RU2415654C1 - Barrier-optic membrane with diaphragmatic properties - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine. Membrane contains optic and flat haptic part in form of circle, and is made from copolymers of acryl or vinyl series. Haptic part is stained the same colour as patient's eyes, has central hole and cut, corresponding to remnants of iris. Size of iris remnants is larger than cut of haptic part with formation of zone of overlapping between haptic part and iris remnants on haptic part. Optic part is made detachable, on its contour made is side board, and longitudinal axis of optic part symmetry coincides with optic axis. On lateral cylindrical surface of optic part on circumference ring-shaped groove from 0.2 to 3.0 mm deep is made. Axis of groove symmetry is perpendicular to longitudinal axis and coincides with transversal axis of haptic part symmetry. Optic part is located in central hole of haptic part coaxially to its longitudinal axis in such a way that sections of anterior, posterior and internal cylindrical surface of haptic part, which enter the entire depth of groove, are congruent to it.

EFFECT: application of claimed membrane makes it possible to achieve maximally possible optic functions, ensures diaphragmatic and cosmetic properties.

7 cl, 9 dwg, 2 ex

Description

The invention relates to medicine, namely to ophthalmology, and can be used in the surgical treatment of concomitant eye pathology, including aphakia, traumatic cataract, lens subluxation, rupture of the lens capsule in combination with partial aniridia, as well as in the presence of severe forms of retinal detachments, requiring tamponade with silicone oil.

The closest analogue is the barrier-optical membrane described in the patent of the Russian Federation for invention No. 2371148. The barrier-optical membrane is made of an elastic transparent material from copolymers of acrylic or vinyl series and contains an optical part in the form of a lens and a flat haptic part, on the front surface of which there are two grooves made tangential to the optical part and parallel to each other, from one to the other edge of the haptic part. In addition, the barrier-optical membrane may further comprise radially spaced stiffeners having a common axis on the front surface of the haptic part.

The disadvantages of the barrier optical membrane are:

firstly, the barrier-optical membrane does not perform diaphragmatic and cosmetic functions, because does not have a painted haptic part; secondly, the barrier-optical membrane does not have a removable optical part and therefore separate implantation of the haptic and optical parts, implantation of the membrane through small incisions is impossible, and there is no possibility of access to the posterior pole of the eye during repeated surgical interventions without violating the integrity of the anatomical iridocrystal diaphragm due to disassembling the membrane inside the eye.

The objective of the invention is to create a design of a barrier-optical membrane with a removable optical part, as well as having diaphragmatic and cosmetic properties.

The technical result, according to the invention, is:

1) the achievement of the maximum possible visual functions;

2) ensuring diaphragmatic and cosmetic properties due to the presence of a colored haptic part;

3) the possibility of separate implantation of the haptic and optical parts;

4) the possibility of implantation of the membrane through small incisions;

5) the ability to access the posterior pole of the eye during repeated surgical interventions without violating the integrity of the anatomical iridocrystal diaphragm due to disassembly of the membrane inside the eye;

6) if necessary, in cases of operated retinal detachment, carry out the removal of silicone through a removable optical part.

The technical result is achieved by the fact that the barrier-optical membrane with diaphragmatic properties contains an optical and flat haptic part in the shape of a circle, while the haptic part is colored according to the color of the patient’s eyes, has a central opening and a cutout corresponding to the remains of the iris, while the size of the remains of the iris exceeds the cutout of the haptic part with the formation of a zone of overlap between the haptic part and the remains of the iris. On the haptic part along the contour of the optical part there is a rim serving to strengthen the structure. The optical part is removable, its longitudinal axis of symmetry coincides with the optical axis. On the lateral cylindrical surface of the optical part, a ring-shaped groove with a depth of 0.2 to 3.0 mm is made around the circumference, the axis of symmetry of the furrow is perpendicular to the longitudinal axis and coincides with the transverse axis of symmetry of the haptic part, while the optical part is placed in the central hole of the haptic part coaxially with its longitudinal axis in such a way that the sections of the front, rear and inner cylindrical surface of the haptic part, which enter the furrow to its entire depth, are congruent to it. Depending on the area of the iris remains, the haptic part of the barrier-optical membrane can have different sizes and shapes. If the cutout of the haptic part is half a circle or more, then the haptic part is additionally equipped with an arcuate, colored according to the color of the patient’s eyes jumper adjacent to the optical part and connecting the radial sides of the haptic part, while the jumper is made in the form of a ring part lying in the same plane as haptic part. The entire membrane is made of copolymers of acrylic or vinyl series.

