WO2022127763A1

WO2022127763A1 - Nailing type retinal hole sealer and implant

Info

Publication number: WO2022127763A1
Application number: PCT/CN2021/137734
Authority: WO
Inventors: 侯豹可
Original assignee: 中国人民解放军总医院
Priority date: 2020-12-14
Filing date: 2021-12-14
Publication date: 2022-06-23
Also published as: CN112472414A

Abstract

A nailing type retinal hole sealer and an implant. The nailing type retinal hole sealer (100) comprises a hydrophobic body portion (110), a fixed tip portion (120), and an electrode handle portion (130). The outer peripheral surface of the hydrophobic body portion (110) is connected to a plurality of hydrophobic branches (111). The plurality of hydrophobic branches (111) can be adhered to the hydrophobic liquid to form a hydrophobic liquid mass (112). The fixed tip portion (120) can be connected to the retina, and is connected to a first end of the hydrophobic body portion (110). The electrode handle portion (130) is connected to a second end of the hydrophobic body portion (110). According to the present invention, an oil-water incompatibility principle is utilized, so that a plurality of hydrophobic branches can well form a hydrophobic liquid mass at the edge of the retinal hole, so as to prevent liquid in a vitreous chamber from flowing into the retina, and thus the surgical objective of sealing the retinal hole (410) in the retinal detachment procedure is achieved, and the patient does not need to keep the prone position after the operation.

Description

Nail type retinal hole sealer and implanter

Related applications

This application claims the priority of the Chinese invention patent with the patent application number of 202011464879.7, the application date of December 14, 2020, and the invention name of "Nail-type retinal hole sealer and implanter".

technical field

The invention relates to the technical field of medical devices, in particular to a nail-type retinal hole sealer and an implanter.

Background technique

Retinal detachment (RD) is the separation of the neuroepithelial layer and the pigment epithelial layer of the retina. The incidence of retinal detachment is very high in the field of fundus diseases. Once it occurs, it will seriously affect the vision of patients and even blindness. Rhegmatogenous retinal detachment (rRD, caused by liquefied vitreous entering the underlying space between the retinal neuroepithelium and the pigment epithelium through one or more retinal breaks) is the majority of RD patients, and rRD patients often require surgical treatment . There are two types of rRD surgery, one is external surgery and the other is internal surgery. Internal surgery, namely vitreoretinal surgery, is the main surgical method for the treatment of severe RD at present. When vitreoretinal surgery is used to treat RD, long-acting gas or silicone oil needs to be filled during the operation, and the patient needs to stay in the prone position for a long time after surgery. Go to bed and bow your head during the day. Long-acting gas needs to be maintained for 2 to 4 weeks, and silicone oil needs to be maintained for 1 to 3 months). Long-term prone position has a great impact on the quality of life of patients after surgery, especially for patients with advanced age, cervical spondylosis and obesity.

The retinal nails currently used for the purpose of treating retinal detachment are usually pure special titanium nails or special plastics (polyacetal), which mechanically penetrate the retina and fix the retina on the choroid (similar to nails nailing picture frames to the wall) , Since retinal tissue and brain tissue are homologous and belong to the central nervous system, mechanical fixation has a huge impact on retinal function and can cause retinal dissolution, which is very ineffective.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a stapled retinal hole sealer which enables the patient not to remain in a prone position after surgery.

Another object of the present invention is to provide an implanter that facilitates the insertion of the above-described stapled retinal hole sealer into the eyeball.

In order to achieve the above object, the present invention provides a nail type retinal hole sealer, which includes:

The hydrophobic body has a plurality of hydrophobic branches connected to its outer peripheral surface, and the plurality of said hydrophobic branches can adhere to the hydrophobic liquid to form a hydrophobic liquid mass;

a fixation tip capable of being attached to the retina, the fixation tip being attached to the first end of the hydrophobic body;

an electrode handle connected to the second end of the hydrophobic body.

