WO2017143117A1 - Scleral depressor - Google Patents

Scleral depressor Download PDF

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Publication number
WO2017143117A1
WO2017143117A1 PCT/US2017/018258 US2017018258W WO2017143117A1 WO 2017143117 A1 WO2017143117 A1 WO 2017143117A1 US 2017018258 W US2017018258 W US 2017018258W WO 2017143117 A1 WO2017143117 A1 WO 2017143117A1
Authority
WO
WIPO (PCT)
Prior art keywords
blade
axis
handle
extension member
plane
Prior art date
Application number
PCT/US2017/018258
Other languages
French (fr)
Inventor
Brett FOXMAN
Original Assignee
Foxman Brett
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 Foxman Brett filed Critical Foxman Brett
Priority to US16/076,737 priority Critical patent/US20190046176A1/en
Priority to EP17753871.7A priority patent/EP3416600A4/en
Publication of WO2017143117A1 publication Critical patent/WO2017143117A1/en

Links

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
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0817—Spatulas or spatula like extensions

Definitions

  • the present invention is directed toward an ophthalmic surgical and examination instrument used during surgery or during an eye examination for depressing the sclera. More particularly, the invention relates to a scleral depressor that provides improved manipulation and does not interfere with the examining physician's field of view.
  • scleral depressors are used to facilitate examination of the fundus or interior surface of the eye including the retina.
  • Substantially all known prior art sclera depressors include a handle and a blade or depressing element that is attached to the handle and which extends therefrom.
  • the blade is arranged to be either straight or at an offset angle from the handle to facilitate manipulation of the blade.
  • the blade of the orizane scleral depressor is in the form of a relatively flat triangle that faces in the same direction as the direction of the axis of the elongated handle.
  • the depressor is designed to allegedly control the rotation of the eyeball along with the depression of the same.
  • Scleral depressors used during surgery typically have a blade depressing element in the form of a cylinder or that has a bulbous structure.
  • the classical and optimal means to provide depression during surgery involves inserting the scleral depressor parallel to the axis of the eye and depressing the sclera in toward the center of the eye, perpendicular to the wall of the eye.
  • the patient is lying in a supine position with the surgeon at the top of the head and the assistant at the side, oriented 90° from the surgeon.
  • the face and body of the patient are covered by sterile cloths with the operative eye being the only exposed body part.
  • the assistant who is typically on the temporal or lateral side of the eye, has several obstacles to adequate scleral depression. For example, depression on the nasal side of the eye is difficult to access as it's on the opposite side as the assistant.
  • the superior side of eye is also difficult to access due to the assistant's hand interfering with the surgeon's hands and instruments and the inferior side of the eye is slightly limited to depression by the cheekbone. Even further, the handle and shaft of the depressor frequently hit the optical system for viewing inside the eye which are either hanging from the microscope above the eye (with the lowermost portion a few millimeters above the eye) or are sitting on the surface of the eye.
  • the present invention is designed to overcome the deficiencies of the prior art discussed above. It is an object of the present invention to provide a scleral depressor that, when in use during surgery, can depress the sclera at substantially any desired location while avoiding other instruments.
  • a scleral depressor particularly suited for use during surgery that includes an elongated handle defining a first axis.
  • An extension member has one end attached to the proximal end of the handle and includes a blade at the remote end thereof.
  • the extension member defines a second axis and extends from the handle at approximately 90° thereby defining a plane.
  • a bulbous or cylindrically shaped blade located at the remote end of the extension member has its rounded surface extending out of the plane. By properly manipulating the handle, the rounded surface of the blade is used to depress the sclera.
  • Figure 1 is a side elevational view of first embodiment of a scleral depressor showing my invention
  • Figure 2 is a perspective view of the first embodiment of the invention shown in Figure 1 ;
