JP4495045B2 - Corneal marker - Google Patents

Description

  The present invention relates to a corneal marker used for performing a required marking on the cornea in advance when operating the cornea of an eye.

  Conventionally, a treatment for forming an incision in the cornea is known as one of the methods for correcting astigmatism and myopia. Specifically, astigmatism correction corneal incision (AK: Astigmatic Keratotomy) and the like. In the corneal incision for correcting astigmatism, as shown in FIG. 13, incisions 110 and 110 parallel to each other are formed by cutting the cornea 100 linearly with a scalpel across the center of the cornea 100, and forming the incisions 110 and 110. Accordingly, the distortion of the cornea 100 is corrected by increasing the surface area of the cornea 100. The lengths of the incisions 110 and 110 are adjusted according to the degree of correction, and are determined based on the corneal surface distortion state confirmed before the treatment. The incisions 110 and 110 are formed using an excimer laser knife or a diamond knife.

  In order to form the incisions 110 and 110 at the correct position of the cornea 100, the cornea 100 is previously marked with a reference position by a corneal marker. The cornea 100 is incised based on the mark.

  Various types of corneal markers have been proposed. Generally, a corneal marker is known in which a radial mark is formed on the cornea by a plurality of radially extending blades (see, for example, Patent Document 1). ).

  In the astigmatism correction corneal incision described above, the surface shape of the cornea 100 after forming the incisions 110, 110 is a so-called pyramid type in order to form the linear incisions 110, 110 with respect to the spherical cornea 100. There is a risk of becoming aspherical.

  Therefore, in recent years, in astigmatism correction corneal incision, arc-shaped incisions 110 ′ and 110 ′ are also formed in the cornea 100 as shown in FIG. Peripheral arc-shaped astigmatism correction extension incision (LRIs) improved incision is often used.

  In this peripheral arc-shaped astigmatism correction extension incision, as shown in FIG. 15, two arc-shaped incisions 210 and 210 are formed in the vicinity of the annular portion 230 along the annular portion 230 that is the outer peripheral edge of the cornea 200. Is. In the peripheral arc-shaped astigmatism correction dilatation incision, the cornea 200 is cut in an arc shape so that the cornea 200 after the arc-shaped incisions 210 and 210 are formed is likely to be an appropriate spherical surface. By forming the arcuate incisions 210 and 210 in the vicinity, the amount of correction per unit length of the arcuate incisions 210 and 210 can be reduced, and the correction can be finely adjusted. When forming the arcuate incisions 210, 210, the cornea 200 is preliminarily formed with radial marks 220 with corneal markers.

  However, there has been a problem that it is difficult to completely eliminate the axial misalignment and overcorrection of the peripheral arc-shaped astigmatism correction extension incision described above.

  In particular, in astigmatism correction corneal incision and peripheral arc-shaped astigmatism correction dilatation incision, the size of the eyeball was determined because the amount of correction was defined only by the length of the incision without considering the size of the eyeball at all. However, the relatively small Japanese had a problem that proper correction was difficult.

  Therefore, the present inventor assumes a virtual circle centered on the center of the cornea as a method for defining the length of the incision, and forms the incision in an arc along the virtual circle. A method to define the length of the incision using the central angle was proposed. Thereby, the dependence on the size of the eyeball can be eliminated, and more reliable correction can be achieved.

  Furthermore, the present inventor has conducted research to develop a more reliable treatment method, and has developed LSLRI (Long & Shallow LRIs), which is an extension of peripheral arc-shaped astigmatism correction extension incision (LRIs).

In this LSLRI, the incision is formed longer instead of shallower than in the peripheral arc-shaped astigmatism correction extension incision.
Special Table 2002-515809

  However, in order to make the incision part long in LSLRI, as shown in FIG. X-1 and FIG. X-2, as shown in FIG. X-1 and FIG. There is a problem that it is difficult to form an incision having an appropriate length only by providing the mark.