One option is one in which the front and rear surfaces of the optical part are convex.

The second option is one in which the front surface of the optical part is convex and the back is flat.

The third option is one in which the front surface of the optical part is convex and the back concave.

The fourth option is one in which the front and rear surfaces of the optical part are concave.

The fifth option is one in which the front surface of the optical part is concave and the back is flat.

The invention is illustrated in figures 1-9, in figures 1-4 shows a top view of a barrier-optical membrane with different forms of the haptic part, in figures 5-9 shows a view A of figure 1 in section, which shows different forms of the optical part (according to variants of the invention), installed in the central hole of the haptic part. The figure 5 shows the optical part, in which the front and rear surfaces are convex; figure 6 shows the optical part, in which the front surface is convex and the back is flat; the figure 7 shows the optical part, in which the front surface is convex and the rear concave; figure 8 shows the optical part, in which the front and rear surfaces are concave; figure 9 shows the optical part, in which the front surface is concave and the rear is flat.

The barrier-optical membrane contains a flat haptic part 1 in the form of a circle made of copolymers of acrylic or vinyl series. The haptic part 1 has a central opening 2 and a cutout 3 corresponding to the remains of the iris. On the haptic part 1, a side 5 is made along the contour of the removable optical part 4. The longitudinal axis of symmetry 6 of the removable optical part 4 coincides with the optical axis, an annular groove 7 with a depth of 0.2 to 3.0 mm is made around the circumference on the lateral cylindrical surface of the optical part 4 , the axis of symmetry 8 of the groove 7 is perpendicular to the longitudinal axis 6 and coincides with the transverse axis of symmetry 9 of the haptic part 1, while the optical part 4 is located in the Central hole 2 of the haptic part 1 coaxially with its longitudinal axis 6 so that and the front, back and the inner cylindrical surface of the haptic part 1 included in the groove at its entire depth, it congruent. If the cut-out 3 of the haptic part 1 is half a circle or more, then the haptic part 1 is additionally equipped with an arched jumper, colored according to the color of the patient’s eyes, adjacent to the optical part 4 and connecting the radial sides 11 of the haptic part 1, while the jumper is made in the form of a part a ring lying in the same plane with the haptic part 1. The front surface of the optical part 4 is indicated by 12, and the rear surface is indicated by 13. The holes 14 for fixing the haptic part are indicated by 14.

The barrier-optical membrane can be made of copolymers of acrylic (from 10% to 90%) or vinyl series (from 10% to 90%). The haptic part of the barrier-optical membrane is colored with organic pigments that are allowed for long-term contact with the tissues of the human body.

A barrier-optical membrane is implanted for a long time, which allows for repeatedly operated patients to achieve persistent medical, social and professional rehabilitation.

The implantation of a barrier-optical membrane is carried out as follows: at 12 o’clock, a corneal tunnel incision is made using a peak knife. Viscoelastic is introduced into the anterior chamber, the haptic part 1 of the barrier-optical membrane colored in the patient’s eye color is implanted for the remains of the iris and on the remains of the lens capsule (if any), it is fixed in the ciliary groove with threads for openings 14. Next, a removable optical part is implanted. 4 into the front chamber and install it in the central hole 2 of the haptic part 1. Viscoelastic is washed out of the front chamber. The corneal incision is sutured with a thread of 10.0. Further, according to the indications, tamponade of the vitreous cavity is carried out with silicone.

Implantation of a barrier-optical membrane is one of the stages of surgery for a combined vitreoretinal pathology or an independent stage in the pathology of the anterior segment of the eye.

