JP2023160562A - Ophthalmic operation knife - Google Patents

Abstract

To provide an ophthalmic operation knife for supporting execution of efficient operation.SOLUTION: An ophthalmic operation knife has a blade body and a handle. The blade body has a pair of sides, a pointed end part positioned on the tip. a first blade provided over the area from the pointed end part to one side in a plane view, and a second blade provided over the area from the pointed end part to the other side. The pointed end part is on a position deviated from a shaft center of the blade body in a plane view.SELECTED DRAWING: Figure 1

Description

The present invention relates to an ophthalmic surgical knife.

When performing eye surgery, various shapes of eye surgery knives are used depending on the purpose of the surgery.

Patent Document 1 discloses a technique related to a corneal perforator. Paragraph [0010] states, ``The quadrilateral-shaped part at the tip of this keratome 1 is made of diamond, and this part has a front end 2 and both side edges 3 that sandwich the front end 2 are continuous blade parts. Furthermore, the front end 2 and both side edges 3 have the same shape on the front and back, and furthermore, the both side edges 3 of the tip are trapezoidal in width, becoming narrower as they get closer to the front end 2. It is stated that.

Registered utility model No. 3044494

In ophthalmological surgery, the desired surgical wound can be created by changing knives depending on the purpose, such as using a straight knife for incision, a crescent knife for dissection, and a slit knife for perforation. obtain.

However, preparing multiple types of knives and replacing them during surgery is not only troublesome for the doctor, but also increases the surgical time and increases the economic burden due to the use of multiple knives. Furthermore, the knife must be cleaned or disposed of after use, which not only increases costs but also increases environmental impact.

The corneal perforator disclosed in Patent Document 1 has a straight front end, and a surgical wound is obtained by pressing the straight part against the eyeball and applying force. Therefore, when perforating, for example, the perforation is more likely to receive resistance from the eyeball than when perforating using a slit knife with a sharp tip, which poses a problem in accurately forming a surgical wound.

The present invention has been made in view of the above points, and an object of the present invention is to provide an ophthalmic surgical knife that supports efficient performance of surgery.

The present application includes a plurality of means for solving at least part of the above problems, examples of which are as follows.

In order to solve the above problems, an ophthalmic surgical knife according to one aspect of the present invention is an ophthalmic surgical knife having a blade body and a handle, the blade body having a pair of side edges and a handle located at a tip thereof. a first blade provided from the pointed end to one of the sides in a plan view, and a second blade provided from the pointed end to the other side; The tip is located at a position offset from the axis of the blade in plan view.

The blade body may have a flat back surface.

The pair of side edges may be parallel in plan view.

In the ophthalmic surgical knife of the present invention, a straight line connecting a contact point between the first blade and the one side and a contact point between the second blade and the other side, in plan view, The blade may be characterized by being inclined with respect to the axial direction of the blade.

The pointed end is located at a position shifted from the axis so that the side where the first blade is provided is narrower, and the second blade has a curved shape that swells outward in plan view. You can also use it as

Each of the pair of side edges may be characterized in that at least a portion thereof is provided with a third blade.

The first blade may have a linear shape in plan view.

According to the present invention, it is possible to provide an ophthalmic surgical knife that supports efficient performance of surgery.

Problems, configurations, and effects other than those described above will be made clear by the description of the embodiments below.