  Therefore, the present inventor invented a corneal marker provided with a blade so as to be able to form a mark in increments of 10 °. However, when an incision having a large central angle is formed, the mark is miscounted. There is a fear that it may be difficult to form an appropriate notch.

The corneal marker of the present invention, a handle portion of the rod-like, Ri Do and a marker unit mounted to the distal end of the handle portion, a corneal marker that is used when incising the cornea in a circular arc shape, the marker unit, It has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially in 10 ° increments on the bottom surface. The blade has a first blade having a predetermined length and a length longer than the first blade. The second blades are arranged in increments of 30 °, two first blades are arranged between two adjacent second blades, and the first blades A blade group that forms marks of 60 ° to 120 ° by the second blade and the second blade is provided to face each other with the through hole interposed therebetween, and the upper surface of the marker portion is aligned with the placement position of the blade. And Even without providing the auxiliary marks for each 90 °.

Also, the corneal marker of the present invention, a handle portion of the rod-like, Ri Do and a marker unit mounted to the distal end of the handle portion, a corneal marker that is used when incising the cornea in a circular arc shape, the marker portion Has a through-hole for cornea confirmation in the center and a plurality of blades arranged radially in 10 ° increments on the bottom surface. The blade includes a first blade having a predetermined length and the first blade. A second blade having a longer length, wherein the first blade and the second blade are alternately arranged , and a mark of 60 ° to 120 ° is formed by the first blade and the second blade. Are provided so as to face each other across the through hole, and an auxiliary mark is provided on the upper surface of the marker portion at least every 90 ° in accordance with the arrangement position of the blade .

Also, the corneal marker of the present invention, a handle portion of the rod-like, Ri Do and a marker unit mounted to the distal end of the handle portion, a corneal marker that is used when incising the cornea in a circular arc shape, the marker portion Has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially in increments of 10 ° on the bottom surface, and this blade includes a first blade provided in the vicinity of the outer peripheral edge of the marker portion, Having a second blade provided closer to the center of the marker portion than the first blade, alternately arranging the first blade and the second blade, and arranging the blades in a staggered manner ; A group of blades forming marks of 60 ° to 120 ° by the first blade and the second blade are provided opposite to each other with the through hole interposed therebetween, and the upper surface of the marker portion is provided with the blur. In accordance with the arrangement position of de, it is provided an auxiliary mark at least every 90 °.

Furthermore, in the corneal marker of the present invention, the marker portion is provided with a notch in a region other than the region where the blade group is provided, and a protruding piece for providing the auxiliary mark is provided in the notch. It also has a feature.

According to the first aspect of the present invention, the marker portion has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially at 10 ° intervals on the bottom surface, and the blade has a predetermined length. The first blade and a second blade longer than the first blade, the second blade being arranged in increments of 30 °, and 2 between the two adjacent second blades. A plurality of first blades, and a group of blades forming marks of 60 ° to 120 ° by the first blades and the second blades facing each other across the through-hole, and a marker An auxiliary mark is provided on the upper surface of the blade at least every 90 ° in accordance with the position of the blade so that the angle can be easily recognized. An appropriate incision can be reliably formed. Further, it is possible to facilitate the alignment of the marker portion with the cornea. Further, the marking can be reliably performed without pressing the marker portion against the cornea with a large force.

According to the invention described in claim 2, the marker portion has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially in steps of 10 ° on the bottom surface, and the blade has a predetermined length. First blades and second blades longer than the first blades, the first blades and the second blades are alternately arranged , the first blades and the second blades A blade group that forms a mark of 60 ° to 120 ° with the blades of the blades is provided to face each other with the through hole interposed therebetween, and at least 90 on the upper surface of the marker portion in accordance with the arrangement position of the blades. by providing the auxiliary marks for each °, probability since it claim 1 particularly easy to recognize the angle same as those of the structure described, it can be difficult to further produce errors counted marks, the proper incision It can be formed on. Further, it is possible to facilitate the alignment of the marker portion with the cornea. Further, the marking can be reliably performed without pressing the marker portion against the cornea with a large force.

