CN114504428A - Artificial capsular bag and implantation instrument and method thereof - Google Patents
Artificial capsular bag and implantation instrument and method thereof Download PDFInfo
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- CN114504428A CN114504428A CN202210111322.8A CN202210111322A CN114504428A CN 114504428 A CN114504428 A CN 114504428A CN 202210111322 A CN202210111322 A CN 202210111322A CN 114504428 A CN114504428 A CN 114504428A
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Images
Classifications
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- 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
Abstract
The present invention provides an artificial capsular bag, an implanting apparatus and a method thereof, the artificial capsular bag comprising: the bag comprises a bag body and at least three fixing wires, wherein the bag body is provided with a bag cavity; the bag body is provided with at least three fixing holes which are distributed circumferentially; the inner of fixed line is equipped with spacing portion, the fixed line is worn to locate in the fixed orifices, spacing portion is located in the sack just can prevent the fixed line breaks away from the fixed orifices just enables the fixed line free rotation. The invention realizes the reconstruction of the capsular bag environment for patients with serious capsular bag damage and patients without the capsular bag, so that the capsular bag environment can reach the implantation condition in the artificial lens capsular bag, the patients without the capsular bag can implant special artificial lenses, the operation difficulty is reduced, and the operation efficiency is improved. The artificial capsular bag can be coated with dark color and used as artificial iris. Can be used as a crystalline iris diaphragm for a silicone eye patient to prevent the silicone oil in the posterior chamber from entering the anterior chamber.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an artificial capsular bag, an implantation instrument and an implantation method thereof.
Background
The cataract ultrasonic emulsification artificial lens implantation is the main means for treating the cataract at present, and the vision of the patient can be recovered after the operation. Intraocular lens implantation is primarily composed of two modalities: intraocular lens suspension surgery and intraocular lens implantation surgery in the capsular bag.
Rupture of the capsular sac or rupture of the suspensory ligament are major intraoperative complications of cataract surgery. When the rupture of the capsular sac is light, the artificial lens can be implanted into the ciliary sulcus; but only intraocular lens suspension can be done for those with severe capsular sac rupture. When the zonules are slightly broken (within 90 degrees), the normal capsular bag can be implanted with an IOL (Intraocular Lens); in heavier weight (90-180 degrees), the IOL is implanted in the IOL capsular bag after the tension ring is implanted; but only IOL suspension can be done if the break exceeds 180 °. In other cases, such as trauma, Marfan syndrome, etc., it may also be desirable to suspend the intraocular lens.
For patients with serious capsular bag injury or congenital diseases such as trauma and Marfan syndrome, the eye clinic can not implant the IOL in the capsular bag, and only can perform IOL suspension surgery (intraocular lens suspension surgery).
IOL suspensions have many specific procedures, but the core is the fixation of the IOL flap to the non-absorbable suspension wire at one end and the sclera at the other end, which allows the IOL to be suspended behind the iris of the eye. Intraocular lens suspension surgery is broadly divided into: (1) anterior chamber IOL implantation, (3) posterior chamber IOL iris sutured fixation, (3) posterior chamber IOL sclera sutured fixation. Intraocular lens suspension surgery includes the following drawbacks:
(1) the position of the intraocular lens after suspension implantation is easy to be abnormal: because the IOL is suspended and fixed on the sclera at two ends of the single line, the IOL is easy to horizontally or vertically deviate and can rotate; the vision of the patient can be greatly affected after the position of the IOL is abnormal; the position of the artificial crystal after suspension is not physiological and is prone to deflection or tilt, making it difficult to correct ametropia or glare.
(2) The IOL suspension is a four-stage surgical operation (the highest stage), the classification is higher than that of other cataract operations (the cataract ultrasonic emulsification and suction and the IOL implantation are three-stage operations), the operation difficulty, complexity and operation risk are higher than those of the conventional cataract operation, and the operation is long.
(3) The cornea, iris and ciliary body are damaged in the operation, particularly, the damage to corneal tissues is large, and the postoperative effect is uncertain due to postoperative complications such as visual deterioration and intraocular inflammation caused by corneal edema and intraocular hemorrhage.
