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CN108852615A - A kind of plant piece and corneal stroma pouch for corneal stroma implantation - Google Patents

A kind of plant piece and corneal stroma pouch for corneal stroma implantation Download PDF

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Publication number
CN108852615A
CN108852615A CN201810437950.9A CN201810437950A CN108852615A CN 108852615 A CN108852615 A CN 108852615A CN 201810437950 A CN201810437950 A CN 201810437950A CN 108852615 A CN108852615 A CN 108852615A
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CN
China
Prior art keywords
cornea
piece
pouch
corneal stroma
corneal
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Pending
Application number
CN201810437950.9A
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Chinese (zh)
Inventor
高华
刘明娜
史伟云
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Shandong Ophthalmology Hospital
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Shandong Ophthalmology Hospital
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Priority to CN201810437950.9A priority Critical patent/CN108852615A/en
Publication of CN108852615A publication Critical patent/CN108852615A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/013Instruments for compensation of ocular refraction ; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/0008Introducing ophthalmic products into the ocular cavity or retaining products therein
    • A61F9/0017Introducing ophthalmic products into the ocular cavity or retaining products therein implantable in, or in contact with, the eye, e.g. ocular inserts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Prostheses (AREA)

Abstract

The present invention relates to field of medical technology, provide a kind of plant piece for corneal stroma implantation, and the plant piece derives from donor's cornea, and the diameter for planting piece is 5.0~10.0mm, and with a thickness of 100~400 μm, angle is 30 °~150 °.The invention also includes the corneal stroma pouches to match with above-mentioned plant piece.The present invention is planted in piece implantation corneal stroma pouch, is sutured after paving or without sewing up the incision, cut closure increases the plant bed thickness of keratoconus, is suitable for carrying out at keratoconus lesion initial stage.For conventional operation on cornea, wound is small, restores fast, from the pain for largely reducing patient.

