EP2173292A1 - Schneidevorrichtung für einen gekrümmten hornhautkanal - Google Patents
Schneidevorrichtung für einen gekrümmten hornhautkanalInfo
- Publication number
- EP2173292A1 EP2173292A1 EP08801497A EP08801497A EP2173292A1 EP 2173292 A1 EP2173292 A1 EP 2173292A1 EP 08801497 A EP08801497 A EP 08801497A EP 08801497 A EP08801497 A EP 08801497A EP 2173292 A1 EP2173292 A1 EP 2173292A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- cornea
- cutting
- channel
- blade
- knife
- 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.)
- Withdrawn
Links
- 210000004087 cornea Anatomy 0.000 claims abstract description 68
- 238000000034 method Methods 0.000 claims description 7
- 125000006850 spacer group Chemical group 0.000 claims description 2
- 238000010276 construction Methods 0.000 description 3
- 230000015556 catabolic process Effects 0.000 description 2
- 238000006731 degradation reaction Methods 0.000 description 2
- 238000005096 rolling process Methods 0.000 description 2
- 230000001960 triggered effect Effects 0.000 description 2
- 208000029091 Refraction disease Diseases 0.000 description 1
- 230000004430 ametropia Effects 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 238000000605 extraction Methods 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 239000011888 foil Substances 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 230000036244 malformation Effects 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 208000014733 refractive error Diseases 0.000 description 1
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
Definitions
- ametropia of the eye is due to the malformation of the cornea, this can be corrected by implanting support rings into the cornea.
- support rings into the cornea.
- channels must be cut into the cornea. This happens z. B. with the help of femtosecond lasers, a very precise method, or purely manual mechanical, z. B. by means of a semi-circular shaped knife edge. For this purpose, a radially extending cut extending to a certain depth is first placed in the cornea. Then the tip of the knife is inserted into a vertical section surface.
- the approximately 180 ° extending and horizontally extending annular knife is connected to a perpendicular thereto designed as a hollow cylinder handle over which the blade unit is manually operated.
- the invention has for its object to provide a device which eliminates the disadvantages and risks mentioned above while maintaining known blade units.
- the present invention solves this problem starting from a device according to the preamble of claim 1 by the features stated in the characterizing part of claim 1. It solves this problem further starting from a method according to the preamble of claim 18 by the features stated in the characterizing part of claim 18.
- the present invention is based on the technical teaching that one achieves a particularly favorable and precise design of the corneal channels when the knife is not only guided transversely to its axis of rotation when cutting the respective channel, but also undergoes an axial fixation, so that a precise cut can be carried out.
- the structure of the device is divided in preferred variants of the invention primarily in two in the plan view semicircular halves (half plate).
- connection between the cornea and the device, which advantageously in the contact area z. B. is formed as 35 dpt curved dome, preferably by evacuation.
- the dome may have on its surface two peculiarities, each formed on a certain radius. On the one hand, it can be a recess introduced as a rounded groove into the calotte and evacuated, and on the other hand, it can also act as a thin-walled trough extending as a displacer or hold-down in a semicircle.
- the device allows the inclusion of only slightly modified and belonging to the prior art blade units for cutting annular channels in the cornea.
- the blade unit is centered in the device mounted rotatable and height adjustable.
- the knife is pivoted back by an opposite rotational movement on the handle and rinsed the channel.
- the device If an annular channel is to be cut in the remaining half of the cornea, the device must be displaced by 180 °. as a result, the half of the cornea already filled with the canal is pressed down and the other is lifted, if necessary.
- the support ring can then be inserted into this half. This process, even if only one support ring is to be implanted, conceivable before the device is removed from the cornea.
- Figure 1 is a schematic view of a first part of a preferred embodiment of the device according to the invention.
- Figure 2 is a schematic plan view of the part of Figure 1;
- Figure 3 is a schematic partial section through the part of Figure 2 along the line III-III;
- FIG. 4 is a schematic plan view of a second part of the device of Figure 1;
- FIG. 5 shows a schematic partial section through the second part from FIG. 4 along the line VV;
- FIG. 6 shows a schematic section through the device according to the invention from FIGS. 1 and 4 along the line VI-VI in the mounted state;
- Figure 7 is a schematic view of a first part of another preferred embodiment of the device according to the invention.
- Figure 8 is a schematic view of another preferred embodiment of the device according to the invention.
- Figure 9 is a schematic sectional view of a part of
- Figure 10 is a schematic sectional view of a fixing ring of the device of Figure 8.
