CN111529083A

CN111529083A - Astigmatic axial position marker and marking method

Info

Publication number: CN111529083A
Application number: CN202010484592.4A
Authority: CN
Inventors: 姚涛
Original assignee: Shenyang Heshi Eye Hospital Co ltd
Current assignee: Shenyang Heshi Eye Hospital Co ltd
Priority date: 2020-06-01
Filing date: 2020-06-01
Publication date: 2020-08-14
Anticipated expiration: 2040-06-01
Also published as: CN111529083B

Abstract

The invention discloses an astigmatism axis marker and a marking method, wherein the astigmatism axis marker comprises: the dial is provided with annular scales; the eyeball-shaped piece is positioned above the dial, the outer surface of the eyeball-shaped piece comprises an eyeball-imitating spherical surface, the bottom edge of the eyeball-imitating spherical surface is positioned on a first plane, a straight line which passes through the vertex of the eyeball-imitating spherical surface and is perpendicular to the first plane is a first straight line, and a gap is formed between the bottom of the eyeball-shaped piece and the dial; the top end of the supporting rod is fixedly connected with the eyeball copying piece, and the bottom end of the supporting rod is fixedly connected with the dial scale; a tear-off marker component applied to an outer surface of the eyeball cam; the first end of the pointer is rotatably connected with the support rod, and the second end of the pointer points to the scale. The structural design of the astigmatism axis marker can effectively reduce the error generated by positioning the astigmatism axis during the operation.

Description

Astigmatic axial position marker and marking method

Technical Field

The invention relates to the technical field of medical instruments, in particular to an astigmatism axis marker and a marking method.

Background

Cataract is the blinding eye disease with the highest incidence worldwide, and phacoemulsification and intraocular lens implantation surgery is the main means for treating cataract at present, wherein the intraocular lens is an optical lens for replacing a turbid lens, the surgery needs to remove the nuclear mass and the cortex of the turbid lens by using phacoemulsification technology, retain a lens bag, and then implant the intraocular lens in the lens bag. Corneal astigmatism is one of the important factors causing poor postoperative vision of cataract patients, and can obviously influence the visual quality after cataract extraction. Currently, the main methods for correcting astigmatism in cataract patients include postoperative lens wearing, corneal excimer laser surgery, corneal limbal relaxing incision ascending on the steep axis of the cornea, and the use of astigmatism correcting intraocular lenses (also known as Toric IOLs). Among them, Toric IOLs are relatively widely used and have positive effects. Accurate axial fixation after Toric IOL implantation is important, however, with an intraocular lens rotation of every 1 ° resulting in under-correction of 3.3% of astigmatism, and rotations above 30 ° resulting in the introduction of additional astigmatism. In order to ensure that the axial position of the astigmatism-corrected intraocular lens after implantation is accurate, it is important to mark and confirm the accurate horizontal position or astigmatism axial position of the operative eye of the patient before and during the operation.

When Toric IOL is implanted, in order to avoid the influence caused by the rotation of eyeballs in the horizontal position (the maximum rotation is about 10 degrees), the traditional method is that when a patient sits in a seat before an operation, a doctor manually marks the seat with a marker pen under a slit lamp microscope, during marking, the slit light of the microscope is firstly adjusted to the horizontal position and is modulated to be narrowest, and the light band passes through the center of a pupil, and the marker pen is used for marking the horizontal position at the corneal limbus. During operation, the marked 0-degree position is referenced, and the astigmatism axis position is further determined by utilizing the annular astigmatism disc with scales. The method has high requirements on operators, poor repeatability and easy occurrence of errors. In order to reduce errors, foreign manufacturers produce markers with bubble levels for marking preoperative surgical eye levels, but the bubble levels are poor in sensitivity, poor in stability of hand holding mode marking, and still prone to generating large errors in the using process. In addition, because the diameter of the cornea is only about 10mm, the existing intraoperative astigmatism marking disc with the large and small diameter is difficult to realize accurate scale marking, generally, the accurate scale marking can only be up to 5 degrees, and a great error is brought to the operation.

In summary, how to effectively reduce the error generated by positioning the astigmatic axis during the operation is a problem that needs to be solved by those skilled in the art.

Disclosure of Invention

In view of the above, the first objective of the present invention is to provide an astigmatic axis marker, which has a structural design capable of effectively reducing the error generated by positioning the astigmatic axis during surgery, and the second objective of the present invention is to provide a marking method using the astigmatic axis marker.

