CN100415190C - Novel aqueous humor drainage device for glaucoma - Google Patents
Novel aqueous humor drainage device for glaucoma Download PDFInfo
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- CN100415190C CN100415190C CNB2005100961866A CN200510096186A CN100415190C CN 100415190 C CN100415190 C CN 100415190C CN B2005100961866 A CNB2005100961866 A CN B2005100961866A CN 200510096186 A CN200510096186 A CN 200510096186A CN 100415190 C CN100415190 C CN 100415190C
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Abstract
The present invention relates to a novel glaucoma aqueous humor drainage device which is formed by connecting a T-shaped pipe with a drainage plate, wherein a transverse pipe of the T-shaped pipe is elastic, the contact surface between the transverse pipe and the aqueous humor is provided with a plurality of liquid inlet holes which are evenly distributed, a straight pipe of the T-shaped pipe is communicated with the center of the transverse pipe and is perpendicular to the transverse pipe, and the straight pipe is backwards communicated with a pressure control system. The front end of the drainage plate is provided with a fixing hole; the front half part of the drainage plate is provided with a groove which is used for coiling the pressure control system; the back half part of the drainage plate is a liquid storing area, the bottom surface of the liquid storing area is evenly widespread with access holes of the aqueous humor, and the center and the periphery of the liquid storing area are provided with raised ridges. The pressure control system is formed by that an extending part of the T-shaped pipe winds in the groove of the drainage plate in a certain mode. The glaucoma aqueous humor drainage device of the present invention enables an explant to be tightly attached to the eyeball so as to enlarge the volumetric capacity of the filtering area and alleviate the stimulation to tissues in the peripheral eye socket and the eyeball. The implanting operation of the present invention has favorable operability, can smoothly lower the ocular tension, and effectively controls the ocular tension in a normal range.
Description
Technical field
The present invention relates to a kind of ophthalmic medical instrument, specifically a kind of aqueous humor drainage device for glaucoma, this device is applicable to glaucoma, especially some intractable glaucomatous treatment.
Background technology
Glaucoma is the great common blinding oculopathy of a kind of hazardness, and the age is 2% greater than crowd's sickness rate of 40 years old, accounts for second of blinding oculopathy in China.For glaucomatous treatment, the most thorny with intractable glaucoma.Intractable glaucoma is called intractable glaucoma or complexity glaucoma again, is meant that maximum tolerance Drug therapy still can not control high intraocular pressure but be not suitable for doing filtering surgery, or the glaucoma of the filtering surgery of use in conjunction anti-fibrosis medicine failure once in the past.Because various, the eye situation complexity of its cause of disease, the success rate of implementing filtering surgery only is 11%～52%.The main cause of operative failure is the synthetic of art district fibroblasts proliferation and extracellular matrix, causes tissue fibering and cicatrization, has hindered the drain and the diffusion of aqueous humor.
For some intractable glaucoma, at present the Therapeutic Method of praising highly clinically be in the eyes anterior chamber, introduce the aqueous humor drainage implant (Aqueous drainage devices, ADDs).Operative indication generally includes: 1. the glaucoma that causes of eye and whole body vascular conditions, as neovascular glaucoma; 2. the glaucoma of the filtering surgery of use in conjunction anti-fibrosis medicine failure once; 3. the glaucoma behind aphakia or the intraocular lens implants behind the cataract operation; 4. the glaucoma of operation back secondary, the glaucoma after injecting postoperative and perfluorocarbon liquid and use as corneal transplantation postoperative, retinal detachment surgery, vitrectomy postoperative, silicone oil etc.; 5. the glaucoma that causes of complexity ocular injury and the glaucoma of repeatedly performing the operation and causing because of wound; The failure of many trabeculotomys or late period congenital glaucoma; 7. uveitis secondary or with uveitic glaucoma; 8. other complicated secondary glaucomas are as iridocorneal endothelial syndrome etc.The operation principle is to set up the artificial path of aqueous humor drainage and diffusion by the drain of implanting the anterior chamber, aqueous humor drainage is arrived in conjunctiva-Tenon ' s capsule, thereby reduce intraocular pressure.
