RU233730U1 - Maintainer for maintaining the volume of the anterior chamber of the eye - Google Patents

Abstract

The utility model relates to medicine, namely to ophthalmosurgery, and can be used to maintain the anterior chamber volume during cataract phacoemulsification. The maintainer includes a flexible body made in the form of a hollow tube 210 mm long and 0.8 mm in diameter with proximal and distal ends. The proximal end allows connecting the body to the irrigation system, the distal end 7 mm long and 0.5 mm in diameter with a cut at an angle of 45 degrees, the working edge of which has a Y-shaped end with shape memory due to a cut along the distal end 1 mm long, which allows fixing in access and maintaining the anterior chamber of the eye during cataract phacoemulsification in patients with high myopia. The tool is made of vinyl chloride polymer and is suitable for single use. The maintainer for maintaining the anterior chamber volume of the eye provides a stable anterior chamber volume during the entire period of surgical intervention.

Description

The utility model relates to medicine, namely ophthalmic surgery, and can be used to maintain the volume of the anterior chamber during cataract phacoemulsification.

During cataract phacoemulsification in patients with high myopia, due to the weakened ligamentous apparatus, the iris-lens diaphragm is displaced posteriorly and the anterior chamber becomes unstable, which leads to pain for patients and poor visualization for the surgeon.

Based on the analysis of patent literature, the closest to a utility model is a 25 G surgical needle. The disadvantages of this needle include lack of flexibility and insufficient length for safe insertion into the anterior chamber of the eye.

Also known is a butterfly needle with a flexible catheter, designed for taking blood. However, this model of needle is not designed for use in ophthalmic surgery.

The objective of the utility model is to maintain the volume of the anterior chamber of the eye in patients with high myopia during the stages of cataract phacoemulsification, which require replenishment of the loss of intraocular fluid during the cessation of work and the change of tips.

The technical result is stabilization of the anterior chamber volume of the eye during cataract phacoemulsification.

The technical result is achieved due to the design of the maintainer for stabilizing the volume of the anterior chamber of the eye. The maintainer includes a flexible body made in the form of a hollow tube 210 mm long and 0.8 mm in diameter with proximal and distal ends. The proximal end allows connecting the body to the irrigation system, the distal end is 7 mm long and 0.5 mm in diameter with a cut at an angle of 45 degrees, the working edge of which has a Y-shaped end with shape memory due to a cut along the distal end 1 mm long, which allows fixing in access and maintaining the volume of the anterior chamber of the eye during cataract phacoemulsification in patients with high myopia.

The instrument is made of vinyl chloride polymer and is suitable for single use.

The utility model is illustrated with figures.

Fig. 1 shows a general view of the utility model.

Position 1 indicates the proximal end of the maintainer, position 2 indicates the flexible body, and position 3 indicates the distal end.

Fig. 2 shows the distal end of the utility model.

The utility model is applied as follows.

Cataract phacoemulsification is performed through the main 2.2 mm access, through which viscoelastic is introduced into the anterior chamber of the eye, anterior capsulorhexis is performed, after the stages of hydrodissection and hydrodelineation, a 0.8 mm wide limbal paracentesis is performed at 6 o'clock, the maintainer is inserted into the access with the distal end in a closed state using tying forceps, an irrigation balanced salt solution is supplied to the proximal end through the infusion system into the anterior chamber at the moment of immersion and removal of the ultrasonic phaco needle and the coaxial tip of the irrigation-aspiration system. After the stages of phacoemulsification and intraocular lens implantation, washing out the viscoelastic, the maintainer is removed from the paracentesis, the accesses are hydrated.

Example

Patient S., 65 years old. Diagnosis upon admission: complicated cataract of the left eye, incomplete complicated cataract of the right eye. High myopia.

During the visus examination OD: 0.05 sph -6.5 = 0.4, OS: 0.05 sph -6.0 = 0.3. IOP OU = 18 mm Hg.

Ultrasound biometry: OD anterior-posterior axis of the eye 28.22 mm, OS anterior-posterior axis of the eye 28.2 mm.

Objectively: OS: the eye is calm. The cornea is transparent, the anterior chamber is deep, the aqueous humor is clean, the pupil is round, 3 mm, the lens is cloudy in the nuclear and cortical layers. The fundus reflex is pink, intraocular pressure (IOP) is normal by palpation. Deep-lying structures are not ophthalmoscoped.

The patient underwent phacoemulsification of the cataract of the left eye using the proposed method. Under local anesthesia (1% lidocaine by drip and 0.5 ml of 0.5% lidocaine solution into the anterior chamber), the main corneal access of 2.2 mm was performed at 10 o'clock on the conventional clock face and 1 paracentesis at 2 o'clock. Viscoelastic (Viscot) was introduced into the anterior chamber. Anterior circular capsulorhexis with a diameter of 5.5 mm, hydrodissection and rotation of the nucleus were performed. A 0.8 mm wide limbal paracentesis was performed at 6 o'clock, a maintainer was inserted into the access with its distal end, the length of which is 7 mm and the diameter is 0.5 mm with a cut at an angle of 45 degrees, the working edge of which has a Y-shaped end with shape memory due to a cut along the distal end 1 mm long, an irrigation balanced salt solution is supplied to the proximal end through a syringe into the anterior chamber at the moment of immersion and removal of the ultrasonic phaco needle and the coaxial tip of the irrigation-aspiration system. The irrigation balanced salt solution passes through the flexible body of the maintainer, made in the form of a hollow tube 210 mm long and 0.8 mm in diameter. After splitting the nucleus, Viscot viscoelastic was reintroduced under the cornea, and fragments of the nucleus were removed. Coaxial aspiration-irrigation was performed with a 25 G cannula. An Acrysof Single-Piece (SA60AT) 5 D intraocular lens was implanted into the capsular bag. The viscoelastic was removed, paracentesis was hydrated. No complications were observed during the surgery. The patient did not experience pain during the surgery when filling the eye with irrigation fluid. A stable anterior chamber volume was noted throughout all stages of phacoemulsification accompanied by the supply of irrigation solution. The postoperative course was uneventful. The pupil area was clear, there were no remnants of lens masses, the posterior capsule was transparent, there was a live pupillary reaction to light.

Visual acuity on the 2nd day: Vis OS=0.3 sph -1.0=0.8, IOP 19 mm Hg.

Upon examination after 1 week: Vis OS=0.4 sph -1.0=1.0, IOP 20 mm Hg.

In our clinic, 10 surgeries were performed using the proposed method on patients with anterior-posterior axis dimensions from 27.05 to 33.5 mm. All surgeries were successful. The maintainer for maintaining the volume of the anterior chamber of the eye ensures a stable volume of the anterior chamber of the eye during the entire period of surgical intervention.

Claims (1)

A maintainer for maintaining the volume of the anterior chamber of the eye, including proximal and distal ends, characterized in that the proximal and distal ends are connected by a flexible body made in the form of a hollow tube 210 mm long and 0.8 mm in diameter, the distal end 7 mm long and 0.5 mm in diameter has a Y-shaped end with shape memory due to a cut in half along the end 1 mm long, wherein said proximal end is made with the possibility of introducing an irrigation balanced salt solution through it into the anterior chamber of the eye.