MULTIMODALITY THERAPY OF PRIMARY OPEN-ANGLE GLAUCOMA AND CATARACT

FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, namely to ophthalmology, and can be used in the multimodality therapy of the patients with primary open-angle glaucoma and a cataract. That is ensured as follows. Trabecular region is exposed to a nanosecond Nd-YAG laser. The exposure is successive for each quadrant to release pigment particles with the pulse- mode radiation parameters: wavelengths 1064 nm, power 0.8-5.0 mJ, pulse duration 30 nsec, spot diametre 10-30 mcm, number of applicators 40-70 in the sector 90 at the exposure area opened to 270. Thus the first stage involves laser hydrodynamic activation of outflow. Then prior to the beginning of cataract extraction, the preoperative preparation proceeds thereby involving papillary dilatation with mydriatics, local anaesthesia. Then 1-3 hours later, the second stage follows that implies cataract extraction by phacoemulsification and extracapsular extraction. The opening of eyeball is directly combined with removal of organic particles and inflammation mediators suspended by the laser exposure, owing to outflow of the intraocular liquid from anterior chamber, and also during evacuation of lenticular mass with using irrigation and aspiration wherein there is an active movement of the liquid and its exchange in eye chambers. Ciliary canal is unblocked with providing opening of intertrabecular space. Within preoperative preparation and postoperative period, antiinflammatory and hypotensive drugs are prescribed. ^ EFFECT: method allows providing long-term compensation of intraocular pressure and stabilisation of visual functions and also essentially reducing probability of postoperative reactive syndrome that is ensured by removal of inflammation mediators and organic particles from anterior chamber. ^ 6 cl, 3 ex Изобретение относится к медицине, а именно к офтальмологии, и может быть использовано при комбинированном лечении пациентов с первичной открытоугольной глаукомой и катарактой. Для этого осуществляют воздействие на зону трабекулы наносекундным Nd-YAG-лазером. Воздействие проводят последовательно на каждый квадрант до выделения частиц пигмента при параметрах лазерного излучения в импульсном режиме: длина волны 1064 нм, энергия 0,8-5,0 мДж, длительность импульса 30 нс, диаметр пятна 10-30 мкм, количество аппликатов 40-70 в секторе 90° с возможностью расширения зоны воздействия до 270°. При этом первым этапом проводят лазерную гидродинамическую активацию оттока. Затем до начала экстракции к