(4) At present, a common suspension wire is an unabsorbable nylon wire, the suspension wire is thin, the weight of the IOL is completely stressed by two single-strand wires, for young patients, eye vibration such as sports can cause suture fatigue, the suture can be broken in 4-6 years on average, the lens is dislocated into the vitreous body, and the lens needs to be suspended again through surgery.
(5) High-end lenses (astigmatism correcting lenses, multifocal lenses, etc.) require that the lens must be in a physiological position (capsular bag, centered), and in intraocular lens suspension surgery, the surgeon adjusts the position by sutures with great deviation and is prone to deflection, failing to center the IOL perfectly horizontally, and thus making it impossible to implant a high-end lens.
Intraocular lens suspension surgery suffers from the drawbacks described above. For cataract surgery, it is currently believed that postoperative vision can only be maximized by implantation of an intraocular lens in the capsular bag.
In clinical practice, the most difficult of conventional suspended IOL surgical procedures are the knotting of the suture to secure the IOL flap and the securing of the other end of the suture to the sclera. Chinese patent application CN107928869A discloses a manual bag provided with at least three positioning holes, and stitches are tied and fixed to the positioning holes. The artificial capsular bag is provided with at least three fixing holes, at least three times of suture and positioning hole knotting fixation are needed in eyes, the operation difficulty is very high, and the artificial capsular bag is difficult to realize in clinical practice.
Disclosure of Invention
The invention aims to provide an artificial capsular bag, an implantation instrument and an implantation method thereof, which are used for reconstructing the capsular bag environment for patients with serious capsular bag damage and patients without capsular bag, so that the artificial capsular bag can achieve implantation conditions in the artificial capsular bag, reduce the difficulty of operation and improve the operation efficiency.
The above object of the present invention can be achieved by the following technical solutions:
the present invention provides an artificial pouch comprising: the bag comprises a bag body and at least three fixing wires, wherein the bag body is provided with a bag cavity;
the bag body is provided with at least three fixing holes which are distributed circumferentially; the inner of fixed line is equipped with spacing portion, fixed line wears to locate in the fixed orifices, spacing portion is located in the sack just can prevent fixed line breaks away from the fixed orifices.
In a preferred embodiment, the pouch body is provided with a plurality of mesh openings, the pouch body including a plurality of pouch threads arranged in a cross, the plurality of pouch threads being connected together in a woven or thermoformed manner.
In a preferred embodiment, the pocket line extends in a radial direction and is inclined in a circumferential direction.
In a preferred embodiment, the size of each of said meshes increases gradually in the direction from the inside to the outside.
In a preferred embodiment, the pouch body includes a circumferential support line, the circumferential support line is arranged along an outer contour of the pouch body, the pouch line is fixedly connected to the circumferential support line, the pouch body includes a plurality of fixing seats fixedly connected to the circumferential support line, and the fixing holes are disposed in the fixing seats.
In a preferred embodiment, the inner end of the fixing wire includes a reverse loop portion extending in a spiral direction, the reverse loop portion being configured as the stopper portion.
In a preferred embodiment, the outer wall of the fixing wire is provided with a non-slip portion.
In a preferred embodiment, the non-slip part comprises a plurality of tapers, which taper expands in the direction of the outer end of the fixing wire towards the inner end of the fixing wire.
The present invention provides an artificial capsular bag implanting device, comprising: the puncture needle comprises a rod part and a tip part, the puncture needle is provided with a wire-passing hole, the side wall of the puncture needle is provided with a wire-passing groove communicated with the wire-passing hole, and a fixed wire can pass through the wire-passing groove to be arranged in the wire-passing hole.
The invention provides an artificial capsular bag implanting method, which is used for implanting the artificial capsular bag and comprises the following steps:
step S10, folding the artificial capsular bag and implanting the artificial capsular bag into the eye;
step S20, the fixation wire is fixed to the sclera by puncturing to fix the capsular bag body.
The invention has the characteristics and advantages that:
the artificial capsular bag reconstructs the capsular bag environment for patients with serious capsular bag damage and patients without the capsular bag, so that the artificial capsular bag can achieve the implantation condition in the artificial intraocular capsular bag, can restore the implantation in the IOL capsular bag, and ensures that the position of the IOL is correct and stable, thereby improving the visual quality of the patients after the IOL is implanted. The artificial capsular bag creates conditions for implanting the IOL at a physiological position, so that patients with serious capsular bag damage and patients without the capsular bag can be provided with high-end crystals such as multifocal crystals and astigmatic correction crystals.