In order to achieve the first object, the invention provides the following technical scheme:

an astigmatic axis marker, comprising:

the dial is provided with annular scales;

the outer surface of the eyeball-shaped piece comprises an eyeball-imitating spherical surface, the bottom edge of the eyeball-imitating spherical surface is positioned on a first plane, a straight line which passes through the vertex of the eyeball-imitating spherical surface and is perpendicular to the first plane is a first straight line, a gap is formed between the bottom of the eyeball-shaped piece and the dial, and the first straight line passes through the center of the annular scale and is perpendicular to the dial;

the top end of the supporting rod is fixedly connected with the eyeball copying piece, the bottom end of the supporting rod is fixedly connected with the dial scale, and the supporting rod extends along the first straight line;

a tearable marker member applied to an outer surface of the eyeball cam, the marker member having a circular outer edge and a center on the first line;

the first end of the pointer is rotatably connected with the supporting rod, the second end of the pointer points to the scale, and the pointer penetrates through a gap between the bottom of the eyeball copying piece and the dial.

Preferably, a through hole is formed in the center of the annular scale, and the bottom end of the supporting rod penetrates through the through hole and is fixedly connected with the through hole through a nut.

Preferably, the through hole is a stepped hole, and the supporting rod is provided with a step platform matched with the stepped hole.

Preferably, the lower end of the reverse folding part is connected with the upper side of the pointer, the reverse folding part is opposite to the eyeball surface, the reverse folding part can be close to or far away from the eyeball surface, and a hollow hole is formed in the reverse folding part.

Preferably, the lower end of the reverse folding part is fixedly connected with the upper side of the pointer; or, the upper side of the pointer is provided with a sliding groove, and the lower end of the reverse folding part is connected with the sliding groove in a sliding manner.

Preferably, the marking part is a marking ring group and comprises an inner ring and an outer ring, and the centers of the inner ring and the outer ring are both located on the first straight line; a connecting strip is connected between the inner ring and the outer ring; a connecting strip is connected between the inner ring and the outer ring;

the diameter of the eyeball imitative piece is 10 +/-1 mm;

the diameter of the outer ring is 9 +/-1 mm, and the diameter of the inner ring is 5.5 +/-0.5 mm.

Preferably, the marking member is ring-shaped; alternatively, the marking member is circular and the surface thereof is curved.

A marking method using an astigmatic axis marker as claimed in any one of the preceding claims, comprising the steps of:

A) marking any point of the corneal limbus and using the marked point as a reference point;

B) measuring to obtain an angle between a connecting line of the center of the cornea and the reference point and a horizontal line, rotating the pointer to point to the measured angle on the dial, marking a position of the marking part, which is opposite to the pointer and is a preset distance away from the outer edge of the marking part, and taking the position as a preset reference point;

C) determining the position of the main incision and the angle between the connecting line of the position of the main incision and the center of the cornea and the horizontal line, rotating the pointer to point at the angle on the dial, marking the position of the marking part, which is opposite to the pointer and is away from the outer edge of the marking part by a preset distance, and taking the marked position as a preset main incision;

C1) determining the Toric crystal preset axis position and the angle between the Toric crystal preset axis bit line and the horizontal line, rotating the pointer to point at the angle on the dial, marking the position of the marking part, which is opposite to the pointer and is a preset distance away from the outer edge of the marking part, and taking the position as a preset axis position;

C2) determining the position and arc length of LRI incision, determining the angle between the horizontal line and the line connecting the starting point of LRI incision arc length and the center of cornea, rotating the pointer to point at the angle on the dial, marking the position of the marking part opposite to the pointer and away from the outer edge of the marking part by a preset distance, and using the marked position as the starting point of preset main incision;

determining the angle between the connecting line of the end point of LRI incision arc length and the cornea center and the horizontal line, rotating the pointer to point to the angle on the dial, marking the position of the marking part, which is opposite to the pointer and is away from the outer edge of the marking part by a preset distance, and taking the position as the preset main incision end point;

D) and tearing off the marking ring group from the eyeball contour piece, placing the marking ring group on the cornea of the patient, and corresponding the preset datum point to the datum point.

Preferably, in step B), the angle between a line connecting the center of the cornea and the reference point and the horizontal line is measured, specifically:

and taking a picture of the eye part marked with the reference point, and measuring by using an electronic protractor or a physical protractor to obtain an angle between a connecting line of the cornea center and the reference point in the picture and a horizontal line.

Preferably, a horizontal position marking line is arranged on the shot eye picture behind the marked reference point; or when the eye picture after marking the reference point is shot, the imaging bottom edge of the lens of the shooting device is horizontal.

