Post-cataract-operation capsular membrane treatment method based on water jet polishing

Abstract

The invention relates to the technical field of ophthalmology medical treatment, in particular to a cataract postoperative capsular membrane treatment method based on water jet polishing, which comprises the following steps: (a) positioning a micro-nozzle to the surface of a capsular membrane implanted with an intraocular lens, and keeping the distance between the nozzle and the capsular membrane to be 100-500 microns; (b) high-speed laminar water beams are directionally sprayed to the surface of the capsule membrane through a micro nozzle with the diameter of 50-200 microns, the pressure of the water beams is 0.2-0.8 MPa, and the impact angle is 30-60 degrees; (c) controlling the water beam to scan and polish the surface of the capsule membrane according to a preset path; (d) the surface morphology of the envelope is monitored in real time through the optical coherence tomography technology, polishing parameters are dynamically adjusted according to the monitoring result, the water beam in the step (b) is pulse water flow, the pulse width is smaller than or equal to 5 ms, and the pulse frequency is 1-10 kHz; the problems that in the prior art, due to physical friction, capsule micro-tearing is caused, the IOL scratch rate is about 5% (SEM electron microscope evidence), and cells are not completely removed are solved.

Description

Technical Field

[0001] This invention belongs to the field of ophthalmic medical technology, specifically a method for treating the cataract capsule after surgery based on water jet polishing. Background Technology

[0002] Posterior capsular opacity (PCO) is a common complication after cataract surgery (occurring in approximately 20%-40% of cases). Traditionally, it is treated with YAG laser posterior capsulotomy. Posterior capsular opacity, also known as posterior cataract, is usually caused by residual cortical and epithelial cells proliferating after cataract surgery. It is a common complication following cataract surgery, and residual lens epithelial cells (LECs) are the core cause of PCO, with a global incidence of 20%-40%. CO patients require a second surgery (YAG laser-assisted capsulotomy), but this procedure has the following inherent drawbacks: Safety risks: Laser energy (usually 3-8 mJ) can easily damage the intraocular lens (IOL) coating, causing glare or displacement (occurrence rate of about 7%), and may induce macular edema (occurrence rate of about 2%); Unstable efficacy: Irregular edges of the capsular opening after laser treatment (clinical reports show an irregularity rate >30%), leading to visual distortion; Limitations of passive treatment: LECs cannot be removed during surgery, and intervention can only be done after PCO has formed; Current intraoperative polishing techniques have limitations. To prevent prolapse and cystic occlusion (PCO), mechanical polishing instruments (such as rotating silicone heads and polishing curettes) are used intraoperatively. However, these techniques have limitations: contact damage, physical friction leading to micro-tears of the capsule (post-operative eye experiments confirm a rupture rate ≥10%), and an IOL scratch rate of approximately 5% (SEM electron microscopy evidence); incomplete cell removal, as instruments cannot reach the equatorial region of the capsule, resulting in a LECs residual rate >35% (see Comparative Example 1); and a lack of standardized procedures, over-reliance on the surgeon's experience, with novice surgeons experiencing a PCO incidence rate of up to 45% after polishing. Summary of the Invention

[0003] This invention relates to the field of ophthalmic medical technology, specifically to a method for treating the cataract capsule after surgery based on water jet polishing. This method addresses the problems in existing technologies, such as micro-tears of the capsule caused by physical friction, an IOL scratch rate of approximately 5% (SEM electron microscopy evidence), and incomplete cell removal.

[0004] This invention proposes a method for treating the cataract capsule after surgery based on water jet polishing, comprising the following steps: (a) Position the micro-nozzle onto the surface of the capsule after implantation of the artificial lens, maintaining a distance of 100-500 μm between the nozzle and the capsule; (b) A high-speed laminar water jet is directionally sprayed onto the membrane surface through a micro-nozzle with a diameter of 50-200 μm, wherein the water jet pressure is 0.2-0.8 MPa and the impact angle is 30°-60°; (c) Control the water jet to scan and polish the membrane surface according to a preset path; (d) The surface morphology of the capsule is monitored in real time by optical coherence tomography, and the polishing parameters are dynamically adjusted according to the monitoring results.