Clinical examples

Example 1

Patient P., 19 years old. Diagnosis: OS - Outcome of a penetrating wound of the cornea, partial aniridia, traumatic cataract, retinal detachment, condition after primary surgical treatment (PCP), high degree hyperopia.

On admission: visual acuity OS - light perception with the correct projection, intraocular pressure (IOP) - 23.0 mm RT. Art. As a result of the injury, a rupture of the anterior and posterior lens capsules occurred. The operation was performed according to the above method. Lensvitrectomy, retinal mobilization, tamponade by an organofluoride compound (PFOS), implantation and fixation of the gray-colored haptic part of the barrier-optical membrane for the remains of the iris were performed, then a removable optical part was installed in the central opening of the haptic part, in which the front and back surfaces are convex . Retinal endolasercoagulation was performed; PFOS was replaced by silicone. After surgery: visual acuity - 0.05; IOP - 24 mm RT. Art., there is no silicone in the anterior chamber, the retina is adjacent. 3 months after surgery: visual acuity increased to 0.2 with correction; IOP - 21 mm RT. Art., the retina is adjacent, the position of the barrier-optical membrane is correct.

Example 2

Patient S., 35 years old. Diagnosis: OD - Postoperative aphakia, partial aniridia. High myopia, peripheral chorioretinal dystrophy.

On admission: visual acuity OD - 0.3 with correction, IOP - 26.0 mm RT. Art., eye length - 27.34 mm. The operation was performed according to the above method. The brown color of the haptic part of the barrier-optical membrane was implanted and fixed for the remains of the iris, then a removable optical part was installed in the central hole of the haptic part, in which the front and back surfaces are concave. After surgery: visual acuity - 0.5 with correction; IOP - 17 mm RT. Art., the retina is adjacent. 3 months after surgery: visual acuity increased to 0.7 with correction; IOP - 18 mm RT. Art., the retina is adjacent, the position of the barrier-optical membrane is correct.

Thus, this method is effective in the surgical treatment of combined eye pathology, including aphakia, traumatic cataract, lens subluxation, rupture of the lens capsule in combination with partial aniridia, as well as in the presence of severe forms of retinal detachments requiring silicone oil tamponade. Depending on the area of the iris remains, the haptic part of the barrier-optical membrane can have different sizes and shapes, which are selected individually for each patient.

Claims (7)

1. The barrier-optical membrane containing the optical and flat haptic part in the form of a circle made of copolymers of acrylic or vinyl series, characterized in that the haptic part is colored to match the color of the patient’s eyes, has a central hole and a cutout corresponding to the remains of the iris, the size of the remains of the iris exceeds the cutout of the haptic part with the formation of a zone of overlap between the haptic part and the remains of the iris on the haptic part, the optical part is removable, in cont which has a rim and the longitudinal axis of symmetry of the optical part coincides with the optical axis, an annular groove with a depth of 0.2 to 3.0 mm is made on the lateral cylindrical surface of the optical part, the symmetry axis of the furrow is perpendicular to the longitudinal axis and coincides with the transverse axis of symmetry the haptic part, while the optical part is located in the Central hole of the haptic part coaxially with its longitudinal axis so that the portions of the front, rear and inner cylindrical surface of the haptic parts that enter the furrow to its entire depth are congruent to it. 2. The barrier membrane according to claim 1, characterized in that if the cutout of the haptic part is half a circle or more, the haptic part is additionally equipped with an arcuate, colored by the color of the patient’s eyes jumper adjacent to the optical part and connecting the radial sides of the haptic part, this jumper is made in the form of a part of the ring lying in the same plane with the haptic part. 3. The barrier membrane according to claims 1 and 2, characterized in that the front and rear surfaces of the optical part are convex. 4. The barrier membrane according to claims 1 and 2, characterized in that the front surface of the optical part is convex and the back is flat. 5. The barrier membrane according to claims 1 and 2, characterized in that the front surface of the optical part is convex and the back is concave. 6. The barrier membrane according to claims 1 and 2, characterized in that the front and rear surfaces of the optical part are made concave. 7. The barrier membrane according to claims 1 and 2, characterized in that the front surface of the optical part is concave and the back is flat.

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