RU101917U1 - IRIS RETRACTOR - Google Patents

Abstract

 1. Iris retractor, made in the form of a closed loop of elastic material, characterized in that the circuit is made in the form of four pairwise symmetric petals. ! 2. Iris retractor according to claim 1, characterized in that the petals are rectangular in shape with rounded corners. ! 3. The iris retractor according to claim 1, characterized in that one pair of symmetrical petals is rectangular in shape with rounded corners, and the other pair of symmetrical petals is conical in shape. ! 4. Iris retractor according to claim 1, characterized in that one pair of symmetrical petals is made of rectangular shape with rounded corners, and the other pair of symmetric petals is made of spherical shape. ! 5. Iris retractor according to claims 1 to 3, characterized in that in section the contour can be made oval. ! 6. Iris retractor according to claims 1 to 3, characterized in that in cross section the contour can be made square. ! 7. Iris retractor according to claims 1 to 3, characterized in that in cross section the contour can be made rectangular. ! 8. Iris retractor according to claims 1 to 6, characterized in that oligocarbonate methacrylate or polymethyl methacrylate can be used as an elastic material.

Description

The utility model relates to medicine, in particular to ophthalmology, and can be used as a device for expanding the pupil during cataract phacoemulsification operations and operations on the vitreous body and retina.

Known pupil dilator in the form of a hook made of nylon, which fixes the pupil at one point of the pupil edge through paracentesis in the cornea (US No. 5174279, IPC A61F 0/007, A61B 17/02, A61B 017/02, published on December 29, 1992) . The disadvantage of this model is that for the full expansion of the pupil, it is necessary to use three or four expanders, introduced through separate corneal paracentesis, which, as a rule, are located near the limb. The application of retractor hooks (or iris retractors) causes an excessive stretching of the pupil edge of the iris and leads to tears, which can cause bleeding, as well as disrupt diaphragmatic function of the iris due to damage to the pupil sphincter muscles.

As the closest analogue - the prototype adopted device for the expansion of the pupil (Certificate of the Russian Federation for utility model No. 14506, IPC A61F 9/00, publ. 10.08.2000). This ring is made of polypropylene thread in the form of loops made in the form of hinges of the first kind, located at the same distance from each other and interconnected. In shape, this device can be round or square.

The advantages of such a pupil ring are: the possibility of implantation and removal without additional incisions, the provision of fixed mydriasis for an unlimited period of time, the preservation of the diaphragmatic function of the iris. However, installing and removing the ring is a rather time-consuming process. An increase in the volume of manipulations in the anterior chamber leads to an extended operation time, does not exclude additional trauma to the endothelium of the cornea and the tissues of the iris itself (pigment output, bleeding), which increases the degree of postoperative inflammatory phenomena (descemetitis, corneal edema, etc.).

The objective of the utility model is to create a new, more advanced device (iris retractor) for uniform dilatation of the pupil necessary for performing phacoemulsification of cataracts and (or) operations on the posterior segment of the eye (vitreous body, retina), which allows implantation and removal of it with minimal trauma.

EFFECT: maintaining fixed intraoperative mydriasis necessary for performing operations, reducing the volume of manipulations in the anterior chamber of the eye when installing and removing an iris retractor, and eliminating intraoperative and postoperative complications.

The specified technical result is achieved by the fact that in the iris retractor, made in the form of a closed loop of elastic material, the loop is made in the form of four pairwise symmetric petals.

All four petals can be made rectangular in shape with rounded corners; either two symmetrical petals are rectangular in shape with rounded corners, and the other two petals are conical; either two symmetrical petals are made rectangular in shape with rounded corners, and the other two petals are made spherical.

The contour of the iris retractor in cross section can be made oval, square or rectangular.

As the elastic material for the manufacture of the circuit can be used oligocarbonate methacrylate or polymethyl methacrylate.

The essence of the utility model lies in the design of the iris retractor.

Firstly, the shape of the contour of the iris retractor in the form of four petals allows you to easily and quickly install it in the pupil. Two opposite parts of the contour are located on the iris, and the other two opposite parts are under the iris, while the pupil acquires a square or rectangular shape. Secondly, the presence of axial symmetry (pair symmetry) of the lobes of the contour allows you to install it in the pupil in any position, which reduces the number of manipulations (turns, movements) with him in the anterior chamber of the eye. Thirdly, the presence of rounded (external and internal) corners of the petals of the contour simplifies the manipulation of this iris retractor design and reduces the trauma of the surrounding eye tissue.

The implementation of all the petals of the contour of a rectangular shape with rounded corners provides easy implantation through an incision measuring 2.5-3.0 mm with tweezers.

The execution of one pair of symmetrical petals of a rectangular shape, and the second pair of symmetrical petals - spherical or cone-shaped provide easy implant implantation through a 2.2 mm incision.

