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3.2.2. The Surgical intervention at carrying out of the combined operation

Patient S, 67 years, 10.10.12 has arrived in a day hospital of clinic "æ" concerning the primary angle-closure not stabilised glaucoma II from the right eye; primary angle-closure I and glaucomas of the left eye.

An initial cataract of both eyes. The accompanying diagnosis: Chronic obstructive illness of lungs of II degree, a diffusive pneumosclerosis? DN II. The Diabetes of II type of moderate severity level.

At survey the Right eye: Vis OD = 0,2, not korrigiruet, the admixed injection of an eyeball, at 11 o'clock in 2 mm from a limbus of 2 knots (silk 10/0), the filtrational pillow is absent, a basal coloboma, an easy edema of a cornea, the forward chamber fine, depth of 1,8 mm, PZO - 22,2 mm, iridokornealnyj an angle narrow, 17 °; the pupil is dilated, the wrong form, back synechias, moderate opacifications of a stroma of a lens, the forward-back size of a lens of 4,5 mm; back amotio of a vitreous. A retina prilezhit in all departments. VGD 36 mm hg, a field of vision - at standard automatic perimetria under the program 24/2 Humphrey are defined plural microscotomas, MD - 10 Db. Eyeground details not oftalmoskopirujutsja because of a cornea and cataract edema.

Fig. 15. UMB iridokornealnogo an angle before operation

The left eye: Vis = 0,4 n/k. The forward chamber of an eye depth of 2,0 mm. Iridokornealnyj an angle 20 °. From features: individual vacuoles, moderate phacoscotasmuses under a forward and back capsule. An optic disk acyanotic, E/D = 0,4, at standard automatic perimetria under the program 24/2 Humphrey are taped plural microscotomas, MD - 6 db.

Under local and intravenous anaesthesia, after preliminary depression VGD, on the right eye to it 11.10.12. Complex operation is executed: microinvasive fakoemulsifikatsija cataracts with IOL (+) 19,0 dptr., a lobby vitrektomija with destruction of a forward hyaloid membrane, a deep sclerotomy and basal corectomy of the right eye. After operation the patient felt well, disturbed insignificant pains in the right eyeball. At survey 11.10.12. The right eye: the easy injection of an eyeball, individual cords of a descemete cover, the forward chamber of average depth, a pupil to 4 mm, IOL costs correctly. Palpatorno - a moderate hypotension. Treatment: instilljatsii - tobradeks 4 times a day, tropikamid 0,5 % - 2 times a day. Injections under a conjunctiva dexamethasone of 0,4 % - 0,3 ml and gentamycin of 4 % of 0,5 ml. - once a day. A postoperative current smooth.

The patient is written out from a day hospital 14.10.12. At an extract of ODES: Vis=0,2; ВГД=19 mm hg the Cornea the transparent, forward chamber of average depth, a pupil round, IOL costs correctly. The forward chamber depth of 3 mm. PZO - 22,2мм, iridokornealnyj an angle 32 °. On an eyeground a disk acyanotic (glaukomatoznaja nejropatija DZN), E/D 0,6. Retinal arteries are narrowed, veins are dilated izvity. At standard automatic perimetria under the program 24/2 Humphrey are taped plural microscotomas, MD - 6 db. The left eye without dynamics.

Survey in three months the Right eye: Vis=0,4; ВГД=19 mm hg the Cornea the transparent, forward chamber of 3 mm, iridokornealnyj an angle 32 ° the pupil round, IOL costs correctly. On an eyeground a disk acyanotic, E/D 0,6. Retinal

Arteries are narrowed, veins are dilated, izvity, at standard automatic perimetria under the program 24/2 Humphrey - without negative dynamics. In a year - indicators of visual acuity, a field of vision, an ophthalmotonus,

The forward chamber, iridokornealnogo an angle, an eyeground without dynamics.

Fig. 16. A kind of patient S after operation.

Fig. 17. Appreciable expansion iridokornealnogo an angle by data

UBM.

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Scientific source Tarasov Konstantin Leonidovich. COMPLEX SURGICAL TREATMENT of the POSTOPERATIVE MALIGNANT GLAUCOMA. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow, 2014. 2014

Other medical related information 3.2.2. The Surgical intervention at carrying out of the combined operation:

  1. the clinical characteristic of groups of children after carrying out of preventive correction
  2. dynamics of a painful index at premedication carrying out in group of surveyed children.
  3. THE MAINTENANCE
  4. INTRODUCTION
  5. a general characteristic of groups of patients
  6. techniques of surgical interventions
  7. the Chapter III. The SUBSTANTIATION of the COMBINED SURGICAL TREATMENT of the POSTOPERATIVE MALIGNANT GLAUCOMA
  8. the analysis of outcomes of surgical treatment of patients with the developed postoperative malignant glaucoma
  9. 3.2. Clinical examples of surgical interventions at carrying out vitrektomii and the combined operation at the developed postoperative malignant glaucoma
  10. 3.2.1. The Surgical intervention at carrying out vitrektomii
  11. 3.2.2. The Surgical intervention at carrying out of the combined operation
  12. 3.3. Fakoemulsifikatsija, executed by us within a year at patients 1 "and" groups
  13. 3.4. Quantity of operative measures at patients of 1 group
  14. the Chapter V. The SUBSTANTIATION of EFFICIENCY of the COMBINED PREVENTIVE OPERATION of the POSTOPERATIVE MALIGNANT GLAUCOMA
  15. the analysis of outcomes of surgical treatment of patients in the investigated groups
  16. 5.2. An intervention at carrying out of the combined preventive operation
  17. the Chapter VI. DISCUSSION of the RECEIVED DATA
  18. 2.2.2. A technique of carrying out of additional radial methods of research (roentgenography, a computer tomography, a magnitno-resonant tomography)
  19. 5.4 Role of ultrasonic research in planning of treatment of patients with tumours and opuholepodobnymi formations of soft tissues in the conditions of a day surgical hospital