Bidirectional trabecular meshwork resection knife

Abstract

The utility model discloses a bidirectional trabecular meshwork resection knife, which comprises a grab handle, a knife handle and a knife handle, one end of the cutter bar is connected with the grab handle, and the other end is provided with a double-cutter-head group; the double-tool-bit set comprises a connecting element and two symmetrically-arranged tool bits, each tool bit comprises double edges and a top edge, the double edges comprise two parallel vertical edges, and the top edges are formed at one ends of the vertical edges. The utility model can effectively solve the problems of difficulty in operation, incomplete excision, easiness in bleeding during and after an operation, need of rotating the direction of a cutting edge during the operation and the like in the conventional instrument, can effectively avoid the damage to surrounding tissues caused by blind operation, improves the curative effect and safety of the operation, and shortens the time of the operation.

Description

Technical Field

[0001] The utility model relates to the field of ophthalmic surgical instruments, in particular to a bidirectional trabecular meshwork removal knife. Background Art

[0002] There are many surgical treatments for glaucoma, one of which is internal drainage surgery, which mainly targets the diseased trabecular meshwork, establishes a direct aqueous humor drainage channel between the anterior chamber and the collecting duct, promotes the drainage of aqueous humor from the physiological channel, and achieves the effect of lowering intraocular pressure.

[0003] Internal drainage surgery mainly includes double-blade (Kahook dual blade, KDB) internal trabeculectomy, trabecular ablation and 360-degree internal trabeculotomy, etc. Compared with traditional external drainage, the operation time is shorter, the complications are fewer, and the recovery is faster.

[0004] However, KDB can only partially cut or remove the trabecular meshwork and the inner wall of the Schlemm's canal. Since it is incompatible with the physiological curvature of the corneoscleral limbus, it is difficult to perfectly and completely cut or remove the trabecular meshwork even under direct vision with a gonioscope. This can easily lead to incomplete opening of the trabecular meshwork, or easy re-healing, easy to cause anterior chamber bleeding, and even scar formation. In addition, the disadvantage of the KDB knife is that it operates in a single direction. This design requires the KDB to be rotated about 180 degrees inside or outside the eye before cutting or removing the trabecular meshwork and the inner wall of the Schlemm's canal in the opposite direction during surgery. This will not only increase the operation time of medical staff, increase the probability of postoperative dry eye and nerve damage caused by exposure of the affected eye to strong light, but may also damage eye tissues such as corneal endothelial cells, reducing the safety factor of the operation. Utility Model Content

[0005] The utility model aims to solve one of the technical problems in the above-mentioned technology at least to a certain extent. To this end, the utility model aims to provide a trabeculectomy knife that is adapted to the physiological curvature of the cornea and sclera and has a bidirectional cutting structure to reduce the number of rotations of the knife head.

[0006] To achieve the above-mentioned purpose, the embodiment of the utility model provides a bidirectional trabecular meshwork removal knife, comprising:

[0007] The handle has a knife bar at one end; the knife bar has a double knife head set at the other end and is connected to the handle at one end;

[0008] Double blade head assembly: includes a connecting element and two symmetrically arranged blade heads, wherein the blade heads include a double blade and a top blade, wherein the double blade includes two vertical blades arranged in parallel, and one end of the vertical blade forms the top blade.

[0009] According to the bidirectional trabecular meshwork removal knife of the embodiment of the utility model, the double blade head group does not need to rotate when changing the cutting direction in the eye, thereby reducing the damage of the blade head to the intraocular tissue.

[0010] In addition, the bidirectional trabecular meshwork removal knife proposed in the above embodiment of the utility model may also have the following additional technical features:

[0011] Optionally, the double blade head group forms an angle of 120-130° with the plane where the vertical blade is located and the plane where the length direction of the blade rod is located.

[0012] Optionally, the cross-section of the knife rod is circular or elliptical.

[0013] Furthermore, when the cross section of the shank is elliptical, the major axis direction of the ellipse is parallel to the cutting direction of the double-edged blades.

[0014] Optionally, the handle is provided with a groove for easy gripping on one side close to the knife rod, and a raised protrusion is provided on the side away from the knife rod. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Figure 1 A partial structure enlargement according to an embodiment of the utility model Figure 1 ;

[0016] Figure 2 A partial structure enlargement according to an embodiment of the utility model Figure 2 ;

[0017] Figure 3 A partial structure enlargement according to an embodiment of the utility model Figure 3 ;

[0018] Figure 4 A partial structure enlargement according to an embodiment of the utility model Figure 4 ;

[0019] Figure 5 It is an overall structural diagram according to an embodiment of the utility model.