The present invention also provides an implanter, which is used for implanting the above-mentioned nail-type retinal hole sealer into the eyeball, the implanter comprising:

a grip rod, which is in the shape of a hollow cylinder, and at least one mounting hole is provided on the outer wall surface of the grip rod;

an implant, which is connected to the first end of the handle, and the interior of the implant communicates with the interior of the handle to form a guide channel, and the nail-type retinal hole sealer is embedded in the implanted in the tube;

The drive assembly includes a flex arm spring that is arranged in the installation hole and can be extended and retracted along the radial direction of the grip rod, the first end of the flex arm spring is connected to the inner wall of the installation hole, and the flex arm spring is connected to the inner wall of the installation hole. The second end of the arm spring extends into the guide channel and is detachably connected with the electrode handle of the staple type retinal hole sealer. A stapled retinal hole sealer is pushed out of the implant and separated from the electrode handle.

Compared with the prior art, the advantages of the present invention are as follows:

The nail-type retinal hole sealer of the present invention is provided with a plurality of hydrophobic branches and utilizes the principle of oil-water incompatibility, so that the plurality of hydrophobic branches can well form a hydrophobic liquid mass at the edge of the retinal hole, so as to prevent the vitreous cavity The internal fluid flows into the retina, which realizes the purpose of closing the retinal hole in retinal detachment surgery, so that the patient does not have to keep the prone position (bends down and bows his head) after surgery, which not only solves the operation of special patients (cervical spondylosis, infirmity, obesity, etc.) The problem of easy failure, and improve the quality of life of patients;

In the nail-type retinal hole sealer of the present invention, by arranging electrodes, during the implantation process, if there is bleeding, the electrodes can conduct electrocoagulation to stop bleeding while puncturing;

In the implanter of the present invention, the nail-type retinal hole sealer is embedded in the implantation tube, so that the operation of sending the nail-type retinal hole sealer into the eye becomes simple and convenient. The operation of the stapled retinal hole sealer becomes simple and convenient, and the staff can operate it with one hand, so that the operation of implanting the stapled retinal hole sealer into the eye is simple and convenient.

Description of drawings

The following drawings are only intended to illustrate and explain the present invention schematically, and do not limit the scope of the present invention. in:

Fig. 1 is the three-dimensional structure schematic diagram of the nail type retinal hole sealer of the present invention;

FIG. 2 is a schematic structural diagram of each hydrophobic branch of the nail-type retinal hole sealer shown in FIG. 1 in a folded state;

Fig. 3 is the use state perspective structure schematic diagram of the nail type retinal hole sealer shown in Fig. 1;

Fig. 4 is the three-dimensional structure schematic diagram of the implanter of the present invention;

Fig. 5 is the enlarged structural representation of A part in Fig. 4;

Fig. 6 is the schematic diagram of the perspective structure of the implanter shown in Fig. 4;

Fig. 7 is a schematic view of the enlarged structure of part B in Fig. 6;

Fig. 8 is the perspective structure schematic diagram of the nail type retinal hole sealer of the present invention assembled with the implanter;

Fig. 9 is the enlarged structural schematic diagram of C part in Fig. 8;

Fig. 10 is the first kind of perspective structure schematic diagram when the implanter of the present invention is in use;

Fig. 11 is the enlarged structural schematic diagram of D part in Fig. 10;

Fig. 12 is the second perspective structure schematic diagram when the implanter of the present invention is in use;

Fig. 13 is the enlarged structural schematic diagram of E part in Fig. 12;

Fig. 14 is the first state structural schematic diagram of using the implanter of the present invention to implant the nail-type retinal hole sealer into the eyeball;

Figure 15 is a schematic view of the structure of pressing the flex arm spring by hand;

16 is a schematic diagram of the second state structure of using the implanter of the present invention to implant the nail-type retinal hole sealer into the eyeball;

Fig. 17 is the enlarged perspective structure schematic diagram of F part in Fig. 16;

FIG. 18 is a schematic diagram of the third state structure of using the implanter of the present invention to implant the nail-type retinal hole sealer into the eyeball;

Fig. 19 is the enlarged perspective structure schematic diagram of G part in Fig. 18;

Figure 20 is a schematic diagram of the first use state of the nail-type retinal hole sealer implanted in the eyeball;

Figure 21 is an enlarged schematic view of the H part in Figure 20;

Figure 22 is a schematic diagram of the second use state of the nail-type retinal hole sealer implanted in the eyeball;

FIG. 23 is a schematic view of the enlarged structure of part I in FIG. 22 .

