WO2010047387A1

WO2010047387A1 - Method for compensating for deterioration in elasticity of sclera of eyeball and spacer used in the method

Info

Publication number: WO2010047387A1
Application number: PCT/JP2009/068270
Authority: WO
Inventors: 憲次吉田
Original assignee: 志村好美
Priority date: 2008-10-23
Filing date: 2009-10-23
Publication date: 2010-04-29
Also published as: WO2010046987A1

Abstract

　A first incision surface (10) and a second incision surface (20) are formed using a femtosecond laser. The first incision surface (10) has a circular shape or an arc shape, and is parallel to the corneal surface (92) in the cornea parenchyma layer (91) near the corneoscleral limbus (7). The second incision surface (20) extends from the first incision surface (10) to the corneal surface (92). Therefore, a region having high flexibility is produced between the corneal peripheral part and the corneoscleral limbus (7), and deterioration in the elasticity of the sclera (5) disposed between the corneoscleral limbus (7) and the ocular attachment part (3) of an extraocular muscle (2) is compensated.

Description

Complementing method for decreasing the sclera extensibility of eyeball and spacer used in the method

The present invention relates to a method for complementing the decrease in extensibility of the sclera located between the eyeball adhering portion and the cornea ring portion of the extraocular muscle, and a spacer used in the method.

The eye movement is explained by the internal eye muscle adjustment theory, the so-called Helmholtz theory, proposed by Helmholtz, a physiologist and physicist in the 19th century. To explain this theory briefly, “The eye movement is driven by the elastic movement of the ciliary muscle in the eyeball, and its effector is only the lens. And it is an effector. The focus of the crystalline lens is adjusted by changing its thickness and position. " However, the Helmholtz theory is not a complete theory because it cannot often explain the eye movement. This is already a well-known fact, but there is still no new theory that can overturn this theory, and Helmholtz theory has been supported to date.

By the way, when we look at the phenomenon called generalized presbyopia, technically weakening of age-related regulation according to Helmholtz theory, as a result of the aging, the ability to stretch and contract the ciliary muscle (inner eye muscle) decreased. It is not possible to give sufficient influence to the lens, which is an effector, and this causes a drop in the eye's accommodation function, and when the focal position (far point) is adjusted far away, it is possible to see near. It will be difficult.

When such age-related accommodation weakness (hereinafter referred to as presbyopia) occurs, until now, wearing a spectacle or contact lens with a convex lens to adjust the focal position (far point) and near vision It has been generally done to improve. However, if the near vision is improved by these methods, the distance vision will be disturbed. Therefore, at present, a multifocal lens or a progressive focus lens is transplanted into the eye and referred to as presbyopia recovery treatment for convenience.

However, the recovery of presbyopia in the essential sense is to restore the eye's ability to adjust. As a fundamental solution for this, according to Helmholtz theory, a method for recovering the function of the ciliary muscle (inner eye muscle) that has declined is required. However, it has been considered impossible to restore the function of the ciliary muscle and the ability to adjust the eye, which appear as part of the aging phenomenon.

Under such circumstances, the present inventor, in the process of examining and treating patients for many years as an ophthalmologist, said, “Only the ciliary muscles that the eyeball's accommodation movement is actively operated are proposed by Helmholtz theory. In other words, it is done by changing the shape of the whole eyeball flexibly. " In addition to the extraocular muscles directly attached to the eyeball, the shape of the entire eyeball changes due to coordinated movements of the eyelids, eyelid fist muscles, facial muscles such as the ocular muscles and the frontal muscles, and further contains the eyeballs We obtained the knowledge that the soft tissue behind the eyeball in the eye socket and the eye socket is also indispensable for the eye movement.

This will be explained in more detail with reference to the drawings as follows.

FIG. 15 is a schematic diagram showing the eyeball and its peripheral part when the external eye muscle is in a relaxed state, and FIG. 16 is a schematic diagram showing the eyeball and its peripheral part when the external eye muscle contracts.

