An intraocular ruler for use in complex macular hole closure surgery

Abstract

The present invention belongs to the technical field of macular hole closure surgical tools, and particularly relates to an intraocular measuring ruler for complex macular hole closure surgery. The technical solution is as follows: An intraocular measuring ruler for complex macular hole closure surgery includes a metal sleeve, and a shape memory wire is sleeved inside the metal sleeve. The shape memory wire is divided into a measuring section and a straight section according to its shape. A length scale is provided on the measuring section. The shape of the measuring section in the natural state is smoothly bent relative to the straight section, and the measuring section extends out from one end of the metal sleeve. The present invention provides an intraocular measuring ruler for complex macular hole closure surgery, which realizes accurate measurement of macular holes and grafts.

Description

Technical Field

[0001] The present invention belongs to the technical field of macular hole closure surgical tools, and particularly relates to an intraocular ruler for 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 combined with retinal detachment, macular holes combined with high myopia, etc. Conventional surgical methods such as internal limiting membrane peeling and internal limiting membrane packing often have poor effects, with a low macular hole closure rate and a high recurrence rate after surgery. Currently, some studies have focused on using grafts to close complex macular holes. The grafts include amniotic membrane, autologous retina, etc. Clinical applications have proven that using grafts to close macular holes is effective.

[0003] Before using a graft to close a macular hole, it is necessary to measure the diameter of the macular hole through OCT, and then cut the graft according to the measured size. When cutting an autologous retinal graft, it is usually cut from the mid-peripheral and peripheral retina. This area cannot be measured by OCT, and it is also impossible to use a tonometer to flatten the area of the graft to be taken in the mid-peripheral and peripheral parts to an angle suitable for OCT measurement before surgery (because tamping requires retrobulbar anesthesia), nor can the area of the graft to be taken be calibrated. Therefore, the size of the required graft can only be determined by estimation. To avoid graft contracture leading to transplantation failure after surgery, a graft larger than the diameter of the macular hole needs to be taken.

[0004] However, there are often large errors in intraoperative estimation. A graft that is too small is prone to graft displacement, contracture, etc., resulting in surgical failure; a graft that is too large is likely to cause graft wrinkles and accumulation, making it difficult for the retina to be repositioned; especially for the surgical method of using autologous retinal transplantation to close macular holes, a graft that is too large will increase the risk of iatrogenic retinal giant holes, bleeding, and iatrogenic retinal detachment; in addition, since retinal tissue is extremely precious, a graft that is too large is also a waste.

[0005] In addition, for patients with macular holes combined with retinal detachment, preoperative OCT measurement often fails due to excessive elevation of the posterior pole retina and irregular retinal morphology. Surgeons can only estimate the size of the macular hole based on experience after flattening the retina with heavy water pressure during the 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 for complex macular hole closure surgery to achieve accurate measurement of macular holes and autologous retinal grafts.

[0007] The technical solution adopted by the present invention is as follows:

[0008] An intraocular ruler for complex macular hole closure surgery includes a metal cannula. A shape memory wire is sleeved inside the metal cannula. The shape memory wire is divided into a measuring section and a straight section according to its shape. Length scales are provided on the measuring section. The shape of the measuring section in its natural state is smoothly bent relative to the straight section, and the measuring section extends from one end of the metal cannula.

[0009] The macular hole is located at the posterior pole of the retina, and there is currently no intraocular tool for measuring the macular hole. After the metal cannula of the present invention is inserted into the eye, the measuring section of the shape memory wire is extended. After the measuring section restores its deformation, it is smoothly bent relative to the straight section, so that the measuring section can be parallel to the macular hole at the posterior pole. By adjusting the direction of the shape memory wire, the diameters of the macular hole in all directions can be measured to obtain the planar size of the macular hole.

[0010] Grafts for closing macular holes include amniotic membrane, autologous retina, etc. During the operation, when taking an autologous graft, first press the area of the mid-peripheral and peripheral parts of the graft to be taken to an angle suitable for microscopic observation and measurement, and then measure the sizes in all directions in the area of the graft to be taken according to the measured size of the macular hole.

[0011] In the prior art, when using OCT for measurement, only the macular hole can be measured, and the size of the autologous graft cannot be measured. Therefore, the size of the autologous graft can only be estimated visually during the operation, which often results in the size of the cut graft being too large or too small. By providing a measuring section of a bent shape memory wire, the present invention can accurately measure the sizes of the macular hole and the mid-peripheral and peripheral parts of the retina to be taken after being flattened. Under the condition of ensuring accurate measurement of the macular hole and the autologous graft, the present invention can avoid graft displacement, contracture caused by the size of the graft, and graft wrinkles and accumulation caused by the graft being too large.

