CN114712036A

CN114712036A - Ciliary sulcus positioner

Info

Publication number: CN114712036A
Application number: CN202210360373.4A
Authority: CN
Inventors: 王素常
Original assignee: Individual
Current assignee: China University of Mining and Technology CUMT
Priority date: 2022-04-06
Filing date: 2022-04-06
Publication date: 2022-07-08

Abstract

Disclosed is a sulcus positioner, comprising: the guide tube is of a straight tube structure, and the interior of the guide tube is used for penetrating a puncture needle; the guide tube has a front end as an insertion end and a rear end opposite to the front end; the front end is provided with a front end opening for the puncture needle to penetrate out, and the rear end is provided with a rear end opening for the puncture needle to penetrate in; the wall of the guide tube is also provided with scale marks; an indicator needle connected to the guide tube and moving together with the guide tube; the indicating needle is provided with an indicating end adjacent to the front end of the guide tube; the indicating end is provided with a light part which can be operated to emit light; the indication end of the indication needle is 1-5 mm away from the front end; the whole pointer and the guide tube extend forwards together, and the indicating end of the pointer and the front end of the guide tube are separated to form a separation opening for clamping an iris between the pointer and the guide tube.

Description

Ciliary sulcus positioner

Technical Field

The application relates to the field of ophthalmic treatment instruments, in particular to a ciliary sulcus positioner.

Background

At present, in an artificial lens loop suture fixing operation, an ophthalmologist needs to puncture a puncture needle into a ciliary sulcus on the inner surface of the root of an iris, introduce a suture and ligate and fix an artificial lens loop in the ciliary sulcus. However, in the actual operation process, due to the shielding of the iris, the situation of the ciliary sulcus cannot be directly observed, and the puncture needle cannot be accurately punctured into the ciliary sulcus under direct vision, so that the puncture operation can be completed by only roughly estimating the position of the ciliary sulcus according to clinical experience, which causes that the probability of really and accurately puncturing into the ciliary sulcus is not high, and the operation risk is large.

If the puncture point is close to the front, the puncture needle is easy to damage the iris and cause complications such as iris hemorrhage, closed angle, secondary glaucoma and the like. If the puncture point is behind, blood vessels in the ciliary body are easily damaged, and a large amount of bleeding is caused in the eyes.

Therefore, at present, there is a need for a locator capable of accurately locating the ciliary sulcus to guide the puncture needle to accurately penetrate into the ciliary sulcus, thereby reducing the risk of the operation.

Disclosure of Invention

In order to solve the above problems, the present disclosure adopts the following technical solutions:

a sulcus positioner, comprising:

the guide tube is of a straight tube structure, and the interior of the guide tube is used for penetrating a puncture needle; the guide tube has a front end as an insertion end and a rear end opposite to the front end; the front end is provided with a front end opening for the puncture needle to penetrate out, and the rear end is provided with a rear end opening for the puncture needle to penetrate in; the wall of the guide tube is also provided with scale marks;

an indicator needle connected to the guide tube and moving together with the guide tube; the indicating needle is provided with an indicating end adjacent to the front end of the guide tube; the indicating end is provided with a light part which can emit light in an operable manner; the indicating end of the indicating needle is spaced from the front end by 1-5 mm; the whole pointer and the guide tube extend forwards together, and the indicating end of the pointer and the front end of the guide tube form a spacing opening for clamping the iris between the pointer and the guide tube.

Preferably, the light part comprises a reflector arranged at the indicating end and/or an optical fiber arranged in the indicating needle in a penetrating way or attached to the outer surface of the indicating needle; the optical fiber is separated from the pointer at a position adjacent to the rear end of the pointer and extends to be matched with a light source; the front end of the optical fiber is disposed adjacent to the reflector.

Preferably, the indicating needle is provided with a main body section parallel to the guide tube, and the indicating end is arranged at the front end of the main body section; the rear end of the main body section is also provided with a bending section connected with the guide tube; the distance between the connecting position of the bending section and the guide pipe is more than 5mm from the front end of the guide pipe.

