RU2758480C1 - Spatula for removing pterygium - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely to ophthalmology. A spatula for removing pterygium, consists of working and holding parts, the width of the working part is 2 mm, the length of the working part is 27 mm, of which 15 mm have notches in the amount of 60 pcs., so that there are 4 notches per 1 mm. The notches are located on the lower surface of the working part. The radius of curvature of the bending of the working part is 3.5 mm. The sides of the working part are pointed.

EFFECT: application of this invention provides effective removal of pterygium without the need for additional tools for cleaning the cornea, reduces the operation time, and also minimizes the risk of complications in the form of damage to the surface layers of the cornea up to its perforation.

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Description

The invention relates to medicine, namely to medical instruments used in ophthalmic practice for the surgical treatment of pterygium.

The pterygium (pterygoid hymen) is a triangular vascularized fold of the conjunctiva that grows onto the cornea. In the pterygium, there are: head, neck, body. According to the length of the growth on the cornea, the pterygium is divided into five degrees: I degree - initial, when the growth is determined only at the limbus, usually without changes in vision or refraction; II degree - the head is located in the middle between the limbus and the edge of the moderately dilated pupil, while the formation of astigmatism and a decrease in vision to 0.9-0.7 are possible; III degree - the head is at the edge of the pupil, visual acuity may decrease to 0.5; IV degree - the head of the pterygium reaches the center of the cornea, visual acuity can be reduced to 0.3-0.2; Stage V - the head goes beyond the center of the cornea and can reach the level of the opposite edge of the pupil, visual acuity is below 0.1 (Titarenko I.V., Titarenko Z.D., Gonchar P.F.Pterygium (pathogenesis, clinic, treatment). - 1992 .-- S. 15).

Analogs

Various tools are known for removing pterygium.

Kopp, Eva. (2004). Cut and paste: A no suture, small incision approach to pterygium surgery. The British journal of ophthalmology. 88. 911-4. 10.1136/bjo.2003.032854.)The literature contains data on the use of a diamond knife (P.S. Hersh, B.M. Zagelbaum, S.L. Kremers, ophthalmosurgery, 2016, p. 105.p), an ophthalmic surgical knife-splitter (A.I. Gorban, A.O. Jaliashvili, eye microsurgery, 1982, p. 37), eye spatula - 0.5 mm (http://www.eyecenter.crimea.com/teach/pterigium/10.html), Grefe linear knife ( operations on the cornea and sclera, V.S.Belyaev, 1984, С-58), a spear-shaped knife (operations on the cornea and sclera, V.S.Belyaev, 1984, С-57), a spatula for the iris (Koranyi, G & Seregard, S &

Kopp, Eva. (2004). Cut and paste: A no suture, small incision approach to pterygium surgery. The British journal of ophthalmology. 88.911-4. 10.1136 / bjo.2003.032854.)

Criticism of analogues.

The use of the above tools is associated with a number of negative aspects due to:

- insufficient removal of pterygium tissues from the surface of the cornea, which requires the use of additional instruments

- the sharp cutting end of the instruments, which causes additional damage to the cornea and there is a risk of damage to the deep layers of the cornea, up to corneal perforation;

- the shape of the tools, they have a straight shape of the working part, because of which it is necessary to change the angle of inclination of the working surface.

Invention prototype.

Kopp, Eva. (2004). Cut and paste: A no suture, small incision approach to pterygium surgery. The British journal of ophthalmology. 88. 911-4. 10.1136/bjo.2003.032854.)As a prototype, we selected the iris spatula used to remove the pterygium (Koranyi, G & Seregard, S &

Kopp, Eva. (2004). Cut and paste: A no suture, small incision approach to pterygium surgery. The British journal of ophthalmology. 88.911-4. 10.1136 / bjo.2003.032854.)

The prototype tool is a rod tool with a total length of 130 mm, a length of the working part of 25 mm, a width of the working part of 1.2 mm, with rounded edges.

Criticism of the prototype.

The presence of rounded lateral edges complicates the separation of the pterygium from the cornea, and due to its smooth surface, the iris spatula does not completely remove the pterygium tissue from the cornea, which requires the use of additional instruments to clean the cornea.

The purpose of the invention.

The aim of the invention is to develop a tool for more effective removal of the pterygium, and providing maximum non-invasiveness and ease of use.

The essence of the invention.

The essence of the invention is illustrated in FIG. 1-3, where FIG. 1 is a general side view of the tool, FIG. 2 pos. 3 is an illustration of the notches; FIG. 3 - working part, side view.

