RU2049454C1 - Ophthalmic forceps - Google Patents

Abstract

FIELD: medical engineering; ophthalmology. SUBSTANCE: device has coaxial tube and rod, clamp having two spoon- shaped knives, holder and unit for moving the rod. The spoon-shaped knives have edges sharpened all around the perimeter capable of overlapping in their joining together. EFFECT: wider range of applications. 2 dwg

Description

 The invention relates to medicine, namely to ophthalmic surgery, and is intended to remove intraocular foreign bodies fixed on the mooring and in the posterior pole of the eye.

Known collet tweezers for removing intraocular foreign bodies, consisting of a coaxial tube and rod, three-petal capture, holder and device for moving the rod [1, 2]
When bringing the tweezers to the localization site of the intraocular foreign body, the surgeon presses the rod moving device, the latter moves relative to the tube and extends the grip. Then the surgeon pushes the open grip on the foreign body and releases the rod. The capture petals are pulled into the tube and fix the foreign body, which is then removed transvitreal. A disadvantage of the known devices is the high invasiveness of the operation of removing foreign bodies fixed on the mooring in the posterior part of the eye. When trying to remove such a foreign body transvitreal, it pulls on the mooring, which often leads to retinal detachment. In some cases, the removal of fixed foreign bodies becomes generally impossible.

 In addition, with transvitreal removal, a foreign body can slip out of the grip.

 The technical result is the reduction of injuries of operations to remove foreign bodies, primarily fixed on the mooring.

 The technical result is achieved in that in an ophthalmic surgical tweezers consisting of a coaxial tube and a rod, grips, a holder and a node for moving the rod, the grippers are made in the form of two spoon-shaped knives with edges sharpened around the entire perimeter and installed with the possibility of overlapping them when closed.

 In FIG. 1 shows folded ophthalmic surgical tweezers; in FIG. 2 the position of the instrument when capturing a foreign body, fixed on a mooring in the posterior part of the eyeball.

 Ophthalmic surgical tweezers consists of a coaxial tube 1 and a rod 2, a gripper 3 made in the form of two spoon-shaped knives, a holder 4, and a node for moving the rod 5, the spoon-shaped knives are made with edges sharpened around the entire perimeter and can overlap when closed.

 In ophthalmic surgery, there are often cases of penetrating eye injuries with the introduction of a foreign body 6 (Fig. 2), which is enclosed in a connective tissue or fibrous capsule 7 and fixed in the back of the eye on the mooring 8. To remove such a foreign body, it is necessary to cut the mooring. because otherwise, retinal detachment 9 or side injuries of the organ of vision may occur when trying to remove a foreign body.

 During the operation, the surgeon makes an incision 10 of the sclera 11 in the area opposite to the fixation site of the foreign body, and inserts the forceps folded into the incision (Fig. 1). In this state, the tool is quite compact and does not require a large incision. When summing up the spoon-shaped knives to a foreign body, the surgeon presses on the node for moving the rod 5 (while the rod 2 advances the spoon-shaped capture 3 (Fig. 2), pushes it onto the foreign body 6 and releases the rod 2. The knives 3 are closed and capture the foreign body 6 in the capsule 7, cutting it off with its sharp edges from the mooring 8. In this case, the foreign body 6 is in an isolated capture volume and, thus, the foreign body falls out of the capture during transvitreal removal.

 EXAMPLES

 1. Patient K., born in 1961 was in the SRI them. Helmholtz from 03/21/89 to 03/26/89 with a diagnosis of OD penetrating scleral wound. Intraocular amagnetic foreign body. According to the patient, the wound occurred in everyday life, when the detonator exploded. PHO produced at the place of residence. Resorption treatment was performed. Referral to an institute to remove a foreign body.

 Upon receipt, visual acuity OD = 0.4 n / a, OS = 1.0. OD is calm. Scleral scar at 11 o’clock in the upper outer quadrant. The cornea is transparent. The anterior chamber is of medium depth, the moisture is clean. Turbidity in the vitreous. Slight clouding of the posterior lens capsule. At 17 o'clock in the back of the vitreous body, a foreign body is visible, from which the mooring to the retina departs. X-ray in the right orbit determines the shadow of a foreign body measuring 1.0 x 1.0 x 1.5 mm, located along the meridians 16 hours 45 minutes 17 hours 00 minutes, 17.5-18.5 mm from the limb and 5.5 -6.0 mm from the anatomical axis. With an echographic study, floating and fixed opacities are determined in the right eye. No retinal detachment. 03/22/89 transvitreal removal of a foreign body from OD was performed. With local anesthesia, the conjunctiva was cut in the upper quadrant and separated from the sclera. Hemostasis. Section of the sclera at 11 o’clock. Tweezers were inserted in the section, under ophthalmoscopic control it was brought to a foreign body, the latter was captured and cut off from the mooring, and removed from the eye cavity transvitreal. Stitches on con-woo and sclera. Under the con-woo introduced dexazone and gentamicin. After the surgical course without complications. At discharge, visual acuity OD = 0.4 n / k, OS = 1.0.

 2. Patient A. b. 1953 was in the Research Institute of GB them. Helmholtz from 05.02.89 to 12.02.90 with a diagnosis of OS, penetrating wound of the cornea, intraocular foreign body. According to the patient, the injury occurred in everyday life during the repair of a car, the wheel exploded and something flew off into the left eye. On the same day, a surgical treatment of the wound was made at the place of life, the foreign body was not removed. On admission visual acuity OD = 1.0; OS = 0.1 n / k. OD is healthy, OS is calm. Treated corneal wound at 17 hours 2 mm from the limbus. The anterior chamber is of medium depth, the moisture is clean, the lens is transparent. In the vitreous body, floating opacities. In the middle layers of Art. body foreign body is ophthalmoscopically.

 X-ray in the left orbit determines the shadow of a foreign body with dimensions of 1.0 x 1.0 x 0.5 mm from the plane of the limb and 4.5-5.0 mm from the anatomical axis. In the vitreous body, floating and semi-fixed opacities are determined, determined by ultrasound. No retinal detachment.

 A magnetic sample of a foreign body is negative. 02/06/90 an operation to transvitreal removal of a foreign body on the OS. Under local anesthesia, the conjunctiva was cut 3 mm from the limbus, its separation from the sclera and the sclera were cut at 11 o’clock. Under ophthalmoscopic control, the tip of the ophthalmic surgical tweezers was inserted into the incision, the foreign body was captured and its transvitreal removal. A seam was laid on the sclera and a seam on the conjunctiva. Postoperative course without complications. The patient was discharged on the 7th day after surgery. At discharge, visual acuity OD = 1.0; OS = 0.1.

 An ophthalmic surgical tool can significantly reduce the injuries of foreign body removal operations, primarily fixed on a mooring, by ensuring that the encapsulated foreign body is cut off from the fixing tissues and, therefore, expand the indications for the use of collet tweezers to remove intraocular fixed foreign bodies.

Claims (1)

 OPHTHALMIC TWEEZERS, consisting of a coaxially mounted tube and a rod with a working part in the form of two spoon-shaped grippers, a holder and a rod displacement unit, characterized in that the grippers are made with edges sharpened around the entire perimeter and installed with the possibility of overlapping them when closed.

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