and cut, and the thread ends are fixed near the sclera surface.

EFFECT: reduced risk of traumatic complications; reliability of retina rupture edges fixation.

3 cl

 

The invention relates to medicine, namely to ophthalmology, and can be used for the surgical treatment of severe forms of retinal, when the edges of the tear or detachment is not fit to be the retina.

There is a method of surgical treatment of severe forms of retinal detachment complicated by gaps and breaks various forms and locations - way combination allocationpolicy (see dissertation: Lickin PV New surgical methods for the treatment of severe retinal detachment: allocationpolicy and combined allocationpolicy. - Moscow, 1996), which consists in performing a Subtotal vitrectomy with simultaneous substitution of saline solution, replacing it with silicone implantation into the vitreal cavity of flat resilient seal in the form of a biopolymer tape, placing it above the fracture and the fixing of the seal and of the retina to be membranes of eyes with retinal nails.

Known locking device for securing the edges of the retinal tear (see dissertation: Lickin PV New surgical methods for the treatment of severe retinal detachment: allocationpolicy and combined allocationpolicy. - Moscow, 1996), which used the retinal nails, each of which contains a working portion with a sharp end. Through a flat elastic PLO is Boo retinal nails are injected into the retina of the eye and fix it to be shells.

A disadvantage of the known method and device is the need of the application of great effort for vcol nails, especially at the periphery and maintain sufficient tone eyes when performing this manipulation. Due to the inability to precisely adjust the dosage amount of force required to vcol nail, this manipulation can be traumatic to the eye, often leads to complications during surgery such as the overshoot of the nail under the retina, or various hemorrhagic complications.

The present invention solves the problem of surgical treatment of severe forms of retinal breaks. The technical result is to reduce the morbidity of the step of fixing the edges of the retinal tear to subject the membranes of the eyes due to the use in a fastening device of direct fine microsurgical needles with a diameter of 0.2 mm and a length of 4-6 mm, which facilitate their vcol in the membrane of the eye. Reducing the morbidity, as a rule, significantly reduces the risk of complications during surgery and in the postoperative period. In addition, fusing the edges of the retinal tear straight portions of the threads connecting the pairs of needles, allows reliable fixation of the retina in place of the gap and improve the results of surgical treatment.

Specified ones the technical result is achieved by a method for fixing the edges of the retinal tear, which consists in the separation of the conjunctiva and tenon's membrane, performing Subtotal vitrectomy and fixation of the retina to be retina using a fixing device, the fixing of the retina conduct on the part of the retina in one or more than one direct plot threads, which provide a consistent end-to-end ukalyvanie couples United surgical thread needle holding devices, output pairs of needles on the outer surface of the sclera, tighten the needle along with thread, needles are cut off, and the remaining ends of the threads is fixed at the surface of the sclera and stitched on the conjunctiva. Thus the fixing of the ends of the threads are implementing or conducting yarn with needles before their circumcision through the elastic stoppers, is pressed against the surface of the sclera, and melt the remaining ends of the threads diathermy, creating the stopper thickening of the melted filament, or by crimping around the threads of the stopper, made in the form of a metallic thin-walled microsilica pressed to the surface of the sclera, or by tying each end of the pair of threads to the outer placed along the ends of the threads of the seam, which before tying stitch on1/2sclera each subsequent thread, or by pressing the ends of the threads to the sclera episcleral seal. Specified the technical result is also achieved by the fact that that the locking device containing the working part with the sharp end, has two working parts, made in the form of a thin direct microsurgical needles connected by a surgical thread.

Device for fixing the edges of the rupture of the retina contains two working parts, made in the form of a thin direct microsurgical needle with a sharp working ends. The ends of the needle opposite to the acute work ends interconnected surgical thread length of about 20 mm

The method of fixing the edges of the retinal tear is as follows.

Usepreview the conjunctiva and tenon shell, perform Subtotal vitrectomy with simultaneous substitution of saline, spread the retina introduction performancesthe connection. Through scleral puncture in the vitreal cavity introducing device for fixing the edges of the retinal break in a pair of microsurgical needles, United surgical thread. It is possible to introduce into the vitreal cavity flat elastic seal, which stitch needles or which is placed under the thread without flashing and through which you can secure the edge of the retinal tear. Secure the edges of the retinal tear conduct on the part of the retina direct plot strands, which form a consistent end-to-end kalyanam needle through about what rocki eye using a special vitreal tweezers. The number of straight sections for fastening the edges of the gap may be one or more depending on the size of the gap or detachment, and its localization. Therefore sequentially inject the necessary number of pairs of needles, getting the required number of straight sections for fastening the edges of the gap. Make the transition from vnutristriatnogo of vcol needles to episcleral manipulation. For this purpose the ends of the needles along with thread output pairs on the outer surface of the sclera. Tighten the needle together with thread, creating the ends of the threads of equal length, about 8 mm, and the needle is cut. The ends of the threads is fixed at the surface of the sclera. The fixing of the ends of the threads are implementing or conducting yarn with needles before their circumcision through the elastic stoppers, made for example of silicone and is pressed to the surface of the sclera, and for a more reliable fixation of the melt remaining ends of the threads diathermy, creating the stopper thickening of the melted filament, when using filament yarn of polypropylene, or crimped around the threads of the stopper, made in the form of a metallic thin-walled microsilica pressed to the surface of the sclera, or by tying each end of the pair of threads to the outer placed along the ends of the threads of the seam, which before tying stitch on1/2sclera each subsequent thread, or by pressing the ends of the threads to skle the e episcleral seal. When attaching the ends of the threads with episcleral seal after cutting the ends of the needles threads remain long for a better pressure seal. Performancesee connection in the cavity of the eye as opposed to saline or silicone oil. Stitched on the conjunctiva.

1. The method of fixing the edges of the retinal tear, which consists in the separation of the conjunctiva and tenon's membrane, performing Subtotal vitrectomy and fixation of the retina to be membranes of eyes with locking device, characterized in that the fixation of the retina conduct on the part of the retina in one or more than one direct plot threads, which provide a consistent end-to-end ukalyvanie pairs of needles, United surgical thread, pairs take the needle to the outer surface of the sclera, tighten the needle along with thread, needles are cut off, and the remaining ends of the threads is fixed at the surface of the sclera and stitched on the conjunctiva.

2. The method according to claim 1, characterized in that the fastening of the ends of the threads are implementing or conducting yarn with needles before their circumcision through the elastic stoppers, is pressed against the surface of the sclera, and melt the remaining ends of the threads diathermy, creating the stopper thickening of the melted filament, or by crimping around the threads of the stopper, in the form of metal rings, prig is that the surface of the sclera, or by tying each end of the pair of threads to the outer placed along the ends of the threads of the seam, which before tying stitch on1/2sclera each subsequent thread, or by pressing the ends of the threads to the sclera episcleral seal.

3. Locking device for implementing the method according to claim 1, containing two working parts, made in the form of straight needles with a diameter of 0.2 mm and 4-6 mm long, connected by a surgical thread from polypropylene.



 

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