[0020] Description of labels:

[0021] Handle 1

[0022] Tool bar 2

[0023] The double blade set 3 comprises a connecting element 31 a blade 32 a double-edged edge 321 a vertical edge 3211 and a top edge 322 . DETAILED DESCRIPTION

[0024] The embodiments of the present invention are described in detail below, and examples of the embodiments are shown in the accompanying drawings, wherein the same or similar reference numerals throughout represent the same or similar elements or elements having the same or similar functions. The embodiments described below with reference to the accompanying drawings are exemplary and are intended to be used to explain the present invention, and should not be construed as limiting the present invention.

[0025] Since the utility model has a double blade head group on the blade rod, the blade head can be removed in different directions without rotating the blade head during surgery, thus avoiding scratching other tissues in the eye.

[0026] In order to better understand the above technical solution, exemplary embodiments of the present invention will be described in more detail below with reference to the accompanying drawings. Although exemplary embodiments of the present invention are shown in the accompanying drawings, it should be understood that the present invention can be implemented in various forms and should not be limited by the embodiments described herein. On the contrary, these embodiments are provided to enable a more thorough understanding of the present invention and to fully convey the scope of the present invention to those skilled in the art.

[0027] In order to better understand the above technical solution, the above technical solution will be described in detail below in conjunction with the accompanying drawings and specific implementation methods.

[0028] Glaucoma is currently the world's leading irreversible blinding eye disease, characterized by the progressive loss of retinal ganglion cells. Large clinical trials have shown that intraocular pressure is the only modifiable risk factor, and timely lowering of intraocular pressure can effectively slow the rate of vision loss caused by glaucoma.

[0029] The level of intraocular pressure is closely related to the dynamic balance of the production and discharge of aqueous humor in the eye. The aqueous humor in the eye is produced by the ciliary body, flows through the posterior chamber, and then enters the anterior chamber through the pupil. Most of the aqueous humor then enters the Schlemm's canal through the trabecular meshwork at the anterior chamber angle, and finally returns to the blood circulation through the collecting duct and the aqueous humor vein. In normal eyes, the amount of aqueous humor produced is the same as the amount discharged, and the intraocular pressure can be kept stable at a normal state. Clinically, angle-closure glaucoma increases intraocular pressure due to the closure of the anterior chamber angle, which increases the resistance to aqueous humor outflow; open-angle glaucoma causes increased intraocular pressure due to pathological changes in the trabecular meshwork, which leads to obstruction of aqueous humor outflow. Therefore, reducing aqueous humor production or increasing aqueous humor outflow has become the central rule for the treatment of glaucoma in the past.

[0030] At present, the main clinical methods for reducing intraocular pressure include laser treatment, local drug treatment and surgery. Among them, the mainstream types of surgery in China mainly include surgery to reduce the production of aqueous humor, such as ciliary body photocoagulation, ciliary body cryotherapy, endoscopic ciliary body photocoagulation, micropulse ciliary body photocoagulation, etc., as well as surgery to increase the outflow of aqueous humor, such as external drainage surgery and internal drainage surgery. External drainage surgery is suitable for open-angle and closed-angle glaucoma. It will drain the aqueous humor that cannot be discharged normally into the non-physiological channel established by the operation, that is, through subconjunctival absorption, but because it is a non-physiological aqueous humor outflow channel, the operation is relatively complicated, the wound is large, and there are many complications. Internal drainage surgery is suitable for glaucoma with an open angle. It mainly operates on the diseased trabecular meshwork, establishes a direct aqueous humor drainage channel between the anterior chamber and the collecting duct, promotes the discharge of aqueous humor from the physiological channel, and achieves the effect of lowering intraocular pressure. Internal drainage surgery mainly includes double-blade (Kahook dual blade, KDB) internal trabeculectomy, trabecular ablation and 360-degree internal trabeculotomy, etc. Compared with traditional external drainage, the operation time is shorter, the complications are fewer, and the recovery is faster.