Description of reference numbers:

100. Nail type retinal hole sealer;

110. Hydrophobic body; 111. Hydrophobic branch; 112. Hydrophobic liquid mass;

120, fixed tip; 121, ring groove; 122, step surface;

130, electrode handle; 131, clamping plane; 1311, clamping convex teeth;

300. Implanter;

310, grip; 311, installation hole;

320. Implantation tube; 321. Implantation warehouse; 322. Fixed support;

330, drive assembly; 331, flex arm spring; 332, connection assembly; 3321, push rod; 33211, clamping part; 33212, snap groove; 3322, tray;

400, eyeball; 410, retinal tear.

Detailed ways

In order to have a clearer understanding of the technical solutions, purposes and effects of the present invention, the specific embodiments of the present invention will now be described with reference to the accompanying drawings. where the adjective or adverbial modifiers "horizontal" and "vertical", "inner" and "outer" are used only to facilitate relative reference between groups of terms and do not describe any particular reference to the modified term direction limit. In addition, the terms "first", "second", etc. are only used for descriptive purposes, and cannot be understood as indicating or implying relative importance or implying the number of indicated technical features, thus, the definition of "first" , "second", etc. features may expressly or implicitly include one or more of that feature. In the description of the present invention, unless otherwise specified, "plurality" means two or more.

At present, vitrectomy mainly includes the following steps:

a) Establish three channels in the pars plana, that is, puncture three holes with a diameter of less than 2 mm in the eyeball wall, one channel establishes perfusion to maintain intraocular pressure, the other channel is optical fiber for intraocular illumination, and the third channel enters the eye. Intraocular manipulation instruments such as vitrectomy tip, retinal forceps, electrocoagulation/photocoagulation fiber, flute needle;

b) Vitrectomy, that is to remove the vitreous body in the vitreous cavity to the greatest extent;

c) Use heavy water or gas-liquid exchange to drain the subretinal fluid, so that the retinal reattachment is smoothed;

d) Apply laser photocoagulation to the retina around the hole to produce an inflammatory response, so that the retina and the retinal pigment cell layer (RPE layer) are tightly adhered (but the inflammatory period takes about 2 weeks, so laser photocoagulation for more than 2 weeks can play the role of adhesion to the retina );

e) Filling of the vitreous cavity, that is, filling the vitreous cavity with gas, long-acting gas or silicone oil, and pressing the retina (internal pressure) in the vitreous cavity to keep the retina attached for at least 2 weeks after surgery (after 2 weeks because of The laser photocoagulation site causes the retina and RPE layer around the hole to adhere, and the retina will not detach again). Since long-acting gas or silicone oil is lighter than water, the patient should keep their head down after surgery, and let the gas or silicone oil press the retina upward.

Embodiment 1

In order to solve the problem of keeping the patient in the prone position after surgery and taking out the secondary silicone oil, as shown in FIG. 1 , the present invention provides a nail-type retinal hole sealer 100 , which includes a hydrophobic body 110 , a fixing tip 120 and Electrode handle 130, wherein:

The outer peripheral surface of the hydrophobic body 110 is connected with a plurality of hydrophobic branches 111 , each of which extends outward along the radial direction of the hydrophobic body 110 , and the plurality of hydrophobic branches 111 can adhere to the hydrophobic liquid to form a hydrophobic Liquid mass 112, each hydrophobic branch 111 is made of a material with good ophthalmological compatibility such as silica gel or silicon sponge, and the hydrophobic branch 111 has good toughness, so that each hydrophobic branch 111 unfolds when not subjected to external force (as shown in FIG. 1 ) state and in the state of shrinkage (as shown in FIG. 2 ) when subjected to external force, so as to facilitate the adhesion and storage of hydrophobic liquid, and the good toughness of the hydrophobic branch 111 can effectively ensure the hydrophobicity The area of the sexual liquid group 112, the hydrophobic liquid is silicone oil, heavy silicone oil (weight than water) or perfluorocarbon and other hydrophobic liquids used in ophthalmic surgery, these liquids have been used in clinical for a long time, and it has been proved that Intraocular tissue has good biocompatibility;

