WO2017195912A1

WO2017195912A1 - Lenticule separation tool for smile operation

Info

Publication number: WO2017195912A1
Application number: PCT/KR2016/004892
Authority: WO
Inventors: 강성용; 최진영
Original assignee: 강성용; 최진영
Priority date: 2016-05-10
Filing date: 2016-05-10
Publication date: 2017-11-16

Abstract

Disclosed is a lenticule separation tool for a SMILE operation. A lenticule separation tool for a SMILE operation according to an embodiment of the present invention comprises: a scraper elongated to have a length in one direction, the lower surface of the scraper having the same radius of curvature in the longitudinal direction as that of a flap surface, the scraper passing through the flap surface and a lenticule surface and cutting a tissue bridge between the cornea and the lenticule, thereby separating the lenticule; and a handle portion having a length in the same direction as the scraper, the handle portion being connected to an end of the scraper so as to have an upward inclination such that the user holds the same.

Description

Smile surgical lenticular separation tool

The present invention relates to a lenticular separation tool for smile surgery, and more particularly, to remove lenticular by removing a tissue bridge from the cornea in a smile surgery using a low energy close to the critical energy, which is the minimum energy for separating the lenticules. The present invention relates to a smile surgical lenticular separation tool.

The use of refractive surgery, which realizes correction of incomplete vision, continues to increase at the same time. In this case, the purpose of the surgical method is to selectively alter the cornea to affect the refraction of light. Various surgical methods are known for this purpose.

The most widely used today is known as laser assisted in-situ keratomileusis, also abbreviated as LASIK. In this case, the corneal lamellar is first separated from the corneal surface of one side and folded to the other side. The lamella can be separated by means known as a mechanical microkeratome or a laser keratome such as sold by Intralase Corp., Irvine, USA. Once the corneal lamellar is detached and folded on the other side, LASIK surgery applies an excimer laser that removes the exposed corneal tissue by ablating in this way. When the volume located in the cornea evaporates in this way, the corneal lamellae unfold again.

Exposing the lamellae (also known as flaps) by applying laser keratone is advantageous because it reduces the risk of infection and increases the quality of the incision. In particular, lamellae can be produced with a much more constant thickness. The incision is also likely to be smoother, which reduces subsequent optical disturbances due to this interface remaining after surgery.

When creating an incision surface in the cornea by laser irradiation, conventional pulsed laser irradiation is introduced into the tissue, where the length of the pulse is generally less than 1 ps. As a result, the power density required to trigger optical penetration for each pulse is limited to a small spatial region. In this regard, U. S. Patent No. 5,984, 916 clearly discloses that the spatial region of optical penetration (in this case the interaction created) is highly dependent on the pulse duration. Therefore, high focusing of the laser beam allows optical penetration with the short pulses described above to be used with precise precision on the cornea. In order to create an incision, a series of optical penetrations are created at a predetermined point so that a incision surface is formed as a result. In the laser kerattom described above, the incision surface forms a folding lamella before using the laser flux.

In conventional LASIK methods, exposed corneal tissue is vaporized, also referred to as "grinding" of the cornea by laser irradiation. The removal of the volume needed to correct incomplete vision is in this case set for each surface element of the exposed cornea by the number of laser pulses and their energy. Different amounts of material are removed depending on the number and energy of the laser pulses.

Very recently, the surgical methods mentioned at the outset have been disclosed and the first trials conducted. Laser irradiation is used to separate the volume within the cornea and then to remove the tissue section that forms the volume. Since pulsed laser irradiation is also commonly used in this case as well, femtosecond lenticule extraction or abbreviation is referred to flex. Volumes are called lenticules.

Now, an experimental value suitable for polishing the cornea by ablative laser irradiation is determined by the refractive ophthalmology, in which the volume to be removed from the cornea is adequately removed to be removed by isolation within the cornea by a three-dimensional incision rather than by ablation of the exposed corneal tissue. It cannot be used for the flex method of surgery because on the one hand the evaporation of the substance to be removed and on the other hand removing the isolated volume is too different. Since there is no such incision surface in conventional LASIK surgery, this is especially true when selecting an incision surface that bounds the volume to be removed. Since the incision surface has different surface structures, the treatment process after surgery is also different.