Under the iris there are symmetrical petals of only a rectangular shape, which are either equal or smaller in size relative to the other two symmetrical petals lying on the iris. This design of the petals provides the best stability of the iris retractor in the pupil, the convenience of manipulation when installed in the pupil, the smallest injury to the pigment epithelium of the iris.

The above listed designs of the iris retractor petals serve to maintain a fixed intraoperative mydriasis, necessary for performing operations, and also reduce the volume of manipulations in the anterior chamber of the eye during their installation. In addition, intraoperative and postoperative complications are excluded.

Performing a section of the iris retractor body square or rectangular ensures its stable position in the pupil and the absence of the effect of “slipping” of the iris. And the execution of the cross section of the contour of the iris retractor oval provides uniform strength of the ring when bending it in the injector.

Thus, between the set of essential features and the achieved technical result, there is a causal relationship.

From an analysis of the scientific, technical and patent literature, we did not identify a similar structural embodiment of devices for dilating the pupil, which allows us to conclude that the claimed technical solution meets the criterion of "novelty."

The utility model is illustrated by the following figures, where:

Figure 1 shows a General view of the iris retractor with rectangular petals;

Figure 2 - General view of the iris retractor with symmetrical pairs of petals of a rectangular and conical shape;

Figure 3 - General view of the iris retractor with symmetrical pairs of rectangular and spherical petals;

Figure 4 - oval (round) section of the contour of the iris retractor;

Figure 5 is a square section of the contour of the iris retractor;

Figure 6 is a rectangular section of the contour of the iris retractor;

Figure 7 - iris retractor implanted in the pupil.

The irsis retractor consists of side lobes 1 and upper and lower lobes 2.

The utility model is as follows.

Indication for the use of an iris retractor is the presence of a narrow pupil of the iris. Pre-perform a corneal tunnel incision 2.2-3.0 mm in size. The anterior chamber is filled with viscoelastic. Then an iris retractor is installed: first it is inserted into the anterior chamber with a tool, and then it is placed in the pupil area.

Example 1. Patient X. was admitted January 18, 2010 with a diagnosis of Complicated cataract of the right eye, open-angle III A (stage of glaucoma according to classification), operated glaucoma. On examination, it was revealed: the anterior chamber is of medium depth, atrophy of the pigment border, narrow pupil, posterior synechiae, cortical layers are translucent, the core is brownish in color, visual acuity is 0.08. 1% mesatone, 1% lidocaine, viscoelastic were introduced into the anterior chamber through paracentesis. A tunnel of 2.8 mm in size was made, through which an iris retractor was introduced using two tweezers into the front chamber, all of its petals having a rectangular shape with rounded corners (Fig. 1), and the contour cross-section was square (Fig. 5). The iris retractor is placed in the pupil with two tweezers for the intraocular lens (IOL) in such a way that the two opposite parts were located on the iris, the other two under the iris (the location is similar to Fig. 7, where: 1 and 2 iris petals retractor, 3 - cornea, 4 - iris, 5 - pupil). The pupil expanded and acquired a square shape in size needed to perform further manipulations. Further, they were performed - continuous circular capsulorexis, hydrodissection, hydrodelineation, ultrasonic phacoemulsification of cataracts according to the standard method. Lens mass was aspirated, a flexible intraocular lens (IOL) was implanted into the capsular bag using an injector. Two rectangular petals with rounded corners located under the iris, lead out from under it into the anterior chamber. Then, by gripping with tweezers, the iris retractor is removed from the anterior chamber through the main incision, then the viscoelastic is aspirated, the eye tone is restored, the operation is completed. On the first day, a reactive postoperative course was observed. On the third day, at discharge, visual acuity is 0.6, the pupil edge is even, of the correct form, the iris diaphragm function is fully preserved.

Example 2. Patient S. was admitted 02.02.10, with a diagnosis of Complicated cataract of the right eye, pseudoexfoliation syndrome, lens subluxation of the 1st degree. On examination, the anterior chamber was found to be of medium depth, atrophy of the pigment border, narrow pupil, pseudoexfoliation along the edge of the pupil, cortical layers translucent, amber-colored core, visual acuity 0.2. 1% mesatone, 1% lidocaine, viscoelastic were introduced into the anterior chamber through paracentesis. Then, a 2.2 mm tunnel cut was made, through which an iris retractor was introduced into the front chamber using an injector, one pair of petals of which was made rectangular with rounded corners, and the other pair of petals was cone-shaped (Fig. 2), the contour section was rectangular (Fig.6). The iris retractor is grabbed by the hook of the injector for the rings at the top of one of the cone-shaped petals and is introduced into the injector in a smooth motion. The injector hole is introduced into the front chamber through the main tunnel section. By the reverse movement of the injector piston, the iris retractor was withdrawn from the injector and introduced into the front chamber. Then the petals of an iris retractor of a rectangular shape with rounded corners are turned on using a pusher and an injector hook under the iris. The iris retractor is located in the area of the pupil so that the two opposite parts lie on the iris, the other two under the iris (the location is similar to Fig.7).

