RU2594448C1 - Marker of corneal centre and zone of implantation of corneal segments and rings - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to ophthalmosurgery and can be used for simultaneous marking of corneal centre and zone of implantation of corneal segments and rings. Marker contains handle in form of tube with piston and helical spring and working part. Working part comprises peripheral ring with two diametrically arranged in a frontal plane horizontally oriented ledges with length of 2 mm; central part, moving in sagittal plane intersecting at angle of 90 degrees 8 mm long pieces with three marks with length of 2 mm on each, remote from centre to distance of 2.5, 3.0 and 3.5 mm, respectively.

EFFECT: higher precision, simultaneous marking anatomic corneal centre and zone of implantation segments and rings of various diameters, providing stability of eyeball during implantation zone marking, minimum colour zone of implantation, that creates favourable conditions for formation of corneal pocket using femtosecond laser.

1 cl, 2 dwg, 1 ex

Description

The invention relates to the field of ophthalmic surgery, and can be used for simultaneous marking of the center of the cornea and the implantation zone of corneal segments and rings.

The closest analogue of the invention is the "marker of the central zone of the cornea" [Bores Optic zone marker. Low profile Markers. Enterprise Medin-Ural. Development - Production - Supply of medical instrument [Electronic resource] Access mode: http://ofto.by/d/682786/d/otmetchiki_16.pdf. Date of appeal: 05/26/2015], having a handle 100 mm long and located at an angle of 45 ° to it, a working part made in the form of a ring with a diameter of 3.0 to 10.0 mm with two segments intersecting in the center. The marker of the central zone is used as follows. After installing the anesthetic, blepharostat is applied to the patient’s eye. A dye layer is applied to the ring. Then the ring is brought to the cornea of the patient. The patient is asked to look straight ahead. The marker is centered using two landmarks: the border of the pupil and the limb. The projection of the marker ring should be located between the border of the pupil and the limb, and the centers of all three circles (pupil, ring and limb) should coincide. The drawback of the marker is the lack of a zero meridian mark, when it is centered, only the pupil and limb are taken as a landmark, without taking into account the location of the optical axis of the eye. In this case, the optical axis does not always coincide with the center of the pupil and the center of the limbal circle. Immobilization of the eyeball when using the marker is achieved by an additional tool. In addition, during marking during the movement of the eyeball, smearing of paint and decentration of marks are possible; the implantation zone is stained, which complicates the implementation of the femtolaser-assisted formation of the corneal pocket.

The objective of the invention is to develop a device that allows you to fix the eyeball and mark the anatomical center and the implantation zone with one tool, which ensures a stable position of the device on the surface of the eyeball with a slight excursion, eliminates its displacement and lubrication of the dye during marking.

The technical result when using the invention is expressed in increasing the marking accuracy, simultaneously marking the anatomical center of the cornea and the implantation zone of segments and rings of various diameters, ensuring the stability of the eyeball during marking of the implantation zone, minimizing the staining of the implantation zone, which creates favorable conditions for the formation of a corneal pocket using femtosecond laser.

The specified technical result is achieved by the fact that the marker of the center of the cornea and the implantation zone of the corneal segments and rings, containing a handle and a working part in the form of a ring with marks, according to the invention is provided with a central part in the form of segments intersecting at an angle of 90 degrees with a length of 8 mm with three marks 1 in length mm on each, distant from the center by a distance of 2.5, 3.0 and 3.5 mm, respectively, and the marks on the working part are made in the form of two horizontally oriented protrusions diametrically located in the frontal plane length of 1.5 mm, and the handle is made in the form of a tube with a piston and a coil spring.

The invention is illustrated by drawings: in FIG. 1 shows the proposed marker, general view; in FIG. 2 - working and central parts.

The proposed scribing device comprises a handle 1 in the form of a tube with a piston and a coil spring for a reciprocating piston and a working part comprising a peripheral ring 2 with a diameter of 11 mm with two horizontally oriented protrusions 3 with a diameter of 2 mm; the central part, moving in the sagittal plane in the form of segments 4-5 intersecting at an angle of 90 degrees, 8 mm long with three marks 6-8, 2 mm long on each, distant from the center at a distance of 2.5, 3.0 and 3.5 mm, respectively (Fig. 1- 2). Pressing the piston provides movement of the working part and marking on the cornea, while the working part with two marks is set on the limb, the horizontal meridian is marked, and the central part marks the implantation zone of the corresponding corneal segment or ring.

The proposed device is used for implantation of corneal rings or segments in the stroma of the cornea as follows. Using the nomogram, the diameter of the corneal ring or segment is selected. At the preoperative stage using special scribers mark the horizontal axis 0 ° -180 °. After applying a blepharostat on the eyelid to get a print, the marker is oriented by setting the working part of the tool (ring) along the limb, comparing the horizontal axis 0 ° -180 ° noted above with the protrusions on the ring. Pressing the piston provides movement of the working part and marking on the cornea, and the center of the cornea and the implantation zone of the corresponding corneal segment or ring are simultaneously marked. Moreover, the fixation of the eyeball around the circumference of the limb (the working part) with the help of the proposed tool eliminates the displacement of the tap during applanation on the cornea (central part) in case of an excursion of the eyeball.

Example. Patient G., year of birth 1996. Diagnosis: OS Keratoconus 3 tbsp.

The patient underwent surgery OS Implantation of the intrastromal corneal ring MyoRing. At the preoperative stage, the proposed marker was used for simultaneous marking of the center of the cornea and the implantation zone of the corresponding corneal ring. Under the epibulbar anesthesia after applying the blepharostat by the proposed marker, the eyeball was fixed by vertically applying it to the eyeball so that the ring of the device was located along the limbus. By pressing the piston, the working part of the device is lowered onto the cornea, leaving a cruciform mark.

When using the proposed device, the fixation of the eyeball and the mark of the anatomical center and the implantation zone is achieved with one instrument, which ensures a stable position of the instrument on the surface of the eyeball with a slight excursion, eliminates the displacement of the instrument and smearing of the dye during marking, simplifies the process of implanting corneal segments or rings onto stage of their positioning.

Claims (1)

Marker of the center of the cornea and the implantation zone of the corneal segments and rings, containing a handle and a working part in the form of a ring with marks, characterized in that it is provided with a central part in the form of segments intersecting at an angle of 90 degrees with a length of 8 mm with three marks 2 mm long on each, remote from the center at a distance of 2.5, 3.0 and 3.5 mm, respectively, and the marks on the working part are made in the form of two horizontally oriented protrusions 2 mm long diametrically located in the frontal plane, and the handle is made in the form of a tube with rshnym and coil spring.

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