It is a figure (part 1) which shows an example of the blade of the knife for ophthalmic surgery. FIG. 1(A) is a plan view showing an example of the blade, and FIG. 1(B) is a diagram (part 1) for explaining an overview of the example of the blade. It is a figure (part 2) which shows an example of the blade of the knife for ophthalmic surgery. FIG. 2(A) is a left side view showing an example of the blade body, FIG. 2(B) is a diagram (part 2) for explaining an overview of the example of the blade body, and FIG. 2 is a bottom view showing an example of the back surface of the blade, and FIG. 2(D) is a diagram showing an example of the AA′ cross section of the blade. It is an example of a six-sided view of a knife for ophthalmic surgery. FIG. 3(A) is an example of a right side view of the ophthalmic surgical knife, FIG. 3(B) is an example of a plan view of the ophthalmic surgical knife, and FIG. 3(C) is an example of the right side view of the ophthalmic surgical knife. FIG. 3(D) is an example of a bottom view of the ophthalmic surgical knife, FIG. 3(E) is an example of a front view of the ophthalmic surgical knife, and FIG. F) is an example of a rear view of an ophthalmic surgical knife. It is an example of an enlarged view of the blade body 10. 4(A) is an example of an enlarged right side view of the blade body 10, FIG. 4(B) is an example of an enlarged plan view of the blade body 10, and FIG. 4(C) is an example of an enlarged right side view of the blade body 10. FIG. 4(D) is an example of an enlarged left side view of the blade 10, FIG. 4(D) is an example of an enlarged bottom view of the blade 10, and FIG. 4(E) is an example of an enlarged front view of the blade 10. be. It is a figure which shows the example of use at the time of trilateral incision of a sclerocorneal with the knife for ophthalmic surgery. FIG. 5(A) is a diagram showing an example of usage for forming the first surface a, FIG. 5(B) is a diagram showing an example of usage for forming the second surface b, and FIG. 5(C) is a diagram showing an example of usage for forming the second surface b. , is a diagram showing an example of use for forming the third surface c. FIG. 2 is a schematic diagram for explaining an example of a trilateral incision of a sclerocornea.

Embodiments of the present invention will be described below based on the drawings.

FIG. 6 is a schematic diagram illustrating an example of a three-sided sclerocorneal incision. A triangular sclerocorneal incision is mainly performed during cataract surgery to form an incision from the outside of the eye toward the anterior chamber. This figure shows an eyeball w, an iris v, a sclera x, a cornea y, and an anterior chamber z as a cross section near the eyeball. In the trilateral incision of the sclerocornea, three surfaces are formed whose cross sections are broken lines, as shown in wound d.

More specifically, the sclera x is incised from the outside of the eyeball w to a desired depth to form the first surface a. Thereafter, the second surface b is formed by peeling the inside of the sclera x toward the cornea y. Thereafter, a third surface c is formed by perforating the anterior chamber z from the cornea y.

According to the trilateral sclerocorneal incision, the cornea y is pressurized from inside the eyeball by intraocular pressure after surgery, and the surgical wound closes naturally without sutures. That is, in that the surgical wound self-closes, it has the advantage that the burden on the patient can be reduced compared to the case of suturing, and that it can prevent infections.

Generally, a straight knife is used to form the first surface a, a crescent knife is used to form the second surface b, and a slit knife is used to form the third surface c. Perform the surgery while changing to a knife suitable for perforation. By using the ophthalmologic surgical knife 1 of this embodiment, triangular sclerocorneal incisions can be performed without changing the knife.

FIG. 1 is a diagram showing an example of a blade body 10 of a knife 1 for ophthalmic surgery. FIG. 1(A) is a plan view showing an example of the blade body 10, and FIG. 1(B) is a diagram (part 1) for explaining an overview of the example of the blade body 10. Note that this figure is a plan view of the blade body 10 on a flat plate viewed from directly above.

The blade body 10 has a blade portion 11 and a shaft portion 41. Although the material of the blade 10 is not limited, for example, stainless steel can be used. The blade portion 11 is a portion having a blade used for forming a surgical wound, and has a flat plate shape. The shaft portion 41 is a portion that connects the blade portion 11 and a handle 50, which will be described later.

The blade portion 11 has a pair of sides substantially parallel to the axial direction (that is, the longitudinal direction) and a pointed end portion 15 . The pointed end portion 15 is located at the tip of the blade portion 11 and has a shape that is pointed toward the front (the side facing the shaft portion 41). The tip portion 15 is located at a position offset from the axis u of the blade body 10 in plan view.

Further, the blade portion 11 has a first blade 12 and a second blade 13. The first blade 12 is a blade provided extending from the tip 15 to one side in plan view. As an example, the first blade 12 has a linear shape in plan view. However, the first blade 12 may have a curved shape that gently bulges outward in plan view.