[0005] Furthermore, the water jet in step (b) is a pulsed water flow with a pulse width ≤ 5ms and a pulse frequency of 1-10kHz.

[0006] Furthermore, the water stream is an isotonic buffer solution with added viscoelasticity enhancer, wherein the viscoelasticity enhancer is sodium hyaluronate, and its mass concentration in the buffer solution is 0.05%-0.2%.

[0007] Furthermore, the preset path in step (c) is a spiral trajectory or a concentric circle trajectory, and the scanning speed is 0.5-2 mm / s.

[0008] Furthermore, in step (b), the Reynolds number Re < 2000 for the laminar water jet, and laminar flow is generated through a conical micro-nozzle.

[0009] Furthermore, the dynamic adjustment of polishing parameters in step (d) includes automatically terminating polishing when the surface roughness Ra of the capsule is ≤0.2μm.

[0010] Furthermore, the positioning in step (a) is achieved by a 6-DOF robotic arm with a positioning accuracy of ±10μm.

[0011] Furthermore, the real-time monitoring in step (d) includes: The membrane thickness was measured using a confocal microscope with a resolution ≤1 μm. The water jet pressure is controlled in a closed loop using a fluid pressure sensor with a range of 0-1 MPa.

[0012] Furthermore, the method is performed immediately after the implantation of an artificial lens during cataract surgery to preventively remove residual lens epithelial cells from the capsule surface.

[0013] Furthermore, the polishing time of the water jet on one side of the capsule is ≤30 seconds, and the total processing time is controlled within 2 minutes.

[0014] Compared with the prior art, the beneficial effects of the present invention are as follows: 1. This invention employs an innovative architecture of "directional water jet ablation + real-time feedback control," utilizing a non-contact design: the distance between the water jet and the membrane is 100-500μm, microscopic observation confirms zero scratches on the IOL surface, and precise microfluidic ablation: pulsed water flow (pulse width ≤5ms) matches the cell adhesion force breakage frequency, and in vitro tests show a LECs residual rate of <5%; sodium hyaluronate thickener (0.05%-0.2%) increases shear force by 43%, clearing hidden cells in the equatorial region; 2. This invention employs a non-contact, high-speed laminar water jet for polishing, completely avoiding physical friction between traditional mechanical instruments (such as rotating silicone heads and polishing spatulas) and the capsule and intraocular lens (IOL). This reduces the capsule micro-tear rate from ≥10% in existing technologies to near zero, while simultaneously reducing the IOL scratch rate from 5% to below 0.1%. By precisely controlling the water jet pressure (0.2-0.8MPa), pulse parameters (pulse width ≤5ms, frequency 1-10kHz), and impact angle (30°-60°), combined with the fluid characteristics of laminar flow (Re<2000), macular edema caused by energy impact during laser treatment (incidence reduced from 2% to <0.1%) and glare and misalignment problems caused by IOL coating damage (incidence reduced from 7% to <0.5%) can be avoided, significantly improving surgical safety.

[0015] 3. By combining optical coherence tomography (OCT) for real-time monitoring of the capsule morphology, confocal microscopy for measuring capsule thickness (resolution ≤1μm), and closed-loop control using a fluid pressure sensor, the water jet parameters can be dynamically adjusted. This ensures efficient operation with a single-sided capsule polishing time ≤30 seconds and a total processing time ≤2 minutes, while avoiding capsule damage caused by over-polishing. The low Reynolds number (Re<2000) design of the laminar water jet further guarantees the controllability of fluid impact, enabling the polishing process to efficiently remove cells without damaging the capsule integrity.

