JPS61290950A - Infusion apparatus equipped illumination function - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a perfusion device used in vitreous surgery, and more particularly to a perfusion device having an intraocular illumination function in addition to a perfusion function.

For example, as shown in Figure 10, vitreous surgery involves
The cloudy part of the jelly-like vitreous body 3 between the eye and the retina 2 is removed and replaced with a clear liquid, allowing light to pass through the crystalline lens 1 and reach the retina 2, thereby restoring vision. It is done for the sake of

Furthermore, the proliferative membrane formed in front of the retina 2 is removed to allow light to reach the retina, and also to eliminate retinal damage caused by contraction of this membrane.

To perform vitrectomy surgery, the following functions are essential: perfusion of perfusion fluid into the eyeball, removal of cloudy vitreous body, suction of the resected material, and illumination of the inside of the eyeball.

In conventional surgery, a cutter 4 with a suction function and an instrument 5 are used. Both are inserted into the sclera 7 at a position approximately 41allll from the cornea 6.

As shown in FIG. 11, this device 5 is provided with a sheath 10 for arranging a bundle of optical fibers 9 for illumination around an irrigation tube 8 through which irrigation fluid flows, and for bundling the bundles.

During the surgery, the operator holds the instrument 5 and the cutter 4,
While illuminating the inside of the eyeball with the optical fiber bundle 9, the cutter 4
The vitreous body 3, which has become cloudy due to the vitreous body, is excised, and the excised material is discharged outside the eyeball by suction while being perfused with perfusate. The intraocular pressure is then filled with irrigation fluid to restore intraocular pressure.

However, according to the structure of the device 5 shown in FIG. 11, in addition to the optical fiber bundle 9 for illumination, the perfusion tube 8 for forming the perfusion channel 11 and the optical fiber bundle 9 are bundled together. Covering 10
It is necessary to set up

Therefore, the cross-sectional area of the part of the instrument 5 that is inserted into the eyeball is at least larger than the sum of the cross-sectional area of the perfusion tube 8 and the cross-sectional area of the optical fiber bundle 9, and has a large diameter.

As a result, there was a problem in that the larger the cross-sectional area of the portion inserted into the eyeball, the more likely the eyeball would collapse when the instrument 5 was removed after the surgery was completed.

The present invention was made to solve the above-mentioned problems, and provides sufficient brightness to secure the field of view necessary for surgery, while reducing the size of the hole to be made in the eyeball. area)
The object of the present invention is to provide a perfusion device with an illumination function that is small in size and can reduce adverse effects such as eyeball collapse.

11 animals 11 In order to achieve this object, the present invention includes a W1 flow section for perfusing irrigation fluid through an irrigation channel from an insertion end inserted into the eyeball, a light source unit having a light source for illuminating the eyeball, and a light source unit having one end. a light transmitting part connected to the light source unit and transmitting light from the light source -F, the other end of the light transmitting part having a hollowed-out shape and forming the insertion end. This is the summary.

1 and 2, the irrigation section 21 has an insertion end 28 that is inserted into the eyeball 90, and the irrigation fluid is introduced from the insertion end 28 through the irrigation channel 32 of the irrigation section 21. It is possible to perfuse the eyeball 90. The light source unit 15 is connected to one end of the light transmission section 22. The light transmission section 22 is for transmitting light from a light source, and the other end has a hollowed-out shape and also serves as an insertion end 28.

This insertion end 28 is coated around the periphery with a refractive index smaller than that of the insertion end 28 .

Further, the flange portion 30 integrated with the insertion end 28 can shield light.

The light from the JL light source units 1 to 15 passes through the light transmission section 22 and the insertion end 28, and is irradiated into the eyeball 90. The irrigation fluid is also perfused into the eyeball 90 through the irrigation channel 32.

Circle LL FIG. 1 is a schematic diagram showing a surgical operation performed by a vitrectomy apparatus having a perfusion device with an illumination function according to the present invention.

The vitrectomy apparatus includes an external housing [12], a perfusion device & (hereinafter referred to as perfusion device) 13 having an illumination function according to the present invention, and a cutter 14.

The external device 12 includes a drive unit 17 and a suction unit 18.

The cutter 14 has a built-in motor (not shown),
The vitreous body 3 of the eyeball can be removed by rotating an inner blade (not shown). A suction path is provided within the cutter 14, and the suction path is connected to the suction unit 18 via a suction pipe 19. The motor is also connected to the drive unit 17 via a power cable 20.