Preferably, the rear end of the pointer is directly connected to the outer tube wall of the guide tube, or the guide tube is fixedly connected to an operating part, and the rear end of the pointer is fixedly connected to the operating part.

Preferably, the outer diameter of the pointer is smaller than the outer diameter of the guide tube, the outer diameter of the pointer is between 0.05mm and 2mm, and the outer diameter of the pointer is between 0.05mm and 0.8 mm.

Preferably, the pointer is made of elastic metal material and is configured to return to an original shape after the external force is removed after deformation.

Preferably, the indicator end does not extend forward beyond the leading end of the guide tube; the distance between the indicating end of the indicating needle and the front end of the guide tube is within 5mm along the length direction of the guide tube, and further, the distance between the indicating end of the indicating needle and the front end of the guide tube is even or 1-3 mm along the length direction of the guide tube.

Preferably, the light source is a pulsed light generator.

Preferably, the operating portion includes a shank portion and a connecting rod; the connecting rod with the guiding tube is the slope and connects, the connecting rod is kept away from the one end of guiding tube still is equipped with the handle and links up the mouth, stalk portion connects the handle links up the mouth.

Preferably, the front end of the guide tube is attached with an arc-shaped support body, and the rear end opening of the guide tube is an oblique opening; the direction of the indicating end is parallel to the guiding pipe, or the indicating end is an upward bending structure arranged on the main body section.

This disclosed ciliary sulcus locator is through setting up an indicator needle to insert the eyeball anterior chamber from eyeball one side, the iris passes through the spacing mouth card and goes into between indicator needle and the guide tube, the indicator needle moves along iris front surface (surface) forward, the guide tube continues to move forward at iris rear surface, until the bright portion of instruction end is close to the peripheral part of iris and cornea, at this moment, the front end opening of guide tube then aims at the ciliary sulcus (the ciliary sulcus is located between iris and the ciliary process), and then realize the location of ciliary sulcus, guide the pjncture needle and accurately pierce in the ciliary sulcus, thereby reduce the operation risk.

Specific embodiments of the present invention are disclosed in detail with reference to the following description and drawings, indicating the manner in which the principles of the invention may be employed. It should be understood that the embodiments of the invention are not so limited in scope.

Features that are described and/or illustrated with respect to one embodiment may be used in the same way or in a similar way in one or more other embodiments, in combination with or instead of the features of the other embodiments.

It should be emphasized that the term "comprises/comprising" when used herein, is taken to specify the presence of stated features, integers, steps or components but does not preclude the presence or addition of one or more other features, integers, steps or components.

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 these drawings without inventive exercise.

FIG. 1 is a schematic view of a sulcus positioner according to one embodiment of the present disclosure;

FIG. 2 is another view of FIG. 1;

fig. 3 is a schematic view of the usage state of fig. 1.

Detailed Description

In order to make those skilled in the art better understand the technical solution of the present invention, the technical solution in the embodiment of the present invention will be clearly and completely described below with reference to the drawings in the embodiment of the present invention, and it is obvious that the described embodiment is only a part of the embodiment of the present invention, and not all embodiments. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, shall fall within the scope of protection of the present invention.

It will be understood that when an element is referred to as being "disposed on" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may be present. The terms "vertical," "horizontal," "left," "right," and the like as used herein are for illustrative purposes only and do not represent the only embodiments.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.

The terms "proximal", "distal" and "anterior", "posterior" are used in this disclosure with respect to the clinician manipulating the ciliary sulcus positioner. The terms "proximal" and "posterior" refer to portions that are relatively close to the clinician, and the terms "distal" and "anterior" refer to portions that are relatively far from the clinician. For example, the extracorporeal portion is proximal and posterior, and the interventional intracorporeal portion is distal and anterior.

Referring to fig. 1, 2 and 3, one embodiment of the present disclosure provides a sulcus positioner 01, including: a guide tube 02 in a straight tube structure, and an indicator needle 05 connected with the guide tube 02 and moving together. The guide tube 02 is a hollow tube, and the inside of the guide tube 02 is used for penetrating a puncture needle. The guide tube 02 has a front end as an insertion end and a rear end opposite to the front end. The front end of the guide tube 02 is provided with a front end opening 08 for penetrating out of the puncture needle, and the rear end of the guide tube 02 is provided with a rear end opening 09 for penetrating in of the puncture needle.