[0016] 4. This invention, through the organic combination of non-contact water jet polishing technology, automated parameter control, and real-time monitoring system, significantly improves the prevention effect of PCO while minimizing surgical risks and shortening operation time. It achieves safety, efficiency, and standardization in postoperative capsule treatment of cataracts, and has extremely high clinical application value. Attached Figure Description

[0017] Figure 1 This is a schematic flowchart of a water jet polishing method for postoperative capsule treatment in cataract surgery according to the present invention. Figure 2 This is a schematic diagram of the water jet polishing path in a cataract surgery capsular treatment method based on water jet polishing according to the present invention.

[0018] Figure 3 This invention provides an OCT comparison of the capsule before and after polishing in a water jet polishing-based cataract surgery capsule treatment method.

[0019] Figure 4 This is a rabbit eye test histopathological comparison (4 weeks post-surgery) of the cataract surgery capsule treatment method based on water jet polishing according to the present invention.

[0020] Figure 5This invention provides a comparison of the effects of traditional methods and water jet polishing techniques in a cataract surgery capsular treatment method based on water jet polishing. Detailed Implementation

[0021] This invention provides a method for treating the cataract capsule after surgery based on water jet polishing. Example 1: Basic Implementation Step 1: Preoperative preparation Preparation of polishing solution: Add 0.1% sodium hyaluronate to the balanced salt solution (BSS); Configure device parameters: Micronozzle diameter 100μm (range: 50-200μm) The pulse width of the water flow is 3ms (≤5ms), and the frequency is 5kHz (1-10kHz). The laminar water jet pressure is 0.5 MPa (0.2-0.8 MPa), and the Reynolds number Re = 1500 (Re < 2000). Step 2: Intraoperative positioning and polishing After phacoemulsification cataract surgery, an intraocular lens (IOL) is implanted. The nozzle is positioned in the center of the posterior capsule using a 6-DOF robotic arm, maintaining a spacing of 300 μm (100-500 μm). The polishing liquid is sprayed at an impact angle of 45° (30°-60°) and scanned along a spiral trajectory at a scanning speed of 1 mm / s (0.5-2 mm / s). The polishing time for a single polishing session is 25 seconds (≤30 seconds), and the total operation time is 1 minute and 40 seconds (<2 minutes).

[0022] Step 3: Real-time monitoring and closed-loop control The integrated OCT module measures the capsule roughness in real time (resolution 0.8 μm). Polishing automatically terminates when the roughness Ra = 0.18 μm (≤ 0.2 μm threshold); The pressure sensor dynamically adjusts the water pressure (range 0-1MPa), with a fluctuation range of ±0.05MPa.

[0023] Verification of results: Confocal microscopy showed that the residual rate of lens epithelial cells (LECs) was <5%, and the capsule was intact without rupture.

[0024] Example 2: Parameter Optimization Comparison Experiment Control group setup: Operation process: Using the same spiral path (scanning speed 1.5 mm / s); The membrane thickness is monitored by OCT, and an alarm is triggered when the thickness decreases by more than 5 μm. Record the time required to achieve Ra≤0.2μm.

[0025] result: Conclusion: The defined parameter range (water pressure 0.2-0.8MPa, angle 30°-60°) has optimal safety and effectiveness.

[0026] Example 3: Preclinical Animal Experiments Experimental subjects: 12 New Zealand rabbits (24 eyes), randomly divided into two groups: Traditional group: Mechanical polishing with cotton swabs (existing technology); Invention Group: Water jet polishing.

[0027] Operation process: Implantation of an IOL following phacoemulsification is followed by immediate capsule polishing. The invention group used a concentric circle path to scan from the center of the capsule to the outer periphery (radius 0-5mm). The patients were sacrificed 4 weeks post-surgery, and histological analysis was performed to determine the amount of residual LECs.

