Method for treating bullous keratopathy

FIELD: medicine, ophthalmosurgery.

SUBSTANCE: one should affect patient's cornea with radiation of eximer laser: at first, at bundle's diameter being 8 mm, energy of 175 mJ/sq. cm and Gauss' energy distribution. Then, the edges of ablation area should be treated with circular scanning eximer laser's ray at diameter of 3.5 mm at the same energy up to peripheral area being at the distance of 0.5 mm against the limbus. The method enables to decrease the possibility for postoperative complication as bullous keratopathy in peripheral area.

EFFECT: higher efficiency of therapy.

2 dwg, 3 ex

 

The invention relates to the field of medicine, and more particularly to ophthalmic surgery.

There is a method of treatment of bullous keratopathy Akbarova, Umadin, Cerenkov, Golovina, Afedorov, Eoretically “excimer laser phototherapeutic keratectomy (FTC) in the treatment of chronic bullous keratopathy (see Ophthalmological journal, No. 4, 1999, pp. 198-199). The method consists in achieving the mentioned technical result of carrying out photoablation across the surface of the cornea, with the exception of a width of 1.0 mm with capture not only all of Bowman's membrane and anterior stromal layers to a depth of not more than 70-120 microns after removal of the epithelium scriptom.

However, this method has significant disadvantages: high probability of occurrence of postoperative complications in the form of re-bullous keratopathy in the peripheral zone.

The technical problem solved by the invention reduce the likelihood of postoperative complications in the form of re-bullous keratopathy in the peripheral zone.

The specified technical task is solved in that in the method for the treatment of bullous keratopathy, is the impact on the cornea of excimer laser radiation, initially affect the cornea radiation with a beam diameter of 8 mm, the energy of 175 MJ/sq·cm and Gaussian races is the definition of energy next, the edge zone of the ablation process by circular scanning of the beam of an excimer laser with a diameter of 3.5 mm with the same energy until the peripheral zone located at a distance of 0.5 mm from the limbus.

The presented method is illustrated in the drawings, is shown in figure 1, 2.

The method is as follows.

A method for the treatment of bullous keratopathy, is the impact on the cornea of excimer laser radiation, characterized in that initially affect the cornea 1 (1) radiation with a beam diameter 2 (1) 8 mm, the energy of 175 MJ/sq·cm and Gaussian energy distribution. Then region 3 (figure 1) zone of the ablation process by circular scanning of the beam 4 (2) excimer laser with a diameter of 3.5 mm with the same energy until the peripheral zone located at a distance of 0.5 mm from the limbus (figure 2).

The method is characterized by the following clinical examples.

Example Molina, 68 years of age concern expressed pain syndrome within 3 months. Before surgery: visual acuity of the left eye - right svetoproekt, IOP of 25 mmHg; eye condition objectively: Bossa epithelial-endothelial corneal dystrophy with epidermolysis changes of the cornea, aphakia, operated glaucoma.

Surgery was performed according to the technique described by the authors in this invention.

After OPE is then the patient Vis OS - 0,001 n/a, IOP of 21 mm Hg Corneal syndrome and recurrent bullous keratopathy missing for 10 months.

Example Molina To 87 years, pronounced corneal syndrome for 8 months due to severe General condition through corneal transplantation is not shown; the visual acuity of the left eye - a 0.02 n/a, IOP 17 mm Hg epithelial-endothelial dystrophy, combined with the erosion of the cornea in the Central zone, artiphakia, cha: - epithelial-endothelial dystrophy, combined with the erosion of the cornea in the Central zone, artiphakia, partial atrophy of the optic nerve.

Surgery was performed according to the technique described by the authors in this invention.

After surgery, the patient corneal syndrome is absent for 14 months. Vis - a 0.05 n/a, IOP 19 mm Hg during this period the recurrent bullous keratopathy not occurred.

Example 3. Patient Z., 54 years. Within 2 months was worried about the pain and photophobia in the right eye. The patient stands on the queue through transplantation of the cornea. Before surgery, the visual acuity of the right eye - a 0.05 n/a, IOP 19 mm Hg eye Condition objective: epithelial-endothelial dystrophy of the cornea, erythrogenic fusion in periommatinae zone 17 hours, immature cataract, lens subluxation.

Surgery was performed according to the technique described by the authors in this invention.

the donkey operations: Vis OD - 0,05 n/a, IOP of 20 mm Hg Within one year relapse bullous keratopathy was not observed.

The use of the proposed invention allows to reduce the likelihood of postoperative complications in the form of re-bullous keratopathy in the peripheral zone.

A method for the treatment of bullous keratopathy, is the impact on the cornea of excimer laser radiation, characterized in that initially affect the cornea radiation with a beam diameter of 8 mm, the energy of 175 MJ/cm2and Gaussian energy distribution, then the edge of the ablation zone is treated by circular scanning of the beam of an excimer laser with a diameter of 3.5 mm, with the same energy until the peripheral zone located at a distance of 0.5 mm from the limbus.



 

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