The wall of the guide tube 02 is also provided with scale marks 10. The scale mark 10 is used for judging the length of the guide tube entering the eye. An arc-shaped support body 07 is attached to the front end of the guide tube 02. The supporter 07 is used to increase the contact area between the front end of the guide tube 02 and human tissues and to prevent the front end of the guide tube 02 from stabbing intraocular tissues. The rear end opening 09 of the guide tube 02 is an oblique opening that faces substantially perpendicular to the plane in which the guide tube 02 and the operation portion are located, and the rear end opening 09 is an oblique opening that faces obliquely upward (with respect to the orientation in fig. 1). The slope of the rear end opening 09 faces upward (in the direction of the ceiling) for easy viewing and manipulation.

In this embodiment, the pointer 05 has a pointer end 12 adjacent to the leading end of the guide tube 02. The interval between the indication end 12 of the indicator needle 05 and the front end is 1-5 mm, further, the interval between the indication end 12 of the indicator needle 05 and the front end is 1.52-4.83 mm, and further, the interval between the indication end 12 of the indicator needle 05 and the front end is 2.327-3.574 mm. The whole pointer 05 extends forwards together with the guide tube 02, and the pointer end 12 of the pointer 05 and the front end of the guide tube 02 are spaced to form a spacing port 25 for clamping the iris 14 between the pointer 05 and the guide tube 02.

The ciliary sulcus locator 01 of the embodiment is provided with a pointer 05, and is inserted into the anterior chamber of the eyeball from one side of the eyeball, the iris is clamped between the pointer 05 and the guide tube 02 through the separation port 25, the pointer 05 moves forwards along the front surface (outer surface) of the iris 14, the guide tube 02 continues to move forwards on the rear surface of the iris 14 until the bright part of the indicating end 12 is close to the peripheral parts of the iris and the cornea, at the moment, the front end opening 08 of the guide tube 02 is aligned with the ciliary sulcus 15 (the ciliary sulcus 15 is positioned between the iris 14 and the ciliary processes 20), the location of the ciliary sulcus 15 is further realized, and the guide puncture needle 16 accurately pierces into the ciliary sulcus 15, so that the operation risk is reduced.

It is noted that any numerical value in this disclosure includes all values from the lower value to the upper value that are incremented by one unit, and that there may be an interval of at least two units between any lower value and any higher value.

For example, the indicating end 12 of the indicator needle 05 is spaced from the front end by 1-5 mm, preferably 1.52-4.83 mm, and more preferably 2.327-3.574 mm, for the purpose of illustrating values such as 2.328mm, 2.845mm, 2.9mm, 2.95mm, 3.157mm, 3.391mm, 3.5mm, which are not expressly listed above.

As noted above, an exemplary range of 0.1 in units of intervals does not preclude an increase in intervals in appropriate units, such as 0.01, 0.02, 0.03, 0.04, 0.05, etc. numerical units. These are only examples of what is intended to be explicitly recited and all possible combinations of numerical values between the lowest value and the highest value enumerated are to be considered to be explicitly recited in this specification in a similar manner.

Unless otherwise indicated, all ranges include the endpoints and all numbers between the endpoints. The use of "about" or "approximately" with a range applies to both endpoints of the range. Thus, "about 20 to about 30" is intended to cover "about 20 to about 30", including at least the endpoints specified.

For other definitions of numerical ranges appearing herein, reference is made to the above description and further description is omitted.

In the ophthalmic surgery, a patient lies down, eyes watch the ceiling, illumination light of an ophthalmic surgery microscope irradiates to the eyes from top to bottom, an objective lens and an illumination light source of the microscope form coaxial illumination, although light rays shot by the objective lens are changed into oblique light rays after light paths are changed, so that an operator can observe the oblique light rays, images seen by the operator still have vertical viewing angles from top to bottom.

