CN113813101B - Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles - Google Patents

Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles Download PDF

Info

Publication number
CN113813101B
CN113813101B CN202111107726.1A CN202111107726A CN113813101B CN 113813101 B CN113813101 B CN 113813101B CN 202111107726 A CN202111107726 A CN 202111107726A CN 113813101 B CN113813101 B CN 113813101B
Authority
CN
China
Prior art keywords
diameter
microbubbles
arch height
height
micro
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN202111107726.1A
Other languages
Chinese (zh)
Other versions
CN113813101A (en
Inventor
杨治坤
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Peking Union Medical College Hospital Chinese Academy of Medical Sciences
Original Assignee
Peking Union Medical College Hospital Chinese Academy of Medical Sciences
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Peking Union Medical College Hospital Chinese Academy of Medical Sciences filed Critical Peking Union Medical College Hospital Chinese Academy of Medical Sciences
Priority to CN202111107726.1A priority Critical patent/CN113813101B/en
Publication of CN113813101A publication Critical patent/CN113813101A/en
Application granted granted Critical
Publication of CN113813101B publication Critical patent/CN113813101B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/013—Instruments for compensation of ocular refraction ; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/1005—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring distances inside the eye, e.g. thickness of the cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/13—Ophthalmic microscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1662—Instruments for inserting intraocular lenses into the eye

Abstract

The invention discloses a method and a device for detecting arch height in ICL (intensive Care filling) by using micro-bubbles. In the method, after the phakic intraocular lens (10) is implanted in the setting, air is injected between the phakic intraocular lens (10) and the natural crystalline lens (23) and microbubbles (3) are formed; the morphology of the microbubbles (3) is detected and the vault height (a) is determined based on the morphology of the microbubbles (3) and the amount of air injected. The method and the device can simply and inexpensively detect the arch height in ICL operation, thereby avoiding improper arch height setting.

