Surgical method for applying photodynamic treatment to premature newborn retinopathy

FIELD: medicine.

SUBSTANCE: method involves applying trans-scleral laser radiation to avascular zones and cushion. Size and location of avascular zones and cushion are transpupillarily determined. Conjunctiva and Tenon's capsule incision is carried out in perpendicular to limb 2-3 mm far from it. Pocket is formed with spatula in parallel to limb in avascular zones and cushion projection area. Photosensibilizer agent is intravenously introduced into one of cubital veins and avascular zones and cushion photosensibilizer agent saturation degree is determined by applying photodynamic fluorescent diagnosis method. Maximum avascular zones and cushion saturation level being achieved, trans-scleral scanning laser radiation is applied to the avascular zones and cushion projection area with wavelength of 661-666 nm during 60-120 s with radiation dose being equal to 40-80 J/cm2. The operation is finished without placing sutures over conjunctiva.

EFFECT: enhanced effectiveness of treatment.

2 cl

 

The invention relates to medicine, namely to ophthalmology, surgical methods of photodynamic treatment of retinopathy of prematurity applied on the threshold stage of retinopathy of prematurity.

The known method of prevention of combined treatment of severe forms of active retinopathy of prematurity, including transscleral laser treatment of avascular zone (see America, Aghajanov, "the Use of laser ophthalmocoagulator in the treatment of active phase of retinopathy of prematurity", Prevention and treatment of retinopathy of prematurity, Moscow, 2000, s-85).

However, the known method when its use has the following disadvantages:

- does not allow to achieve an effective preventive treatment of active ROP,

- does not exclude development leading to loss of vision severe forms of the disease.

The objective of the invention is the creation of a surgical method of photodynamic treatment of retinopathy of prematurity.

The technical result is to increase the effectiveness of the active treatment phase of retinopathy of prematurity and prevention of progression of fibrovascular proliferation, reducing the risk of scar development stages of retinopathy of prematurity, stabilization and reverse the development of an active process, and that is the preservation of visual function.

The technical result is achieved by surgical photodynamic treatment of retinopathy of prematurity due to the destruction of newly formed vessels when conducting photodynamic therapy. The use of photosensitizers in this method helps save it in the newly formed vessels, which in turn when conducting laser irradiation with a wavelength of 661-666 nm leads to the destruction of newly formed vessels. Used photodynamic therapy stimulates phagocytosis and slows the process of cell proliferation, restores microcirculation and prevents neutrophil infiltration. The effect applies only to the pathological tissue of the retina.

The method is as follows. Transpupillary determine the size and localization of avascular zones and the shaft, and then perpendicular to the limb 2-3 mm from him perform incision of the conjunctiva and tenon's membrane and parallel to the limb with a spatula to form a pocket in the area of the projection of avascular zones and the shaft, is injected into one of the cubital vein of the photosensitizer and using photodynamic (fluorescent) diagnostics (FDD) determine the degree of saturation of the avascular zones shaft and a photosensitizer and, upon reaching the maximum level of saturation avascular zones and the shaft of the property is nebulization performed with the use of placed in the pocket formed laser probe transscleral scanning laser irradiation projection avascular zones and shaft with a wavelength of 661-666 nm within 60-120 seconds with a total dose of 40 to 80 j/cm2and the surgery is completed without stitches on the conjunctiva. The photosensitizer used is 0.1-2% aqueous solution of a photosensitizer chlorin number selected from the group Photolon, Radachlorin or photoditazine at a dose of 0.8-1.1 mg/kg

In the clinical practice of applying the proposed method of surgical photodynamic treatment of retinopathy of prematurity was found that the use of all the selected parameters of the proposed method has improved the effectiveness of the active treatment phase of retinopathy of prematurity at its threshold stage.

Implementation of the proposed method is illustrated by the following clinical examples.

Example 1. Patient A., 2 months, body weight at birth 1400, gestational period of 30 weeks. Entered the Kaluga branch of IRTC “eye microsurgery” with the following clinic: OU - calm, transparent cornea, anterior chamber 1.7mm, lens transparent in the fundus - JI pale pink, clear boundaries, Vienna, expanded, full-blooded, tortuous, on the periphery from the temporal side (zone 3) is determined by the shaft with extrarational of fibrovascular tissue, determined arteriovenous shunts. The diagnosis of retinopathy of prematurity OU, stage III (threshold), the active phase.