According to the invention described in claim 3, the marker portion has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially in 10 ° increments on the bottom surface . A first blade provided in the vicinity of the outer peripheral edge and a second blade provided closer to the center of the marker portion than the first blade, and the first blade and the second blade are alternately arranged The blade groups are arranged in a staggered manner, and a group of blades forming marks of 60 ° to 120 ° by the first blade and the second blade are provided facing each other across the through hole. with, on the upper surface of the marker portion, in accordance with the arrangement position of the blade, by providing the auxiliary marks at least every 90 °, it is possible to easily occur mistakes counting marks, proper incision The can be reliably formed. In particular, since the interval between marks can be increased, marking can be reliably performed without pressing the marker portion against the cornea with a large force. Further, it is possible to facilitate the alignment of the marker portion with the cornea. Further, the marking can be reliably performed without pressing the marker portion against the cornea with a large force.

According to a fourth aspect of the present invention, in the corneal marker according to any one of the first to third aspects, the marker portion is provided with a notch in a region other than the region where the blade group is provided, and the same. By providing a protruding piece for providing the auxiliary mark in the notch portion, it is possible to easily align the marker portion with the cornea.

  The corneal marker of the present invention is a corneal marker comprising a rod-like handle portion and a marker portion attached to the tip of the handle portion, and the marker portion has a plurality of blades arranged radially in 10 ° increments on the bottom surface. Is provided.

  In particular, the blade is composed of a first blade having a predetermined length and a second blade that is longer than the first blade, and the second blade is provided at a predetermined interval to prevent miscounting of marks. It is what you are doing.

  Alternatively, the blade is composed of a first blade provided near the outer peripheral edge of the marker portion and a second blade provided closer to the center of the marker portion than the first blade. By arranging the two blades alternately and arranging the blades in a staggered manner, it is easy to prevent mark miscounting.

  By forming marks on the cornea using two different types of blades as described above, it is possible to prevent miscounting of marks, and it is possible to reliably form an appropriate incision in the cornea.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. 1 is a front view of a corneal marker M of the present embodiment, FIG. 2 is a left side view thereof, FIG. 3 is a right side view thereof, FIG. 4 is a plan view thereof, and FIG. The rear view appears symmetrically with the front view of FIG.

  The corneal marker M includes a rod-like handle portion 10 and a cylindrical marker portion 20 attached to the tip of the handle portion 10. This corneal marker M is made of SUS303.

  The handle portion 10 is composed of a cylindrical rod 11 having a diameter of about 5 mm. Two flat surfaces 12 and 12 are provided on the circumferential surface of the cylindrical rod 11 so that the cylindrical rod 11 is flattened so that it can be easily grasped with one hand. ing. In particular, the flat surfaces 12, 12 provided on the cylindrical rod 11 are provided with a plurality of concave grooves 13 in parallel with the direction orthogonal to the extending direction of the cylindrical rod 11 to provide anti-slip. The tip of the cylindrical rod 11 is tapered, and a marker portion 20 is provided at the tip.

  The marker portion 20 is composed of a cylindrical body 22 having a diameter of about 11 mm provided with a through-hole 21 in the central portion, and a plurality of pieces arranged radially at 10 ° intervals on the bottom surface of the cylindrical body 22 as shown in FIG. A blade is provided.

  The blade is sharpened in a wedge shape at the tip, and marking is performed to form a linear mark made of a concave groove on the cornea by pressing the tip portion against the cornea. The mark is not limited to the case where the mark is formed by a concave groove, and a mark dye may be attached to the tip of the blade and transferred to the cornea to form a mark.

  In addition, the radially extended blade is curved so that the tip edge thereof has a concave arc shape along the extending direction so that the blade can be uniformly brought into contact with the spherical cornea. Therefore, a part of the blade can be prevented from coming into strong contact with the cornea, and the entire tip of the blade can be reliably pressed against the cornea, so that a mark that can be easily seen can be formed.