  • Figure 3 is a front elevational view of the first embodiment
  • Figure 4 is a side elevational view showing a second embodiment of my invention.
  • Figure 5 is a perspective view of the second embodiment of the invention shown in Figure 4.
  • Figure 6 is a front elevational view of the second embodiment
  • Figure 7 is a side elevational view showing a third embodiment of my invention.
  • Figure 8 is a bottom plan view of the third embodiment of the invention shown in Figure 7, and
  • Figure 9 is a perspective view of the third embodiment. Best Modes for Carrying Out the Invention
  • Figures 1 , 2 and 3 a first embodiment of a scleral depressor constructed in accordance with the principles of the present invention and designated generally as 10.
  • the scleral depressor 10 is comprised essentially of an elongated handle 12 which defines a first axis.
  • the handle 12 includes a distal end 14 and a proximal end 16.
  • An extension 18 of the handle 12 has its first end 20 attached to the proximal end 16 of the handle and includes a second remote end 22.
  • extension member 18 is bent so that the latter portion or member 24 thereof defines an axis which is between
  • the second axis is approximately 90° from the first axis.
  • the axes of the handle 12 and of the portion 24 of the extension member 18 essentially define a plane which, as viewed in Figure 1 , is the plane of the paper.
  • a blade 28 is carried by the remote end 22 of the extension member 24 and includes rounded surfaces 30 and 32 on the sides thereof. As shown best in Figure 3, the rounded surface 30 extends in a first direction out of the plane approximately 90° to the plane. The second rounded surface 32 extends in a second direction substantially opposite to the first direction and out of the plane.
  • the blade 28 in the first embodiment is essentially bulbous shaped but other shapes are possible.
  • the second embodiment utilizes a cylindrically shaped blade 128.
  • the outer surface of the cylinder 128 provides the rounded surfaces 130 and 132 that extend in opposite directions out of the plane defined by the handle 1 12 and the lower portion 124 of the extension member 1 18.
  • the third embodiment of the invention as shown in Figures 7, 8 and 9 is also similar in most respects to the first embodiment shown in Figures 1 , 2 and 3. Accordingly, as with the second embodiment, many of the parts thereof will not be re-described and are referenced by the same reference numerals as above but preceded by a 2.
  • the primary difference between the first and third embodiments is in the curvature of the extension member between the handle portion and the blade.
  • the extension member 24 is bent essentially at a right angle.
  • the extension member 224 is a continuous arcuate curve.
  • radius of curvature is about 12.5 mm which is roughly the radius of the eye.
  • the arc is essentially 90 degrees.
  • the position of the bulbous blade 228 is essentially in the same 90 degree position from the handle 212 as the bulbous blade 28 is to the handle 12 of the first embodiment.
  • the third embodiment also differs from the first and second embodiments in that the free end 214 includes an additional blade 236.
  • the preferred form of the additional blade 236 is cylindrically shaped similar to blade 128. However, other blade shapes are also possible.
  • the improved scleral depressor 10, 1 10 or 210 of the present invention is used in the following manner.
  • the rounded surface 30 or 32, 130 or 132 or 230 or 232 is positioned adjacent the sclera at the desired position.
  • the blade 28, 128 of 228 is then moved in either the first or second direction out of the plane defined by the handle 12, 1 12 or 212 and the extension member 24, 124 224 so that the rounded surface depresses the sclera. This can be done by either moving the handle 12, 1 12 or 212 sideways to the left or right or by rotating the handle about its axis.

Abstract

A scleral depressor (10, 110, 220) includes an elongated handle (12, 112, 212) defining a first axis. An extension member (24, 124, 224) has one end (20) attached to the proximal end (16) of the handle and includes a blade (28, 128, 228) at the remote end thereof. The extension member defines a second axis and extends from the handle at approximately 90° thereby defining a plane. A bulbous (28, 228) or cylindrically shaped (128) blade located at the remote end of the extension member has its rounded surface (30, 32 or 130, 132 or 230, 232) extending out of the plane. By properly manipulating the handle, such as by rotating the same, the rounded surface of the blade is used to depress the sclera.