The offered tool is a tool with a total length of 145 mm. Consists of a working (Fig. 1, pos. 1) and retaining parts (Fig. 1, pos. 2). The length of the working part is 27 mm, of which 15 mm have notches (Fig. 1, pos. 3); width - 2 mm, bending curvature radius - 3.5 mm. The notches are illustrated in FIG. 2 pos. 3. Notches are located on the lower surface of the working part in the amount of 60 pieces, so that there are 4 notches per 1 mm. The sides of the working part are pointed (Fig. 3, pos. 4) The length of the holding part (Fig. 1, pos. 2) is 118 mm, the diameter is 5 mm.

An example of a specific application of the proposed spatula

The skin of the eyelids and the conjunctival cavity are treated with 5% betadine solution. Establish a blepharostat. The body of the pterygium is grasped and lifted with forceps over the limbus. The proposed spatula is carried out under the raised neck of the pterygium, and the separation is carried out in several reciprocating (sawing) movements in the direction from the limbus to the center of the cornea. Further stages of the operation are carried out according to the standard method.

Example 1: Patient M, 59 years old. Diagnosis: OS - Pterygium grade 3.

Instillation anesthesia with 0.5% proxymetacaine solution. Installed blepharostat. Subconjunctival anesthesia in the area of the pterygium neck with 2% lidocaine solution. Separation of the pterygium head from the corneal surface using a spatula to remove the pterygium. Removal of the head and subconjunctival tissue of the pterygium. Perilimbal diathermocoagulation of episclera. Hardware corneomicroabrasion of the corneal bed of the pterygium.

Sealing the edges of the conjunctival incision with interrupted sutures (9/00) in the amount of 3 pcs.

Example 2: Patient A, 73 years old. Diagnosis: OD - Pterygium 2-3 degrees.

Instillation anesthesia with 0.5% proxymetacaine solution. Installed blepharostat. Subconjunctival anesthesia in the area of the pterygium neck with 2% lidocaine solution. Separation of the pterygium head from the corneal surface using a spatula to remove the pterygium. Removal of the head and subconjunctival tissue of the pterygium. Perilimbal diathermocoagulation of episclera. Hardware corneomicroabrasion of the corneal bed of the pterygium.

Sealing the edges of the conjunctival incision with interrupted sutures (9/00) in the amount of 2 pcs.

Features of the invention that differ from the prototype.

1. Difference in purpose: The proposed instrument is a specialized instrument for removing the pterygium, in contrast to the prototype instrument, the direct purpose of which is to manipulate the iris.

2. The proposed tool has notches on the bottom surface, in contrast to the prototype, which has smooth surfaces.

3. The working part of the proposed tool is curved along the plane, and in its configuration follows the curvature of the cornea, in contrast to the prototype, which has a straight shape.

4. The proposed tool has pointed side edges, while the prototype has rounded edges.

The technical result from the application of this method.

The use of the proposed tool provides effective removal of the pterygium without the need for additional tools for cleaning the cornea, shortens the operation time, and also minimizes the risk of complications in the form of damage to the surface layers of the cornea up to its perforation.

Sources of information taken into account:

1) Titarenko I.V., Titarenko Z.D., Gonchar P.F. Pterygium (pathogenesis, clinical picture, treatment). - 1992.

2) P.S. Hersh, B.M. Zagelbaum, S.L. Kremers, ophthalmic surgery, 2016

3) A.I. Gorban, A.O. Jaliashvili, eye microsurgery, 1982

4) V.S. Belyaev, operations on the cornea and sclera, 1984.

5) Ashok Garg, Essam EL Toukhy, Belquiz A Nassaralla, Sunil Moreker, Surgical and Medical Management of PTERYGIUM, 2009.

6) F.C Blodi, G. Mackensen, H. Neubauer, Surgical ophthalmology, 1991.

7) Koranyi, G & Seregard, S & Dafgard Kopp, Eva. (2004). Cut and paste: A no suture, small incision approach to pterygium surgery. The British journal of ophthalmology. 88.911-4. 10.1136 / bjo.2003.032854. - prototype.

Claims (1)

A spatula for removing pterygium, consisting of a working and holding parts, the width of the working part is 2 mm, the length of the working part is 27 mm, of which 15 mm have notches in the amount of 60 pieces, so that there are 4 notches per 1 mm, the notches are located on the lower surface of the working part, the radius of curvature of the bending of the working part is 3.5 mm, the sides of the working part are pointed.

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