As shown in FIGS. 1 and 2, the perfusion section +a13 is composed of a light source unit 15 having a built-in light source 70, a perfusion section 21, and a light transmission section 22.

The perfusion section 21 has a first member 23, a second member 24, and an insertion section 25. The second member 24 is made of, for example, a silicon tube, and a material with excellent flexibility is selected.

The first member 23 has a T-shaped cross section, and the connecting portion 23
a is inserted into the side wall 15a of the light source unit 15.

The light receiving ends 26 of the two light transmitting parts 22 are fitted into the connecting part 23a.

Each light receiving end 26 faces the light source 70 of the light source unit 15, and a relay lens 80 is set between the light source 70 and the light receiving end 26. That is, the image of the light source 70 can be projected onto the light receiving end 26 by the relay lens 80. Light from the light source unit 15 can be transmitted through these two seamless light transmitting sections 22. The light transmission section 22 is preferably an optical fiber made of plastic or glass with excellent flexibility.

The two light transmitting sections 22 are arranged within the first member 23 and within the tubular second member 24 . That is, the light receiving fN26 sides of the light transmitting sections 22 are arranged side by side within the first member 23 (see FIG. 3), but the two light transmitting sections 22 are particularly restrained within the second member 24. They are distributed without any problems. Therefore, the flexibility of the second member 24 is not impaired by the light transmission section 22.

The connecting portion 23b of the first member 23 is connected to the perfusion unit 16 via a connecting pipe 27, as shown in FIGS. 1 and 2. Further, the connecting portion 23G is fitted into one end of the second member 24.

The insertion portion 25 is located at the other end of the second member 24.

The insertion end 28 of the insertion portion 25 is formed obliquely so that it can be inserted into the inside of the sclera 7.

The insertion end 28 is fitted into the second member 24 and closely connected to the light irradiation end 29 of the light transmission section 22 . The insertion end 28 has a hollowed-out shape, for example, a cylindrical shape. (See FIG. 4) The other end of the light transmission section 22 thus constitutes the insertion end 28.

That is, the insertion end 28, which is the other end of the light transmission section 22, is made of a transparent material such as plastic, has approximately the same curvature as the light transmission section 22, and has an outer surface similar to that of the insertion end 28. It is coated with a substance having a lower refractive index than the material of the end 28. By doing so, no reflected light is generated at the contact surface with the light transmitting portion 22, and the light passing through the insertion end 28 can be transmitted into the eyeball 90 without leaking to the outside.

This coat can also be made of a metal film such as aluminum.

A flange portion 30 made of an opaque material such as metal is fixed around the middle to upper portion of the insertion end 28. As shown in FIG. 4, this flange portion 30 is provided with cutout portions 31 at four corners.

This notch 31 connects the perfusion part 21 to the sclera 7 of the eyeball 90.
This is the part where the thread is threaded when w.

The reason why the flange portion 30 is made of an opaque material is that if it is transparent, light passing through the insertion end 28 will go around the flange portion 30.
This is because the end portion of the flange portion 30 will shine, and the inside of the eyeball 90 will be irradiated and the operator will be disturbed when looking at it. That is, the flange portion 30 is made of a material that blocks light.

Incidentally, inside the connecting tube 27, the first and second members 23, 24, and the insertion end 28 is an irrigation channel 32 that carries irrigation fluid from the irrigation unit 16 into the eyeball 90.

During surgery, a cutter 14 and an irrigation part 21 are placed on the sclera 7.
Two incisions are made for the fan, and another incision is made for the fan if necessary, and the cutter 14 is inserted into one incision, and the insertion end 28 of the irrigation section 21 is inserted into the other incision. . The flange portion 30 is then sewn and fixed to the sclera 7 with thread.

The light source 70 of the light source unit 15 is turned on, and the light from the light source 70 is transmitted to the eyeball 9 through the two light transmission sections 22 and the insertion end 28.
Efficiently transmit and irradiate within 0. And cutter 1
4, the operator removes the opaque portion of the vitreous body 3.

Furthermore, the perfusion unit 16 is operated to supply perfusion liquid to the perfusion path 3.
2 from the insertion end 28 into the eyeball 90, and the suction unit 18 is operated to suction the resected material together with the irrigation fluid.

After the excision and aspiration are completed, the vitreous cavity is filled with perfusion fluid to restore intraocular pressure.

After the surgery is completed, the insertion end 28 and the cutter 14 are assembled, and each incision is sutured.