[0031] In recent years, internal drainage surgery has developed rapidly, but the cost is relatively high. The reason is that the successful completion of KDB internal trabeculectomy or 360-degree internal trabeculectomy requires the use of expensive KDB knives. The KDB knives currently used in clinical practice can only partially cut or remove the trabecular meshwork and the inner wall of the Schlemm canal. Because they are not compatible with the physiological curvature of the corneoscleral limbus, it is difficult to perfectly and completely cut or remove the trabecular meshwork even under direct vision with a gonioscope, which can easily lead to incomplete opening of the trabecular meshwork, or easy re-healing, easy to cause anterior chamber bleeding, and even scar formation.

[0032] The disadvantage of the existing KDB knife is that it only operates in one direction. This design requires the KDB knife to be rotated about 180 degrees inside or outside the eye before cutting or removing the trabecular meshwork and the inner wall of the Schlemm canal in the opposite direction during surgery. This will not only increase the operation time of medical staff, increase the probability of postoperative dry eyes and nerve damage caused by exposure of the affected eye to strong light, but also may damage eye tissues such as corneal endothelial cells, reducing the safety factor of the operation.

[0033] Figures 1 to 5 The bidirectional trabecular meshwork removal knife according to the embodiment of the utility model comprises:

[0034] Handle 1: a knife bar 2 is provided at one end;

[0035] Knife bar 2: Knife bar 2 is a structure for delivering the double knife head group 3 to the surgical area.

[0036] The double blade set 3 includes a connecting element 31 and two symmetrically arranged blades 32 . The blade 32 includes a double blade 321 and a top blade 322 . The double blade 321 includes two parallel vertical blades 3211 . One end of the vertical blade 3211 forms a top blade 322 .

[0037] The double blade group 3 of the embodiment of the utility model has a principle similar to that of the existing KDB: during surgery, the top blade 322 first contacts the trabecular meshwork. The top blade 322 is a curved sickle shape when viewed from the side, but its cutting direction is different from that of the sickle. The blade edge of the sickle is set in a concave shape, while the cutting edge of the top blade 322 is at the tip: during surgery, the tip of the top blade 322 cuts into the trabecular meshwork by swinging, and the trabecular meshwork cut by the top blade 322 moves along the inner circle of the blade head 32.

[0038] However, compared with the trapezoidal structure of the existing KDB, each set of blade heads 32 of the present invention is more flexible in operation because it is similar to a curved sickle: the existing KDB needs to use the straight part of the top blade 322 (equivalent to the bottom surface of the trapezoidal structure) as a cutting guide surface to cut the trabecular meshwork, so that the tissue surface after cutting is flat. However, the embodiment of the present invention has double blade heads 32. Therefore, even if the blade head 32 is changed to a curved sickle structure and the length of the above-mentioned straight part is reduced, since the blade head 32 on the other side also has a bottom surface, the cut part can still be kept straight and complete during cutting, and it can also be operated more flexibly.

[0039] Specifically, the lengths of the two vertical blades 3211 are both 0.5-2 mm, and the widths are both 0.3-0.8 mm.

[0040] After being cut by the top blade 322, the tissue will move through the inner circle of the curved sickle. Of course, the trabecular meshwork has thickness, and the thickness of the entire blade head 32 may be less than that of the trabecular meshwork. Therefore, the function of the double blade 321 is to further cut the trabecular meshwork into strips with a width not greater than the distance between the two vertical blades 3211 during the movement. In this way, the excised trabecular meshwork tissue is peeled off.

[0041] This is the structural design and application principle of the cutter head 32 of the embodiment of the utility model.

[0042] Compared with the existing KDB, the blade rod 2 and the double blade head group 3 of the embodiment of the utility model are relatively bent. This is because, based on the data of the postoperative main incision height, the preoperative and postoperative trabecular meshwork position, and the preoperative height of the trabecular meshwork from the iris surface of dozens of patients who have undergone KDB internal trabeculectomy or 360-degree internal trabeculotomy, it is analyzed that after the main incision is made from the nasal or temporal side, the height and bending angle of the trabeculectomy knife should be improved to avoid compression or damage to the main incision.

[0043] Specifically, the double blade group 3 forms an angle of 120-130° with the plane where the vertical blade 3211 is located and the plane where the length direction of the blade rod 2 is located. Figure 4 As shown in the α angle.

[0044] In some embodiments, the cross section of the knife bar 2 may be circular or elliptical. In the existing KDB, this part of the structure is rectangular, and the embodiment of the utility model further improves it into a circular or elliptical cross section, which can better reduce damage to surrounding tissues. Through the connecting element 31, the knife head 32 and the knife bar 2 can be smoothly transitioned. The connecting element 31 can be processed and formed at the same time as other parts, or the knife head 32 can be processed first and then welded to the knife bar 2 by brazing. In this case, the connecting element 31 is composed of solder.