When looking near (when adjusting near), not only the ciliary muscle (inner eye muscle) contracts and adjusts, but also all extraocular muscles 2 (outer eye muscle 2) attached to the eyeball 1. The other end is attached to the bone forming the orbit via a tendon) but contracts while maintaining balance (from the state shown in FIG. 15 to the state shown in FIG. 16. In FIG. 16, the arrow C) Indicated by). At this time, the eyeball 1 is pulled toward the rear of the orbit with the eyeball attachment portion 3 of the external eye muscle 2 as the action point. As a result, the optic nerve and soft tissue 8 existing in the rear of the eye socket in contact with the eyeball 1 are pressed from the eyeball bottom 4. The internal pressure of the soft tissue 8 that has been compressed increases, and the eyeball bottom 4 is pushed back evenly with a pressure P1 having the same magnitude as the internal pressure. Thereby, the drag force P2 generated in the eyeball 1 becomes a force P3 for extending the sclera 5 and the cornea 6 positioned in front of the extraocular muscle adhesion portion 3 of the eyeball 1 toward the front. As a result, the eyeball axis extends. At this time, the extraocular muscle adhering part 3 works as an action point, and therefore the sclera 5 part from the extraocular muscle adhering part 3 to the corneal ring part 7 is most strongly extended (indicated by an arrow E in FIG. 16). .) By the way, anatomically, the portion of the sclera 5 to which the extraocular muscles 2 are attached is the thinnest, and is originally a site with excellent extensibility. The present inventor has found that not only the expansion and contraction movement of the ciliary muscle (inner eye muscle) but also the extension of the eyeball axis due to the extension of the sclera 5 has a great influence on the adjustment movement of the eyeball. Therefore, hereinafter, the sclera is also referred to as a regulatory sclera in the present specification. In addition, the code | symbol 6 in a figure shows an optic nerve, 9 shows a cornea, respectively.

The extensibility of the regulatory sclera 5 depends on its thickness and the moisture content of the collagen tissue constituting it. This decrease in the moisture content of the collagen tissue leads to the hardening of the tissue, leading to a decrease in the extensibility of the regulatory sclera 5. The moisture content of the collagen constituting the regulatory sclera 5 tends to decrease with aging, similar to that of the skin. Therefore, the extensibility of the regulatory sclera 5 decreases with age, and as a result, the ability to adjust the eyeball is reduced. The present inventor has discovered that a decrease in the ability to adjust the eyeball by such a series of mechanisms leads to the development of presbyopia.

According to the above-mentioned theory of the present inventor, when a treatment that complements the decrease in extensibility of the regulatory sclera due to aging is performed, the ability to adjust the eyeball is restored, and presbyopia can be cured. Therefore, the present inventor has proposed a constant-depth corneal ring-shaped incision device for the treatment of presbyopia based on the above theory (see Patent Document 1). In addition, in order to prevent the incision formed in the cornea from being repaired by re-adhesion and adhesion and to maintain the incision, an indwelling ring inserted into the incision was proposed (Patent Document). 2).

If the desired constant depth annulus incision is formed in the corneal region near the corneal limbus using the constant depth corneal annulus incision instrument, this incision becomes a new extension site to replace the regulatory sclera 5, and as a result The decrease in the extensibility of the regulatory sclera 5 due to aging is complemented. Further, if the intracorneal indwelling ring is inserted into the incision, adhesion and adhesion of the incision are prevented, so that the function of the incision is maintained, and the above complementation can be continued. As a result, the ability to adjust the eyeball is restored and presbyopia is healed.

JP 2007-130334 A JP 2007-151768 A

However, in the above-mentioned incision device, the suction ring having the suction means is fixed to the cornea and the adjustment sclera with suction pressure. The patient had discomfort during the procedure.

In addition, the revolver equipped with the blade is rotated by hand, so that an incision is formed at a predetermined position of the cornea with the blade. Therefore, adjustment of the position and posture of the blade and the amount of protrusion of the blade that determines the depth of the incision Adjustment was cumbersome.

Furthermore, since the cornea diameter varies greatly among individuals, it was necessary to prepare a plurality of suction rings with different diameters.

Also, since the incision was formed with a blade, the cross-sectional shape of the incision was limited to a straight line. For this reason, unless the incision is formed to a very deep part of the cornea, the function of the incision as described above cannot be fully exhibited.

And above all, since the formation of the incision is manual, a high level of skill is required to obtain high incision accuracy. In particular, as the incision is formed, the vicinity of the corneal ring becomes easier to move, so that the blade tends to enter deeper than a predetermined depth into the cornea. For this reason, it was almost impossible to form a constant depth incision.