The pupil expanded and acquired a square shape, the size necessary for further manipulations. A continuous circular capsulorexis was performed, an intracapsular ring was additionally inserted into the capsule bag, ultrasound cataract phacoemulsification was performed according to the standard method, lens mass was aspirated, IOL was implanted implanted. Initially, the rectangular petals of an iris retractor were pulled out from under the iris and laid on top of it with a tool. Then the iris retractor was removed by an injector inserted into the front chamber. Viscoelastic aspiration was performed, eye tone was restored, the operation was completed. During manipulations with the iris retractor, there was no bleeding from the iris, no additional pigment output. At discharge, visual acuity is 0.8, the pupil is even, of the correct form, the iris diffraction function is preserved.

Example 3. Patient P. 63 years old was admitted 01.03.10, with a diagnosis of immature, complicated cataract, open-angle IIA stage (operated) glaucoma of the left eye.

Standard instillation of medications before surgery did not affect pupil size. After conduction anesthesia with a 2% lidocaine, an eyelid expander was installed. At 2 and 8 hours, tunnel paracentoses were made in the size of 1 mm. At 11 o'clock the main tunnel section was made with a size of 2.2 mm. Viscoelastic is introduced into the anterior chamber; posterior synechiae are separated by spatulas. Given a pupil size of 4 mm, even after separation of synechia and the alleged cataract phacoemulsification with IOL implantation through a 2.2 mm incision, a decision was made to implant an iris retractor, two symmetrical petals of which have a rectangular shape with rounded corners, and the other two are spherical ( figure 3), and the cross-section of the contour is round (oval) (figure 4). The iris retractor is grabbed by the hook of the injector for the rings at the top of one of the spherical petals and is pulled into the injector cavity with a smooth movement. The injector hole is introduced into the front chamber through the main tunnel section. The reverse movement of the piston iris retractor introduced into the front chamber. Rectangular petals with rounded corners are started using a pusher and an injector hook under the iris (Fig. 7). A pupil of a square shape with a diagonal of 5 mm was obtained. Continuous capsulorexis has been produced. Phaco chop core is phaco emulsified using the phaco chop technique. Cortical masses are removed by aspiration - irrigation. The anterior chamber and lens capsule are filled with viscoelastic. An IOL is implanted using an injector, which is immersed in a capsule bag before the optical part is opened. Initially, the rectangular petals of an iris retractor were pulled out from under the iris and laid on top of it with a tool. The iris retractor is grabbed onto the spherical petal by the hook of the injector and pulled into the injector, then removed through the main incision. Viscoelastic is washed, restore the tone of the eye.

The use of an iris retractor made it possible to achieve a metered (5 mm), stable pupil size throughout the operation without additional surgical dissection. Deformation of the pupil edge of the iris, intra- and postoperative bleeding, inflammatory reaction was not noted. The pupil size on the retractor made it possible to successfully complete all the standard stages of phacoemulsification with a main incision size of 2.2 mm. The postoperative recovery process took place in a short time. Visual acuity in the first day after surgery is 0.8. On the fourth day, the patient was discharged from the hospital. Despite repeated surgical intervention (cataract removal), after anti-glaucoma surgery, no inflammatory reaction was noted, the pupil is even, of the correct form, the reaction to the light is preserved.

Using this design, a device for dilating the pupil (iris retractor) in the Sverdlovsk Regional Clinical Hospital for War Veterans, 20 operations were performed on the anterior (phacoemulsification of cataract) and the posterior segment of the eye (vitreous body, retina). This allowed us to optimize the performance of these operations and reduce intraoperative trauma.

Claims (8)

1. Iris retractor, made in the form of a closed loop of elastic material, characterized in that the circuit is made in the form of four pairwise symmetric petals. 2. Iris retractor according to claim 1, characterized in that the petals are rectangular in shape with rounded corners. 3. The iris retractor according to claim 1, characterized in that one pair of symmetrical petals is rectangular in shape with rounded corners, and the other pair of symmetrical petals is conical in shape. 4. Iris retractor according to claim 1, characterized in that one pair of symmetrical petals is made of rectangular shape with rounded corners, and the other pair of symmetric petals is made of spherical shape. 5. Iris retractor according to claims 1 to 3, characterized in that in section the contour can be made oval. 6. Iris retractor according to claims 1 to 3, characterized in that in cross section the contour can be made square. 7. Iris retractor according to claims 1 to 3, characterized in that in cross section the contour can be made rectangular. 8. Iris retractor according to claims 1 to 6, characterized in that oligocarbonate methacrylate or polymethyl methacrylate can be used as an elastic material.