The fixed tip 120 can puncture the choroid and then be fixed between the sclera layers. The fixed tip 120 is connected to the first end of the hydrophobic body 110. Specifically, the fixed tip 120 is made of one or more biocompatible materials. , in this embodiment, the material of the fixed tip 120 may include titanium or polymethyl methacrylate or other suitable polymers, etc.;

The electrode handle 130 is connected to the second end of the hydrophobic body 110. Considering that the fixed tip 120 needs to penetrate the choroid to reach the interscleral layer, the choroid is rich in vascular tissue, and occasional bleeding is inevitable during the puncture process. The part 130 is connected to the electrocoagulation/RF lead to achieve the purpose of electrocoagulation/RF hemostasis during the puncture process.

In use, as shown in Figure 1 and Figure 3, after intraoperative retinal reattachment, laser photocoagulation of the retina around the hole is performed to produce an inflammatory response, and after the operation to make the retina and RPE tightly adhere, each hydrophobic branch 111 is adhered Hydrophobic liquid (silicone oil), and then puncture the sclera through the fixed tip 120 to implant the staple retinal hole sealer 100 at the edge of the retinal hole 410, so that the hydrophobic liquid straddles the edge of the retinal hole 410 on both sides, followed by The vitreous cavity is filled with intraocular perfusion fluid. Due to the good compatibility between the hydrophobic liquid and the hydrophobic branch 111, when the vitreous cavity is filled with water, under the action of surface tension, the outside of the hydrophobic body 110 can be well The hydrophobic liquid mass 112 is formed, so that the vitreous humor (aqueous liquid) cannot enter the retina, and the purpose of closing the retinal hole 410 to maintain the retinal reattachment is achieved, and, if there is bleeding during the implantation process, it can be punctured at the same time. Hemostasis by electrocoagulation through electrode conduction.

In the nail-type retinal hole sealer 100 of the present invention, a plurality of hydrophobic branches 111 are provided, and the principle of oil-water incompatibility is used, so that the plurality of hydrophobic branches 111 can well form a hydrophobic liquid mass 112 at the edge of the retinal hole 410 , in order to prevent the fluid in the vitreous cavity from flowing into the retina, to achieve the purpose of closing the retinal hole 410 in retinal detachment surgery, so that the patient does not need to keep the prone position (bend down and bow the head) after surgery, which not only solves the problem of special patients (cervical spondylosis, frailty) In addition, during the implantation process, if there is bleeding, the electrode handle 130 can conduct electrocoagulation/radiofrequency while puncturing. Stop bleeding.

Further, as shown in FIG. 1 , the hydrophobic body 110 is cylindrical, so that the hydrophobic liquid mass 112 has a larger coverage area. Of course, the hydrophobic body 110 can also be elliptical or prismatic.

Further, as shown in FIG. 1 , the hydrophobic branch 111 is provided with a plurality of annular portions arranged at intervals, and the annular portion may be a circular ring or an elliptical ring, and the inner diameter of each annular portion is along the extending direction of the hydrophobic branch 111 . Gradually increase to increase the compatible area between the hydrophobic branch 111 and the hydrophobic liquid, thereby ensuring that the volume of the hydrophobic liquid mass 112 to be formed meets the usage requirements.

In an embodiment of the present invention, as shown in FIG. 1 and FIG. 3 , the plurality of hydrophobic branches 111 are divided into at least one circle of hydrophobic branches 111 , and each circle of hydrophobic branches 111 includes at least three hydrophobic branches arranged at intervals The stems 111, such an arrangement, can achieve a good purpose of retaining the hydrophobic liquid. Preferably, the hydrophobic branches 111 of each group of hydrophobic branches 111 are arranged at equal intervals. Of course, it can also be used in actual use. Different numbers of hydrophobic branches 111 are set according to actual use requirements.