Description

Description
SCLERAL DEPRESSOR Technical Field
The present invention is directed toward an ophthalmic surgical and examination instrument used during surgery or during an eye examination for depressing the sclera. More particularly, the invention relates to a scleral depressor that provides improved manipulation and does not interfere with the examining physician's field of view.
Background Art As is well known in the art, scleral depressors are used to facilitate examination of the fundus or interior surface of the eye including the retina.
During such an examination, and particularly during the study of areas of the retina, it is sometimes necessary to control the position of the eye.
During vitrectomy surgery, instruments are placed through the sclera or white wall of the eye, into the vitreous cavity to repair or correct problems inside the eye. Complete surgical dissection of the peripheral vitreous and retina is not possible without deliberate depression of the sclera. Under most situations, the surgeon's hands are occupied with the surgical
instruments. Accordingly, an assistant is required to perform "scleral
depression." Several sclera depressors have been designed for this purpose.
Substantially all known prior art sclera depressors include a handle and a blade or depressing element that is attached to the handle and which extends therefrom. The blade is arranged to be either straight or at an offset angle from the handle to facilitate manipulation of the blade.
One known example of such a scleral depressor is available from
Inami Ophthalmic Instruments under the name Morizane. The blade of the orizane scleral depressor is in the form of a relatively flat triangle that faces in the same direction as the direction of the axis of the elongated handle. The depressor is designed to allegedly control the rotation of the eyeball along with the depression of the same.
Scleral depressors used during surgery typically have a blade depressing element in the form of a cylinder or that has a bulbous structure. The classical and optimal means to provide depression during surgery involves inserting the scleral depressor parallel to the axis of the eye and depressing the sclera in toward the center of the eye, perpendicular to the wall of the eye.
Typically, the patient is lying in a supine position with the surgeon at the top of the head and the assistant at the side, oriented 90° from the surgeon. The face and body of the patient are covered by sterile cloths with the operative eye being the only exposed body part.
Using the current straight scleral depressors that are available, the assistant, who is typically on the temporal or lateral side of the eye, has several obstacles to adequate scleral depression. For example, depression on the nasal side of the eye is difficult to access as it's on the opposite side as the assistant.
His or her hand has to reach all the way around the eye to access this region.
The superior side of eye is also difficult to access due to the assistant's hand interfering with the surgeon's hands and instruments and the inferior side of the eye is slightly limited to depression by the cheekbone. Even further, the handle and shaft of the depressor frequently hit the optical system for viewing inside the eye which are either hanging from the microscope above the eye (with the lowermost portion a few millimeters above the eye) or are sitting on the surface of the eye.
There is, therefore, a need for a scleral depressor that allows an assistant to apply a depression force to the sclera at almost any location and in almost any direction without interfering with the surgeon or any of the surgical instruments.
Disclosure of the Invention
The present invention is designed to overcome the deficiencies of the prior art discussed above. It is an object of the present invention to provide a scleral depressor that, when in use during surgery, can depress the sclera at substantially any desired location while avoiding other instruments.
It is another object of the present invention to provide a scleral depressor that, when in use during surgery, does not interfere with a surgeon's field of view.
It is a still further object of the present invention to provide a scleral depressor that, when in use during surgery, can be easily slid along the surface of the eye to a desired position without interfering with other instruments or with a surgeon's field of view.
In accordance with the illustrative embodiments demonstrating features and advantages of the present invention, there is provided a scleral depressor particularly suited for use during surgery that includes an elongated handle defining a first axis. An extension member has one end attached to the proximal end of the handle and includes a blade at the remote end thereof. The extension member defines a second axis and extends from the handle at approximately 90° thereby defining a plane. A bulbous or cylindrically shaped blade located at the remote end of the extension member has its rounded surface extending out of the plane. By properly manipulating the handle, the rounded surface of the blade is used to depress the sclera.
Other objects, features, and advantages of the invention will be readily apparent from the following detailed description of the preferred embodiment thereof taken in conjunction with the drawings.
For the purpose of illustrating the invention, there are shown in the accompanying drawings forms which are presently preferred; it being understood that the invention is not intended to be limited to the precise arrangements and instrumentalities shown.
