WO2014147646A2 - Anneau de rétractation d'iris de 360 degrés - Google Patents

Anneau de rétractation d'iris de 360 degrés Download PDF

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Publication number
WO2014147646A2
WO2014147646A2 PCT/IN2014/000169 IN2014000169W WO2014147646A2 WO 2014147646 A2 WO2014147646 A2 WO 2014147646A2 IN 2014000169 W IN2014000169 W IN 2014000169W WO 2014147646 A2 WO2014147646 A2 WO 2014147646A2
Authority
WO
WIPO (PCT)
Prior art keywords
iris
ring
pupil
retractor
degree
Prior art date
Application number
PCT/IN2014/000169
Other languages
English (en)
Other versions
WO2014147646A3 (fr
Inventor
Satish D SHET
Original Assignee
Shet Satish D
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Shet Satish D filed Critical Shet Satish D
Publication of WO2014147646A2 publication Critical patent/WO2014147646A2/fr
Publication of WO2014147646A3 publication Critical patent/WO2014147646A3/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0231—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for eye surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
    • 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

Definitions

  • the present invention generally refers to a medical device or surgical instrument for use in ophthalmic surgery, and in particular to an iris retractor for use in eye surgery for retraction of the iris.
  • This invention relates to an iris retractor for increasing the pupillary aperture during eye surgery.
  • One of the major problems in phacoemulsification which is a small incision extracapsular cataract surgery, with implantation of a foldable intraocular lens, is the size of the pupil.
  • the pupil usually is dilated using topical preparations such as Homatropine, Cyclopentolate, Tropicamide and Phenylephrine combinations.
  • the increased intraocular manipulation which accompanies these new procedures is usually attended by constriction of the pupil, which makes visualization of the anterior lens capsule, the lens and posterior lens capsule quite difficult.
  • Inadequate pupil dilation can be observed in cases complicated by pseudoexfoliation syndrome, uveitis, posterior synechiae, trauma, chronic miotic therapy or previous intraocular surgery.
  • the pupil does not dilate in certain situations such as Diabetes, Intraoperative Floppy Iris Syndrome (IFIS) and in complicated cataract.
  • IFIS Intraoperative Floppy Iris Syndrome
  • a principal object of this invention is to provide an iris retractor that can be quickly and easily inserted into the eye.
  • a further object of this invention is to provide an iris retractor that can be quickly and easily removed from the eye at completion of surgery. Yet another object of this invention is to achieve a gradual incremental expansion of the pupil so as to prevent injury to the delicate iris structure during insertion. In addition, this controlled stretching of the pupil to a precisely determined and limited extent may restore the pupil to a more normal and desirable size, improving its function as an iris diaphragm.
  • Another object of this invention is to prevent the over-stretching of the pupil during the operative maneuvers by limiting its expansion to a precise, predetermined size just large enough to accomplish the intended surgical maneuvers.
  • Another object of this invention is to attach the appliance securely to the iris by the clamping effect of its "C" cross section so that the entire pupil aperture created can be transposed in the plane of the iris by gentle lateral pressure on the ring thereby exposing additional fields for surgical maneuvers.
  • Yet another object of this invention is to provide sustained dilation and protection of the pupil margin during surgical procedures such as in phacoemulsification.
  • the appliance would also allow re- expansion of the pupil where the pupil constricts during the course of a surgical procedure thereby restoring visibility and surgical access.
  • Another object of this invention is to provide an iris retractor which can be made in different sizes depending on the anticipated surgical procedure such as cataract surgery, retinal surgery, vitreous surgery, etc.
  • Yet another object of this invention is to provide an iris retractor that will stay in place once it is inserted, and which will not irritate or damage the eye tissues.
  • Another object of this invention is to provide an iris retractor which can be easily transported, stored and otherwise handled and manipulated.
  • the instant invention provides an iris retractor for use during eye surgery.
  • the retractor comprises a substantially circular, resilient C- shaped ring of hollow PMMA (Polymethyl methacrylate) or silicone or other biomaterial formed into a partial circle in cross section having curved surface to cover the anterior (upper)and the Posterior (lower) portion of the iris at the pupillary margin. It has a 360 degree rim with two open ends-one end with an eyelet with a keyhole like opening on the upper surface and the other end with a button on an arm on the same surface to provide an interlocking mechanism. Once the ring is placed in situ with an interlocking mechanism, it provides 360 degree tension on the iris to retract.
  • the (PMMA or silicone) ring can be injected through a 2.2mm or larger incision either manually or through a custom made injector. This eliminates the need to make several extra paracentesis.
  • the 360 degree retractor comprises a resilient C -shaped hollow ring with two open ends-with an eyelet at one end with a keyhole like opening and a button with an arm at the other end to provide an interlocking mechanism.
  • the circumference of the retractor is preferably about 7-8 mm.
  • the anterior portion of the eye with the cornea Prior to the eye surgery, the anterior portion of the eye with the cornea is completely intact. In order for the surgery to proceed, the cornea must be incised at the limbus or clear cornea and a 2.2mm or more incision is made to permit insertion of the retractor into the pupil.
  • two Sinskey Hooks are used to mobilize the ring into position with the help of three dialing holes on the anterior (Upper) surface at locations as shown in the drawings to retract the iris.
  • the rim of the retractor is thus worked into an abutting relationship with the iris, in which the rim holds back the iris by an interlocking mechanism at the two ends of the retractor and thereby enlarges the pupil.
  • the retraction afforded by the retractor allows easy access to the lens and the capsular fornix around the entire circumference of the anterior chamber, thereby reducing the need for additional instrumentation in the eye.
  • the retractor is advanced across the anterior chamber until the middle portion of the retractor engages the iris at a 6 o'clock position.
  • a Sinskey hook or lens manipulator is used to hold the retractor in place with the help of a dialing hole against the iris sphincter. Once the ring is engaged against the iris sphincter the Sinskey hook is moved to another dialing hole adjacent to the eyelet with a keyhole like opening at one end.
  • Another Sinskey hook is inserted through the main port and engaged into another dialing hole adjacent to the button on an arm at the other end of the ring and both Sinskey hooks are maneuvered to engage the ends of the ring into a locking mechanism at 12 o'clock position of the iris.
  • Sinskey hooks are again engaged into the dialing holes to unlock the 360 degree iris retraction ring.
  • One end of the ring is brought out of the sideport incision and the other end follows through the same incision site.
  • the retractor should be formed from a non-toxic, disposable biomaterial, preferably PMMA or silicone and is intended for a single use only.
  • the instant invention overcomes the foregoing problems by providing an iris retractor which is held in place by an interlocking mechanism which can be unlocked at the end of phacoemulsification procedure and which provides equal stretching for 360 degrees around the iris.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Ophthalmology & Optometry (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un dispositif de rétraction d'iris destiné à être utilisé pendant une chirurgie oculaire. Le dispositif de rétraction comprend un anneau creux, souple et sensiblement circulaire en forme de C formé en PMMA (méthacrylate de polyméthyle), en silicone ou autre biomatériaux formé en une section transversale partiellement circulaire ayant une surface incurvée pour couvrir la partie antérieure et la partie postérieure de l'iris au niveau du bord pupillaire. Il possède un rebord de 360 degrés avec deux extrémités ouvertes. Une extrémité possède un œillet ayant une ouverture de type trou de serrure sur la surface supérieure et l'autre extrémité possède un bouton sur un bras sur la même surface pour fournir un mécanisme de verrouillage. Une fois que l'anneau est placé in situ avec un mécanisme de verrouillage, il fournit une tension de 360 degrés sur l'iris pour la rétraction. L'anneau (en PMMA ou en silicone) peut être injecté à travers une incision cornéenne ou limbique franche de 2,2 mm ou plus, manuellement ou à l'aide d'un dispositif d'injection personnalisé.
PCT/IN2014/000169 2013-03-19 2014-03-17 Anneau de rétractation d'iris de 360 degrés WO2014147646A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IN1176/CHE/2013 2013-03-19
IN1176CH2013 2013-03-19

