Ophthalmic surgery practice device

Abstract

To provide a vitreous body surgery practicing device which allows a user to easily practice separating an inner limiting layer by using a dummy eyeball.SOLUTION: An eye surgery practicing device 1 includes: a base board 10 having a hollow part 11; a dummy strong film member 20, which is soft and forms a part of a spherical surface; and fixing means 101, 102, 103, and 104 for fixing the dummy strong film member to the base board, the fixing means being removed to exchange the dummy strong film member. An external cover 30 can be used as fixing means.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to an ophthalmic surgery training device used for training internal limiting membrane peeling (ILM peeling) in vitreous surgery. [Background technology]

[0002] There is an eye disease called macular hole, in which a small hole appears in the center of the retina, resulting in decreased vision. Treatment for macular holes involves vitreous surgery, in which the vitreous body near the retina is removed, the internal limiting membrane around the hole is peeled off, and gas is injected into the eye. The reason for peeling the internal limiting membrane is that peeling promotes the proliferation of glial cells near the hole, which has the effect of facilitating the closure of the hole.

[0003] However, internal limiting membrane peeling cannot be practiced well even using animal eyes, so the technique is basically acquired through experience in clinical settings. However, performing a delicate procedure such as internal limiting membrane peeling in a clinical setting can be unsettling, and there are not many opportunities to practice before mastering the technique.

[0004] Therefore, Patent Document 1 discloses an internal limiting membrane peeling model suitable for training in internal limiting membrane peeling techniques. Fig. 10 is a cross-sectional view of an internal limiting membrane peeling model having a pseudo internal limiting membrane made primarily of a polymer material. This internal limiting membrane peeling model 110 is formed by laminating a pseudo retina 130 and a pseudo internal limiting membrane 120 on a support substrate 140, and the pseudo internal limiting membrane 120 is made primarily of a polymer material.

[0005] 11 shows an example of an internal limiting membrane peeling training device that uses an internal limiting membrane peeling model. This internal limiting membrane peeling training device 100 includes a model set main body 132 having an insertion port 131 for inserting a surgical instrument 133, and is configured so that an internal limiting membrane peeling model 110 can be set below. Then, while viewing the model set main body 132 from directly above, practice can be performed using the surgical instrument 133, such as tweezers, to peel the pseudo internal limiting membrane 120 provided on the surface of the internal limiting membrane peeling model 110.

[0006] Using such an internal limiting membrane peeling training device 100, it is possible to practice internal limiting membrane peeling, but there are many differences from actual internal limiting membrane peeling, such as the complicated manufacturing of the internal limiting membrane peeling model 110 and the fact that the internal limiting membrane peeling model 110 is flat.

[0007] Therefore, Non-Patent Document 1 discloses a method for practicing internal limiting membrane peeling, using the inner shell membrane of a quail egg as a pseudo-eyeball, in which the inner shell membrane of a quail egg is used as the internal limiting membrane. The pseudo-eyeball is produced by cutting off the upper part of the shell of a quail egg with special shears, leaving the contents, sealing it with a silicone pseudo-sclera, and filling it with ocular irrigation solution. Quail eggs are similar in size to an eyeball, and the sensation of peeling the inner shell membrane of a quail egg is similar to internal limiting membrane peeling, making them suitable for use as pseudo-eyeballs. Furthermore, they are inexpensive and easy to prepare. In other words, using quail eggshells allows for practical internal limiting membrane peeling practice in the laboratory.