When using the indwelling ring, since the cross-sectional shape of the incision formed by the incision instrument is limited to a straight line as described above, the incision is formed to a considerably deeper position. Otherwise, the intracorneal indwelling ring will be pushed out of the cornea from the incision. However, forming an incision deep in the cornea often involves a risk of excision (separation) of the cornea itself.

Further, when presbyopia is treated using the above incision instrument, or both the incision instrument and the indwelling ring, the Bowman's membrane, which is the corneal constituent tissue, is incised, and the function of the Bowman's membrane, particularly the traction force Since the resistance to resistance is impaired, a highly plastic site appears on the cornea along the incision. As a result, during the near-field adjustment, the shape of the cornea is sharpened more strongly in the periphery of the cornea than in the incision, while the curvature of the cornea does not change in the center of the cornea than in the incision or is flattened and close. In other words, hyperregulation occurs as a result. Therefore, although the above treatment corrects myopia, the degree of correction may not be sufficient for patients who have had high myopia. Therefore, there are cases where further corrective surgery for myopia is performed. On the other hand, a viewer who has been hyperopic from the beginning is required to perform corrective surgery for hyperopia because hyperopia further proceeds after treatment. In that case, it is conceivable to adopt the LASIK surgery that has been widely used for the treatment of myopia and hyperopia in recent years. However, forming a corneal flap with a laser in LASIK surgery so that it does not cross with the incision formed with the incision instrument means that the center of the incision by the incision instrument (the center of the circle drawn by the incision) and the corneal flap It was actually impossible because it was extremely difficult to match the center without any difference.

Therefore, in order to solve the above-mentioned problems, the present invention provides a method for complementing the decrease in scleral extensibility and a spacer used in the method, which can be performed safely without burdening the patient. It is an object.

In order to achieve the above object, the method for complementing the decrease in sclera extensibility of the eye according to the invention of claim 1 is characterized by creating a highly flexible region between the corneal periphery and the corneal limbus. A method of complementing the decrease in extensibility of the sclera located between the eyeball adhering portion and the corneal limbus, wherein the corneal stroma in the vicinity of the corneal limbus has a ring-like or arc-like shape parallel to the corneal surface. Including a step of forming one incisional wound surface and a step of forming a second incisional wound surface reaching from the first incisional wound surface to the corneal surface, and each of the steps is performed by a femtosecond laser.

An eyeball sclera extensibility reduction complementing method according to a second aspect of the present invention is a method of creating a highly flexible region between the cornea peripheral part and the cornea ring part, thereby providing an eyeball adhering part and a cornea ring part of the extraocular muscle. A method of complementing the decrease in extensibility of the sclera located between the corneal limbus and forming a ring-shaped or arc-shaped first excision layer parallel to the corneal surface in the corneal stroma in the vicinity of the corneal limbus; And a step of forming a second ablation layer reaching from the first ablation layer to the corneal surface, and each step is performed by a femtosecond laser.

The sclera extensibility reduction complementing method according to each of the above inventions may further include a step of inserting a spacer into the incision wound surface or the excision layer, respectively.

That is, the scleral extensibility reduction complementing method according to the first aspect of the present invention may further include a step of inserting a spacer into the first incision wound surface.

The scleral extensibility reduction complementing method according to the invention of claim 2 may further include a step of inserting a spacer into the first ablation layer.

The above spacers are preferably ring-shaped or arc-shaped. In this case, a material that is harmless to the living body is selected. For example, a synthetic resin that is harmless to a living body, such as polymethyl methacrylate (PMMA) used as a material for contact lenses, or gold (Au) or platinum (Pt) is selected. The spacer is preferably flat.

When the spacer is ring-shaped or arc-shaped, the spacer is inserted not in the incision along the thickness direction of the cornea as in the prior art, but in the first incision surface (or the first excision layer) along the radial direction of the cornea. Even if it tries to move into the second incisional wound surface (or second excision layer) along the thickness direction of the cornea from that position, it is caught at the lower end of the second incisional wound surface (or second excision layer). Therefore, since the spacer always stays in the first incisional wound surface (or the first excision layer) along the radial direction of the cornea, there is no possibility of slipping out of the cornea.

In the scleral extensibility reduction complementing method according to the first aspect of the present invention, a plurality of chip-like spacers having anchor portions that enter the first incision wound surface are further provided in the second incision wound surface. The process of inserting over may be included.

In the scleral extensibility reduction complementing method according to the second aspect of the present invention, chip-like spacers having anchor portions that enter the first ablation layer are further provided in a plurality of locations in the second ablation layer. May include a step of inserting.

