JPH0520103B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION Field of Industrial Application The present invention relates to a perfusion device used in vitreous surgery, and more particularly to a perfusion device having an intraocular illumination function in addition to a perfusion function.

BACKGROUND TECHNOLOGY As shown in FIG. 10, vitrectomy surgery involves removing the cloudy part of the jelly-like vitreous body 3 located between the crystalline lens 1 and the retina 2, and replacing it with a clear liquid to allow light to pass through. This is done to improve visual acuity by allowing the lens to pass through the crystalline lens 1 and reach the retina 2.

Furthermore, the proliferative membrane formed in front of the retina 2 is removed to allow light to reach the retina, and also to eliminate retinal damage caused by contraction of this membrane.

To perform vitrectomy, the following functions are essential: perfusion of irrigation fluid into the eyeball, removal of cloudy vitreous body, suction of the resected material, and illumination of the inside of the eyeball.

In conventional surgery, a cutter 4 with a suction function and an instrument 5 are used. Both are inserted into the sclera 7 at a position approximately 4 mm away from the cornea 6. As shown in FIG. 11, this device 5 includes an optical fiber bundle 9 for illumination arranged around a perfusion tube 8 through which perfusion fluid flows, and a sheath 10 for binding the bundle.

During surgery, the operator uses instruments 5 and cutter 4.
While irradiating the inside of the eyeball with the optical fiber bundle 9, the cloudy vitreous body 3 is removed with the cutter 4, and the removed material is discharged out of the eyeball by suction while being irrigated with an irrigation solution. The eye is then filled with irrigation fluid to restore intraocular pressure.

Problem to be Solved by the Invention However, according to the structure of the device 5 shown in FIG.
It is necessary to provide a perfusion tube 8 for forming the optical fiber bundle 1 and a sheath 10 for bundling the optical fiber bundle 9.

Therefore, the cross-sectional area of the part of the instrument 5 inserted into the eyeball is at least larger than the sum of the cross-sectional area of the perfusion tube 8 and the cross-sectional area of the optical fiber bundle 9, and has a large diameter.

As a result, there has been a problem in that the larger the cross-sectional area of the part inserted into the eyeball, the more likely it is that the eyeball will collapse when the instrument 5 is removed after the surgery is completed.

The present invention was made to solve the above problems, and provides sufficient brightness to secure the field of view necessary for surgery, and the size (area) of the hole to be made in the eyeball is small. The purpose of the present invention is to provide a perfusion device equipped with an illumination function that can reduce adverse effects such as eyeball collapse.

Means for Solving the Problems In order to achieve this object, the present invention provides a hollow insertion end made of a transparent material to be inserted into the eyeball, and an irrigation fluid introduced into the eyeball through the hollow portion of the hollow insertion end. a perfusion unit for perfusing, a light source unit having a light source for illuminating the eyeball, and a light receiving end connected to the light source unit;
a light transmitting part, the light emitting end being connected to the hollow insertion end and transmitting light from the light source to the hollow insertion end, the light from the light source being connected to the transmitting part and the hollow insertion end; The gist of the present invention is a perfusion device with an illumination function, characterized in that it is configured to illuminate the inside of the eyeball through the end.

Embodiment FIG. 1 is a schematic diagram showing a surgical operation performed by a vitrectomy apparatus having a perfusion device equipped with an illumination function according to the present invention.

The vitrectomy apparatus includes an external device 12, a perfusion device (hereinafter referred to as perfusion device) 13 having an illumination function according to the present invention, and a cutter 14.

The external device 12 is composed of a drive unit 17 and a suction unit 18.

The cutter 14 has a built-in motor (not shown), and can cut out the vitreous body 3 of the eyeball by rotating an inner blade (not shown). A suction path is provided in the cutter 14, and the suction path is connected to the suction unit 18 via a suction pipe 19. The motor is also connected to the drive unit 17 via a power cable 20.

As shown in FIGS. 1 and 2, the perfusion device 13 includes a light source unit 15 having a built-in light source 70, a perfusion section 21, and a light transmission section 22.

The perfusion section 21 includes a first member 23, a second member 24, and an insertion section 25. For example, a silicon tube or the like is used for the second member 24, and a material with excellent flexibility is selected.

The first member 23 has a T-shaped cross section, and its connecting portion 23a is inserted into the side wall 15a of the light source unit 15. The light receiving ends 26 of the two light transmitting parts 22 are fitted into the connecting part 23a.

