WO2020197517A1

WO2020197517A1 - A symblepharon ring set

Info

Publication number: WO2020197517A1
Application number: PCT/TR2019/050974
Authority: WO
Inventors: Altan Atakan OZCAN
Original assignee: Cukurova Universitesi Rektorlugu
Priority date: 2019-03-27
Filing date: 2019-11-19
Publication date: 2020-10-01
Also published as: TR201904587A2

Abstract

The invention relates to a symblepharon ring-tissue-specific locking system developed for patients of advanced age and who cannot undergo general anesthesia in a single procedure, without the need for any suture for eye diseases and corneal wounds with symblepharon.

Description

A SYMBLEPHARON RING SET

TECHNICAL FIELD

The invention relates to a single symblepharon ring-tissue locking system for eye diseases and corneal wounds associated with Symblepharon (Adhesion), developed in a single operation without the need for any suture, especially in emergencies or for patients who cannot receive general anesthesia at an advanced age.

PRIOR TECHNIQUE

Adhesion of the eyeball and the eyelid (symblepharon) is an important eye condition that can cause movement restriction and dysfunction in the eye and eyelids. This undesirable condition may occur after Membranous Conjunctivitis of the eyelid and Bulbus Conjunctiva, Alkali or Acid Burns, Steven-Johnson Syndrome, Benign Ocular Pemphigoid and Conjunctival Trauma.

Corneal wounds may develop as a result of these diseases or secondary to infection, trauma, surgery or dry eye. Unfortunately, if these diseases, which are most urgent, could not be treated at the right time can cause permanent visual disturbances.

In the acute phase, implantation of the "Symblepharon Ring" is useful for the prevention of symblepharon (Adhesion), but in most cases tissue grafts are needed to protect the ocular surface from the possibility of puncture and to suppress inflammation. Similarly, in the case of corneal wounds that do not heal or the possibility of perforation of the cornea, tissue grafts are applied both to support and to suppress inflammation. Buccal mucosal grafts and amniotic membrane are the accepted approaches in the treatment of grafts. Oral mucosa graft can be taken from the lips or cheeks. A graft as thin as possible should be obtained. Amniotic membrane is the innermost layer obtained from placenta and contains many growth factors (EGF, bFGF, HGF, KGF, TGF a, TGF b-1 , b-2, b-3), both suppressing inflammation and accelerate epithelialization. At the same time, it supports the tissue underneath and prevents perforations. All grafts are placed on the ocular surface with absorbable sutures or tissue adhesives, and it is recommended to place an acrylic symblepharon ring in the lid to fit the surface, and there may be difficulties in fixing the grafts with the suture on the ocular surface. The first study of this treatment was reported by Dr: Rotth in the United States in 1940; With the use of human amniotic membrane; In the early 1990s, amniotic membrane transplantation was performed. General anesthesia is often required for these procedures and there may be difficulties in fixing the grafts with suture to the ocular surface.

BRIEF DESCRIPTION OF THE INVENTION

The invention is a single system capable of performing two procedures at the same time, especially in the event of a risk of melting or perforation of the eye in urgent conditions, or for those in need of such treatment and for those who are inconvenient to enter the operating room at an advanced age. In this way, the patient can be applied to the eye surface by inserting the symblepharon ring in a single operation without the need for repeated surgery and without any suture application. As a result, it is often difficult to suture these tissues on the ocular surface, tissue may rupture during the surgical procedure, and sutures can be opened and tissue dissociation can be observed during follow-up. In some cases, sutures cause discomfort to the patient. In this way, both time-saving and suture-related problems do not occur, and patients can take these two treatments at the outpatient clinic conditions without going to the operating room. It is a very important advantage especially for elderly patients who cannot get general anesthesia.

LIST OF FIGURES

Figure 1. PMMA Ring (Female)

Figure 2. PMMA Ring (Male)

Corresponding parts shown in the figures

1. Hollow ring (Female)

2. Hollow ring (Male) DETAILED DESCRIPTION OF THE INVENTION

Our invention consists of two interlocking symblepharon rings and a particular feature of the tissue of the invention. Our tissue may be at least one of the amniotic membrane or buccal mucosa according to the nature of the case.

Semblefaron rings are hollow rings made of PMMA (polymethylmethacrylate) material, usually of a single diameter (about 14-15 mm). It is placed on the eye surface and prevents the adhesion of the lids and conjunctiva on each other. In the present invention, the hollow ring (female) (1 ) is mounted on the the hollow ring (male) (2) symblepharon ring so that it cannot be separated from each other by means of tight fitting and locking method. The selected tissue is fixed between the two symblepharon rings. Thus, by means of our invention, any tissue can be placed on the surface of the eye without stitches.

Alkaline or Acid burns and Steven-Johnson Syndrome are eye emergencies and, if not treated on time, may result in melting of the eye and blindness. Especially in alkali burns, even minutes are important. It is necessary to apply the amniotic membrane to stop the melting of the eye as soon as possible. In such cases, in order to suppress the inflammation and stop melting of the damaged corneal tissue the ring should be covered with appropriate tissues. In order to ensure that the lids do not stick together permanently, a symblepharon ring is placed on the surface of the eye. However, in urgent conditions, these two procedures cannot be performed in time and sometimes it is difficult to find suitable tissues. With our invention, both time saving and suture problems can be prevented and patients can take these two treatments at the same time in outpatient clinics without entering the operating room.

Again, thanks to our invention, we can use multiple layers of amniotic membranes, which can lead to good results in cases where more effective treatment is required. In this system, where buccal mucosa can be used instead of amniotic membrane, the diameter of the ring is also important. Since the standard ring diameter is not suitable for every person, in some cases or in pediatric patients, the ring may not fit into the eye. The inner diameter of this ring for children is 15 mm, the outer diameter is 20 mm; The inner diameter of this ring for adults is planned to be 17 mm and the outer diameter is 22 mm. The invention relates to a hollow ring (female) (1 ) made of PMMA with an inner diameter of 15 mm - 17 mm and an outer diameter of 20 mm - 22 mm, with a hollow ring (male) (2) to be locked by means of a tight fit between the amniotic membrane or buccal mucosa.

Another important issue is that the product prepared as described in our invention can be sent to hospitals and centers that do not have this graft under appropriate conditions. As a result, widespread use of the product when necessary will result in a reduction in patient referrals and a reduction in costs. In addition to amniotic membrane and buccal mucosa, symblepharon and chemical burns, it has a wide range of usage in different eye diseases (corneal non-healing epithelial defects, corneal ulcers, corneal neurotrophic keratitis, expose keratitis, advanced dry eye, bullous keratopathy).

The invention consists of three parts, the hollow ring (female) (1 ), the hollow ring (male) (2), and the tissue to be placed between the two parts.

The hollow ring (female) (1 ) is in circular form and includes cavities to allow the male part to fit fully.

The hollow ring (male) (2) comprises a protrusion form which will ensure that the female part is fully seated. In this way, the two parts pass through each other completely and tightly to ensure that the tissue remains stable. The tasks of the tissue are described above.

Claims

1. A Sembleferon ring set characterized by comprising; a PMMA hollow ring (female) (1 ) with inner diameter in the range of 15 mm - 17 mm, external diameter in the range of 20 mm - 22 mm, which can be clamped together by means of a tight fit and allows the fixation of the single or multiple layers of amniotic membrane or buccal mucosa to the eye surface without the need for seams. (1 ) and a PMMA hollow ring (male) (2).