  In particular, in the blade of the corneal marker M shown in FIGS. 1 to 5, as shown in the enlarged bottom view of the cylindrical body 22 in FIG. 6, the first blade b1 having a predetermined length and the first blade b1 longer than the first blade b1 are used. The two blades b2 are composed of two types of blades, and the second blade b2 is arranged in increments of 30 °. That is, the second blade b2 is 12 o'clock, 1 o'clock, 2 o'clock, 3 o'clock, 4 o'clock, 5 o'clock, 6 o'clock, 7 o'clock, 8 o'clock on the bottom surface of the cylindrical body 22. , 9 o'clock, 10 o'clock and 11 o'clock.

  And between 10 o'clock and 11 o'clock, between 11 o'clock and 12 o'clock, between 12 o'clock and 1 o'clock, between 1 o'clock and 2 o'clock, there are 2 The first blade b1 is arranged to form the first blade group g1, and between 4 o'clock and 5 o'clock, between 5 o'clock and 6 o'clock, between 6 o'clock and 7 o'clock Also, between the 7 o'clock part and the 8 o'clock part, two first blades b1 are arranged in 10 ° increments to form a second blade group g2.

  Thus, between 2 o'clock and 3 o'clock, between 3 o'clock and 4 o'clock, between 8 o'clock and 9 o'clock, and between 9 o'clock and 10 o'clock, respectively, the first blade b1 By providing the first blade group g1 and the second blade group g2 with the through-hole 21 interposed therebetween, the number of blades in contact with the cornea can be reduced, so that when the marker portion 20 is pressed against the cornea Dispersion of the pressing force can be suppressed, and marking can be reliably performed without pressing the marker portion 20 against the cornea with a large force.

  In particular, marking can be performed more reliably by pressing the first blade group g1 and the second blade group g2 alternately and slightly against the cornea.

  Further, in the first blade group g1 and the second blade group g2, a mark can be formed on the cornea over 120 °, and the treatment in the LSLRI is performed by the mark formed in the cornea with the second blade b2 provided every 30 °. In this case, it is possible to make it difficult to cause miscounting of marks, and it is possible to reliably form an appropriate notch.

  In the corneal marker M shown in FIGS. 1 to 5, auxiliary marks 23 are provided on the upper surface of the marker portion 20 in accordance with the arrangement position of the blade on the bottom surface of the marker portion 20 as shown in FIG. 4. The auxiliary mark 23 is provided to confirm whether the marker part 20 is located at the correct position when the marker part 20 is pressed against the cornea, and at least 12 o'clock part, 3 o'clock part, What is necessary is just to provide at 6 o'clock part and 9 o'clock part.

  When the marker portion 20 provided with the auxiliary mark 23 is pressed against the cornea in this way, as shown in FIG. 7, the reference mark 31 indicating the positions of the 12 o'clock portion and the 3 o'clock portion in advance on the white eye portion around the cornea. , 31 is set, and the 12 o'clock auxiliary mark 23 of the marker portion 20 is aligned with the reference mark 31 indicating the 12 o'clock portion, and the 3 o'clock auxiliary portion of the marker portion 20 is indicated on the reference mark 31 indicating the 3 o'clock portion. A mark 32 is formed on the cornea 30 by aligning the mark 23 and pressing the marker portion 20 against the cornea 30.

  In particular, since the marker portion 20 has a through-hole 21 for confirming the cornea in the center, the top of the cornea 30 can be visually recognized through the through-hole 21. The portion 20 is positioned approximately in the center of the cornea 30, and then the auxiliary mark 23 can be aligned with the reference mark 31 while rotating the marker portion 20, and the alignment of the marker portion 20 with respect to the cornea 30 can be performed in a very short time, and It can be done reliably. FIG. 7 shows a marking state in the case of correction of direct astigmatism.