- Figure 11 is a schematic plan view of the fixing ring of Figure 10;
- Figure 12 is a schematic sectional view of a
- Figure 13 is a schematic plan view of the cutting template of Figure 12;
- Figure 14 is a schematic sectional view of part of another preferred embodiment of the device according to the invention.
- Both parts 101 and 102 each have a semicircular support 101.1, 102.1.
- the part 101 is equipped with a central axis 101.2 serving as a bearing device, on which a hollow cylinder 103.1 of a cutting device in the form of a blade unit 103 is mounted rotatably or pivotably and height-adjustable.
- a height adjustment unit 104 is eccentrically pushed or pivoted eccentrically onto the part 101 on the base side, comprising a lockable micrometer screw 104.1.
- a micrometer screw 104.1 On the micrometer screw 104.1 sits a knurled nut 104.2, which forms a height-adjustable area.
- On the knurled nut 104.2 is rotatably seated a fork 104.3, which engages perfectly in the groove 103.2 located on the hollow cylinder 103.1 and thus brings and holds the blade unit 103 in the desired height position.
- the part 101 is aligned and positioned on the cornea 105 without blade unit 103 and height adjustment unit 104, and is fastened thereto by vacuum extraction (via suitable channels 101.3). Subsequently, with a depth-adjustable blade (not shown), which is guided at the separating edge 101.4 of the part 101, two incisions, tuned to the channel or support ring diameter, are introduced into the cornea 105. In other words, the part 101 thus forms a cutting template for these cuts.
- the trough 102.3 thus forms a hold-down unit, which is arranged in the region of the blade movement space of the blade 103.3 when the channel is cut and displaces the part of the cornea 105 which is not to be provided with the channel in the current section from the blade movement space.
- blade unit 103 is pushed onto the central axis 101.2 of the part 101.
- the blade unit 103 is to be positioned such that the circular-arc-shaped blade 103.3 fits into the arc of the trough 102.3.
- the height adjustment of the knife 103.3 is carried out with the height adjustment unit 104 described above. Subsequently, the knife tip 103.4 is inserted into the end wall 105.1 exposed by the depression of the trough-side half of the cornea 105 by means of a rotary or pivoting movement, triggered on the handle 103.5 of the blade unit 103 by hand, introduced and cut to approximately 180 ° circumference of the channel.
- the knife 103.3 is rotated back by pivoting direction reversal, the height adjustment device 104 is withdrawn from the part 101 and the blade unit 103 and the blade unit 103 is removed from the central axis 101.2.
- the part 102 is ventilated and lifted off the cornea 105 and the part 101.
- the part 101 is ventilated and also removed from the cornea 105 or rotated by 180 ° on the with the (previously cut) channel equipped half of the cornea 105 set radially accurate and the structure and (after cutting the second channel) the degradation in known Made way.
- the provided support rings can be implanted.
- FIG. 7 shows (in a half view corresponding to the view from FIG. 1) a variant of the device 200 according to the invention, in which a first part 201 which is slightly modified with respect to the first part 101 is used.
- the cornea 105 is not pressed down on the channel not currently to be canalized by the trough 102.3 after setting the radial cuts in order to expose the front wall 105.1 of the cornea 105 for applying the knife 103.3 , Rather, via a curvature of the blade 103 adapted groove 201.6 and associated suction channels 201.7 the side of the cornea 105 in the groove 201.6 inside (ie in Figure 7 up) sucked to raise the end wall 105.1 of the cornea 105 and thus for applying the Knife 103.3 uncover.
- the groove 201.6 and the suction channels 201.7 are thus part of a lifting unit, which is arranged in the region of the knife movement space of the knife 103.3 traversed when cutting the channel and lifts the part of the cornea 105 to be provided with the channel during the current cut into the blade movement space ,
- the knife 103.3 is then positioned similarly to the first variant via the height adjustment device 104 (at the level of the groove 201.6) and attached to the end wall 105.1 (which then lies in the groove 201.6) and the channel is cut as described above. It can be provided to cover the open ends of the groove with a cover (eg a foil or the like) in order to ensure sufficient suction of the cornea 105 into the groove. The cover is then pierced when cutting the channel.
- a cover eg a foil or the like
- the second part 102 is not necessarily needed. In particular, no trough must be provided. However, an annular second part to support the device against tilting of serving (for guiding the blade unit 103) central axis 201.2 be helpful
- this device 200 corresponds in construction and mode of operation to the device 100, so that reference is made to the above statements to avoid repetition and only the differences are discussed.
- similar components are provided with increased by the value 200 reference numerals. Unless otherwise stated below, reference is expressly made to the above statements with regard to the features of these components.
