RU191333U1 - Pupil dilation tool - Google Patents

Abstract

The utility model relates to medicine, namely to ophthalmology, and can be used in the surgical treatment of cataract by phacoemulsification with implantation of an intraocular lens or without it with a narrow and “collapsing” pupil to stretch the pupil and hold it in one position. Obtained when using the proposed tool, the technical result is to increase work efficiency. The presence of a handle 2 with faces allows you to conveniently hold the tool in your hands without the danger of slipping, and the performance of an opaque material allows you to control the tool when it is installed. The instrument for expanding the pupil contains a rod 1 with a handle 2 at one end and a working part 3 bent in the form of a hook at the other end. A clamp clip 4 is placed on the rod 1. After standard processing of the surgical field, blepharostat is applied. A tunnel stepwise limbic-corneal incision is performed at 135 ° and additional manipulation paracentesis at 3, 5, 9 and 12 hours. A 1% mesatone is introduced into the anterior chamber. The front capsule is contrasted with a solution of methylene blue, the front chamber is filled with viscoelastic. Instruments for dilating the pupil are introduced through paracentesis at 5, 9, and 12 hours, holding each of them during insertion by the handle 2. The hooked working part 3 is inserted into the anterior chamber and fixed to the pupil edge of the iris. Moving the clamp clip 4 along the shaft 1, the required pupil diameter is obtained. Each tool is fixed with a clamping clip 4 located on the shaft 1 outside the cavity of the eye. After installing each instrument to expand the pupil, its distal end is cut off. Then the lens is removed using the standard cataract phacoemulsification technique. After implantation of an intraocular lens, instruments for dilating the pupil are removed. 1 ill.

Description

The utility model relates to medicine, namely, to ophthalmology and can be used in the surgical treatment of cataracts by phacoemulsification with implantation of an intraocular lens or without it with a narrow and "collapsing" pupil to stretch the pupil and hold it in one position.

A known instrument for dilating the pupil (http://etpmicro.ru/etp/polim/), comprising a rod with a handle at one end and a working part bent in the form of a hook at the other end and a clamp clip located on the rod.

However, the use of a known instrument causes inconvenience to the surgeon due to the fact that the instrument is flexible and thin, therefore it is difficult to hold and difficult to manipulate. Due to its flexibility, the instrument does not enter paracentesis well, makes additional movements in the anterior chamber, it does not capture the pupil edge the first time, etc. The material from which the instrument for dilating the pupil is made is translucent, therefore it is poorly visualized in the surgical field. The operation phacoemulsification of cataracts with implantation of an intraocular lens or without it with a narrow and “collapsing” pupil using a known instrument is very difficult. It is difficult for the surgeon to control the course of the operation, which can lead to serious complications.

The proposed utility model solves the problem of creating a new tool for expanding the pupil. The technical result obtained during its use consists in increasing the work efficiency using the tool we offer for expanding the pupil. The presence of a handle with faces allows you to conveniently hold the tool in your hands without the danger of its slipping, the manufacture of the tool from an opaque material - to control it during use. Such a tool will be easier and faster to manipulate during the operation.

The specified technical result is achieved in that in a pupil dilating tool containing a rod with a handle at one end and a working part bent in the form of a hook on the other end and a clamping clip located on the rod, the handle of the pupil dilating tool is made with a diameter exceeding the diameter of the core with faces from opaque material.

The utility model is illustrated in the drawing, which schematically shows the proposed tool.

The instrument for expanding the pupil contains a rod 1 with a handle 2 at one end and a working part 3 bent in the form of a hook at the other end. A clamp clip 4 is placed on the rod 1. The handle 2 of the instrument for expanding the pupil is made with a diameter exceeding the diameter of the rod 1; has edges from opaque material.