Description

Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles
Technical Field
The invention relates to the technical field of vision correction, in particular to a method and a device for detecting arch height in ICL (intensive care language) by using microbubbles.
Background
For high myopia, intraocular lens implantation surgery (ICL) is a common myopia correction method. Currently there are over 100 million ICL crystal implants worldwide. Can be used for correcting myopia, hyperopia and astigmatism in a large range without removing or damaging corneal tissues and suturing after operation, and has particularly obvious correction effect on high myopia. And as the safety is improved, the requirement of the operation is increased.
Phakic intraocular lenses (PIOLs) are classified according to implantation location and fixation, and include anterior chamber angle supporting phakic intraocular lenses, iris fixation phakic intraocular lenses, and posterior chamber phakic intraocular lenses. The ICL procedure of the present invention is applicable to posterior chamber phakic intraocular lenses. That is, referring to fig. 1, the ICL procedure of the present invention refers to the implantation of a phakic intraocular lens 10 between the natural crystalline lens iris 23 and iris 22.
One of the most important indicators after ICL surgery is the vault height, which is the distance between the posterior ICL surface and the anterior natural lens surface, dimension a in fig. 1. Too high an arch may increase the risk of angle closure, glaucoma, while too low an arch may increase the risk of cataract. The patient needs to be examined by a slit lamp after operation, and if the arch height is not ideal, the patient needs to perform secondary operation and adjust, or the patient needs to take out the crystal for secondary implantation, so that the pain of the patient and the operation cost are increased.
The only currently feasible way to detect arch height intraoperatively is to use intraoperative OCT (optical correlation tomography), which is a very reliable method for intraoperative arch height detection. OCT is a non-invasive, non-contact inspection method that scans the cross-section of the fine structure of the retina in vivo.
The disadvantage is that the cost of the corresponding OCT device is very high, and usually a whole set of the OCT device is more than 200 RMB and is difficult to popularize.
Disclosure of Invention
It is an object of the present invention to provide a solution that overcomes or at least alleviates at least one of the above-mentioned drawbacks of the prior art.
To achieve the above object, the present invention provides a method for detecting vault height in ICL surgery using microbubbles, wherein,
injecting air between the intraocular lens with the lens and the natural crystalline lens to form micro-bubbles after the intraocular lens with the lens is implanted and adjusted;
the morphology of the microbubbles is detected and the vault height is determined based on the morphology of the microbubbles and the amount of air injected.
Preferably, the size of the microbubbles is observed from the front of the eyeball by using a microscope, and the arch height is determined according to the comparison relation between the size of the microbubbles and the injected air volume; and/or
And observing the size change time curve of the microbubbles from the front of the eyeball by using a microscope, and determining the arch height according to the comparison relation between the size change time curve of the microbubbles and the time curve of the injected air volume.
Preferably, a set volume V of air is injected, assuming the diameter of the ideal spherical bubble corresponding to said set volume V is the ideal diameter D, wherein V = (4/3) × pi × (D/2) 3 ，
If the diameter of the micro-bubble observed by a microscope is equivalent to the ideal diameter D, determining that the arch height is greater than or equal to the ideal diameter D;
if the diameter of the microbubbles observed by the microscope is larger than the ideal diameter D, determining that the arch height is smaller than the ideal diameter D,
wherein V is more than or equal to V1, V1= (4/3) × pi = (D1/2) 3 D1 is the minimum acceptable arch height; or
V≥V2，V2＝(4/3)*π*(D2/2) 3 D2 is the maximum acceptable arch height.
Preferably, an acceptable vault-height interval [ Amin, amax ] is predetermined,
injecting air into a first set volume V1, and assuming that the diameter of an ideal spherical bubble corresponding to the first set volume V1 is a first diameter D1, wherein V1= (4/3) × π × (D1/2) 3 And D1= Amin,
and if the diameter of the micro-bubble observed by using a microscope is larger than the first diameter D1, determining that the arch height is smaller than Amin, namely judging that the arch height is too small.
Preferably, an acceptable vault-height interval [ Amin, amax ] is predetermined,
injecting air into a second set volume V2, assuming that the diameter of the ideal spherical bubble corresponding to the second set volume V2 is a second diameter D2, wherein V2= (4/3) × π × (D2/2) 3 And D2= Amax and is,
if the diameter of the micro-bubble observed by the microscope is equal to the second diameter D2, the arch height is determined to be larger than or equal to Amax, namely the arch height is determined to be too large.