The second blade 13 is a blade provided from the tip portion 15 to the other side in plan view. As an example, the second blade 13 has a curved shape that gently swells outward in plan view. The second blade 13 can have a substantially arc shape in plan view. Note that the second blade 13 may have a linear shape. The pointed end portion 15 is located at a position shifted from the axis u of the blade portion 11 so that the side where the first blade 12 is provided is narrower in plan view.

Further, the third blade 14 may be provided on at least a portion of each of the pair of sides of the blade portion 11. One third blade 14 is continuous with the first blade 12, and the other third blade 14 is continuous with the second blade 13. Note that the third blade 14 is provided on the entire side of the blade portion 11 in FIG. 1 .

A contact point between the first blade 12 and one side is a contact point 16, and a contact point between the second blade 13 and the other side is a contact point 17. The blade portion 11 shown in FIG. 1 is angular outward at the contact points 16 and 17 to form a corner. Note that the contacts 16 and 17 may be rounded. As shown in FIG. 1(B), in plan view, the straight line s connecting the contact points 16 and 17 is inclined with respect to the axis U (ie, the axial direction).

Additionally, if the third blade 14 is provided on the blade portion 11, it is useful for expanding the incision wound in a direction substantially perpendicular to the axial direction, for example, during ablation.

Further, the blade portion 11 has inclined surfaces 21 , 22 , 23 and a flat surface 24 . The blade portion 11 has an upwardly raised shape when viewed from the side, and the plane 24 is the most raised portion when viewed from the side, and is approximately parallel to the back surface 25 of the blade portion 11 . The inclined surface 21 is a surface inclined from the plane 24 toward one side. The inclined surface 22 is a surface inclined from the plane 24 toward the other side. The inclined surface 23 is a surface inclined from the plane 24 toward the first blade 12 and the second blade 13.

To explain using FIG. 1(B), the distance t1 of the blade portion 11 in the transverse direction is preferably 0.7 cm or more and less than 0.9 cm. The distance t1 of the blade portion 11 in this embodiment can be, for example, 0.8 cm. The distance t2 in the transverse direction from the tip 15 to the side on which the first blade 12 is provided is preferably 0.1 cm or more and less than 0.3 cm, more preferably 0.2 cm or more and less than 0.3 cm. Less than 25 cm. The distance t2 of the blade portion 11 in this embodiment can be, for example, 0.23 cm.

The ratio of the distance t2 from the tip 15 to the side on the first blade 12 side to the distance t1 in the short direction of the blade 11 is preferably 26% or more and less than 30%. That is, the ratio of the distance from the tip 15 to the axis u to the distance t1 in the short direction of the blade 11 is preferably 20% or more and less than 24%. In other words, it can be said that the tip portion 15 is located at a position shifted from the axis U by 20% or more and less than 24% with respect to the overall length of the blade portion 11 in the transverse direction. In the present embodiment, the tip portion 15 is provided at a position shifted from the axis u by, for example, 21.25% with respect to the overall length of the blade portion 11 in the transverse direction.

The distance t3 in the longitudinal direction of the blade portion 11 is preferably 4.5 cm or more and less than 6 cm, more preferably 5 cm or more and less than 5.5 cm. The distance t3 of the blade portion 11 in this embodiment can be, for example, 5.26 cm. The distance t4 in the longitudinal direction from the tip 15 to the contact point 16 is preferably 0.2 cm or more and less than 0.5 cm, more preferably 0.3 cm or more and less than 0.4 cm. The distance t4 of the blade portion 11 in this embodiment can be, for example, 0.34 cm. Note that the distance t4 in the longitudinal direction between the tip portion 15 and the contact point 16 is related to the penetration depth by the blade body 10. By forming the first blade 12 as described above, when forming a surgical wound with the pointed end 15 at the beginning, the depth of the wound can be easily recognized and over-cutting can be prevented.

