| Autor: |
Onischenko AL; Novokuznetsk State Institute of Advanced Training of Physicians, Russian Medical Academy of Continuing Professional Education, 5 Stroiteley Av., Novokuznetsk, Kemerovo region, Russian Federation, 654005., Kolbasko AV; Novokuznetsk State Institute of Advanced Training of Physicians, Russian Medical Academy of Continuing Professional Education, 5 Stroiteley Av., Novokuznetsk, Kemerovo region, Russian Federation, 654005., Kramer ER; Novokuznetsk State Institute of Advanced Training of Physicians, Russian Medical Academy of Continuing Professional Education, 5 Stroiteley Av., Novokuznetsk, Kemerovo region, Russian Federation, 654005., Popova AS; Novokuznetsk State Institute of Advanced Training of Physicians, Russian Medical Academy of Continuing Professional Education, 5 Stroiteley Av., Novokuznetsk, Kemerovo region, Russian Federation, 654005., Kurtish EN; Novokuznetsk State Institute of Advanced Training of Physicians, Russian Medical Academy of Continuing Professional Education, 5 Stroiteley Av., Novokuznetsk, Kemerovo region, Russian Federation, 654005. |
| Abstrakt: |
Treatment and rehabilitation of patients with destructive lesions of the cornea is a serious problem for ophthalmologists due to severity of the outcome of the disease - the formation of leukomas with a persistent decrease in vision, or even a complete loss of visual functions. The article presents a clinical case of a patient with posttraumatic ectaticized leukoma of the functionally promising eye, which course was complicated by perforation. The authors, in the absence of the donor cornea, faced a complex clinical task - the risk of functional and anatomical death of the single eyeball in the absence of adequate care for the patient. After enucleation of the subatrophic blind right eye, we took a corneal specimen with a scleral rim of 12 mm trepan. To collect the material, we used an original method of introducing viscoelastic into the vitreal cavity of the hypotonic enucleated eyeball through the intersected optic nerve. This allowed to create the normotony of the enucleated eyeball and perform trepanation of the corneoscleral disc. Trepanation of the sharply ectatic cornea of the left eye was performed after paracentesis and massage of the dome of ectatic cornea with a spatula, which led to the 'subsidence' of the hyperinflated tissue. The corneoscleral disc was fixated with interrupted suture with a 9-0 thread. The postoperative period proceeded smoothly. The autograft has taken with active vascularization. For optical rehabilitation, the patient is scheduled to undergo a keratoprosthetic operation in a planned manner. |