Manual removal requires specific mechanical stability of the slice sections, which is an additional requirement along with the intended refractive effect. In addition, shipment is required to minimize or at least be predictable the refractive effect of the treatment process.

If the isolated volume breaks (breaks) during the manual extraction process, the isolated volume in itself presents no problem to the refraction effect. However, it is necessary to eliminate the isolated volume as completely as possible, which is a requirement to be strictly adhered to, especially in the optically related areas (projection of the pupil opening into the cornea) to avoid further optical aberrations. Thus, rupture of the isolated volume may be associated with a major additional effect in removing a portion of the isolated volume, as a result being less stable and jeopardizing the success of refractive therapy.

It is also desirable to make refractive changes (also known as degeneration) as small and predictable as possible during the course of treatment.

The present invention has been made to solve the above-mentioned conventional problems, the object of the present invention is as follows.

First, the present invention is suitable for Asians, and is intended to provide a smile surgical lenticular separation tool that can minimize the damage to the eye by intensively applied to a portion of the eye when removing the lenticule.

Second, the present invention is to provide a smile surgical lenticular separation tool that can separate the lenticule by removing the tissue bridge more effectively during the low-energy smile surgery close to the critical energy, which is the minimum energy for separating the lenticules.

The objects of the present invention are not limited to the above-mentioned objects, and other objects that are not mentioned will be clearly understood by those skilled in the art from the following description.

In order to achieve the above object, a smile surgical lenticular separation tool according to an embodiment of the present invention includes a scraper and a handle part.

The scraper is formed to have a length in one direction, the lower surface has the same radius of curvature as the flap surface in the longitudinal direction. Then, the tissue bridge between the cornea and the lenticule is cut through the flap surface and the lenticule surface to separate the lenticules.

The handle part has a length in the same direction as the scraper, and is connected to one end of the scraper so as to be inclined upward to be gripped by the user.

Here, the flap surface may be formed parallel to the rear surface of the cornea.

And, the radius of curvature of the flap surface may be formed between 8.3mm ~ 8.7mm which is the average curvature of the cornea of the Asian.

In addition, the curvature of the scraper according to the radius of curvature of the flap surface may be changed according to the radius of curvature of the flap surface.

To this end, when the desired radius of curvature is input after the scraper is inserted, a curvature change device for applying heat and pressure to the scraper to change the radius of curvature of the scraper into a radius of curvature input by a user may be provided.

On the other hand, the connecting portion which is a portion that is connected to the scraper and the handle portion may be formed to have a curvature.

In addition, the cross section perpendicular to the longitudinal direction of the scraper may increase in height toward the center.

The lower portion of the cross section perpendicular to the longitudinal direction of the scraper may have the same radius of curvature as the radius of curvature of the scraper in the longitudinal direction.

The other end of the scraper may be formed with a round portion having a diameter larger than the width of the cross section perpendicular to the longitudinal direction of the scraper.

The edge portion of the round portion may be formed to decrease in thickness toward the outside.

Referring to the effects of the present invention configured as described above are as follows.

First, the lenticular separation tool for smile surgery according to an embodiment of the present invention has the same curvature as the lenticular curvature according to the curvature of the front surface of the cornea of the Asian, and thus is suitable for the operation of the Asian. Can be removed. In addition, since the connecting portion connecting the scraper and the handle portion has a curvature, it is possible to minimize damage to the eye by the connecting portion when the lenticule is removed.

Second, the corneal damage is minimized and the quality of vision is improved through low energy smile LASIK, which is close to the critical energy, which is the minimum energy for separating the lenticules, and a smile surgical lenticular separation tool according to an embodiment of the present invention is used. Fast and accurate separation of the lenticules from the corneal parenchyma allows for rapid recovery.

The effects of the present invention are not limited to the above-mentioned effects, and other effects not mentioned will be clearly understood by those skilled in the art from the description of the claims.

The above summary as well as the detailed description of the preferred embodiments of the present application described below will be better understood when read in connection with the accompanying drawings. Preferred embodiments are shown in the drawings for the purpose of illustrating the invention. However, it should be understood that the present application is not limited to the precise arrangements and instrumentalities shown.