In the astigmatism axis marker provided by the invention, the diameter of the annular scale is far larger than that of the eyeball profiling piece, so that the precision of the annular scale can reach 1 degree or 0.5 degree, the preoperative eye marking and the astigmatism axis confirming in the operation can be conveniently, quickly and accurately carried out by utilizing the matching of the annular scale and the outer ring, and the error of locating the astigmatism axis is greatly reduced. In addition, when the astigmatism axis marker provided by the invention is applied, the mode of selecting the datum point is adopted instead of only taking the horizontal line as the datum, so that the operation can be simplified, and the error can be further reduced.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.

Figure 1 is a top view of an astigmatic axis marker provided by an embodiment of the present invention;

figure 2 is an exploded view of an astigmatism axis marker provided by an embodiment of the invention;

FIG. 3 is a schematic view of an astigmatism axis marker provided by an embodiment of the invention;

FIG. 4 is a top view of a marker ring set provided by an embodiment of the present invention;

figure 5 is a partial cross-sectional view of an astigmatic axis marker provided by an embodiment of the present invention;

figure 6 is a partial cross-sectional view of an astigmatism axis marker provided in accordance with another embodiment of the invention;

FIG. 7 is a schematic view of a marking member provided in accordance with another embodiment of the present invention;

FIG. 8 is a schematic view of a marking member provided in accordance with another embodiment of the present invention;

FIG. 9 is a schematic view of step A) of the astigmatic axial marking method provided by an embodiment of the present invention;

FIG. 10 is a schematic view of an electronic protractor used for measuring an angle in the astigmatism axis marking method according to an embodiment of the present invention;

FIG. 11 is a schematic view of a mark on the outer ring according to an embodiment of the present invention;

FIG. 12 is a schematic diagram of a marking ring set after marking is completed according to an embodiment of the present invention;

fig. 13 is a schematic view illustrating a marker ring set attached to an eyeball according to an embodiment of the present invention;

FIG. 14 is a schematic view of a surgical procedure performed according to a marker point on a marker ring set, according to an embodiment of the present invention;

FIG. 15 is a schematic diagram of a Toric crystal after implantation, according to an embodiment of the present invention.

In fig. 1-15:

1-dial, 2-eyeball profiling piece, 3-marking ring group, 3 a-inner ring, 3 b-outer ring, 3 c-connecting bar, 4-pointer, 5-inflection part and 6-supporting rod.

Detailed Description

The first purpose of the invention is to provide an astigmatism axis marker, the structure design of which can effectively reduce the error generated by locating the astigmatism axis during operation, and the second purpose of the invention is to provide a marking method using the astigmatism axis marker.

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

In the description of the present invention, it is to be understood that the terms "upper", "lower", "front", "rear", "left" and "right", etc., indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience of description and simplification of description, but do not indicate or imply that the positions or elements referred to must have specific orientations, be constructed in specific orientations, and be operated, and thus are not to be construed as limitations of the present invention. Furthermore, the terms "first" and "second" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.

Referring to fig. 1 to 5, the astigmatism axis marker provided by the present invention includes a scale 1, an eyeball cam 2, a support rod 6, a marking member, and a pointer 4.

The dial 1 is provided with annular scales. The instant dial 1 is provided with an annular 360-degree scale mark, and the precision of the scale mark is 1 degree or 0.5 degree. Preferably, the scale on the dial 1 may be a double ring scale.

The eyeball cam 2 is located above the scale 1. The outer surface of the eye contour 2 comprises a contour of the eye sphere, i.e. the outer surface of the eye contour 2 is made to resemble the anterior surface of the eye. The bottom edge of the eye-imitating spherical surface is positioned on the first plane, and a straight line which passes through the vertex of the eye-imitating spherical surface and is vertical to the first plane is a first straight line. The base of the eyeball cam 2 is located on the first plane. The first line passes through the apex of the simulated eye surface and is perpendicular to the bottom surface of the eyeball contour 2. There is a gap between the bottom of the eyeball cam 2 and the scale 1, and the first plane and the scale 1 are parallel to each other. And the first straight line crosses the center of the ring scale and is perpendicular to the scale 1.

The top end of the supporting rod 6 is fixedly connected with the eyeball copying piece 2, the bottom end of the supporting rod 6 is fixedly connected with the dial 1, and the supporting rod 6 extends along a first straight line. The extension direction of the supporting rod 6 passes through the circle center of the annular scale.