[0012] The measuring section of the shape memory wire of the present invention has a special situation. It can restore its deformation in the eye without external force, so as to accurately and reliably measure the macular hole at the fundus. Its structure is simple and the measurement is accurate. It can replace the OCT measuring device for measuring the macular hole.

[0013] As a preferred solution of the present invention, one end of the metal cannula is connected with a semi-circular metal cannula, the other end of the shape memory wire is connected with a metal rod, and the metal rod is sleeved inside the semi-circular metal cannula; an electrocoagulator is also included. The electrocoagulator is connected with a conductive wire. The anode of the conductive wire is connected with the metal semi-circular cannula, and the cathode of the conductive wire is connected with the metal rod.

[0014] 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.

[0015] 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.

[0016] 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.

[0017] 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.

[0018] As a preferred embodiment of the present invention, the length of the electrocoagulation end is 0.1 mm.

[0019] 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.

[0020] 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.

[0021] 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.

[0022] As a preferred solution of the present invention, the length of the measuring section is 1 cm.

[0023] The beneficial effects of the present invention are:

[0024] 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.

[0025] 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.

[0026] 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

[0027] Figure 1 It is a schematic diagram of the structure of the present invention when used for measurement;

[0028] Figure 2 yes Figure 1 A partial enlarged view of the middle A;

[0029] Figure 3 It is a schematic diagram of the structure of the present invention when used for electrocoagulation;

[0030] Figure 4 yes Figure 3 A partial enlarged view of point B in the middle.

[0031] 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

[0032] To make the objectives, 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 with reference to the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are some, but not all, of the embodiments of the present invention. The components of the embodiments of the present invention described and illustrated herein can be arranged and designed in various different configurations.

[0033] Therefore, the following detailed description of the embodiments of the present invention provided in the drawings is not intended to limit the scope of the claimed invention, but merely represents selected embodiments of the present invention. All other embodiments obtained by those of ordinary skill in the art based on the embodiments of the present invention without creative efforts fall within the scope of protection of the present invention. It should be noted that, without conflict, the embodiments of the present invention and the features in the embodiments can be combined with each other.

[0034] As Figures 1 to 4 shown, the intraocular ruler for complex macular hole closure in this embodiment includes a metal sleeve 1. A shape memory wire 2 is sleeved inside the metal sleeve 1. The shape memory wire 2 is divided into a measurement section 21 and a straight section 22 according to its shape. A length scale (0.1 mm / grid, a total of 40 grids) is provided on the measurement section 21. The shape of the measurement section 21 in its natural state is smoothly bent relative to the straight section 22, and the measurement section 21 extends from one end of the metal sleeve 1.

[0035] Among them, the measurement section 21 is arcuately bent by 90° relative to the straight section 22 in its natural state. The measurement section 21 is smoothly bent by 90° relative to the straight section 22. After the metal sleeve 1 is inserted into the eye, when the measurement section 21 extends, it can be parallel to the macular hole area at the fundus of the eye, ensuring the accuracy of measurement. The length of the measurement section 21 is 1 cm, and the surface laser scale of the measurement section 21 is 0.1 mm / grid × 40 grids. The metal sleeve 1 is made of stainless steel conforming to GB / T 18457-2024 and can be disinfected by high temperature, high pressure, and radiation. The shape memory wire 2 is a shape memory alloy conforming to GB / 24627-2009 and can be disinfected by high temperature, high pressure, and radiation.

[0036] 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 measurement section 21 of the shape memory wire 2 extends. After the measurement section 21 restores its deformation, it is smoothly bent relative to the straight section 22, so that the measurement section 21 can be parallel to the macular hole at the posterior pole. By adjusting the direction of the shape memory wire 2, the diameters of the macular hole in all directions can be measured to obtain the planar size of the macular hole.

[0037] 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.

[0038] 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.

[0039] 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.

[0040] 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.

[0041] 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.

[0042] 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.

[0043] 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.

[0044] 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.

[0045] The present invention realizes reliable insulation through the insulating coating. The memory metal wire 2 is divided into 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.

[0046] The measurement method used in complex macular hole closure surgery of this embodiment includes the following steps:

[0047] 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;

[0048] S2: measuring the size of the macular hole by means of a measuring section 21 with a length scale;

[0049] 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;

[0050] 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;

[0051] S5: Repeat step S4 to measure and calibrate all length dimensions.

[0052] 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.

[0053] 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.

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