1 is a plan view of an ocular cornea having a lenticule and an incision;

2 is a cross-sectional view of FIG. 1;

3 is a perspective view of a smile surgical lenticular separation tool according to an embodiment of the present invention;

Figure 4 is a view showing the separation of the lenticules from the corneal parenchyma using the smile surgical lenticular separation tool according to an embodiment of the present invention;

5 is a cross-sectional view taken along line A-A of FIG. 4;

6 is a cross-sectional view taken along line B-B in FIG. 4;

Figure 7 is an enlarged view of the scraper portion of the smile surgical lenticular separation tool according to an embodiment of the present invention;

8 is a photograph showing the state of the cornea according to the high-energy smile surgery and low-energy smile surgery;

9 to 11 are photographs showing the separation of the lenticular from the corneal stroma using the smile surgical lenticular separation tool according to an embodiment of the present invention; And

12 is a photograph showing a state in which the lenticules are taken out through the incision using tweezers.

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings. However, the accompanying drawings are only described in order to more easily disclose the contents of the present invention, but the scope of the present invention is not limited to the scope of the accompanying drawings that will be readily available to those of ordinary skill in the art. You will know.

In describing the embodiments of the present invention, the same components and the same reference numerals are used for the components having the same functions, and are not completely identical to the components of the prior art.

Also, the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. Singular expressions include plural expressions unless the context clearly indicates otherwise. In this application, the terms "comprise" or "have" are intended to indicate that there is a feature, number, step, operation, component, part, or combination thereof described in the specification, and one or more other features. It is to be understood that the present invention does not exclude the possibility of the presence or the addition of numbers, steps, operations, components, components, or a combination thereof.

First, in order to remove the lenticules excised from inside the corneal parenchyma according to the vision correction surgery according to the present invention, the incision formed in the cornea is largely an incision formed in the front of the cornea, and the corneal parenchyma in which the lenticule is located from the incision. It is formed to extend into the inside is divided into a cutting tunnel connected to the flap surface, and will be described in detail with reference to the drawings illustrated below.

Prior to the description of the incision in accordance with the present invention, the femtosecond laser is a corneal tissue is turned into a gas plasma when the pulsed laser beam is irradiated to the corneal tissue is made of extremely fine bubbles, through the continuous process of the corneal tissue accurately The principle is to ablate as much as desired, and by using such femtosecond laser, the laser beam penetrates the corneal surface and cuts and separates the lenticulars, which are corneal parenchymal fragments of the correct amount, such as hyperopia, astigmatism, myopia, presbyopia, or mixed astigmatism. The surgery to correct incomplete vision of the back is called Smile Incision Lenticule Extraction.

In addition, even if another laser or the same laser with a similar effect is used in different companies, even if the name is different, it is regarded as the same type of surgery.

The laser beam described above allows each spot to create optical penetrations in the corneal stroma, which penetrates the plasma bubble, thereby separating the lenticular fragments of the corneal stroma from the corneal stroma.

To ablate the lenticular, the focus of the laser beam is directed towards the target point in the cornea in areas located below the epithelial and Bowman's membranes and above the Descemet's and endothelial tissues. To this end, the femtosecond laser has a mechanism for displacing the focal position of the laser beam in the cornea, and a detailed description of such a mechanism will be omitted.

1 is a plan view of an ocular cornea having a lenticule and an incision, and FIG. 2 is a cross-sectional view of FIG. 1.

As shown in FIGS. 1 and 2, the laser beam is irradiated into the corneal parenchyma 150 helically toward the center of the cornea 100 or outward from the center, displacing the focal position, and thus the upper corneal parenchyma 150. The upper and lower flap planes 110 that can be separated from the flap surface 110, and the lenticular surface 120, which is a lower separation plane that can be separated from the lower corneal parenchyma 150 while having the same center point as the flap plane 110, The flap surface 110 is formed larger than the lenticular surface 120, wherein the outer periphery of the lenticular surface 120 intersects at any point toward the center from the outer periphery of the flap surface 110, the cornea The stereoscopic lenticular 130 having a lens shape is excised from the parenchyma 150. Here, when the incomplete visual acuity is not corrected, the imaging effect is on the one hand from the ocular lens that relaxes when the eye is not controlled, On the other hand It is substantially defined by a cornea front (100a) and the corneal back surface (100b) Similarly, due to the curvature radius is derived from the cornea 100 of the eye having an image-forming effect. That is, the optical effect of the cornea 100 is due to the radius of curvature of the entire cornea 100a.