Description

A kind of plant piece and corneal stroma pouch for corneal stroma implantation
Technical field
The present invention relates to field of medical article technology, and in particular to a kind of plant piece and cornea base for corneal stroma implantation Matter pouch.
Background technique
Keratoconus or kerectasis disease are the common non-inflammatory of one kind, chronic, progressivity, cornea differentially expanding Disease, with central cornea matrix, thinning, central summit is in that cone protrudes deformation, cornea loses normal arc, generates irregularly The formation of astigmatism and scar is characterized, and is seriously reduced so as to cause the optical property of cornea.It often results in highly irregular myopia Astigmatism, advanced stage will appear acute corneal edema, form scar, and eyesight is remarkably decreased.It is mainly in teenager, normal eyes successively carry out Property morbidity, seriously affect quality of life, the study and work of patient.Since the cause of disease is still not clear, the treatment of this disease is relatively difficult.
Keratoconus or kerectasis disease early stage main be crosslinked by corneal collagen contact with hard air-permeable cornea Mirror (Rigid Gas Permeable, RGP) treatment.Corneal collagen crosslinking art is the ultraviolet light,long wave activation core yellow with 370nm wavelength Plain (a kind of photosensitizer), forms it into active chalcogen, and it is anti-that chemical crosslinking occurs between the amino of active chalcogen induction collagenous fibres It answers, generates corneal collagen fibre diameter thickening, promote keratocyte apoptosis, improve cornea to resistance of a variety of degrading enzymes etc. Various biological effect controls the state of an illness of lesion initial stage patient, avoids so that the mechanical strength of corneal stroma be made to increase Continue to deteriorate.But corneal collagen crosslinking cannot be such that thinning cornea thickens, and nearest the study found that utilizing ophthalmic reaction instrument (one Kind biological mechanics detector) it checks, fail to show that biological mechanics includes the (survey of viscous damping of corneal hysteresis amount Amount) and cornea resistance factor (related to the viscoplasticity of cornea and deformation) dramatically increase for a long time.Therefore therapeutic effect at a specified future date is still It is to be assessed.RGP cannot also prevent disease progression, and have some patientss working environment perhaps uncomfortable wearing RGP or the trouble having Person's compliance is bad, is late for further consultation, is easy to appear the relevant complication of contact lense.When RGP cannot wear or correct defects of vision difference When just need to do corneal graft.Corneal graft can increase the thickness of keratoconus plant bed, but 360 degree of cuttings are refreshing Through normal level is not achieved in postoperative corneal sensitivity and nerve recovery forever.
Summary of the invention
In view of the above-mentioned problems, being matched the present invention provides a kind of plant piece for corneal stroma implantation and with the plant piece Corneal stroma pouch, which is implanted into corneal stroma pouch, increases the plant bed thickness of keratoconus, increases cornea Elasticity and resistance, wound is small, restores fast.
Technical scheme is as follows:
The present invention provides a kind of plant piece for corneal stroma implantation, the plant piece derives from donor's cornea, the plant The diameter of piece is 5.0~10.0mm, and with a thickness of 100~400 μm, angle is 30 °~150 °.
Preferably, the plant piece has diopter.
It is furthermore preferred that the sphere power for planting piece is -12.00D~+6.00D.
It is furthermore preferred that the cylindrical mirror diopter for planting piece is -6.0D~+6.0D.
It is described the present invention also provides the corneal stroma pouch for planting piece described in a kind of matching above-mentioned technical proposal any one The internal diameter of pouch is 5.0~10.0mm, and depth is 100~400 μm, 1~15mm of pouch mouth arc length.
The prior art is compared, and the present invention has the following advantages that:
The present invention provides a kind of plant piece for corneal stroma implantation and with the plants piece matched corneal stroma capsule Bag.When the plant piece is implanted into, corneal stroma pouch is made in patient's corneal stroma upper cut, the present invention is planted into piece and is implanted into cornea base It is sutured in matter pouch, after paving or without sewing up the incision, increases the plant bed thickness of keratoconus, increase weak cornea Elasticity and resistance, biomethanics obviously become strong and develop to have the function that control disease, be suitable for keratoconus (or its His kerectasis disease) lesion initial stage carries out.For operation on cornea compared with the existing technology, wound is small, restores fast, generally Wound healing within 3 days, corneal diopter, elasticity and resistance stability are good, from the pain for largely reducing patient.
Detailed description of the invention
Fig. 1 is that corneal graft is implanted into corneal stroma schematic diagram, wherein 1 is plant piece, 2 be pouch, and 3 be corneal stroma.
Specific embodiment