The structure of existing aqueous humor drainage implant is made of two parts usually: the one, implant the drainage tube in the anterior chamber, and be responsible for aqueous humor drainage to coupled explant place; The 2nd, explant for being positioned at aequator oculi or conjunctiva-Tenon ' s capsule thereafter, has the drain dish of definite shape and surface area.To form a potential aqueous humor impoundment dedicated around the explant, promptly the rear portion filters bubble.
Modern aqueous humor drainage implant can be divided into non-limiting aqueous humor drainage implant and restricted aqueous humor drainage implant according to whether having the mobile pressure sensibility valve cell of restriction aqueous humor.Non-limiting aqueous humor drainage implant does not have the design of pressure sensibility valve cell, soaks barium implant and homemade HAD implant etc. as external Molteno, Schocket, Baerveldt, and the drainage tube of this implant directly links to each other with the explant at rear portion; And restricted aqueous humor drainage implant has designs such as valve, elastica or drain Impedance Membrane between drainage tube and explant, the restriction aqueous humor is the unipolarity outflow under certain pressure, make intraocular pressure have relative controllability, glaucoma air relief valve, glaucoma intraocular pressure actuator or aqueous humor split flow pump etc. therefore are otherwise known as.External at present restricted aqueous humor drainage implant commonly used has Ahmed, Krupin, Joseph implant, White pump part flow arrangement and OpitMed glaucoma pressure regulator etc.
Yet, kind surplus the complication of aqueous humor drainage implant surgery can reach 20, Chang Yong aqueous humor drainage device was the single tube drain in the past, clinical common mainly containing: hyphema, drainage tube touches eye inner tissue, and drainage tube is shifted, shrinks back, deviates from, postoperative ocular hypotension, shallow of anterior chamber or do not have the anterior chamber, the postoperative drainage pipe is caused by obstructions such as the blood in the anterior chamber, inflammation chip, fibrous membrane, iris, vitreous body and filters failure, and choroid seepage, disengaging, hemorrhage and intraocular pressure raise etc. once more.Though restricted aqueous humor drainage implant can reduce and keep intraocular pressure more reposefully with respect to non-limiting aqueous humor drainage implant, still there is some structural defective in restricted aqueous humor drainage implant commonly used.
Summary of the invention
In view of the many complication that exist in intractable glaucomatous clinical characters and the implant surgery of existing aqueous humor drainage thing, the objective of the invention is to, absorb, use for reference the advanced design theory of external clinical aqueous humor drainage implanting device commonly used, based on fluid mechanics principle, a kind of aqueous humor drainage device for glaucoma is provided, or be called artificial girder aqueous drainage system of the eye (artificial trabeculum drainage system, ATDS).
In order to realize above-mentioned task, the present invention takes following technical solution:
A kind of aqueous humor drainage device for glaucoma is connected to form by T shape pipe and drain dish, it is characterized in that an end of described T shape pipe has the inlet opening that is evenly distributed, and the other end is connected with control pressurer system.The design of described drain dish first half has groove, the straight tube extendible portion of T shape pipe in groove around; Latter half is the liquid storage district, and there is the aqueous humor access hole that is evenly distributed the bottom surface, the central authorities in liquid storage district and the bossed ridge of periphery design.The front end of drain dish upper surface is provided with fixing hole.
Some other characteristics of the present invention are: described T shape pipe is divided into feed tube and drainage tube two parts, and drainage tube is connected with the outer arc central part of feed tube.
Described feed tube both ends open slyness has elasticity, and the curved pipe that flexible one-tenth and angle of anterior chamber radian adapt is about the about 6mm of radius of curvature.
Inlet opening is evenly distributed on the tube wall face that aqueous humor contacts in described feed tube and the eyes.
Described drain dish is pyriform, circle, fan-shaped, square, trapezoid disk-like structure, and the bottom surface bending is sphere, conforms to human eye's scleral surface curvature.
Described control pressurer system designs according to fluid mechanics principle, constitutes by being coiled in the drainage tube that has the mode that necessarily detours in the groove.The two ends of control pressurer system communicate with T shape pipe and liquid storage district respectively.
Described T shape pipe is made by medical grade silicon rubber.
Described drain dish is made by light-cured resin.
