RU2355367C2 - Capsular sac retainer - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: retainer accommodates an open ring or its part comprising a segment of the radius corresponding to that of capsular sac, and haptic elements. At least one haptic element comprises a hook across the ring generatrix with "П"-shaped or semiannular end at its top, made of a wire piece, with ring rakers of its ends located at the bottom of the ring and mounted so that, at least the hook end within ring plane transcends.

EFFECT: retainer allows improving vision quality due to relocation of ligature attaching point outside of a ring or a convex part of the segment with high-quality capsular support of intraocular lens.

2 cl, 4 dwg

Description

The invention relates to medicine, in particular to ophthalmology, and can be used for implantation of an artificial lens in conditions of ligament defect of congenital or acquired nature.

A known method is the suture fixation of an elastic intraocular lens (IOL) during cataract extraction [1], which is accompanied by the absence or insufficiency of capsular support and involves implantation and suturing of the elastic artificial lens for the haptic element to the fibrous capsule of the eye (sclera) or to the iris in the posterior chamber eyes. The haptic element of the IOL is stitched before implantation. The dimensions of the seam pitch on the iris and haptic element of the lens are different, but parallel to one another and to the axis of the provided IOL centering, and centering is performed by loosening the outer ends of the thread. The disadvantage of this method is that it can be used only for minor damage to the ligaments. With significant defects of the ligamentous apparatus for fixing the position of the capsule bag, it is more reliable to use a special device for this.

Known and closest in essence to the proposed, and therefore taken by us as a prototype is a device for fixing the capsule bag [2]. It contains an open ring or part thereof, for example, in the form of a segment whose radius corresponds to the radius of the capsular bag, and an arc-like haptic element attached to the ring from the concave side.

One of the main disadvantages of using the known device is the partial overlap of the lens with a haptic element with a ligature, which does not allow to fully use the chance of achieving high quality vision in a patient after IOL implantation. In addition, in the well-known device we have taken as a prototype, the end of the haptic element, to which the ligature is to be attached, is made in the form of an arc and is not quite reliable. The elimination of the aforementioned disadvantages is the main objective of the present invention.

The solution to this problem is achieved by the fact that in the known device for fixing the capsule bag, which includes an open ring or part of it in the form of a segment whose radius corresponds to the radius of the capsule bag (hereinafter ring), and haptic elements, in accordance with the proposed solution, at least one the haptic element is made in the form of a hook located across the generatrix of the ring with a U-shaped or semi-ring end that makes up the top of the hook and is made, for example, of a piece of wire with fasteners Nia to the ring at its ends, with an end hook and a large part of its upper half in the plane of the ring in all cases located outside the same or the opposite side relative to the lower part of the hook or fixing points to the ring.

All haptic elements are located on one side of the ring and evenly around its perimeter, with the upper and lower parts of the hook can be located on different sides of the ring or on one of its sides.

Instead of a wire, any material can be used, including synthetic, from which a hook can be made to the U-shaped or rounded (semi-ring) end of its upper part, part of which should protrude beyond the ring and have a secure hook to the ring.

An unclosed ring at its ends may have additional haptic elements for fixation to the fibrous membrane of the eye.

The technical result achieved by the proposed solution is to improve the quality of vision by moving the ligature attachment point to the haptic element beyond the ring or convex part of the segment with high quality capsule support of the artificial lens.

The proposed solution is illustrated by the following drawings:

Figure 1 - view of the capsule bag (fragment) with a haptic element mounted on the ring in the form of a hook for cases where the upper and lower parts are located on different sides of the ring;

Figure 2 - device for fixing the capsule bag in plan (in the plane of the ring);

Figure 3 is a view of the device according to A in Figure 2, when the upper and lower parts of the haptic element (hook) are located on one side of the ring;

Figure 4 is a view of the device according to A in Figure 2, when the upper and lower parts of the haptic element (hook) are located on opposite sides of the ring.

Positions in the drawings:

1 - open ring;

2 - the lower part of the haptic element (hook);

3 - elements for attaching the hook to the ring or the ends of the length of wire from which the hook is made;

4 - the upper part of the hook;

5 - U-shaped or rounded end of the hook;

6 - capsule bag;

7 - cornea;

8 - iris;

9 - fibrous membrane of the eye (sclera);

10 - additional haptic elements located at the ends of an open ring (segment).

The device includes an open ring 1, on which are located the haptic elements in the form of hooks, each of which has a lower part 2 with elements (points) for attaching the hook 3 to the ring 1, and the upper part 4 with the hook end 5 protruding outside the ring 1 in the plane.

The implantation technique using the proposed device allows for continuous circular capsulorexis in the anterior lens capsule and implantation of the device in the equatorial part of the capsular bag in the absence of ligaments so that the upper part of the haptic element is placed on top of the front of the capsule. Fixation of the ring 1 to the fibrous membrane of the eye 9 is carried out using a seam.

The efforts exerted when introducing the device into the capsular bag have a minimal effect on the ligaments that remain, so that the possibility of damage to them during the manipulation will be minimal. After implantation of the device, the lens can be removed by phacoemulsification or phacoaspiration (in young patients) using minimal incisions.

The resumption of the anatomical position of the capsular bag allows for the intracapsular implantation of the IOL, in particular flexible artificial lenses.

Information sources

1. RF patent No. 2135137 C1, IPC A61F 9/007 "Method for suture iris fixation of an elastic intraocular lens".

2. Cionni RJ, Osher RH. Management of profound zonular dialysis or weakness wich a new endocapsular ring designed for scleral fixation. J Cataract Refract Surg 1998; 24: 1299-1306.

Claims (2)

1. A device for fixing the capsule bag, comprising an open ring or part thereof in the form of a segment, the radius of which corresponds to the radius of the capsule bag and haptic elements, characterized in that at least one haptic element is made in the form of a hook with a U-shaped located across the generatrix of the ring or a semicircular end on its upper part, made of a piece of wire, with fastening elements of its ends to the ring located on the lower part of the ring and installed so that at least the end to yuchka in the plane of the ring is located outside. 2. The device for fixing the capsule bag according to claim 1, characterized in that all the haptic elements are located on one side of the ring and evenly around its perimeter, with the upper and lower parts of the hook can be located on different sides of the ring or on one of its parties.

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