Here, the number of chip-shaped spacers inserted is arbitrary, but 4 to 8 is preferable. Moreover, it is preferable that the insertion interval of a spacer becomes equal intervals along a 2nd incisional wound surface or a 2nd excision layer. For example, when the number of inserted spacers is four, the interval is 90 °, and when the number is eight, the interval is 45 °.

The chip-shaped spacer includes a flaky main body portion inserted into the second incision wound surface or the second excision layer, and the first spacer protruding from one end or both sides from the lower end of the main body portion. What provided the anchor part which penetrates in an incisional wound surface or a 1st excision layer is preferable.

In the spacer having such a configuration, the anchor portion enters the first incision wound surface (first excision layer) and functions as an anchor, so that the spacer remains stably in the second incision wound surface (second excision layer). There is no risk that the spacer will come out of the cornea.

As for the spacer, a material that is harmless to a living body is selected as in the case of the ring-shaped or arc-shaped spacer. For example, a synthetic resin that is harmless to a living body, such as polymethyl methacrylate (PMMA) used as a material for contact lenses, or gold (Au) or platinum (Pt) is selected.

The tip-shaped spacer as described above is easier to insert into the incisional wound surface (excision layer) than the above-described ring-shaped or arc-shaped spacer, and the treatment time can be further shortened.

Further, as the spacer, a granular material or powder of gold (Au) or platinum (Pt) is also suitable.

When gold or platinum is used as the spacer material, the corneal opacity can be effectively reduced or suppressed after the operation.

In the present invention, the incision wound surface (or excision layer) along the radial direction of the cornea and the incision wound surface (or excision layer) along the thickness direction of the cornea are adjacent to each other in the vicinity of the corneal ring portion. Since it is formed, it is possible to obtain greater extensibility at the formation site than when the conventional incision is formed. That is, it is possible to create a part having higher flexibility than the conventional part between the corneal peripheral part and the corneal ring part.

In addition, when forming a corneal flap, the same femtosecond laser as that used to form the incised wound surface is used in a series of treatments, so there is no risk of both crossing and short-term myopia. And correction of hyperopia.

In the present invention, the phrase “parallel to the corneal surface” means a direction along the radial direction of the cornea, and does not mean to be strictly parallel to the corneal surface. Therefore, the first incisional wound surface and the first excision layer each include a case where the inclined surface is slightly inclined with respect to the surface of the cornea.

According to the present invention, an incisional wound surface having a desired cross-sectional shape can be formed without imposing a burden on the patient, and a region having higher flexibility than the conventional one can be created between the corneal peripheral part and the corneal ring part. Can do. Thereby, since the extensibility of the sclera can be complemented, the ability to adjust the eyeball can be restored more effectively. It can also correct myopia and astigmatism.

It is the schematic diagram which looked at the cornea from the front. It is a schematic diagram which shows the end surface which follows the II-II line | wire in FIG. It is a figure corresponding to FIG. 2 which shows the other example of the positional relationship of a 1st incision wound surface and a 2nd incision wound surface. It is a figure corresponding to FIG. 2 which shows the positional relationship of a 2nd incision wound surface and a corneal flap. It is a figure corresponding to FIG. 2 which shows the state which inserted the spacer in the 1st incision wound surface. It is a perspective view which shows one Embodiment of a spacer. It is a front view which shows other embodiment of a spacer. It is a top view of the spacer shown in FIG. It is a side view of the spacer shown in FIG. It is the schematic diagram which looked at the cornea from the front which shows an example of arrangement | positioning of the spacer shown in FIG. It is a schematic diagram which shows the end surface which follows the XI-XI line in FIG. It is a figure corresponding to FIG. 11 which shows the state which inserted the spacer shown in FIG. 7 in the 2nd incisional wound surface. It is a front view which shows other embodiment of a spacer. It is a figure corresponding to Drawing 11 showing the state where the spacer shown in Drawing 13 was inserted in the 2nd incisional wound surface. It is a schematic diagram which shows the eyeball and its peripheral part when the extraocular muscle is in a relaxed state. It is a schematic diagram which shows the eyeball and its peripheral part when an extraocular muscle contracts.

Hereinafter, the best mode for carrying out the present invention will be described with reference to the drawings.