In this embodiment, the indicator end 12 is provided with a light portion operable to emit light. The light part can actively emit light or reflect corresponding light to form light spots, and further shows the front end position of the indicating needle 05.

The light part comprises a reflection plate 11 arranged at the indication end 12, the reflection plate 11 can reflect microscope illumination light from top to bottom to the objective lens, an operator can conveniently determine the position of the indication end 12 by using a bright reflection point, and an active light source is not required to be additionally arranged. The reflector 11 is a mirror structure, and further, the reflector 11 is a convex spherical surface (convex mirror), which has the advantage that even if the angle of the reflector 11 is not on the horizontal plane, the reflector can still see the reflective spots when the reflector is slightly inclined. The reflector 11 is fixedly connected to the front end of the pointer 05, and the reflector 11 may face away from the guide tube 02 to reflect light toward the outside of the eyeball.

In order to avoid insufficient reflected light intensity, an optical fiber 13 penetrates through the indicating needle 05. The front end of the optical fiber 13 is adjacent to the front end opening of the pointer 05, and further, the front end of the optical fiber 13 may slightly protrude from or be nearly flush with the front end opening of the pointer 05. The optical fiber 13 forms a bright light emitting point at the indicating end by active light emission, showing the position of the indicating end. The reflector 11 and the optical fiber 13 may be used in combination or separately, and the present disclosure is not limited thereto.

The optical fibre 13 exits adjacent the rear end of the pointer 05 and is connected to a light source. The light source is a pulsed light source, not necessarily a laser light source, but may be a strong intense light source. In particular, the light source is a pulsed light generator (not shown), such as a pulsed laser generator. The front end of the optical fiber 13 (e.g., optical fiber) is disposed adjacent to the reflector 11. The light from the optical fiber 13 is emitted from the light-emitting end face of the indicating end 12 and can be directly observed by a microscope. The inside of the pointer 05 may be filled with light guide resin to prevent the optical fiber 13 from being broken and protect the optical fiber 13.

The terminal surface of instruction end 12 is the light-emitting terminal surface, and when having reflector panel 11, the light that optical fiber 13 jetted out can also be through the outside reflection of light of reflector panel 11, combines the microscope illumination light of 11 self reflections of reflector panel, and the facula is instructed in furthest's promotion light intensity, can provide the facula of position indication comparatively clearly, realizes the providing of instruction end 12 position. The indicating end 12 and the leading end of the guide tube 02 are relatively fixed in position.

In other embodiments, the optical fiber does not have to run inside the pointer 05, and can be attached to the surface of the pointer 05, so that the manufacturing difficulty is reduced.

In a possible embodiment, the light part may further extend backward from the indicating end 12 to form a light emitting strip with a certain length, so as to remind the position and bending condition of the whole indicating needle 05 by the light emitting strip when entering into the eyeball, thereby avoiding the occurrence of unexpected bending or unexpected touch which causes the relative position of the indicating end 12 and the front end of the guiding tube 02 to change, and avoiding the occurrence of wrong positioning of the ciliary sulcus 15.

In this embodiment, the pointer 05 is made of an elastic metal material, and can be deformed in the vertical direction by an external force, and returns to the original state (the initial state shown in fig. 2) after the external force is terminated. The pointer 05 is an integrally molded structure made of a memory alloy material such as nitinol, and more specifically, the pointer 05 is a hot-press integrally molded structure. The pointer 05 is deployed by virtue of the memory properties of nitinol.

In one embodiment, to reduce the size of the wound during insertion and reduce surgical trauma to the eye, the indicator needle 05 may be constrained by a constraining tube prior to insertion into the eye, and after removal of the constraining tube, the indicator needle 05 returns to its initial (deployed) state. In the bound state, the pointer 05 is attached to the outer wall of the guide tube 02.

