Intraocular lens cutting tool in cataract surgery

Abstract

The invention relates to an intraocular lens cutting tool (10) for the removal of artificial lenses (21) of different structures and contents placed in the eye (20) during cataract surgery, without enlarging the corneal incision (30) outside the eye (20), characterised by; a handle (17) through which the cutting wire (16) passes, opening and closing the gripping tips (11) to hold or release the lens (21) inside the eye (20); a gripping tip (11), bevelled in accordance with the corneal incision (30) and the anterior chamber inclination, clamping the lens (21) to keep it fixed in the anterior chamber during the cutting process; cutting wire (16), positioned on the inside of the handle (17), moving between the gripping tips (11) for cutting the lens (21); a small reel (14), positioned on the handle (17), releasing the cutting wire (16) wound thereon simultaneously with the big reel (15) for cutting the lens (21) enwrapped by the cutting wire (16) by shortening it; a big reel (15) positioned on the handle (17), which releases the cutting wire (16) wound thereon simultaneously with the small reel (14) for cutting the lens (21) enwrapped by the shortening of the cutting wire (16).

Description

[0001] INTRAOCULAR LENS CUTTING TOOL IN CATARACT SURGERY

[0002] Technical Field

[0003] The invention relates to a surgical tool for fixing the lens in the anterior chamber, the tip of which is bevelled in accordance with the corneal incision and the inclination of the anterior chamber and comprises a cutting wire integrated into a gripper with a design that enables the tool to be used even for incisions smaller than 2 mm.

[0004] Background Art

[0005] Cataract is an eye disease in which the eye's lens loses its transparency, resulting in reduced visual acuity. Cataracts usually occur with the ageing process but can also be caused by trauma, diabetes or side effects of certain medications. Cataracts affect the quality of vision by making it difficult for the eye's lens to transmit light. This results in a blurred or dull image, faded colours and poor night vision. In advanced cases, cataract treatment is usually performed surgically. In surgery, the cloudy natural lens is removed and replaced with an artificial lens. Cataract surgery is a fairly common and successful procedure. It is usually uncomplicated and painless and significantly improves the patient's quality of life by providing a clearer vision.

[0006] During cataract surgery, artificial lenses with different structures and contents are implanted into the eye. These foldable lenses are inserted into the sulcus or capsule after passing through a 2.2 mm or 2.75 mm corneal incision. Lenses improperly designed or of incorrect power inserted into the eye, dysphotopsia, opacities forming on the lens, or tears occurring during implantation may necessitate the removal of these lenses from the eye and their replacement with new ones. In such cases, removing the lens from the eye through the corneal incision is very challenging. Therefore, the corneal incision needs to be enlarged. Enlarging the incision can lead to refractively unfavourable outcomes, and sometimes, it becomes necessary to suture the cornea. Since widening the incision is not preferred, the lens is usually divided into two or more pieces in the eye and removed through the corneal incision. However, cutting the lens into pieces in the anterior chamber without damaging the corneal endothelium above and the lens capsule, zonules, and iris below requires some complicated manipulations and is not easy. Two methods are generally used to cut the lens in the anterior chamber: cutting with scissors or using a knife and chisel. In the scissors-cutting method, viscoelastic material is given to the corneal endothelium and posterior capsule elements to prevent trauma after the lens is taken into the anterior chamber. The intraocular lens is cut mechanically with scissors (Vannas scissors) inserted through the corneal incision. During the incision, the risk of traumatising the cornea and capsule increases significantly by the repetitive opening and closing movement of the two sharp ends of the scissors. Furthermore, the opening and closing movement of the two blades of the scissors pushes the lens in the eye forward in the direction of the scissors during cutting. Thus, the lens needs to be held with a second tool, such as a pliers or a gripper. During the repetitive cutting movement of the scissors, the up and down movement of the distal ends of the lens may cause trauma, so it is necessary to fix it with a second tool during cutting.

[0007] In the knife-chisel method, blades designed to cut the lens at the wound site or inside the eye are used to solve the problems encountered with scissors. These blades are placed in a slot perpendicular to the corneal incision and are moved externally after the lens is held to cut the lens. Although surgical instruments with different structures are produced for this purpose, they are generally not preferred because they do not provide sufficient incision and efficient use.

[0008] Many new constructions have been developed recently to safely and easily retrieve the lens implanted in the eye. One of these constructions is the invention subject to utility model application CN213607399U. The invention relates to a pair of groove-type intraocular lens scissors comprising two cutting blade bodies. Two of said cutting blade bodies are hinged by a pin shaft. The cutting blade body comprises a cutting blade head. The cutting blade head has a cutting blade handle integrally disposed thereon and a spring plate connected to the rear end of the cutting blade handle. The inner side of one of the cutting blade heads is provided with a cutting drive blade; the inner side of the other cutting blade head is supplied with a storage space corresponding to the cutting drive blade of the groove. The two side walls of said storage groove are also used as passive cutting blades matching with said cutting active blades to cut the artificial lens. The invention has a simple structure and reasonable design, which can effectively prevent the artificial lens from slipping, and reduce the cutting times of the scissors, and the artificial lens piece can be stored to avoid foreign matter from remaining in the eyes.

