CN110384582A - A kind of air pocket method Deep liminal keratoplasty device and its application method - Google Patents

Abstract

The present invention relates to the field of medical equipment, more specifically, it relates to a device for deep lamellar keratoplasty by large bubble method and its use method, aiming at solving the problem of incomplete corneal resection in ophthalmic surgery, the main points of the technical solution are: It includes a base, a cutter part screwed to the base, a negative pressure part connected to the base and in contact with the cornea, and an air injection separation part connected to the base. The invention can insert the gas injection needle into the cornea with high precision through the design of the gas injection separation part, so that the gas injection can directly separate the cornea.

Description

A large-bubble deep lamellar keratoplasty device and its application method

technical field

The invention relates to the field of medical equipment, more specifically, it relates to a device for deep lamellar keratoplasty by large air bubble method and its application method.

Background technique

Deep lamellar keratoplasty (DALK) is a surgical method in which the epithelial cells and stroma of the host cornea are removed until the Descemet's layer is transplanted into a donor cornea of corresponding thickness.

DALK is commonly used clinically for keratoconus without a history of edema, corneal scars that do not involve the Descemet's membrane, and dystrophy that does not involve the Descemet's membrane and the endothelial layer. DALK traditionally uses manual separation of the anterior cornea to the deep stroma or Descemet's membrane. At present, it is widely used to push balanced salt solution or viscoelastic agent into the posterior matrix layer, and selectively separate the matrix layer and the posterior elastic layer.

DALK preserves the Descemet's and endothelial layers, and the chances of endothelial cell loss and rejection are reduced postoperatively. However, if the corneal stroma is not completely removed during DALK surgery, an irregular interface may form between stromas, affecting postoperative vision and causing astigmatism.

Contents of the invention

Aiming at the deficiencies in the prior art, the object of the present invention is to provide a deep lamellar keratoplasty device using the large bubble method and its use method. Through the design of the gas injection separation part, the gas injection needle can be inserted into the cornea with high precision, thereby Capable of direct air insufflation to separate the cornea.

The above-mentioned technical purpose of the present invention is achieved through the following technical solutions: a deep lamellar keratoplasty device with large air bubble method, comprising a base, a cutter part screwed to the base, a knife part connected to the base and in contact with the cornea Negative pressure part, gas injection separation part connected to the base.

The negative pressure part is used to connect the base and the cornea together, and the cutter part is used to cut out the incision. After the incision is made by the cutter part, the air injection and separation part is used to inject air, so that the part of the cornea after the incision can be Bubbling occurs and eventually separates.

The present invention is further set as follows: the base is hollow, and the inner wall is provided with a driving thread, and the cutter part includes a knife seat screwed to the driving thread, a drive plate for driving the knife seat to rotate, and a coaxially connected knife seat. The ring cutting knife, wherein the knife seat is also hollow, and the inner wall of the ring cutting knife is provided with a front sight that is convenient for aligning the cornea to be cut.

The ring cutter is used to cut the cornea. When in use, first make a mark on the cornea at the position to be cut, then align the front sight with the mark, and then turn the driving disc, the knife seat and the ring cutter move towards the cornea. Cut the cornea until the circumcision knife touches the cornea.

The present invention is further configured as follows: the knife seat is threadedly connected to the top of the driving thread, the bottom of the driving thread is threadedly connected with a locking threaded seat that locks the position of the knife seat, the locking threaded seat is hollow, and the ring cutter passes through the locking thread along the inner wall of the locking threaded seat seat.

When using the circumcision knife to cut, although the sight can be used to ensure that the circumcision position of the circumcision knife is not deflected, the cutting depth of the circumcision knife can only be judged by the doctor's experience. very high;

Therefore, the locking thread seat is set, and the depth of circumcision is determined according to the patient's condition before the operation, and then the rotating locking thread seat is adjusted and rotated before the operation. When the thread of the knife seat is turned to touch the thread of the locking thread seat, the knife seat will not be able to Continue to rotate, and the cutting depth of the ring cutter is the required cutting depth.

The present invention is further set as follows: the bottom of the base is provided with a gas injection channel along its radial direction, and the gas injection separation part includes a support frame connected to the base, a gas injection needle connected to the support frame, and a gas injection needle that controls the movement of the gas injection needle toward the cornea The needle drive part and the injector for supplying gas to the gas injection needle, wherein the support frame is provided with a sliding slot along the radial direction of the base, and the gas injection needle slides along the sliding slot.