The treatment is conducted under General anesthesia. N is the preparatory stage after conducting anesthesia was performed processing of the surgical field. Transpupillary determined the size and localization of avascular zones and shaft. Then perpendicular to the limb 3 mm from it complied with the incision of the conjunctiva and tenon's membrane and parallel to the limb putty knife pocket formed in the area of the projection of avascular zones and the shaft and placed in it as a light source of the laser probe. Intravenous introduced in one of the cubital vein as photosensitizer 0.1% aqueous solution of a photosensitizer chlorin number of Photolon - dose of 1.1 mg/kg weight of the patient. Using photodynamic (fluorescent) diagnostics (FDD) determined the degree of saturation of the avascular zones and shaft photosensitizer and at the maximum level of saturation avascular zones and shaft photosensitizer made photodynamic therapy, in which process to use is placed in the pocket formed laser probe is held transscleral scanning laser irradiation projection avascular zones and shaft with a wavelength of 661 nm for 120 seconds with a total dose of 80 j/cm2. The operation was completed without stitches on the conjunctiva.

After treatment in the fundus a decreasing tortuosity and hyperemia of the vessels, the disappearance extrarational fibrovascular tissue.

Example 2. Patient I., 2.5 months, body weight at birth 1150 g, g is stationy term 29-30 weeks. Entered the Kaluga branch of IRTC “eye microsurgery” with the following clinic: OU - calm, transparent cornea, anterior chamber 1.5 mm, lens transparent in the fundus: JI swollen, stosowana its borders, vessels dramatically expanded, defines a shaft with extrarational of fibrovascular tissue in zone 2. The Central shaft ninananajna segment is determined by retinal detachment exudative nature, not exciting area of the macula. The diagnosis of retinopathy of prematurity, IV “and” phase, the active phase.

The treatment is conducted under General anesthesia. At the preparatory stage after conducting anesthesia was performed processing of the surgical field. Transpupillary determined the size and localization of the avascular zone of the shaft. Then perpendicular to the limb in 2 mm from it complied with the incision of the conjunctiva and tenon's membrane and parallel to the limb putty knife pocket formed in the area of the projection of avascular zones and shaft, placed there as the light source of the laser probe. Intravenous introduced in one of the cubital vein as photosensitizer 2% aqueous solution of a photosensitizer chlorin number of Radachlorin in a dose of 0.8 mg/kg of patient weight. Using photodynamic (fluorescent) diagnostics (FDD) determined the degree of saturation of the avascular zone of the photosensitizer and the achievement of mA the maximum level of saturation avascular zones photosensitizer made photodynamic therapy, in the process, using placed in the pocket formed laser probe is held transscleral scanning laser irradiation projection avascular zones and shaft with a wavelength of 666 nm for 60 seconds with a total dose of 40 j/cm2. The operation was completed without stitches on the conjunctiva.

After treatment: the disappearance extrarational fibrovascular tissue, a gradual reduction of the phenomena of exudation, the fit of the retina.

1. The surgical method of photodynamic treatment of retinopathy of prematurity, including transscleral laser treatment of avascular zone and the shaft, wherein transpupillary determine the size and localization of avascular zones and the shaft, and then perpendicular to the limb 2-3 mm from him perform incision of the conjunctiva and tenon's membrane and parallel to the limb with a spatula to form a pocket in the area of the projection of avascular zones and the shaft, is injected into one of the cubital vein of the photosensitizer and using photodynamic fluorescent diagnostics determine the degree of saturation of the avascular zones shaft and the photosensitizer and to achieve the maximum level of saturation avascular zones shaft and the photosensitizer is performed with the use of placed in the pocket formed laser probe transscleral with aneroussa laser irradiation projection avascular zones and shaft with wavelength 661-666 nm within 60 to 120 C at a total dose of 40 to 80 j/cm 2and the surgery is completed without stitches on the conjunctiva.

2. The method according to claim 1, characterized in that the photosensitizer used is 0.1-2%-aqueous solution of a photosensitizer chlorin number selected from the group Photolon, Radachlorin or photoditazine at a dose of 0.8-1.1 mg/kg



 

Same patents:

FIELD: medicine.

