Keratopathies

 

(57) Abstract:

The invention relates to medicine, namely to ophthalmology, and can be used to restore vision in severe Belm eyes. Keratopathies contains an inner support element and an outer support element. The inner support element is designed in the form of a sleeve with internal thread for screwing in the inner support element. The outer supporting element has a Central axial threaded bore screwed onto the optical cylinder. The sleeve is made detachable and provided with a retaining ring. The fixation plate is made in the form of a rectangular perforated tape, placed crosswise and perpendicular relative to each other, with the length of the outside diameter of the cornea. The outer supporting element is made of two interconnected plates. The front plate is made of a monolithic rigid with an outer diameter corresponding to the parameters of the operated cornea. The back plate is made of a porous elastic with a diameter greater than the diameter of the front plate. The inner radius of curvature of the outer support element is selected in accordance with an outer radius of curvature from which proteza in the eye by increasing the diameter of the optical cylinder. 1 C.p. f-crystals, 5 Il.

The invention relates to medicine, a particular to ophthalmology, and is intended for prosthetic cornea with heavy Belm eyes.

Known keratopathies containing the support plate with the Central and side openings and mated with her mushroom-shaped optical rod, while the support plate is made with a radial slit (see and.with. N 562277, M. CL. 2 A 61 F 1/16, BI, 1977, N 23).

The disadvantages of the above technical solutions are odnogolosy and rigidity of the front support element, which cause pressure ulcers in the cornea and form a "pocket"' for foreign particles and microorganisms, which contribute to the development of complications leading to rejection of the prosthesis.

The closest to the technical nature of the claimed createprocessw is a technical solution (see RF patent N 1804809, Ál.5 A 61 F 2/14, B. I. , 1993, N 12), in which keratopathies consists of two supporting plates, sequentially implanted into the tissue of the cornea and into the space between the eyeball and the eyelids, and a removable optical cylinder, screw in the center hole of the support plate. While one plate is provided with pins and installed on the optical cylinder ity of the internal reference element, for implantation requires extensive cuts and layering of the cornea. Another disadvantage of such a prosthesis is an internal support element in size, limited by the diameter of the cornea, which does not allow to increase the size of the optical cylinder to maintain a sufficient degree of fixation, preventing the rejection of the prosthesis.

The technical problem to be solved in the invention, a warning of the possibility of rejection of the prosthesis when the increase in the diameter of the optical cylinder.

This technical result of the invention, representing keratopathies containing the internal reference element made in the form of a sleeve with internal thread and the fixation plate, and the optical cylinder with an external thread for screwing into the internal supporting element, and the outer supporting element is coaxial with the Central screw hole for screwing on the optical cylinder is achieved in that the sleeve is made detachable and provided with a retaining ring, the ends of the hub parts of the sleeve and adjacent the ends of adjacent parts made parallel relation to the axis diameter of the sleeve, and the opposite ends of the details and Smagina plate made in the form of a rectangular perforated tapes, placed crosswise and perpendicular relative to each other, the length of the outside diameter of the cornea. In addition, the outer supporting element is made of two interconnected plates, with the front plate is made of a monolithic rigid with an outer diameter corresponding to the parameters of the operated cornea, and back plate made of a porous elastic with a diameter greater than the diameter of the front plate, while the inner radius of curvature of the front support element is selected in accordance with an outer radius of curvature of the operated cornea.

In Fig. 1 shows keratoprosthesis top of Fig. 2 shows keratopathies in the section, Fig. 3 shows a disconnected internal reference element, a top view, in Fig. 4 shows the internal reference element in the section, Fig. 5 shows a split outer bearing element in the section.

The figures are marked by numbers: 1 - optical cylinder, 2 - sleeve, 3 - fixing plate 4 to the front of the monolithic plate, 5 - rear porous plate, 6 - retaining ring, 7 - cornea, 8 - sclera, 9 - direct oculomotor muscles, 10 - conjunctiva.

