Method for prevention and treatment of postoperative complications in cataract extraction

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmology, and can be used for prevention and treatment of postoperative complications in cataract extraction that involves implantation of an intraocular lense (IOL). That implies subconjunctival injection of a preparation in a dose 0.5 ml; as an antioxidant preparation, 0.007% p-amino-benzoic acid is used. It is followed with percutaneous exposure to the low-frequency variable rotating magnetic field of frequency 17 Hz, induction amplitude 20 mT, reversal time 10 sec, "+" rotation mode during 8 minutes. The therapeutic course makes 3-7 daily procedures. Further, the preparation is instilled 4 times a day during 14 days.

EFFECT: method allows improving quality of the postoperative rehabilitation following cataract extraction due to prevention and treatment of inflammatory complications of anterior segment and corneal dystrophic damages.

2 ex

 

The invention relates to medicine, namely to ophthalmology, and can be used for the prevention and treatment of postoperative complications of cataract extraction with implantation of an intraocular lens (IOL).

It is proved that one of the factors affecting the postoperative period, is to increase the level of free radical compounds that have a damaging effect on the cellular structure of tissues and membranes of the cells, thereby playing a role in the pathogenesis of postoperative inflammation. Risk factor for inflammation may serve as infection rates in patients with herpes simplex viruses. In response to the implantation of the IOL, as a foreign body, can develop fibrinous inflammation through the activation of macrophage system of the body.

There are ways of prevention and treatment of postoperative complications of cataract extraction various antioxidant drugs: vannochkovogo phonophoresis 30% oil solution of tocopherol acetate, adding carnosine in the irrigation solution, parabulbar injection 1% emoxipin, instillation of lipofono (Sosin, I.N., Buevich A.G. Physical therapy of eye diseases. - Simferopol: Taurus, 1998, p.71-72; Khojaev NS cataract Surgery using small incisions: clinical and theoretical substantiation: author. thesis... doctor who RA honey. Sciences. - M., 2000. - 48; Pavlyuchenko C.P. Features the prevention and treatment of secondary cataract in patients with intraocular correction: author. thesis... Dr. med. Sciences. - Odessa, 1990. - 21 S.; Pasechnikov NV, Gorshkova R.A., Gaydamak T.B. Preliminary assessment of the anti-inflammatory action of the drug "Lipovan in patients after extracapsular cataract extraction. // Eye magazine. - 2005. No. 3. - s-17.).

The disadvantages of these methods are:

- insignificant anti-inflammatory actions of some individual listed products;

- inability to create sufficient therapeutic drug concentrations in the tissues of the eye for a short period of time when the proposed methods of introduction.

The closest analogue of the invention is a method of treating post-operative complications of cataract extraction, namely, that spend vannochkovogo the magnetophoresis of the antioxidant drug of Dioselina diluted 1:100 with distilled water, using a pulsed magnetic field is sinusoidal with the induction of 15 MT and a frequency of 50 Hz in continuous mode, generated by the "Gradient-1" within 10 minutes, the course of treatment 7 procedures (Egorov V.V., Borisov T.V., Didenko so-CALLED. et al. Neosulin in the treatment of inflammatory complications after extra is the cataract with IOL implantation // Modern technologies in cataract surgery. - 2002. - s-83.).

Neosulin (neutral) contains sodium Selenite, and 0.5 g of purified water to 10 ml of the Biological role of selenium is associated with its antioxidant properties, due to the involvement of selenium in the building, in particular, one of the key antioxidant enzymes - glutathione peroxidase.

The disadvantages of this method are:

- the need for dilution before use;

- lack of anti-inflammatory action of the drug is only because of antioxidant properties;

pulse magnetic field of the sine wave generated by the "Gradient-1", is inefficient for phoresis drug. In this way therapeutic effect is possible with combined drug effect and magnetic therapy.

The objective of the invention to develop a method for the prevention and treatment of postoperative complications of cataract extraction, ensuring a higher quality of rehabilitation of patients after cataract surgery due to the prevention and treatment of inflammatory complications of the anterior eye segment and dystrophic lesions of the cornea.

The technical result is the reduction of terms of treatment of postoperative inflammatory complications and healing of incision, preventing degenerative processes of the cornea.

Specified technology the economic result is achieved by a method for prevention and treatment of postoperative complications of cataract extraction, including magnetophoresis of the antioxidant drug, according to the invention as an antioxidant drug used to 0.007% solution of para-aminobenzoic acid, in doing so, a subconjunctival injection of the drug at a dose of 0.5 ml, followed by percutaneous exposure to low-frequency alternating rotating magnetic field with a frequency of 17 Hz and amplitude of 20 MT induction, the time reversal of rotation 10, the rotation mode "+" for 8 min, the treatment is 3-7 daily procedures, then the drug is used in the form of installations 4 times a day for 14 days.