The present invention provides a kind of plant piece for corneal stroma implantation, the plant piece derives from donor's cornea, the plant The diameter of piece is 5.0~10.0mm, preferably 6.0~8.0mm;It is described plant piece with a thickness of 100~400 μm, preferably 200~ 300μm;The angle for planting piece is 30 °~150 °, more preferably 50 °~120 °.
Plant piece of the present invention preferably has diopter.The sphere power for planting piece preferably -12.00D~+ 6.00D, more preferably -8.00D~+4.00D, for improving because of myopia or long sight caused by ametropia problem.The plant The cylindrical mirror diopter of piece is preferably -6.0D~+6.0D, more preferably -4.00D~+4.00D, caused by improving because of astigmatism Ametropia problem.Plant piece with certain diopter can improve patient because bending while increasing cornea plant bed thickness Light not just caused by eye-blurred.
The present invention is not particularly limited the production method for planting piece, using the conventional cornea making machine in this field It is prepared, such as the laser machine of commercialization.
The present invention also provides the corneal stroma pouches for matching above-mentioned plant piece, containing for planting piece.Cornea base of the invention Matter pouch is the corneal pocket being opened on cornea, for containing the plant piece.In the present invention, the internal diameter of the pouch is 5.0 ~10.0mm, preferably 6.0~8.0mm;The depth of the pouch is 100~400 μm, preferably 200~300 μm.The present invention Thickness of the depth of the pouch containing corneal epithelium.The mouth arc length of pouch of the present invention is 1~15mm, preferably 5~10mm.
Corneal stroma pouch of the present invention preferably uses the conventional cornea machine in this field to make, and such as commercialization swashs Optic angle film machine.After setting machine parameter, operation production is directly carried out on patient's cornea.
The present invention plants the donor's cornea made in piece implantation corneal stroma pouch, paves, sews up the incision.This hair Donor's cornea plant piece is preferably passed through pouch using iris repositor or injector by the bright implantation for planting piece Notch is sent into recipient cornea stromal pocket, and paves.Suture of the present invention is preferably sutured with ophthalmology suture, such as 10-0 Nylon wire.
The present invention plants donor's cornea in piece implantation recipient cornea pouch, and the plant bed that can increase keratoconus is thick Degree, increases the elasticity and resistance of weak cornea, and biomethanics obviously becomes strong to have the function that control disease development, is suitble to It is carried out at keratoconus lesion initial stage.For operation on cornea compared with the existing technology, wound is small, restores fast, general 3 days it Interior wound healing, corneal diopter stability is good, from the pain for largely reducing patient.
To make the objectives, technical solutions, and advantages of the present invention clearer, below with reference to embodiment to the present invention into Row detailed description, but they cannot be interpreted as limiting the scope of the present invention.
Embodiment 1
1, donor's cornea plants the production of piece:
1) corneal graft parameter is arranged in FS200 femtosecond laser machine:Diameter 7.8mm, 200 μm of thickness, 150 ° of angle;
2) corneal graft is put on artificial anterior chamber, injecting balanced salt solution using syringe makes the artificial anterior chamber pressure be about 40-50mmHg, and keep pressure steady;
3) artificial anterior chamber is put on station, starting FS200 femtosecond laser machine is planted according to step 1) parameter production cornea Piece;
4) blunt separation corneal graft, and it is spare to remove corneal graft;
2, the production of recipient cornea stromal pocket:
1) corneal stroma pouch parameter is arranged in the full femtosecond laser machine of Zeiss visumax:Diameter 8.3mm, depth is (containing on cornea Skin thickness) 150 μm, pouch mouth arc length 2.3mm;
2) after the completion of parameter setting, negative pressure ring attracts cornea, and negative pressure is formed well, starts full femtosecond laser machine transmitting and swashs Light makes corneal stroma pouch;
3) blunt separation corneal stroma pouch;
3, piece is planted using the donor's cornea that iris repositor makes step 1 and step 2 receptor angle is sent by pouch notch Membrane matrix pouch, and pave;
4,10-0 nylon line suture recipient cornea stromal pocket notch.
1 embodiment of table, 1 preoperative and postoperative cornea recovery situation
Embodiment 2
1, donor's cornea plants the production of piece:
1) corneal graft parameter is arranged in FS200 femtosecond laser machine:Diameter 5.8mm, 150 μm of thickness, 55 ° of angle;
2) corneal graft is put on artificial anterior chamber, injecting balanced salt solution using syringe makes the artificial anterior chamber pressure be about 40~50mmHg, and keep pressure steady;
3) artificial anterior chamber is put on station, starting FS200 femtosecond laser machine is planted according to step 1) parameter production cornea Piece;
4) blunt separation corneal graft, and it is spare to remove corneal graft;
2, the production of recipient cornea stromal pocket:
1) corneal stroma pouch parameter is arranged in the full femtosecond laser machine of Zeiss visumax:Diameter 6.3mm, depth is (containing on cornea Skin thickness) 100 μm, pouch mouth arc length 2.0mm;