In addition, since the flap surface 110 is formed to have a constant distance from the corneal front surface 100a after the correction, the flap surface 110 has a curvature path located at a predetermined distance below the corneal front surface 100a after the correction. That is, a radius of curvature smaller than the radius of curvature of the cornea 100 after the correction may be specified with respect to the flap surface 110 by a distance between the cornea front surface 100a and the flap surface 110.

The thickness of the lenticules 130 to be removed from the cornea 100 is generally determined by the lenticular surface 120 which is not at a constant distance from the corneal front 100a.

Here, the outer circumference of the lenticular surface 120 may be formed to be spaced apart without crossing any one point toward the center from the outer circumference of the flap surface 110, wherein the outer circumference and flap of the lenticular surface 120 One point from the outer periphery of the surface 110 toward the center is connected through a separate incision surface by irradiation of a laser beam with a change in the position of the focal point, so as to form a three-dimensional lens other than the lens shape from the corneal parenchyma 150. Ticule 130 may be ablation.

As such, when the lenticules 130 are excised in the corneal parenchyma 150, the excised lenticules 130 are drawn out of the cornea 100 and removed.

In this case, in order to draw the lenticules 130 to the outside of the cornea 100, the corneal 100 may be a separation tool 200 or a completely separated lenticule 130 that completely separates the lenticules 130 from the corneal parenchyma 150. The house which can be drawn out is formed in the cornea 100 with a cutout 140 consisting of a cut-out inlet 141 and a cut tunnel 142 so that the tool can enter and exit.

It includes an incision 141 and an incision tunnel 142 constituting the incision 140, first, the incision 141 is a horizontal direction so that the laser beam using a femtosecond laser is curved on the surface of the cornea 100 It is formed to be irradiated with, the transverse length is usually composed of a length of about 2mm to 4mm, the longitudinal width is composed of a length of about 0.11mm around.

The location of the incision 141 may be formed on the surface of the cornea 100 that meets a vertical line facing upward at an outer circumference of the flap surface 110 formed inside the corneal parenchyma 150, for example.

In another embodiment, the location of the incision 141 may be formed in the corneal front surface 100a that meets an acute or obtuse line toward the upper side from the outer circumference of the flap surface 110 formed inside the corneal parenchyma 150.

Incision 141 may be formed in a variety of positions in the radial direction as well as up, down, left, and right with respect to the center of the flap surface 110, the position can be changed depending on the surgical direction of the operator or the position of the eyeball fixing device. have.

The incision 141 may be formed in a plurality of positions at various positions in a radial shape as well as up, down, left, and right with respect to the center of the flap surface 110.

The incision tunnel 142 is a passage extending from the incision 141 described above toward the lenticule 130 inside the corneal parenchyma 150, through the incision 141 described above and the incision tunnel 142. A separation tool 200 or tweezers is inserted to completely separate the lenticules 130 from the corneal parenchyma 150. The separated lenticules 130 use the tweezers to cut the incision tunnel 142 and the incision 141. It is withdrawn to the outside and removed.

The incision tunnel 142 has a predetermined depth in the process of forming the above-described incision 141 on the corneal front surface 100a through the irradiation of a laser beam to the inside of the corneal parenchyma 150 where the lenticule 130 is located. The tip of the incision tunnel 142 facing the inside of the corneal parenchyma 150 is preferably connected to the flap surface 110.

The incision tunnel 142 is formed by an incision tool inserted into the corneal parenchyma 150 where the lenticule 130 is located through the incision 141 after the incision 141 is formed, and the tip end of the incision tunnel 142. May be connected to the flap surface 110.

The incision tunnel 142 has a length corresponding to the transverse length of the incision 141 described above, and the longitudinal width also has a length corresponding to the longitudinal width of the incision 141 described above.

In the connection between the front end of the incision tunnel 142 and the flap surface 110, the front end of the incision tunnel 142 may be connected to the outer circumference of the flap surface 110, and if necessary, the front end may be the outer side of the flap surface 110. It may be connected at any one point inward from the perimeter to the center.

Therefore, the cutting tunnel 142 may be variously modified depending on the position of the tip portion and the position of the cutting opening 141 described above.