Low-frequency AC rotating magnetic field (NPUMP) increases the permeability gematologicheskogo barrier, thereby to create the necessary concentration of the drug in the tissues of the eye. NPUMP itself can significantly change the rate of lipid peroxidation (LPO), which contributes to the activation of trophic processes in organs and tissues, eliminates infiltration and accelerates epithelization of wounds. Drug Actipol (0,007% solution PABK) - interferon inducer, is a powerful bioantioxidants, regenerating the enzyme catalase, principal of metabolism FLOOR in the eye tissues, activates fibrinolysis processes, that the same work To a+, Na+ -ATP-AZ, the function of which is the prevention and elimination of edema, this drug as one of the b vitamins, has a neurotrophic effect, regulates cellular reproduction (Prospect "Actipol", p.12).

The proposed method is as follows. Spend the interstitial magnetophoresis antioxidant, why do subconjunctival injection of Actipole 0,007% solution of para-aminobenzoic acid (PABK) at a dose of 0.5 ml once a day, with subsequent percutaneous exposure to low-frequency alternating rotating magnetic field generated by the apparatus of pole-3 second stage: frequency 17 Hz, amplitude of 20 MT induction, the time reversal of rotation 10, the rotation mode "+" for 8 minutes While the inductor placed on closed eyelids operated eye, spend 3-7 procedures daily. Further Actipol used in the form of installations 4 times a day for 14 days.

The method is illustrated by the following examples:

Example 1. Patient N., 75 years. Diagnosis: Mature senile cataract, right eye, initial age of the left eye. Visual acuity before surgery OD/OS=light sensation with the correct projection Nicholas/0.1 s Corr. -2.0D=0,3.

Progress OD without features. On the first day after surgery showed marked edema of the cornea. Assigned to the interstitial magnetophoresis antioxidant, OD - made with conjunctival injection Actipole 0,007% solution PABK - 0.5 ml once a day, with subsequent percutaneous exposure to low-frequency alternating rotating magnetic field generated by the apparatus of pole-3 second stage: frequency 17 Hz, amplitude of 20 MT induction, the time reversal of rotation 10, the rotation mode "+" for 8 min, the coil was placed on the closed eyelids of the right eye. After the third procedure, magnetophoresis corneal edema considerably decreased, the patient was discharged from the clinic. VIS=OD/OS=0,5 Nicholas/0.1 s Corr. -2,0D=0,3. Outpatients received antibiotic and steroid anti-inflammatory drops, additionally drops Actipol 4 times a day for 14 days. At the control examination after 2 weeks OD - calm IOL in the center, visual acuity OD/OS=1,0/0,1 with Corr. - 2,0D=0,3.

Example 2. Patient M 54 years., Diagnosis: Traumatic cataract of the left eye. Visual acuity before surgery OD/OS=1,0/0,005 NC.

Was traumatic cataract phacoemulsification and the implantation of a foldable intraocular lens (AcrySof IQ). The first day OS is a state of calm eyes, the cornea is transparent, moisture anterior chamber clean. On the second day in the pupillary zone of the lens appeared effusion of fibrin. In addition to the traditional local treatment assigned to the interstitial magnetophoresis antioxidant, OS made subconjunctival injection Actipole solution PABK 0,007% 0.5 ml once a day, with subsequent percutaneous influence is the influence of low-frequency alternating rotating magnetic field, generated by the apparatus of pole-3 second stage: frequency 17 Hz, amplitude of 20 MT induction, the time reversal of rotation 10, the rotation mode "+" for 8 min, the coil was placed on the closed eyelids of the left eye. After daily treatment for 6 days, the inflammatory reaction is controlled completely, the patient was discharged from the clinic. VIS=OD/OS=1,0/0,6 Nicholas at discharge. Outpatients received antibiotic and steroid anti-inflammatory drops, additionally drops Actipol 4 times a day for 14 days. At the control examination after 2 weeks OS - calm IOL in the center, VIS=OD/OS=1,0/1,0.

Thus, the proposed method for the prevention and treatment of postoperative complications of cataract extraction allows to solve the problem: to improve the quality of rehabilitation of patients after cataract extraction surgery due to the prevention and treatment of inflammatory complications of the anterior eye segment and dystrophic lesions of the cornea.

Method of prevention and treatment of postoperative complications of cataract extraction, including magnetophoresis of the antioxidant drug, characterized in that the antioxidant drug used to 0.007%solution of para-aminobenzoic acid, in doing so, a subconjunctival injection of the drug at a dose of 0.5 ml, followed by percutaneous exposure to low totem variables rotating magnetic field with a frequency of 17 Hz, the amplitude of the induction of 20 MT, the time reversal of rotation 10, the rotation mode "+" for 8 min, the treatment is 3-7 daily procedures, then the drug used in treatment period 4 times a day for 14 days.



 

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