Figure 1 is a side elevational view of first embodiment of a scleral depressor showing my invention; Figure 2 is a perspective view of the first embodiment of the invention shown in Figure 1 ;
Figure 3 is a front elevational view of the first embodiment;
Figure 4 is a side elevational view showing a second embodiment of my invention;
Figure 5 is a perspective view of the second embodiment of the invention shown in Figure 4;
Figure 6 is a front elevational view of the second embodiment;
Figure 7 is a side elevational view showing a third embodiment of my invention;
Figure 8 is a bottom plan view of the third embodiment of the invention shown in Figure 7, and
Figure 9 is a perspective view of the third embodiment. Best Modes for Carrying Out the Invention
With reference now to the drawings in detail wherein like reference numerals have been used throughout the various figures to designate like elements, there is shown in Figures 1 , 2 and 3 a first embodiment of a scleral depressor constructed in accordance with the principles of the present invention and designated generally as 10.
The scleral depressor 10 is comprised essentially of an elongated handle 12 which defines a first axis. The handle 12 includes a distal end 14 and a proximal end 16. An extension 18 of the handle 12 has its first end 20 attached to the proximal end 16 of the handle and includes a second remote end 22.
As shown in Figure 1 , the extension member 18 is bent so that the latter portion or member 24 thereof defines an axis which is between
approximately 90° to 120° from the axis of the handle 12. In the preferred embodiment of the invention, the second axis is approximately 90° from the first axis. The axes of the handle 12 and of the portion 24 of the extension member 18 essentially define a plane which, as viewed in Figure 1 , is the plane of the paper.
A blade 28 is carried by the remote end 22 of the extension member 24 and includes rounded surfaces 30 and 32 on the sides thereof. As shown best in Figure 3, the rounded surface 30 extends in a first direction out of the plane approximately 90° to the plane. The second rounded surface 32 extends in a second direction substantially opposite to the first direction and out of the plane. The blade 28 in the first embodiment is essentially bulbous shaped but other shapes are possible.
The second embodiment of the invention as shown in Figures 4, 5 and 6 is similar in most respects to the first embodiment shown in Figures 1 , 2 and 3 and described above. Accordingly, many of the parts thereof will not be re- described and are referenced by the same reference numerals as above but preceded by a 1 .
The only significant difference between the two embodiments is in the blade. In lieu of the bulbous blade 28, the second embodiment utilizes a cylindrically shaped blade 128. As shown most clearly in Figure 6, the outer surface of the cylinder 128 provides the rounded surfaces 130 and 132 that extend in opposite directions out of the plane defined by the handle 1 12 and the lower portion 124 of the extension member 1 18.
The third embodiment of the invention as shown in Figures 7, 8 and 9 is also similar in most respects to the first embodiment shown in Figures 1 , 2 and 3. Accordingly, as with the second embodiment, many of the parts thereof will not be re-described and are referenced by the same reference numerals as above but preceded by a 2.
The primary difference between the first and third embodiments is in the curvature of the extension member between the handle portion and the blade. In the first embodiment, the extension member 24 is bent essentially at a right angle. In the third embodiment, the extension member 224 is a continuous arcuate curve. In the preferred embodiment, radius of curvature is about 12.5 mm which is roughly the radius of the eye. The arc is essentially 90 degrees. As a result, the position of the bulbous blade 228 is essentially in the same 90 degree position from the handle 212 as the bulbous blade 28 is to the handle 12 of the first embodiment.
The third embodiment also differs from the first and second embodiments in that the free end 214 includes an additional blade 236. The preferred form of the additional blade 236 is cylindrically shaped similar to blade 128. However, other blade shapes are also possible.
The improved scleral depressor 10, 1 10 or 210 of the present invention is used in the following manner. During an eye examination or during surgery, the rounded surface 30 or 32, 130 or 132 or 230 or 232 is positioned adjacent the sclera at the desired position. The blade 28, 128 of 228 is then moved in either the first or second direction out of the plane defined by the handle 12, 1 12 or 212 and the extension member 24, 124 224 so that the rounded surface depresses the sclera. This can be done by either moving the handle 12, 1 12 or 212 sideways to the left or right or by rotating the handle about its axis.
In addition to the foregoing, with the embodiments of the invention shown in Figures 1 to 2 and Figures 7 to 9 with the bulbous blade 28 or 228, there are additional advantages over the prior art. Because of the bulbous shape, it can be moved in almost any direction for the purpose of scleral depression. The most likely directions would be in a circle perpendicular to the axis of the extension. So, if an assistant is depressing the nasal side of the eye, the motion of the blade would be in the general direction of the assistant. In all cases, however, there would be minimal interference with the surgeon or any surgical instruments.
The present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof and accordingly, reference should be made to the appended claims rather than to the foregoing specification as indicating the scope of the invention.