SUBSTANCE: method involves transpupillarily determining size and location of avascular zones and cushion. Conjunctiva and Tenon's capsule incision is carried out in perpendicular to limb 2-3 mm far from it and pocket is formed with spatula in perpendicular to limb in avascular zones and cushion projection area using laser probe set in the formed pocket. Preliminary trans-scleral laser irradiation is applied to the avascular zones and cushion projection area with pulsating and continuous non-collimated beam of laser radiation of low intensity and wavelength of 800-950 nm having mean power of 5-20 mW at probe end during 5-10 min. Photosensibilizer agent is introduced into one of cubital veins and avascular zones and cushion photosensibilizer agent saturation degree is determined by applying photodynamic fluorescent diagnosis method. Maximum avascular zones and cushion saturation level being achieved, trans-scleral scanning laser radiation is applied to the avascular zones and cushion projection area with wavelength of 661-666 nm during 30-90 s with radiation dose being equal to 20-60 J/cm2. The operation is finished without placing sutures over conjunctiva.

EFFECT: enhanced effectiveness of treatment.

2 cl

FIELD: medicine; medical engineering.

SUBSTANCE: method involves first scattering laser radiation and then selecting the scattered radiation by means of diffuse reflection. The method is put in practice by applying special purpose device for stimulating visual function. Laser radiation of visible and/or infrared spectrum light is applied. Scattering and following radiation selection is carried out in isogonal direction with respect to radiation propagation direction. Patient vision field is restricted preventing it against action of external illumination and non-scattered rays from optic axes of the radiators.

EFFECT: improved quality of uniformly scattered optical radiation.

6 cl, 1 dwg

FIELD: medicine, dermatology.

SUBSTANCE: one should apply an applicator onto affected parts of skin that contains 5-aminolevulinic acid at concentration of 5-20%. After keeping and removing the applicator it is necessary to irradiate with light at wave length being 630 ± 10 nm and energy density of 10-1200 J/sq. cm. Control should be carried out due to evaluating the concentration of photosensitizer at affected parts of skin due to fixing fluorescence ranges at all basic stages of photodynamic therapy. The method enables to adjust skin relief and achieve scars' whitening and their regression.

EFFECT: higher efficiency of therapy and control.

6 cl, 2 dwg, 3 ex

FIELD: medical engineering.

SUBSTANCE: device has two parts. Light guide part has short flexible light guide having end piece and needle with its holder. The second part has radiation-emitting head attached to semiconductor laser and end piece fastening member manufactured as latch plug. The light guide part is single-use removable part.

EFFECT: high reliability of radiation power; enhanced effectiveness of treatment.

5 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: method involves filling external acoustic duct with 1% Imoxipine solution. Distal end of monofiber light guide to is brought to transplant surface manufactured from human fetus dura mater to close perforation opening in tympanic membrane. Helium-neon laser radiation is applied with output power of 10-20 mW, light spot diameter of 4-6 mm, power flow density of 35-80 W/cm2, unit dose of 3.0-5.5 J/cm2 and exposure time of 3-5 min.

EFFECT: deep penetration and rapid adsorption via transplant surface and acoustic duct skin.

FIELD: medicine, gastroenterology, reflexotherapy.

SUBSTANCE: biologically active points (BAP) should be affected with electromagnetic radiation from the unit of linear spectrum. Moreover, upon RN-12 point one should apply bismuth-containing material. While affecting points KI19 and BL21 - rhenium-containing material, at affecting ST21 point - titanium-containing material. At affecting the point BL50 - beryllium. Simultaneously, one should affect 7 additional points. At affecting the first additional beryllium-containing material, at affecting the second and the 6th additional points - strontium-containing material, at affecting the 3d and the 7th additional points - platinum-containing material, for the 4th additional point - bismuth-containing material for the fifth additional points - titanium-containing material. The innovation provides objective control of impact degree and excludes indexing, as well.

EFFECT: higher efficiency of application.

2 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves exposing biologically active points and auxiliary points to electromagnetic radiation produced by line spectrum source. Material containing platinum is used as source glow material when acting upon DV-8, BL-47 and RN 15 points and material containing osmium is used when treating GB 24 and BL 18 points. Material containing platinum is used as source glow material when acting upon the first auxiliary points, material containing osmium is used when treating the third auxiliary points and material containing nickel is used when treating the second and the fourth auxiliary points.