FIG. 1 is a schematic view of the cornea as viewed from the front, and FIG. 2 is a schematic view showing an end surface taken along line II-II in FIG.

The method for complementing the decrease in sclera extensibility of the eyeball according to the present invention creates a highly flexible portion between the cornea peripheral part and the corneal ring part 7 to thereby provide the eyeball attachment part 3 and the corneal ring part 7 of the extraocular muscle 2. It is a method of complementing the decrease in the extensibility of the regulatory sclera 5 positioned between the two. That is, in the method according to the present invention, the step of forming a ring-shaped first incisional face 10 parallel to the corneal surface 92 in the corneal substantial layer 91 in the vicinity of the corneal ring portion 7, and the first incisional wound face 10 to the corneal surface 92. Forming the second incisional wound surface 20 that reaches the point, and each of these steps is performed by a femtosecond laser.

In order to form the first incisional wound surface 10 by the femtosecond laser, the laser beam emitted from the laser irradiation means is stored in advance in the memory of the femtosecond laser device, with the spot in the corneal substantial layer 91. The light is guided so as to reach the depth of one incisional wound surface 10, and the laser light spot is scanned by any of the following methods. That is, scanning is performed in a ring shape along the corneal ring portion 7 while performing amplitude scanning with the width of the first incision wound surface 10 stored in advance in the memory of the femtosecond laser apparatus. Or within the range of the width | variety of the 1st incision wound surface 10 memorize | stored previously in memory, it scans in a concentric form over a corneal ring part 7 in a ring shape and several times. In this case, scanning may be started from the inner peripheral side of the cornea 9 or may be started from the outer peripheral side (corneal ring portion 7 side). Alternatively, scanning is performed in a ring shape and a spiral shape along the corneal ring portion 7 within the range of the width of the first incision wound surface previously stored in the memory. Also in this case, scanning may be started from the inner peripheral side of the cornea 9 or may be started from the outer peripheral side (corneal ring portion 7 side).

The depth of the first incision surface 10 is selected from the range of 100 to 900 μm from the corneal surface 92, and preferably 400 to 600 μm. The width W of the first incision wound surface 10 is preferably 500 μm or more for the purpose of correcting myopia and astigmatism, and 1000 μm or more for the purpose of presbyopia correction, glaucoma, macular degeneration, keratoconus and the like.

The first incision wound surface 10 is not limited to the ring shape as described above, but may be an arc shape. Which form is selected, and how long is the arc shape? This may be determined as appropriate in consideration of the entire eyeball and the state of the cornea.

Next, in order to form the second incisional wound surface 20 by the femtosecond laser, a laser beam spot emitted from the laser irradiation means is directed from the first incisional wound surface 10 toward the corneal surface 92 or from the corneal surface. Scan along the first incision wound surface 10 in the direction toward the one incision wound surface. As a result, the second incisional wound surface 20 is connected to the first incisional wound surface 10 at the lower end thereof. Here, in FIG. 1, the second incision wound surface 20 is connected to the first incision wound surface 10 at a substantially central portion in the width direction, and these two incision wound surfaces 10 and 20 form an “inverted T shape”. However, when the treatment subject is an elderly person, there may be a white and cloudy part in the periphery of the cornea (specially called the elderly ring). 2 The incisional wound surface 20 should be separated from the corneal ring portion 7. Therefore, as shown in FIG. 3, the second incision wound surface 20 is connected to the first incision wound surface 10 at its inner peripheral end (inner peripheral edge on the center side of the cornea 9) or at a position closer to the inner peripheral end. Is good. The distance of the second incision wound surface 20 from the corneal ring portion 7 is preferably 0.1 to 2.0 mm, more preferably 0.5 to 1.0 mm.

In addition, the 1st incision wound surface 10 and the 2nd incision wound surface 20 are good also as an excision layer instead of these, respectively. In other words, a certain region of tissue may be excised along the first incision wound surface 10 and the second incision wound surface 20.

When performing myopia correction or hyperopia correction by LASIK surgery, use a femtosecond laser device used to form the first incision wound surface 10 and the second incision wound surface 20, as shown in FIG. Thus, the corneal flap 60 is formed in the inner region of the second incision wound surface 20. The corneal flap 60 may be before or after the first incision wound surface 10 and the second incision wound surface 20 are formed. Moreover, you may make the circumferential outer edge of the corneal flap 60 and the 2nd incisional wound surface 20 correspond, as shown in FIG.

