METHOD FOR ENDOVITREAL REMOVAL OF CHOROID MELANOMA WITH PREVENTION OF METASTASIS AND THROMBOEMBOLISM

摘要

FIELD: medicine.;SUBSTANCE: invention relates to ophthalmology. For the treatment of choroid melanoma (CM) by its endovitreal removal, subtotal vitrectomia, retinotomy, coagulation around visible macroscopically base CM, removal of CM from its apex to base with formation of surgical colobolism within visible macroscopically boundaries of healthy tissues, endolaser coagulation (ELC) on surface of scleral bed after removal of CM, retinopexy by ELC along retinotomy margin followed by vitreous cavity tamponade with silicone oil, adjuvant BT with radionuclide Ruthenium-106. First, a conjunctival is incised in 3 mm from the limb, the Tenon's membrane is separated along the whole perimeter, the sclera and vorticose veins are carefully examined. In the absence of extraocular propagation of CM, one vorticose or two vortical veins are blocked, the ampoule or ampoule of which are found in the quadrant or quadrants of CM localization at a distance of at least 2 cm from the venous/vein outlet from the sclera. Subtotal vitrectomy is performed using instruments 25 G, complete tamponade of the VP is applied with a perfluororganic compound with creation of increased intraocular pressure to 50 mm Hg, coagulation around the visible macroscopically CM base is performed by diathermocoagulation, the retinotomy is performed along a diathermocoagulation boundary with the subsequent resectionectomy of the obtained area above the CM; additional 1 mm thick layer of surrounding tissues is additionally resected with a vitreous cutter at frequency of 6000 cuts/min along the entire perimeter of the formed colophony.;EFFECT: method enables complete endovitreal removal of CM with maximum preservation of healthy functionally significant surrounding tissues, reduced dissemination of tumor cells in the vitreal cavity.;1 cl, 1 ex