After the cutting is completed, due to the design of the gas injection channel, the gas injection needle can pass through the base to operate the cornea, the gas injection needle is inserted into the cornea, and the gas is supplied through the syringe;

When gas is injected, the gas injection needle and the syringe are arranged separately, so that the volume of the gas injection needle can be made smaller, and the interference of the gas injection needle by pressing the syringe can be avoided.

The present invention is further set as follows: the driving part of the gas injection needle includes a slider sliding along the chute, the slider is rotatably connected with a first threaded driving sleeve; The inner wall of the sleeve and the outer wall of the second threaded driving sleeve are provided with matching threads, the second threaded sleeve has a smooth section extending toward one end of the gas injection channel, and the slider is provided with a through hole for the smooth section to pass through.

The outer wall of the gas injection needle is connected to the second threaded driving sleeve, and the gas injection needle can move with high precision through the thread through the thread cooperation between the second threaded sleeve and the first threaded driving sleeve.

The present invention is further configured as follows: the peripheral wall of the smooth section is provided with a limiting groove along its length direction, and the slider is provided with a limiting block embedded in the limiting groove.

Through the cooperation of the limiting groove and the limiting block, the gas injection needle can slide along the limiting groove without being deflected with the thread rotation of the first threaded driving sleeve.

The present invention is further provided that: the negative pressure part includes a negative pressure chamber opened on the bottom surface of the base, a guide block connected to the inner wall of the negative pressure chamber, and a negative pressure suction syringe connected to the negative pressure chamber.

In order to ensure that the cutting depth is accurate enough, it is necessary to ensure that the base is fully attached to the cornea during each resection. Once the base does not fit the cornea or there is a slight error in height, the preset If the depth of the knife is not enough, the knife will be cut too deep or too shallow, which will have a bad influence on the surgical effect.

The present invention is further provided that: the side wall of the base is provided with a finger handle, and a pair of finger handles are arranged opposite to the side of the base.

All functional parts are connected to the base, and the whole base is moved and controlled by holding the finger grip, so that it is more coordinated with the fingers and more stable in use.

A method of using a deep lamellar keratoplasty device using the large air bubble method,

S1: Turn the locking threaded seat to adjust the locking position of the locking threaded seat;

S2: Move the base and align the position of the base with the cornea;

S3: Use a negative pressure suction syringe to connect the base with the cornea;

S4: Rotate the knife holder to circumcision the cornea to reach the position in front of the cornea's posterior elastic membrane;

S5: Move the gas injection needle, twist the first threaded drive sleeve to insert the gas injection needle to the bottom end of the corneal incision;

S6: injecting air, separating the Descemet's membrane and the corneal stroma, and exposing the corneal implant bed.

In summary, the present invention has the following beneficial effects:

First, through the design of the gas injection separation part, the gas injection needle can be inserted into the cornea with high precision, so that the gas injection can be directly separated from the cornea;

Second, by locking the cooperation between the threaded seat and the knife seat, the driving position of the knife seat is locked, thereby pre-locking the circumcision depth during circumcision.

Description of drawings

Fig. 1 is the structural representation of present embodiment;

Fig. 2 is the structural schematic diagram of cutter part;

Figure 3 is a top view of the cutter portion;

Fig. 4 is a structural schematic diagram of the negative pressure part;

Fig. 5 is a structural schematic diagram of the negative pressure part and the gas injection separation part;

FIG. 6 is an enlarged view of part A of FIG. 1 .

In the figure: 1. base; 11. air injection channel; 12. finger handle; 2. cutter part; 21. knife seat; 22. drive plate; 23. ring cutter; 24. front sight; 25. locking thread 3, negative pressure part; 31, negative pressure chamber; 32, negative pressure suction syringe; 33, guide block; 4, gas injection separation part; 41, support frame; 411, chute; 412, support through groove ; 413, nut; 42, gas injection needle; 43, slide block; 44, first thread drive sleeve; 45, second thread drive sleeve; 451, smooth section; 452, thread section; 453, limit groove; 46, limit block.

Detailed ways

The present invention will be described in detail below in conjunction with the accompanying drawings and embodiments.