2) after the completion of parameter setting, negative pressure ring attracts cornea, and negative pressure is formed well, starts full femtosecond laser machine transmitting and swashs Light makes corneal stroma pouch;
3) blunt separation corneal stroma pouch;
3, piece is planted using the donor's cornea that injector makes step 1 and step 2 recipient cornea base is sent by pouch notch Matter pouch, and pave;
4,10-0 nylon line suture recipient cornea stromal pocket notch.
2 embodiment of table, 2 preoperative and postoperative cornea recovery situation
Embodiment 3
1, donor's cornea plants the production of piece:
1) corneal graft parameter is arranged in FS200 femtosecond laser machine:Diameter 9.8mm, 380 μm of thickness, 110 ° of angle;Plant piece band There is diopter, sphere power is -1.75D, and cylindrical mirror diopter is -0.50D;
2) corneal graft is put on artificial anterior chamber, injecting balanced salt solution using syringe makes the artificial anterior chamber pressure be about 40-50mmHg, and keep pressure steady;
3) artificial anterior chamber is put on station, starting FS200 femtosecond laser machine is planted according to step 1) parameter production cornea Piece;
4) blunt separation corneal graft, and it is spare to remove corneal graft;
2, the production of recipient cornea stromal pocket:
1) corneal stroma pouch parameter is arranged in the full femtosecond laser machine of Zeiss visumax:Diameter 10.0mm, depth (contain cornea Epithelial thickness) 200 μm, pouch mouth arc length 4.5mm;
2) after the completion of parameter setting, negative pressure ring attracts cornea, and negative pressure is formed well, starts full femtosecond laser machine transmitting and swashs Light makes corneal stroma pouch;
3) blunt separation corneal stroma pouch;
3, donor's cornea described in step 1 is planted by piece using injector and step 2 recipient cornea matrix is sent by pouch notch Pouch, and pave;
4,10-0 nylon line suture recipient cornea stromal pocket notch.
3 embodiment of table, 3 preoperative and postoperative cornea recovery situation
Embodiment 4
1, donor's cornea plants the production of piece:
1) corneal graft parameter is arranged in FS200 femtosecond laser machine:Diameter 7.8mm, 250 μm of thickness, 80 ° of angle;Plant piece band There are diopter, sphere power 3.5D, cylindrical mirror diopter is 5.0D;
2) corneal graft is put on artificial anterior chamber, injecting balanced salt solution using syringe makes the artificial anterior chamber pressure be about 40-50mmHg, and keep pressure steady;
3) artificial anterior chamber is put on station, starting FS200 femtosecond laser machine is planted according to step 1) parameter production cornea Piece;
4) blunt separation corneal graft, and it is spare to remove corneal graft;
2, the production of recipient cornea stromal pocket:
1) corneal stroma pouch parameter is arranged in the full femtosecond laser machine of Zeiss visumax:Diameter 8.3mm, depth is (containing on cornea Skin thickness) 200 μm, pouch mouth arc length 3.5mm;
2) after the completion of parameter setting, negative pressure ring attracts cornea, and negative pressure is formed well, starts full femtosecond laser machine transmitting and swashs Light makes corneal stroma pouch;
3) blunt separation corneal stroma pouch;
3, donor's cornea described in step 1 is planted by piece using iris repositor and step 2 recipient cornea is sent by pouch notch Stromal pocket, and pave;
4,10-0 nylon line suture recipient cornea stromal pocket notch.
4 embodiment of table, 4 preoperative and postoperative cornea recovery situation
Comparative example 1
Keratoconus, in the preoperative with the recovery situation of 3 months after operation, is being shown in Table 5 through collagen cross-linking post-operative cornea.
5 keratoconus of table is in collagen cross-linking post-operative cornea recovery situation
It is preoperative Postoperative March
Uncorrected visual acuity 0.15 0.1
It corrects defects of vision 0.3 0.1
Curvature 50.0/56.7 55.2/57.2
Corneal thickness 430 444
Biomethanics (DA) 1.28 1.22
Biomethanics (SP-A1) 45.1 35.7
Wherein, in table 1~5, biomethanics (DA) represents Central corneal deformability/periphery 2mm deformability ratio, number Value is higher, and the cornea that represents is softer, and biomethanics is poorer;Biomethanics (SP-A1) represents cornea stiffness, the higher representative of numerical value Biological mechanics is better.
As it can be seen that the present invention has a clear superiority compared with corneal collagen is crosslinked treatment keratoconus:1, operating time obviously contracts It is short, operating time of the present invention 10 minutes and corneal collagen is crosslinked operating time 20 minutes;2, postoperative patient discomfort significant reaction subtracts Gently;3, the present invention can increase the corneal thickness of patient in terms of postoperative effect, so that biomethanics (cornea hardness) is obvious Become by force to have the function that control disease development.
The above is only a preferred embodiment of the present invention, it is noted that for the ordinary skill people of the art For member, various improvements and modifications may be made without departing from the principle of the present invention, these improvements and modifications are also answered It is considered as protection scope of the present invention.

