CYCLODIALYSIS

From Big Medical Encyclopedia

CYCLODIALYSIS (cyclodialysis; Greek kyklos a circle, a cycle + dialysis) — operation of flaking of a ciliary (ciliary) body from a sclera for the purpose of creation of the message between an anterior chamber of the eyeglobe and suprakho-rioidalny space providing outflow of intraocular liquid. C. L. Heine is offered in 1905.

C. it is shown at primary and secondary, including and afakichesky, to glaucoma with an open corner of an anterior chamber (see Glaucoma).

C. carry out under local anesthesia. Section of a conjunctiva dli-


Fig. Diagrammatic representation of operation of a cyclodialysis: 1 — the conjunctiva

is cut parallel to a limb; 2 — a section of a sclera; 3 — the pallet entered between a sclera and a ciliary body (the direction of the movement of the pallet and his corresponding movements during the peeling of a ciliary body from a scleral spur are shown by an arrow and a dotted line); 4 — eyelid lifters; 5 — the seams handles imposed on edges of a scleral wound; in — an iris; 7 — a pupil.

ache 5 — 6 mm produce parallel to a limb, otstupya 5 mm from it, most often in verkhnenaruzhny or nizhnenaruzhny quadrants of an eyeglobe, in the area, free from goniosinekhiya and neogenic vessels (fig). Bare an episkleralny plate, and then make a through tangential section of a sclera parallel to a limb 2 — 3 mm long. After imposing of seams handles enter a tip of the thin pallet into a section of a sclera and the pendulum movements advance it in suprakhorioidalny space towards a cornea, pressing to an inner surface of a sclera. Progress of the pallet separate a ciliary body on V3 of its circle from a scleral spur. After the end of operation the pallet bring into initial situation and take from an operational wound. On a conjunctiva put a stitch. Under a conjunctiva enter corticosteroids (e.g., Dexasonum) and antibiotics, are more often gentamycin.

During operation damage of a ciliary body with loss of a vitreous (see), damage of a crystalline lens (see), peeling of a descemete cover of a cornea (see), formation of a hyphema is possible (with - m). To avoid damage of a crystalline lens and a ciliary body, operation is made under control of an operative microscope (see). For the prevention of formation of a hyphema during C. the eyeglobe in the field of operation is pressed down a wet cotton plug. At emergence of blood through previously made puncture of a cornea at a limb enter sterile air into an anterior chamber, and then replace it with isotonic solution of sodium chloride, washing away blood and its clots.

The crack formed as a result of operation between a ciliary body and a sclera provides outflow of intraocular liquid and contributes to normalization of intraocular pressure. The lasting hypotensive effect is noted in 60 — 70% of cases. In case of inefficiency of operation it is possible to execute it repeatedly.

Bibliography: The multivolume guide to eye diseases, under the editorship of V. N. Arkhangelsky, t. 5, page 108, M., 1960; The Guide to eye surgery, under red * M. L. Krasnova, page 213, M., 1976.

B. N. Alekseev.

Яндекс.Метрика