That is, the distal end portion of the incision tunnel 142 is connected to the outer circumference of the flap surface 110, the incision 141 is formed in the corneal front surface (100a) that meets in a vertical line on the outer circumference of the flap surface 110, the incision 140 can be made.

And the distal end portion of the incision tunnel 142 is connected to the outer periphery of the flap surface 110, the incision 141 is formed in the corneal front surface (100a) that meets the acute or obtuse line around the outer flap surface 110 incision The unit 140 may be made.

In addition, the front end portion of the incision tunnel 142 is connected to any one portion of the inner side toward the center from the outer circumference of the flap surface 110, the incision 141 is in front of the cornea that meets the vertical line on the outer circumference of the flap surface 110 The cutout 140 may also be formed at 100a.

In addition, the distal end portion of the incision tunnel 142 is connected to any one portion of the inner side toward the center from the outer periphery of the flap surface 110, the inlet 141 is an acute angle line or obtuse line in the outer periphery of the flap surface 110 and The incision 140 may be formed on the meeting cornea front surface 100a.

Meanwhile, as described above, the flap surface 110 is formed of a plurality of spots that are continuous as the spots of the laser beam starting at the center of the cornea 100 are formed outward while drawing a dense spiral. It is to be an incision line, and the flap surface 110 may be incision from the corneal parenchyma 150 by this incision line.

Therefore, the distal end of the incision tunnel 142 is connected to the outer periphery of the flap surface 110 is that the distal end is located in the last incision line portion forming the outer periphery of the flap surface 110 is connected to each other, the incision tunnel ( 142 is connected to any one point of the inner side toward the center from the outer circumference of the flap surface 110, that is, the front end portion of any one of the incision line located inward toward the center from the outer circumference of the flap surface 110 It means that it is located and connected to each other.

Here, the flap surface 110, which is an upper separation surface of the corneal parenchyma 150 and the lenticule 130, and the lenticular surface 120, which is a lower separation surface of the corneal parenchyma 150 and the lenticule 130, has a spot shape. The spot of the laser beam is irradiated while drawing a dense spiral to cut the lenticular 130 of the three-dimensional form from the corneal parenchyma 150, but the corneal parenchyma 150 due to the tissue bridge that is the area between the spot and the spot of the laser beam From the lenticules 130 is not completely separated.

Therefore, after the separation tool 200 is inserted through the above-described inlet 141 and the incision tunnel 142, the separation tool 200 passes through the lenticular surface 120 as a whole, and the flap surface 110 also passes through as a whole. By cutting the above-described tissue bridge by the separation tool 200 which passes by, it is possible to completely separate the lenticules 130 from the corneal stroma 150. Then, the separation tool 200 is removed and the incision 141 is removed. And tweezers such as tweezers through the incision tunnel 142, and then pull out the lenticules 130 completely separated from the corneal parenchyma 150 through the incision tunnel 142 and the incision opening 141. Just do it.

3 is a perspective view of a smile surgical lenticular separation tool according to an embodiment of the present invention.

And, Figure 4 is a view showing the separation of the lenticules from the corneal parenchyma using the smile surgical lenticular separation tool according to an embodiment of the present invention, Figure 5 is a cross-sectional view of Figure 4 AA, Figure 6 It is BB sectional drawing of FIG.

Figure 7 is an enlarged view of the scraper portion of the smile surgical lenticular separation tool according to an embodiment of the present invention.

As shown in Figure 3, the present invention relates to the separation tool 200 is inserted through the incision 141 and the incision tunnel 142 for the smile surgical lenticular separation tool 200, the present invention Separation tool 200 according to an embodiment of the scraper 210 and the handle portion 220.

As shown in FIG. 4, the scraper 210 passes through the flap surface 110 and the lenticular surface 120 and cuts the tissue bridge between the cornea 100 and the lenticule 130 to cut the lenticular 130. As a separating part, it is formed to be thin and long to have a length in one direction. The length of the scraper 210 may be formed to be the same as or similar to the diameter of the lenticules 130 formed during the smile LASIK of Asians.

As shown in FIG. 5, the lower surface of the scraper 210 has the same radius of curvature as the flap surface 110 in the longitudinal direction. The flap surface 110 here may be formed in parallel with the corneal front surface 100a after the correction. The corneal front 100a after the correction may be formed in parallel with the rear surface of the cornea.