Embodiment 1: A large bubble method deep lamellar keratoplasty device, as shown in Figure 1, includes a base 1, a cutter part 2 threadedly connected to the base 1, a negative part connected to the base 1 and in contact with the cornea. The pressure part 3 , the gas injection separation part 4 connected to the base 1 , and the finger handle 12 connected to the side wall of the base 1 . When working, the negative pressure part 3 is used to connect the base 1 and the cornea together, and the cutter part 2 is used to cut out the edge of the knife. The part of the cornea after the incision can bubble up and eventually separate.

As shown in Figures 1 and 2, the base 1 is hollow, and the inner wall is provided with a driving thread, and the cutter part 2 cooperates with the driving thread to perform high-precision movement under the driving of the driving thread. The cutter part 2 includes a knife seat 21 screwed to the top of the drive thread, a drive plate 22 for driving the knife seat 21 to rotate, a locking thread seat 25 threaded to the bottom of the drive thread, and a ring cutter 23 passing through the base 1, wherein The ring cutter 23, the knife seat 21, and the locking thread seat 25 are all hollow. The circumcision knife 23 is connected to the knife seat 21 and passes through the base 1 and the locking threaded seat 25. The doctor rotates the knife seat 21 to lift the circumcision knife 23 during operation.

As shown in Fig. 2 and Fig. 3, the inner wall of the ring cutter 23 is also provided with a crosshair 24. When in use, first make a mark on the cornea at the position to be cut, and then align the sight 24 with the mark. Turn the driving disk 22, and the knife seat 21 moves towards the cornea with the ring cutter 23 until the ring cutter 23 cuts into the cornea to a certain depth, and the cutting of the cornea is completed.

When using the circumcision knife 23 to cut, although it can be aligned with the front sight 24 to ensure that the circumcision position of the circumcision knife 23 is not deflected, the real-time cutting depth of the circumcision knife 23 can only be judged by the doctor's experience. The requirements for surgeons are very high;

Therefore, the locking threaded seat 25 is set, and the depth to be cut by the ring cutter 23 is determined according to the patient's condition before the operation, and then the rotating locking threaded seat 25 is adjusted before the operation, when the thread of the knife seat 21 is rotated to touch the locking threaded seat 25 During the screw thread, knife seat 21 will not be able to continue to rotate, and the depth of cut of ring cutter 23 is the desired depth of cut at this moment. The shape and size of the locking threaded seat 25 and the knife seat 21 are the same, and both of them are connected with the driving disc 22 , the difference is that the inner wall of the knife seat 21 is connected with the ring cutter 23 . During the downward movement of the ring cutter 23, the outer wall always abuts against the inner wall of the locking threaded seat 25, so that the locking threaded seat 25 can also increase the stability of the ring cutter 23.

As shown in FIG. 4 , in order to ensure that the cutting depth of the circumcision knife 23 is accurate enough, it is necessary to ensure that the base 1 is fully attached to the cornea during each resection. Once the base 1 does not fit the cornea or there is a little error in height, if the preset cutting depth is used to feed the knife, the ring cutter 23 will be cut too deep or too shallow, which will affect the surgical effect. bad influence.

Therefore, a negative pressure part 3 directly in contact with the cornea is provided at the bottom of the base 1, and the negative pressure part 3 includes a negative pressure chamber 31 provided on the bottom surface of the base 1, a negative pressure suction syringe 32 communicating with the negative pressure chamber 31 ( 1 ), the negative pressure suction syringe 32 is connected to the negative pressure chamber 31 through a hose, and both ends of the hose are sealed with fillers such as rubber.

Due to the convex shape of the cornea, in order to reduce the negative effect of negative pressure on the cornea and to make the abutment with the cornea more stable, a guide block 33 is provided on the inner wall of the negative pressure chamber 31, and the contact between the negative pressure chamber 31 and the cornea The surface is also provided with chamfers, so that the outer wall of the negative pressure chamber 31, the guide block 33, and the inner wall of the negative pressure chamber 31 are arranged along an arc to form an arc abutting against the cornea.