Claims

Claims
1 . A scleral depressor comprising:
an elongated handle having a distal end and a proximal end and defining a first axis;
an extension member having a first end attached to the proximal end of said handle and having a second remote end, said extension member defining a second axis which is between approximately 90° to 120° from said first axis; said first and second axes defining a plane, and
a blade carried by said extension member at the remote end thereof, said blade including a first rounded surface extending out of said plane in a first direction approximately 90 degrees from said plane.
2. The scleral depressor as claimed in claim 1 wherein said blade includes a second rounded surface extending out of said plane in a second direction substantially opposite to said first direction.
3. The scleral depressor as claimed in claim 2 wherein said blade is bulbous shaped extending in all directions about the axis of the extension member.
4. The scleral depressor as claimed in claim 2 wherein said blade is substantially cylindrically shaped.
5. The scleral depressor as claimed in claim 1 wherein the angle between said first and second axes is approximately 90°.
6. A method for depressing portion of the sclera of an eye during an examination or surgery comprising:
providing a scleral depressor having an elongated handle with a distal end and a proximal end and defining a first axis, said depressor further havingan extension member with a first end attached to the proximal end of said handle and having a second remote end, said extension member defining a second axis which is between approximately 90° to 120° from said first axis, said first and second axes defining a plane, and a blade carried by said extension member at the remote end thereof, said blade including a first rounded surface extending out of said plane in a first direction approximately 90 degrees from said plane;
positioning said blade adjacent the sclera at the desired position, and
moving said blade in said first direction to depress the sclera.
7. The method as claimed in claim 6 wherein said blade is moved by rotating said handle about its axis.
8. The method as claimed in claim 6 wherein said blade is bulbous in shape and can be moved in any direction to depress the sclera.
PCT/US2017/018258 2016-02-19 2017-02-17 Scleral depressor WO2017143117A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US16/076,737 US20190046176A1 (en) 2016-02-19 2017-02-17 Scleral Depressor
EP17753871.7A EP3416600A4 (en) 2016-02-19 2017-02-17 Scleral depressor

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US15/047,724 US10251634B2 (en) 2016-02-19 2016-02-19 Scleral depressor
US15/047,724 2016-02-19

Publications (1)

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WO2017143117A1 true WO2017143117A1 (en) 2017-08-24

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EP (1) EP3416600A4 (en)
WO (1) WO2017143117A1 (en)

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"SCHOCKET SCLERAL DEPRESSOR, DOUBLE ENDED", STEPHENS INSTRUMENTS, 3 April 2015 (2015-04-03), XP055411687, Retrieved from the Internet <URL:http://stephensinst.com/product/schocket-scleral-depressor-double-ended> [retrieved on 20170410] *
See also references of EP3416600A4 *

Also Published As

Publication number Publication date
EP3416600A4 (en) 2019-11-06
EP3416600A1 (en) 2018-12-26
US10251634B2 (en) 2019-04-09
US20170238919A1 (en) 2017-08-24
US20190046176A1 (en) 2019-02-14

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