[0009] Another application is the invention subject to utility model application CN210843628U. The invention relates to special scissors for cutting an artificial lens. It is a special scissors for an artificial lens belonging to the field of technology of an ophthalmic surgical instrument, comprising a blade body hinged to one end of the left blade body and a right blade body and cutter. The cutter consists of the cutter head, and the left handle part is integrated with the cutter head and connected to the left handle part's left spring. The right tip and the right handle part are integrated into the blade head, where the blade edge features a serrated structure. In the invention, the cutter head of the blade is a sawtooth-shaped structure; when the medical care personnel cut the lens, it can be effectively fixed to prevent the lens from slipping and improve reliability.

[0010] In conclusion, the need for an improved surgical instrument to remove the lens implanted in the eye that eliminates the disadvantages of the existing technique and the inadequacy of the existing solutions necessitated a development in the relevant technical field.

[0011] Brief Description of the Invention

[0012] The present invention relates to a surgical tool which fulfils the requirements mentioned above, which eliminates all disadvantages and brings some additional advantages, including a cutting wire which keeps the lens fixed in the anterior chamber, the tip of which is integrated into a gripper, which has a bevelled design in accordance with the corneal incision and the inclination of the anterior chamber, and which can be applied even in incisions smaller than 2 mm.

[0013] Based on the known state of the art, the invention aims to enable the surgical tool to be applied even in incisions smaller than 2 mm, thanks to the cutting wire whose tip is bevelled in accordance with the corneal incision and anterior chamber inclination and integrated into the gripper that keeps the lens fixed in the anterior chamber.

[0014] The object of the invention is to remove the intraocular lens without opening a new incision in the eye or enlarging the existing incision by cutting the lens with a cutting moving wire in the surgical instrument.

[0015] Another object of the invention is to enable the cutting wire, which is located along the inner part of the upper and lower wing at the tip of the gripper through a system of two rollers of different diameters, to enter through the holes at the tip of the gripper and to move back and forth by the movement of the rollers along the channels. The purpose of the invention is to ensure that the cutting wire wrapped around the smaller diameter pulley of two pulleys with different diameters, placed on the same motion axis in the reel system integrated into the upper part, unwinds while the larger diameter pulley rewinds the wire. This mechanism allows the lens, which is securely and stably held by the flat and narrow end of the clamp within the eye, to be cut by the cutting wire acting like a wire saw. The process is carried out by simply rotating the reel axis without requiring an additional device or an opening-closing motion, ensuring that the wire cuts the lens between the clamp's jaws without touching other tissues.

[0016] Another purpose of the invention is to ensure that, due to the difference in diameter between the winding and unwinding pulleys, the cutting wire shortens as it cuts the lens by friction. This allows the wire, which cuts by friction, to advance toward the entry and exit holes at the tip of the clamp and cut the lens inward from the corneal incision to the tip of the gripper.

[0017] Another object of the invention is to minimise the possibility of trauma to the endothelium and capsular structure without any repetitive opening-closing movement since the gripper is fixed while cutting the lens.

[0018] A further object of the invention is to eliminate the need for extra eye manoeuvres by holding the lens while cutting.

[0019] Another object of the invention is to enable the lens to be cut in the desired number, length and direction by holding the lens in the desired direction without the need for a second tool or gripper.

[0020] Another object of the invention is to ensure that the lens is kept stationary while the wire is incised by means of the curved and thin tip of the gripper and that the direction of movement of the wire, i.e. the location and length of the incision, can be determined.

[0021] Another object of the invention is to provide a cutting wire which can move in the lumen of the grippers and cut the lens during this movement so that the gripper can be moved along the entire lumen by winding and loosening with the pulley system within the lumen structure of the gripper.

[0022] A further object of the invention is to enable the cutting of lenses of any hardness, preferably using diamond-coated wire. Another object of the invention is to enable the lens to be removed from the eye without widening the corneal incision, as the lens can be cut into the desired number and size of pieces.

[0023] The structural and characteristic features and all the advantages of the invention will be more clearly understood through the figures below and the detailed description given with references to these figures; therefore, the evaluation should be made by considering these figures and detailed descriptions.

[0024] Brief Description of the Figures

[0025] In order to best understand the structure of the present invention and its advantages with additional elements, it should be evaluated together with the figures described below.