- the holding device of the device 100 comprises a half 301, which is formed as a simple dome, ie without a groove, while the second half 302 is again designed with a trough-like hold-down. Both parts 301 and 302 are integrally connected to each other and each form a semicircular support 301.1, 302.1.
- the component 301, 302 is equipped with a bearing bushing 301.2 serving as a bearing device into which a shaft device in the form of a pin 303.1 of a cutting device in the form of a blade unit 303 is rotatable or pivotable and mounted.
- the cornea 105 facing distal end of the pin 303.1 sits on a stop surface 301.8 of the bearing bush 301.2, so that thereby the position of the pin 303.1 is defined in the radial direction R.
- the blade unit 303 comprises a handle 303.5 to which the blade 303.3 is attached.
- the handle 303.5 is in turn rotatably connected via an anti-rotation 303.6 but longitudinally displaceable with the pin 303.1.
- a height adjustment unit 104 is provided on the handle 303.5 at the end facing away from the cornea 105.
- the height adjustment unit 104 includes a rotatable and axially fixed to the handle 303.5 connected thread wheel (or a knurled nut) 304.2, which with an end thread of the pin
- the blade unit 303 is screwed. Via this thread wheel 304.2, the blade unit 303 can be brought and held in the desired radial direction R in the desired height position (above the cornea 105).
- the component 301, 302 is held by a fixing ring 306.1 of a fixing device 306 (shown in more detail in FIGS. 10 and 11).
- the fixation ring 306.1 is first placed on the cornea 105 and aligned. Subsequently, a negative pressure is generated via suction channels 306.2, via which the fixing ring 306.1 is fixed on the cornea 105.
- the fixing ring 306.1 has on its inside a toothing 306.3, for example a straight toothing, or other fixing means, via which the component 301, 302 (by means of suitable counterparts) rotatably connected to the fixing ring 306.1 can be connected.
- a toothing 306.3 for example a straight toothing, or other fixing means
- a cut template 307 (shown in more detail in FIGS. 12 and 13) is first inserted into the fixation ring 306.1.
- the Sehnittschablone 307 comprises at its outer periphery a toothing 307.1, which cooperates with the toothing 306.3 of the fixing ring 306.1 and so the cutting template 307 rotatably connected to the fixing ring 306.1. Subsequently, a negative pressure is generated via suction channels 307.2, via which the cutting template 307 is fixed on the cornea 105. With a cutting depth-adjustable knife (not shown), which is guided through openings 307.3 of the cutting template 307, then two incisions, matched to the channel or support ring diameter, are introduced into the cornea 105.
- the cutting template 307 is removed from the fixing ring 306.1 and the component 301, 302 is inserted into the fixing ring 306.1. This is done in such a way that the trough 302.3 - flush with the previously introduced radial cuts - is pressed into the cornea 105 until the calotte half 301.1 rests on the cornea 105. Subsequently, the component 301, 302 is firmly connected to the cornea 105 by evacuation (via suitable channels 301.3 and 302.4).
- the trough 302.3 thus forms a hold-down unit, which is arranged in the region of the blade movement space of the blade 303.3 when the channel is cut and displaces the part of the cornea 105 which is not to be provided with the channel in the current section from the blade movement space.
- the blade unit 303 is inserted with the pin 303.1 in the bearing bush 301.2 (which may optionally be provided with corresponding rolling and / or plain bearings).
- the blade unit 303 is to be positioned so that the circular-arc-shaped blade 103.3 fits into the arc of the trough 302.3.
- the height adjustment of the blade 303.3 is carried out with the height adjustment unit 304 described above. Thereafter, the blade tip 303.4 is pushed in by the depression the trog Desken half of the cornea 105 exposed end wall 105.1 by means of rotary or pivoting movement, triggered by the handle 303.5 of the blade unit 303 by hand, introduced and cut to approximately 180 ° circumference of the channel.
- the knife 103.3 is rotated back by swing direction reversal, the blade unit 303 is removed.
- the component 301, 302 is ventilated and lifted from the fixing ring 306.1 and the cornea 105, optionally rotated by 180 ° and placed again on the cornea 105 radial reinforcegenau and the structure and made (after cutting the second channel) the degradation in a known manner.
- the fixing ring may be provided with a corresponding scale or mark to facilitate the attachment of the component 301, 302. If necessary, this marking can also be used when setting the radial cuts by means of the cutting template 307, thus making it easier to position the components with radial-precision positioning.
- the provided support rings can be implanted.
