RU2396929C1 - Microsurgical misun's keratotome-extractor for removal of forein bodies of eye cornea of any localisation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to ophthalmology and can be used in new microsurgical technologies of removal of foreign bodies of eye cornea of any localisation. Microsurgical keratotome-extractor consists of handle, cone-shaped junction and working part. Working part has curved form and obtuse lateral faces. Working part point is piercing-cutting. Handle is made with faces and has incisions.

EFFECT: as a result of keratotome-extractor application surgical treatment traumaticity is minimised, treatment terms are considerably reduced and patient's vision acuity is maximally preserved.

2 dwg

Description

The tool for removing foreign bodies of the cornea of the eye of any location - Misyuna microsurgical keratotome-extractor refers to the tools used in medicine, in particular in ophthalmology, and can be used to perform microsurgical operations to remove foreign bodies of the cornea of the eye of any location by paramedics, general practitioners, family doctors, ophthalmologists at clinics and ophthalmosurgeons of hospitals.

Known Schotter tool for removing foreign bodies of the cornea of the eye, consisting of a handle and a working part, made in the form of a pointed spatula with blunt side faces. The size of the end part of the tool is 0.5-1 mm [1].

The large size of the working part not only does not allow to control manipulations under a microscope or a slit lamp, closing the surgical field, but also at the time of removal, a lacerated corneal wound is applied that is larger than a foreign body.

The closest in design to the claimed tool is a tool for removing foreign bodies from the surface of the cornea of the eye [5], including the working part in the form of a needle of a triangular shape with a piercing end and a handle of a cylindrical shape with a ribbed surface. The needle 12-13 mm long has a rounded shape with 1 / 4-3 / 8 circumference with a circle radius of 4.75-5.9 mm, and the side edges of the needle are cutting.

Clinical experience with this tool revealed the following technical disadvantages:

1 - carrying out microsurgical operations requires a good fixation of the instrument in the hands of the surgeon and providing microsurgical manipulations with the working tip of the instrument, which does not allow to fully make a round shape of the handle with notches,

2 - the piercing tip of the instrument, injuring the corneal tissue, leaves clouding behind itself,

3 - since the thickness of the cornea of the eye ranges from 1 mm to 0.3 mm, the cutting lateral sides of the instrument cause additional trauma to the corneal tissue, as well as the triangular shape of the instrument.

The technical problem solved by the proposed design of the Misyun microsurgical keratotome-extractor to remove foreign bodies of the cornea of the eye of any location is to reduce the invasiveness of the operation and reduce the treatment time due to new technical changes to the tool.

1. The handle was made of a faceted shape with notches, which gave a good fixation in the surgeon's hand and ensured accurate micromanipulation of the working tip of the tool.

2. The tip of the tool has a piercing-cutting shape, which ensures minimal injury to the cornea, and the lateral cutting edge of the tip is quite sufficient for carrying out cutting manipulations on the corneal tissue.

3. The flat shape of the working part of the tool after the tip and the absence of lateral cutting faces on it prevent excessive trauma to the cornea tissue.

Figure 1 shows the Misyun microsurgical keratotome-extractor for removing foreign bodies of the cornea of the eye of any location, which consists of 1 - faceted handle with notches, 2 - cone-shaped transition, 3 - working part of the tool.

Figure 2 - the working part of the tool:

4 - piercing-cutting tip of the tool;

5 - side cutting edges of the conical tip of the tool;

6 - flat part of the tool;

7 - blunt side faces of the flat part of the tool.

The above technical changes made it possible to reduce the invasiveness of the operation, and consequently the associated opacification of the cornea of the patient’s eye, to a minimum and reduce the treatment time. New microsurgical technologies developed by us for the removal of foreign bodies from the deep layers of the cornea [4], multiple, foreign bodies of the cornea [7], foreign bodies with partial standing in the anterior chamber of the eye [6], elongated solid foreign bodies with an oblique arrangement in the cornea of the eye [8 ] identified the need to develop new technical solutions in the tool:

1. the diameter of the working part of the tool should correspond to the size of the foreign body;

2. the diameter of the working part of the tool, its curvature and length must correspond to the diameter of the wound channel and the features of the wound course;

3. Each microsurgical technology has its own specifics, to which the microsurgical instrument must technically correspond.

