METHOD OF SINGLE-STAGE SURGERY OF CATARACT AND GLAUCOMA BY TRABECULOTOMY ab interno AND RELATED INSTRUMENT

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, more specifically to ophthalmosurgery and can be used in single-stage surgery of cataract and glaucoma by trabeculotomy ab interno. In the method of single-stage surgery of cataract and glaucoma consisting in extraction of cataracts through an approach to an upper sector, implantation of an intraocular lens in a capsular sac and trabeculotomy ab interno, with using a gonioscope aided cutting instrument, cataract is extracted by phacoemulsification through a small tunnel incision, and trabeculotomy is performed through a paracentesis or paracenteses with using a trabeculotome applied to uncover trabecule; then the instrument is directed in ciliary canal with a blunt distal end set against an external wall of the canal and keeping this contact, a motion is made on a bow-shaped trajectory with dissecting trabecule; and in glaucoma stages I and II trabecule is dissected throughout 3-4 hours from temporal or nasal side, and in glaucoma stage III both from temporal and nasal side throughout 2-3 hours for each region. The trabeculotome comprises a handle, an intermediate piece and a working part in the form of a flat spatula. The spatula has lateral double-edged cutting edges. The working part is symmetrically extending towards the distal end. The distal end is blunt and arch-shaped of radius 0.5 mm with the rounded sides. The lateral cutting edges do not reach 0.125 mm the upper distal end along the longitudinal axis of the instrument.;EFFECT: offered method and device allow improving effectiveness of the combined operation and reducing injures that in turn ensures higher visual acuity, stable normalisation of intraocular pressure and reduced operative and postoperative complications.;1 dwg, 2 ex