Table 1 below shows the average radius of curvature of the Asian cornea.

The radius of curvature of the corneal back surface 100b of Asians is, on average, between 6.4 mm and 6.8 mm, and thus the radius of curvature greater by the distance between the flap surface 110 and the flap surface 110 than the curvature radius of the corneal back surface 100b. This may be specified for the flap surface 110.

Oriental corneas have an average thickness of 550 μm, with a distance of 120 μm from the front of the cornea to the flap surface. Therefore, the distance from the back surface of the cornea to the flap surface is 430 µm on average.

That is, the radius of curvature R of the flap surface may be 6.83mm≤R≤7.23mm. Accordingly, the radius of curvature of the scraper may also be 6.83 mm ≤ R ≤ 7.33 mm.

In general, Asian cornea 100 has a more convex form than Westerners. That is, the radius of curvature of the cornea 100 of the Asian is smaller than the radius of curvature of the cornea 100 of the Western. Therefore, even with the same smile lasik surgery, it is better to use different tools depending on race.

In the present embodiment, the scraper 210 has a radius of curvature equal to the radius of curvature of the flap surface 110 of the Asian, so that the flap surface 110 can be neatly separated with less rotation time than before.

Therefore, the operation time can be shortened, which can shorten the contact time of the corneal parenchyma with air and can maximize the advantages of low-energy smile surgery. In other words, the possibility of infection may be lowered and a rapid recovery may be expected after surgery.

As shown in FIG. 6, the cross section perpendicular to the longitudinal direction of the scraper 210 may be formed as a curved surface that increases in thickness toward the center. In addition, the lower end of the cross section perpendicular to the longitudinal direction of the scraper 210 may have the same curvature radius as the radius of curvature of the scraper 210 in the longitudinal direction.

In addition, as shown in FIG. 7, one end of the scraper 210 may be formed with a rounded round part 212. The round part 212 may be formed in a circular shape having a diameter larger than the width of the cross section perpendicular to the longitudinal direction of the scraper 210. The edge portion of the round portion 212 may be formed to decrease in thickness toward the outside.

Accordingly, the scraper 210 may move more smoothly on the flap surface 110 and the lenticular surface 120, and the scraper 210 passes through the flap surface 110 and the lenticular surface 120. It is possible to minimize the possibility of damaging the product. That is, the lenticules 130 may be more completely removed.

On the other hand, the radius of curvature of the scraper 210 is set to the same state as the radius of curvature of the flap surface 110 of the Asian in the initial state. However, since the curvature radius of the flap surface 110 of everyone is not the same, the curvature of the scraper 210 can be changed according to the curvature radius of the flap surface 110.

In order to implement this, a curvature changing device capable of changing the curvature of the scraper 210 may be provided. The curvature changing device may insert the scraper 210 and input a desired curvature to apply heat and pressure to the scraper 210 to change the curvature of the scraper 210 to the curvature input by the user.

To this end, the material of the scraper 210 is not changeable by external force at room temperature, but a material that can be deformed by applying pressure at a predetermined temperature or more may be applied.

Of course, the apparatus for changing the curvature of the scraper 210 is not limited to the above-described, any one that can change the curvature of the scraper 210 may be applied.

Meanwhile, as illustrated in FIGS. 3 and 5, one end of the scraper 210 has a length in the same direction as the scraper 210 and a handle portion 220 having an inclination upward. The handle portion 220 is a portion for holding and detaching the separation tool 200 according to the present embodiment by hand, and may have a straight line shape.

In addition, the connecting portion 230, which is a portion to which the scraper 210 and the handle portion 220 are connected, may be formed to have a curvature.

The connection portion 230 is a portion that supports the separation tool 200 to the cornea 100 when the scraper 210 moves in the corneal parenchyma 150. The connection portion 230 mainly handles the connection portion 230 in the state fixed to the cornea 100. The lenticular 130 is separated by rotating the unit 220.

At this time, the separation tool 200 inserted into the incision 141 and the incision tunnel 142 is moved along the lenticular surface 120 and the flap surface 110 and the separation tool 200 in the process of cutting the tissue bridge. A force supporting the force may be applied to a portion of the cornea 100 supporting the connector 230 through the connector 230.