A tool for dilating the pupil is used as follows. After standard processing of the surgical field, it is covered with a sterile napkin with a pocket and an adhesive layer. Blepharostat is applied. A tunnel stepwise limbic-corneal incision is performed with a width of 2.2 mm at 135 ° with a disposable metal blade of 2.2 mm and additional manipulation paracentesis at 3, 5, 9 and 12 hours with a disposable metal blade of 20 G. A 1% mesaton is introduced into the anterior chamber. The front capsule is contrasted with a solution of methylene blue, the front chamber is filled with viscoelastic. Instruments for dilating the pupil are introduced through paracentesis at 5, 9, and 12 o'clock, holding each of them during insertion by the handle 2 connected to the rod 1. The hooked working part 3 at the other end of the rod 1 is inserted into the anterior chamber and fixed to the pupil the edge of the iris. Moving the clamp clip 4 along the shaft 1, the required pupil diameter is obtained. Each tool is fixed with a clamping clip 4 located on the shaft 1 outside the cavity of the eye. After installing each instrument to expand the pupil, its distal end is cut off. Capsulotomy is carried out using a single 27 G injection needle according to the method of continuous circular capsulorexis. Hydrodissection and hydrodelineation of 25 G cannulas are performed. Then, the lens is removed using the standard cataract phacoemulsification technique. After implantation of the intraocular lens, the instruments for dilating the pupil are removed and the viscoelastic is removed using an irrigation-aspiration system. Wound sealing is achieved by hydrating the edges of the surgical wound with a balanced saline solution. Subconjunctival injection of dexazone 2 mg and ceftazidime 50 mg. Aseptic dressing.

Clinical example.

Patient A., born in 1953. He lives in Astrakhan.

Diagnosis: Complicated myopizing cataract of the right eye. Initial cataract of the left eye. Vitreous degradation of the 1st degree of both eyes.

Visual acuity of the right eye before surgery 0.05 with sph -3.5 D = 0.4.

Left eye - 0.8 n / a.

IOP of both eyes 20 mm RT. Art.

PZO of the right eye 22.9 mm, left eye 22.8 mm

The depth of the anterior chamber of the right eye is 2.79 mm, the left eye is 3.0 mm.

The thickness of the lens of the right eye is 4.75 mm, the left eye is 3.87 mm.

Keratometry:

Right eye: K1 = 43.5 ah 12 °, K2 = 43.75 ah 102 °.

Left eye: K1 = 43.0 x 24 °, K2 = 43.0 x 114 °.

On March 16, 2017, cataract phacoemulsification with implantation of an intraocular lens model Aery Sof IQ Natural (Alcon. USA.) + 22.5 D was performed on the right eye.

During the operation, narrowing of the pupil is possible. To expand the pupil through paracentesis at 3, 5, 9 and 12 hours, the inventive instruments for expanding the pupil were successively installed. To do this, holding the handle 2, connected with the rod 1, the working part 3 at the other end of the rod 1, bent in the form of a hook, was introduced into the anterior chamber and fixed to the pupil edge of the iris. Moved the clamping clip 4 along the shaft 1 to obtain the required pupil diameter. Similarly, other instruments for dilating the pupil were installed. The instruments fixed the enlarged pupil diameter using clamping clips 4 placed outside the eye cavity on the rods 1. After installing each instrument to dilate the pupil, its distal end was cut off. The operation was continued according to the standard cataract phacoemulsification technique.

After implantation of the intraocular lens, the instruments for dilating the pupil were removed and the viscoelastic was removed using an irrigation-aspiration system. Wound sealing was achieved by hydrating the edges of the surgical wound with a balanced saline solution. Subconjunctival injection of dexazone 2 mg and ceftazidime 50 mg. Aseptic dressing. At discharge, visual acuity of the right eye is 1.0. IOP was 19 mm. Hg

Claims (1)

A pupil expansion tool comprising a rod with a handle at one end and a working part bent in the form of a hook at the other end and a clamping clip located on the rod, characterized in that the handle of the pupil expansion tool is made with a diameter exceeding the diameter of the rod with faces of opaque material.

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