[0026] Figure-1 ; is a schematic overview of the cross-section of the intraocular lens-cutting instrument,

[0027] Figure-2a; is a schematic overview of the cross-section of the intraocular lens-cutting instrument before the lens is held,

[0028] Figure-2b; is a schematic overview of the cross-section of the gripping tips aligned with the lens,

[0029] Figure-2c; is a schematic cross-sectional view of the way the lens is held by the intraocular lens cutting tool,

[0030] Figure-3; is a schematic general view of the cross-section of the intraocular lens-cutting instrument positioned in the anterior chamber through the corneal incision,

[0031] Figure-4a; is a schematic side cross-sectional view of the cutting wire positioned in the lens before the cutting movement,

[0032] Figure-4b; is a schematic top cross-sectional view of the cutting wire positioned in the lens before the cutting movement,

[0033] Figure-5a; is a schematic side cross-sectional view of the cutting wire during the cutting process,

[0034] Figure-5b; is a schematic top cross-sectional view of the cutting wire during the cutting process,

[0035] Figure-6a; is a schematic side cross-sectional view of the cutting wire and eye at the end of the cutting process,

[0036] Figure-6b; is a schematic top cross-sectional view of the cutting wire and eye at the end of the cutting process, Figure-7a; is a schematic side cross-sectional view of the cutting wire and eye at the end of the cutting process,

[0037] Figure-7b; is a schematic top cross-sectional view of the cutting wire and eye at the end of the cutting process,

[0038] Reference Numbers

[0039] 10. Intraocular lens cutting tool

[0040] 11. Gripping tip

[0041] 12. Hole

[0042] 13. Head

[0043] 14. Small reel

[0044] 15. Big reel

[0045] 16. Cutting wire

[0046] 17. Handle

[0047] 18. Rotator

[0048] 20. Eye

[0049] 21 . Lens

[0050] 30. Corneal Incision

[0051] 31 . Wire cut in the lens

[0052] Detailed Description of the Invention

[0053] In this detailed description, the intraocular lens cutting tool (10) comprises a cutting wire (16) integrated into a handle (17), has a design which holds the inventive lens (21 ) fixed in the anterior chamber, the tip of which is bevelled in accordance with the corneal incision (30) and the anterior chamber inclination, and which can be applied even in corneal incisions (30) smaller than 2 mm, is described only as an example for a better understanding of the subject matter and without any limiting effect.

[0054] The intraocular lens cutting tool (10), shown in Figure-1 , which was developed for the removal of artificial lenses (21) of different structures and contents placed inside the eye (20) during cataract surgery without enlarging the corneal incision (30) outside the eye (20), is designed as a clamp, pliers or a similar shape and all elements are integrated into a handle (16). Said intraocular lens cutting instrument (10) comprises a handle (17) through which the cutting wire (16) passes and a gripping tip (11), which is bevelled in accordance with the corneal incision (30) and the anterior chamber inclination, and which holds the lens (21) fixed in the anterior chamber during the cutting process. In a preferred implementation of the invention, the intraocular lens cutting tool (10) is in the form of a clamp, and the cutting wire (16) travelling within the closed lumen structure of the intraocular lens cutting tool (10) only exits through the holes (12) in the mutually facing surfaces of the gripping tips (11). Before starting the process with said intraocular lens cutting tool (10), a part of the cutting wire (16) is located in the slot on the inner surfaces of the gripping tips (11). The gripping tip (11 ) can be closed by pressing the handle (17) and reopened when the pressure is removed. The small reel (14) and the big reel (15) are positioned horizontally within the head (13) positioned on the handle (17), preferably at the top thereof, and the rotator (18) for rotating said big reel (15) and said small reel (14) is positioned thereon. Said small reel (14) and said big reel (15) have different diameters.

[0055] To hold the intraocular lens (21) inside the eye (20) using the intraocular lens cutting tool

[0056] (10), preferably in the form of a clamp as shown in Figure-2a, pressure on the handle (17) is first released, causing the gripping tips (11) to open and move apart. When the gripping tips

[0057] (11 ), as shown in Figure-2b, are aligned with the lens (21) for holding it, pressure is applied to the handle (17), causing the gripping tips (11) to move toward each other and close securely around the lens (21). While the gripping tips (11) shown in Figure-2c are closed by moving towards each other, the lens (21) is pinned between the two gripping tips (11) and grasped by the gripping tips (11 ).

[0058] The intraocular lens cutting tool (10) shown in Figure-3 is positioned in the anterior chamber of the eye (20) through the corneal incision (30). Then, when the rotator (18) positioned on the head (13), as shown in Figure-4a, is turned, the small reel (14) on the handle (17) releases the cutting wire (16) wrapped around it while the big reel (15) on the handle (17) rewinds the cutting wire (16) wrapped around it. As a result, the cutting wire (16) inside the handle (17) is positioned on the lens (21), as shown in Figure-4b, before the cutting motion.