In the example shown in FIG. 1, a flat ring-shaped spacer 50 (see FIG. 6) may be inserted into the first incision wound surface 10 as shown in FIG. The material of the spacer 50 is preferably gold or platinum. Further, the thickness can better compensate for the decrease in extensibility of the adjusting sclera 5 as the thickness increases, but a thickness of about 50 μm is preferable. In addition to the flat ring-shaped spacer, the spacer may be gold or platinum particles or powder. A metal having a low ionization tendency and low toxicity can also be used as the spacer material.

The spacer is not limited to the ring shape as described above, and may be a chip-like spacer 52 as shown in FIGS.

The spacer 52 includes a flaky body portion 521 inserted into the second incision wound surface 20 and an anchor portion 522 that protrudes from the lower end of the body portion 521 to both sides and enters the first incision wound surface 10. As shown in FIG. 7, it has an arrow shape facing downward.

In this example, the anchor portion 522 is formed in a wedge shape so that it can be easily inserted into the second incision wound surface 20.

The spacer 52 thus configured is inserted into the second incision wound surface 20 over a plurality of locations as indicated by a circle A in FIG. In the example shown in FIG. 10, eight spacers 52 are inserted at intervals of 45 °. The number of spacers 52 is not limited to eight, and may be four to seven. Also in this case, it is preferable that the insertion interval of the spacers 52 is equal.

In the spacer 52 having such a configuration, the anchor portion 522 enters the first incision wound surface 10 and functions as an anchor. Therefore, the spacer 52 stays stably in the second incision wound surface 20, and the spacer 52 comes out of the cornea. There is no fear. In addition, as shown in FIG. 11, the second incision wound surface 20 actually intersects the first incision wound surface 10 in relation to the treatment accuracy, and the lower end 22 of the second incision wound surface 20 is slightly slightly in the first incision wound surface 10. It is formed so as to protrude downward. In such a case, if the shape of the anchor portion 522 is a so-called wedge shape as shown in FIG. 7, the tip of the anchor portion 522 bites into the lower end 22 of the second incision wound surface 20 as shown in FIG. The anchor portion 522 is not displaced in the direction along the first incisional wound surface 10, and the spacer 52 is not inclined in the second incisional wound surface 20.

Note that the anchor portion 522 does not necessarily protrude from the lower end of the main body portion 521 on both sides, and may protrude only one side from the lower end of the main body portion 521 as shown in FIG. FIG. 14 shows a case where the spacer 52 shown in FIG. 13 is used.

As for the spacer 52, as in the case of the ring-shaped or arc-shaped spacer 50, a material that is harmless to the living body is selected. For example, a synthetic resin that is harmless to a living body, such as polymethyl methacrylate (PMMA) used as a material for contact lenses, or gold (Au) or platinum (Pt) is selected.

In the chip-shaped spacer 52 as described above, the insertion work into the incision wound surface (second incision wound surface 20) is easier than the above-described ring-shaped or arc-shaped spacer 50, and the treatment time is further shortened. be able to.

The present invention can be applied not only to the treatment of presbyopia, but also to myopia and astigmatism, and particularly to irregular irregular astigmatism that has not been treated before. Unlike the existing LASIK surgery, the present invention enables myopia and astigmatism correction surgery without impairing the thickness of the cornea, so that it is possible to treat myopia and astigmatism even in an eyeball with a thin cornea thickness. Moreover, since the effect of reducing intraocular pressure is also obtained, it is effective for the treatment of glaucoma. In addition, since the tension of the extraocular muscles can be released, it is also effective in treating senile macular degeneration, retinitis pigmentosa, keratoconus, and cataract prevention.

DESCRIPTION OF SYMBOLS 1 Eyeball 2 Extraocular muscle 3 Extraocular muscle eye adhesion part 4 Eyeball bottom 5 Sclera (regulatory sclera)
6 Optic Nerve 7 Corneal Annulus 8 Soft Tissue 9 Cornea 10 First Incision Wound 20 Second Incision Wound 50 Spacer 52 Spacer 521 Main Body 522 Anchor 60 60 Corneal Flap