The first blade 12 can be used like a typical straight knife. When performing the above-mentioned trilateral incision of the sclerocornea, for example, the tip 15 can be used to form the first surface a in FIG. 6 . To this end, the angle θ between the axis u of the blade body 10 and the first blade 12 is preferably 30 degrees or more and less than 40 degrees, more preferably 32 degrees or more and less than 36 degrees. The angle θ in this embodiment can be, for example, 34 degrees.

As described above, the second blade 13 is formed to draw a curve that bulges outward. Thereby, the second blade 13 can be used like a general crescent knife. When performing the above-mentioned three-sided sclerocorneal incision, for example, the second blade 13 can be used to form the second plane b in FIG. 6 . For this purpose, the radius of curvature R of the second blade 13 is preferably 1.00 mm or more and less than 2.5 mm, more preferably 1.2 cm or more and less than 1.7 cm. The radius of curvature R in this embodiment can be, for example, 1.55 cm.

The longitudinal distance t5 from the tip 15 to the contact point 17 is preferably 0.5 cm or more and less than 1 cm. The distance t5 of the blade portion 11 in this embodiment can be, for example, 0.85 cm. Note that the first blade 12 and the second blade 13 are formed so that the distance t5 is longer than the distance t4. By providing the first blade 12 and the second blade 13 on both sides of the tip 15, the tip of the blade 11 can be used like a general slitting knife. When performing the above-mentioned trilateral incision of the sclerocornea, for example, the third surface c in FIG. 6 can be formed by using the first blade 12 and the second blade 13 with the apex 15 as the leading edge. can.

Note that although the pair of side edges of the blade portion 11 shown in FIG. The blade body 10 may be formed to be inclined with respect to the axis u so that the width of the blade body 10 is increased.

FIG. 2 is a diagram (part 2) showing an example of the blade body 10 of the knife 1 for ophthalmic surgery. FIG. 2(A) is a left side view showing an example of the blade body 10, and FIG. 2(B) is a diagram (part 2) for explaining an overview of the example of the blade body 10. C) is a bottom view showing an example of the back surface 25 of the blade 10, and FIG. 2(D) is a diagram showing an example of the AA' cross section of the blade 10. 2(A) and 2(B) are left side views of the blade 10 viewed from the side, and FIG. 2(C) is a bottom view of the blade 10 on a flat plate viewed from the back.

To explain using FIG. 2(A), the blade 10 in this embodiment has a so-called bevel-up shape in which the upper part is raised and the lower back surface 25 is flat in side view. It has become. That is, during surgery, the user of the ophthalmic surgical knife 1 holds the knife so that the inclined surfaces 22 and 23 face upward and the back surface 25 faces downward.

The thickness of the blade portion 11, that is, the distance t6 from the flat surface 24 to the back surface 25, is preferably 0.05 cm or more and less than 0.3 cm, and more preferably 0.1 cm or more and less than 0.2 cm. The distance t6 of the blade portion 11 in this embodiment can be 0.14 cm. Further, the shape of the shaft portion 41 is not limited, but it is, for example, a substantially cylindrical shape having a diameter t7 of 0.4 cm or more and less than 1 cm. The diameter t7 of the blade portion 11 in this embodiment can be, for example, 0.6 cm.

FIG. 2(D) shows an example of a cross section taken along line AA' in FIG. 1(A). As shown in this figure, the back surface 25 of the blade part 11 has a planar shape, and the third blade 14 is formed at both ends, and is inclined from the upper flat surface 24 toward the third blade 14 on the side. .

In the example shown in FIGS. 2(A) and 2(B), the blade portion 11 and the shaft portion 41 are connected in a straight line so as to have the same axis, but as will be described later, the shaft portion 41 is It can be configured to be bent upward in this figure and connected to the handle 50.