The marking means is applied to the outer surface of the eyeball cam 2 and the marking means is torn off. The outer edge of the marking part is circular and the center of the circle is positioned on a first straight line

The first end of the pointer 4 is rotatably connected to the rod 6, i.e. the pointer 4 is rotatable around the rod 6. The axis of rotation of the pointer 4 about the rod 6 coincides with the first line. The second end of the pointer 4 points to the scale. The pointer 4 passes through the gap between the bottom of the eye cam 2 and the scale 1.

When the astigmatism axis marker is applied, firstly, a point mark is made at any position of the corneal edge of an eyeball of a patient, the point mark is used as a reference point, an eye picture after the reference point is marked is shot, an angle between a connecting line of the center of the cornea and the reference point in the picture and a horizontal line is obtained by measuring with an electronic protractor or a physical protractor, the angle can be defined as a first angle, then a pointer 4 of the astigmatism axis marker is rotated to enable the pointer 4 to point at the first angle, then a marking point is made at a position of a marking part, which is opposite to the pointer 4 and is a preset distance away from the outer edge of the marking part, and the marking point is used as a. Then, according to the operation habit or the inherent corneal astigmatism axis position of the patient, the main incision position is confirmed on the eyeball of the patient as the angle between the main incision mark point and the connecting line between the main incision mark point and the cornea center and the horizontal line, the angle can be defined as a second angle, then the pointer 4 of the astigmatism axis position marker is rotated to enable the pointer 4 to point to the second angle, then the mark point is made at the position of the mark part, which is opposite to the pointer 4 and is a preset distance away from the outer edge of the mark part, and the mark point is used as a preset main incision.

The intraocular lens software was used to determine the location of the pre-placement axis of the implanted Toric lens on the patient's eye and the angle between the line of the pre-placement axis of the implanted Toric lens and the horizon (which correlates to the patient's inherent axis of corneal astigmatism and the location of the main incision and the resulting surgically-induced astigmatism), which may be defined as the third angle. Then, the pointer 4 of the astigmatism axis marker is rotated to enable the pointer 4 to point to a third angle, and then two axially symmetrical mark points are made at the position, opposite to the pointer 4 and a preset distance away from the outer edge of the mark part, and the two axially symmetrical mark points are used as the preset placing axes of the Toric crystal.

If the Limbal Relaxing Incision (LRI) is to be performed in combination, the position of the LRI incision and the incision arc length (related to the age, the magnitude and axis of the intrinsic corneal astigmatism, etc.) on the eyeball of the patient are determined by software, the angle between the line connecting the starting point of the LRI incision arc length and the center of the cornea and the horizontal line is determined, the angle can be defined as a fourth angle, the pointer 4 is rotated to point at the fourth angle on the scale 1, and the position of the marking part, which is opposite to the pointer 4 and is a preset distance away from the outer edge of the marking part, is marked and used as the starting point of the preset LRI incision. An angle between a line connecting the end point of the LRI incision arc length and the center of the cornea and the horizontal line is determined, which may be defined as a fifth angle, and the pointer 4 is turned to point at the fifth angle on the scale 1, and a position of the marking member opposite to the pointer 4 and at a predetermined distance from the outer edge thereof is marked as the end point of the predetermined LRI incision.

And tearing the marking part from the eyeball copying piece 2, placing the marking part on the cornea of the patient, adjusting the position of the marking part to enable the circle center of the marking part to correspond to the center of the cornea, and enabling the preset datum point on the edge of the marking part to correspond to or coincide with the datum point marked on the edge of the cornea of the patient. Finally, according to the position of each marking point on the marking part, the operations of preparing a main notch, placing a Toric crystal, rotating to the position, carrying out LRI and the like are started by taking the marking point as a reference. In the astigmatism axis marker provided by the invention, the diameter of the annular scale is far larger than that of the eyeball profile part 2, so that the precision of the annular scale can reach 1 degree or 0.5 degree, and the preoperative eye marking and the intraoperative astigmatism axis confirming can be conveniently, quickly and accurately carried out by matching the annular scale and the marking part, and the error of locating the astigmatism axis is greatly reduced. In addition, when the astigmatism axis marker provided by the invention is applied, the mode of selecting the datum point is adopted instead of only taking the horizontal line as the datum, so that the operation can be simplified, and the error can be further reduced.

The predetermined distance may be zero or other value. I.e. it may be marked at the outer edge of the marking member or at other positions of the marking member. The marking method may be marking with a marker pen or punching, and is not limited herein.

