WO2011029267A1 - Couteau épithélial sous guidage d'une carte de topographie cornéenne - Google Patents

Couteau épithélial sous guidage d'une carte de topographie cornéenne Download PDF

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Publication number
WO2011029267A1
WO2011029267A1 PCT/CN2010/001329 CN2010001329W WO2011029267A1 WO 2011029267 A1 WO2011029267 A1 WO 2011029267A1 CN 2010001329 W CN2010001329 W CN 2010001329W WO 2011029267 A1 WO2011029267 A1 WO 2011029267A1
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WO
WIPO (PCT)
Prior art keywords
microprocessor
control box
epithelial
motor
cpu2
Prior art date
Application number
PCT/CN2010/001329
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English (en)
Chinese (zh)
Inventor
卢先领
褚仁远
张宝华
周行涛
戴锦辉
周浩
王斌
Original Assignee
无锡市康明医疗器械有限公司
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Application filed by 无锡市康明医疗器械有限公司 filed Critical 无锡市康明医疗器械有限公司
Publication of WO2011029267A1 publication Critical patent/WO2011029267A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/013—Instruments for compensation of ocular refraction ; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea
    • A61F9/0133—Knives or scalpels specially adapted therefor

Definitions

  • the present invention relates to a medical device for ophthalmic refractive laser surgery, and more particularly to an epithelial knife guided by a corneal topography.
  • ophthalmic excimer laser corneal refractive surgery has experienced rapid development from PRK, LASIK to LASEK and Epi-LASIK.
  • the revision of surgical procedures has always centered on improving predictability while reducing complications.
  • LASIK has been widely used in accordance with the anatomical and physiological characteristics of the cornea, the incidence of Haze is small, and the regression is light. It has been widely used, but the adhesion between the corneal stroma layers is weak due to the cross-shaped layer and the external force. It is prone to cracking and dislocation. In the clinical, there was a soldier who had been treated for 10 years after LASIK.
  • Epi-LASIK is the future development direction of LASIK, because its flap thickness is only 50-70um.
  • the thickness of the corneal stromal bed is more than 300um, more corneal tissue can be cut with excimer laser, which can correct more.
  • High myopia followed by a relatively uniform thickness of the corneal epithelial flap, so that the laser can better maintain the original aspheric curvature of the cornea, so that better visual quality after surgery.
  • the epithelial flap directly and the corneal stroma tissue adhered to the cornea with higher strength and greater impact resistance. Therefore, Epi-LASIK is the future direction of excimer laser correction refractive surgery.
  • the living epithelial flap should make the epithelial separation ability of the epithelial knife constant, which is the epithelial separation ability created by our company in the second prize of the 2006 National Technology Invention Award, "Key Technology and Application of Myopia Surgical Microkeratome System".
  • M N * V1/F * V2
  • M (representing the separation ability of the separation epithelium) should be constant, because the surface of the eyeball is a rugged surface similar to our earth, the separation piece should be "alpine” during the separation process. Or “squatting” should be pressed on a plane to advance, so that the positive pressure N acting on the separation piece decreases with the increase of "mountain” with the “squatting".
  • N positive pressure
  • An epithelial knife guided by a corneal topography comprising a control box, a cutter head, a separation piece, a dual motor assembly, a suction ring, a water gas separator, a foot switch, the control box is provided with a topographic map input interface, and a control box A microprocessor is disposed therein, and a surface of the control box is provided with a color display that displays a simulated corneal topography.
  • the microprocessor includes a channel scan processor, a graphics microprocessor, and a separation capability stable microprocessor.
  • the topographic map input interface is respectively connected with the channel scanning processor and the graphic microprocessor in the control box, the channel scanning processor is respectively connected with the separation capability stable microprocessor and the graphic microprocessor, and the graphic microprocessor is connected to the color display.
  • the separation capability stabilization microprocessor is also sequentially connected with the vacuum pump and the sampling sensor provided in the control box, and the separation capability is stabilized.
  • the first motor and the second motor of the dual motor assembly are respectively connected to the microprocessor, and the first motor and the second motor are respectively respectively The separator and separator are connected, and the separation function is stabilized.
  • the control switch is also connected to the microprocessor.
  • a strip is disposed on the side wall of the separator adjacent to the cutting edge, and the distance between the strip and the edge of the separator is 60 ⁇ m to 120 ⁇ m.