EFFECT: enhanced effectiveness in controlling action intensity in objective way.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves acting with pulsating low intensity laser radiation in infrared bandwidth upon lesion focus and introducing special-purpose preparation. Pulsating low intensity laser radiation treatment is stopped not earlier as alkaline phosphotase activity level in blood serum in fractured extremity surpassing one in healthy extremity. The special-purpose preparation is administered at a dose of 750 mg taken as one dose twice a day per os in combination with intramuscular injection at a dose of 400 mg twice a day. Calcium and glycosaminoglycans levels being equalized in blood serum in fractured and intact extremity, preparation dose is to be reduced to 750 mg taken per os once a day.

EFFECT: enhanced effectiveness in activating periosteum repair; reduced risk of complications.

3 cl

FIELD: medicine.

SUBSTANCE: method involves producing ophthalmoscopic tumor image and visually estimating its pigmentation. Digital computer-assisted analysis of tumor image color parameters is carried out by applying Adobe Photoshop software. Digital 0 code is assigned to absolutely black color and digital code of 765 is assigned to absolutely white color. Transpupillary diode laser thermotherapy is started with color code of 153 to 289 beginning from power density of 4.2 W/cm2. Color code being of 290 to 503, the treatment begins with 7.8 W/cm2. Color code being of 504 to 635, the treatment begins with 11.4 W/cm2.

EFFECT: enhanced effectiveness of treatment owing to initial power density being accurately selected.

FIELD: medical engineering.

SUBSTANCE: device is applied for carrying out combined simultaneous blood irradiation at red light wavelength and infusion therapy with physiologic saline containing drugs supplied to the same point in patient vein via dropper. Needle of cocoon cross-section is used.

EFFECT: enhanced effectiveness of treatment.

2 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: method involves transpupillarily determining size and location of avascular zones and cushion. Conjunctiva and Tenon's capsule incision is carried out in perpendicular to limb 2-3 mm far from it and pocket is formed with spatula in perpendicular to limb in avascular zones and cushion projection area using laser probe set in the formed pocket. Preliminary trans-scleral laser irradiation is applied to the avascular zones and cushion projection area with pulsating and continuous non-collimated beam of laser radiation of low intensity and wavelength of 800-950 nm having mean power of 5-20 mW at probe end during 5-10 min. Photosensibilizer agent is introduced into one of cubital veins and avascular zones and cushion photosensibilizer agent saturation degree is determined by applying photodynamic fluorescent diagnosis method. Maximum avascular zones and cushion saturation level being achieved, trans-scleral scanning laser radiation is applied to the avascular zones and cushion projection area with wavelength of 661-666 nm during 30-90 s with radiation dose being equal to 20-60 J/cm2. The operation is finished without placing sutures over conjunctiva.

EFFECT: enhanced effectiveness of treatment.

2 cl

FIELD: medicine.

SUBSTANCE: method involves building tunnel to posterior eyeball pole in inferoexterior and superexterior quadrants. The tunnel is used for implanting flexible polymer magnetolaser implant to the place, the subretinal neovascular membrane is localized. The implant has a permanent magnet shaped as a cut ring and is provided with drug delivery system and a short focus scattering lens of laser radiator connected to light guide. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 5-7 mTesla units intensity. It is arranged with its north pole turned towards sclera at the place of the subretinal neovascular membrane projection with extrascleral arrangement of laser radiator lens membrane being provided in the subretinal neovascular membrane projection area. The other implant end is sutured to sclera 5-6 mm far from the limb via holes made in advance. The implant is covered with conjunctiva and retention sutures are placed thereon. Light guide and drug supply system lead is attached to temple with any known method applied. Drugs are supplied via the implant drug supply system in retrobulbary way in any order. Triombrast is given in the amount of 0,4-0,6 ml and dexamethasone or dexone in the amount of 0,4-0,6 ml during 3-4 days every 12 h. 0.1-1% aqueous solution of khlorin is intravenously introduced at the third-fourth day after setting the implant as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, at a bolus dose of 0.8-1.1 mg/kg. Visual control of subretinal neovascular membrane cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the subretinal neovascular membrane with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at general dose of 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the subretinal neovascular membrane via laser light guide and implant lens, repeated laser irradiation of the subretinal neovascular membrane is carried out with radiation dose of 30-60 J/cm2.