The artificial capsular bag can be painted into dark color such as black or brown, and can provide artificial iris function for patients with iris defect or defect.
The artificial capsular bag can provide temporary capsular bag support for a patient filled with silicone oil through anterior-posterior combined surgery, and provides convenience for implantation in a secondary IOL capsular bag.
The artificial sac does not need to be knotted and fixed in eyes, reduces the difficulty of operation and improves the efficiency of the operation. Also, the fixing wire 40 can freely rotate with respect to the capsular bag body 10, so that the capsular bag body 10 is not deflected or displaced as the fixing wire 40 twists or rotates, improving the accuracy and stability of the implantation position of the capsular bag body 10.
Drawings
In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings needed to be used in the description of the embodiments will be briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.
Fig. 1-4 are schematic views of the construction of an artificial capsular bag according to the present invention;
fig. 5 is an exploded view of the artificial pouch shown in fig. 1;
FIGS. 6-9 are schematic views of the construction of the body of the bladder in the artificial bladder of FIG. 1;
FIGS. 10-12 are schematic views of the structure of the securing line in the artificial pouch of FIG. 1;
FIGS. 13-15 are schematic views of alternative embodiments of the securing line in an artificial pouch according to the present invention;
FIGS. 16-18 are schematic views of the present invention providing an artificial capsular bag for ocular installation;
fig. 19-21 are schematic structural views of a puncture needle in an artificial capsular bag implanting apparatus provided by the present invention.
The reference numbers illustrate:
10. a pouch body; 11. a bag cavity;
21. mesh openings; 22. a pouch line; 23. a circumferential support wire;
31. a fixing hole; 32. a fixed seat;
40. fixing the wire; 41. a string body portion; 42. a thread head portion;
50. a limiting part; 51. a reverse winding part;
60. an anti-slip portion; 61. a conical body;
70. puncturing needle; 71. a rod portion; 72. a tip portion; 73. a handle; 701. a wiring hole; 702. a threading slot;
81. a sclera; 82. a cornea; 83. the retina.
Detailed Description
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.
The artificial lens implantation technology can well replace the diseased crystalline lens of a patient at present, and improve the vision of patients with lens opacity and patients with abnormal crystalline lens position. Ophthalmic medical workers consider: only when the capsular bag is implanted, the intraocular lens is positioned in the middle of the visual axis and is vertical to the visual axis, so that the ideal visual acuity is achieved. However, ocular diseases such as Marfan's syndrome and severe ligamentum suspensum are loosened, surgical accidents such as capsular bag rupture and ligamentum suspensum damage in cataract surgery are avoided, and trauma may cause severe damage to the capsular bag of a patient or loss of the capsular bag of a lens, resulting in loss of implantation conditions in the artificial lens capsular bag.
Scheme one
The present invention provides an artificial capsular bag, as shown in fig. 1-18, comprising: a pouch body 10 and at least three securing wires 40, the pouch body 10 having a pouch cavity 11; the pouch body 10 is provided with at least three circumferentially distributed fixation holes 31; the inner end of the fixing wire 40 is provided with a limiting part 50, the fixing wire 40 penetrates through the fixing hole 31, and the limiting part 50 is located in the bag and can prevent the fixing wire 40 from separating from the fixing hole 31.
The artificial capsular bag reconstructs the capsular bag environment for patients with serious capsular bag damage and patients without the capsular bag, so that the artificial capsular bag can achieve the implantation condition in the artificial intraocular capsular bag, can restore the implantation in the IOL capsular bag, and ensures that the position of the IOL is correct and stable, thereby improving the visual quality of the patients after the IOL is implanted. The artificial capsular bag creates conditions for implanting the IOL at a physiological position, so that patients with serious capsular bag damage and patients without the capsular bag can be provided with high-end crystals such as multifocal crystals and astigmatic correction crystals.
The periphery of the artificial capsular bag can be painted into dark color such as black or brown, and can provide artificial iris function for patients with iris defect or defect.