Further, the hydrophobic branch 111 is in a curved shape, preferably, the hydrophobic branch 111 is in a conic shape, so that the hydrophobic liquid can be close to the retina. Of course, the hydrophobic branch 111 can be in an arc shape.

Further, as shown in FIGS. 1 and 3 , the outer peripheral surface of the fixing tip 120 is provided with at least one ring groove 121 , so that the outer peripheral surface of the fixing tip 120 is formed with at least one stepped surface 122 , and the stepped surface 122 faces the hydrophobicity The body portion 110 enables the step surface 122 to increase the contact area with the retina, thereby improving the reliability of the connection between the fixed tip portion 120 and the retina.

Further, as shown in FIG. 1 , the electrode handle 130 has two clamping planes 131 arranged opposite to each other, and the clamping plane 131 is provided with a plurality of clamping protrusions 1311 arranged at intervals. Specifically, the cross section of the electrode handle 130 is a Oval, two opposite planes of the electrode handle 130 are clamping planes 131, and a plurality of clamping protrusions 1311 are arranged at intervals along the direction toward the fixed tip 120 on the clamping plane 131. The cross-section of the engaging protruding teeth 1311 is rectangular, and the engaging protruding teeth 1311 are arranged at equal intervals.

Embodiment 2

In order to conveniently implant the staple-type retinal hole sealer 100 into the eye, as shown in FIGS. 4 , 5 , 6 and 7 , the present invention also provides an implanter 300 , which is used to implant the above-mentioned staples The retinal hole sealer 100 is implanted into the eyeball 400, and the implanter 300 includes a handle 310, an implant tube 320 and a drive assembly 330, wherein:

The handle bar 310 is in the shape of a hollow cylinder. At least one mounting hole 311 is formed on the outer wall of the handle bar 310. The mounting hole 311 is located in the middle and lower part of the handle bar 310. When the outer wall surface of the handle bar 310 is provided with a plurality of mounting holes 311, each The mounting holes 311 are arranged at equal intervals along the circumferential direction of the grip rod 310 , preferably, the mounting holes 311 are elongated, and each mounting hole 311 extends along the axial direction of the grip rod 310 ;

The implant tube 320 is connected to the first end of the handle bar 310, the outer diameter of the implant tube 320 is suitable for the surgical channel of vitrectomy, and the inside of the implant tube 320 communicates with the inside of the handle bar 310 to form a guide channel, preferably , the implant tube 320 and the grip rod 310 are integral structure, the inner diameter of the implant tube 320 is smaller than the inner diameter of the grip rod 310, of course, the implant tube 320 can also be welded and connected to the first end of the grip rod 310, and in the grip rod The first end of 310 is provided with a through hole, so that the inside of the implant 320 can communicate with the inside of the handle 310 through the through hole to form a guide channel. Preferably, the diameter of the through hole is approximately the same as the inner diameter of the implant 320 8 and 9, the stapled retinal hole sealer 100 is embedded in the implant 320, and the stapled retinal hole sealer 100 can be removed from the implantation tube 320 under the action of external force;

The drive assembly 330 includes a flexure spring 331 disposed in the installation hole 311 and capable of extending and contracting along the radial direction of the grip rod 310 . Specifically, as shown in FIGS. 4 and 5 , each installation hole 311 is provided with a flexure spring 331 , the first end of the flexure spring 331 is in contact with the inner wall of the installation hole 311, the second end of the flexure spring 331 extends into the guide channel and is detachably connected with the electrode handle 130 of the staple retinal hole sealer 100, And the flexure arm spring 331 protrudes out of the mounting hole 311 along the radial direction of the handle bar 310 to facilitate the pressing operation, and the flex arm spring 331 radially contracts along the handle bar 310 to push the staple retinal hole sealer 100 out of the implant. 320 and is separated from the electrode handle 130. Specifically, as shown in FIG. 8, FIG. 9, FIG. 10, FIG. 11, FIG. 12 and FIG. radial contraction, at this time, since the first end of the flexure spring 331 is restricted by the inner wall of the mounting hole 311 and cannot move, the second end of the flexure spring 331 will move toward the free end of the implant tube 320 along the guide channel Move until the second end of the flexure spring 331 protrudes from the free end of the implant 320, at this time, the flexure spring 331 pushes the staple retinal hole sealer 100 out of the implant tube 320 and engages with the staple retinal hole sealer 100 Disengaged, the stapled retinal hole sealer 100 can be pierced through the fixation tip 120 into the scleral lamella.