The present invention adopts the T shape pipe design of single tube drain different from the past, cooperates the tractive, fixing of whole ATDS, solves problems such as drainage tube is shifted, shrinks back, deviates from; Feed tube is adjacent to the angle, room, and parallel with iris, can prevent that in the ocular movement process pipeline from touching eye inner tissue and causing corresponding complication; The feed tube both ends open also has a plurality of inlet opening uniform distribution on it, from having reduced the incidence rate that drainage tube blocks to a great extent.The bottom surface of drain dish is designed to and the corresponding to crooked sphere of sclera sphere, and explant and eyeball are closely attached, and alleviates eyeball and the stimulation of socket of the eye tissue on every side.Liquid storage district central median ridge can support Tenon ' s capsule, enlarges the filtration zone volume, and peripheral ridge is to be interrupted to be arranged, be convenient to aqueous humor by the ridge gap to around diffusion.Control pressurer system designs according to fluid mechanics principle, can science, control intraocular pressure steadily, effectively.
Description of drawings
Fig. 1,2, the 3rd, the structural representation of artificial girder aqueous drainage system of the eye; Wherein Fig. 1 is a plane graph, and Fig. 2, Fig. 3 are the axonometric charts that different angles are placed;
Fig. 4,5 is respectively that T shape pipe is implanted behind the eyeball and the structural representation when not implanting;
Fig. 6 is the position view that artificial girder aqueous drainage system of the eye is implanted eyeball.
Be described in further detail below in conjunction with the operation principle and the construction features of accompanying drawing artificial girder aqueous drainage system of the eye.
The specific embodiment
Shown in Fig. 1～3, the T shape pipe 1 that artificial girder aqueous drainage system of the eye is implanted camera oculi anterior by front end constitutes with the drain dish 2 that is attached thereto, is positioned at the aequator oculi scleral surface.T shape pipe 1 is divided into feed tube (transverse tube) 9 and drainage tube (straight tube) 10 two parts again.The first half of drain dish 2 is provided with the control pressurer system 3 that coils in groove 4; Respectively there is a semicircle fixed-wing leading edge both sides of front end, and a fixing hole 5 is arranged on it.The latter half of drain dish 2 is liquid storage district 6, its central authorities and the bossed ridge 8 of periphery design, and peripheral ridge is to be interrupted to be arranged, and design has the aqueous humor access hole 7 that is evenly distributed between central median ridge and the peripheral ridge.
As shown in Figure 6, aqueous humor is drained into liquid storage district 6 through implanting anterior chamber's feed tube 9, drainage tube 10 and control pressurer system 3, in this diffusion around drain dish 2, is absorbed by connective tissue on every side gradually afterwards.
1.T the structure of shape pipe and functional characteristics
Shown in Fig. 4,5, they are respectively that T shape pipe is implanted behind the eyeball and the structural representation when not implanting; T shape pipe 1 is made up of horizontal feed tube 9 and vertical with it drainage tube 10 two parts.Feed tube 9 has elasticity, the both ends open slyness, and because of the rearward pulling force of drainage tube straight tube, the curved pipe that flexible one-tenth and angle of anterior chamber radian adapt, radius of curvature is about about 6mm.Feed tube 9 extrados link to each other with drainage tube 10, except that this joint face and with room angled tissue mutually the veneer, be distributed with uniform inlet opening (micropore) 11 on the feed tube tube wall.
The feed tube 9 of T shape pipe passes the limbus of corneae operative incision, is embedded in angle of anterior chamber, and the arc plane is parallel with iris; Drainage tube 10 walks to walk to the ambitus in the eyeball scleral surface along meridian direction.Because have than higher pressure in the anterior chamber, aqueous humor will enter drainage tube by the micropore on the feed tube 9 11 under action of pressure, and will flow to control pressurer system 3 and liquid storage tank 6.
T shape pipe of the present invention has the following advantages:
(1) soft and resilient feed tube can cooperate angle Gong Yuan radian size and be adjacent to the angular position, room, cooperates the tractive, fixing of whole ATDS, solves problems such as drainage tube is shifted, shrinks back, deviates from;
(2) feed tube is adjacent to the angle, room, and parallel with iris, can prevent that in the ocular movement process pipeline from touching eye inner tissue and causing corresponding complication;
(3) feed tube both ends open also has a plurality of inlet opening uniform distribution on it, from having reduced the incidence rate that drainage tube blocks to a great extent.