[0045] When the cross section of the shank 2 is an ellipse, the major axis direction of the ellipse is parallel to the cutting direction of the top blade 322 .

[0046] The appropriate angle and height also allow the double blade group 3 to fully contact the trabecular meshwork and the inner wall of the Schlemm's canal, so that the trabeculae can be completely cut or removed, thereby improving the success rate of the operation, avoiding damage to other intraocular tissues, and reducing the risk of intraoperative anterior chamber hemorrhage.

[0047] At the same time, the design of the bidirectional blade 32 in the double blade group 3 prevents the blade from rotating inside the eye, thus avoiding possible damage to the intraocular tissue. It also avoids the blade from rotating and adjusting outside the eye, saving surgical time, reducing the damage to the patient's ocular surface and fundus caused by continuous irradiation of the surgical light source, and greatly improving the safety of the surgery.

[0048] Preferably, the handle 1 is provided with a groove for easy gripping on one side close to the shank 2, and a raised protrusion is provided on the side away from the shank 2. Specifically, the shank 2 can be integrally formed, and the whole is a gourd-shaped structure that is easy to hold. The handle 1 has a gripping portion and a gripping portion 1 connecting portion, and the gripping portion is provided with anti-slip textures on the surface, and is made of plastic or rubber. The diameter of the end connected to the handle 1 is 1-2 mm, and the diameter of the end connected to the blade is 0.25-1 mm, and the length of the connecting rod is 10-20 cm.

[0049] In the description of the present invention, it should be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inside", "outside", "clockwise", "counterclockwise" and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the accompanying drawings, and are only for the convenience of describing the present invention and simplifying the description, and do not indicate or imply that the referred device or element must have a specific orientation, be constructed and operated in a specific orientation, and therefore should not be understood as a limitation on the present invention.

[0050] In the present utility model, unless otherwise clearly specified and limited, a first feature being "above" or "below" a second feature may include that the first and second features are in direct contact, or may include that the first and second features are not in direct contact but are in contact through another feature between them. Moreover, a first feature being "above", "above" and "above" a second feature includes that the first feature is directly above and obliquely above the second feature, or simply indicates that the first feature is higher in level than the second feature. A first feature being "below", "below" and "below" a second feature includes that the first feature is directly below and obliquely below the second feature, or simply indicates that the first feature is lower in level than the second feature.

[0051] In the description of this specification, the description with reference to the terms "one embodiment", "some embodiments", "example", "specific example", or "some examples" etc. means that the specific features, structures, materials or characteristics described in conjunction with the embodiment or example are included in at least one embodiment or example of the utility model. In this specification, the schematic representation of the above terms should not be understood as necessarily being directed to the same embodiment or example. Moreover, the specific features, structures, materials or characteristics described may be combined in any one or more embodiments or examples in a suitable manner. In addition, those skilled in the art may combine and combine different embodiments or examples described in this specification.

[0052] Although the embodiments of the present invention have been shown and described above, it can be understood that the above embodiments are exemplary and cannot be understood as limitations of the present invention. Ordinary technicians in the field can change, modify, replace and modify the above embodiments within the scope of the present invention.

Claims

1. Bidirectional trabecular meshwork resection knife, characterized by: include: Handle: There is a knife handle at one end; Knife bar: one end is connected to the handle, and the other end is provided with a double knife head group; Double blade head assembly: includes a connecting element and two symmetrically arranged blade heads, wherein the blade heads include a double blade and a top blade, wherein the double blade includes two vertical blades arranged in parallel, and one end of the vertical blade forms the top blade.

2. The bidirectional trabecular meshwork resection knife according to claim 1, characterized in that: The double cutter head assembly forms an angle of 120-130° with the plane where the vertical blade is located and the plane where the length direction of the cutter bar is located.

3. The bidirectional trabecular meshwork resection knife according to claim 1, characterized in that: The cross section of the knife rod is circular or elliptical.

4. The bidirectional trabecular meshwork resection knife according to claim 3, characterized in that: When the cross section of the knife bar is elliptical, the major axis direction of the ellipse is parallel to the cutting direction of the double-edged blade.

5. The bidirectional trabecular meshwork resection knife according to claim 1, characterized in that: The handle is close to the knife bar and is surrounded by a groove for easy gripping, and the groove is away from the knife bar and is surrounded by a raised protrusion.

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