Incision positioner for vitrectomy combined cataract surgery

Abstract

The invention discloses an incision positioning device suitable for a vitrectomy combined cataract surgery. The incision positioning device comprises a left eye positioner and a right eye positioner, the left eye positioner is composed of a shell, and three trocar positioning marks are arranged on the shell and correspond to incision positions respectively, including a main incision position and a side incision position; the cornea mark position is horizontally aligned with the cornea at 0 degree; the incision of the first trocar is positioned on the temporal side of the left eye; anticlockwise rotating the side incision position by 30 degrees by taking the incision position of the first trocar as a reference; anticlockwise rotating the notch position of the third trocar by 20 degrees by taking the side notch position as a reference; anticlockwise rotating the position of the main incision by 80-135 degrees by taking the position of the third trocar incision as a reference; and the incision position of the second trocar is anticlockwise rotated by 30 degrees by taking the main incision position as a reference. By applying the incision positioning device provided by the invention, a reference position for opening an incision can be provided for a doctor, so that a relatively unified and normative incision position is realized in a cataract vitrectomy operation, fixation of an eyeball in the operation is assisted, lateral tension damage to a sclera wall caused by a surgical instrument when the eyeball is pulled is reduced, and the surgical efficiency is improved. And the eyeball fixing device can be used in an ophthalmologic operation assisted by a surgical robot.

Description

Technical Field

[0001] The present invention relates to the technical field of ophthalmic treatment aids, and specifically to an incision locator for vitrectomy combined with cataract surgery, which can assist in fixing the eyeball during the operation, reduce the damage to the scleral wall caused by the lateral pulling force when the surgical instrument pulls the eyeball, and can also be used as an eyeball fixation device in surgical robot-assisted ophthalmic surgery. Background Art

[0002] Generally speaking, the probability of cataract combined with fundus diseases in the elderly aged 60 and above is relatively high. The proportions of the elderly aged 60 and above suffering from hypertension, diabetes, and arteriosclerosis are high, which increases the probability of fundus lesions, such as diabetic retinopathy and hypertensive fundus lesions. The occurrence of cataract is also related to these diseases to a certain extent. When cataract develops to a certain degree, if there are conditions such as vitreous hemorrhage, epiretinal membrane, preretinal membrane, macular hole, and retinal detachment at the same time, vitrectomy combined with cataract surgery can be considered. If cataract surgery and vitrectomy are performed separately, the patient needs to experience the trauma and recovery processes of two surgeries, and the interval between the surgeries may cause further changes in the eye condition. The combined surgery can handle multiple lesions at one time, reducing the risks of complications such as infection and intraocular tissue damage caused by multiple surgeries. After the surgery, the patient only needs to follow a unified rehabilitation plan for nursing and follow-up, which is convenient for managing and evaluating the patient's eye condition.

[0003] In the prior art, in the combined surgery, due to the large number of incisions, it is necessary to locate the positions of each incision, such as the main incision, the side incision position, the trocar incision, etc. It is roughly located according to the doctor's surgical experience, which is unscientific and unreasonable. For example: If the main incision position and the trocar position are in the same direction and the misalignment is less than 20°, it may cause the two incisions to affect each other, resulting in an unstable anterior chamber of the patient during the operation, affecting the surgical operation, and complications such as leakage of the main incision or scleral incision after the surgery. Moreover, mastering various incision selection methods requires spending more time and energy on learning and practice, and under different incision methods, the requirements for surgical procedures and instrument operations will also be different, which makes it difficult to control the quality of the surgery. Therefore, standardizing the position of the combined surgery incision is very meaningful!

[0004] In addition, during vitrectomy, when dealing with delicate structures such as the epiretinal membrane and the inner limiting membrane, a fixed eyeball allows the surgeon or surgical robot to operate more efficiently. During the operation, if the eyeball rotates randomly, the surgeon or surgical robot needs to continuously adjust the position and direction of the instruments, which will greatly prolong the operation time. The eye ring designed in the present invention is a fixing device that directly contacts the surface of the eyeball. It restricts the movement of the eyeball through gentle contact with the surface of the eyeball. When the eye ring is placed on the eyeball, it generates a moderate circumferential force. By fixing the eyeball, it can effectively avoid the collision and traction between the instruments and the intraocular tissues caused by the movement of the eyeball, reducing the risk of intraocular tissue injury by about 30%-50%. Based on this, the technical solution of this application is proposed. Summary of the Invention

[0005] The purpose of the present invention is to provide an incision locator for vitrectomy combined with cataract surgery, which can assist in fixing the eyeball during the operation, reduce the damage to the scleral wall caused by the lateral pulling force when the surgical instrument pulls the eyeball, and can also be used as a device for fixing the eyeball in robot-assisted ophthalmic surgery, so as to solve the problems raised in the above background technology.