If the scraper 210 and the handle portion 220 are sharply connected to each other, the cornea 100 may be damaged by the connection portion 230, and the damage may be easily exposed to external infection. This can slow down stabilization and slow down postoperative recovery.

Therefore, the connection portion 230 is formed to have a curvature, thereby dispersing the force, thereby minimizing damage to the cornea 100.

Hereinafter, the process of the smile LASIK operation will be described with reference to FIGS. 8 to 12.

8 is a photograph showing the state of the cornea according to the high-energy smile surgery and low-energy smile surgery, Figures 9 to 11 are lenticular from the corneal stroma using a lenticular separation tool for smile surgery according to an embodiment of the present invention 12 is a photograph showing a state of separating the lenticules to the outside through the incision using a pick-up tool.

First, the partially anesthetized subject is laid on a bed with a femtosecond laser, and then the triple centrifugation is performed in consideration of the error between the pupil axis and the visual axis.

Here, the centration is a technique that proceeds to the center of the cornea 100 to increase the accuracy of the surgery, it is possible to prevent light bleeding or glare diplopia.

The triple centrifugation is based on the marking of the center of the pupil and the femtosecond laser, and the marking of the center of the femtosecond laser and the marking of the femtosecond laser. May cause the laser beam of the to be irradiated.

After the triple centrifugation is completed, the laser beam is irradiated to the cornea 100 from a femtosecond laser which is programmed according to the corneal 100 correction amount of the subject, and draws a spiral toward the center of the cornea 100 from the outside. While a plurality of spots are formed in succession, a lenticular surface 120 separated from the corneal parenchyma 150 is formed first.

Subsequently, the laser beam of the femtosecond laser has a displacement of a focal position, a focal point is formed above the lenticular surface 120, and a plurality of spots are continuously drawn while spiraling outward from the center of the cornea 100. The flap surface 110 is formed to be separated from the corneal parenchyma 150, the size of the flap surface 110 is formed larger than the lenticular surface 120, the outer periphery of the lenticular surface 120 is the flap surface Three-dimensional lenticules 130 having upper and lower flap surfaces 110 and lenticular surfaces 120 are excised from the corneal parenchyma 150 while crossing inside the outer circumference of the outer circumference 110.

As described above, the laser beam is irradiated into the corneal stroma 150 to ablate the lenticules 130 from the corneal stroma 150. At this time, a minimum energy is required in the process of separating the lenticules 130. This is called threshold energy, and the lower the energy near the threshold, the less corneal damage and the better the visual quality. This method of surgery is called Low Energy SMILE.

As can be seen in the left photo of FIG. 8, the higher the energy of the laser, the larger and more bubbles are generated on the flap surface 110 and the lenticular surface 120, resulting in a rough and uneven corneal cutting surface. In other words, damage to the cornea may cause problems such as edema, cloudy vision, and slow recovery.

On the other hand, according to the low energy smile surgery (Low Energy SMILE), as shown in the right picture of FIG. This can improve the discomfort of the blurred vision and slow vision recovery that lasted 2-3 weeks after conventional smile surgery.

Indeed, the rate of achieving monocular 1.0 in one day after surgery in high-energy smile surgery is 42% of all patients, but the rate of achieving monocular 1.0 in one day after surgery in low-energy smile surgery is 91% of all patients.

In addition, minute refractive errors, high-order aberrations, and coma aberration of the eye causing light bleeding occur less as the energy of smile lasik is lower, and the low energy smilelasik decreases by 36.7% on average compared to the increase in coma after the high energy smile lasik. The same 1.0 can provide clearer vision.

Then, the lenticules 130 are completely separated from the corneal parenchyma 150, and then the curved transverse lengths are formed on the front surface 100a of the cornea that is close to the outer periphery of the flap surface 110 in order to draw out the cornea 100. The incision 141 and the incision tunnel 142 having the same transverse length as the incision 141 and communicating with the incision line of the flap surface 110 are formed.

As such, after the incision tunnel 142 and the inlet 141 are made, the separation tool 200 is inserted through the inlet 141 and the incision tunnel 142 as shown in FIG. 9, and then FIG. 10. As shown in, the separation tool 200 is inserted into the flap surface 110 through the incision 141 and the incision tunnel 142, and is not completely separated by the tissue bridge while rotating in both directions along the flap surface 110. Flap surface 110 is completely separated from corneal parenchyma.