[0059] In Figure-5a, the cutting wire (16) is unwound from the small reel (14), and the big reel (15) winds the cutting wire (16) more than the small reel unwinds it. As a result, the cutting wire (16) at the tip of the handle (17) shortens and cuts the lens (21). The wire cut (31) shown in Figure-5b grows towards the holes (12) as the movement of the cutting wire (16) in the intraocular lens cutting tool (10) between the gripping tips (11) continues. As the cutting movement shown in Figure-6a and Figure-6b continues, the cutting wire (16) passes through the centre of the lens (21 ), and the area of the wire cut in the lens (31) enlarges. When the winding on the small reel (14) shown in Figure-7a is completed, the cutting wire (16) reaches the holes (12) in the gripping tip (11 ), and as shown in Figure 7b, the wire cut (31) in the lens (21 ) is completed along the entire length of the lens.

[0060] Before using the inventive intraocular lens cutting tool (10), the gripping tip (11) is closed by squeezing the cheek on the handle (17) and is inserted into the eye (20) through the corneal incision (30) in a closed manner. After entering the eye (20), the tip of the gripper (11 ) is opened by loosening it again. After the aforementioned lens (21) is grasped and pinched with the end of the gripper (11 ), the rotator (18) is rotated so that the small reel (14) releases the cutting wire (16) into the lumen and the big reel (15) winds it. Thus, the cutting wire (16) shortening in the closed lumen system shortens the cutting wire (16), wrapping the lens (21) between the gripping tips (11). The cutting wire (16), which moves from the small reel (14) to the big reel (15) and starts to shorten during this movement, starts to cut the lens (21) by pressurised friction. When the wrapping process initiated by the rotator (18) is finalised, the cutting wire (16) winding on the small reel (14) is completed, and the cutting wire (16) at the gripping tip (11 ) is stretched by reaching the holes (12). During all these steps, the lens (21) is held tightly between the two gripping tips (11 ) of the intraocular lens cutting tool (10) and resists the cutting force. Otherwise, if the lens (21 ) is not held firmly by the gripping tips (11), the cutting operation does not take place, and the lens (21) is pushed forward in the eye (20) as a result of the shortening of the cutting wire (16) during the operation. When the cutting process is finished, the small reel (14) and the big reel (15) movements are reversed, and the cutting wire (16) in the gripping tip (11 ) is loosened, and the gripping tip (11) is opened, and the cut lens (21) is released. The intraocular lens cutting tool (10) is removed from the corneal incision (30) so that the cut and reduced lens (21 ) pieces can be easily removed from the corneal incision (30) without enlarging the corneal incision (30). These operations can be repeated on the remaining parts of the lens (21) to obtain smaller parts.

Claims

CLAIMS1. It is an intraocular lens cutting tool (10) for the removal of artificial lenses (21) of different structures and contents placed in the eye (20) during cataract surgery without enlarging the corneal incision (30) outside the eye (20) characterised by the following:- a handle (17) through which the cutting wire (16) passes, which opens and closes the gripping tips (11) for holding or releasing the lens (21) in the eye (20);- a gripping tip (11), bevelled in accordance with the corneal incision (30) and anterior chamber inclination, clamping the lens (21 ) to keep it fixed in the anterior chamber during the cutting process; cutting wire (16) positioned on the inside of the handle (17), moving between the gripping tips (11) for cutting the lens (21 ); a small reel (14) positioned on the handle (17), which releases the cutting wire (16) wound around it simultaneously with the big reel (15), allowing the cutting wire (16) to shorten and cut the lens (21 ) it encircles;- a big reel (15) positioned on the handle (17), which releases the cutting wire (16) wound around it simultaneously with the small reel (14), allowing the cutting wire (16) to shorten and cut the lens (21) it encircles.

2. The intraocular lens cutting tool (10) according to claim 1 , characterised in that it has a hole (12) positioned on the surfaces of the gripping tips (11) facing each other for the cutting wire (16) to come out.

3. The intraocular lens cutting tool (10) according to claim 1 , characterised in that it comprises slots positioned on the inner surfaces of the gripping tips (11) in which a portion of the cutting wire (16) is located before the lens (21) is cut.

4. The intraocular lens cutting tool (10) according to claim 1 , characterised in that it comprises a head (13) positioned on a handle (17), which comprises the small reel (14) and big reel (15).

5. The intraocular lens cutting tool (10) according to claim 1 , characterised in that it comprises a rotator (18) positioned on the head (13) for rotating the big reel (15) and small reel (14).

6. The intraocular lens cutting tool (10) according to claim 1 , characterised in that the diameters of the small reel (14) and big reel (15) are different.

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