Expandable Lens Support for Capsule Tear Management
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Solution Overview
Problem
Cataract surgery complications such as posterior capsule tears and zonular dialysis lead to difficulties in removing nuclear fragments and supporting the lens, resulting in potential retinal detachment and other complications, with existing techniques being inadequate in preventing migration and subluxation of lens fragments into the vitreous body.
Innovation Solution
A hands-free lens support system comprising a cannula, a piston with a lens support, a fixation device, and a stop, which allows precise placement between the posterior capsule and vitreous body to prevent nuclear fragment migration and provide support during extracapsular cataract surgery, especially in cases of posterior capsule tears or zonular dialysis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a net is mechanically constrained and inserted into the lens capsule to capture nuclear fragments, then nuclear fragment migration is prevented, but the technique may block removal of nuclear fragments that are between the net and the posterior capsule or have partially migrated into the vitreous body
Solution Approach 1:
A probe is introduced as an intermediary tool to manipulate and elevate nuclear fragments that are trapped by the net or have migrated into the vitreous body. The probe allows surgeons to retrieve fragments without removing the net, thus maintaining the prevention function while enabling fragment removal.
Solution Approach 2:
The device separates the functions of fragment capture (performed by the net) and fragment removal (performed by the probe). This segmentation allows both functions to operate independently and effectively without interfering with each other.
2Reliability
If a probe with small diameter (0.5-0.8 mm) is used for posterior assisted levitation to elevate nuclear fragments, then the technique can facilitate removal of fragments behind the posterior capsule, but balancing and elevating fragments on the probe is technically difficult
Solution Approach 1:
The expandable net acts as an intermediary structure that provides a stable platform for nuclear fragments. Instead of balancing fragments on a small probe, the net captures and supports multiple fragments simultaneously, making the procedure less technically demanding.
Solution Approach 2:
The net transitions from a compressed delivery state to an expanded functional state within the eye. This dynamic transformation allows the net to adapt to the spatial requirements for fragment support, providing a larger, more stable surface area for fragment elevation.
3Reliability
If the posterior capsule is left intact during extracapsular cataract surgery, then it can support the vitreous body and prevent forward movement into the anterior portion, but complications including posterior capsule tear, zonular dialysis and intraocular lens subluxation can occur
Solution Approach 1:
The net is deployed in advance to provide reinforcement to the posterior capsule before complications can occur. This preliminary support structure prevents capsule tears and lens subluxation by distributing mechanical stresses that would otherwise concentrate on the capsule and zonular fibers.
Solution Approach 2:
The net serves as a cushioning layer behind the posterior capsule, absorbing and distributing forces that might cause trauma. This protective barrier prevents direct transmission of mechanical stress to the capsule and vitreous body during surgical manipulation.
4Reliability
If a hands-free lens support system is used to provide continuous support during surgery, then the risk of further complications is reduced, but the device complexity increases with multiple components
Solution Approach 1:
Multiple functions are merged into a single integrated device: the net provides both structural support and fragment capture, while the delivery system combines cannula, piston, and stop components into a coordinated assembly. This merging reduces the number of separate devices needed while maintaining hands-free operation.
Solution Approach 2:
The device is designed to be self-retaining through the stop mechanism that engages with the cannula, eliminating the need for continuous manual manipulation. The net automatically maintains its expanded configuration and support function once deployed, providing continuous hands-free support throughout the surgical procedure.
Data Source
AI summary
A lens support system for use during extracapsular cataract surgery. The lens support system may be used to support a lens or lens fragment in the event of a posterior capsule tear or zonular dialysis. The lens support system comprises a cannula in which a piston attached to a lens support is slidably disposed. By means of the piston, the lens support is movable between collapsed and expanded configurations.