  In this embodiment, the reference mark 31 is formed by forming a small bleeding spot on the bulbar conjunctiva with a 27G needle. The reference mark 31 is not limited to being provided at the 12 o'clock and 3 o'clock positions, and may be provided at the 3 o'clock and 6 o'clock positions as shown in FIG. In the case of FIG. 8, astigmatism is obtained by aligning the 12 o'clock portion of the marker portion 20 with the reference mark 31 provided at 3 o'clock and aligning the 3 o'clock portion of the marker portion 20 with the reference mark 31 provided at 6 o'clock. The marking state in the case of straightening is shown. The correction of oblique astigmatism can be dealt with by providing the reference mark 31 at a predetermined position. By providing as many auxiliary marks 23 as possible on the upper surface of the marker portion 20 as in the present embodiment, it is possible to easily cope with oblique astigmatism. In addition, the reference mark 31 may be formed using ink for the reference mark 31 as well as the case of forming with bleeding spots.

  As shown in FIGS. 7 and 8, in the corneal marker M of the present embodiment, the cornea 30 has a 30 ° mark 32 formed by the second blade b2 and a 10 ° formed by the first blade b1. For example, the first blade b1 and the second blade b2 are alternately provided on the bottom surface of the marker portion 20 in increments of 10 °, as shown in FIG. While b2 forms a mark 32 'in increments of 20 ° on the cornea 30, a mark 33' in increments of 10 ° may be formed between the marks 32 'in increments of 20 °.

  As described above, even when the first blade b1 and the second blade b2 are alternately arranged on the bottom surface of the marker portion 20, the angle can be recognized particularly easily, so that it is possible to make it difficult to make a mistake in counting the marks. Thus, it is possible to reliably form an appropriate incision.

  Alternatively, the second blade is not longer than the first blade, but is approximately the same length as the first blade, while being arranged closer to the center of the marker portion than the first blade, as shown in FIG. The distinction between the mark 33 "formed by the first blade and the mark 32" formed by the second blade may be improved.

  That is, the first blade is provided near the outer periphery of the marker portion, the second blade is provided closer to the center of the marker portion than the first blade, and the first blade and the second blade are arranged in increments of 10 °. Thus, by arranging the blades in a staggered manner along the circumferential direction of the marker portion, as shown in FIG. 10, a mark 33 "formed by the first blade and a mark 32" formed by the second blade It can be arranged in a staggered pattern.

  Thus, by arranging the first blade and the second blade in a staggered manner along the circumferential direction of the marker portion, the mark 33 "formed by the first blade and the mark 32" formed by the second blade are identified. And the mark counting error can be made difficult to occur, and the interval between the first blades adjacent in the circumferential direction and the interval between the second blades adjacent in the circumferential direction can be increased. Therefore, when the mark is formed by pressing the cornea, the mark can be easily attached.

  That is, when the cornea is pressed with a blade in 10 ° increments as shown in FIGS. 7 to 9, the entire cornea is pressed to make it difficult to leave a blade mark on the cornea, but the blades are arranged in a staggered manner. By increasing the distance between the blades, the entire cornea can be prevented from being pressed, and only the cornea in contact with the blade can be pressed without being affected by the adjacent blade. Therefore, a mark can be formed reliably.

  The center side end of the marker portion of the mark 33 "formed by the first blade and the outer peripheral side end of the marker portion of the mark 32" formed by the second blade are positioned on substantially the same circumference, The cornea 30 is incised along the circumference.

  The marker portion of the corneal marker in which the first blade and the second blade are formed as described above is not limited to a cylindrical shape, and as shown in FIG. As a butterfly-shaped marker portion 20 ', a notch 41 is provided between the three portions, between the three o'clock portion and the four o'clock portion, between the eight o'clock portion and the nine o'clock portion, and between the nine o'clock portion and the ten o'clock portion. Also good.

  In particular, at 3 o'clock and 9 o'clock, by providing a protruding piece 44 for providing the auxiliary mark 43, the auxiliary mark 43 can be further easily identified, and the alignment of the marker portion 20 'with the cornea Can be performed very easily.

