RU77156U1 - DEVICE FOR FACOEMULSIFICATION OF CATARACTS AT RIGID PUPIL - Google Patents

Abstract

The utility model relates to the field of medicine, in particular to ophthalmic surgery, and is intended for phacoemulsification of cataracts with a rigid pupil. The device has two handles for irrigation and aspiration. The working end of the irrigation handle is equipped with a hook in the shape of a hatchet. The device provides removal of the lens masses atraumatic for the iris, with good visual control and without inflammatory complications in the postoperative period and with obtaining fast high clinical and functional results.

Description

The utility model relates to the field of medicine, in particular to ophthalmic surgery, and is intended for phacoemulsification of cataract with bimanual irrigation - aspiration of the crystalline masses with a rigid pupil under visual control.

A device is known for phacoemulsification of cataracts, in particular, for a rigid pupil, which includes a manual coaxial handle for irrigation / aspiration of the lens masses during phacoemulsification of cataracts (Product catalog for anterior segment surgery of the company ALCON, 2007, ULTRAFLOW series, No. 8065817001). on the one hand, with a rigid pupil it is convenient to use, because in the other hand, the surgeon can take a tool to move the pupil. However, its use complicates the aspiration of the masses in the area of the handle, so many ophthalmic surgeons prefer bimanual technique. The closest analogue of the invention is a phacoemulsification device comprising a bimanual kit for irrigation / aspiration (product catalog for the surgery of the anterior segment of the eye company ALCON, 2007, No. 170.11), consisting of two handles: one for supplying fluid to the eye - irrigation, and the other for aspiration. The disadvantage of this device when working with a rigid pupil is the lack of visualization of the lens masses located behind the iris, and, therefore, blind aspiration. This can lead to undesirable complications:

- suction to the capsule and partial tearing of the ligaments, which complicates the implantation of the IOL, increases the risk of rupture of the posterior capsule, worsens the centering of the IOL, and ultimately reduces postoperative visual acuity;

- aspiration of the masses is not complete, which will lead to an inflammatory reaction after surgery.

The objective of this utility model is to improve the device for phacoemulsification of cataracts with a rigid pupil. The technical result of the proposed utility model are:

- providing visual control over the manipulation;

- preservation of the diaphragmatic function of the pupil and its integrity;

- reduced risk of bleeding during surgery and inflammatory reactions in the postoperative period;

- reduced operation time, because the introduction and removal of additional dilators of the pupil is not required.

The technical result is achieved due to the presence on the working end of the irrigation handle of the iris hook in the form of a “hatchet”, which allows to displace the pupil edge around the entire circumference and visualize all the masses in the capsular bag and, accordingly, completely aspirate them, as well as not to injure the iris the introduction of additional devices for the expansion of the pupil.

Figure 1 shows the irrigation handle 1 and the hook on the working end of the handle in the shape of a hatchet 2.

The device is used as follows.

During phacoemulsification, after epibulbar anesthesia, a 2.5 mm tunnel is performed from the temporal side and paracentesis in the upper inner and lower outer segments is 1.3 mm in size. The capsule is stained with trepan blue dye. After the introduction of viscoelastic, a continuous circular capsulorexis is performed wider than the diameter of the pupil, moving the pupil with a buttoned manipulator. Hydrodissection, fragmentation of the lens nucleus by a L-shaped sharp chopper is performed within

pupil and removal of fragments. Through paracentesis, handles for irrigation and aspiration are introduced and the lens masses are removed under visual control, pulling the pupil to the periphery sequentially around the entire circumference. Handles are removed from the cavity of the eye. An IOL is implanted in the capsule bag. Viscoelastic is washed and stroma hydration closes the incisions.

Example 1

Patient H., No. 25039, 77 years old

Upon enrolment

VIS OD = 0.01 P ₀ = 9 mmHg

The cornea is transparent, the anterior chamber is of medium depth, dystrophy of the pupil border, pseudoexfoliation, the pupil is round 2 mm, the lens is cloudy, the fundus is not ophthalmoscopic.

Diagnosis OD PES Cataract IV Art.

The patient underwent surgery with drug mydriasis 4 mm, using the proposed device. Arms for irrigation and aspiration were introduced through paracentesis and the lens masses were removed under visual control, pulling the pupil to the periphery sequentially around the entire circumference. The handles are removed from the cavity of the eye. The capsule bag is completely cleared of lens masses, there were no injuries to the pupil.

The postoperative period was uneventful.

After surgery on the first day:

VIS OD = 0.7 P ₀ = 15 mmHg

An eye without signs of inflammation, the pupil is even, the reaction to light is alive.

Thus, the use of the proposed device provides removal of the lens masses atraumatic for the iris, with good visual control and without inflammatory complications in the postoperative period and with obtaining fast high clinical and functional results.

Claims (1)

A device for phacoemulsification of cataracts in the eyes with a rigid pupil, including two handles for irrigation and aspiration, characterized in that the working end of the irrigation handle is equipped with a hook in the form of a hatchet.