RU2300355C1 - Artificial crystalline lens and method of implantation of eye crystalline - Google Patents

Abstract

FIELD: medicine; ophthalmology.

SUBSTANCE: artificial crystalline lens can be used at surgical treatment of cataract or at presence of residual ametropia during post-operational period. Artificial crystalline lens has optical part and support member. Support member is made of round ring and two loops attached to the ring. Two similar symmetrical blind recesses in form of segment of ring are made at front and back surfaces of ring; recesses are disposed at ends of diameter of ring. Recesses onto back surface are disposed cress-cross relatively recesses onto front surface. Side walls of segments are parallel to sagittal plane; bases of segments are perpendicular to the plane. Ring-shaped groove is made in rest four parts of ring from inside in center of; thickness and depth of groove are enough to fix optical part in it. Optical part is made of elastic material. Method of implantation of artificial crystalline lens includes making cataract cut, continuous circular capsulorraphy, and phacoemulsification of cataract and removal of cortical masses. Support member is implanted separately from optical part. Loop and recesses onto front part of ring of support member are disposed at axis from 12 to 6 o'clock; optical part is implanted in folded view by means of forceps, which is disposed in parallel to axis of symmetry of recesses at front surface of ring. Optical part is fixed in circular groove of artificial crystalline lens by means of putting branches of forceps apart.

EFFECT: higher efficiency of correction of ametropia during post-operational period; reduced risk of post-operational complications.

5 cl, 7 dwg, 1 att

Description

The invention relates to medicine, more specifically to ophthalmology, and can be used in the surgical treatment of cataracts or in the presence of residual ametropia in the postoperative period.

The possibility of replacing the optical part of the artificial lens of the eye (IHG) seems to be very relevant in cases of errors in calculating the optical power of the IHG and, as a result, the occurrence of residual ametropia in the postoperative period. Most often, this situation occurs during cataract extraction against the background of a high degree of initial ametropia. After stabilization of postoperative refractive indices in the presence of residual ametropia, it is possible to replace the optical part of the IHG to correct the patient's vision.

Known IHG for the surgical correction of artifact with residual ametropia and the method of implantation (RU 2155560), where the IHG contains an optical lens and a support element.

However, such a design is intended for correction of postoperative error in the calculation of the optical power of IHG during artifact, when an additional optical part is fixed on a previously implanted optical lens. If necessary, the additional optical part can be replaced with another, with the necessary optical power. But the removal of additional IHG can lead to complications such as rupture of the posterior capsule, damage to surrounding tissues, and prolapse of the vitreous. In this case, the composite optics of the IHG negatively affects the optical characteristics as a whole due to aberrations on the optical surfaces of the interface (the plane between the two optics).

An object of the invention in terms of IHG is to create an IHG design with the ability to correct ametropia in the postoperative period, to reduce the risk of intra- and postoperative complications due to the possibility of replacing only the optical part.

The technical result in the part of the IHG is achieved by the fact that the IHG contains an optical part and a support element consisting of a round ring (torus) and two loops, while on the front surface of the ring there are two identical diametrically arranged symmetrical through cutouts. The cutouts are segments of a ring (torus) bounded by side walls parallel to the sagittal plane and a base perpendicular to it with a central angle & from 30 to 150 degrees. The depth of the cuts is from 1/2 to 9/10 of the thickness of the ring (diameter of rotation of the torus). On the back surface, cutouts similar in geometry and size are located crosswise with respect to the cutouts on the front surface, i.e. the symmetry axis of the cutouts on the front and rear surfaces are mutually perpendicular (obtained by rotating the ring around the central axis of symmetry by 90 degrees). In the remaining four parts of the ring, an annular groove is made on the inner side in the middle, with a thickness of 1/2 to 4/5 of the thickness of the ring, to a depth of 1/2 to 9/10 of the width of the ring, sufficient to fix the optical part in it.

For more stable fixation of the optical part in the support element at the periphery of the optical part, two diametrically arranged flat protrusions of rounded shape (crescent shape) lying in the plane of the optical part can be made.

The technical result in terms of the implantation method is achieved by the fact that after removal of cataracts and cortical masses in the capsular bag, the support element consisting of a ring and two loops is first implanted; while the loops and cutouts on the front surface of the ring of the support element are arranged along the axis from 12 hours to 6 hours. Then, the optical part is implanted, when folded, with tweezers parallel to the axis of symmetry of the notch cutouts on the front surface of the ring; however, with the dilution of the branches of the tweezers, the optical part is fixed in the annular groove of the IHG.

The proposed IHG combines the following useful properties.

Firstly, the combined design of the IHG provides the ability to correct residual ametropia during artifact by replacing only the optical part.

Secondly, a removable optical part made of elastic material allows replacement at various times after surgery through a small incision without injuring the surrounding tissue.

Thirdly, according to the invention, the optical part is fixed to the support element outside the optical zone and is devoid of the disadvantages of the occurrence of aberrations at the boundary of the optical media, as is the case when two ICH are implanted in the capsular bag.

The invention is illustrated in figures 1-7, where figure 1 shows the front surface of the support element; figure 2 - its rear surface; figure 3 shows the support element in section along aa '; figure 4 is a support element in section along bb '; figure 5 shows the optical part; figure 6 shows the optical part with two flat protrusions of rounded shape; Fig.7 is the same optical part, side view.

The IHG contains an optical part 1, a support element 2, consisting of a ring 3 and two loops 4. On the front surface of the ring 3 there are two identical symmetrical diametrically located through-cuts 5 bounded by the side walls, with a central angle of & 30-150 degrees. Two side walls of the cutouts are parallel to the sagittal plane, and cutouts 6 are made on the back surface of the ring, similar to the cutouts on the front surface 5 and are located in a crosswise relation to them. In the remaining four parts of the ring 3 from the inner side in the middle, an annular groove 7 is made to a depth of 1 / 2-9 / 10 of the width of the ring, 1 / 2-4 / 5 of its thickness. The optical part can be made with two diametrically located flat protrusions 8 of a rounded shape (in the shape of a crescent).

Implantation is carried out as follows: under local anesthesia, a corneal tunnel incision is performed, 2.75-3.0 mm long. Under the viscoprotector, continuous circular capsulorexis and hydrodissection are performed. Phacoemulsification of cataracts is carried out in the traditional way, followed by aspiration of the cortical masses. Then the incision is expanded to 3.5-4.0 mm and the support element 2 is implanted, consisting of a ring 3 and two loops 4, while the loops and cutouts on the front surface are placed along the axis from 12 to 6 hours. Optical part 1 is implanted separately. when folded, with implantation forceps, which are placed parallel to the axis of symmetry of the through-cutouts 5 on the front surface of the ring. As you dilute the jaws of the tweezers, the optical part 1 is installed in the annular groove 7 IHG. The operation ends with leaching of the viscoprotector from the anterior chamber and the application of an aseptic dressing.

Example: Patient M., 57 years old, was admitted with a diagnosis of complicated cataract of the right eye. Visual acuity at admission 0.05 n / a. Preoperative refraction OD = SF -5.0 cyl -1.0 axis 145. Phacoemulsification of cataract with implantation of ICH + 17dptr according to the invention was carried out. The operation went without complications. A week after the operation, visual acuity OD = 0.1 sf + 3.0 = 0.9. The patient is not satisfied with the result of the operation, so the next day the optical part was replaced with a stronger one (+19 diopters). The operation and the postoperative period were uneventful. There were no technical difficulties when replacing the optical part. Visual acuity a week after replacing the optical part of the OD = 0.9 n / k.

Five proposed IHGs were implanted, in all cases high visual functions were obtained, patients were satisfied with the result of the operation.

Claims (4)

1. An artificial lens of the eye, consisting of an optical part and a support element, characterized in that the support element consists of a round ring and two loops attached to it; on the front surface of the ring, two identical symmetrical, diametrically located non-through cutouts are made in the form of a segment of the ring, the side walls of which are parallel to the sagittal plane, and the base is perpendicular to it; On the back surface of the ring, cutouts are made that are similar in shape and size to the cutouts on the front surface and are located crosswise in relation to them, and in the remaining four parts of the ring, an annular groove is made in the middle in the middle, sufficient in depth and thickness to fix the optical part in it, wherein the optical part itself is made of elastic material. 2. The artificial lens of the eye according to claim 1, characterized in that on the periphery of the optical part there are two flat diametrically arranged protrusions of a rounded shape lying in the main plane of the optical part. 3. The method of implanting an artificial lens of the eye (IHG), including performing a small cataract incision, continuous circular capsulorexis, phacoemulsification of cataracts, removal of cortical masses, characterized in that they perform separate implantation of a support element consisting of a round ring with two equally symmetrical, diametrically located non-through cutouts on its front surface and two loops and an optical part attached to the ring; while the loops and cuts on the front surface of the ring of the support element are arranged along the axis from 12 to 6 hours, and the optical part is implanted folded with tweezers located parallel to the axis of symmetry of the cuts on the front surface of the ring; when the tweezers are pulled apart, the optical part is fixed in the ring IHG groove. 4. The method according to claim 3, characterized in that during implantation of the optical part of the IHG, on the periphery of which there are two flat diametrically arranged protrusions of a rounded shape lying in the main plane of the optical part, the protrusions are arranged on the axis of 3 and 9 hours.

Images