CN114869589A

CN114869589A - Fixed depth cornea mark trephine

Info

Publication number: CN114869589A
Application number: CN202210566101.XA
Authority: CN
Inventors: 李方烃; 金恩忠; 张钦
Original assignee: Peking University Peoples Hospital
Current assignee: Peking University Peoples Hospital
Priority date: 2022-05-24
Filing date: 2022-05-24
Publication date: 2022-08-09

Abstract

The invention relates to a fixed depth cornea mark trephine and an operation method thereof, wherein the trephine comprises the following components in split type design: the knife part comprises a knife part finger-holding part and a blade, and the blade is fixed at the lower end of the knife part finger-holding part. The lower end of the marking part is provided with raised marking lines which are uniformly distributed along the circumferential direction and extend radially, the central axis of the marking line coincides with the central axis of the cylinder of the marking part, and the cutter part is in nested fit with the marking part. When the cutter is nested, the central axis of the marking line is superposed with the central axis of the cutter blade, the upper end surface of the marking part is contacted with the lower end of the cutter finger-supporting part, and the cutter blade protrudes out of the inner side of the marking line of the marking part to a preset cutting depth. When the fixed-depth cornea mark trephine is used for cutting the recipient cornea, the blade at the knife part can not continuously cut downwards after the cutting depth reaches the preset cutting depth, so that the cornea can be cut at a uniform depth. Meanwhile, the cornea circumcision center is coaxial with the cornea mark line, so that the operation is safer and more accurate.

Description

Fixed depth cornea mark trephine

Technical Field

The invention relates to a fixed-depth cornea mark trephine, and belongs to the technical field of medical instruments.

Background

Blinding keratopathy, together with diabetic retinopathy and glaucoma, are three major blinding diseases in the world today. At present, the only way to recover from blinding keratopathy is to perform corneal transplantation. According to statistics, more than 150 patients with blindness-causing keratopathy exist in China, but because the source of the corneal donor is very limited, only about 1 ten thousand patients can receive the corneal transplantation operation every year. Therefore, improving the survival rate of corneal donors, perfecting corneal transplantation surgery, and reducing postoperative complications during surgery are critical to the success of corneal transplantation surgery.

In the corneal transplantation, cutting the cornea of a patient to an appropriate depth is a very important step in the corneal transplantation. FIG. 1 is a schematic sectional view of a cornea of a patient cut in a corneal transplantation operation. In the corneal transplantation operation, a corneal ring drill 20 is used to perform a circular resection of the cornea 10 of a patient, and then a normal corneal donor is transplanted to the eyeball of the patient. Figure 2 shows a side view of a corneal trephine currently in use. When the existing corneal trephine 20 is used to perform the circular cutting of the cornea of the patient, the cutting edge of the corneal trephine 20 is placed on the cornea 10 of the patient, and then the upper end of the finger support portion 21 of the corneal trephine 20 is lightly pressed by one hand, and the outer side surface of the finger support portion 21 is touched by the other hand to rotate the corneal trephine 20, so that the corneal trephine 20 cuts the cornea 10 of the patient. As can be seen from the above description, when the corneal trephine 20 is used, the pressing force in all directions cannot be uniform by slightly pressing the hollow cylindrical finger support part 21 of the corneal trephine 20 with a finger and rotating, so that the corneal trephine 20 cannot accurately control the cutting depth 51 of one circle to be uniform when the cornea of a patient is cut, and if the depth in one direction is too deep, an incision easily penetrates through the cornea of the patient to damage the iris and the crystalline lens, which brings about operative complications; if the cutting depth is too shallow and uneven, the difficulty of the subsequent operation is increased, the cornea cannot be cut uniformly and the suture cannot be completed, and the prognosis vision of the patient is affected.

There is currently a corneal trephine. The corneal trephine is fixed on the cornea of a patient by using a negative pressure suction ring, and the depth of the corneal trephine for cutting the cornea of the patient can be controlled by manually rotating the angle of the corneal trephine. However, the negative pressure corneal trephine has the problems of complex operation, disposable use, high price and the like, and greatly increases medical insurance payment and economic burden of patients.