  • the present invention increases the topographic map input interface interface and the microprocessor, and processes the corneal topographic map input through the U disk;
  • the separation ability stable microprocessor implements the control of the width of the motor pulse to control the linear velocity of the separation piece VI, the separation piece (the machine), the forward center point rotation linear velocity V2 speed.
  • N represents the positive pressure between the epithelium of the septum. Unit: Newton;
  • VI linear linear velocity of the separator. Unit: m/Sec;
  • V2 Separation piece (machine) forward center point rotation linear velocity Unit: m/Sec.
  • the corneal surface of the human eye can be clearly seen. It is not a smooth spherical surface, but a high and low undulating terrain like a mountain.
  • the separation piece of the corneal epithelial knife is flattened and separated from the epithelium on this uneven terrain.
  • the positive pressure N is different when the positive pressure of the separation piece separates the epithelium along the uneven terrain.
  • N N ⁇ V1/F ⁇ V2 (N is the positive pressure, VI is the moving speed of the separator, F is the sharpness of the separator, and V2 is the speed of the cutter head that drives the separator, that is, the speed at which the separator separates the epithelium)
  • the separation ability M is made constant, and as the positive pressure changes, the linear velocity VI of the separator and the forward center point rotation linear velocity of the separator are constantly adjusted.
  • the invention refers to the principle of "ballistic missile", scans the corneal topography of the patient through the corneal map instrument, and inputs it into the control box of the epithelial knife through the U disk; in the control box of the epithelial knife, the input is through software programming.
  • the topographic map was scanned on the corneal topography of the 6 mm wide track on the epithelial knife separation trajectory by recreating the patient's corneal topography on the color display of the control box and scanning the separation piece on a 6 mm wide channel.
  • the separation piece (machine) advances the center point rotation linear velocity V2, because the separation piece is indefinite (sharpness) F is determined to be constant, and the linear velocity VI of the separation piece is adjusted by the principle that the separation ability M of the separation epithelium is constant Separation piece (device)
  • the forward center point rotates the linear velocity V2.
  • the corneal epithelial blade of the present invention is designed to have a clear requirement for the length of the arcuate groove of the separator, the distance of the bar from the edge of the separator, and the control performance of the control box, thereby ensuring that the epithelial keratome can be completely Separating the epithelial flap with the basement membrane and separating the strip on the sheet increases the rigidity of the septum and limits the increment of the positive pressure N of the septum between the corneal epithelium.
  • the groove increases the flexibility of the septum; The new type completely separates the epithelial flap without damaging the stromal layer, while retaining the integrity of the corneal epithelial layer and the anterior elastic layer.
  • Figure 1 is a schematic view of the structure of the present invention
  • Figure 2 is a schematic structural view of a control box of the present invention
  • FIG. 3 is a schematic structural view of a separator with a strip of the present invention.
  • Figure 4 is a flow chart of the operation of the present invention.
  • Figure 5 is a corneal topography
  • Figure 6 is a trajectory of the separation piece guided by the corneal topography.
  • An epithelial knife guided by a corneal topography comprising a control box 1, a cutter head 2, a separation piece 3, a dual motor assembly 5, a suction ring 6, a water gas separator 7, a foot switch 8, and the control box 1 is set There is a topographic map input interface 10, and a control unit 1 is provided with a microprocessor.
  • the surface of the control box 1 is provided with a color display 11, and the color display 11 displays a corneal topographic map.
  • the microprocessor includes a channel scan processor CPU 1, a graphics microprocessor 12, and a separation capability stabilization microprocessor CPU2. ,
  • the topographic map input interface 10 is respectively connected to the channel scan processor CPU1 and the graphic microprocessor 12 in the control box 1, and the channel scan processor CPU1 is respectively connected with the separation capability stabilization microprocessor CPU2 and the graphic microprocessor 12, and the graphics
  • the microprocessor 12 is connected to the color display 11, and the separation capability stabilization microprocessor CPU2 is also sequentially connected with the vacuum pump 13 and the sampling sensor 14 provided in the control box 1, and the separation capability is stabilized.
  • the microprocessor 2 is also connected to the dual motor assembly 5 respectively.