As shown in Figures 5 and 6, the ring cutter 23 only cuts out a circular cutting mark. In order to separate the cut part from the cornea after cutting by the cutter, an air injection separation part is also connected to the base 1. 4. The gas injection separation part 4 includes a gas injection needle 42 connected to the base 1 , and a syringe for supplying gas to the gas injection needle 42 , and the syringe and the gas injection needle 42 are also sealed and connected by a hose.

Because the injection needle is relatively large, in order to facilitate the operation, the injection needle is connected to the outer wall of the base 1, and the cornea is operated through the base 1 when needed. Therefore, at the bottom of the base 1, there is an air injection channel 11 along the radial direction of the base 1. There is no communication between the air injection channel 11 and the negative pressure chamber 31. The gas injection needle 42 passes through the gas injection channel 11 to realize contact with the cornea. touch. It should be noted that since the cornea is convex, the injection needle is often bent to insert the injection needle into the cornea for the convenience of observation, and then the injection needle is inserted into the cornea in a translational manner. Observe the hollow position in order to make the insertion depth more accurate.

In order to improve the operation accuracy of the gas injection needle 42, a support frame 41 is also connected to the side wall of the base 1. The support frame 41 extends radially along the base 1 and has a chute 411. The chute 411 is a through groove. The axial direction runs through the support frame 41 . Both sides of the chute 411 are also connected with a support channel 412 passing through the support frame 41, and a slide block 43 is slidably connected in the chute 411. The two sides of the slide block 43 are provided with threaded rods passing through the support channel 412. The passing end of the rod is threaded with a nut 413 . Therefore, the slider 43 can not only rotate, but also slide along the slide groove 411. After the position is selected, the nut 413 and the threaded rod can be pressed against the support frame 41 to realize locking.

The slide block 43 is provided with a through hole for the gas injection needle 42 to pass through, and the outer wall of the gas injection needle 42 is provided with a second threaded drive sleeve 45, and the inner wall of the second threaded drive sleeve 45 is provided with a shrinkage, so as to be compatible with the gas injection needle. 42 interference fit, buttightly connected together. One end of the second threaded driving sleeve 45 is provided with a threaded section 452, and the rest of the position is a smooth section 451. The smooth section 451 fits with the inner wall of the through hole of the slider 43 to increase the stability of the movement of the gas injection needle 42. The threaded section 452 is externally threaded. A first threaded drive sleeve 44 is connected.

The bottom surface of the first threaded driving sleeve 44 is rotatably connected to the end surface of the slide block 43, so that it can only rotate by itself. The inner wall of the first threaded drive sleeve 44 is provided with a screw thread that matches the second threaded drive sleeve 45. By rotating the first threaded drive sleeve 44, the second threaded drive sleeve 45 and the gas injection needle 42 can be driven along the passageway of the slider 43 together. Axial movement of the hole.

In order to prevent the second threaded drive sleeve 45 from rotating together with the first threaded drive sleeve 44, a limit groove 453 is opened on the peripheral wall of the smooth section 451, and the limit groove 453 extends along the axis direction of the second threaded drive sleeve 45. The inner wall of the hole is provided with a limiting block 46 embedded in the limiting groove 453 , and the shape of the limiting block 46 fits with the limiting groove 453 to lock the movement direction of the second threaded driving sleeve 45 .

Embodiment 2: A method of using a large-bubble deep lamellar keratoplasty device, comprising:

S1: Turn the locking threaded seat 25, adjust the locking position of the locking threaded seat 25, so as to lock the maximum depth that the knife seat 21 and the ring cutter 23 can go deep into, and ensure that the depth of the ring cutting will not be too deep or too shallow;

S2: Move the base 1, and align the crosshair 24 with the mark on the cornea to ensure that the cutting position of the ring cutter 23 will not be deflected;

S3: Use the negative pressure suction syringe 32 to connect the base 1 and the cornea through negative pressure, so as to ensure that the distance between the circumcision knife 23 and the cornea is the same when cutting different corneas;

S4: Turn the knife seat 21 to perform circumcision on the cornea until the cutting reaches the position in front of the elastic layer of the cornea, then reversely twist the knife seat 21 to reset the circumcision knife 23;

S5: Move the gas injection needle 42, twist the first threaded driving sleeve 44 to insert the gas injection needle 42 to the bottom end of the corneal incision;

S6: injecting air, separating the Descemet's membrane and the corneal stroma, and exposing the corneal implant bed.