In clinical practice, combined ophthalmic and postsurgical (i.e., cataract combined vitrectomy) silicone oil-filled patients are not suitable for first-stage IOL implantation, but at the time of second-stage silicone oil removal + IOL implantation, the capsular bag is often organized to adhere and fails to implant an IOL in the capsular bag. The artificial capsular bag can provide temporary capsular bag support for a patient filled with silicone oil through anterior-posterior combined surgery, and provides convenience for implantation in a secondary IOL capsular bag.
In the artificial capsular bag, the capsular bag body 10 is fixed on the sclera 81 by the fixing line 40, the inner end of the fixing line 40 is penetrated in the fixing hole 31 and is limited by the limiting part 50, and knotting fixation in eyes is not needed, so that the difficulty of operation is reduced, and the operation efficiency is improved. In addition, the fixing wire 40 is engaged with the capsular bag body 10 in a manner of being inserted into the fixing hole 31, and the fixing wire 40 can freely rotate relative to the capsular bag body 10, so as to avoid the position abnormality of the capsular bag body 10 caused by the twisting or rotation of the fixing wire 40 under the action of external force or self elasticity during the operation. The artificial capsular bag increases the degree of freedom between the fixation wire 40 and the capsular bag body 10, so that the capsular bag body 10 does not deflect or shift as the fixation wire 40 twists or rotates, improving the accuracy and stability of the implantation position of the capsular bag body 10.
As shown in fig. 10, the fixing thread 40 includes a thread body portion 41 and a thread head portion 42, and the thread head portion 42 is pointed and located at an outer end of the fixing thread 40. The structural form of the stopper portion 50 is not limited to one, for example: the position-limiting portion 50 may be a seat body, and the outer diameter of the seat body is larger than the wire diameter of the fixing wire 40 and larger than the hole diameter of the fixing hole 31, so as to limit the fixing wire 40 in the fixing hole 31. In one embodiment, the inner end of the fixing wire 40 includes a reverse winding part 51, as shown in fig. 10-15, the reverse winding part 51 extends along the spiral direction, the reverse winding part 51 is configured as a limiting part 50, and the outer contour of the inner end of the fixing wire 40 is enlarged through the reverse winding part 51 to have a limiting effect, so that the operation of knotting and fixing in the eye is omitted. Specifically, the reverse wound portion 51 may be formed by heat fusion; the diameter of the fixing wire 40 and the size of the reverse winding part 51 are both adapted to the diameter of the fixing hole 31. The fixing line 40 and the bag body 10 are manufactured before operation, and the fixing line 40 and the bag body 10 form a complete set of products.
The fixing wire 40 may be a single wire or may be composed of multiple strands. The fixation wire 40 may be fixed to the sclera 81 by puncturing, and a friction force is generated between an outer wall of the fixation wire 40 and the sclera 81, thereby achieving fixation of the fixation wire 40 to the capsular bag body 10.
Further, the outer wall of the fixing wire 40 is provided with the non-slip portion 60, and the non-slip portion 60 is combined with the sclera 81, thereby improving the stability of the position of the fixing wire 40 and the capsular bag body 10.
The anti-slip part 60 may be constructed in various forms, for example: the anti-slip portion 60 may be a ring-shaped protrusion, a dot-shaped protrusion, or a thorn-shaped protrusion formed on the outer wall of the fixing wire 40, and may also be a spiral groove or an annular groove. In one embodiment, the anti-slip part 60 comprises a plurality of cones 61, as shown in fig. 13-15, the cones 61 are enlarged along the outer ends of the fixing wires 40 toward the inner ends of the fixing wires 40, after the fixing wires 40 are fixed to the sclera 81 by penetration, the cones 61 are combined with the sclera 81, so as to increase the force which can be borne by the fixing wires 40 along the direction from the inner ends of the fixing wires 40 toward the outer ends of the fixing wires 40, which is beneficial to more accurately and stably positioning the capsular bag body 10 in the eye; also, the fixation wire 40 enters the sclera 81 in an inside-out direction during the procedure, which is advantageous in reducing the resistance of the fixation wire 40 to entering the sclera 81.