[0006] To achieve the above purpose, the present invention provides the following technical solutions:

[0007] This application provides an incision locator for vitrectomy combined with cataract surgery, including a left-eye locator and a right-eye locator; the left-eye locator includes: a housing; on the housing, the incision positions for three azimuth trocars to enter, a main incision position, and a side incision position are marked; a corneal horizontal 0° mark.

[0008] The first trocar positioning incision position is located on the temporal side of the left eye; the side incision position rotates 30° counterclockwise with respect to the first positioning incision position; the third trocar positioning incision position rotates 30° counterclockwise with respect to the side incision position; the main incision position rotates 120° counterclockwise with respect to the third trocar positioning incision position; the second positioning incision position rotates 30° counterclockwise with respect to the main incision position.

[0009] Optionally, the housing is provided with marks at the positioning incision positions, the main incision position, the side incision position, and the corneal mark.

[0010] Optionally, an indicating scale is provided inside the opening at the main incision position for marking the main incision position.

[0011] Optionally, a corneal hole is opened in the middle of the housing, and the diameter of the corneal hole is not less than 12.5 mm.

[0012] Optionally, the diameter of the housing is not less than 19.5 mm;

[0013] At least two sub-positioning holes are arranged at the first trocar positioning incision position, the second trocar positioning incision position, and the third trocar positioning incision position in the extending direction of the radius of the housing, and the distance between two adjacent sub-positioning holes is 0.5 mm.

[0014] Optionally, the material of the housing is a transparent material.

[0015] Optionally, the distance range between the small circular hole at the trocar positioning incision position and the limbus corneae is: 3.0 mm, 4.0 mm.

[0016] Optionally, for the pupils of aphakic eyes and patients with intraocular lenses, the positioning hole with a distance of 3.0 mm between the selectable trocar positioning incision position and the corneal limbus is selected; for patients with high myopia and phakic eyes, the positioning hole with a distance of 4.0 mm between the selectable trocar positioning incision position and the corneal limbus is selected.

[0017] Optionally, the first trocar positioning position (7) of the right eye locator is located on the temporal side of the right eye;

[0018] The side incision position (6) and the first trocar positioning incision position (7) are rotated counterclockwise by 120° based on the base; the third trocar incision position (9) is rotated counterclockwise by 30° based on the side incision position (6); the main incision position (4) is rotated counterclockwise by 120° based on the third trocar incision position (9); the second trocar incision position (8) is rotated counterclockwise by 30° based on the main incision position (4).

[0019] Compared with the prior art, the beneficial effects of the present invention are:

[0020] The present application provides an incision locator for vitrectomy combined with cataract surgery, including a left eye locator and a right eye locator. By using the incision locator provided by the present application, a reference position for opening the incision can be provided for the doctor within a reasonable range. In this way, in the cataract combined with vitrectomy surgery, there is a relatively unified incision position specification, which is more convenient for medical staff to use. It can also assist in fixing the eyeball during the operation, reduce the damage to the scleral wall caused by the lateral pulling force when the surgical instrument pulls the eyeball, and can also be used as an eyeball fixing device in the surgical robot-assisted ophthalmic surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1 It is a front view structural schematic diagram of the left eye locator.

[0022] Figure 2 It is a structural schematic diagram of the left eye locator.

[0023] Figure 3 Frontal view structural schematic diagram of the right eye locator.

[0024] Figure 4 Structural schematic diagram of the right eye locator.

[0025] In the figure: 1. Left eye locator; 2. Right eye locator; 3. Housing; 4. Main incision position; 5. Side incision position; 6. Corneal marker; 7. First trocar incision position; 8. Second trocar incision position; 9. Third trocar incision position. Specific implementation mode

[0026] Next, the technical solutions in the embodiments of the present invention will be clearly and completely described in conjunction with the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the protection scope of the present invention.

[0027] In addition, an element in the present invention is referred to as being "fixed to" or "disposed on" another element, and it can be directly on the other element or there can also be an intermediate element. When an element is considered to be "connected" to another element, it can be directly connected to the other element or there may be an intermediate element at the same time. The terms "vertical", "horizontal", "left", "right" and similar expressions used herein are only for the purpose of illustration and do not represent the only implementation mode.

[0028] As Figure 1 shown, in the embodiment of the present invention, the present application provides a left eye locator 1 and a right eye locator 2; the left eye locator 1 includes: a housing 3; on the housing 3, there are marked three incision positions 7, 8, 9 for the entry of azimuth trocars, a main incision position 4, a corneal horizontal 0° marker 5, and a side incision position 6.