Preferably, an acceptable vault-height interval [ Amin, amax ] is predetermined,
injecting air into a first set volume V1, and assuming that the diameter of an ideal spherical bubble corresponding to the first set volume V1 is a first diameter D1, wherein V1= (4/3) × π × (D1/2) 3 And D1= Amin,
if the diameter of the micro-bubble observed by using a microscope is larger than the first diameter D1, determining that the arch height is smaller than Amin, namely judging that the arch height is too small; if the diameter of the micro-bubble observed by a microscope is equal to the second diameter D1, determining that the arch height is greater than or equal to Amin;
and/or
Injecting air into a second set volume V2, assuming the diameter of the ideal spherical bubble corresponding to the second set volume V2 is a second diameter D2, wherein V2= C(4/3)*π*(D2/2) 3 And D2= Amax,
if the diameter of the micro-bubble observed by the microscope is equal to the second diameter D2, determining that the arch height is larger than or equal to Amax, namely judging that the arch height is too large; if the diameter of the micro-bubble observed by the microscope is larger than the first diameter D1, determining that the arch height is smaller than Amax.
Preferably, the amount of injected air V (t) is continuously recorded, and the diameter size D (t) of the microbubbles is continuously observed, and in the initial stage, V (t) and D (t) satisfy the following formula:
V(t)＝(4/3)*π*(D(t)/2) 3 ，
after the inflection value V (tx) or D (tx), V (t)<(4/3)*π*(D(t)/2) 3 ，
Taking D (tx) as the detected camber value, namely A Side survey ＝D(tx)。
Preferably, if the injected air is equal to or greater than the maximum air injection amount Vmax, and the inflection point value V (tx) or D (tx) is not detected, it is determined that a is present Measuring Is greater than or equal to Amax, and is,
wherein Vmax = (4/3) × π × (Dmax/2) 3 Dmax = Amax, amax being the maximum arch height acceptable.
The present invention also provides an apparatus for detecting vault height in ICL surgery using microbubbles, the apparatus comprising:
the micro-bubble injection unit injects air between the intraocular lens with the lens and the natural crystalline lens to form micro-bubbles after the intraocular lens with the lens is implanted and positioned;
a microbubble detection unit that detects a form of microbubbles; and
an analysis unit that determines the arch height based on the morphology of the microbubbles and the amount of air injected.
Preferably, the microbubble detection unit comprises a microscope,
the microscope is used for observing the microbubbles from the front side of the eyeball to obtain the sizes of the microbubbles, and the analysis unit determines the arch height according to the comparison relation between the sizes of the microbubbles and the injected air volume; and/or
The microscope is used for observing the micro-bubbles from the front of the eyeball to obtain a size change time curve of the micro-bubbles, and the analysis unit is used for determining the arch height according to the comparison relation between the size change time curve of the micro-bubbles and a time curve of an injected air volume.
The method and the device can simply and inexpensively detect the arch height in ICL operation, thereby avoiding improper setting of the arch height.
Drawings
FIG. 1 is a schematic illustration of a phakic intraocular lens implantation procedure to which the present invention is applicable.
Figure 2 is a schematic view of a phakic intraocular lens.
Fig. 3 is a schematic view of injection microbubbles, and in the state of fig. 3, the diameter of ideal microbubbles is substantially the same size as the height of the arch. In this state, the microbubbles are spherical.
Fig. 4 is another schematic illustration of the injected microbubbles, in the state of fig. 4 the diameter of the ideal microbubbles is larger than the size of the arch height. In this state, the microbubbles are spherical.
Fig. 5 is a further schematic illustration of the injected microbubbles, in the state of fig. 5 the diameter of the ideal microbubbles is smaller than the size of the arch height. In this state, the microbubbles are collapsed.
Reference numerals:
10 intraocular lens with lens 21 Cornea
11 Optical part 22 Iris (iris)
12 Supporting part 23 Natural crystalline lens
13 Locating hole 30 Micro bubbles
14 Center hole
15 Side hole
Detailed Description
In the drawings, the same or similar reference numerals are used to denote the same or similar elements or elements having the same or similar functions. Embodiments of the present invention will be described in detail below with reference to the accompanying drawings.
In the description of the present invention, the terms "central", "longitudinal", "lateral", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", etc., indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience in describing the present invention and simplifying the description, but do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed in a particular orientation, and be operated, and therefore, should not be construed as limiting the scope of the present invention.