In use, as shown in FIGS. 14 and 15 , the stapled retinal hole sealer 100 is embedded in the implant tube 320 , and the free end of the implant tube 320 is filled with hydrophobic liquid, so that each hydrophobic branch is The stem 111 can adhere to the hydrophobic liquid to form a hydrophobic liquid mass 112, hold the rod 310 in hand, and insert the implant 320 into the eye through the surgical channel of vitrectomy, until the free end of the implant 320 reaches the front of the retina and faces the retina. Then, press the flex arm spring 331, so that the flex arm spring 331 pushes the staple retinal hole sealer 100 out of the implant tube 320 and separates from the staple retinal hole sealer 100, at this time, as shown in Figure 16, Figure 17, As shown in Fig. 18, Fig. 19 and Fig. 20, the nail-type retinal hole sealer 100 is fixed between the sclera layers after puncturing the choroid through the fixed tip 120, and each hydrophobic branch 111 can adhere to the hydrophobic liquid to form a hydrophobic liquid mass 112 to seal The retinal hole 410 is blocked to prevent the fluid in the vitreous cavity from entering the subretinal through the retinal hole 410. Finally, the stapled retinal hole sealer 100 is withdrawn from the vitrectomy surgical channel.

In the implanter 300 of the present invention, the staple-type retinal hole sealer 100 is embedded in the implantation tube 320, so that the operation of feeding the staple-type retinal hole sealer 100 into the eye becomes simple and convenient. The spring 331 makes the operation of ejecting the staple-type retinal hole sealer 100 simple and convenient, and the staff can operate with one hand, thereby making the operation of implanting the staple-type retinal hole hole sealer 100 into the eye simple and convenient.

Further, as shown in FIG. 7 , the free end of the implantation tube 320 is provided with an implantation chamber 321, and the nail-type retinal hole sealer 100 is embedded in the implantation chamber 321. Inside the storage bin 321, there is a fixing bracket 322 that can be sleeved on the outside of each hydrophobic branch 111 of the nail-type retinal hole sealer 100. It is ensured that after the implant tube 320 is inserted into the eye, the fixing bracket 322 can be firmly placed in the implantation chamber 321, and the fixing bracket 322 can fix the hydrophobic body 110 so that it always moves axially, which can make the fixing tip The portion 120 penetrates smoothly into the sclera, so that the stapled retinal hole sealer 100 can be embedded in the implantation cartridge 321 .

In a specific example of this embodiment, as shown in FIG. 6 , the second end of the flexure spring 331 is detachably connected to the electrode handle 130 through a connection assembly 332 , and the connection assembly 332 can connect the flexure spring 331 to the electrode The connection and separation between the handles 130 become simple and convenient.

Further, as shown in FIG. 7 , the connecting assembly 332 includes a push rod 3321, the first end of the push rod 3321 is connected to the second end of the flexure spring 331, and the second end of the push rod 3321 is provided with a clamping portion 33211, which clamps the The holding portion 33211 can hold the electrode handle portion 130, and the inner surface of the holding portion 33211 is provided with a snap-fit groove 33212 that matches with the snap-on protruding teeth 1311 of the electrode handle portion 130. The snap fit of the groove 33212 makes the connection between the clamping portion 33211 and the electrode handle portion 130 more reliable. Specifically, the clamping portion 33211 includes two oppositely arranged elastic splints, and the two elastic splints and the push rod 3321 are Y-shaped. The engaging grooves 33212 are disposed on two opposite surfaces of the two elastic splints. Of course, the clamping portion 33211 can also be a sleeve sleeved on the outside of the electrode handle portion 130 .

