Surgery – Instruments – Internal pressure applicator
Patent
1992-04-30
1994-02-15
Pellegrino, Stephen C.
Surgery
Instruments
Internal pressure applicator
604 96, A61M 2902
Patent
active
052862615
DESCRIPTION:
BRIEF SUMMARY
FIELD OF INVENTION
This invention relates generally to an improved inflatable balloon for use in eye surgery. More specifically, the invention relates to an inflatable balloon for use in the treatment of retinal detachments. The balloon is comprised of a hollow elliptic-shaped body, a solid base, and a solid cylindrical stem. The balloon is inserted into Tenon's space by first inserting a fine blunt-ended needle longitudinally through the solid base and stem of the balloon. The needle is then used to guide the balloon into place. Once the balloon is in place, it is inflated with a sterile solution to create the necessary degree of buckling in the sclera. The needle is then removed and the cylindrical stem is trimmed to the desired length.
BACKGROUND OF INVENTION
Vision is accomplished through a complex process wherein light rays are refracted or bent so as to focus on the retina, which then transmits these signals through the fibers of the optic nerve to the brain. To function properly, the retina must contact the choroid, from which it receives a significant portion of the oxygen and glucose required for its normal nourishment. If the retina is detached from the choroid, it is therefore no longer able to accomplish its function.
Retinal detachment is typically the result of subretinal fluid that has permeated between the retina and the choroid through one or more holes in the structure of the retina. The retinal holes generally have the shape of either round holes or "horseshoe" shaped breaks. The permeated subretinal fluid causes portions of the retina to break away from the choroid. As a result of retinal detachment, patients observe some degree of reduction in their visual acuity and field of vision, dependent upon the extend of the retinal detachment.
Treatment of retinal detachment requires occlusion of the ruptures of the retina. In the prior art, occlusion is accomplished by suturing permanent silicone implants to the outer wall of the sclera. The implants cause a buckling or bulging in the sclera toward the area of the retinal holes. The buckling in the sclera causes the sclera and its internally contiguous layer, the choroid, to move inward and occlude the holes of the detached retina. After this occlusion occurs, subretinal fluid is reabsorbed, allowing the retina to settle back into position, in contact with the choroid. In order to induce an inflammatory reaction and augment the adhesiveness of the retina to its normal position in the areas in which it was previously detached, diathermy, cryotherapy, or laser therapy is also applied to the area of the retinal rupture.
This procedure for treating retinal detachment, however, presents several problems. For example, under this procedure, the patient is required to undergo general anesthesia. The surgery also demands a substantial amount of time. Moreover, because the procedure requires extensive surgical manipulation of ocular tissue, the patient is likely to suffer from pain and ocular edema in the post-operative period. Furthermore, substantial dexterity is needed in order to suture the solid implant to the patient's sclera.
Attempts to solve these problems have resulted in Lincoff's inflatable balloon. Prior Art FIG. 1 shows a representation of the Lincoff balloon during treatment of the detached retina. Lincoff's balloon is used to cause a buckling effect similar to that generated by the previously discussed solid permanent implants.
Referring now to FIG. 1 Prior Art, the prior art Lincoff balloon 12 is shown inserted in Tenon's space 14 near a detached retinal portion 18. In the Lincoff balloon technique, the balloon 12 is first inserted into Tenon's space 14 through an incision 20 in the conjunctiva 22. Once it is in a proper location in Tenon's space 14, the balloon 12 is inflated with a saline solution via a catheter 24. The catheter 24 further includes an intricate valve used to maintain the saline solution in the balloon 12. The balloon 12 is shown in FIG. 1 in a semi-inflated state. As the balloon 12 is further inflated, the sclera
REFERENCES:
patent: 3834394 (1974-09-01), Hunter et al.
patent: 4299227 (1981-10-01), Lincoff
patent: 4517979 (1985-05-01), Pecenka
patent: 4545367 (1985-10-01), Tucci
patent: 4638803 (1987-01-01), Rand
patent: 4686962 (1987-08-01), Haber
Parabulbar Balloon to Augment a Failing Buckle; Lincoff, H and Kreissig, I.; Am. Journal of Ophthalmology 92; pp. 647-652, 1981.
Results With A Temporary Balloon Buckle For The Repair Of Retinal Detachments; Lincoff, H. and Kreissig, I.; Am. Journal of Ophthalmology 92; pp. 245-251, 1981.
Expandable Silicone Implants for Scleral Buckling; Huamote, F., Refojo, M. and Banuelos, A.; Arch Ophthalmol; 93: pp. 429-431, 1975.
Diagnostic Uses For A Unsecured Balloon Buckle; Lincoff, H. and Kreissi, I.; Mod. Probl. Ophthalmol; 20: pp. 157-163, 1979.
A Temporary Balloon Buckle For The Treatment of Retinal Detachment; Lincoff, H., Kreissig, I. and Hahn, Y. S.; Opthalmology 86: p. 586, 1979.
Expandable Silicone Implants for Scleral Buckling; I. Intro. of a New Concept; Banuelos, A., Refojo, M. F., Schepens, C. L., Arch Ophth. 89: pp. 500-502, 1972.
Expandable Silicone Implants For Scleral Buckling; II Experiments in Vitro; Arch Ophthalmol 90: pp. 127-130, 1973.
Die Balloon Operation; Eine Verlaufskontrolle; Kreissig, I. and Lincoff, H.; Fortschr Ophthalmol 79: p. 229, 1982.
A Fiberoptic Stylette for Localizing the Balloon Buckle; Lincoff, H.; Stergio, P. Kreissig, I.; Arch Ophthalmol 108:607, 1990.
Additional Indications for a Temporary Balloon Buckle; Lincoff, H. and Kreissig, I.; Trans. Ophthalmol; Soc. U.K.
Expandable Silicone Implants for Scleral Buckling; Huamote, F., Refojo, M. and Banuelos, A.; Arch Ophthalmol; 93: pp. 429-431, 1975.
Lewis William
Pellegrino Stephen C.
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