The present inventors sought to find a method that would enable detection of vault height during ICL surgery. The method determines the arch height size simply and inexpensively through preliminary judgment. Thus, it is possible to determine whether it is necessary to adjust the position of the phakic intraocular lens 10, rotate the angle of the phakic intraocular lens 10, or even replace the phakic intraocular lens 10 intraoperatively.
The inventors of the present invention noted that there was liquid between the intraocular lens and the natural lens. The liquid is aqueous humor in physiological state, the perfusion liquid is special perfusion liquid for operation, and after the liquid is metabolized, the perfusion liquid is replaced by the aqueous humor generated by the human body.
The inventors have also noted that if bubbles are generated in the perfusate or aqueous humor, they will be quickly absorbed.
Thus, one embodiment of the present invention provides a method for detecting vault height in ICL surgery using microbubbles. In the method, after the phakic intraocular lens 10 (also simply referred to as intraocular lens) is implanted in the accommodation position, air is injected between the phakic intraocular lens 10 and the natural lens 23 and microbubbles 3 are formed.
Referring to fig. 1, a phakic intraocular lens 10 is generally disposed between an iris 22 and a natural crystalline lens 23. Outside the iris 22, there is a cornea 21. The phakic intraocular lens 10 is used in conjunction with the natural crystalline lens 23 for refractive accommodation. In order for the phakic intraocular lens 10 to perform the proper refractive function, it is generally desirable that the phakic intraocular lens 10 be in the proper position. In particular, it is desirable to have a suitable distance between the phakic intraocular lens 10 and the natural crystalline lens 23. For example, the arch height a shown in fig. 1 is required to be within a proper range.
Microbubbles 3 are formed between the phakic intraocular lens 10 and the natural lens 23. The air for forming the microbubbles 3 can be injected through the small hole (air injection hole) of the intraocular lens with lens 10.
Referring to fig. 2, a phakic intraocular lens 10 can include an optic 11 and haptics 12. The optical portion 11 is used to realize a dioptric function or a light-adjusting function. The support 12 is used for positioning.
A central hole 14 is provided at the center of the optical portion 11. The support portion 12 is provided with a positioning hole 13 and a side hole 15. The central hole 14 can serve as a small hole as in the previous paragraph, or an air injection hole. Of course, other holes, not shown, may be provided for air injection. Side holes may also be used as air injection holes. These air injection structures are within the scope of the present invention.
The air injection may be a one-time injection, a continuous stable injection, or a pulse injection. In one embodiment, the air injection quantity may be recorded as a function of time, V (t).
In an embodiment of the present invention, the vault height a (see fig. 1) is determined by detecting the morphology of the microbubbles 3 and based on the morphology of the microbubbles 3 and the amount of air injected. More specifically, the arch height a is determined by the correspondence between the form of the microbubbles 3 and the injected air volume.
The form of the microbubbles 3 includes, for example, the shape of the microbubbles 3; the size of the microbubbles 3; and the shape, size, and dimension of the microbubbles 3 change with time.
Comparing the determined vault height a (which may also be referred to as the measured vault height) with the ideal vault height, it may be determined whether an adjustment is required to adjust the position of the phakic intraocular lens 10, to rotate the angle of the phakic intraocular lens 10, or even to replace the phakic intraocular lens 10. It should be noted that the determined arch height a may be a specific value or may be a range. For example, if it is determined that the vault height a is too small, the position of the phakic intraocular lens 10 needs to be adjusted to increase the vault height.
The desired post-operative vault height is, for example, 250-750 microns, or other vault height range determined by the patient and the phakic intraocular lens 10.
In one embodiment of the present invention, the size of the microbubbles 3 is observed with a microscope, for example, the size of the microbubbles 3 is observed from the front of the eyeball. The arch height a is determined from the comparison or correspondence between the size of the microbubbles 3 and the amount of air injected. In this case, a range of arch heights a may be obtained or determined. For example, it may be determined that the arch height a is greater than a value corresponding to the air injection amount, or less than a value corresponding to the air injection amount.
In another embodiment of the present invention, the size of the microbubbles 3 is observed from the front of the eyeball using a microscope, and a size change time curve is acquired. The arch height a is determined from the comparison of the time curve of the change in the size of the microbubbles 3 with the time curve of the injected air volume. In this case, a range of the arch height a may be obtained or determined; a relatively more certain value of the arch height a may also be determined (still a predicted value, not particularly accurate, but sufficient for determining whether the arch height a meets the requirements).