The diameter of the fixing line 40 is relatively large, so that on one hand, a relatively large contact area is formed between the side wall of the fixing line 40 and the sclera 81, a relatively large friction force can be generated, and the firmness of combination of the fixing line 40 and the sclera 81 is guaranteed; on the other hand, the inner end of the fixing wire 40 is reversely wound by one or a few layers to form a limiting part 50, so as to realize the limiting function. Preferably, 6-0, 8-0 nonabsorbable thread may be used as the fixing thread 40.
The stationary wire 40 may be mounted to the sclera 81 by a puncture needle 70. As shown in fig. 19 to 21, the puncture needle 70 comprises a rod part 71 and a tip part 72, the puncture needle 70 is provided with a wiring hole 701, the side wall of the puncture needle 70 is provided with a wiring groove 702 communicated with the wiring hole 701, during operation, the puncture needle 70 is punctured into the eye perpendicular to the sclera 81, the fixing wire 40 is punctured in the wiring hole 701 through the wiring groove 702, and the wiring hole 701 forms a puncture tunnel for the fixing wire 40 to pass through; after the puncture needle 70 is removed, the fixed wire 40 is bonded to the sclera 81. By using special auxiliary devices such as the puncture needle 70, the outer end of the fixing wire 40 can be quickly and safely fixed to the sclera 81 without knotting and wire embedding, and the whole operation is safe, quick, simple and reliable.
The number of the fixing lines 40 in the artificial pouch may be three or more, and accordingly, the number of the fixing holes 31 in the pouch body 10 is three or more. When the artificial capsular bag includes three fixing wires 40, the three fixing wires 40 may be circumferentially distributed around the center of the capsular bag body 10, and the three fixing wires 40 fix the position of the capsular bag body 10 in the eye. Preferably, as shown in fig. 1-5, the artificial capsular bag includes four fixation wires 40, the extension lines of the four fixation wires 40 all point to the center of the capsular bag body 10 and the adjacent fixation wires 40 are perpendicular. The fixing hole 31 is preferably a circular hole to facilitate the rotation of the fixing wire 40 within the fixing hole 31.
The artificial sac disclosed in chinese patent application CN107928869A mimics the sac membrane in physiological state, and the main body consists of an anterior sac membrane + a thick sac membrane. However, the inventors found that: the double-layer artificial capsule membrane has large surface area and is easy to initiate intraocular inflammatory reaction; the fixed connection structure of the peripheral edge part of the double-layer cyst membrane is not beneficial to the flow of aqueous humor and risks of forming glaucoma due to aqueous humor obstruction.
As shown in fig. 6-9, the bag body 10 of the artificial bag is provided with a plurality of meshes 21, the weight of the bag body is reduced, the meshes 21 can be used as a channel for aqueous humor to flow smoothly, the bag body 10 is soft and elastic, aqueous humor circulation is guaranteed, and the risk of glaucoma caused by aqueous humor blockage is avoided.
The pouch body 10 can be formed in a variety of ways, such as: the mesh 21 is formed on the bag body 10 by using a direct integral molding process, specifically, injection molding process, etc. through a mold. In one embodiment, the bladder body 10 includes a plurality of bladder threads 22 arranged in a cross, the plurality of bladder threads 22 being connected together in a braided manner; alternatively, the plurality of pocket threads 22 are attached together in a thermoforming manner, specifically, the intersections of the pocket threads 22 are secured using heat fusion to achieve thermoforming. The capsular wire 22 is made of a non-degradable and non-absorbable material, such as an eye suture, an eye suspension wire or a suspension nylon wire, and the capsular wire 22 has good biocompatibility with the intraocular tissue, high safety and is not easy to cause intraocular inflammation.
The shape of the capsular bag body 10 is arranged according to the intraocular tissue, and as shown in fig. 6 to 8, the capsular bag body 10 is a solid of revolution, i.e., the projected shape of the capsular bag body 10 is a circle.
The arrangement of the pocket line 22 is not limited to one, for example: in one embodiment, the bladder body 10 includes an annular bladder string 22 and a radially extending bladder string 22 disposed in an intersecting relationship, configured as a bladder body 10 and mesh 21.
In another embodiment, the pocket line 22 extends substantially in a radial direction, and the extending direction of the pocket line 22 is not completely parallel to the radial direction, as shown in fig. 8 and 9, the pocket line 22 is a space curve, and the pocket line 22 extends in the radial direction while being inclined in the circumferential direction. The radial direction refers to a direction pointing outward from the center line of the capsular bag body 10 or a direction pointing outward toward the center line of the capsular bag body 10. The two ends of the bag body 10 are provided with openings. As shown in fig. 7, the pocket line 22 may be an opening extending from one end to the other.