Still further, as shown in FIG. 6 , considering that when multiple flex arm springs 331 are provided, in order to facilitate the connection between each flex arm spring 331 and the push rod 3321, a movable tray 3322 is provided in the handle bar 310, The second end of the arm spring 331 is connected to the push rod 3321 through the tray 3322, so that the connection between each bending arm spring 331 and the push rod 3321 is simple and convenient, and each bending arm spring 331 transmits the thrust to the push rod through the tray 3322. The rod 3321 can transmit the thrust more stably.

The use process of the nail-type retinal hole sealer 100 of the present invention will be specifically described below in conjunction with the accompanying drawings:

a) Establish a conventional minimally invasive vitrectomy channel, that is, establish three channels in the pars plana, that is, puncture three holes with a diameter of less than 2 mm in the wall of the eyeball 400, one channel establishes perfusion, maintains intraocular pressure, and the other channel guides Optical fiber intraocular illumination, the third channel into the vitrectomy head, retinal forceps, electrocoagulation/photocoagulation fibers, flute needles and other intraocular manipulation instruments;

b) Vitrectomy, that is, the vitreous body in the vitreous cavity is removed to the greatest extent clean (only the vitreous body around the retinal hole 410 may be removed, or the vitreous body may be completely or partially removed);

c) Exchange the liquid and gas in the vitreous cavity, that is, apply heavy water or gas-liquid exchange to drain the subretinal fluid, so as to stabilize the retinal reattachment;

d) Apply laser photocoagulation to the retina around the hole to produce an inflammatory response, so that the retina and RPE are closely adhered;

e) As shown in FIG. 14 , the implanter 300 equipped with the stapled retinal hole sealer 100 is inserted into the eye through the surgical incision until it reaches the front of the retina and is facing the edge of the hole;

f) As shown in Fig. 15 to Fig. 19, press the flex arm spring 331, the flex arm spring 331 pushes the push rod 3321 out of the implant tube 320 through the tray 3322, so that the push rod 3321 pushes the staple retinal hole sealer 100 out of the implant Into the tube 320, at this time, the fixed tip 120 of the nail-type retinal hole sealer 100 punctures the choroid at the edge of the retinal hole 410, enters the scleral layer to be fixed, and achieves the purpose of sealing the hole, and each hydrophobic branch 111 loses the implantation tube. 320 and the fixing bracket 322 are in an expanded state after being restricted. Since the implantation chamber 321 is provided with a hydrophobic liquid (including but not limited to silicone oil, heavy silicone oil and other hydrophobic liquids suitable for implantation in vivo), each hydrophobic branch is The stem 111 can adhere to the hydrophobic liquid to form a hydrophobic liquid mass 112, the hydrophobic liquid mass 112 contacts the retina, and each hydrophobic branch 111 does not contact the retina;

g) As shown in Figure 20 and Figure 21, the implanter 300 is withdrawn, so that the staple retinal hole sealer 100 is free and fixed on the chorioretina, and the hydrophobic protrusions are wrapped by the hydrophobic liquid mass, covering both sides of the edge of the retinal hole 410, to achieve The purpose of preventing the fluid in the vitreous cavity from entering the subretinal through the retinal hole 410;

h) If the hole is large and cannot be covered by the one-pin retinal hole sealer 100, steps e to f can be repeated several times to make the hydrophobic liquid mass wrap around the retinal hole, as shown in Figure 22 and Figure 23, surrounding the retinal hole The 410 edge is repeatedly implanted with a circle of retinal tear 410 sealer to achieve the purpose of closing the tear;

i) After implantation of the nail-type retinal hole sealer 100, the gas-liquid exchange in the vitreous cavity can be performed, the glass fluid/perfusate can be filled, and the gas in the vitreous cavity can also be retained;

j) Close the incision in the flat part of the eyeball 400 to complete the operation.

The specific operation processes of steps a to d and i to j are all in the prior art and will not be repeated here.