Furthermore, in addition to the function of inserting irrigation fluid into the eyeball 90, the insertion end 28 constitutes the other end of the light transmission section 22 and has a light transmission function, so that the inner body of the light transmission section 22 is inserted into the eyeball 90. There is no need for a protective coating dedicated to the light transmission section 22, ie, the optical fiber.

Figures 5 to 9 show other embodiments.

The following two points differ from the embodiments shown in FIGS. 1 and 2. First, a connecting portion 152 between two light transmitting sections 122 and an insertion end 128 that constitutes the other end of the light transmitting section 122.
It is.

Another light transmitting section 200 is connected to the light receiving end 126 of the light transmitting section 122, and the light transmitting section is composed of 122 and 200.

Therefore, the cross-sectional area of the insertion end 28 can be made smaller than that of the prior art (see FIG. 11) by reducing the total cross-sectional area of the optical fiber bundle and the protective coating. Even if you do this, eyeball collapse is unlikely to occur. Furthermore, since the insertion section 25 can be made small and lightweight, it can be directly attached and fixed to the eyeball 90, and there is no need for the operator to support the perfusion section 21 with his hands.

In addition, the insertion end 28 is long enough so that its tip is located near the sclera as shown in FIG.
The light emitting end surface of No. 8 into the eye can be separated from the fundus by a considerable distance.

As a result, it becomes possible to illuminate a wide range of the fundus,
Operators' work progresses.

The two light transmitting parts 122 are connected to the second member 12 in some places.
4 (see FIG. 7). Light transmission part 1
The light emitting end 129 of 22 is fitted into the insertion end 128, as shown in FIGS. 8 and 9. By doing so, the relative positions of the light transmitting portion 122 and the insertion end 128 do not shift at all, and light can be reliably transmitted into the eyeball. The flange 130 is similar to the flange 30 described above.

On the other hand, the light receiving end 126 of the light transmitting section 122 is connected to the first member 1'
23 (see FIG. 6), and are closely butt-butted and connected via a connector 210 to a light transmission section 200 having a larger diameter than these.

This light transmission section 200 is connected to the light source unit 150 , and the light from the light source 170 is incident through the relay lens 180 . .

By doing this, the total number of optical transmission groups is 122 and 200.
It can be divided into two parts, increasing the degree of freedom in terms of configuration and operation.

By the way, the present invention is not limited to the above embodiments.

For example, the light transmitting part 22.122 does not need to be made of two pieces of silk;
The number may be one book or more than two. In any case, the irrigation parts 21 and 121 must have excellent flexibility as a whole so that the surgery can be performed easily and no unnecessary burden is placed on the eyeball.

11 Sad 11 According to the perfusion device equipped with the illumination function of the present invention, sufficient brightness can be obtained to secure the field of view necessary for surgery, and the size and area of the hole made in the eyeball can be reduced. It is small and can reduce the negative effects of surgery such as eyeball collapse.

[Brief explanation of the drawing]

FIG. 1 is a schematic diagram showing a surgical state using a vitrectomy apparatus having a perfusion device equipped with an illumination function according to the present invention, FIG. 2 is a sectional view showing an embodiment of the perfusion device, and FIG. A-
A sectional view, FIG. 4 is a sectional view taken along line B-8 in FIG. 2, FIG. 5 is a sectional view showing another embodiment of the perfusion device of the present invention, and FIG. 6 is a sectional view taken along line C-C in FIG. , FIG. 7 is a sectional view taken along line DD in FIG.
8 is a sectional view taken along the line E-E in FIG. 5, FIG. 9 is a partial perspective view of FIG.
FIG. 1 is a cross-sectional view of a conventional instrument. 15...Light source unit 21...Perfusion section 22...Light transmission section 28...Insertion end Fig. 1 Fig. 9 Fig. 10 Fig. 11 m

Claims (3)

[Claims] (1) A perfusion part that perfuses perfusion fluid from an insertion end inserted into the eyeball through a perfusion channel, a light source unit having a light source for illuminating the eyeball, and one end connected to the light source unit to transmit light from the light source. A perfusion device with an illumination function, characterized in that the other end of the light transmission section has a hollowed-out shape and constitutes the insertion end. (2) A perfusion device with an illumination function according to claim 1, wherein the other end of the light transmission section is coated around the other end with a refractive index smaller than the refractive index of the light transmission section. . (3) The insertion end further has a flange portion for sewing onto the eyeball, and the flange portion is made of a material that blocks light so as not to transmit light from the light transmission portion. A perfusion device having an illumination function according to scope 1.