RU60859U1 - SPATULA-TRAKEKULOT - Google Patents

Abstract

Spatula-trabeculotom belongs to the tools for ophthalmology and is intended for antiglaucomatous operations. The putty knife consists of a handle and a working element. The handle has a free end and an end connected to the working part. The work item consists of three knees. The first elbow is connected to the handle and has a length of 10 mm. The next elbow has a length of 9 mm and a diameter of 0.4 mm. Both knees are located in the same plane and at an angle of 150 °. The last elbow has a length of 4.5 mm and a diameter of 0.2 mm and is located in a plane perpendicular to the previous one. The utility model provides a reduction in trauma during trabeculotomy in the process of antiglaucomatous surgery.

Description

The utility model relates to ophthalmology, and in particular, to instruments for conducting anti-glaucomatous operations, in particular, for rupturing a trabeculae in the process of non-perforating trabeculotomy.

For carrying out anti-glaucomatous operations, various spatula designs are used - one-sided and two-sided, with different blade sizes, with short and long handles (Medin Ural Catalog of Medical Instruments, Yekaterinburg, 2002, p. 42).

The closest analogue of the utility model is a trabeculot containing a handle, a shoulder and a working element, the shoulder being bent with a radius of curvature corresponding to the radius of curvature of the Shlemmov channel, ending with a working element in the form of a hook with a sharpened tip and a rounded apex, the angle between the hook and shoulder is 60 °.

Moreover, the curved shoulder has a diameter of 0.15 mm, and the hook has a height of 0.4 mm (RU 2188608, 09/10/2002).

The technical result is to reduce the morbidity during trabeculotomy in the process of antiglaucomatous surgery.

The proposed spatula-trabeculot has the following design.

The handle has a free end and an end connected to the working part. The working part consists of three knees. The first elbow connected to the handle with a length of 10 mm and the next elbow with a length of 9 mm and a diameter of 0.4 mm are located in the same plane and at an angle of 150 °. The last elbow has a length of 4.5 mm and a diameter of 0.2 mm and is located in a plane perpendicular to the previous plane.

The configuration of the knees provides the convenience and ease of manipulation during the intervention on the helmet head channel.

Figure 1 presents a schematic representation of a spatula-trabeculotoma, where 1 is the handle, 2 is the first knee, 3 is the next knee, 4 is the last knee.

A spatula-trabeculot is used as follows.

When conducting anti-glaucomatous surgery, a conjunctival flap is formed with the base to the limb. Under it, through-through incisions, the sclera outlines a U-shaped area 3 × 2 mm in size. Within the outlined area, the sclera is stratified. At the bottom, the canal is identified and opened. In the course of the channel, first in one, then in the other direction, the last knee of the spatula-trabeculotoma is drawn. By rotating to the pupil, the inner wall of the canal is torn throughout this knee of the spatula-trabeculotoma, leaving a section of the wall corresponding to the site of introduction of the spatula-trabeculotoma intact. The scleral flap is put in place and sewn with several seams. Impose a continuous seam on the conjunctiva.

Example. Patient N., 70 years old, diagnosis: open-angle glaucoma II. From the right eye, trabecular retention. Visual acuity with correction - 0.5. Intraocular pressure (Po) of the right eye is 27 mm Hg, the coefficient of ease of outflow of intraocular fluid is 0.02.

The operation was performed in the described manner using a spatula-trabeculotome. After anesthesia and akinesia, a bridle suture was applied to the superior rectus muscle. The conjunctiva and tenon capsule were cut and separated at 10-14 hours. Through open cuts, the sclera outlined a U-shaped area 3 × 2 mm in size. Within the outlined area, the sclera was stratified. At the bottom, the canal was identified and opened. In the course of the channel, first in one, then in the other direction, the last knee of the spatula-trabeculotome was drawn. By rotating to the pupil, the inner wall of the canal was torn over the last knee of the spatula-trabeculotoma, leaving a section of the wall corresponding to the site of introduction of the spatula-trabeculotoma intact. The scleral flap was put in place and sewn

a few stitches. They put a continuous suture on the conjunctiva 8 \ 0. The postoperative period was uneventful. After discharge on the 6th day after the operation, visual acuity has not changed, the anterior chamber is of medium depth. The intraocular pressure (Po) was 14.5 mmHg.

The use of a spatula-trabeculotoma during an anti-glaucomatous operation provides a reduction in morbidity and an increase in the hypotensive effectiveness of the intervention.

Claims (1)

A spatula-trabeculot, characterized in that it contains a handle and a working element, while the handle has a free end and an end connected to the working part, and the working element consists of three elbows, the first of which is connected to the handle and has a length of 10 mm, the next elbow - 9 mm long and 0.4 mm in diameter with both knees in the same plane and at an angle of 150 °, the last knee has a length of 4.5 mm and a diameter of 0.2 mm and is located in a plane perpendicular to the previous one.