- this device 400 corresponds in construction and mode of operation to the device 300, so that reference is made to the above statements in order to avoid repetition and that only the differences are discussed.
- similar components are provided with increased by the value 100 reference numerals. Unless otherwise stated below, reference is expressly made to the above statements with regard to the features of these components.
- FIG. 14 shows (in a partial view corresponding to the view from FIG. 8) a variant of the device 400 according to the invention, in which the height adjustment unit is realized by exchangeable spacers 404, via which the height adjustment of the blade 303.3 in the radial direction R can be performed.
- the blade unit 403 then differs from the blade unit 303 only insofar as the pin 403.1 can be rigidly connected to the handle 403.5.
Landscapes
- Health & Medical Sciences (AREA)
- Ophthalmology & Optometry (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
- Eye Examination Apparatus (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102007035447A DE102007035447A1 (de) | 2007-07-26 | 2007-07-26 | Vorrichtung für die Verwendung eines kreisförmigen Messers zum Schneiden eines ebenso geformten Kanals in die Hornhaut des Auges |
PCT/EP2008/006217 WO2009013023A1 (de) | 2007-07-26 | 2008-07-28 | Schneidevorrichtung für einen gekrümmten hornhautkanal |
Publications (1)
Publication Number | Publication Date |
---|---|
EP2173292A1 true EP2173292A1 (de) | 2010-04-14 |
Family
ID=40028145
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP08801497A Withdrawn EP2173292A1 (de) | 2007-07-26 | 2008-07-28 | Schneidevorrichtung für einen gekrümmten hornhautkanal |
Country Status (5)
Country | Link |
---|---|
US (1) | US20100211089A1 (de) |
EP (1) | EP2173292A1 (de) |
KR (1) | KR20100074115A (de) |
DE (1) | DE102007035447A1 (de) |
WO (1) | WO2009013023A1 (de) |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN103976819A (zh) * | 2014-04-23 | 2014-08-13 | 王超庆 | 角膜移植钻台架 |
Family Cites Families (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE69330827T2 (de) | 1992-04-10 | 2002-05-29 | Keravision Inc | Zentrierende, mit vakuum arbeitende führungsvorrichtung und dissektor für die hornhaut |
US5405355A (en) * | 1993-09-10 | 1995-04-11 | Vitrophage, Inc. | Method of radial keratotomy employing a vibrating cutting blade |
US6197038B1 (en) * | 1997-11-17 | 2001-03-06 | O'donnell, Jr. Francis E. | Apparatus for lamellar keratoplasty |
US20010053917A1 (en) * | 2000-06-16 | 2001-12-20 | Chwen-Yih Lin | Non-plane cut microkeratome and method of performing non-plane keratotomy |
US6649061B2 (en) * | 2000-12-28 | 2003-11-18 | Exxonmobil Research And Engineering Company | Membrane process for separating sulfur compounds from FCC light naphtha |
FR2820026B1 (fr) * | 2001-02-01 | 2004-02-06 | Gilbert Cohen | Dispositif pour le traitement oculaire |
-
2007
- 2007-07-26 DE DE102007035447A patent/DE102007035447A1/de not_active Ceased
-
2008
- 2008-07-28 KR KR1020107004242A patent/KR20100074115A/ko not_active Application Discontinuation
- 2008-07-28 US US12/670,293 patent/US20100211089A1/en not_active Abandoned
- 2008-07-28 WO PCT/EP2008/006217 patent/WO2009013023A1/de active Application Filing
- 2008-07-28 EP EP08801497A patent/EP2173292A1/de not_active Withdrawn
Non-Patent Citations (1)
Title |
---|
See references of WO2009013023A1 * |
Also Published As
Publication number | Publication date |
---|---|
WO2009013023A1 (de) | 2009-01-29 |
DE102007035447A1 (de) | 2009-01-29 |
KR20100074115A (ko) | 2010-07-01 |
US20100211089A1 (en) | 2010-08-19 |
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Legal Events
Date | Code | Title | Description |
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PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
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17P | Request for examination filed |
Effective date: 20100125 |
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Kind code of ref document: A1 Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MT NL NO PL PT RO SE SI SK TR |
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AX | Request for extension of the european patent |
Extension state: AL BA MK RS |
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DAX | Request for extension of the european patent (deleted) | ||
RAP1 | Party data changed (applicant data changed or rights of an application transferred) |
Owner name: TOMALLA, JUTTA Owner name: TOMALLA, KARIN |
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17Q | First examination report despatched |
Effective date: 20120209 |
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STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN |
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18D | Application deemed to be withdrawn |
Effective date: 20120620 |