In one embodiment of the invention, a set volume V of air is injected, assuming the diameter of the ideal spherical bubble corresponding to the set volume V is the ideal diameter D, wherein V = (4/3) × pi × (D/2) 3 ，
If the diameter of the micro-bubble observed by a microscope is equivalent to the ideal diameter D, determining that the arch height is greater than or equal to the ideal diameter D;
if the microbubble diameter observed with the microscope is larger than the ideal diameter D, it is determined that the arch height is smaller than the ideal diameter D.
The set volume V is determined, for example, on the basis of a first set volume V1 or a second set volume V2.
Wherein V is more than or equal to V1, V1= (4/3) × pi = (D1/2) 3 D1 is the minimum acceptable arch height; or alternatively
V≥V2，V1＝(4/3)*π*(D2/2) 3 And D2 is the maximum acceptable arch height.
In one embodiment, the amount of air for V1 is injected first, and then the amount of air for the same bubble is injected again (V2-V1), from which it can be determined whether the actual camber is between the minimum camber and the maximum camber.
In one embodiment of the present invention, an acceptable vault interval [ Amin, amax ] is predetermined]. Injecting air into a first set volume V1, assuming the diameter of an ideal spherical bubble corresponding to the first set volume V1 is a first diameter D1, wherein V1= (4/3) × π × (D1/2) 3 And D1= Amin,
and if the diameter of the micro-bubble observed by using a microscope is larger than the first diameter D1, determining that the arch height is smaller than Amin, namely judging that the arch height is too small.
In combination with the above methods, or separately; the following determination method was used:
predetermining an acceptable arch height interval [ Amin, amax ],
injecting air into a second set volume V2, assuming that the diameter of the ideal spherical bubble corresponding to the second set volume V2 is a second diameter D2, wherein V2= (4/3) × π × (D2/2) 3 And D2= Amax and is,
if the diameter of the microbubbles observed by the microscope is equal to the second diameter D2, the arch height is determined to be greater than or equal to Amax, namely, the arch height is judged to be too large.
In yet another embodiment of the present invention, the method described below is used to detect arch height in ICL using microbubbles,
predetermining an acceptable arch height interval [ Amin, amax ],
injecting air into a first set volume V1, and assuming that the diameter of an ideal spherical bubble corresponding to the first set volume V1 is a first diameter D1, wherein V1= (4/3) × π × (D1/2) 3 And D1= Amin,
if the diameter of the micro-bubble observed by using a microscope is larger than the first diameter D1, determining that the arch height is smaller than Amin, namely, determining that the arch height is too small; if the diameter of the micro-bubble observed by a microscope is equal to the second diameter D1, determining that the arch height is greater than or equal to Amin;
and/or
Injecting air into a second set volume V2, assuming the diameter of the ideal spherical bubble corresponding to the second set volume V2 is a second diameter D2, wherein V2= (4/3) × π × (D2/2) 3 And D2= Amax and is,
if the diameter of the micro-bubble observed by a microscope is equal to the second diameter D2, determining that the arch height is larger than or equal to Amax, namely judging that the arch height is too large; if the diameter of the micro-bubbles observed by a microscope is larger than the first diameter D1, the arch height is determined to be smaller than Amax.
The microscope is, for example, an electron microscope. And the size of the arch height is accurately determined according to the automatic analysis of the shape and the size of the micro-bubbles by using a picture acquired by an electron microscope.
In yet another embodiment of the present invention, the following method is employed to detect arch height in ICL using microbubbles: the amount of injected air V (t) is continuously recorded and the diameter size D (t) of the microbubbles (3) is continuously observed.
In the initial stage, V (t) and D (t) satisfy the following formula:
V(t)＝(4/3)*π*(D(t)/2) 3 ，
after the inflection value V (tx) or D (tx), V (t)<(4/3)*π*(D(t)/2) 3 ，
D (tx) is taken as the detected camber value, namely A Side survey ＝D(tx)。
The initial stage, i.e. the state in which the microbubbles are not collapsed. It can be understood as a change from the state of fig. 4 (freely larger) to the state of fig. 3 (larger to a critical value).
After the inflection value V (tx) or D (tx), the microbubbles are collapsed. It can be understood that the change from the fig. 3 state (enlarged to a critical value) to the fig. 5 state (microbubbles collapsed or constrained in the direction of the vault and can no longer maintain a spherical shape).
Further, if the injected air is equal to or greater than the maximum air injection amount Vmax, and no inflection point value V (tx) or D (tx) is detected, it is determined that a is not detected Measuring Is greater than or equal to Amax, and is,
wherein Vmax = (4/3) × π × (Dmax/2) 3 Dmax = Amax, amax being the maximum arch height acceptable.
Embodiments of the present invention also provide an apparatus for detecting vault height in ICL surgery using microbubbles. The device comprises:
a microbubble injection unit which injects air between the intraocular lens with lens 10 and the natural crystalline lens 23 and forms microbubbles 3 after the intraocular lens with lens 10 is implanted and positioned;
a microbubble detection unit that detects the form of the microbubbles 3; and
and an analyzing unit that determines the arch height a based on the morphology of the microbubbles 3 and the amount of air injected.
The microbubble injection unit may employ any suitable air injection means. Either plunger-pulsed or continuous injection and metered. The plunger pulse type air injection device is similar to a syringe and can inject air with the quantity not exceeding the set quantity in one time. The continuous injection and metered air injection device is capable of recording the amount of injection over time, advantageously enabling a uniform injection speed.
In one embodiment, the microbubble detection unit comprises a microscope,
the microscope is used for observing the micro-bubbles 3 from the front of the eyeball to acquire the size of the micro-bubbles 3, and the analysis unit determines the arch height A according to the comparison relation between the size of the micro-bubbles 3 and the injected air volume; and/or
The microscope is used for observing the microbubble 3 from the front of the eyeball to obtain a size change time curve of the microbubble 3, and the analysis unit determines the arch height A according to the comparison relation between the size change time curve of the microbubble 3 and the time curve of the injected air volume.
It will be appreciated that the apparatus for detecting vault height during ICL using microbubbles as described above can detect vault height using any suitable method as described above.
It should be noted that the intraoperative ocular pressure is about 10-15mmHg, that is, the pressure of the perfusate is 10-15mmHg, and the injection can be carried out as long as it is higher than this pressure. It is noted that the pressure actually refers to a pressure (pressure) difference above atmospheric pressure. The actual pressure needs to be added to the atmospheric pressure.
After injection into the perfusate, the pressure within the microbubbles will be the same or about the same as the pressure of the perfusate. One standard atmosphere is one atmosphere equal to 760mm hg.
According to a krabbe Long Fangcheng, PV = nRT,
p is gas pressure in Pa; v is the gas volume in m 3 (ii) a n is the amount of the gas substance in mol, and T is the system temperature in K; and R is a proportionality coefficient.
The thermodynamic scale is in units of K (Kelvin) and the absolute zero is 0K (about-273.15 deg.C).
Assuming an operating room temperature of 20 degrees celsius, corresponding to 293K, this temperature can be considered as the pre-infusion temperature T1. Assuming that the temperature of the perfusion fluid dedicated for surgery is 36 degrees celsius, corresponding to 309K, this temperature can be considered as the temperature T2 after infusion.
(T2-T1)/T2＝(309-293)/309＝5.18％
That is, the difference in temperature may have a large influence on the volume, and therefore, the temperature factor needs to be taken into consideration.
One approach is to make T1 and T2 as identical as possible. For example, after drawing air, the air syringe was placed in a 36 degree celsius incubator for storage.
Of course, the temperature of the perfusion fluid also needs to be taken into account. For example, one approach is to set the temperature of the perfusate to 36 degrees celsius, which is consistent with the human body; another approach is to estimate the approximate temperature of the perfusate after injection into the eye.
The size of the microbubbles is related to the intraocular pressure and the temperature before and after the injection by inputting a fixed amount of gas.
Assuming the same temperatures before and after, the pressure is inversely proportional to the volume.
P1*V1＝P2*V2
P1 is atmospheric pressure, 760mm Hg, 760mmHg;
v1 is the volume measured by the syringe,
p2 is intraocular pressure, 10-15mmHg (calculated by maximum value) +760mmHg =775mmHg
Thus, V2= P1V 1/P2
(P2-P1)/P2＝(775-760)/775＝1.9％。
If calculated as a small value of intraocular pressure, (P2-P1)/P2 = (770-760)/770 =1.3%.
That is, the influence of the pressure difference is small. Can be ignored.
The air forming the microbubbles may be sterile air. On a general operating table, the syringe is extracted through a filter, even a few of the syringes are directly extracted on an alcohol lamp, and the sterility of gas is ensured.
The embodiment of the invention can realize that obvious abnormal arch height can be found in time in the operation, adjustment is carried out, the operation is completed in one operation, and the risk that the operation needs to be carried out again due to unsatisfactory arch height after the operation is avoided.
Finally, it should be pointed out that: the above examples are only for illustrating the technical solutions of the present invention, and are not limited thereto. Those of ordinary skill in the art will understand that: modifications can be made to the technical solutions described in the foregoing embodiments, or some technical features may be equivalently replaced; such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.