Each light receiving end 26 is connected to a light source 70 of the light source unit 15.
A relay lens 80 is set between the light source 70 and the light receiving end 26 . That is, the image of the light source 70 can be projected onto the light receiving end 26 by the relay lens 80. Light from the light source unit 15 can be transmitted through these two seamless light transmitting sections 22. The light transmission section 22 is preferably an optical fiber made of plastic or glass with excellent flexibility.

The two light transmitting sections 22 are arranged within the first member 23 and within the tubular second member 24 .
That is, the light receiving end 26 side of the light transmitting section 22 is connected to the first
In the member 23, they are arranged side by side (see FIG. 3), but in the second member 24, the two light transmitting parts 2 are arranged side by side (see FIG. 3).
2 is assigned without any particular restrictions. Therefore, the flexibility of the second member 24 is not impaired by the light transmission section 22.

The connecting portion 23b of the first member 23 is shown in FIGS.
As shown in the figure, it is connected to the perfusion unit 16 via a connecting tube 27. Further, the connecting portion 23c is connected to the second
It is fitted into one end of member 24.

The insertion portion 25 is located at the other end of the second member 24. The insertion end 28 of the insertion portion 25 is formed obliquely so that it can be inserted into the inside of the sclera 7.

The insertion end 28 is fitted into the second member 24, and
Moreover, it is closely connected to the light irradiation end 29 of the light transmission section 22 . The insertion end 28 has a hollow shape, for example, a cylindrical shape (see FIG. 4). The other end of the light transmission section 22 thus constitutes a hollow insertion end 28.

Hollow insertion end 28 which is the other end of the light transmission section 22
is made of a transparent material such as plastic, its curvature is approximately the same as that of the light transmitting portion 22, and its outer surface is similar to that of the hollow insertion end 22.
It is coated with a material having a smaller curvature than that of material No. 8. By doing this, the light transmission section 22
No reflected light is generated at the contact surface with the insertion end 28, and the light passing through the insertion end 28 can be transmitted into the eyeball 90 without leaking to the outside. This coat can be formed of a metal film such as aluminum.

Around the middle to upper part of the hollow insertion end 28,
Flange portion 30 made of opaque material such as metal
is fixed. This flange portion 30 has a fourth
As shown in the figure, notches 31 are provided at the four corners.

This notch 31 is a part where a thread is threaded when sewing the perfusion part 21 to the sclera 7 of the eyeball 90.

The reason why the flange part 30 is made of an opaque material is that if it is transparent, the light passing through the insertion end 28 will pass through the flange part 30.
This is because the end portion of the flange portion 30 will shine, causing an unpleasant sensation when the inside of the eyeball 90 is irradiated and viewed by the operator. Flange part 30
is made of a material that blocks light.

By the way, the inside of the connecting tube 27, the first member 23, the second member 23, and the insertion end 28 is connected to the perfusion unit 16.
An irrigation channel 32 is formed within the eyeball 90 to carry irrigation fluid.

During the surgery, two incisions are made on the sclera 7 for the cutter 14 and the irrigation part 21, and another for forceps if necessary, and the cutter 14 is inserted into one incision and the other. The insertion end 28 of the irrigation section 21 is inserted into the incision. The flange portion 30 is then sewn and fixed to the sclera 7 with thread.

The light source 70 of the light source unit 15 is turned on, and the light from the light source 70 is transmitted to the two light transmitting sections 22 and the insertion end 28.
The light is efficiently transmitted and irradiated into the eyeball 90 via. Then, the operator cuts out the clouded part of the vitreous body 3 using the cutter 14. Furthermore, the perfusion unit 16 is operated to perfuse the perfusate into the eyeball 90 from the insertion end 28 via the perfusion path 32,
The suction unit 18 is activated to aspirate the resected material together with the irrigation fluid.

After the excision and aspiration are completed, the vitreous cavity is filled with irrigation fluid to restore intraocular pressure.

After the surgery is completed, the insertion end 28, cutter 14, etc. are removed, and each incision is sutured.

In addition to the function of introducing the irrigation fluid into the eyeball 90, the insertion end 28 constitutes the other end of the light transmission section 22 and has a light transmission function. Therefore, the light transmission section 22
The light transmission unit 2 does not enter the eyeball 90 itself.
2. That is, there is no need for a protective coating exclusively for the optical fiber.

5 to 9 show a second embodiment.