EFFECT: accelerated subretinal edema and hemorrhages resorption; regression and obliteration of the subretinal neovascular membrane; prolonged vision function stabilization.

6 cl

FIELD: medicine.

SUBSTANCE: method involves intravitreously introducing two electrodes into intraocular neoplasm after carrying out vitrectomy and retinotomy to expose the intraocular neoplasm. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with current intensity of 100 mA during 1-10 min or 10 mA during 10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2.The transformed retina and tumor destruction products are intravitreally removed. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. Another embodiment of the invention involves adjusting position and size of the intraocular neoplasm in trans-scleral diaphanoscopic way. Rectangular scleral pocket is built above the intraocular neoplasm to 2/3 of sclera thickness with its base turned away from limb. Several electrodes are introduced into intraocular neoplasm structure via the built bed. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with the same current intensity in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. Superficial scleral flat is returned to its place and fixed with interrupted sutures. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg after having carried out vitrectomy and retinotomy. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2. The transformed retina and tumor destruction products are intravitreally removed using vitreotome. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. The number of electrodes is equal to 4-8.

EFFECT: reduced risk of metastasizing.

4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves intravenously administering 0.1-1% aqueous solution of khlorin, selected from group containing photolon, radachlorine or photoditazine at a dose of 0.2-0.5 mg/kg or 0.2-1% aqueous solution of porphyrin like photogem at a dose of 0.2-1 mg/kg. Laser irradiation of blood is carried out 5-15 min later after beginning photosensitizer injection into cubital vein of one arm via laser light guide set in advance in the cubital vein of the other arm during 10-40 min at wavelength of 661-666 nm and power of 20-50 mW one session per day during 3-10 days with the aqueous solution of khlorin used as the photosensitizer, or laser irradiation of blood with wavelength equal to 630-633 nm during 10-45 min with power of 20-50 mW one session per day with the aqueous solution of porphyrin used as the photosensitizer. Repeated intravenous administration of photosensitizer is carried out 1-3 months later combined with repeated laser irradiation of blood.

EFFECT: reduced risk of tumor cells dissemination and metastasis development.

2 cl

FIELD: medicine.

SUBSTANCE: method involves applying transscleral diaphanoscopic examination method for adjusting intraocular neoplasm localization and size. Rectangular scleral pocket is built 2/3 times as large as sclera thickness which base is turned from the limb. Several electrodes manufactured from a metal of platinum group are introduced into intraocular neoplasm structure via the built scleral pocket. Next to it, intraocular neoplasm electrochemical destruction is carried out in changing electrodes polarity with current intensity of 100 mA during 1-10 min, and the electrodes are removed. Superficial scleral flap is returned to its place and fixed with interrupted sutures. 0.1-2% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transpupillary laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2. the operation is ended with placing sutures on conjunctiva. Platinum, iridium or rhodium are used as the metals of platinum group. The number of electrodes is equal to 4-8. 0.1-1% khlorin solution, selected from group containing photolon, radachlorine or photoditazine, is additionally repeatedly intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2.

EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: method involves creating tunnel between sclera and Tenon's capsule in intraocular neoplasm projection. Intraocular neoplasm localization and size is adjusted by applying transscleral diaphanoscopic examination method. 0.1-0.3 ml of photosensitizing gel based on viscoelastic of hyaluronic acid, selected from group containing chealon, viscoate or hyatulon, is transsclerally introduced into intraocular neoplasm structure using special purpose needle in dosed manner. The photosensitizing gel contains khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-1% by mass. Flexible polymer magnetolaser implant is extrasclerally introduced into the built tunnel in intraocular neoplasm projection zone under visual control using guidance beam. The implant has permanent ring-shaped magnet axially magnetized and producing permanent magnetic field of 3-4 mTesla units intensity, in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The implant is arranged with its north pole turned towards the intraocular neoplasm so that implant laser radiator lens is extrasclerally arranged in intraocular neoplasm projection zone. The implant light guide is sutured to sclera 5-6 mm far from the limb with single interrupted suture. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transscleral intraocular neoplasm laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm. The treatment course being over, the flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, neodymium-iron-boron or samarium-iron-nitrogen. 0.1-1% khlorin solution as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is additionally intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg and repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2 15-20 min later during 30-90 s.

EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

FIELD: medicine.

SUBSTANCE: method involves making incision in conjunctiva and Tenon's capsule of 3-4 mm in size in choroid hemangioma projection to sclera 3-4 mm far from limb. Tunnel is built between sclera and Tenon's capsule to extrasclerally introduce flexible polymer magnetolaser implant through the tunnel to the place, the choroid hemangioma is localized, after performing transscleral diaphanoscopic adjustment of choroid hemangioma localization and size, under visual control using guidance beam. The implant has permanent ring-shaped magnet in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 2-3 mTesla units intensity. It is arranged with its north pole turned towards the choroid hemangioma so that extrascleral implant laser radiator disposition. The other end of the implant is sutured to sclera 5-6 mm far from the limb with two interrupted sutures through prefabricated openings. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. 0.1-1% khlorin solution is injected in intravenous bolus dose of 0.8-1.1 mg/kg as photosensitizer and visual control of choroid hemangioma cells fluorescence and fluorescent diagnosis methods are applied. After saturating choroid hemangioma with the photosensitizer to maximum level, transscleral choroid hemangioma laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm with total radiation dose being equal to 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the intraocular neoplasm, repeated laser irradiation of the choroid hemangioma is carried out with radiation dose of 30-60 J/cm2.

EFFECT: enhanced effectiveness of treatment.

4 cl

FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

EFFECT: excluded recurrences of surgically removed neovascular membrane and development of proliferative retinopathy and retina detachment; retained vision function.

3 cl, 5 dwg

The invention relates to new compounds, metalcomplexes of carboranylporphyrins General formula I,

with antitumor activity and low toxicity, which can be used in boron neutron capture therapy had cancer

The invention relates to palletization derived bacteriochlorophyll formula I, I' or I"

where a is a HE, OR1, -O-(CH2)n-Y, -S-(CH2)n-Y, -NH-(CH2)n-Y, -O-(CH2)2-OH, -NH-(CH2)2-NH-BOC, or-N(CH2-CH=CH2)2where R1represents Na+, K+, (CA2+)0,5, (Mg2+)0,5Li+, NH+4,+NH3-C(CH2OH)3,+NH3-CH2-(CHOH)4-CH2OH,+NH2(CH3)-CH2(SNON)4-CH2OH, or+N(Cn'H2n'+1)4; R2represents N or C1-C12the alkyl for the compounds of formula I', and R2represents H, HE or COOR4for the compounds of formula I, where R4represents C1-C12alkyl or C3-C12cycloalkyl; R3represents N or C1-C12the alkyl for the compounds of formula I', and R3represents H, HE, or C1-C12alkyl or alkoxy with the R'3X-where R'1, R'2and R'3each independently represents-CH3or-C2H5; X represents F, Cl, Br or I, n is 1, 2, 3 or 4, and where * denotes an asymmetric carbon atom and --- represents a single saturated bond or an unsaturated double bond pharmaceutical composition having a capacity of detection or treatment of tumors containing at least one compound of formula I, I' or I", three methods for obtaining the compounds of formula I

FIELD: medicine.

SUBSTANCE: method involves transpupillarily determining size and location of avascular zones and cushion. Conjunctiva and Tenon's capsule incision is carried out in perpendicular to limb 2-3 mm far from it and pocket is formed with spatula in perpendicular to limb in avascular zones and cushion projection area using laser probe set in the formed pocket. Preliminary trans-scleral laser irradiation is applied to the avascular zones and cushion projection area with pulsating and continuous non-collimated beam of laser radiation of low intensity and wavelength of 800-950 nm having mean power of 5-20 mW at probe end during 5-10 min. Photosensibilizer agent is introduced into one of cubital veins and avascular zones and cushion photosensibilizer agent saturation degree is determined by applying photodynamic fluorescent diagnosis method. Maximum avascular zones and cushion saturation level being achieved, trans-scleral scanning laser radiation is applied to the avascular zones and cushion projection area with wavelength of 661-666 nm during 30-90 s with radiation dose being equal to 20-60 J/cm2. The operation is finished without placing sutures over conjunctiva.

EFFECT: enhanced effectiveness of treatment.

2 cl

Up!