2. the structural design of drain dish and function
Liquid storage district 6 occupies the latter half of of drain dish 2, is the exit position of drain aqueous humor.Liquid storage district 6 central authorities and peripheral bossed ridges 8, the Tenon ' s capsule around being used for supporting makes aqueous humor and Tenon ' s capsule have bigger contact area under the situation of drain dish size, shape invariance, helps the diffusion and the absorption of aqueous humor.The ridge of periphery is be interrupted to be arranged, also be beneficial to aqueous humor by the ridge gap to around diffusion.The bottom design in liquid storage district has the aqueous humor access hole 7 that connects the drain dish, and the aqueous humor of drain dish front and back scleral surface is connected, and increases to absorb; If the later stage fibrous tissue is grown into, fixedly explant reduces the ophthalmic uncomfortable sense.
3. the structure of control pressurer system
As shown in Figure 1, control pressurer system constitutes by being embedded in the drainage tube that has the mode that necessarily detours in the drain dish 2 anterior grooves 4, and its outlet is positioned at the antetheca in liquid storage district 6.Drainage tube is the continuity of the T shape pipe in the place ahead.The basic concept of design pressure control system is the Ha Gen-Bai vertical bamboo flute Ye Dinglv in the fluid mechanics principle.Be fluid in the tract process of flowing because the energy impairment of fluid and tube wall and fluid self friction, reducing, elbow etc. causes energy or pressure loss along journey, thus at entrance and port of export formation energy difference or pressure difference.Therefore,, silica gel tube is coiled,, just can between the liquid feeding end of silica gel tube and liquid outlet, form fixed pressure difference by principles such as above energy impairment, local resistances according to regular length and direction.This fixed pressure difference is the mobile key of controlling liquid.Have only and when the pressure of liquid feeding end is higher than this value, just can cause flowing of liquid in the pipeline; On the contrary, then do not cause mobilely, have only the pressure of waiting for liquid feeding end to increase gradually, and when surpassing this pressure difference, just cause the mobile of liquid if the pressure of liquid feeding end is lower than this value.The mobile mechanism of control pressurer system control aqueous humor that Here it is.
Below be the instantiation that the inventor provides, need to prove, the invention is not restricted to these embodiment.
Embodiment 1: as shown in Figure 1, artificial girder aqueous drainage system of the eye is made of T shape pipe 1 and the drain dish 2 that is attached thereto.T shape pipe 1 is made by the medical grade silicon rubber pipe of internal diameter 0.3mm, external diameter 0.6mm.Feed tube 9 is about the about 6mm of radius of curvature after 8mm, the bending, the both ends open slyness, and tube wall and aqueous humor contact surface, every 0.5mm one diameter being arranged is the inlet opening 11 of 0.25mm, the outer arc pars intermedia communicates with the drainage tube 10 that is about 13mm.Drain dish 2 is the pyriform disk-like structure of the wide 13mm of long 16mm, high 1.7mm, and bending is sphere (radius of curvature 12mm), surface area 192.2mm
2The drain dish 2 of this ATDS is made with light-cured resin.Control pressurer system 3 is embedded in drain dish 2 anterior high about 0.9mm grooves 4.As shown in Figure 1, the runner that this control pressurer system constitutes is about 38.5mm, has 8 elbows, angle of bend have 3 greater than right angle, 2 less than the right angle, 3 equal the right angle.
Embodiment 2: through the hydrodynamics manometric test, the aerial opening pressure of control pressurer system is about 7.9～9.7mmHg, and (1.184 ± 0.119kPa), occlusion pressure is about: 5.0～7.4mmHg (0.822 ± 0.159kPa); Opening pressure in balanced salt solution is about 7.9～9.3mmHg, and (1.152 ± 0.094kPa), occlusion pressure is about: 4.9～6.0mmHg (0.791 ± 0.143kPa); When balanced salt solution is mobile with the speed of 2.5 μ l/min, can produce about 7.9～9.0mmHg (pressure difference of 1.124 ± 0.075kPa).So the applicant thinks that control pressurer system has the effect of uniaxial pressure sensitivity valve.Can be effectively the pressure difference at system two ends be controlled at claimed range.