[0029] The first trocar positioning incision position 7 is located on the temporal side of the left eye; the side incision position (6) is rotated counterclockwise by 30° with respect to the first positioning incision position (7); the third trocar positioning incision position (9) is rotated counterclockwise by 30° with respect to the side incision position; the main incision position (4) is rotated counterclockwise by 120° with respect to the third trocar positioning incision position (9); the second positioning incision position (8) is rotated counterclockwise by 30° with respect to the main incision position;

[0030] In this embodiment, in the actual application process, it is necessary to first select the left eye locator 1 or the right eye locator 2 provided by the present application according to the patient's eye condition. If the patient has a disease in the left eye, the left eye locator 1 is selected; if the patient has a disease in the right eye, the right eye locator 2 is selected.

[0031] After determining the locator, according to the actual situation of the patient, select the appropriate type of left-eye locator 1, place the locator on the patient's eye for fixation. During vitrectomy, the position where the trocar enters is mainly the pars plana of the ciliary body, between the ora serrata and the root of the iris, presenting an annular band-shaped area where no important visual structures such as the retina are closely attached. This area has relatively fewer blood vessels, reducing the risk of intraoperative bleeding; and it is at a certain distance from the optical center of the eyeball. Performing surgical operations such as inserting trocars and other instruments at this position has a relatively low probability of direct damage to the central vision-related structures such as the retina in the macular area. The pars plana is the posterior two-thirds part of the ciliary body. Usually, there is no clear individual measurement data for its diameter, but the overall width of the ciliary body is about 6-7 mm.

[0032] Specifically: For aphakic and pseudophakic patients, the positioning hole with a distance of 3.0 mm between the positioning incision position of the trocar and the corneal limbus can be selected; for highly myopic and phakic patients, the positioning hole with a distance of 4.0 mm between the positioning incision position of the trocar and the corneal limbus can be selected.

[0033] Further, as Figure 1 shown, in the left-eye locator 1 provided by the present application, two sub-positioning holes are designed at the first trocar incision position. The incision position of the first trocar hole is about 3.0 mm from the corneal limbus; the second opening is the positioning incision position with a distance of 4.0 mm from the corneal limbus. After determining which type of locator, the locator can be fixed on the patient's eye for positioning. Note: 23G: about 0.64 mm, 25G: about 0.51 mm, 27G: about 0.41 mm. The diameter of the positioning hole can select these parameters.

[0034] In this embodiment, in order to better provide positioning, the housing is provided with marks at the positioning incision position, the main incision position 4, the corneal mark 5, and the side incision position 6. During the positioning process, only need to make incisions according to the corresponding corneas at each position to achieve positioning.

[0035] Further, the corneal mark 5 is used to achieve the positioning of the entire device based on the patient's cornea. After setting the positioning incision position, incisions can be made according to each positioning position. For example, the first trocar incision is set according to the first positioning incision position 7, the second trocar incision is set according to the second positioning incision position 8, and the third trocar incision is set according to the third trocar positioning incision position 9; the main incision is set according to the main incision positioning position 4, and the side incision is set according to the side incision positioning position 6.

[0036] Specifically: The position of the main incision 4 is determined by rotating counterclockwise 30° with the position of the second positioning incision 8 as the reference, and the position of the main incision 4 is corresponding to the actual situation of the patient. The positioning of the main incision 4 can be achieved according to the above distance.

[0037] Further, a corneal hole is provided in the middle of the housing, and the diameter of the corneal hole is about 12.5 mm. The diameter of the outer shell is not less than 19.5 mm; at least two sub-positioning holes are provided at the first trocar incision position 7, the second trocar incision position 8, and the third trocar positioning incision position 9 in the extending direction of the radius of the outer shell, and the distance between two adjacent sub-positioning holes is 0.5 mm.

[0038] In a specific embodiment, the material of the outer shell is a transparent material. For example, the present application provides a silicone hydrogel material, and by mass percentage, the silicone hydrogel is polymerized from the following components: silicone-containing monomer: 15-80%; hydrophilic monomer: 20-70%; crosslinking agent: 0.1-10%; initiator: 0.1-10%; solvent: 35-65%; wherein, the sum of the mass percentages of each component is 100%; the silicone-containing monomer is a mixture of bis-3-methacryloxypropyltetramethyldisiloxane and methacryloxypropyltris(trimethylsiloxy)silane; or: the silicone-containing monomer is a mixture of bis-3-methacryloxypropyltetramethyldisiloxane, methacryloxypropyltris(trimethylsiloxy)silane and (3-methacryloxy-2-hydroxypropoxy)propylbis(trimethylsiloxymethyl); or: the silicone-containing monomer is a mixture of bis-3-methacryloxypropyltetramethyldisiloxane, methacryloxypropyltris(trimethylsiloxy)silane and (3-methacryloxy-2-hydroxypropoxy)propyldi(trimethylsilyloxy)methylsilane.