To sum up, in the nail-type retinal hole sealer of the present invention, a plurality of hydrophobic branches are arranged, and the principle of oil-water incompatibility is used, so that the plurality of hydrophobic branches can well form a hydrophobic liquid mass at the edge of the retinal hole. , to prevent the fluid in the vitreous cavity from flowing into the retina, to achieve the purpose of closing the retinal hole in retinal detachment surgery, so that the patient does not need to keep the prone position (bend down and head down) after surgery, which not only solves the problem of special patients (cervical spondylosis, frail, Obesity and other patients) the problem of easy failure of surgery, and improve the quality of life of patients;

In the nail-type retinal hole sealer of the present invention, by arranging electrodes, during the implantation process, if there is bleeding, the electrodes can conduct electrocoagulation to stop the bleeding while puncturing;

The above descriptions are only exemplary embodiments of the present invention, and are not intended to limit the scope of the present invention. Equivalent changes and modifications made by any person skilled in the art without departing from the concept and principles of the present invention shall fall within the protection scope of the present invention. Moreover, it should be noted that each component of the present invention is not limited to the above-mentioned overall application, and each technical feature described in the specification of the present invention can be used alone or in combination according to actual needs. Therefore, the present invention Of course, other combinations and specific applications related to the inventive point of the present application are covered.

Claims

A nail-type retinal hole occluder, wherein the nail-type retinal hole occluder comprises:

The hydrophobic body has a plurality of hydrophobic branches connected to its outer peripheral surface, and the plurality of said hydrophobic branches can adhere to the hydrophobic liquid to form a hydrophobic liquid mass;

a fixation tip capable of being attached to the retina, the fixation tip being attached to the first end of the hydrophobic body;

an electrode handle connected to the second end of the hydrophobic body.
The stapled retinal hole occluder of claim 1, wherein,

The plurality of said hydrophobic branches are divided into at least one circle of hydrophobic branch groups, and each circle of said hydrophobic branch group includes at least three said hydrophobic branches arranged at intervals.
The stapled retinal hole occluder of claim 1, wherein,

The hydrophobic branch is provided with a plurality of annular portions arranged at intervals.
The stapled retinal hole occluder of claim 1, wherein,

The outer peripheral surface of the fixed tip is provided with at least one ring groove.
The stapled retinal hole occluder of claim 1, wherein,

The electrode handle has two oppositely arranged clamping planes, and the clamping planes are provided with a plurality of clamping protrusions arranged at intervals.
An implanter for implanting the stapled retinal hole sealer of any one of claims 1 to 5 into an eyeball, wherein the implanter comprises:

a grip rod, which is in the shape of a hollow cylinder, and at least one mounting hole is provided on the outer wall surface of the grip rod;

an implant, which is connected to the first end of the handle, and the interior of the implant communicates with the interior of the handle to form a guide channel, and the nail-type retinal hole sealer is embedded in the implanted in the tube;

The drive assembly includes a flex arm spring that is arranged in the installation hole and can be extended and retracted along the radial direction of the grip rod, the first end of the flex arm spring is connected to the inner wall of the installation hole, and the flex arm spring is connected to the inner wall of the installation hole. The second end of the arm spring extends into the guide channel and is detachably connected with the electrode handle of the staple type retinal hole sealer. A stapled retinal hole sealer is pushed out of the implant and separated from the electrode handle.
The implanter of claim 6, wherein,

The second end of the flex arm spring is detachably connected to the electrode handle through a connecting assembly.
The implanter of claim 7, wherein,

The connecting assembly includes a push rod, the first end of the push rod is connected with the second end of the flex arm spring, the second end of the push rod is provided with a clamping part, and the clamping part can clamp Hold the electrode handle.
The implanter of claim 8, wherein,

The second end of the flex arm spring is connected to the push rod through a tray.
An implanter according to any one of claims 6 to 9, wherein,

The free end of the implanting tube is provided with an implantation chamber, and the nail-type retinal hole sealer is embedded in the implantation chamber, and the implantation chamber is provided with an implantation chamber capable of being sleeved on the nail-type retinal hole. Retaining brackets on the outside of each hydrophobic limb of the closure.