And, as shown in FIG. 11, the separation tool 200 is inserted into the lenticular surface 120, and the corneal parenchyma is not completely separated by the tissue bridge while bidirectionally rotating along the lenticular surface 120. Completely separate from

Here, since the scraper 210 of the separation tool 200 of the present embodiment has the same radius of curvature as the radius of curvature of the flap surface 110, the rotation time of the separation tool 200 can be reduced, thereby reducing the operation time. Can be. In addition, the shortening of the operation time means a shortening of the time for which the corneal parenchyma 150 is in contact with the air, thereby reducing the possibility of infection and enabling rapid recovery of the tissue. As a result, the advantages of low energy smile surgery may be maximized.

At this time, after the separation of the flap surface 110 is completed, the separation tool 200 is completely removed from the incision 141 and then inserted into the incision 141 again to separate the lenticular surface 120. Although, the separation tool 200 may be moved directly toward the lenticular surface 120 through a skill of finely lowering the inside of the incision tunnel 142 without completely removing the outside of the incision 141. Then, the separation tool 200 is rented. By using a technique that completely separates the lenticular surface 120 from the corneal parenchyma 150 while rotating in both directions along the curved surface 120, the procedure time can be shortened as much as possible.

Of course, the lenticular surface 120 may be separated first, and then the flap surface 110 may be separated.

Thus, after completely separating the lenticules 130 from the corneal parenchyma 150 through the separation tool 200, the lenticular through the incision 141 and the incision tunnel 142 as shown in FIG. 12. (130) is placed into the corneal parenchyma (150) is located, then picked up the separated lenticules 130 and removed from the incision 141, and then put the eye solution through the incision 141 and the separation tool (200) Use to remove and organize the floats.

As described above, the preferred embodiments of the present invention have been described, and the fact that the present invention can be embodied in other specific forms in addition to the above-described embodiments without departing from the spirit or scope thereof has ordinary skill in the art. It is obvious to them. Therefore, the above-described embodiments should be regarded as illustrative rather than restrictive, and thus, the present invention is not limited to the above description and may be modified within the scope of the appended claims and their equivalents.

Claims

A scraper which is formed to have a length in one direction, passes through the flap surface and the lenticule surface, and cuts the tissue bridge between the cornea and the lenticule to separate the lenticules; And

A handle part having a length in the same direction as the scraper and connected to one end of the scraper so as to be inclined upwardly and formed to be gripped by a user;

Including;

The scraper is a smile surgical lenticular separation tool having a lower surface the same radius of curvature as the flap surface in the longitudinal direction.
The method of claim 1,

The flap surface of the smile surgical lenticular separation tool is formed parallel to the back of the cornea.
The method of claim 2,

The radius of curvature of the flap surface,

Smile surgical lenticular separation tool of 6.83mm≤R≤7.23mm which is the average radius of curvature of the corneal back of Asians plus the distance from the corneal back to the flap surface.
The method of claim 1,

Smile surgical lenticular separation tool that can change the curvature of the scraper in accordance with the radius of curvature of the flap surface.
The method of claim 4, wherein

After inserting the scraper, if the desired radius of curvature is a smile surgical lenticular separation tool provided with a curvature changing device for applying heat and pressure to the scraper to change the radius of curvature of the scraper to the curvature radius input by the user.
The method of claim 1,

Smile surgical lenticular separation tool is formed to have a curvature of the connecting portion is a portion that is connected to the scraper and the handle portion.
The method of claim 1,

The cross section perpendicular to the longitudinal direction of the scraper is,

Smile surgical lenticular separation tool that increases in height toward the center.
The method of claim 1,

Smile surgical lenticular separation tool having a lower portion of the cross section perpendicular to the longitudinal direction of the scraper has the same radius of curvature as the radius of curvature of the scraper.
The method of claim 1,

At the other end of the scraper,

Smiley lenticular separation tool is formed with a round portion having a diameter larger than the width of the cross section perpendicular to the longitudinal direction of the scraper.
The method of claim 9,

Smile surgical lenticular separation tool is formed so that the edge portion of the round portion is reduced in thickness toward the outside.