[0008] However, artificial eyes made from quail eggs use the entire quail egg to represent the eyeball, and before reaching the inner shell membrane, procedures such as removing the yolk and albumen using a vitreous cutter are required. Furthermore, the eggshell must be completely sealed to perform perfusion, and usable eggshells must be selected based on the variation in eggshell diameter between individuals. Furthermore, when performing the procedure, each egg must be individually fixed to a base to prepare it for simulated surgery. There is a risk of the egg breaking when fixed to the base, so careful preparation is required, which is a complex process. [Prior art documents] [Patent documents]

[0009] [Patent Document 1] International Publication No. 2015 / 151939 [Non-patent literature]

[0010] [Non-Patent Document 1] Akira Hirata, Ryo Iwakiri, Satoshi Okinami : A simulated eye for vitreous surgery using Japanese quail eggs. Graefe's Archive for Clinical and Experimental Ophthalmology, Volume 251, Issue 6, pp 1621-1624, 2013 Summary of the Invention [Problem to be solved by the invention]

[0011] In view of this situation, the present invention , doubt To provide an ophthalmic surgery training device that can easily perform training in internal limiting membrane peeling using a pseudo-eyeball and training in anterior segment surgery. [Means for solving the problem]

[0012] The ophthalmic surgery training device of the present invention comprises a base having a hollow portion and a pseudo-sclera member having a shape that is soft and consists of a part of a sphere, the cross-sectional area of ​​the hollow portion being shaped so that it decreases from the top to the bottom, and when in use, the hollow portion Doubt The artificial eyeball is housed in the artificial eyeball, a pseudo-sclera member is placed on the upper side of the base, and a surgical instrument can come into contact with the surface of the artificial eyeball through the pseudo-sclera member.

[0013] Here, the pseudo-sclera member may have a transparent top, or may have a hole at the top with the periphery of the hole reinforced with silicone, resin, etc. Also, an outer cover may be provided that has a through-hole at the top end and is placed over the pseudo-sclera member.

[0014] Also, it has a hollow soil A base, a pseudo-sclera member having a shape consisting of a part of a soft sphere, and a fixing device for fixing the pseudo-sclera member to the base. The pseudo-sclera element has a step, and the fixing means can be removed to replace the pseudo-sclera element. It may also be an ophthalmic surgery training device. Furthermore, the device may be an ophthalmic surgery training device in which the pseudo-sclera member is fixed between the outer cover and the base, which are fixing means. [Effects of the Invention]

[0015] According to the ophthalmic surgery training device of the present invention, the device is made up of only a few components, namely, a base, a pseudo-sclera member, and an outer cover. , doubt The use of an artificial eyeball has the effect of making it easy to practice internal limiting membrane peeling. The ophthalmic surgery training device of the present invention has an excellent structure that can reproduce the sensation of inserting a surgical instrument into the sclera and can clamp and hold a self-supporting sclera in a replaceable manner. Furthermore, with the ophthalmic surgery training device of the present invention, if the sclera is damaged by a surgical instrument, By removing the fixing means, the pseudo-sclera component can be easily removed. can be exchanged. [Brief explanation of the drawings]

[0016] [Figure 1] 1 is an exploded perspective view of an ophthalmic surgery training device. FIG. [Figure 2] 1 is a cross-sectional view showing the ophthalmic surgery training device in use. [Figure 3] 10 is an example of a pseudo-sclera member. [Figure 4] 1 is an example of a base. [Figure 5] FIG. 10 is a cross-sectional view of the artificial eyeball stored in the base. [Figure 6] 10 is an ophthalmic surgery training device according to another embodiment, which includes a clamper as a fixing means. [Figure 7] 10 is an ophthalmic surgery training device according to another embodiment, in which the fastening means includes a screw. [Figure 8] 10 is an ophthalmic surgery training device according to another embodiment, the fixation means including a fixation ring. [Figure 9] 10 is another embodiment of an ophthalmic surgery training device, the fastening means being an elastic band. [Figure 10] FIG. 1 is a cross-sectional view of an internal limiting membrane peeling model having a pseudo-internal limiting membrane made primarily of a polymer material. [Figure 11] 1 shows an example of an internal limiting membrane peeling training device using an internal limiting membrane peeling model. DETAILED DESCRIPTION OF THE INVENTION

[0017] Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. Fig. 1 is an exploded perspective view of the ophthalmic surgery training device, and Fig. 2 is a cross-sectional view showing the ophthalmic surgery training device in use.