FIG. 3 is an example of a six-sided view of the knife 1 for ophthalmic surgery. 3(A) is an example of a right side view of the knife 1 for ophthalmic surgery, FIG. 3(B) is an example of a plan view of the knife 1 for ophthalmic surgery, and FIG. 3(C) is an example of a right side view of the knife 1 for ophthalmic surgery. FIG. 3(D) is an example of a bottom view of the knife 1 for ophthalmic surgery, and FIG. 3(E) is an example of a front view of the knife 1 for ophthalmic surgery. 3(F) is an example of a rear view of the knife 1 for ophthalmic surgery. Note that in the side views shown in FIGS. 3(A) and 3(C), the blade portion 11 and the shaft portion 41 are connected in a bent manner.

In addition, FIG. 3(B) is an example of a plan view of the handle 50 viewed from directly above, and FIGS. 3(A) and 3(C) are right and left side views of the handle 50 viewed from the side. FIG. 3(D) is an example of a bottom view of the handle 50 as seen from the back, and FIGS. 3(E) and (F) are front and rear views of the handle 50 as seen from the front and rear directions. This is an example.

The ophthalmic surgical knife 1 has a handle 50 in addition to the blade 10 described above. The blade body 10 is connected to one end of the handle 50. For example, the inside of the handle 50 is hollow, and by operating the other end of the handle 50, the blade 10 can be stored inside or exposed as shown in FIG. can. Note that the handle 50 and the blade body 10 may be fixed, or the blade body 10 may be detachably connected to the handle 50 and the blade body 10 may be replaceable.

FIG. 4 is an example of an enlarged view of the blade body 10. 4(A) is an example of an enlarged right side view of the blade body 10, FIG. 4(B) is an example of an enlarged plan view of the blade body 10, and FIG. 4(C) is an example of an enlarged right side view of the blade body 10. FIG. 4(D) is an example of an enlarged left side view of the blade 10, FIG. 4(D) is an example of an enlarged bottom view of the blade 10, and FIG. 4(E) is an example of an enlarged front view of the blade 10. be.

FIG. 4(B) is a partially enlarged view of the BB′ section in FIG. 3(B). 4(A) is a right side view of the BB′ portion shown in FIG. 4(B) as a plan view, and FIG. 4(C) is a right side view of the B-B′ portion shown in FIG. 4(D) is a left side view when the B′ portion is taken as a plan view, and FIG. 4(D) is a bottom view when the BB′ portion shown in FIG. 4(B) is taken as a plan view. 4(A), (B), (C), and (D) show the blade portion 11, and portions other than the blade portion 11 are shown with dotted lines. In addition, the boundary between the blade portion 11 and other portions is shown by a dashed-dotted line for convenience.

FIG. 5 is a diagram showing an example of use of the ophthalmic surgical knife 1 at the time of trilateral incision of the sclerocornea. FIG. 5(A) is a diagram showing an example of usage for forming the first surface a, FIG. 5(B) is a diagram showing an example of usage for forming the second surface b, and FIG. 5(C) is a diagram showing an example of usage for forming the second surface b. , is a diagram showing an example of use for forming the third surface c.

First, as shown in FIG. 5(A), the pointed end 15 is applied to a desired part of the sclera x and moved to slide toward another part of the sclera x to make an incision. As a result, the first surface a is incised. More specifically, after applying the pointed end 15 to a desired portion of the sclera x, a linear incision is obtained by moving the blade 11 laterally. By providing the sharp tip portion 15 at the front, it is easy to form a straight incision line.

Next, change the advancing direction of the ophthalmic surgical knife 1 so that the second blade 13 is at the top, and change the cutting angle of the blade 11 so that it becomes shallower than when forming the first surface a. 11 (FIG. 5(B)). At this time, by rotating the blade 11 around the tip 15 or the second blade 13 in a tilted manner, the tip of the blade 11 is stabilized, and the tissue near the blade is more stable than when using a bi-bevel blade. can be prevented from being scratched. This forms the second surface b.

In addition, the second blade 13 is used to delaminate the half-layered incision resulting from the formation of the first surface a. By using the substantially arc-shaped second blade 13 for delamination, if the blade part 11 on the flat plate is moved laterally, any part of the second blade 13 will make an incision, allowing smooth peeling. It can be performed.

Note that if the third blade 14 is formed on the side, the width of the surgical wound can be more easily widened during ablation.