In addition, corneal transplantation surgery is not only a therapeutic surgery, but doctors and patients have higher vision expectation after corneal transplantation, but different from relatively perfect cataract surgery, the prognosis vision of patients after corneal transplantation surgery is often not ideal, the main reason for poor postoperative vision is postoperative irregular astigmatism, and the irregular astigmatism is often difficult to correct, so that how to reduce the astigmatism of corneal transplantation surgery becomes a problem to be solved by corneal transplants. The reason for the generation of irregular astigmatism in the corneal transplantation operation is mainly that perfect contraposition suture of a corneal donor and a corneal receptor cannot be realized when the cornea is manually contraposition sutured in the operation, the corneal transplantation generally needs 16 intermittent suture needles, and ideal perfect suture is 16-halved suture. However, the manual suture cannot complete uniform 16-equal-part suture without marks, and the conventional corneal transplantation operation adopts a mode of carrying out mark 16-equal-part line auxiliary suture on the cornea of a patient in advance (figure 3), but the conventional mode of carrying out corneal marking first and then cutting by a corneal trephine leads to the fact that a marking central axis is not consistent with a cutting central axis of the corneal trephine (figure 4), so that the 16-equal-part suture cannot be uniformly carried out during the suture, and the irregular astigmatism of the cornea is increased due to the nonuniform suture. If the accurate 16-equal mark can be coaxially performed when the cornea of the patient is cut, the accurate 16-equal suture along the 16-equal mark line of the cornea of the patient can reduce the suture error (figure 5), reduce the irregular astigmatism of the cornea after operation and improve the vision of the cornea after the cornea transplantation.

Disclosure of Invention

In order to solve the technical problems, the invention provides a fixed-depth cornea marking trephine, which can accurately and uniformly cut the cornea of a patient with a fixed depth when the fixed-depth cornea marking trephine is used for corneal transplantation operation, so that over-deep cutting, over-shallow cutting and uneven cutting of the cornea of the patient are avoided, and meanwhile, a suture position mark coaxial with the cutting of the trephine is provided, so that the operation is more accurate and safer.

In order to achieve the purpose, the invention adopts the following technical scheme:

a fixed depth corneal marker trephine, comprising the following components in a split design:

the marking part is a hollow cylinder, a cutter part can be nested in the marking part, the cutter blade is exposed out of the preset cutting height of the marking part after the cutter blade is nested and combined, the preset heights can be different by using the fixed depth parts with different heights according to requirements, and the lower end of the marking part is a raised marking line.

The knife part comprises a knife part finger-holding part and a blade, the blade is fixed at the lower end of the knife part finger-holding part, and the central axis of the finger-holding part coincides with the central axis of the knife part. The blade is in nested fit with the fixed depth part, and the central axis of the blade is overlapped with the central axis of the marking line of the marking part after nesting.

In the fixed depth cornea marker trephine, preferably, the diameter of the blade of the cutter part is the same as the diameter of the cavity of the marker part, the height of the marker part is smaller than the height of the cavity of the cutter part, and the height difference between the two is a preset fixed depth.

The fixed depth cornea marker trephine preferably has a marker height that varies according to a predetermined cutting depth.

The cornea with the fixed depth is marked and trephined, and the number of the marking lines is preferably 8-16.

In the fixed depth cornea marker trephine, when the cornea is transplanted by using the cornea trephine, the marker marking line is dyed by trypan blue, the marker is placed on the cornea of a patient and is pressed downwards to be fixed, and the cornea of the patient is marked by the trypan blue on the marking line. The blade of the knife part is nested into the marking part, the marking part is stably fixed on the cornea of a patient by one hand, the other hand presses and rotates the cornea trephine finger supporting part downwards, so that the blade of the cornea trephine rotates, and the cornea of the patient is cut circularly. When the cutting reaches the preset depth, the upper end of the marking part contacts the cutter part finger-supporting part, and the cutter blade can not cut downwards when the cutter part is continuously pressed downwards and rotated. Thus, the cutting instrument can be safely pressed downwards during the whole cutting process, the cornea is not cut through suddenly, the maximum cutting depth can be controlled accurately, and meanwhile, a suture marking line which is coaxial with the trephine cutting is marked on the cornea of a patient, so that the operation is safer and more accurate.