The clearance between the bottom of the eyeball cam 2 and the dial 1 is 1-2mm so that the pointer 4 passes through the clearance.

In order to connect the supporting rod 6, a through hole is arranged at the center of the annular scale, and a through hole is arranged at the center of the annular scale on the instant dial 1. The bottom end of the supporting rod 6 penetrates through the through hole and is fixedly connected with the through hole through a nut. The nut is in threaded connection with the part of the supporting rod 6 penetrating through the through hole, so that the bottom end of the supporting rod 6 is fixedly connected with the dial 1.

As shown in fig. 5, the through hole may be a stepped hole, and the strut 6 is provided with a step engaged with the stepped hole. So set up, branch 6's stair platform and shoulder hole cooperation have realized the spacing of 6 vertical directions of branch. Preferably, the diameter of the upper end of the stepped hole is smaller than that of the lower end.

As shown in fig. 6, the stepped hole may be an asymmetric stepped hole, so as to prevent the eyeball analogue and the dial from twisting in the horizontal direction, realize horizontal position limitation, and facilitate assembly. Of course, the through hole may also be a circular hole with a constant aperture, and only the support rod 6 is provided with a limit boss, and the limit boss on the support rod 6 abuts against the upper side of the dial 1 to limit the support rod 6, which is not limited herein.

In order to facilitate marking at a position of the marking member opposite to the pointer 4 and at a predetermined distance from the outer edge thereof, the astigmatism axis marker further comprises a reverse folding portion 5 connected to the upper side of the pointer 4, the reverse folding portion 5 being opposite to the outer surface of the eyeball cam 2, and the reverse folding portion 5 being opposite to the marking member attached to the outer surface of the eyeball cam 2. That is, the lower end of the reverse folding portion 5 is connected to the upper side of the indicating needle 4. The inflection part 5 can be close to or far away from the surface of the eyeball-shaped part 2, so that the inflection part 5 can be in clearance with the outer surface of the eyeball-shaped part 2 to avoid influencing the rotation of the pointer 4, and the inflection part 5 can also be attached to the outer surface of the eyeball-shaped part 2 to facilitate accurate marking. The reverse folding part 5 is provided with a hollow hole, the hollow hole is opposite to the position of the marking part away from the outer edge of the marking part by a preset distance, so that the marking part can conveniently pass through the hollow hole for marking, the limiting effect of the hollow hole is realized, and the marking position is ensured to be more accurate. The hollow holes can be in the shape of thin strips.

In one embodiment, the bottom side of the flap 5 is fixedly connected to the pointer 4, and the top end of the flap 5 is a free end, so that the free end of the flap 5 can be close to or away from the outer surface of the eyeball cam 2. When the marking part needs to be marked, the free end of the reverse folding part 5 is close to the outer surface of the eyeball copying part 2; when it is desired to tear off the marker member, the free end of the flap 5 is simply moved away from the outer surface of the eye contour 2.

In another embodiment, the upper side of the pointer 4 is provided with a sliding slot, and the lower end of the reverse folding part 5 is connected with the sliding slot in a sliding manner. The sliding groove extends along the length of the pointer and the inflection portion 5 slides along the sliding groove to approach or depart from the eyeball analogue. When the mark needs to be made on the marking part, the reverse folding part 5 is made to slide along the sliding groove to be close to the outer surface of the eyeball copying part 2; when it is desired to tear off the marker member, the reverse fold 5 is slid along the chute in the opposite direction away from the outer surface of the eyeball cam 2.

The scale 1 should be of a rigid material, in particular cardboard or PE (polyethylene) board, etc., with a diameter of the annular scale of 10 ± 2cm, preferably 10 cm.

The marking member may be a set of marking rings 3. The marker ring set 3 is applied to the outer surface of the eye contour 2 and the marker ring set 3 is removable. The marking ring group 3 comprises an inner ring 3a and an outer ring 3b, and the centers of the inner ring 3a and the outer ring 3b are both located on a first straight line. I.e. the inner ring 3a and the outer ring 3b are concentric rings, seen in top view. The circle center of the inner ring 3a, the circle center of the outer ring 3b and the circle center of the annular scale are all located on the first straight line. When the ring group 3 is marked, the outer ring 3b may be directly marked.

In addition, the inner ring 3a can help the operator to determine whether the optical part of the intraocular lens is centered or not when the surgical steps of implanting the intraocular lens and adjusting the position of the intraocular lens are carried out.

