RU31948U1 - A device for transscleral threading in the surgical treatment of aphakia in the absence of the posterior wall of the capsule - Google Patents

Description

The proposal is related to medicine, namely to ophthalmology and can be used in the treatment of aphakia with the absence of a back capsule.

A device for the treatment of aphakia Paimu J.S. A new suturing technique for sulcus fixation in absence of posterior capsule. Ophthalmic Surg. 1988). The device is used as follows: at 9 and 3 hours, two superficial scleral flaps are cut out, with the base to the limb. At a distance of 0.5-0.75 mm from the limb from under the flap, at 9 o'clock spend a special needle with 10-0 prolene thread. RTG must be introduced from the inside out. A needle with a thread is also held for 3 hours.

Disadvantages: insufficient treatment effect, duration and high invasiveness of the operation, risk of hemorrhagic complications.

A well-known tool for transscleral threading (Astakhov S.Yu. Modern methods of surgical rehabilitation of patients with cataracts and glaucoma. Abstract, diss. ... Dr. med. Sciences St. Petersburg, 1998) adopted by us for the prototype.

The tool contains a 23-gauge conductor needle with a point in the form of a pointed microhirsphgic knife (lancet), curved at the border of the lower and middle third at an angle close to 90 °, which has a through hole in the bend for removing the needle and thread.

As a handle can be used the usual "LUER or insulin syringe. The conductor needle is inserted from under the flap for 3 hours towards the needle with a propylene thread. In the area of the pupil, a needle with a thread is inserted into the lumen of the conductor needle and it is brought out. If the needle with the thread is straight, then it can be passed through through the hole in the conductor, after which the conductor is removed. If the needle with the thread is bent, it is enough to introduce it into the lumen of the conductor, which in this case plays the role of a “lock, and bring it together with the conductor through an injection under the flap.

Disadvantages: a device for trans-scleral conduction of a thread proposed by S. Astakhov. and Kugleev AA, requires the introduction of a needle with a thread into the conductor in the pupil, which presents difficulties in the implementation of this manipulation. A prerequisite is the presence of an expensive operating microscope, a transparent cornea, the needle may slide off the thread and, therefore, the need for repeated manipulations, which inevitably affects the duration of the operation and increases the morbidity, healing time.

Tasks:

-Providing quality surgical treatment in the absence of a posterior capsule;

-Reduction of operation time;

-Reduction of the cost of operations;

-Reduction of trauma;

-Creation of the possibility of treatment for secondary cataract, when implantation in the capsular bag is impossible: expanding the capabilities of the device with different variants of pathology.

The technical novelty of the device is the following: an elastic metal loop is made at the end of the needle and the device is equipped with a micro hook for thread extraction by the loop when it is passed through the fundus.

The technical result of the utility model is the simplicity and reliability of the thread for subsequent transscleral fixation of the intraocular lens. NM does not require an expensive surgical microscope and special factory tools, the thread can be carried out including with not quite transparent cornea.

For a better understanding, the device is shown in FIG. 1-3, where 1 is the needle, is the loop at the end of the needle, 3 is mshf01fyuchok, 4 is the projection of the pupil, 5 is the cannula.

The device is used as follows. A needle 1 with a cannula 5 is provided at the end with a loop 2 (Fig. 1). Thread 9-00 is threaded into the loop and from outside the scleral flap at 12-00 o'clock it is carried out from the outside to the eyeball into the projection of the pupil 4 (Fig. 2). With a crochet hook 3, inserted from under the flap at 6-00 o’clock, the loop-conductor 2 is grasped from the outside in and out. Then tweezers capture the thread, remove the loop-conductor (Fig. 3).

The device was tested on 18 patients during 1999-2003. The operations were successful. The morbidity has decreased. Long-term results showed that in all patients visual acuity increased by 60-80%. No complications after surgery were observed. Operation time was reduced by 30-40%, and hospital days - by 20-35%. All patients improved their quality of life.

Applicants: b // A S.G. Zhiltsov Date: | 1 L

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GO. . (I.G. Sutovsky

T.P. Lukyanova Vvo AI. Eremenko

Claims (1)

A device for trans-scleral threading in the surgical treatment of aphakia in the absence of a posterior capsule, containing a cannula with a curved needle, characterized in that an elastic metal loop is made at the end of the needle and the device in the kit has a microhook for removing the thread into the loop when it is passed through the fundus.