Due to the adoption of the technical scheme, the invention has the following advantages:

according to the invention, the marking part is added on the corneal trephine, so that the cutting part of the corneal trephine is exposed out of the blade with the fixed cutting height, the maximum cutting depth can be accurately controlled, and meanwhile, a suture marking line coaxial with the cutting of the trephine is marked on the cornea of a patient, so that the operation is safer and more accurate.

Drawings

Fig. 1 is a perspective view of a cornea of a ring-cut patient in a conventional corneal transplantation operation.

FIG. 2 is a schematic sectional view of a cornea of a patient cut in a conventional corneal transplantation operation.

Fig. 3 is a schematic diagram of a patient's cornea after marking in a conventional corneal transplantation procedure.

FIG. 4 is a schematic illustration of a patient's cornea after non-coaxial ring-cutting with a marker line in a conventional corneal transplantation procedure.

Fig. 5 is a schematic diagram of a patient's cornea after a fixed depth corneal mark trephine and a mark line coaxial circumcision are provided according to this embodiment of the present invention.

Fig. 6 is an exploded view of the fixed depth corneal marker trephine provided in accordance with this embodiment of the present invention.

Fig. 7 is a combination diagram of a fixed depth corneal marker trephine according to this embodiment of the present invention.

Figure 8 is a cross-sectional view of a fixed depth corneal marker trephined circumcising the cornea in accordance with this embodiment of the present invention.

The respective symbols in the figure are as follows:

10-the cornea of the patient; 11-corneal marker line; 12-corneal ring-cut position; 20-existing corneal trephines; 21-existing corneal trephine fingering; 22-existing keratome trephine blade; 30-a knife section; 31-the knife part refers to the holding part; 32-a blade portion blade; 40-a marker portion; 41-lower end surface of the marking part; 42-mark section mark line; 51-trephine cutting depth; 52-predetermined depth of cut.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention are described clearly and completely below, and it is obvious that the described embodiments are some, not all embodiments of the present invention. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention.

Unless defined otherwise, technical or scientific terms used herein shall have the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs. As used herein, the terms "first," "second," "third," "fourth," and the like do not denote any order, quantity, or importance, but rather are used to distinguish one element from another. The word "comprising" or "comprises", and the like, means that the element or item listed before the word covers the element or item listed after the word and its equivalents, but does not exclude other elements or items. The terms "connected" or "coupled" and the like are not restricted to physical or mechanical connections, but may include electrical connections, whether direct or indirect.

As shown in fig. 6 and 7, which are exploded and assembled views of the fixed depth cornea marker trephine provided by the present invention, the present invention comprises a knife portion 30 and a marker portion 40, and the components are as follows:

the knife portion 30 is composed of a knife portion finger-supporting portion 31 and a blade 32. The cutter portion supporting portion 31 is a hollow cylindrical structure with two open ends, the lower end is connected with the annular blade 32, and the cutter portion supporting portion can be combined with the marking portion 40 in a nested mode.

The marking part 40 is a hollow cylindrical structure, the upper end surface of the marking part is a plane which can contact the lower end of the cutter part finger-supporting part 31, the lower end surface 41 of the marking part is an arc surface which is sunken towards the axis, and the surface of the arc surface is provided with 16 bump marking lines 42 which are uniformly distributed along the circumferential direction and extend in the radial direction. More preferably, the number of marker lines 42 (e.g., 8, 12, etc.) may be altered as desired. The inner diameter of the cavity of the marking portion 40 is the same as the outer diameter of the cylinder of the cutter portion blade 32. Preferably, when nested on the cylinder of the knife blade 52, the central axis of the nested marking line 42 coincides with the central axis of the blade 32. Preferably, when the marker 40 is nested on the cylinder of the knife blade 32 and the upper end surface of the marker 40 is in contact with the lower end surface of the knife finger 31, the knife blade 32 protrudes from the inner edge of the lower end of the marker line by a fixed cutting depth 52. More preferably, the fixed depth portion height may be adjusted as needed to alter the length of the fixed cutting depth 52.