[0018] The ophthalmic surgery training device 1 comprises three components: a base 10 that houses a pseudo eyeball 50 in a hollow portion 11; a pseudo sclera member 20 that has a pseudo sclera portion 21; and an outer cover 30 that presses the pseudo sclera member 20 from above.

[0019] It is preferable to use a processed quail eggshell as the pseudo eyeball 50. Specifically, the pseudo eyeball 50 can be produced by cutting off the upper part of a quail eggshell with a regular shear, removing all of the contents, staining the inner shell membrane, and filling it with ocular irrigation solution. However, the pseudo eyeball is not limited to quail eggshell, and any eggshell that can reproduce vitreous surgery in an equivalent manner to a quail eggshell can naturally be used. Furthermore, if it is desired to reproduce ophthalmic surgery other than vitreous surgery (for example, incision of the eyeball or fixation of an intraocular lens), a pseudo eyeball equipped with a crystalline lens may be used.

[0020] The base 10 has an outer shape of a cylinder or a truncated cone, and when viewed from above, it has a circular shape with a hollow portion 11. The hollow portion 11 has a cross-sectional area that decreases from top to bottom. Specifically, it has the shape of an inverted cone or an inverted truncated cone with an open top. During use, the artificial eyeball 50 is stored in the hollow portion 11. Because the cross-sectional area of ​​the hollow portion 11 decreases from top to bottom, the artificial eyeball 50 can be inserted from above and locked midway through the hollow portion 11. Since the eggshells that make up the artificial eyeballs 50 vary in size, the position of the eggshell base for each artificial eyeball 50 varies, making it possible to reproduce the difference in axial length between actual eyes. Furthermore, since the artificial eyeball 50 can be inserted into the hollow portion 11 from above, installation is simple and there is little risk of it breaking.

[0021] The pseudo sclera member 20 is placed on the upper side of the base 10 and used as a pseudo sclera. Fig. 3 shows an embodiment of the pseudo sclera member. Two types of pseudo sclera member 20 are given as examples: a pseudo sclera member 20 having a hole 23 at the top, and a pseudo sclera member 20' without a hole.

[0022] The pseudo sclera members 20, 20' are formed of a soft material such as silicone, and each includes a self-standing pseudo sclera portion 21 formed from a portion of a sphere, and a hollow, disk-shaped edge portion 22 that protrudes outward at the lower end of the pseudo sclera portion 21. When practicing surgery, the pseudo sclera member 20, 20' is used with the edge portion 22 in contact with the upper side of the base 10. In other words, the pseudo sclera member 21 is placed directly above the pseudo eyeball 50. If the upper side of the base 10 is provided with a groove 12 into which the edge portion 22 fits, the placement position of the pseudo sclera member 20, 20' can be clearly determined, further preventing movement.

[0023] The pseudo sclera portion 21 has a self-standing shape consisting of a portion of a sphere, and its curvature is set to match the average diameter of a human eye. Furthermore, since the pseudo sclera portion 21 is made of a soft material such as silicone, a cannula 60 can be attached to it. Therefore, when practicing surgery, the cannula 60 can be attached to the pseudo sclera portion 21, and the state in which a surgical instrument 61, such as forceps, is inserted into the inside of the eyeball can be reproduced through the cannula 60. In other words, the sensation of inserting an instrument into the sclera can be reproduced, and a state in which the inner surface of the pseudo eyeball 50 can be contacted through the pseudo sclera members 20, 20' is created.

[0024] Here, the apex of the pseudo scleral member 20, 20' corresponds to the position of the cornea of ​​the eyeball. In other words, when practicing surgery, the inside of the pseudo eyeball 50 is visualized through the apex of the pseudo scleral member 20, 20'. Therefore, examples are given of the pseudo scleral member 20, 20' with and without a hole 23 at the apex. In the pseudo scleral member 20' without a hole, the apex is made transparent so that the inside can be visualized. In other words, in the pseudo scleral member 20' without a hole at the apex, the transparent apex serves as the pseudo cornea portion 25.