For the manufacture of the claimed keratoprosthesis use is ratesa and optical power cylinder are selected in accordance with parameters of the patient's eye.

Implanted claimed keratopathies as follows:

the first stage usepreview conjunctiva (10) in a circle from the limbus to the width corresponding to the projection of the back plate (5) of the outer support element (Fig. 2 and 5);

the second stage is marked zone trepanation holes, delamination of the cornea (7) and sclera (8), scleral incisions, thus projecting it diagonally in relation to direct oculomotor muscles (9);

the third stage produces a total removal of the corneal epithelium (7), the Central axial blind the trephination of the cornea (7) 2/3 thickness, diameter, 0.3-0.5 mm smaller outer diameter of the sleeve (2), and parallel limb incisions in the sclera (8) 2/3 thickness;

the fourth stage of counter stratification of the cornea (7) and sclera (8) form the channels, from trepanation holes pave the fixation plate (3) and derive their ends to the surface through the scleral incisions;

the fifth stage sostakovic details bushings (2) inside snap ring (6), and item with the parallel ends of the stack last;

the sixth stage is implemented through the trephination of the cornea (7) with a diameter corresponding to the internal thread diameter of the sleeve (2), and screwed izvodyat peripheral puncture of the cornea (7) outside areas of the placement of the fixation plate (3), injected into the anterior chamber of the eye with saline and oxygen to the extent necessary, doverchivaya optical cylinder (1) to a predetermined depth;

the eighth stage screw outer supporting element (Fig. 2 and 5) on the optical cylinder (1), while the protruding ends of the fixation plates (3) are placed in different variants, fix them and the back plate (5) seams to the sclera (8);

the ninth stage cover the protruding part of the rear plate (5) conjunctiva (10), impose temporary seams, the surgery is completed.

The positive effects of the proposed keratoprosthesis are:

the implementation of the internal reference element is detachable with a specific configuration and position of the fixation plates allows implanting it through trepanation hole of the cornea, to stratify fabric only to the extent necessary, of appropriate size and position of the fixation plates to keep around trepanation holes pressline areas of the cornea, which reduces the invasiveness of the surgery;

the distribution of the supporting elements on the region of the sclera and the connection between them strengthens the fixation and creates opportunities to increase the diameter of the optical cylinder, which increases the funk what parameters and physical properties ensured by the rigidity and solidity of the front plate mechanical protection and cosmetic effect, due to the elasticity, porosity and larger diameter back plate overlying the retainer to the sclera seams, to cover the protruding portion of the plate conjunctiva, allows you to grow tissues in the plate, and also allows you to create a depot of necessary drugs prior impregnation of the gel plate of definite composition, all of this is enhanced fixation increases tightness, obstructed the formation of "pockets" for foreign particles and microflora under the outer support element, which reduces the likelihood of complications, leading to the rejection of the prosthesis.

Thus, in the result of the combination of all these private benefits, which are provided by the claimed structural nodes keratoprosthesis, achieved total technical result, i.e., the prevention of possible rejection of the prosthesis when the increase in the diameter of the optical cylinder.

In addition, the implementation of keratoprosthesis collapsible retains the possibility of implanting it in one or two stages, in case you need to replace the optical cylinder and access to the inside of the eye.

1. Keratopathies containing the internal reference is ski cylinder with an external thread for screwing into the internal supporting element, and the outer supporting element with a Central axial threaded bore screwed onto the optical cylinder, characterized in that the sleeve is made detachable and provided with a retaining ring, the fixation plate is made in the form of a rectangular perforated tape, placed crosswise and perpendicular relative to each other, with the length of the outside diameter of the cornea.

2. Keratopathies under item 1, characterized in that the outer supporting element is made of two interconnected plates, with the front plate is made of a monolithic rigid with an outer diameter corresponding to the parameters of the operated cornea, and back plate made of a porous elastic with a diameter greater than the diameter of the front plate, while the inner radius of curvature of the outer support element is selected in accordance with an outer radius of curvature of the operated cornea.

 

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