In one possible embodiment, the pointer 05 is made of transparent material or light-transmitting material. For example, the pointer 05 is made of transparent plastic, and the pointer 05 made of transparent plastic not only has structural toughness and elasticity, but also is convenient to be connected with the guide tube 02. At this time, the light portion extends from the indicating end 12 to the rear end of the indicating needle 05, and the inside of the indicating needle 05 is a light emitting cable, which is different from an optical fiber in that the whole light is emitted. And then whole pointer 05 is whole can give out light, can clearly show to the state of whole pointer 05 when stabbing and fixing a position, for doctor's operation provides more clear audio-visual show, for doctor provides accurate positioning, ensures going on smoothly of operation.

In this embodiment, the outer diameter of the pointer 05 is smaller than the outer diameter of the guide tube 02, the outer diameter of the pointer 05 is 0.05mm to 2mm, and the outer diameter of the pointer 05 is 0.1mm to 0.8 mm. The pointer 05 has a body section 51 parallel to the guide tube 02. The main body section 51 and the guide tube 02 are spaced in parallel by 1-5 mm, the main body section 51 and the guide tube 02 are spaced in parallel by 1.52-4.83 mm, and the main body section 51 and the guide tube 02 are spaced in parallel by 2.327-3.574 mm. The indicator end 12 is located at the front end of the main body segment 51 and is oriented parallel to the front end of the guide tube 02, with the indicator end 12 now oriented parallel to said guide tube 02.

Of course, in other embodiments, the indicating end 12 may also be an upward bent structure disposed at the front end of the main body segment 51.

In the present embodiment, the indicating end 12 is disposed at the front end of the main body segment 51; the indicator end 12 does not extend forward beyond the front end of the guide tube 02. The distance between the indicating end 12 of the indicating needle 05 and the front end of the guide tube 02 is within 5mm along the length direction of the guide tube 02, and the distance between the indicating end 12 of the indicating needle 05 and the front end of the guide tube 02 is further within 1-3 mm along the length direction of the guide tube 02.

The rear end of the main body section 51 is also provided with a bending section connected with the guide tube 02. The curved section gradually approaches the guide tube 02 backwards until it is connected to the guide tube 02. In order to form a space for clamping the iris between the pointer 05 and the guide tube 02 and avoid interference of an iris inner ring formed at the rear end of the pointer 05, the distance between the bent section and the guide tube 02 is more than 3mm, and further more, more than 5mm from the front end of the guide tube 02. The pointer 05 is made of an elastic metal material and is configured to return to an original shape after an external force is removed after deformation.

The rear end of the pointer 05 is directly connected (e.g. glued) to the outer tube wall of the guide tube 02. The guide tube 02 is fixedly connected with an operating part, and the operating part comprises a handle part 04 (operating handle) and a connecting rod 03. When the device is used, the plane where the guide tube 02 and the connecting rod 03 are located is taken as a horizontal plane, and the device can be inclined at a certain angle even in a vertical plane. The connecting rod 03 is connected with the guide tube 02 in an inclined manner. The connecting rod 03 is connected with the guide tube 02 at an obtuse angle or at another angle such as vertical. One end of the connecting rod 03, which is far away from the guide tube 02, is also provided with a handle joint port 06. The handle 04 is connected to the handle connection opening 06.

In other embodiments, the rear end of the pointer 05 can also be fixedly connected with the operating part, and specifically, the rear end of the pointer 05 is fixedly connected with the connecting rod 03.

As shown in figure 3, during the use process, the guide tube 02 and the indicator needle 05 enter the anterior chamber through the right corneal incision, the positioner 01 is adjusted to move the indicator needle 05 forward along the front surface of the iris 14 and the guide tube 02 forward along the rear surface of the iris 14 until the light reflecting plate 11 at the front end of the indicator needle 05 approaches the peripheral parts of the iris 14 and the cornea 18, the front end opening 08 of the guide tube 02 is aligned with the ciliary sulcus 15 (the ciliary sulcus 15 is positioned between the iris 14 and the ciliary processes 20), the puncture needle 16 is penetrated into the guide tube 02 from the rear end opening 09 and then is penetrated into the ciliary sulcus 15 from the front end opening 08, the puncture needle 16 continues to pass through the sclera 19 to the outside of the eye, a suture 17 is introduced, the positioner 01 is withdrawn, an artificial lens is implanted, and an artificial lens loop is ligated and fixed in the ciliary sulcus (not shown), and the operation is completed.