As shown in fig. 8, the mesh openings 21 are gradually increased in size along the direction from inside to outside, which is beneficial to ensuring the tension balance of the bag body 10, and the bag mouth of the artificial bag is not easy to tear during the operation.
In one embodiment, the bladder body 10 includes a circumferential support line 23, the circumferential support line 23 being disposed along an outer contour of the bladder body 10, the bladder line 22 being secured to the circumferential support line 23. The material of the circumferential support line 23 and the pocket line 22 may be the same or different.
In the artificial capsular bag disclosed in the chinese patent application CN107928869A, in clinical practice, the two layers of capsular sac will stick together after being implanted into the eye, and the fixed connection structure of the peripheral edge of the double-layer capsular sac can not form a supported capsular bag shape, and the artificial capsular bag can be implanted into the eye only with a large incision, which causes great damage to the cornea 82 of the eye of a patient, and great astigmatism and other complications after operation.
The artificial capsular bag provided by the invention can be implanted into eyes by applying a folding implantation method through a standard phacoemulsification incision, and can be automatically unfolded after being implanted, so that the IOL can be very conveniently implanted into the capsular bag cavity 11 of the artificial capsular bag. The artificial capsular bag can be implanted into eyes through a common artificial lens implantation device, and is more convenient to implant, smaller in incision and less in damage to the cornea 82. The incision implanted into the artificial capsular bag may be the same corneal 82 limbus incision as that used for phacoemulsification, and the bag is folded and implanted into the eye through a standard cataract surgery incision.
The capsular bag body 10 is formed by a plurality of capsular bag lines 22 in a weaving or thermal forming mode, is a three-dimensional capsular bag, automatically unfolds after being implanted into eyes, has good tension balance in the IOL implantation capsular bag cavity 11, the tension balance state is close to a physiological capsular bag, which is beneficial to tension diffusion, the stability of the capsular bag body 10 and the stability of the position of the implanted IOL are good, and the IOL is centered on the visual axis and vertical to the visual axis, so that the implantation of a high-end lens becomes possible.
In one embodiment, the pouch body 10 includes a plurality of fixing bases 32 fixed to the circumferential supporting wires 23, the fixing holes 31 are disposed in the fixing bases 32, the inner ends of the fixing wires 40 are inserted into the fixing holes 31, the limiting portions 50 are abutted against the fixing bases 32, the position of the fixing wires 40 is limited, and the fixing wires 40 can rotate in the fixing holes 31. The fixing seat 32 and the circumferential support wire 23 may be an integral structure.
In ophthalmic clinics, surgery on patients with and without a natural capsular bag is two distinct procedures. The artificial capsular bag has the function of reconstructing the capsular bag, is suitable for patients who lose the natural capsular bag, and realizes the implantation of the artificial lens in the capsular bag for patients with capsular bag injuries.
Although the artificial capsular bag disclosed in chinese patent application CN107928869A has the function of reconstructing capsular bag, the artificial capsular bag disclosed in CN107928869A has very complicated intraocular fixation operation, and cannot keep the opening of capsular bag, which is not favorable for uniform distribution of tension, large incision for implantation into eye, large injury, high risk, and difficult realization of clinical practice.
The artificial capsular bag provided by the invention is fixed on the sclera 81 through the fixing wire 40 by using special auxiliary devices such as the puncture needle 70 and the like, and the wire embedding is not needed, so that the operation difficulty is reduced, the operation efficiency is improved, and the artificial capsular bag has a high clinical application value.
The shape of the artificial capsular bag is consistent with that of a physiological capsular bag, and after a patient without the capsular bag is implanted into the artificial capsular bag, the implantation method and the implantation position of the artificial lens at the later stage are the same as those of a patient with a complete capsular bag. After the artificial lens is implanted into the artificial capsular bag, the artificial lens crystal climbs and supports the peripheral artificial capsular bag to deform the artificial capsular bag, and the artificial capsular bag can tightly wrap the artificial lens to enable the artificial lens to be positioned at a physiological position and can be suitable for implantation of artificial lenses including but not limited to aspheric surface crystals, astigmatic correction crystals, multifocal crystals and the like.
