Corneal Interlocking Cuts for Posterior Lamellar Keratoplasty
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Solution Overview
Problem
Existing posterior lamellar keratoplasty procedures are highly complex and risky, with potential damage to the patient's eye, and there is a high risk of the resected cornea element and implant falling into the anterior chamber during removal and insertion.
Innovation Solution
The use of a laser-based ophthalmological treatment apparatus with a computerized control device to implement precise cornea cuts, including anterior lamellar, side, and access cuts, along with complementary interlocking structures, to facilitate safe removal and insertion of the cornea implant.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional surgical methods are used for posterior lamellar keratoplasty, then the procedure can be performed, but the complexity and risk of damaging the patient's eye increases substantially
Solution Approach 1:
The cornea is divided into distinct layers (anterior lamella and posterior lamella) through precise laser cuts. The anterior lamellar cut and posterior lamellar cut create separate planes that allow the posterior layer to be manipulated independently, reducing surgical complexity and improving safety by enabling controlled removal and replacement of only the defective posterior layer.
Solution Approach 2:
The laser creates all necessary cuts (anterior lamellar cut, posterior lamellar cut, side cuts, and access cuts) before the actual implantation. The patient cornea element is fully prepared and defined by these preliminary cuts, allowing for safe removal through the access cut without requiring complex intraoperative maneuvers that could damage the eye.
2Reliability
If conventional methods are used to remove and insert the cornea implant, then the procedure can be completed, but there is a high risk of the implant falling into the anterior chamber
Solution Approach 1:
The access cut serves as an intermediary structure that provides a controlled pathway for both removing the patient cornea element and inserting the donor cornea element. This predefined通道 allows surgical instruments to access the implantation site without requiring manipulation that could cause the implant to fall into the anterior chamber, while still enabling relatively easy insertion of the new element.
Solution Approach 2:
The side cuts create a circumferential structure that provides localized support and containment for the donor cornea element during insertion. This localized structural feature prevents the implant from dislodging into the anterior chamber while allowing the rest of the procedure to proceed with ease through the access cut.
3Ease of operation
If simple cuts are made in the cornea, then the procedure is easier to perform, but the cornea implant cannot be securely positioned without movement
Solution Approach 1:
Multiple distinct cuts are made to create a segmented structure: the anterior lamellar cut, posterior lamellar cut, and side cuts work together to define the implantation space. This segmentation allows the donor cornea element to be precisely positioned and held stable by the interlocking geometry of these cuts, while still enabling relatively easy insertion through the access cut.
Solution Approach 2:
All positioning structures (anterior lamellar cut, posterior lamellar cut, side cuts forming circumferential surfaces) are created before implantation. This preliminary structuring of the cornea ensures that when the donor element is inserted through the access cut, it automatically assumes the correct position and remains stable without requiring complex intraoperative positioning maneuvers.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The method allows for easy and safe removal of the patient cornea element and insertion of the cornea implant with minimal risk of damage, avoiding the need for sutures and ensuring the implant remains in place without falling into the anterior chamber.
Implementation Method 1
a treatment laser device for implementing cornea cuts
Data Source
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AI summary
The present disclosure concerns, an ophthalmological treatment apparatus for resecting a patient cornea element form a patient cornea in posterior lamellar keratoplasty, an ophthalmological manufacture apparatus for manufacturing from a donor cornea a cornea implant, as well as corresponding manufacture and implantation methods. In accordance with the present disclosure, the patient cornea cut pattern that is implemented in the patient cornea includes defines a patient cornea interlocking structure, the patient cornea interlocking structure being configured to interlock the patient cornea (21) with a cornea implant (411) after replacing the patient cornea element (211) by the cornea implant. The corneal implant may have a corresponding cornea implant interlocking structure. The patient cornea interlocking structure and the cornea implant interlocking structure may in particular be arranged at the posterior side of the patient cornea element and the cornea implant, respectively. The ophthalmological treatment apparatus and the ophthalmological manufacture apparatus may include in each case an ophthalmological laser device, in particular with a femtosecond laser source.