This second embodiment differs from the first embodiment shown in FIGS. 1 and 2 in the following two points. first,
The first difference is the connecting portion 152 between the two light transmitting sections 122 and the insertion end 128 that constitutes the other end of the light transmitting section 122. The second difference is that another light transmitting section 200 is connected to the light receiving end 126 of the light transmitting section 122. The light transmission section is composed of 122 and 200.

Therefore, the cross-sectional area of the insertion end 28 can be reduced by the total cross-sectional area of the optical fiber bundle and the protective coating when compared with the prior art (see FIG. 11).
Because it can be made quite small, the insertion end 2
Even if 8 is removed from the eyeball, eyeball collapse is unlikely to occur. Furthermore, since the insertion section 25 can be made small and lightweight,
It can be directly sewn onto the eyeball 90 to fix it, and there is no need for the operator to support the perfusion part 21 with his hands.

Furthermore, by making the insertion end 28 long enough so that its tip is located near the sclera as shown in FIG. 1, the end surface of the insertion portion 28 from which light enters the eye can be placed a considerable distance from the fundus.

As a result, it becomes possible to illuminate a wide range of the fundus, facilitating the operator's work.

The two light transmitting parts 122 are fitted into grooves 124a provided at various places on the inner wall of the second member 124 (see FIG. 7).

The light emitting end 129 of the light transmitting section 122 is fitted into the insertion end 128, as shown in FIGS. 8 and 9. By doing this, the light transmission section 12
2 and the insertion end 128 do not deviate in relative position at all, and light can be reliably transmitted into the eyeball. The flange 130 is similar to the flange 30 described above.

On the other hand, the light receiving end 126 of the light transmitting section 122 is connected to the first
They are arranged in parallel within the member 123 (see Fig. 6),
They are closely butt-butted and connected to a light transmission section 200 having a larger diameter than these through a connector 210.

This light transmission section 200 is connected to the light source unit 150, and the light from the light source 170 is transmitted to the relay lens 1.
80.

By doing this, the entire light transmission section can be divided into two parts 122 and 200, and the structure
Increased degree of freedom in operations, etc.

By the way, the present invention is not limited to the above embodiments.

For example, the number of light transmission sections 22, 122 may not be two, but may be one or more than two. In any case, the perfusion sections 21 and 121 are
It is preferable to have excellent overall flexibility so that the surgery can be performed easily and no unnecessary burden is placed on the eyeball.

Effects of the Invention In the perfusion device equipped with the illumination function according to the present invention, sufficient brightness can be obtained to secure the field of view necessary for surgery, and the size (area) of the hole made in the eyeball is small. This can reduce the negative effects of surgery, such as eye collapse.

[Brief explanation of drawings]

FIG. 1 is a schematic diagram showing a surgical state using a vitrectomy apparatus having a perfusion device equipped with an illumination function according to the present invention, FIG. 2 is a sectional view showing an example of the perfusion device, and FIG. 4 is a sectional view taken along line BB in FIG. 2, FIG. 5 is a sectional view showing another example of the perfusion device according to the present invention, and FIG. 6 is a sectional view taken along line C in FIG. 5.
-C sectional view, Fig. 7 is a DD sectional view in Fig. 5, Fig. 8 is a sectional view taken along E-E in Fig. 5, Fig. 9 is a partial perspective view of Fig. FIG. 11 is a schematic diagram showing an example surgical situation, and a cross-sectional view showing a conventional instrument. 15... Light source unit, 21... Perfusion section, 22
...Light transmission section, 28...Insertion end.

Claims (1)

[Scope of Claims] 1. A hollow insertion end made of a transparent material to be inserted into the eyeball, an irrigation section for perfusing an irrigation fluid into the eyeball through the hollow part of the hollow insertion end, and an irrigation section for illuminating the eyeball. a light source section having a light source; and a light transmission section having a light receiving end connected to the light source section, a light emitting end connected to the hollow insertion end, and transmitting light from the light source section to the hollow insertion end. A perfusion device having an illumination function, characterized in that the light from the light source section illuminates the inside of the eyeball through the transmission section and the hollow insertion end. 2. The perfusion device with an illumination function according to claim 1, wherein the hollow insertion end is coated around the hollow insertion end with a refractive index smaller than that of the light transmission section. 3. The hollow insertion end further has a flange portion to be sewn to the eyeball, and the flange portion is made of a material that blocks light so as not to transmit light from the light transmission portion. A perfusion device equipped with an illumination function according to scope 1.