  • a motor 16 and a second motor 17, the first motor 16 and the second motor 17 are connected to the separator 18 and the separator 19, respectively.
  • the separation capability stabilization microprocessor CPU2 is also connected to the control switch 15.
  • a strip 4 is disposed on the side wall of the separator 3 near the cutting edge
  • the distance between the strip 4 and the edge of the separator 3 is 60 ⁇ ⁇ ! ⁇ 120 ⁇ m.
  • the width of the arc-shaped closed groove (9) is 0. 25 ⁇ ! ⁇ 0. 5 discussion.
  • the working principle of the invention is as follows: the separating piece 3 is driven by the power of the dual motor assembly 5, and the main motor, that is, the first motor 16 is rapidly rotated, and the reciprocating linear motion is changed by the shank to obtain the power for separating the epithelium, and the sub motor is the first
  • the second motor 17 drives the cutter head 2 assembly to rotate or linearly through the suction ring 6, so as to achieve the purpose of safety protection and flexibility when separating the upper skin.
  • the resistance bar 4 pushes the epithelial resistance to one end of the movement direction, and the barrier strip 4 blocks the separation piece 3 once the separation piece 3 is cut through the epithelium and penetrates into the matrix layer.
  • the CPU calculates the treatment software with 1/1000 second real-time monitoring to monitor the change of the separation epithelial current consumption.
  • the monitoring strip 4 prevents the separation piece 3 from deepening and causes the secondary motor current to start increasing.
  • the current limit once the current is increased, the dual motor assembly 5 will automatically stop, which will not hurt the pre-corneal elastic layer.
  • the pressure is increased, and the arc-shaped groove 9 of the separating piece just exceeds the pressure too small, so that the cutting head 2 of the separating piece 3 is elastically deformed up and down.
  • This upper and lower elastic deformation also relieves the positive pressure of the separating piece 3 during the up and down slope movement.
  • the separation piece 3 is formed to be flexible when the epithelium is separated, and the purpose of flexible separation is achieved.
  • the control box 1 is a dual motor power source that not only drives the main and auxiliary motors, but also generates a vacuum to cause the suction ring 6 to absorb the eyeball. More importantly, the control box 1 automatically controls the flapping process to achieve a safe and reliable flap.
  • There is a CPU treatment calculation software the main and auxiliary motors during operation are sampled in real time by the sampling circuit, and the auxiliary motor operating current is compared with the safety value by 1/1000 second. When the current is steeply increased, the circuit is disconnected and stopped. Work to ensure that it does not cut into the front elastic layer.
  • the control box CPU knows the working current of the secondary motor through sampling, thereby tracking the current in time. If the separation piece is cut into the front elastic layer, the secondary motor current must exceed the safe current range due to the prevention of the resistance of the resistance strip 4, thereby cutting off the voltage of the dual motor and stopping the operation.
  • the speed VI is lowered, the rotational linear velocity V2 of the separator 3 is also lowered, and the bluntness K of the separator 3 is also increased, so that the basic separation ability of the separator 3 is constant, ensuring safety and reliability in the separation process.
  • the invention refers to the principle of "ballistic missile", scans the corneal topography of the patient through the corneal map instrument, and inputs it into the control box 1 of the epithelial knife through the U disk; in the control box 1 of the epithelial knife, through software programming,
  • the input topographic map is scanned on the corneal topography of the 6 mm wide track on the epithelial knife separation track line by recreating the patient's corneal topography on the color display 11 of the control box 1 and scanning the separation piece on a 6 mm wide channel.
  • the linear linear velocity VI and the separation piece (the machine) advance the center point rotation linear velocity V2, because the separation piece 3 is dull (sharpness) F is determined to be constant, and the separation line is adjusted by the principle that the separation ability M of the separation epithelium is constant.
  • the linear velocity VI and the separation piece (the machine) advance the center point to rotate the linear velocity V2.
  • the corneal epithelial knives of the present invention are designed to have clear requirements for the length of the arcuate groove of the separator, the distance of the strip from the edge of the separator, and the control performance requirements of the control box, thereby ensuring that the epithelial keratome can be
  • the epithelial flap with basement membrane is completely separated, and the stromal layer is not damaged, ensuring the safety and reliability of the operation.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Eye Examination Apparatus (AREA)
  • Prostheses (AREA)
  • Laser Surgery Devices (AREA)