The artificial sac has the function of separating the anterior chamber from the posterior chamber, can play a role in intercepting silicone oil when silicone oil without a sac fills eyes, and prevents the silicone oil in the posterior chamber from entering the anterior chamber. Micro wearable devices can be implanted in the artificial capsular bag to meet special needs of patients, and the micro wearable devices include but are not limited to special wearable electronic devices with functions of artificial vision, visual enhancement, telescopic magnification and the like.
Scheme two
The present invention provides an artificial capsular bag implanting apparatus, including: the puncture needle 70 comprises a rod part 71 and a tip part 72, the puncture needle 70 is provided with a wiring hole 701, the side wall of the puncture needle 70 is provided with a threading groove 702 communicated with the wiring hole 701, and the fixing thread 40 can be threaded through the wiring hole 701 through the threading groove 702. The artificial capsular bag implanting device comprises all functions and beneficial effects of the artificial capsular bag, and is not described in detail herein.
Further, the puncture needle 70 is further provided with a shank 73, the shank 73 and the tip 72 are respectively located at both ends of the shaft portion 71, a thread passing hole 701 penetrates the shank 73, and a thread passing groove 702 may be provided at the tip 72 or the shaft portion 71, preferably, the thread passing groove 702 is provided at the shaft portion 71 and near the tip 72.
Scheme three
The invention provides an artificial capsular bag implanting method, which comprises the following steps: step S10, folding the artificial capsular bag and implanting the artificial capsular bag into the eye; at step S20, the fixing wire 40 is fixed to the sclera by piercing to fix the capsular bag body 10.
In step S10, the intraocular lens pocket can be implanted into the eye with a conventional intraocular lens implanting device, which is more convenient to implant, with a smaller incision and less damage to the cornea. The fixing wire 40 can freely rotate relative to the capsular bag body 10, so as to avoid the position abnormality of the capsular bag body 10 caused by the fixing wire 40 twisting or rotating under the action of external force or self elasticity during the operation.
In step S20, the fixing wire 40 may be mounted to the sclera 81 through the puncture needle 70. During operation, the puncture needle 70 is punctured into eyes perpendicular to the sclera 81, the fixing wire 40 is arranged in the wiring hole 701 through the wiring groove 702, and the wiring hole 701 forms a puncture tunnel for the fixing wire 40 to pass through; after the puncture needle 70 is taken out, the fixing wire 40 is combined with the sclera 81, the outer end of the fixing wire 40 can be quickly and safely fixed to the sclera 81, and the wire embedding by knotting is not needed, so that the operation is convenient, and the operation efficiency is improved.
The artificial capsular bag automatically unfolds upon implantation to facilitate implantation of the IOL therein with good tension balance, the IOL being centered and perpendicular to the visual axis, making it possible to implant a high-end lens.
The eye has physiological structures such as sclera 81, cornea 82, and retina 83. Specifically, as shown in fig. 16-18, the implementation steps of the artificial capsular bag implantation method include:
(1) making 3.2mm ultrasonic emulsification standard incision on the corneal limbus;
(2) injecting viscoelastic into the anterior chamber to maintain the anterior chamber depth;
(3) placing the artificial capsular bag into an IOL implanter to be folded, and implanting the artificial capsular bag into the anterior chamber by using a bolus injection mode;
(4) the puncture needle 70 punctures the vertical sclera 81 of 2-3mm behind the corneal limbus into the eye, and hooks the fixing line 40 of the artificial capsular bag out of the eye with the assistance of the positioning hook or the forceps in the eye;
(5) the puncture needle 70 punctures the sclera 81 in a laminated manner at a distance of 2-4mm from the puncture port of the sclera 81, so that the exit is at the puncture port of the sclera 81 (namely, the incision in the step (4)), and the hook fixing wire 40 passes through the puncture tunnel;
(6) puncturing the sclera 81 (forming an acute angle with the fixed line 40 in the step (4)) by using a plate layer of the puncture needle 70 which is 2-4mm away from the position where the fixed line 40 penetrates out, enabling the exit to be at the exit of the fixed line 40 (namely, the incision in the step (5)), and hooking the fixed line 40 to pass through the puncture tunnel;
(7) repeating steps (3) - (5) to secure additional fixation wires 40 to sclera 81;
(8) adjusting the tension of all the fixing lines 40 to ensure that the artificial capsular bag is normal in the intraocular position;
(9) injecting viscoelastic agent again to expand the artificial capsular bag;
(10) implanting the IOL into the capsular bag;
(11) pulling and cutting off all the fixing wires 40 with a certain force to make the broken ends retract into the sclera 81 plate layer and not be exposed on the surface of the conjunctiva;
(12) injecting and sucking viscoelastic agent in eyes;
(13) the corneal incision was sealed in water and intraocular pressure was adjusted to normal.