Embodiment 3: zoopery
15 Chinese screech owl white rabbits of health are implemented artificial girder aqueous humor drainage device implantation, clinical follow intraocular pressure and anterior ocular segment response situation.Observed result shows that the preceding intraocular pressure of art of ATDS implantation eye is 15.380 ± 1.005mmHg in the recent period, postoperative steadily descended in 7 days, postoperative was reduced to minimum on 14th: 9.080 ± 0.675mmHg, intraocular pressure gos up gradually afterwards, postoperative rose to 10.470 ± 1.656mmHg on the 28th, but still be starkly lower than the preceding intraocular pressure of art, and difference has significance (P＜0.01), and 14,21,28 days intraocular pressures of postoperative do not have obvious fluctuation.Slight anterior ocular segment reaction appears in minority eye after surgery in early days, oozes out as anterior chamber's scintillation, cellulose, all disappears in 2～10 days after surgery, does not find shallow of anterior chamber, lenticular opacity, posterior synechia and iris surface new vessels etc.Postoperative angle Gong Yuan wound healing is good, and phenomenon is shunk back, deviate to no drainage tube.The wound seepage is not found in the dyeing of 1% fluorescein sodium eye table.
In sum; by above-mentioned embodiment; the applicant has made detailed description with the design and the embodiment of artificial girder aqueous drainage system of the eye of the present invention; can make various conversion and improvement on this basis; stream mode etc. as material, structure, specification, control pressurer system; if but these changes and improvements do not break away from basic concept of the present invention, all should be at the protection domain of claims of the present invention.
Claims (8)
1. an aqueous humor drainage device for glaucoma is connected to form by T shape pipe (1) and drain dish (2), it is characterized in that, the first half design of described drain dish (2) is useful on the groove (4) of coiling control pressurer system, and the disk body front end is provided with fixing hole (5); Latter half is liquid storage district (6), the central authorities of liquid storage district (6) and periphery design bossed ridge (8), and there is the aqueous humor access hole (7) that is evenly distributed its bottom surface; The straight tube extendible portion of T shape pipe (1) groove (4) in around, the transverse tube that T shape is managed (1) has the inlet opening (11) that is evenly distributed, straight tube is connected with control pressurer system (3).
2. aqueous humor drainage device for glaucoma as claimed in claim 1 is characterized in that, described T shape pipe (1) is divided into feed tube (9) and drainage tube (10) two parts, and drainage tube (10) is connected the outer arc central authorities of feed tube (9).
3. aqueous humor drainage device for glaucoma as claimed in claim 2 is characterized in that, described feed tube (9) has elasticity, and the both ends open slyness is bent upwards the curved pipe that adapts with the angle of anterior chamber radian, radius of curvature 6mm.
4. aqueous humor drainage device for glaucoma as claimed in claim 2 is characterized in that, on the tube wall face that aqueous humor contacts in described feed tube (9) and the eyes inlet opening (11) that is evenly distributed is arranged.
5. aqueous humor drainage device for glaucoma as claimed in claim 1 is characterized in that, described drain dish (2) is pyriform, circle, fan-shaped, square or trapezoid disk-like structure, and the bottom surface bending is sphere, conforms to the scleral surface curvature of human eye.
6. aqueous humor drainage device for glaucoma as claimed in claim 1 is characterized in that, described control pressurer system (3) constitutes by being coiled in the drainage tube that has the mode that necessarily detours in the groove (4).
7. aqueous humor drainage device for glaucoma as claimed in claim 1 is characterized in that, described T shape pipe (1) is made by medical grade silicon rubber.