Claims (5)

1. a kind of plant piece for corneal stroma implantation, which is characterized in that the plant piece derives from donor's cornea, the plant piece Diameter is 5.0~10.0mm, and with a thickness of 100~400 μm, angle is 30 °~150 °.
2. plant piece according to claim 1, which is characterized in that the plant piece has diopter.
3. plant piece according to claim 2, which is characterized in that it is described plant piece sphere power be -12.00D~+ 6.00D。
4. plant piece according to claim 2, which is characterized in that the cylindrical mirror diopter for planting piece is -6.0D~+6.0D.
5. planting the corneal stroma pouch of piece described in a kind of matching Claims 1 to 4 any one, which is characterized in that the pouch Internal diameter be 5.0~10.0mm, depth be 100~400 μm, 1~15mm of pouch mouth arc length.
CN201810437950.9A 2018-05-09 2018-05-09 A kind of plant piece and corneal stroma pouch for corneal stroma implantation Pending CN108852615A (en)

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CN201810437950.9A CN108852615A (en) 2018-05-09 2018-05-09 A kind of plant piece and corneal stroma pouch for corneal stroma implantation

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Application Number Priority Date Filing Date Title
CN201810437950.9A CN108852615A (en) 2018-05-09 2018-05-09 A kind of plant piece and corneal stroma pouch for corneal stroma implantation

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN116492505A (en) * 2023-05-11 2023-07-28 山东第一医科大学附属眼科医院(山东省眼科医院) Artificial cornea endothelial transplanting sheet and application thereof

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020138070A1 (en) * 2001-03-23 2002-09-26 Peyman Gholam A. Adjustable ablatable inlay
CN101066471A (en) * 2007-04-25 2007-11-07 中山大学中山眼科中心 Cell-eliminating coanea matrix and its prepn process
CN101400321A (en) * 2006-03-16 2009-04-01 阿尔贝特·达克瑟尔 corneal implant
RU2565485C1 (en) * 2014-06-25 2015-10-20 Учреждение Российской академии медицинских наук Научно-исследовательский институт глазных болезней РАМН (НИИГБ РАМН) Method for surgical management of keratoconus
CN105664254A (en) * 2015-12-09 2016-06-15 北京大学第三医院 Application and use method of acellular dermal matrix

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020138070A1 (en) * 2001-03-23 2002-09-26 Peyman Gholam A. Adjustable ablatable inlay
CN101400321A (en) * 2006-03-16 2009-04-01 阿尔贝特·达克瑟尔 corneal implant
CN101066471A (en) * 2007-04-25 2007-11-07 中山大学中山眼科中心 Cell-eliminating coanea matrix and its prepn process
RU2565485C1 (en) * 2014-06-25 2015-10-20 Учреждение Российской академии медицинских наук Научно-исследовательский институт глазных болезней РАМН (НИИГБ РАМН) Method for surgical management of keratoconus
CN105664254A (en) * 2015-12-09 2016-06-15 北京大学第三医院 Application and use method of acellular dermal matrix

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN116492505A (en) * 2023-05-11 2023-07-28 山东第一医科大学附属眼科医院(山东省眼科医院) Artificial cornea endothelial transplanting sheet and application thereof
CN116492505B (en) * 2023-05-11 2023-12-08 山东第一医科大学附属眼科医院(山东省眼科医院) Artificial cornea endothelial transplanting sheet and application thereof

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Application publication date: 20181123