IRIDOTSIKLEKTOMIYA

From Big Medical Encyclopedia

IRIDOTSIKLEKTOMIYA (iridocyclectomia; grech, iris, irid[os] a rainbow + kyklos a circle, an eye + ektome excision, removal) — the operation consisting in excision of a part of an iris and ciliary body. Indications to And. the tumors of an iris reaching its root, the new growths which are located in a corner of an anterior chamber of an eyeglobe, the tumors of a ciliary body combined under the name «iridotsiliarny tumours» are. If the tumor is localized in a ciliary body, and the iris remains intact, only a part of a ciliary body is excised (cyclectomy). Character of a new growth of iridotsiliarny area clinically manages to be defined not always in this connection it should be considered as obviously malignant tumor. And. it is contraindicated at the tumors extending to a half of a circle of an iris and a ciliary body.

Fig. 1. The diagrammatic representation of an iridotsiklektomiya by Stallard's method: 1 — the rags divorced after the T-shaped section of a sclera; 2 — a tumor of iridotsiliarny area; 3 — the line of excision of an iris and ciliary body; 4 — thread of a P-shaped provisional seam.
Fig. 2. The diagrammatic representation of an iridotsiklektomiya by Linnik's method: 1 — the rags shutters formed after the H-shaped section of a sclera; 2 — a tumor of iridotsiliarny area; 3 — the line of excision of an iris and ciliary body; 4 — threads of provisional seams.

Preparation to And. shall include careful definition of border of spread of a tumor in the way gonioskopiya (see), tsikloskopiya and diafanoskopiya (see). Medicamentous preparation includes sedative and dehydrational means.

At the small tumors (3 — 4 mm) taking only nachalna]! the department of a ciliary body, is applied Stallard's technique. Principle I. it is represented in the figure 1. Excision of an iris and ciliary body is made with the help an iris scissors and an iris tweezers within healthy fabrics, otstupya from borders of a tumor of 2,5 — 3,0 mm. Closing of an operational wound is carried out by means of a P-shaped provisional seam and additional knotty corneoscleral seams. At tumors, fascinating 1/4 and more circles of an iris and a ciliary body, access to a zone of tumoral defeat provide scleral or corneoscleral cuts (fig. 2).

After operation the high bed rest with a binocular bandage is appointed to 3 — 7 days depending on the volume of the made operation. Preventive antibacterial, dehydrational therapy, locally — atropinizations for achievement as much as possible a leg of a mydriasis for the purpose of the prevention of formation of back synechias is carried out.

Treat operational complications loss vitreous (see), hyphema (see), hemophthalmia (see), to frequent complications in the postoperative period — iridocyclitis (see) with the sharp hypotonia of an eye lasting sometimes 1,5 — 2 months. Measures of fight against it is the complex of the general and local antiinflammatory therapy.

The fabrics excised during operation are exposed patogistol, to a research for establishment of nature of a tumor and completeness of its removal; an eye can be kept only on condition of an oncotomy within healthy fabrics, otherwise urgent is shown enucleation of an eye (see).

As a rule, ambassador I. patients keep good sight on the operated eye; dispensary observation for the purpose of early detection of a possible recurrent tumor, and also for control of the level of intraocular pressure is obligatory (see. Tonografiya , Tonometriya ).

Recurrent tumors meet approximately in 3% of cases; they arise in the first 1,5 — 2 years and are shown as implantation growth in a postoperative hem. A recurrence of a leiomyoma is limited to local growth. At not considerably remote melanomas hematogenous metastasises are possible.


Bibliography: Wolves V. V., Country T. P. and Somov E. E.Sklerouveoektomiya with a single-step homoplasty of a sclera at tumors of a vascular path, Vestn, oftalm., No. 4, page 10, 1970; At N-d about r about in and R. A. and 3 and and N of and r about in and G. G. Microsurgery of the uveal tumors which are localized in doekvatorialny department of an eye, in the same place, No. 2, page 15, 1974; E r about sh e in with to and y T. I., L and N of N and to L. f! and P and N f and N. I. Fotokoagulyation's fishing in clinical practice of the ophthalmologist, Oftalm, zhurn., No. 3, page 201, 1969; 3 and-angirova G. G. and d river. Surgical treatment of nodal iridotsiliarny tumors, in the same place, No. 5, page 340; Linnik of L. F. Iridotsiklektomiya as a method of removal of the tumors of an iris of the eye burgeoning in a ciliary body, Vestie, oftalm., No. 2, page 15, 1966; S t and 1 1 r d H. Century of Partial cyclectomy, Brit. J. Ophthal., v. 48, p. 1, 1964.

L. F. Linnik.

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