8. aqueous humor drainage device for glaucoma as claimed in claim 1 is characterized in that, described drain dish (2) is made by light-cured resin.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2005100961866A CN100415190C (en) | 2005-10-17 | 2005-10-17 | Novel aqueous humor drainage device for glaucoma |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2005100961866A CN100415190C (en) | 2005-10-17 | 2005-10-17 | Novel aqueous humor drainage device for glaucoma |
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| CN1748661A CN1748661A (en) | 2006-03-22 |
| CN100415190C true CN100415190C (en) | 2008-09-03 |
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| CNB2005100961866A Expired - Fee Related CN100415190C (en) | 2005-10-17 | 2005-10-17 | Novel aqueous humor drainage device for glaucoma |
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Families Citing this family (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103190983A (en) * | 2012-01-05 | 2013-07-10 | 首都医科大学 | Aqueous humor drainage implant |
| US20160030242A1 (en) * | 2013-03-14 | 2016-02-04 | Hanita Lenses R.C.A. Ltd. | Miniature Glaucoma Shunt |
| CN106420158B (en) * | 2016-11-02 | 2019-02-19 | 杨建军 | A kind of rated pressure induction control formula aqueous drainage system of the eye |
| US11523940B2 (en) * | 2017-03-17 | 2022-12-13 | W. L. Gore & Associates, Inc. | Delivery aids for glaucoma shunts |
| JP6529050B2 (en) * | 2017-10-23 | 2019-06-12 | 株式会社ドックスネット | Implant and implant system |
| KR102190257B1 (en) * | 2017-12-20 | 2020-12-16 | 주식회사 마이크로트 | An ocular disease implant apparatus for controlling intraocular pressure |
| CN112689488B (en) * | 2018-09-06 | 2024-04-12 | 洛桑联邦理工学院 | Device for treating excess intraocular fluid with elastic membrane |
| CN110037854B (en) * | 2019-03-29 | 2021-04-20 | 温州医科大学附属眼视光医院 | Glaucoma aqueous humor drainage device |
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| CN1057586A (en) * | 1990-06-26 | 1992-01-08 | 布鲁斯·A·昂格莱德 | Intraocular pressure reducing device |
| CN1026754C (en) * | 1989-11-17 | 1994-11-30 | 斯图尔特·格雷戈里·史密夫 | Intraocular pressure eliminating device and implanting method thereof |
| CN1249922A (en) * | 1999-10-26 | 2000-04-12 | 苏州医疗器械总厂 | Aqueous humor drainer |
| US6077299A (en) * | 1998-06-22 | 2000-06-20 | Eyetronic, Llc | Non-invasively adjustable valve implant for the drainage of aqueous humor in glaucoma |
| CN2414757Y (en) * | 2000-04-07 | 2001-01-17 | 北京市橡胶制品设计研究院 | Glaucoma aqueous humor drainage plate |
| CN1354642A (en) * | 1999-04-26 | 2002-06-19 | Gmp视力康复公司 | Shunt device and method for treating glaucoma |
| JP2003180730A (en) * | 2001-11-08 | 2003-07-02 | Glaukos Corp | Medicine releasing trabecular implant for treatment of glaucoma |
| CN2863041Y (en) * | 2005-10-17 | 2007-01-31 | 西安交通大学 | Aqueous humor drainage device for new type glaucoma |
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2005
- 2005-10-17 CN CNB2005100961866A patent/CN100415190C/en not_active Expired - Fee Related
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1026754C (en) * | 1989-11-17 | 1994-11-30 | 斯图尔特·格雷戈里·史密夫 | Intraocular pressure eliminating device and implanting method thereof |
| CN1057586A (en) * | 1990-06-26 | 1992-01-08 | 布鲁斯·A·昂格莱德 | Intraocular pressure reducing device |
| US6077299A (en) * | 1998-06-22 | 2000-06-20 | Eyetronic, Llc | Non-invasively adjustable valve implant for the drainage of aqueous humor in glaucoma |
| CN1354642A (en) * | 1999-04-26 | 2002-06-19 | Gmp视力康复公司 | Shunt device and method for treating glaucoma |
| CN1249922A (en) * | 1999-10-26 | 2000-04-12 | 苏州医疗器械总厂 | Aqueous humor drainer |
| CN2414757Y (en) * | 2000-04-07 | 2001-01-17 | 北京市橡胶制品设计研究院 | Glaucoma aqueous humor drainage plate |
| JP2003180730A (en) * | 2001-11-08 | 2003-07-02 | Glaukos Corp | Medicine releasing trabecular implant for treatment of glaucoma |
| CN2863041Y (en) * | 2005-10-17 | 2007-01-31 | 西安交通大学 | Aqueous humor drainage device for new type glaucoma |
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