As shown in fig. 8, in performing a corneal transplantation operation using the fixed-depth corneal marking trephine of the present invention, after determining a cutting depth 51 at which a patient's cornea 10 needs to be cut, a corresponding marking portion 40 is selected. The marker 40 marker line 42 is stained with trypan blue, the marker 40 is placed on the patient's cornea 10 and pressed down to be fixed, and the patient's cornea 10 is marked with trypan blue on the marker line 42, resulting in a cornea marker line 11. The blade 32 of the corneal trephine is rotated by nesting the blade into the marker 40, holding the marker 40 firmly with one hand against the patient's cornea 10 and pressing and rotating the corneal trephine finger rest 31 with the other hand downward to perform a circular cut of the patient's cornea 10. When the cut reaches the predetermined depth 52, the upper end of the marking portion 40 will contact the lower end of the knife portion finger rest portion 31, and the knife portion blade 32 can not cut downward by pressing and rotating the finger rest portion 31 downward. Thus, it is possible to safely press down throughout the cutting process without a sudden cut through the cornea, so that the cutting depth 51 is the same as the predetermined cutting depth 52. Meanwhile, the cutting depth 51 of the knife blade 32 in all directions for cutting the cornea 10 of the patient is the preset cutting depth 52, the cutting is uniform, and the damage to the structures in the eyes such as the iris, the crystalline lens and the like caused by the fact that the cornea is cut suddenly through due to too deep cutting is avoided. Meanwhile, the central axis of the corneal marking line 11 is coincident with the central axis of the corneal circular incision 12, so that the operation is safer and more accurate.

Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.

Claims

1. A fixed depth corneal marker trephine, comprising the following components in a split design:

the knife part (30) comprises a finger-holding part (31) and a blade (32), the blade (32) is fixed at the lower end of the knife-holding part (31), and the knife part (30) is in nested fit with the marking part (40);

the mark part (40) is of a hollow cylindrical structure, the lower end face (41) of the mark part is provided with ridge mark lines (42) which are uniformly distributed along the circumferential direction and extend in the radial direction, and the fixed depth part (40) is in nested fit with the cutter part (30).

2. The fixed depth corneal marker trephine of claim 1, wherein the blade (32) outer diameter is the same as the cavity diameter of the marker (40) and the cylinder height is less than the cavity height of the marker (40).

3. The fixed depth corneal marker trephine of claim 1, wherein the lower end surface (41) of the marker portion (40) is an arc-shaped surface depressed toward the axial center.

4. The fixed depth corneal marker trephine of claim 1, wherein the lower end face (41) of the marker portion (40) is provided with circumferentially uniformly distributed radially extending raised marker lines (42), the central axis of the marker lines (42) coinciding with the central cylindrical axis of the marker portion (40).

5. The fixed depth corneal marker trephine of claim 1, wherein the number of marker lines (42) is 8-16.

6. The fixed depth corneal marker trephine of claim 1, wherein the blade (32) protrudes a predetermined cutting depth (52) inside the marker line (42) after the upper end surface of the marker (30) and the lower end surface of the blade finger rest (31) are in contact when the marker (40) is nested in the blade (32).

7. The fixed depth corneal marker trephine of claim 1, wherein a central axis of the marker marking line (42) coincides with a central axis of the blade (32) when the marker (40) is nested in the blade (32).

8. A method of performing negative pressure marking corneal trephine as claimed in any one of claims 1 to 7, comprising the steps of:

staining the marker marking line (42) by trypan blue, placing the marker (40) on the cornea (10) of the patient and pressing and fixing downwards, wherein the marker marking line (42) generates a cornea marking line (11); the blade (32) of the knife part is nested into the marking part (40), the marking part (40) is stably fixed on the cornea (10) of a patient by one hand, the other hand presses and rotates the knife part finger-supporting part (31) downwards, so that the blade (32) of the cornea trephine rotates downwards, and the cornea (10) of the patient is cut annularly; when the cutting depth (51) reaches the preset depth (52), the upper end of the marking part (40) contacts the lower end of the cutter part finger-supporting part (31), and the cutter part blade (32) can not cut downwards any more; meanwhile, the central axis of the cornea mark line (11) is coincided with the central axis of the cornea circumcision (12).