[0025] On the other hand, in the case of a pseudo sclera member 20 having a hole 23 at its apex, which serves as a pseudo cornea portion, a reinforcing portion 24 is provided around the periphery of the hole 23, reinforcing the periphery of the hole 23 with silicone, resin, adhesive, or the like that is thicker than other positions on the pseudo sclera portion 21. Without such a reinforcing portion 24, the pseudo sclera portion 21 is likely to deform when the cannula 60 is attached to the pseudo sclera portion 21 or when the surgical instrument 61 is moved. In other words, providing the reinforcing portion 24 around the periphery of the hole 23 allows the pseudo sclera portion 21 to stand on its own and prevents the pseudo sclera portion 21 from being depressed when the cannula 60 is attached or from being distorted or moved when the inserted surgical instrument 61, such as forceps, is moved, thereby improving the reproducibility of the simulated surgery.

[0026] Furthermore, by placing the outer cover 30 over the pseudo scleral member 20, 20′ and pressing it from above, movement of the pseudo scleral member 20, 20′ can be suppressed. The pseudo scleral member 20, 20′ is held in place by a structure in which a portion of the outer cover 30 rests on the upper surface of the edge portion 22 of the pseudo scleral member 20, 20′. The portion resting on the upper surface of the edge portion 22 is defined as an edge pressing portion 31. Thus, the weight of the outer cover 30 can limit movement of the pseudo scleral member 20, 20′. In other words, the groove 12 into which the edge portion 22 fits and the outer cover 30 function as fixing means for fixing the pseudo scleral member 20, 20′ to the base 11. Furthermore, a through-hole 32 is formed in the top edge of the outer cover 30, and the pseudo scleral portion 21 of the pseudo scleral member 20, 20′ fits into this through-hole 32 and is installed so as to protrude outward.

[0027] FIG. 4 shows an example of a base. Bases 10 and 10' must have hollow portions 11 and 11' capable of accommodating a pseudo-eyeball 50 made of a quail eggshell. FIG. 4 shows two examples: base 10 having an inverted truncated cone-shaped hollow portion 11 with an open top, and base 10' having an inverted cone-shaped hollow portion 11'. However, the shape of the hollow portion is not limited to these examples. Any hollow portion with a cross-sectional area that decreases from top to bottom and that can accommodate a quail eggshell is acceptable. The inclination and diameter of the inverted truncated cone or inverted cone shape should be determined so that a quail eggshell can be accommodated and the distance from cannula 60 to the bottom of the eggshell roughly corresponds to the variation in axial length in human eyes.

[0028] FIG. 5 is a cross-sectional view of the artificial eyeball when it is stored in the base. Here, the cross-sectional view is of the base 10 having the hollow portion 11 shaped like an inverted truncated cone. However, the base 10' having the hollow portion 11' shaped like an inverted cone may also be used. If the artificial eyeball 50 is stored in such a hollow portion 11 shaped like an inverted truncated cone or an inverted cone, the artificial eyeball 50 may rotate and become unstable. Therefore, to stabilize the artificial eyeball 50 when stored, it is recommended to pour a small amount of water 51 into the gap between the hollow portion 11 and the artificial eyeball 50. This allows the artificial eyeball 50 to fit without any gap between the hollow portion 11 and the artificial eyeball 50, and the surface tension of the water 51 accumulated in the gap stabilizes the artificial eyeball 50.