Claims

It is a method that compensates for the decrease in extensibility of the sclera located between the eyeball adhering part of the extraocular muscles and the corneal ring by creating a highly flexible region between the cornea peripheral part and the corneal ring part. And
Forming a ring-shaped or arc-shaped first incisional face parallel to the corneal surface in the corneal stroma in the vicinity of the corneal limbus;
Forming a second incision wound surface extending from the first incision wound surface to the corneal surface;
Including
A method for complementing the decrease in scleral extensibility of the eyeball, wherein each of the steps is performed with a femtosecond laser.
It is a method that compensates for the decrease in extensibility of the sclera located between the eyeball adhering part of the extraocular muscles and the corneal ring by creating a highly flexible region between the cornea peripheral part and the corneal ring part. And
Forming a ring-shaped or arc-shaped first excision layer parallel to the corneal surface in the corneal stroma in the vicinity of the corneal limbus;
Forming a second ablation layer reaching the corneal surface from the first ablation layer;
Including
A method for complementing the decrease in scleral extensibility of the eyeball, wherein each of the steps is performed with a femtosecond laser.
In the method for supplementing decrease in scleral extensibility of the eyeball according to claim 1,
The method further comprises a step of forming a corneal flap with a femtosecond laser on the inner side of the second incisional wound surface, and a method for complementing the reduction in eyeball sclera extensibility.
In the sclera extensibility reduction complementation method of the eyeball according to claim 2,
Furthermore, the sclera extensibility fall complementation method of an eyeball including the process of forming a corneal flap with a femtosecond laser inside the said 2nd excision layer.
In the eyeball sclera extensibility reduction complementation method according to claim 1 or 3,
Furthermore, the sclera extensibility fall complementation method of an eyeball including the process of inserting a spacer in the said 1st incision wound surface.
In the sclera extensibility reduction complementation method of the eyeball according to claim 2 or 4,
Furthermore, the sclera extensibility fall complementation method of the eyeball including the process of inserting a spacer in the said 1st excision layer.
In the eyeball sclera extensibility reduction complementation method according to claim 1 or 3,
Furthermore, the sclera extensibility fall complementation method of an eyeball including the process of inserting the chip-shaped spacer provided with the anchor part which penetrates in the said 1st incision wound surface in two or more places in the said 2nd incision wound surface.
In the sclera extensibility reduction complementation method of the eyeball according to claim 2 or 4,
Furthermore, the sclera extensibility fall complementation method of an eyeball including the process of inserting the chip-shaped spacer provided with the anchor part which penetrates in the said 1st excision layer over two or more places in the said 2nd excision layer.
In the sclera extensibility reduction complementation method of the eyeball according to claim 5 or 6,
A method for supplementing a decrease in scleral extensibility of an eyeball using a ring-shaped or arc-shaped spacer as the spacer.
In the eyeball sclera extensibility reduction complementation method according to any one of claims 7 to 9,
The spacer is made of synthetic resin, gold or platinum as a material, and is a supplementary method for supplementing the decrease in scleral extensibility of the eyeball.
In the sclera extensibility reduction complementation method of the eyeball according to claim 5 or 6,
A method for complementing the decrease in scleral extensibility of the eyeball using a granular material or powder of gold or platinum as the spacer.
In the eyeball sclera extensibility reduction complementation method according to claim 1 or 3,
Furthermore, the sclera extensibility fall complementation method of an eyeball including the process of inserting the granule or powder of gold or platinum as a spacer in the said 2nd incisional wound surface.
In the sclera extensibility reduction complementation method of the eyeball according to claim 2 or 4,
Furthermore, the sclera extensibility fall complementation method of an eyeball including the process of inserting the granule or powder of gold or platinum as a spacer in the said 2nd excision layer.
A spacer used in the method for complementing the decrease in sclera extensibility of the eyeball according to claim 5 or 6,
A ring-shaped or arc-shaped spacer inserted into the first incision wound surface or the first excision layer.
The spacer according to claim 14,
The spacer is a flat spacer.
A chip-like spacer used in the method for complementing the decrease in sclera extensibility of the eye according to claim 7,
A flaky body inserted into the second incision wound surface;
A spacer provided with an anchor portion protruding into one side or both sides from the lower end of the main body portion and entering the first incision wound surface.
A chip-like spacer used in the sclera extensibility reduction complementation method of the eyeball according to claim 8,
A flaky body inserted into the second ablation layer;
A spacer provided with an anchor portion that protrudes from the lower end of the main body portion to one side or both sides and enters the first cut layer.
The spacer according to any one of claims 14 to 17,
The spacer is a spacer made of synthetic resin, gold or platinum.