The above description is only a few embodiments of the present invention, and those skilled in the art can make various changes or modifications to the embodiments of the present invention according to the disclosure of the application document without departing from the spirit and scope of the present invention.
Claims (10)
1. An artificial capsular bag, comprising: the bag comprises a bag body and at least three fixing wires, wherein the bag body is provided with a bag cavity;
the bag body is provided with at least three fixing holes which are distributed circumferentially; the inner of fixed line is equipped with spacing portion, the fixed line wears to locate in the fixed orifices, spacing position in the sack just can prevent the fixed line breaks away from the fixed orifices.
2. The manual pouch of claim 1, wherein said pouch body is provided with a plurality of mesh openings;
the pouch body includes a plurality of cross-arranged pouch threads that are connected together in a woven or thermoformed manner.
3. An artificial capsular bag according to claim 2 wherein the capsular wire extends radially and is inclined circumferentially.
4. An artificial sachet according to claim 2 wherein the size of each mesh progressively increases in the inside-out direction.
5. An artificial sachet according to claim 4, wherein the sachet body comprises a circumferential support line arranged along the outer contour of the sachet body, the sachet line being affixed to the circumferential support line;
the bag body comprises a plurality of fixing seats fixedly connected with the circumferential supporting lines, and the fixing holes are formed in the fixing seats.
6. An artificial sachet according to claim 1, wherein the inner end of the securing thread comprises a reverse loop extending in a helical direction, the reverse loop being configured as the stop.
7. An artificial capsular bag according to claim 1 wherein the outer wall of the securing thread is provided with a non-slip portion.
8. An artificial sachet according to claim 7, wherein the non-slip portion comprises a plurality of tapers which expand in the direction of the outer end of the securing thread towards the inner end of the securing thread.
9. An artificial capsular bag implanting device, comprising: the puncture needle and the artificial capsular bag of any one of claims 1 to 8, wherein the puncture needle comprises a rod part and a tip part, the puncture needle is provided with a thread hole, the side wall of the puncture needle is provided with a thread groove communicated with the thread hole, and the fixed thread can be arranged in the thread hole through the thread groove.
10. An artificial capsular bag implantation method for implanting an artificial capsular bag according to any one of claims 1-8 comprising:
step S10, folding the artificial capsular bag and implanting the artificial capsular bag into the eye;
step S20, the fixing wire is fixed to the sclera by piercing to fix the capsular bag body.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210111322.8A CN114504428A (en) | 2022-01-29 | 2022-01-29 | Artificial capsular bag and implantation instrument and method thereof |
| PCT/CN2023/073664 WO2023143555A1 (en) | 2022-01-29 | 2023-01-29 | Artificial capsular bag, and implantation instrument and method therefor |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210111322.8A CN114504428A (en) | 2022-01-29 | 2022-01-29 | Artificial capsular bag and implantation instrument and method thereof |
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| Publication Number | Publication Date |
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| CN114504428A true CN114504428A (en) | 2022-05-17 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202210111322.8A Pending CN114504428A (en) | 2022-01-29 | 2022-01-29 | Artificial capsular bag and implantation instrument and method thereof |
Country Status (2)
| Country | Link |
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| CN (1) | CN114504428A (en) |
| WO (1) | WO2023143555A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2023143555A1 (en) * | 2022-01-29 | 2023-08-03 | 中国人民解放军总医院第一医学中心 | Artificial capsular bag, and implantation instrument and method therefor |
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| Publication number | Publication date |
|---|---|
| WO2023143555A1 (en) | 2023-08-03 |
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