Publications (2)

Publication Number Publication Date
WO2014147646A2 true WO2014147646A2 (fr) 2014-09-25
WO2014147646A3 WO2014147646A3 (fr) 2014-12-24

Family

ID=51581567

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IN2014/000169 WO2014147646A2 (fr) 2013-03-19 2014-03-17 Anneau de rétractation d'iris de 360 degrés

Country Status (1)

Country Link
WO (1) WO2014147646A2 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3364852A4 (fr) * 2015-10-20 2019-06-26 National University of Singapore Dispositif d'expansion destiné à maintenir séparés les bords d'une ouverture dans un tissu et procédé de fonctionnement correspondant

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5163419A (en) * 1991-04-04 1992-11-17 Goldman Kenneth N Device for expanding the pupil of a human eye
US5267553A (en) * 1992-02-18 1993-12-07 Graether John M Pupil expander and method of using the same

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5163419A (en) * 1991-04-04 1992-11-17 Goldman Kenneth N Device for expanding the pupil of a human eye
US5267553A (en) * 1992-02-18 1993-12-07 Graether John M Pupil expander and method of using the same

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3364852A4 (fr) * 2015-10-20 2019-06-26 National University of Singapore Dispositif d'expansion destiné à maintenir séparés les bords d'une ouverture dans un tissu et procédé de fonctionnement correspondant
US10716555B2 (en) 2015-10-20 2020-07-21 National University Of Singapore Expander for holding apart an opening in a tissue and method of operating the same

Also Published As

Publication number Publication date
WO2014147646A3 (fr) 2014-12-24

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