Abstract

Cette invention concerne un couteau épithélial sous guidage d'une carte de topographie cornéenne comprenant un boîtier de commande (1), un outil rapporté (2), une pièce de séparation (3); un ensemble à deux moteurs (5), un anneau d'aspiration (6), un séparateur d'humidité (7) et une pédale (8). Le boîtier de commande (1) est équipé d'une interface (10) pour la saisie d'une carte de topographie, un microprocesseur est prévu dans le boîtier de commande (1), et un écran couleur (11) est prévu sur la surface du boîtier de commande (1), l'écran couleur (11) affichant une simulation de la carte de topographie de la cornée. Le microprocesseur comprend un processeur d'analyse de canaux (CPU1), un microprocesseur d'images (12) et un microprocesseur de stabilisation de capacité de séparation (CPU2). L'interface (10) de saisie de la carte de topographie est reliée au processeur d'analyse de canaux (CPU1) et au microprocesseur d'images (12) dans le boîtier de commande (1) respectivement, et le processeur d'analyse de canaux (CPU1) est relié au microprocesseur de stabilisation de capacité de séparation (CPU2) et au microprocesseur d'images (12). Le microprocesseur d'images (12) est relié à l'écran couleur. Le microprocesseur de stabilisation de capacité de séparation (CPU2) est aussi relié en série avec une pompe à vide et un détecteur d'échantillonnage prévu dans le boîtier de commande (1), le microprocesseur de stabilisation de capacité de séparation (CPU2) étant aussi relié au premier moteur (16) et au second moteur (17) de l'ensemble à deux moteurs (5) respectivement, le premier moteur (16) et le second moteur (17) étant reliés au séparateur et à une pièce de séparation (3) respectivement, le microprocesseur de stabilisation de capacité de séparation (CPU2) étant relié à un dispositif de commande.
PCT/CN2010/001329 2009-09-04 2010-09-01 Couteau épithélial sous guidage d'une carte de topographie cornéenne WO2011029267A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN2009100347317A CN101690686B (zh) 2009-09-04 2009-09-04 角膜地形图引导下的上皮刀
CN200910034731.7 2009-09-14

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Publication Number Publication Date
WO2011029267A1 true WO2011029267A1 (fr) 2011-03-17

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WO (1) WO2011029267A1 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101690686B (zh) * 2009-09-04 2011-04-06 无锡市康明医疗器械有限公司 角膜地形图引导下的上皮刀
CN108186194A (zh) * 2018-01-03 2018-06-22 沈阳何氏眼科医院有限公司 眼科手术超声刀

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5909270A (en) * 1996-05-10 1999-06-01 California Institute Of Technology Conoscopic system for real-time corneal topography
CN1268340A (zh) * 1999-03-10 2000-10-04 路易斯·安东尼奥·鲁伊兹 使用地形学和激光系统界面的交互式眼球矫正手术系统
CN2812880Y (zh) * 2005-08-17 2006-09-06 无锡市康明医疗器械有限公司 一种自动、直进式、无压力、可视智能角膜上皮刀
CN101690686A (zh) * 2009-09-04 2010-04-07 无锡市康明医疗器械有限公司 角膜地形图引导下的上皮刀
CN201469515U (zh) * 2009-09-04 2010-05-19 无锡市康明医疗器械有限公司 角膜地形图引导下的上皮刀

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2429150Y (zh) * 2000-05-22 2001-05-09 无锡市康明医疗器械有限公司 角膜板层切割刀片

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5909270A (en) * 1996-05-10 1999-06-01 California Institute Of Technology Conoscopic system for real-time corneal topography
CN1268340A (zh) * 1999-03-10 2000-10-04 路易斯·安东尼奥·鲁伊兹 使用地形学和激光系统界面的交互式眼球矫正手术系统
CN2812880Y (zh) * 2005-08-17 2006-09-06 无锡市康明医疗器械有限公司 一种自动、直进式、无压力、可视智能角膜上皮刀
CN101690686A (zh) * 2009-09-04 2010-04-07 无锡市康明医疗器械有限公司 角膜地形图引导下的上皮刀
CN201469515U (zh) * 2009-09-04 2010-05-19 无锡市康明医疗器械有限公司 角膜地形图引导下的上皮刀

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CN101690686B (zh) 2011-04-06
CN101690686A (zh) 2010-04-07

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