The above descriptions are only preferred implementations of the present invention, and the scope of protection of the present invention is not limited to the above-mentioned embodiments, and all technical solutions under the idea of the present invention belong to the scope of protection of the present invention. It should be pointed out that for those skilled in the art, some improvements and modifications without departing from the principle of the present invention should also be regarded as the protection scope of the present invention.

Claims (9)

1. a kind of air pocket method Deep liminal keratoplasty device, it is characterised in that: including pedestal (1), be threadedly connected to pedestal (1) Cutter portion (2), be connected to pedestal (1) and with the negative pressure portion (3) of Corneal Contact, be connected to the gas injection separation unit of pedestal (1) (4).

2. a kind of air pocket method Deep liminal keratoplasty device according to claim 1, it is characterised in that: the pedestal (1) hollow setting, and inner wall be equipped with driving screw thread, the cutter portion (2) include be threadedly connected to driving screw thread tool apron (21), Drive disk (22), the coaxially connected circular cutter (23) in tool apron (21) of tool apron (21) rotation are driven, wherein tool apron (21) is same In hollow setting, the inner wall of circular cutter (23) is equipped with convenient for the foresight (24) of alignment cornea position to be cut.

3. a kind of air pocket method Deep liminal keratoplasty device according to claim 2, it is characterised in that: the tool apron (21) it is threadedly connected to driving threaded top, the driving bottom of thread is threaded with the locking screw thread seat of locking tool apron (21) position (25), locking screw thread seat (25) hollow setting, circular cutter (23) pass through locking screw thread seat (25) along locking screw thread seat (25) inner wall.

4. a kind of air pocket method Deep liminal keratoplasty device according to claim 1, it is characterised in that: the pedestal (1) bottom radially offers gas injection channel (11), gas injection separation unit (4) include be connected to pedestal (1) support frame (41), It is connected to the gas injection syringe needle (42) of support frame (41), the syringe needle driving portion that control gas injection syringe needle (42) is moved towards cornea, to note The syringe of air tube head (42) gas supply, wherein support frame (41) radially offers sliding slot (411), gas injection syringe needle along pedestal (1) (42) (411) are slided along the chute.

5. a kind of air pocket method Deep liminal keratoplasty device according to claim 4, it is characterised in that: the gas injection needle Head (42) driving portion includes the sliding block (43) of (411) sliding along the chute, is rotatably connected to the first screw drive set on sliding block (43) (44)；The second screw drive set (45), the first screw drive set (44) inner wall and the second screw thread are arranged with outside gas injection syringe needle (42) Actuating sleeve (45) outer wall is equipped with the screw thread of cooperation, and one end of the second thread bush towards gas injection channel (11) is extended with smooth section (451), sliding block (43) offers the through-hole passed through for smooth section (451).

6. a kind of air pocket method Deep liminal keratoplasty device according to claim 5, it is characterised in that: the smooth section (451) peripheral wall is provided with limiting slot (453) along its length, and sliding block (43) is equipped with the limited block of insertion limiting slot (453) (46).

7. a kind of air pocket method Deep liminal keratoplasty device according to claim 1, it is characterised in that: the negative pressure portion (3) include the negative pressure chamber (31) for being opened in pedestal (1) bottom surface, the guide pad (33) for being connected to negative pressure chamber (31) inner wall, connect The negative-pressure ward syringe (32) of logical negative pressure chamber (31).

8. a kind of air pocket method Deep liminal keratoplasty device according to claim 1, it is characterised in that: the pedestal (1) side wall is equipped with finger grip (12), and finger grip (12) is relatively set with a pair in the side of pedestal (1).

9. a kind of air pocket method Deep liminal keratoplasty device application method, it is characterised in that:

S1: turning locking screw thread seat (25), adjusts the latched position of locking screw thread seat (25)；

S2: moving pedestal (1), by pedestal (1) position alignment cornea；

S3: it uses negative-pressure ward syringe (32), pedestal (1) is connect with cornea；

S4: turning tool apron (21), carries out ring cutting to cornea, the position before reaching entocornea；

S5: moving gas injection syringe needle (42), and turning the first screw drive set (44) makes gas injection syringe needle (42) be inserted into corneal ablation Bottom end；

S6: injection air separates entocornea and corneal stroma, and exposure obtains cornea plant bed.