A plurality of elements, components, parts or steps can be provided by a single integrated element, component, part or step. Alternatively, a single integrated element, component, part or step may be divided into separate plural elements, components, parts or steps. The disclosure of "a" or "an" to describe an element, ingredient, component or step is not intended to foreclose other elements, ingredients, components or steps.

It is to be understood that the above description is intended to be illustrative, and not restrictive. Many embodiments and many applications other than the examples provided will be apparent to those of skill in the art upon reading the above description. The scope of the present teachings should, therefore, be determined not with reference to the above description, but should instead be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. The disclosures of all articles and references, including patent applications and publications, are hereby incorporated by reference for all purposes. The omission in the foregoing claims of any aspect of subject matter that is disclosed herein is not intended to forego such subject matter, nor should the inventors be construed as having contemplated such subject matter as being part of the disclosed subject matter.

Claims

1. A sulcus positioner, comprising:

an indicator needle connected to the guide tube and moving together with the guide tube; the indicating needle is provided with an indicating end adjacent to the front end of the guide tube; the indicating end is provided with a light part which can emit light in an operable manner; the indication end of the indication needle is 1-5 mm away from the front end; furthermore, the indication end of the indication needle is spaced from the front end by 1.52-4.83 mm, and further, the indication end of the indication needle is spaced from the front end by 2.327-3.574 mm; the whole pointer and the guide tube extend forwards together, and the indicating end of the pointer and the front end of the guide tube are separated to form a separation opening for clamping an iris between the pointer and the guide tube.

2. The ciliary sulcus locator of claim 1, wherein the light portion comprises a light reflecting plate disposed at the indicating end and/or a light-conducting fiber disposed through the indicating needle or attached to an outer surface of the indicating needle; the optical fiber is separated from the pointer at a position adjacent to the rear end of the pointer and extends to be matched with a light source; the front end of the optical fiber is disposed adjacent to the reflector plate.

3. The ciliary sulcus locator of claim 1 wherein said pointer has a body section parallel to said guide tube, said pointer end being disposed at a forward end of the body section; the rear end of the main body section is also provided with a bending section connected with the guide tube; the distance between the connecting position of the bending section and the guide pipe is more than 5mm from the front end of the guide pipe.

4. The ciliary sulcus positioner according to claim 1, wherein an operating part is fixedly connected to the guide tube, and the rear end of the pointer is directly connected to the outer tube wall of the guide tube, or the rear end of the pointer is fixedly connected to the operating part.

5. The sulcus locator of claim 1, wherein the outer diameter of the pointer is smaller than the outer diameter of the guide tube, the outer diameter of the pointer being between 0.05mm and 2mm, and further the outer diameter of the pointer being between 0.05mm and 0.8 mm.

6. The ciliary sulcus positioner of claim 1 wherein the pointer is made of a resilient metal material configured to return to an original shape after deformation and removal of an external force.

7. The ciliary sulcus locator of claim 1 wherein said indicator end is forward not beyond the forward end of said guide tube; the distance between the indicating end of the indicating needle and the front end of the guide tube is within 5mm along the length direction of the guide tube, and further, the distance between the indicating end of the indicating needle and the front end of the guide tube is even or 1-3 mm along the length direction of the guide tube.

8. The ciliary sulcus positioner of claim 2 wherein the light source is a pulse light generator.

9. The sulcus positioner of claim 4, wherein the operating portion comprises a handle and a connecting rod; the connecting rod with the guiding tube is the slope and connects, the connecting rod is kept away from the one end of guiding tube still is equipped with the handle and links up the mouth, stalk portion connects the handle links up the mouth.

10. The ciliary sulcus positioner according to claim 1, wherein an arc-shaped support body is attached to the front end of the guide tube, and the rear end opening of the guide tube is an oblique opening; the direction of the indicating end is parallel to the guiding pipe, or the indicating end is an upward bending structure arranged on the main body section.