Further, the diameter of the eyeball-shaped member 2 is 10. + -.1 mm, and the diameter of the eyeball-shaped surface of the eyeball-shaped member 2 is 10. + -.1 mm. Preferably, the diameter of the spherical surface of the eyeball cam 2 is 10 mm.

In the marker ring set 3, the outer ring 3b has a diameter of 9. + -.1 mm, and the inner ring 3a has a diameter of 5.5. + -. 0.5 mm. Preferably, the outer ring 3b has a diameter of 9mm, the inner ring 3a has a diameter of 5.25mm, and the diameters of the outer ring 3b and the inner ring 3a may be selected according to the size of the patient's cornea, the size of the pre-implant intraocular lens optic, and the like. Where the diameter of the outer ring 3b refers to the inner diameter of the outer ring 3b and the diameter of the inner ring 3a refers to the inner diameter of the inner ring 3 a.

In order to prevent the inner ring 3a and the outer ring 3b from being misaligned, a connecting bar 3c is connected between the inner ring 3a and the outer ring 3 b. One end of the connecting strip 3c is connected with the inner ring 3a, and the other end of the connecting strip 3c is connected with the outer ring 3b, so that the centers of circles of the inner ring 3a and the outer ring 3b are ensured to be positioned on the same straight line, and the inner ring 3a is higher than the outer ring 3 b. The number of the connecting strips 3c may be two, and the two connecting strips 3c are positioned corresponding to 0 °/180 ° of the scale when the marker ring set 3 is attached to the eyeball analogue 2. Preferably, the outer ring position corresponding to 0 degree is also provided with marks in the form of round holes and the like, and the designs can provide indication and guidance when the marking ring group 3 is taken off and placed on the surface of the eyeball of the patient, so that the rapid and smooth contraposition placement is realized.

The inner ring 3a and the outer ring 3b may be made of PET (polyethylene terephthalate), PP (polypropylene), PE (polyethylene), etc., and may be made of a low-cost paper material without affecting the surgical field.

As shown in fig. 7 and 8, the marking member may also be ring-shaped. Or, the marking part is round and the surface thereof is a curved surface, that is, the whole marking part can be a transparent arc top film structure, an inner ring mark is arranged on the transparent arc top film structure or a central inner ring part is punched, and the purpose of taking off the marked part and then placing the marked part on the surface of the eyeball of the patient to guide the operation can also be achieved.

Based on the astigmatic axis marker provided in the above embodiment, the present invention also provides an astigmatic axis marking method using the astigmatic axis marker, the astigmatic axis position marking method including the steps of:

s1) marking any point of the limbus and using the marked point as a reference point;

specifically, as shown in fig. 9, a point mark may be made at an arbitrary position of the corneal limbus of the patient under the flesh eye using an ultra-fine marker, and the point mark may be used as a reference point.

S2) measuring the angle between the line connecting the center of the cornea and the reference point and the horizontal line, rotating the pointer 4 to point to the measured angle on the scale 1, and marking the position of the marking member opposite to the pointer 4 and a predetermined distance from the outer edge thereof as a predetermined reference point;

an angle between a line connecting the center of the cornea and the reference point and a horizontal line is measured, and the measured angle is taken as a first angle. As shown in fig. 11, the pointer 4 is rotated such that the pointer 4 points to a first angle on the scale 1, and then a position of the marking member opposite to the pointer 4 and a predetermined distance from the outer edge thereof is marked and used as a predetermined reference point.

Specifically, as shown in fig. 10, a smartphone with a macro photography function may be used to photograph, and under the guidance of a level meter, even if the smartphone cannot be completely kept horizontal or vertical, the photographed photograph may simultaneously display a horizontal mark line, and an angle between the reference point and the corneal center line and the horizontal line is obtained by using an electronic protractor APP or a physical protractor with reference to the horizontal mark line of the photograph. The pointer 4 of the astigmatism marker is rotated to point to the measured power value, and the marking member is marked with a marker as a predetermined reference point.

S3) determining the position of the main incision and the angle between the line connecting the position of the main incision and the center of the cornea and the horizontal line, rotating the pointer 4 to point at the above-mentioned angle on the scale 1, and marking the position of the marking member which is opposite to the pointer 4 and is a predetermined distance from the outer edge thereof and as a predetermined main incision;

according to the operation habit or the inherent corneal astigmatism axis position of the patient, the position of a main incision is confirmed on the eyeball of the patient as a main incision mark point and an angle between a connecting line of the main incision mark point and the center of the cornea and a horizontal line, wherein the angle can be defined as a second angle, then a pointer 4 of the astigmatism axis marker is rotated to enable the pointer 4 to point to the second angle, then a mark point is made at the position of a mark part, which is opposite to the pointer 4 and is away from the outer edge of the mark part by a preset distance, and the mark point is used as a preset main incision.