Claims (8)

1. A method for detecting vault height in ICL technique by using micro-bubble,
after the intraocular lens (10) with the lens is implanted and positioned, injecting air between the intraocular lens (10) with the lens and the natural crystalline lens (23) and forming micro-bubbles (3);
detecting the morphology of the microbubbles (3) and determining the vault (A) based on the morphology of the microbubbles (3) and the amount of air injected,
wherein the size of the microbubbles (3) is observed from the front of the eyeball by using a microscope, and the arch height (A) is determined according to the comparison relation between the size of the microbubbles (3) and the injected air volume; and/or
The time curve of the change in the size of the microbubbles (3) is observed from the front of the eyeball by a microscope, and the arch height (A) is determined from the comparison between the time curve of the change in the size of the microbubbles (3) and the time curve of the injected air volume.
2. The method for detecting vault height during ICL using microbubbles according to claim 1,
injecting air into a set volume V, assuming the diameter of an ideal spherical bubble corresponding to the set volume V is an ideal diameter D, wherein V = (4/3) × π × (D/2) 3 ，
If the diameter of the micro-bubble observed by a microscope is equivalent to the ideal diameter D, determining that the arch height is greater than or equal to the ideal diameter D;
if the diameter of the microbubbles observed by the microscope is larger than the ideal diameter D, determining that the arch height is smaller than the ideal diameter D,
wherein V is more than or equal to V1, V1= (4/3) × π ([ D1/2) ] 3 D1 is the minimum acceptable arch height; or alternatively
V≥V2，V2＝(4/3)*π*(D2/2) 3 And D2 is the maximum acceptable arch height.
3. The method for detecting vault height in ICL using microbubbles of claim 1,
predetermining an acceptable arch height interval [ Amin, amax ],
injecting air into a first set volume V1, and assuming that the diameter of an ideal spherical bubble corresponding to the first set volume V1 is a first diameter D1, wherein V1= (4/3) × π × (D1/2) 3 And D1= Amin,
and if the diameter of the micro-bubble observed by using a microscope is larger than the first diameter D1, determining that the arch height is smaller than Amin, namely judging that the arch height is too small.
4. The method for detecting vault height during ICL using microbubbles according to claim 1,
predetermining an acceptable arch height interval [ Amin, amax ],
injecting air into a second set volume V2, assuming the diameter of the ideal spherical bubble corresponding to the second set volume V2 is a second diameter D2, wherein V2= (4/3) × π × (D2/2) 3 And D2= Amax and is,
if the diameter of the microbubbles observed by the microscope is equal to the second diameter D2, the arch height is determined to be greater than or equal to Amax, namely, the arch height is judged to be too large.
5. The method for detecting vault height in ICL using microbubbles of claim 1,
predetermining an acceptable arch height interval [ Amin, amax ],
injecting air into a first set volume V1, assuming the diameter of an ideal spherical bubble corresponding to the first set volume V1 is a first diameter D1, wherein V1= (4/3) × π × (D1/2) 3 And D1= Amin,
if the diameter of the micro-bubble observed by using a microscope is larger than the first diameter D1, determining that the arch height is smaller than Amin, namely judging that the arch height is too small; if the diameter of the micro-bubble observed by a microscope is equal to the first diameter D1, determining that the arch height is greater than or equal to Amin;
and/or
Injecting air into a second set volume V2, assuming the diameter of the ideal spherical bubble corresponding to the second set volume V2 is a second diameter D2, wherein V2= (4/3) × π × (D2/2) 3 And D2= Amax and is,
if the diameter of the micro-bubble observed by the microscope is equal to the second diameter D2, determining that the arch height is larger than or equal to Amax, namely judging that the arch height is too large; if the diameter of the micro-bubble observed by the microscope is larger than the first diameter D1, determining that the arch height is smaller than Amax.
6. The method for detecting vault height in ICL using microbubbles of claim 1,
continuously recording the injected air volume V (t), and continuously observing the diameter size D (t) of the microbubbles (3), wherein V (t) and D (t) satisfy the following formula in the initial stage:
V(t)＝(4/3)*π*(D(t)/2) 3 ，
after the inflection value V (tx) or D (tx), V (t)<(4/3)*π*(D(t)/2) 3 ，
D (tx) is taken as the detected camber value, namely A Side survey ＝D(tx)。
7. The method of detecting vault height during ICL using microbubbles of claim 6,
if the injected air is equal to or greater than the maximum air injection amount Vmax and the inflection point value V (tx) or D (tx) is not detected, A is judged Measuring Is greater than or equal to Amax, and is,
wherein Vmax = (4/3) × π × (Dmax/2) 3 Dmax = Amax, amax being the maximum arch height acceptable.
8. An apparatus for detecting vault elevation in ICL surgery using microbubbles, comprising:
a microbubble injection unit which injects air between the intraocular lens (10) and the natural crystalline lens (23) to form microbubbles (3) after the intraocular lens (10) is implanted and positioned;
a microbubble detection unit that detects the morphology of microbubbles (3);
an analysis unit that determines an arch height (A) based on the form of the microbubbles (3) and the amount of injected air,
wherein the microbubble detection unit comprises a microscope,
the microscope is used for observing the micro-bubbles (3) from the front of the eyeball and acquiring the size of the micro-bubbles (3), and the analysis unit determines the arch height (A) according to the comparison relation between the size of the micro-bubbles (3) and the injected air volume; and/or
The microscope is used for observing the micro-bubbles (3) from the front of the eyeball and acquiring a size change time curve of the micro-bubbles (3), and the analysis unit determines the arch height (A) according to the comparison relation between the size change time curve of the micro-bubbles (3) and a time curve of an injected air volume.
CN202111107726.1A 2021-09-22 2021-09-22 Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles Active CN113813101B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202111107726.1A CN113813101B (en) 2021-09-22 2021-09-22 Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202111107726.1A CN113813101B (en) 2021-09-22 2021-09-22 Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles

Publications (2)

Publication Number Publication Date
CN113813101A CN113813101A (en) 2021-12-21
CN113813101B true CN113813101B (en) 2023-04-14

Family

ID=78920814

Family Applications (1)

Application Number Title Priority Date Filing Date
CN202111107726.1A Active CN113813101B (en) 2021-09-22 2021-09-22 Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles

Country Status (1)

Country Link
CN (1) CN113813101B (en)

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2535019A1 (en) * 2011-06-15 2012-12-19 Ulfert Detmers Accommodative intraocular phakic artificial lens with highly refractive medium

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1563694A1 (en) * 1988-02-16 1990-05-15 Военно-Медицинская Краснознаменная Академия Им.С.М.Кирова Method of intraoperative localization of posterior crystalline capsule
DE102011103360B3 (en) * 2011-05-27 2012-09-13 Carl Zeiss Meditec Ag A method for determining at least one optical property of a patient's eye with an intraocular lens
CN109890325B (en) * 2016-08-24 2021-10-26 Z晶状体有限责任公司 Dual mode accommodative-accommodative intraocular lens
CN111358594A (en) * 2020-03-17 2020-07-03 爱博诺德(北京)医疗科技股份有限公司 Intraocular lens with lens

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2535019A1 (en) * 2011-06-15 2012-12-19 Ulfert Detmers Accommodative intraocular phakic artificial lens with highly refractive medium

Also Published As

Publication number Publication date
CN113813101A (en) 2021-12-21

Similar Documents

Publication Publication Date Title
Visser et al. Accuracy of toric intraocular lens implantation in cataract and refractive surgery
Visser et al. Toric intraocular lenses: historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications
Dick et al. Primary posterior laser-assisted capsulotomy
Schmidinger et al. Long-term changes in posterior chamber phakic intraocular collamer lens vaulting in myopic patients
JP2022031502A (en) Intraocular lens designs for improved stability
Strenn et al. Capsular bag shrinkage after implantation of an open-loop silicone lens and a poly (methyl methacrylate) capsule tension ring
AU2020289827B2 (en) Laser methods and systems for the aligned insertion of devices into a structure of the eye
Petternel et al. Effect of accommodation and pupil size on the movement of a posterior chamber lens in the phakic eye
Khng et al. Evaluation of the relationship between corneal diameter and lens diameter
JP2017520327A (en) Method and device for implanting an intraocular pressure sensor
JP6608820B2 (en) System and method for intraoperative ocular biometry or refractive power measurement
Lakshminarayanan et al. Refractive changes induced by intraocular lens tilt and longitudinal displacement
CN113813101B (en) Method and device for detecting arch height in ICL (intensive Care filling) operation by using micro-bubbles
Werner et al. Meridional differences in internal dimensions of the anterior segment in human eyes evaluated with 2 imaging systems
Packer et al. The LENSAR® Laser System–fs 3D for femtosecond cataract surgery
RU2548503C1 (en) Method of determining indications for ablation of presbyopic crystalline lens with implantation of intraocular lens in case of hypermetropia
Cao et al. Comparison of toric intraocular lens alignment between femtosecond laser–assisted capsular marking and manual corneal marking
Werner et al. Phakic anterior chamber intraocular lenses
US20220062043A1 (en) Methods and apparatus for performing ocular biometry
SooHoo et al. Comparison of stability between a modular intraocular lens system and a single-piece hydrophobic acrylic intraocular lens
Fang et al. Advanced intraocular lens power calculations
Singh et al. Limitation of 25-gauge vitrectomy instrumentation in highly myopic eyes
Torii et al. Changes in higher-order aberrations after iris-fixated phakic intraocular lens implantation
RU2665677C1 (en) Method for personalized determination of optical strength of an intraocular lens with intracapsular fixation in patients with keratectasia
Polat et al. Evaluation of scleral-fixated intraocular lens position anomalies by anterior segment optical coherence tomography

Legal Events

Date Code Title Description
PB01 Publication
PB01 Publication
SE01 Entry into force of request for substantive examination
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant