Intraocular measuring scale and measuring method for complex macular pore sealing operation

Abstract

The invention belongs to the technical field of macular pore sealing operation tools, and particularly relates to an intraocular measuring scale and a measuring method for a complex macular pore sealing operation. According to the technical scheme, the intraocular measuring scale used in the complex macular pore sealing operation comprises a metal sleeve, a memory metal wire is arranged in the metal sleeve in a sleeved mode, the memory metal wire is divided into a measuring section and a straight section according to the shape, length scales are arranged on the measuring section, and the shape of the measuring section in the natural state is smoothly bent relative to the straight section. And the measuring section extends out of one end of the metal sleeve. The invention provides an intraocular measuring scale and a measuring method used in a complex macular pore sealing operation, which are used for realizing accurate measurement of macular pores and implant.

Description

Technical Field

[0001] The invention belongs to the technical field of macular hole closure surgical tools, and in particular relates to an intraocular ruler and a measuring method used in complex macular hole closure surgery. Background Art

[0002] Complex macular hole surgery is a difficult problem in the ophthalmology field, including giant macular holes, recurrent macular holes, macular holes with retinal detachment, and high myopia with macular holes. Conventional surgical methods such as internal limiting membrane peeling and internal limiting membrane tamponade often have poor results, low macular hole closure rates, and high hole recurrence rates. Currently, some studies have focused on graft closure of complex macular holes, including amniotic membrane, autologous retina, etc. Clinical applications have shown that graft closure of macular holes is effective.

[0003] Before the graft is used to close the macular hole, the diameter of the macular hole needs to be measured by OCT, and then the graft is cut according to the measured size. When cutting the autologous retinal graft, it is usually cut in the mid-peripheral and peripheral retina. This area cannot be measured by OCT, and before the operation, it is impossible to use a pressing device to flatten the mid-peripheral and peripheral areas to be grafted to an angle suitable for OCT measurement (because pressing requires retrobulbar anesthesia), and it is also impossible to calibrate the area to be grafted. Therefore, the required graft size can only be determined by estimation. In order to avoid transplant failure caused by postoperative graft contracture, a graft larger than the diameter of the macular hole needs to be taken.

[0004] However, there are often large errors in intraoperative estimates. A graft that is too small is prone to graft displacement and contracture, leading to surgical failure. A graft that is too large is prone to graft wrinkling and accumulation, making it difficult to reposition the retina. Especially for surgeries that use autologous retinal transplantation to close macular holes, a graft that is too large will increase the risk of iatrogenic giant retinal holes, hemorrhage, and iatrogenic retinal detachment. In addition, because retinal tissue is extremely precious, a graft that is too large is also a waste.

[0005] In addition, for patients with macular hole and retinal detachment, preoperative OCT measurement often fails because the posterior pole retinal detachment is too high and the retinal morphology is irregular. The surgeon can only estimate the size of the macular hole based on experience after flattening the retina with heavy water during surgery. Summary of the invention

[0006] In order to solve the above problems existing in the prior art, the purpose of the present invention is to provide an intraocular ruler and a measurement method for use in complex macular hole closure surgery, so as to achieve accurate measurement of macular holes and autologous retinal grafts.

[0007] The technical solution adopted by the present invention is: An intraocular ruler used in complex macular hole closure surgery comprises a metal sleeve with a memory metal wire sleeved therein. The memory metal wire is divided into a measuring section and a straight section according to its shape. A length scale is arranged on the measuring section. The shape of the measuring section in a natural state is smoothly bent relative to the straight section. The measuring section extends from one end of the metal sleeve.

[0008] The macular hole is located in the posterior pole of the retina, and there is currently no tool for measuring the macular hole in the eye. After the metal sleeve of the present invention is inserted into the eye, the measuring section of the memory metal wire is extended, and the measuring section is smoothly bent relative to the straight section after the deformation is restored, so that the measuring section can be parallel to the macular hole in the posterior pole. By adjusting the direction of the memory metal wire, the diameter of the macular hole in all directions can be measured to obtain the plane size of the macular hole.

[0009] The grafts used to close the macular hole include amniotic membrane, autologous retina, etc. When taking the autologous graft during the operation, first press the mid-peripheral and peripheral areas to be grafted to an angle suitable for observation and measurement under a microscope, and then measure the dimensions of the graft area in each direction according to the measured size of the macular hole.

[0010] In the prior art, when OCT is used for measurement, only the macular hole can be measured, but the size of the autologous graft cannot be measured. Therefore, the size of the autologous graft can only be estimated by visual inspection during surgery, which often makes the size of the graft cut too large or too small. The present invention can accurately measure the size of the macular hole and the mid-peripheral and peripheral retinal grafts to be taken after flattening by setting a measuring section of a bent memory metal wire. While ensuring the accurate measurement of the macular hole and the autologous graft, the present invention can avoid graft displacement and contracture caused by the size of the graft, as well as graft wrinkles and accumulation caused by the graft being too large.

[0011] The measuring section of the memory metal wire of the present invention has a special feature that it can restore its deformation in the eye without being affected by external forces, thereby accurately and reliably measuring the macular hole in the fundus. It has a simple structure and precise measurement, and can replace the OCT measuring device for measuring macular holes.

[0012] As a preferred embodiment of the present invention, one end of the metal sleeve is connected to a semi-annular metal sleeve, the other end of the memory metal wire is connected to a metal rod, and the metal rod is sleeved in the semi-annular metal sleeve; it also includes an electrocoagulation device, the electrocoagulation device is connected to a conductive wire, the anode of the conductive wire is connected to the metal semi-annular sleeve, and the cathode of the conductive wire is connected to the metal rod.

[0013] The memory metal wire of the present invention is connected to the electrocoagulation instrument through a metal rod and a conductive wire, so that it has an electrocoagulation function. After the periorbital graft to be taken is pressed to be flush with the fundus, electrocoagulation can be performed on the measured size position in the graft area to be taken, and electrocoagulation will form a significant white electrocoagulation spot on the retinal surface, and the electrocoagulation spot shows the boundary of the sampling area. Repeated measurement and electrocoagulation calibration have been calibrated for the diameter size in each direction, so that it is convenient for the operator to cut or tear the autologous retinal graft, ensuring that the size of the autologous graft taken is accurate.

[0014] The present invention has both measurement and electrocoagulation functions. By pushing the protrusion, the measurement section of the memory metal wire is extended or retracted from the metal sleeve, thereby realizing the switching of the measurement and electrocoagulation functions. When the measurement section is pushed out, the present invention can measure the macular hole or the autologous graft; when the measurement section is retracted and only the electrocoagulation end is left outside the metal sleeve, the present invention can electrocoagulate the autologous graft area to calibrate the position of the graft area.

[0015] As a preferred solution of the present invention, a section of the conductive wire connecting the metal rod is a retractable spring coil, which can be retracted accordingly to ensure that when the metal rod is pushed, the metal rod is always electrically connected to the electrocoagulation instrument through the guide wire.

[0016] As a preferred embodiment of the present invention, the memory metal wire is divided into an insulating section and an electrocoagulation end away from one end of the metal rod according to insulation properties. The insulating section of the memory metal wire, the metal rod, the conductive wire, the metal sleeve except the opening, and the metal semi-annular sleeve are all covered with an insulating coating.

[0017] As a preferred embodiment of the present invention, the length of the electrocoagulation end is 0.1 mm.

[0018] As a preferred solution of the present invention, a protrusion is connected to the metal rod, the protrusion extends from the opening side of the metal semi-annular sleeve, and an insulating rubber sleeve is sleeved on the protrusion.

[0019] As a preferred solution of the present invention, the outer shell of the metal semi-annular sleeve is connected to a plastic sleeve shell, a groove is arranged on the plastic sleeve shell, and the protrusion extends out of the groove.

[0020] As a preferred embodiment of the present invention, the measuring section is naturally curved 90° relative to the straight section. The measuring section is smoothly bent 90° relative to the straight section, so that after the metal cannula is inserted into the eye, the measuring section can be extended parallel to the macular hole area to ensure the accuracy of the measurement.

[0021] As a preferred solution of the present invention, the length of the measuring section is 1 cm.

[0022] A measurement method for complex macular hole closure surgery, comprising the following steps: S1: insert the metal sleeve into the eye, and adjust the metal rod by pushing the raised part so that the measuring section of the memory metal wire extends out of the metal sleeve, and the measuring section of the memory metal wire automatically restores the bent shape; S2: Measure the size of the macular hole in the fundus through the measuring segment with length scale; S3: Use a press to press the peripheral retinal graft area to a suitable angle for observation and measurement under a microscope; S4: by pushing the raised part to adjust the metal rod, the measuring section of the memory metal wire is extended from the metal sleeve, and the measurement is performed at the periorbital area to be implanted according to one of the length dimensions measured in step S2; after the measurement, the raised part is pushed in the reverse direction, the metal rod is adjusted, and only the electrocoagulation end of the memory metal wire is left outside the metal sleeve, and the measured position is electrocoagulated and calibrated; S5: Repeat step S4 to measure and calibrate all length dimensions.

[0023] The beneficial effects of the present invention are: 1. In the prior art, when OCT is used for measurement, only the macular hole can be measured, but the autologous graft cannot be measured, so the size of the autologous graft can only be estimated, which ultimately leads to the size of the graft being too large or too small. The present invention can accurately measure the macular hole at the fundus and the flattened periorbital graft to be taken by setting a measuring section of a bent memory wire. While ensuring the accurate measurement of the macular hole and the autologous graft, the present invention can avoid graft displacement and contracture caused by the size of the graft, and can avoid graft wrinkles and accumulation caused by too large a graft.

[0024] 2. The measuring section of the memory metal wire of the present invention has a special feature that it can restore its deformation in the eye without being affected by external forces, thereby accurately and reliably measuring the macular hole in the fundus. It has a simple structure and precise measurement, and can replace the OCT measuring device for measuring macular holes.

[0025] 3. The memory metal wire of the present invention is connected to the electrocoagulation instrument through a metal rod and a conductive wire, so that it has an electrocoagulation function. After the periorbital graft to be taken is pressed to be flush with the fundus, the measured size position can be electrocoagulated in the graft area to be taken, and the electrocoagulation will form a significant white electrocoagulation spot on the retinal surface, which shows the boundary of the sampling area. Repeated measurement and electrocoagulation calibration have been calibrated for the diameter size in all directions, so that it is convenient for the operator to cut or tear the autologous retinal graft, ensuring that the size of the autologous graft taken is accurate. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] Figure 1 It is a schematic diagram of the structure of the present invention when used for measurement; Figure 2 yes Figure 1 A partial enlarged view of the middle A; Figure 3 It is a schematic diagram of the structure of the present invention when used for electrocoagulation; Figure 4 yes Figure 3 A partial enlarged view of point B in the middle.

[0027] In the figure: 1-metal sleeve; 2-memory metal wire; 3-metal semi-annular sleeve; 4-metal rod; 5-conductive wire; 6-electrocoagulation instrument; 7-plastic sleeve shell; 21-measuring section; 22-straight section; 41-protrusion; 51-spring coil. DETAILED DESCRIPTION

[0028] In order to make the purpose, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are part of the embodiments of the present invention, not all of the embodiments. Generally, the components of the embodiments of the present invention described and shown in the drawings here can be arranged and designed in various different configurations.

[0029] Therefore, the following detailed description of the embodiments of the present invention provided in the accompanying drawings is not intended to limit the scope of the claimed invention, but merely represents selected embodiments of the present invention. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in the field without creative work are within the scope of protection of the present invention. It should be noted that the embodiments of the present invention and the features in the embodiments can be combined with each other without conflict.

[0030] like Figure 1 to Figure 4 As shown, the intraocular ruler used in complex macular hole closure surgery of this embodiment includes a metal sleeve 1, a memory metal wire 2 is sleeved inside the metal sleeve 1, and the memory metal wire 2 is divided into a measuring section 21 and a straight section 22 according to the shape. The measuring section 21 is provided with a length scale (0.1 mm / grid, 40 grids in total). The shape of the measuring section 21 in a natural state is smoothly bent relative to the straight section 22, and the measuring section 21 extends from one end of the metal sleeve 1.

[0031] The measuring section 21 is naturally curved 90° relative to the straight section 22. The measuring section 21 is smoothly bent 90° relative to the straight section 22, so that after the metal sleeve 1 is inserted into the eye, the measuring section 21 can be parallel to the macular hole area of ​​the fundus when extended, ensuring the accuracy of the measurement. The length of the measuring section 21 is 1 cm, and the laser scale on the surface of the measuring section 21 is 0.1 mm / grid × 40 grids. The metal sleeve 1 is made of stainless steel in accordance with GB / T 18457-2024 and can be sterilized by high temperature, high pressure and radiation. The memory metal wire 2 is a shape memory alloy in accordance with GB / 24627-2009 and can be sterilized by high temperature, high pressure and radiation.

[0032] The macular hole is located in the posterior pole of the retina, and there is currently no tool for measuring the macular hole in the eye. After the metal sleeve 1 of the present invention is inserted into the eye, the measuring section 21 of the memory metal wire 2 extends out, and the measuring section 21 is smoothly bent relative to the straight section 22 after recovering the deformation, so that the measuring section 21 can be parallel to the macular hole in the posterior pole. By adjusting the direction of the memory metal wire 2, the diameter of the macular hole in all directions can be measured to obtain the plane size of the macular hole.

[0033] When measuring the size of the macular hole, the maximum and minimum diameters of the macular hole are generally measured. When measuring the intended graft, with the aid of a wide-angle lens or an assistant, the measuring section 21 of the memory wire 2 is used to measure the retina of the intended graft area: for allogeneic transplantation procedures, such as amniotic membrane transplantation to close the macular hole, after determining the graft diameter, the graft of the appropriate size can be directly trimmed along the measured edge to close the macular hole; for autologous retinal transplantation procedures, under a microscope, after measuring the edge of the graft in the intended area, the memory wire 2 is retracted into the metal sleeve 1, leaving only the head without the insulating coating at the front end, and the edge of the graft is subjected to 360° spot electrocoagulation; the graft is cut off along the inner edge of the electrocoagulation spot, and the graft is implanted below the macular hole with intraocular forceps.

[0034] Grafts for macular holes include amniotic membrane, autologous retina, etc. When taking autologous grafts during surgery, first press the mid-peripheral and peripheral areas to be grafted to an angle suitable for observation and measurement under a microscope, and then measure the dimensions of the graft area in all directions based on the measured size of the macular hole.

[0035] In the prior art, when OCT is used for measurement, only the macular hole can be measured, but the autologous graft cannot be measured. Therefore, the size of the autologous graft can only be estimated by the surgeon visually, which easily leads to the graft being cut too large or too small. The present invention can accurately measure the macular hole at the fundus and the flattened periorbital graft to be taken by setting the measuring section 21 of the bent memory metal wire 2. While ensuring the accurate measurement of the macular hole and the autologous graft, the present invention can avoid graft displacement and contracture caused by the size of the graft, and can avoid graft wrinkles and accumulation caused by too large a graft.

[0036] The measuring section 21 of the memory metal wire 2 of the present invention has a special feature that it can restore its deformation in the eye without being affected by external forces, thereby accurately and reliably measuring the macular hole in the fundus. It has a simple structure and precise measurement, and can replace the OCT measuring device for measuring macular holes.

[0037] In order to mark the area of ​​the retinal mid-periphery and peripheral part to be transplanted, one end of the metal sleeve 1 is connected to a metal semi-annular sleeve 3, and the other end of the memory metal wire 2 is connected to a metal rod 4, and the metal rod 4 is sleeved in the metal semi-annular sleeve 3. The present invention also includes an electrocoagulation device 6, which is connected to a conductive wire 5, the anode of the conductive wire 5 is connected to the metal semi-annular sleeve 3, and the cathode of the conductive wire 5 is connected to the metal rod 4.

[0038] The metal rod 4 is connected with a protrusion 41, which extends from the opening side of the metal semi-annular sleeve 3, and an insulating rubber sleeve is sleeved on the protrusion 41. The metal semi-annular sleeve 3 is connected with a plastic sleeve shell 7, and a slot is set on the plastic sleeve shell 7, and the protrusion 41 extends from the slot. A section of the conductive wire 5 connected to the metal rod 4 is a retractable spring coil 51. The metal semi-annular sleeve 3 is made of a polyetheretherketone polymer material for surgical implants that complies with YY / T0660, and can be sterilized by high temperature, high pressure, and radiation. The insulating rubber sleeve is made of a polyetheretherketone polymer material for surgical implants that complies with YY / T0660, and can be sterilized by high temperature, high pressure, and radiation.

[0039] The memory metal wire 2 of the present invention is connected to the electrocoagulation instrument 6 through the metal rod 4 and the conductive wire 5, so that it has the electrocoagulation function. After the area to be transplanted is pressed to an angle suitable for observation and measurement under a microscope, the measured size position can be electrocoagulated in the area to be transplanted, and the electrocoagulation will form a significant white electrocoagulation spot on the retinal surface, which shows the boundary of the transplant area. Repeat the measurement and electrocoagulation calibration, and calibrate the diameter size in each direction, so as to facilitate the operator to cut or tear the autologous retinal transplant, and ensure that the size of the autologous transplant obtained is accurate.

[0040] The present invention has both measurement and electrocoagulation functions. By pushing the protrusion 41, the measurement section 21 of the memory metal wire 2 is extended or retracted from the metal sleeve 1, thereby realizing the switching of the measurement and electrocoagulation functions. When the measurement section 21 is pushed out, the present invention can measure the macular hole or the autologous graft; when the measurement section 21 is retracted and only the electrocoagulation end is outside the metal sleeve 1, the present invention can electrocoagulate the autologous graft area and calibrate the position of the graft area. The spring coil 51 can be extended and retracted accordingly to ensure that when the metal rod 4 is pushed, the metal rod 4 is always connected to the electrocoagulation instrument 6 through the guide wire.

[0041] The present invention realizes reliable insulation through the insulating coating. The memory metal wire 2 includes an insulating section and an electrocoagulation end away from one end of the metal rod 4 according to the insulation property; the electrocoagulation end is not covered with an insulating layer and is 0.1 mm long. The insulating section of the memory metal wire 2, the metal rod 4, the conductive wire 5, and the metal semi-annular sleeve 3 are all covered with an insulating coating. Except for the edge of the opening of the metal sleeve 1, which is not covered with an insulating coating, the rest of the parts are covered with an insulating coating.

[0042] The measurement method used in complex macular hole closure surgery of this embodiment includes the following steps: S1: insert the metal sleeve 1 into the eye, and adjust the metal rod 4 by pushing the protrusion 41, so that the measuring section 21 of the memory metal wire 2 extends out of the metal sleeve 1, and the measuring section 21 of the memory metal wire 2 automatically restores the bent shape; S2: measuring the size of the macular hole by means of a measuring section 21 with a length scale; S3: Use a press to press the mid-peripheral and peripheral retinal graft areas to a suitable angle for observation and measurement under a microscope; S4: by pushing the protrusion 41 to adjust the metal rod 4, the measuring section 21 of the memory metal wire 2 is extended from the metal sleeve 1, and the measurement is performed at the periorbital area to be implanted according to one of the length dimensions measured in step S2; after the measurement, the protrusion 41 is pushed in the reverse direction, the metal rod 4 is adjusted, and only the electrocoagulation end of the memory metal wire 2 is left outside the metal sleeve 1, and the electrocoagulation calibration is performed on the measured position; S5: Repeat step S4 to measure and calibrate all length dimensions.

[0043] After the graft to be taken is calibrated, the autologous retinal graft can be cut or torn along the boundary of the sampling area formed by the white electrocoagulation spot. After the autologous graft is cut, the free graft is implanted under the macular hole to perform macular hole closure. The present invention improves the success rate of surgery and reduces surgical risks and complications by taking a graft of appropriate size.

[0044] The present invention is not limited to the above-mentioned optional implementation modes. Anyone can derive other various forms of products under the inspiration of the present invention. However, no matter what changes are made in the shape or structure, all technical solutions that fall within the scope defined by the claims of the present invention fall within the protection scope of the present invention.

Claims

1. An intraocular ruler for use in complex macular hole closure surgery, characterized in that: The invention comprises a metal sleeve (1), wherein a memory metal wire (2) is sleeved inside the metal sleeve (1), wherein the memory metal wire (2) is divided into a measuring section (21) and a straight section (22) according to the shape, wherein a length scale is arranged on the measuring section (21), wherein the shape of the measuring section (21) in a natural state is smoothly bent relative to the straight section (22), and the measuring section (21) extends from one end of the metal sleeve (1).

2. The intraocular ruler for complex macular hole closure according to claim 1, characterized in that: One end of the metal sleeve (1) is connected to a metal semi-annular sleeve (3), the other end of the memory metal wire (2) is connected to a metal rod (4), and the metal rod (4) is sleeved in the metal semi-annular sleeve (3); and the device also includes an electrocoagulation device (6), the electrocoagulation device (6) is connected to a conductive wire (5), the anode of the conductive wire (5) is connected to the metal semi-annular sleeve (3), and the cathode of the conductive wire (5) is connected to the metal rod (4).

3. The intraocular ruler for complex macular hole closure according to claim 2, characterized in that: The section of the conductive wire (5) connected to the metal rod (4) is a retractable metal spring ring (51).

4. The intraocular ruler for complex macular hole closure according to claim 2, characterized in that: The memory metal wire (2) comprises an insulating section and an electrocoagulation end away from one end of the metal rod (4) according to insulation properties. The insulating section of the memory metal wire (2), the metal rod (4), the conductive wire (5), the metal sleeve (1) except for the opening, and the metal semi-annular sleeve (3) are all covered with an insulating coating.

5. The intraocular ruler for complex macular hole closure according to claim 4, characterized in that: The length of the electrocoagulation end is 0.1 mm.

6. The intraocular ruler for complex macular hole closure according to claim 4, characterized in that: The metal rod (4) is connected to a protruding portion (41), the protruding portion (41) protrudes from the opening side of the metal semi-annular sleeve (3), and an insulating rubber sleeve is sleeved on the protruding portion (41).

7. The intraocular ruler for complex macular hole closure according to claim 6, characterized in that: The outer surface of the metal semi-annular sleeve (3) is connected to a plastic sleeve shell (7), and a groove is provided on the plastic sleeve shell (7), and the protrusion (41) extends out of the groove.

8. The intraocular ruler for complex macular hole closure according to claim 1, characterized in that: In a natural state, the measuring section (21) is curved at 90° relative to the straight section (22).

9. The intraocular ruler for complex macular hole closure according to claim 1, characterized in that: The length of the measuring section (21) is 1 cm.

10. A measurement method for complex macular hole closure surgery, according to claim 6, characterized in that: The following steps are involved: S1: inserting the metal sleeve (1) into the eye, and adjusting the metal rod (4) by pushing the protrusion (41) so that the measuring section (21) of the memory metal wire (2) extends out from the metal sleeve (1), and the measuring section (21) of the memory metal wire (2) automatically restores the bent shape; S2: Measure the size of the macular hole on the fundus using a measuring segment with a length scale (21); S3: Use a press to press the peripheral retinal graft area to a suitable angle for observation and measurement under a microscope; S4: by pushing the raised portion (41) to adjust the metal rod (4), the measuring section (21) of the memory metal wire (2) is extended from the metal sleeve (1), and the measurement is performed at the periorbital region to be implanted according to one of the length dimensions measured in step S2; after the measurement, the raised portion (41) is pushed in the reverse direction, the metal rod (4) is adjusted, and only the electrocoagulation end of the memory metal wire (2) remains outside the metal sleeve (1), and the electrocoagulation calibration is performed on the measured position; S5: Repeat step S4 to measure and calibrate all length dimensions.

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