[0039] Among them, the hydrophilic monomer is one or a mixture of several of hydroxyethyl methacrylate, N-vinylpyrrolidone, methacrylic acid, methyl methacrylate, and polyethylene glycol methacrylate.

[0040] Using the silicone hydrogel material provided by the present application, it has a harder hardness than contact lenses. In actual use, it can better fit the patient's eyes, is not easily deformed, and is more convenient for users to use.

[0041] See Figure 3 As shown, in a specific embodiment, the first trocar positioning position (7) of the right eye locator is located on the temporal side of the right eye;

[0042] The side incision position (6) is rotated 120° counterclockwise with respect to the first trocar positioning incision position (7); the third trocar incision position (9) is rotated 30° counterclockwise with respect to the side incision position (6); the main incision position (4) is rotated 120° counterclockwise with respect to the third trocar incision position (9); and the second trocar incision position (8) is rotated 30° counterclockwise with respect to the main incision position (4).

[0043] For those skilled in the art, it is obvious that the present invention is not limited to the details of the above-described exemplary embodiments, and the present invention can be implemented in other specific forms without departing from the spirit or basic characteristics of the present invention. Therefore, from any point of view, the embodiments should be regarded as exemplary and non-restrictive. The scope of the present invention is defined by the appended claims rather than the above description. Therefore, all changes falling within the meaning and scope of the equivalent elements of the claims are intended to be embraced within the present invention. Any reference signs in the claims should not be construed as limiting the claims involved.

[0044] In addition, it should be understood that although this specification is described according to embodiments, not every embodiment only contains an independent technical solution. This narrative manner of the specification is only for clarity. Those skilled in the art should regard the specification as a whole, and the technical solutions in each embodiment can also be appropriately combined to form other embodiments that can be understood by those skilled in the art.

Claims

1. An incision locator for vitrectomy combined with cataract surgery, characterized in that, It includes a left eye locator (1) and a right eye locator (2); the left eye locator (1) includes: a housing (3); on the housing (3), there are marked three incision positions (7, 8, 9) for the entry of trocars, a main incision position (4), a corneal horizontal 0° mark (5); and a side incision position (6). The first trocar positioning incision position (7) is located on the temporal side of the left eye; the side incision position (6) rotates counterclockwise by 30° with respect to the first positioning incision position (7); the third trocar positioning incision position (9) rotates counterclockwise by 30° with respect to the side incision position (6); the main incision position (4) rotates counterclockwise by 120° with respect to the third trocar positioning incision position (9); the second positioning incision position (8) rotates counterclockwise by 30° with respect to the main incision position (4).

2. The incision locator for vitrectomy combined with cataract surgery according to claim 1, wherein, The housing is provided with marks at the positioning incision positions, the main incision position (4), the side incision position (6), and the corneal mark (5).

3. The incision locator for vitrectomy combined with cataract surgery according to claim 2, wherein, An indicating scale is provided inside the opening of the main incision position (4) for marking the main incision position (4).

4. The incision locator for vitrectomy combined with cataract surgery according to claim 3, wherein, A corneal hole is opened in the middle of the housing, and the diameter of the corneal hole is not less than 12.5 mm.

5. The incision locator for vitrectomy combined with cataract surgery according to claim 4, characterized in that, The diameter of the housing is not less than 19.5 mm. At the first trocar positioning incision position (7), the second trocar positioning incision position (8), and the third trocar positioning incision position (9), at least two sub-positioning holes are provided along the radial extension direction of the housing, and the distance between two adjacent sub-positioning holes is 0.5 mm.

6. The incision locator for vitrectomy combined with cataract surgery according to claim 1, wherein, The material of the housing is a transparent material.

7. The incision locator for vitrectomy combined with cataract surgery according to claim 1, characterized in that, The distance range between the small circular hole on the trocar positioning incision position and the limbus is: 3.0 mm, 4.0 mm.

8. The incision locator for vitrectomy combined with cataract surgery according to claim 7, characterized in that, For the pupils of aphakic and pseudophakic patients, the positioning hole with a distance of 3.0 mm between the selectable trocar positioning incision position and the corneal limbus is selected; for highly myopic and phakic patients, the positioning hole with a distance of 4.0 mm between the selectable trocar positioning incision position and the corneal limbus is selected.

9. The incision locator for vitrectomy combined with cataract surgery according to claim 1, characterized in that, The first positioning incision position (7) of the right eye locator (2) is located on the temporal side of the right eye. The side incision position (6) rotates counterclockwise by 120° with respect to the first trocar positioning incision position (7); the third trocar incision position (9) rotates counterclockwise by 30° with respect to the side incision position (6); the main incision position (4) rotates counterclockwise by 120° with respect to the third trocar incision position (9); the second trocar incision position (8) rotates counterclockwise by 30° with respect to the main incision position (4).

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