S31) determining the Toxic crystal preset axis position and the angle between the Toxic crystal preset axis position line and the horizontal line, rotating the pointer 4 to point at the angle on the dial 1, marking the position of the marking part, which is opposite to the pointer 4 and is a preset distance away from the outer edge of the pointer 4, and taking the marking as the Toxic crystal preset axis position;

the intraocular lens software was used to determine the location of the pre-placement axis of the implanted Toric lens on the patient's eye and the angle between the line of the pre-placement axis of the implanted Toric lens and the horizon (which correlates to the patient's inherent axis of corneal astigmatism and the location of the main incision and the resulting surgically-induced astigmatism), which may be defined as the third angle. And rotating the pointer 4, enabling the pointer 4 to point to a third angle on the dial 1, and making two axially symmetrical mark points at the positions, opposite to the pointer 4 and a preset distance away from the outer edge of the mark part, wherein the two axially symmetrical mark points are used as Toric crystal preset axes.

S32) determining the LRI incision position and the incision arc length, determining the angle between the horizontal line and the line connecting the start of the LRI incision arc length and the center of the cornea, rotating the pointer 4 to point at the above-mentioned angle on the dial 1, and marking the position of the marking member opposite to the pointer 4 and a predetermined distance from the outer edge thereof as the start of the predetermined LRI incision;

determining the angle between the connecting line of the end point of the LRI incision arc length and the cornea center and the horizontal line, rotating the pointer 4 to point at the angle on the dial 1, marking the position of the marking part, which is opposite to the pointer 4 and is a preset distance away from the outer edge of the marking part, and taking the position as the end point of the preset LRI incision;

S4) the marking member is torn off from the eyeball contour 2 and placed on the cornea of the patient, and the preset reference point is corresponded to the reference point.

As shown in fig. 13, the marking member is detached from the eyeball cam 2 and placed on the cornea of the patient, the position of the marking member is adjusted so that the center of the circle of the marking ring set 3 corresponds to the center of the cornea, and the preset reference point on the marking member corresponds to or coincides with the reference point marked on the limbus of the patient. Finally, according to the position of each marking point on the marking part, the operations of preparing a main notch, placing a Toric crystal, rotating to the position, carrying out LRI and the like are started by taking the marking point as a reference.

Preferably, in step S2), the angle between the horizontal line and the line connecting the center of the cornea and the reference point is measured, specifically:

Furthermore, a horizontal position marking line is arranged on the shot eye picture behind the reference point; or when the eye picture after marking the reference point is shot, the imaging bottom edge of the lens of the shooting device is horizontal.

The intelligent mobile phone or other equipment with the macro photographing function can be used for photographing, even if the photographing equipment cannot be completely kept horizontal or vertical, the photographed photos can simultaneously display the horizontal mark line, and the electronic protractor APP or the physical protractor is used for obtaining the angle between the reference point and the cornea center connecting line and the horizontal line by taking the photo horizontal mark line as the reference. Or, under the guidance of a level gauge, the imaging bottom edge of the photographing device is ensured to be placed horizontally, namely, the photographing device is placed horizontally, and the angle between the reference point and the cornea center connecting line and the horizontal line is obtained by using the electronic protractor APP or the physical protractor with the horizontal side as the reference.

The marking method is suitable for TORIC artificial lens implantation, astigmatism correction type ICL implantation, LRI and other operations, and is simple in operation, high in accuracy, low in cost and suitable for popularization.

The embodiments in the present description are described in a progressive manner, each embodiment focuses on differences from other embodiments, and the same and similar parts among the embodiments are referred to each other.

The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

In the description herein, references to the description of "one embodiment," "an example," "a specific example" or the like are intended to mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.