[0028] result: *p<0.01 vs. traditional group (t-test) Pathological sections: The surface of the capsule in the invention group was smooth (Ra=0.15±0.03μm) and showed no fibrosis or hyperplasia. Clustered residues of LECs were visible in the conventional group (indicated by arrows). Summary of technical effects The embodiments of this invention confirm that: Highly effective prevention of PCO: LECs clearance rate >96% (compared to 60-70% for traditional methods); Zero instrument contact: No scratches on the IOL surface (verified by SEM electron microscopy); Standardized operation: Robotic arm path control increases the success rate of novice doctors to 95%.

[0029] This invention, through the organic combination of non-contact water jet polishing technology, automated parameter control, and real-time monitoring system, significantly improves the prevention effect of PCO while minimizing surgical risks and shortening operation time. It achieves safety, efficiency, and standardization in postoperative capsule treatment of cataracts, and has extremely high clinical application value.

[0030] The above description is only a preferred embodiment of the present invention, but the scope of protection of the present invention is not limited thereto. Any equivalent substitutions or modifications made by those skilled in the art within the scope of the technology disclosed in the present invention, based on the technical solution and inventive concept of the present invention, should be covered within the scope of protection of the present invention.

[0031] In the description of this specification, the references to terms such as "one embodiment," "some embodiments," "example," "specific example," or "some examples," etc., indicate that a specific feature, structure, material, or characteristic described in connection with that embodiment or example is included in at least one embodiment or example of the present invention. In this specification, the illustrative expressions of the above terms do not necessarily refer to the same embodiment or example. Furthermore, the specific features, structures, materials, or characteristics described may be combined in any suitable manner in one or more embodiments or examples. Moreover, without contradiction, those skilled in the art can combine and integrate the different embodiments or examples described in this specification, as well as the features of different embodiments or examples.

[0032] Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention. Those skilled in the art can make changes, modifications, substitutions and variations to the above embodiments within the scope of the present invention.

Claims

1. A method for treating the cataract capsule after surgery based on water jet polishing, characterized in that, Includes the following steps: (a) Position the micro-nozzle onto the surface of the capsule after implantation of the artificial lens, maintaining a distance of 100-500 μm between the nozzle and the capsule; (b) A high-speed laminar water jet is directionally sprayed onto the membrane surface through a micro-nozzle with a diameter of 50-200 μm, wherein the water jet pressure is 0.2-0.8 MPa and the impact angle is 30°-60°; (c) Control the water jet to scan and polish the membrane surface according to a preset path; (d) The surface morphology of the capsule is monitored in real time by optical coherence tomography, and the polishing parameters are dynamically adjusted according to the monitoring results.

2. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The water jet in step (b) is a pulsed water flow with a pulse width ≤ 5ms and a pulse frequency of 1-10kHz.

3. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The water stream is an isotonic buffer solution with added viscoelasticity enhancer, which is sodium hyaluronate, and its mass concentration in the buffer solution is 0.05%-0.2%.

4. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The preset path in step (c) is a spiral trajectory or a concentric circle trajectory, and the scanning speed is 0.5-2 mm / s.

5. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, In step (b), the laminar water jet has a Reynolds number Re < 2000, and laminar flow is generated through a conical micro-nozzle.

6. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The dynamic adjustment of polishing parameters in step (d) includes automatically terminating polishing when the surface roughness Ra of the capsule is ≤0.2μm.

7. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The positioning in step (a) is achieved by a 6-DOF robotic arm with a positioning accuracy of ±10μm.

8. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The real-time monitoring in step (d) includes: The membrane thickness was measured using a confocal microscope with a resolution ≤1 μm. The water jet pressure is controlled in a closed loop using a fluid pressure sensor with a range of 0-1 MPa.

9. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The method is performed immediately after cataract surgery and intraocular lens implantation to preventively remove residual lens epithelial cells from the capsule surface.

10. The method for treating the cataract capsule after surgery based on water jet polishing according to claim 1, characterized in that, The polishing time of the water jet on one side of the capsule is ≤30 seconds, and the total processing time is controlled within 2 minutes.

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