This necessitates the development of a set of three tools that have common essential technical design features that solve the general problem of ensuring the entire complex of microsurgical operations on the cornea of the eye and have specific technical parameters.

Tool No. 1

Technical parameters of the working part of the tool:

- bend 1 / 8-2 / 8; diameter 0.3-0.4 mm, length 4-6 mm.

Tool No. 2

- bend 1 / 8-2 / 8; diameter 0.2-0.25 mm, length 3-5 mm.

Tool number 3

- bend 1/8; diameter 0.15-0.2 mm, length 3-4 mm.

The proposed set of three tools allows you to achieve a technical result, expressed in the fact that these tools allow the removal of foreign bodies of the cornea of the eye of any location, make it possible to immediately provide full surgical assistance. This is especially important for the mass arrival of patients with various injuries of the cornea of the eye by foreign bodies (man-made disasters, earthquakes, house explosions, military conflicts, etc.).

The Misyuna extractor declared by keratot, together with new microsurgical technologies, were successfully used in the ophthalmology department of the Republican hospital and polyclinics in Petrozavodsk. The obtained clinical observations showed minimal trauma of surgical interventions, quick recovery of patients (2-3 times) with maximum preservation of visual acuity even with severe injury to the cornea of the eye.

Information sources

1. Medical instruments, devices, apparatus and equipment. M., 1968 - Catalog, book 3, section 07 “Ophthalmology and spectacle optics”. - S. 237.

2. Medical instruments, devices, apparatus and equipment. M., 1968 - Catalog, book 3, section 07 “Ophthalmology and spectacle optics”. - P.41.

3. A method of removing a foreign body that caused infiltration and / or metallosis of surrounding tissues from the surface of the cornea of the eye. Copyright certificate No. 1651893, dated February 1, 1991. Author F. Misyun

4. A method of removing a foreign body from the deep layers of the cornea. Author's certificate No. 1769876, dated June 22, 1992. Author F. Misyun

5. A tool for removing foreign bodies from the surface of the cornea of the eye. Utility Model Patent No. 53144 of June 10. 2006. Authors Misyun F.A., Rianov V.V.

Applications for the invention

6. The method of removing a foreign body of the cornea partially protruding into the anterior chamber of the eye No. 2007128384, the decision to grant a patent on September 9, 2008. Author Misyun F.A.

7. A method for the treatment of combined lesions of the cornea of the eye with multiple chemically non-aggressive foreign bodies. Notice of consideration of the application on the merits of November 27, 2008 No. 2008139348 (050754). The author Misyun F.A.

8. A method for removing solid elongated foreign bodies with an oblique arrangement in the cornea of the eye. Notification of consideration of the application on the merits of November 2, 2008 No. 2008139442 (050930). The author Misyun F.A.

Claims (4)

1. Microsurgical keratotome extractor for removing foreign bodies of the cornea of the eye of any location, consisting of a handle, a cone-shaped transition and the working part of the tool, characterized in that the tip of the working part of the tool is prickly-cutting, the working part of the tool has a curved shape and blunt side faces, and cutted tool handle with notches. 2. Keratotom extractor according to claim 1, characterized in that the working part of the tool has the following technical parameters: bend 1 / 8-2 / 8; diameter 0.3-0.4 mm, length 4-6 mm. 3. Keratotom extractor according to claim 1, characterized in that the working part of the tool has the following technical parameters: bend 1 / 8-2 / 8; diameter 0.2-0.25 mm, length 3-5 mm. 4. Keratotom extractor according to claim 1, characterized in that the working part of the tool has the following technical parameters: 1/8 bend; diameter 0.15-0.2 mm, length 3-4 mm.

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