  In FIG. 11, the marker portion 20 ′ allows a mark to be formed on the cornea over 120 °. However, when 60 ° is sufficient, as shown in FIG. 12, 1 o'clock and 3 o'clock A notch 41 "may be provided between 3 o'clock and 5 o'clock, between 7 o'clock and 9 o'clock, and between 9 o'clock and 11 o'clock.

  In this case, the marker portion 20 "has a cross shape so that the marker portion 20" can be more easily aligned with the cornea.

It is a front view of the corneal marker of this embodiment. It is a left view of the corneal marker of this embodiment. It is a right view of the corneal marker of this embodiment. It is a top view of the corneal marker of this embodiment. It is a bottom view of the corneal marker of this embodiment. It is a bottom enlarged view of the cylindrical body which comprises a marker part. It is a schematic diagram of the marked cornea. It is a schematic diagram of the marked cornea. It is a schematic diagram of the marked cornea. It is a schematic diagram of the marked cornea. It is a front view of the marker part part in the corneal marker of other embodiment. It is a front view of the marker part part in the corneal marker of other embodiment. It is explanatory drawing of incision part formation by astigmatism correction corneal incision. It is explanatory drawing of incision part formation by astigmatism correction corneal incision. It is explanatory drawing of incision part formation by a peripheral part arc-shaped astigmatism correction extension incision.

Explanation of symbols

M cornea marker
10 Handle section
11 cylindrical bar
12 plane
13 concave groove
20 Marker section
21 Through hole
22 Cylindrical body
23 Auxiliary mark
b1 1st blade
b2 2nd blade
g1 First blade group
g2 Second blade group

Claims (4)

And the rod of the handle portion, Ri Do and a marker unit mounted to the distal end of the handle portion, a corneal marker that is used when incising the cornea in a circular arc shape,
The marker portion has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially in 10 ° increments on the bottom surface. The blade portion includes a first blade having a predetermined length and the first blade. has a second blade that is longer than the blade, the second blade is arranged at 30 ° increments, place two first blade between the two said second blades were provided adjacent the A group of blades forming marks of 60 ° to 120 ° by the first blade and the second blade are provided opposite to each other with the through-hole interposed therebetween, and the upper surface of the marker portion has an arrangement of the blades. in accordance with the installation position, corneal marker characterized in that an auxiliary mark at least every 90 °. And the rod of the handle portion, Ri Do and a marker unit mounted to the distal end of the handle portion, a corneal marker that is used when incising the cornea in a circular arc shape,
The marker portion has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially in 10 ° increments on the bottom surface. The blade portion includes a first blade having a predetermined length and the first blade. A second blade that is longer than the first blade, the first blade and the second blade are alternately arranged, and the first blade and the second blade are used for 60 ° to 120 °. The blade group for forming the mark is provided so as to face each other with the through hole interposed therebetween, and an auxiliary mark is provided on the upper surface of the marker portion at least every 90 ° in accordance with the arrangement position of the blade. corner membrane markers shall be the feature. And the rod of the handle portion, Ri Do and a marker unit mounted to the distal end of the handle portion, a corneal marker that is used when incising the cornea in a circular arc shape,
The marker portion has a through-hole for cornea confirmation in the center, and has a plurality of blades arranged radially in 10 ° increments on the bottom surface. The blade is a first blade provided in the vicinity of the outer peripheral edge of the marker portion. And a second blade provided closer to the center of the marker portion than the first blade, and the first blade and the second blade are alternately arranged to arrange the blades in a staggered manner. And a blade group that forms a mark of 60 ° to 120 ° by the first blade and the second blade, facing each other across the through-hole, and the upper surface of the marker portion has the in accordance with the blade arrangement position of, corneal marker characterized in that an auxiliary mark at least every 90 °. The marker portion is provided with a notch portion in a region other than the region where the blade group is provided, and a protruding piece for providing the auxiliary mark is provided in the notch portion. The corneal marker according to any one of 3 above.

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