Next, the advancing direction is changed so that the pointed end 15 is at the top, and the angle of the blade 11 is changed so that the cutting angle of the blade 11 becomes deeper than when forming the second surface b (see FIG. 5). C)). At this time, similarly to the transition from the first surface a to the second surface b, by rotating the blade part 11 around the point 15 as an axis to lift the blade part 11, the tip of the blade part 11 is stabilized and the bi-bevel is maintained. Compared to the case where a blade is used, tissue near the blade can be prevented from being scraped. Further, by pushing up the tissue that was peeled off during the formation of the second surface b by the inclined surface 23, the perforation can be more easily performed. This forms the third surface c.

In addition, by applying the tip 15 to the perforation location and pushing the blade 11 straight in substantially perpendicular to the longitudinal direction of the blade 11, the incision on the third surface c can be easily formed. Having the pointed end 15 in the front facilitates insertion into the anterior chamber z. Moreover, at this time, if the first blade 12 is formed in a straight line, it can more easily penetrate the desired location.

As described above, according to the ophthalmic surgical knife 1 of the present embodiment, when performing operations such as incision, exfoliation, and perforation, a desired surgical wound can be smoothly obtained without changing the knife. Therefore, the ophthalmic surgical knife 1 enables incisions in almost all ophthalmic surgeries. This not only makes it possible to reduce the number of knife replacements and shorten surgical time, but also contributes to cost reduction and reduces environmental burden. That is, it is possible to support efficient surgical performance.

In addition, according to the ophthalmic surgical knife 1 of this embodiment, a desired surgical wound can be obtained without changing the knife even when performing surgery other than trilateral sclerocorneal incision. For example, operations such as trabeculotomy and vitrectomy can be performed efficiently.

Although each embodiment according to the present invention has been described above, the present invention is not limited to the requirements shown in the above embodiments. The requirements shown in the above embodiments can be changed within a range that does not impair the gist of the present invention, and can be appropriately determined depending on the application thereof.

Moreover, each embodiment can combine respective features. Any of the above-described ophthalmic surgical knives 1 may also have features of other embodiments.

1: Ophthalmic surgical knife, 10: Blade body, 11: Blade portion, 12: First blade, 13: Second blade, 14: Third blade, 15: Tip portion, 16/17: Contact point, 21・22/23: Inclined surface, 24: Plane, 25: Back surface, 41: Shaft, 50: Handle, a: First surface, b: Second surface, c: Third surface, d: Wound, s: Straight line , t1, t2, t3, t4, t5, t6: distance, t7: diameter, u: axis, x: sclera, y: cornea, z: anterior chamber

Claims (7)

An ophthalmic surgical knife having a blade body and a handle,
The blade body is
a pair of sides;
A pointed part located at the tip,
a first blade provided extending from the tip to one of the sides in plan view;
a second blade provided from the pointed end to the other side;
An ophthalmic surgical knife, wherein the pointed end is located at a position offset from the axis of the blade body in plan view. The ophthalmic surgical knife according to claim 1,
An ophthalmic surgical knife, wherein the blade has a flat back surface. The ophthalmic surgical knife according to claim 1 or 2,
An ophthalmic surgical knife, wherein the pair of side edges are parallel in plan view. The ophthalmic surgical knife according to claim 1 or 2,
A straight line connecting the contact point between the first blade and the one side edge and the contact point between the second blade and the other side edge is inclined with respect to the axial direction of the blade body in plan view. An ophthalmological surgical knife that is characterized by: The ophthalmic surgical knife according to claim 1 or 2,
The pointed end is at a position shifted from the axis so that the side where the first blade is provided is narrower than the axis,
An ophthalmic surgical knife, wherein the second blade has a curved shape that swells outward in plan view. The ophthalmic surgical knife according to claim 1 or 2,
An ophthalmic surgical knife, wherein each of the pair of side edges is provided with a third blade on at least a portion thereof. The ophthalmic surgical knife according to claim 1 or 2,
An ophthalmic surgical knife, wherein the first blade has a linear shape in plan view.

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