|Year : 1981 | Volume
| Issue : 3 | Page : 293-295
Russian technique of myopia surgery
P Ranga Reddy
Sarojini Devi Eye Hospital, Hyderabad, India
P Ranga Reddy
Prof of ophthalmology & Civil Surgeon, Sarojini Devi Eye Hospital, Hyderabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Reddy P R. Russian technique of myopia surgery. Indian J Ophthalmol 1981;29:293-5
Surgical treatment of myopia has engaged the attention of a number of workers - Shortening/support of sclera and extraction of lens. Barraquer introduced the technique of refractive keratoplasty.
Since the cornea is responsible for such a large proportion of the refractive power of the eye and since surgery of the cornea has gone through such a great deal of development in the past few decades attention is focussed on the subject of modification of the refractive index of the cornea.
Four years ago Prof. S.N. Fyodorov of USSR developed a new surgical technique for correcting myopia. He described his surgical operation as Dissection ligamentum circular cornea. It is popularly known as "Anterior Keratotomy". This paper describes our experiences with the operation of "Anterior Keratotomy".
| Material and methods|| |
All the cases of myopia are investigated in the cornea clinic and a detailed examination including visual acuity with and without glasses, Placido's disc and slit lamp examination, corneal sensations, precorneal film break up time, Keratometry & Pachometry were done. In addition retinoscopy and port mydriatic test, fundus examination, orthoptic check up and clinical photography were done for all cases. The surgery was done under General anaesthesia/local anaesthesia under an operating microscope.
Steps of operation
The eye lids were separated using lid sutures or speculum. A superior rectus stitch was passed. Then a central marking of the cornea corresponding to the optical centre using a "special trephine" was done. Using a razor blade with holder, 4 cardinal incisions were made starting from the central mark to the limbus. Then radial incisions were made in between these cardial incisions the number of incisions depending on the degree of myopia like spokes of a wheel. Each incision extended upto the limbus and the limbus must be cut. Postoperatively only antibiotic drops were used and both eyes were bandaged for 24 hours. Subsequently green shade or dark glasses were given to reduce the photophobia which lasted for about a week. All the investigations mentioned earlier were repeated every week.
A total of 310 eyes were operated. Detailed analysis is available for 200 cases. The follow up period varies from 3-22 months.
Observations are summarized in [Table - 1][Table - 2][Table - 3][Table - 4][Table - 5][Table - 6].
| Discussions|| |
The operation of Anterior Keratotomy is very simple and easy to perform. Practically there are no complications post operatively except photophobia. Radial incisions are made on the cornea. Re-operation can be done. There is a dioptric improvement of visua acquity in the first and second weeks. Later it slowly comes down in 60% of the cases and in 40% of the cases vision was retained to 6/6. The cornea becomes flatter by 1 to 2 mm. in the first and second weeks, and this flattness gradually decreases assuming the normal contour of the cornea. The incisions made on the cornea do not affect either the field of vision or accommodation and convergence. There is no change in the corneal thickness. Change in the refraction is between-3-4 diaoptres only. There is a residual myopia in all the cases. The maximum follow up is 22 months and minimum is 3 months in this series.
| Summary|| |
Anterior keratotomy was analysed in 200 myopic eyes. The cases are followed post operatively every day for two weeks, thereafter at weekly intervals for about four months followed by monthly intervals for the rest of the period.
In almost all the cases, there is 100% improvement in the visual acquity during the Ist week after the surgery. Thereafter upto the period of three months it is observed that in 60" of the cases there is a gradual reduction in the visual acqiry, as a result of reduciion of corneal flatness. This fall of vision in these cases is proportional to the degree of corneal flatness. There were no changes after operation in the field of vision, accommodation and convergence and in the corneal thickness.
The operation is useful in only 40% of cases.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6]