Claims

1. An astigmatic axis marker, comprising:

the scale disc (1), wherein annular scales are arranged on the scale disc (1);

the eyeball cam (2) is positioned above the dial (1), the outer surface of the eyeball cam (2) comprises an eyeball cam surface, the bottom edge of the eyeball cam surface is positioned on a first plane, a straight line which passes through the vertex of the eyeball cam surface and is perpendicular to the first plane is a first straight line, a gap is formed between the bottom of the eyeball cam (2) and the dial (1), and the first straight line passes through the center of the annular scale and is perpendicular to the dial (1);

the top end of the supporting rod (6) is fixedly connected with the eyeball cam (2) and the bottom end of the supporting rod (6) is fixedly connected with the dial scale (1), and the supporting rod (6) extends along the first straight line;

a tearable marker member applied on the outer surface of the eye contour (2), the outer edge of the marker member being circular and the centre of the marker member being located on the first line;

pointer (4), the first end of pointer (4) with branch (6) rotate the connection, the second end point to scale of pointer (4), pointer (4) pass the bottom of eyeball profile (2) with the clearance between calibrated scale (1).

2. Astigmatic axis marker according to claim 1, characterized in that a through hole is provided at the center of the annular scale, through which the bottom end of the rod (6) passes and is fixedly connected by a nut.

3. Astigmatic axis position marker according to claim 2, characterized in that the through hole is a stepped hole and the strut (6) is provided with a step that cooperates with the stepped hole.

4. The axial marker of astigmatism of claim 1, further comprising a reverse folding part (5), wherein the lower end of the reverse folding part (5) is connected with the upper side of the pointer (4), the reverse folding part (5) is opposite to the eyeball-imitating surface, the reverse folding part (5) can be close to or far away from the eyeball-imitating spherical surface, and a hollowed-out hole is formed in the reverse folding part (5).

5. An astigmatic axis marker according to claim 4, wherein the lower end of the inflected section (5) is fixedly connected to the inflected section (5) at the upper side of the pointer (4); or a sliding groove is formed in the upper side of the pointer (4), and the lower end of the reverse folding part (5) is connected with the sliding groove in a sliding mode.

6. The astigmatic axis marker of claim 1, wherein the marking member is a marking ring set (3) and includes an inner ring (3a) and an outer ring (3b), and the centers of the inner ring (3a) and the outer ring (3b) are both located on the first straight line; a connecting strip (3c) is connected between the inner ring (3a) and the outer ring (3 b);

the diameter of the eyeball copying piece (2) is 10 +/-1 mm;

the diameter of the outer ring (3b) is 9 +/-1 mm, and the diameter of the inner ring (3a) is 5.5 +/-0.5 mm.

7. The astigmatic axis marker of claim 1, wherein the marking member is annular; alternatively, the marking member is circular and the surface thereof is curved.

8. A marking method using the astigmatic axis marker of any one of claims 1-6, comprising the steps of:

B) measuring to obtain an angle between a connecting line of the center of the cornea and the reference point and a horizontal line, rotating the pointer (4) to point to the measured angle on the dial (1), marking a position of the marking part, which is opposite to the pointer (4) and is a preset distance away from the outer edge of the marking part, and taking the position as a preset reference point;

C) determining the position of the main incision and the angle between the connecting line of the position of the main incision and the center of the cornea and the horizontal line, rotating the pointer (4) to point at the angle on the dial (1), marking the position of the marking part, which is opposite to the pointer (4) and is away from the outer edge of the pointer by a preset distance, and taking the position as a preset main incision;

C1) determining the Toric crystal preset axis position and the angle between the Toric crystal preset axis position line and the horizontal line, rotating the pointer (4) to point at the angle on the dial (1), marking the position of the marking part, which is opposite to the pointer (4) and is a preset distance away from the outer edge of the marking part, and taking the marking as a preset axis position;

C2) determining the LRI incision position and the incision arc length, determining the angle between the connecting line of the starting point of the LRI incision arc length and the cornea center and the horizontal line, rotating the pointer (4) to point at the angle on the dial (1), marking the position of the marking part, which is opposite to the pointer (4) and is away from the outer edge of the marking part by a preset distance, and taking the position as the preset main incision starting point;

determining the angle between the connecting line of the end point of the LRI incision arc length and the cornea center and the horizontal line, rotating the pointer (4) to point at the angle on the dial (1), marking the position of the marking part, which is opposite to the pointer (4) and is away from the outer edge of the pointer by a preset distance, and taking the position as a preset main incision end point;

D) the marking part is torn off from the eyeball contour piece (2) and is placed on the cornea of the patient, and the preset datum point corresponds to the datum point.

9. An astigmatic axis marking method according to claim 8, wherein in step B), the angle between the horizontal and the line connecting the center of the cornea and the reference point is measured, specifically:

10. The astigmatism axis marking method of claim 9, wherein a horizontal mark line is provided on the eye picture after marking the reference point; or when the eye picture after marking the reference point is shot, the imaging bottom edge of the lens of the shooting device is horizontal.