[0029] When a quail eggshell dummy eyeball was set in the vitreous surgery training device described above and used by a surgeon, it was observed that the instrument operability and the behavior of the internal limiting membrane during peeling were extremely similar to the clinical experience. Furthermore, if a fully stained eggshell was prepared, it could be set into the vitreous surgery training device in approximately 30 seconds. Furthermore, it was confirmed that sufficient observation was possible using both a surgical microscope and a binocular stereomicroscope. Therefore, by using the vitreous surgery training device of the present invention, it was possible to create a dummy eyeball using readily available quail eggshells, thereby easily providing a highly reproducible training environment for internal limiting membrane peeling.

[0030] Furthermore, the ophthalmic surgery training device of the present invention uses a pseudo-sclera member to reproduce the sensation of inserting a surgical instrument into the sclera, and further has the advantage that any pseudo-sclera member damaged by the instrument can be easily replaced. Therefore, the present invention is extremely excellent as a training device for ophthalmic surgery.

[0031] FIGS. 6 to 9 show ophthalmic surgery training devices (1′ to 1″″) according to other embodiments. The ophthalmic surgery training devices (1′ to 1″″) shown in FIGS. 6 to 9 include a circular base 10 having a hollow portion 11, a pseudo-sclera member 20 that is soft and has a shape consisting of a portion of a sphere, and fixing means (101 to 104) for fixing the pseudo-sclera member 20 to the base 10. The fixing means shown in FIG. 6 is a clamper 101, and the pseudo-sclera member 20 is fixed to the base 10 by bending a portion of the clamper 101 in the direction of the arrow. The fixing means shown in FIG. 7 is a screw 102, and the pseudo-sclera member 20 is fixed to the base 10 by threading the screw 102 in the direction of the arrow. The fixing means shown in FIG. 7 may be a pin, and the pseudo-sclera member 20 is fixed to the base 10 by driving the pin in the direction of the arrow. The fixing means shown in FIG. 8 is a fixing ring 103. The fixing ring 103 can be separated into two parts, and the parts of the fixing ring 103 are joined together so as to sandwich the pseudo sclera member 20 and the base 10, thereby fixing the pseudo sclera member 20 to the base 10. The fixing means shown in Fig. 9 is a rubber band 104, and the pseudo sclera member 20 is fixed to the base 10 by the force of the rubber band 104 contracting toward the base 10.

[0032] These ophthalmic surgery training devices (1' to 1'''') are applicable to the practice of ophthalmic surgery using ophthalmic instruments other than a dummy eye (e.g., an intraocular lens) and for the practice of anterior segment ophthalmic surgery (e.g., scleral incision creation and trocar placement). The ophthalmic surgery training devices (1' to 1'''') may or may not be equipped with a dummy eye, and may be equipped with a substitute other than a dummy eye made of eggshell (e.g., a dummy eye with a lens). [Explanation of symbols]

[0033] 1,1',1'',1''',1'''' Vitreous surgery training device 10,10' base 11,11' Hollow part 12,12' groove 20,20' Pseudo-scleral element 21 Pseudo-scleral part 22 Edge 23 holes 24 Reinforcement 25 Pseudo cornea part 30 outer cover 31 Edge presser 32 Through hole 50 pseudo-eyeballs (made from quail eggshells) 51 water 60 cannula 61 Surgical instruments 101,102,103,104 Fixing means

Claims

1. a base having a hollow portion whose cross-sectional area decreases from the top to the bottom; a pseudo-sclera member that is soft and has a shape consisting of a part of a sphere, and that can reproduce the sensation of inserting a surgical instrument into the sclera when piercing the pseudo-sclera member with the surgical instrument; a fixing means for fixing the pseudo-sclera member to the base, The fixing means can be removed to replace the pseudo-sclera member, The base is capable of storing an artificial eyeball in the hollow portion. An ophthalmic surgery training device, characterized in that the surgical instrument can pierce the pseudo sclera member and come into contact with the surface of the pseudo eyeball.

2. 2. The ophthalmic surgery training device according to claim 1, further comprising an outer cover having a through hole at its top end and placed over the pseudo-sclera member, wherein the pseudo-sclera member is fixed between the outer cover and the base, which is the fixing means.

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