U.S. patent application number 12/895058 was filed with the patent office on 2011-09-01 for ophthalmic wound closure devices and methods.
Invention is credited to Edwin Ryan.
Application Number | 20110213386 12/895058 |
Document ID | / |
Family ID | 44505693 |
Filed Date | 2011-09-01 |
United States Patent
Application |
20110213386 |
Kind Code |
A1 |
Ryan; Edwin |
September 1, 2011 |
OPHTHALMIC WOUND CLOSURE DEVICES AND METHODS
Abstract
A method and device for wound closure is provided. One advantage
of wound closure devices and methods shown includes a simple and
inexpensive modified suture with increased pullout resistance to
close wounds in eyes and prevent leakage. Another advantage
includes a visualization tool to aid in locating the wound on the
eye.
Inventors: |
Ryan; Edwin; (St. Paul,
MN) |
Family ID: |
44505693 |
Appl. No.: |
12/895058 |
Filed: |
September 30, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61247818 |
Oct 1, 2009 |
|
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|
Current U.S.
Class: |
606/148 ;
606/228 |
Current CPC
Class: |
A61B 2017/00902
20130101; A61B 2017/06176 20130101; A61B 17/06166 20130101; A61F
9/007 20130101; A61B 17/04 20130101; A61B 17/0482 20130101 |
Class at
Publication: |
606/148 ;
606/228 |
International
Class: |
A61F 9/007 20060101
A61F009/007; A61B 17/04 20060101 A61B017/04 |
Claims
1. A suture, comprising: a number of unidirectional, pressed in,
side features to increase a pullout resistance of the suture along
a first direction; and a distal end protrusion to resist suture
pullout from a second direction opposite the first direction.
2. A suture, comprising: a portion of a suture, having a flattened
cross section; and a number of textured side features to increase a
pullout resistance of the suture.
3. The suture of claim 2, wherein the number of textured side
features includes a pressed in cross-hatch pattern.
4. The suture of claim 2, wherein the number of textured side
features includes a number of unidirectional features.
5. The suture of claim 2, wherein the number of textured side
features includes a number of spaced apart knots.
6. An ophthalmic wound visualization device, comprising: a
substantially transparent portion to place in contact with an eye
near an ophthalmic wound; a handle to apply pressure to the
substantially transparent portion; and a suture clearance cutaway
to facilitate insertion of a suture while the substantially
transparent portion is in contact with the eye.
7. The ophthalmic wound visualization device of claim 6, further
including one or more frictional protrusions on one side of the
substantially transparent portion.
8. The ophthalmic wound visualization device of claim 7, wherein
the frictional protrusions include a number of teeth.
Description
RELATED APPLICATION
[0001] This application claims the benefit of priority, under 35
U.S.C. Section 119(e), to Provisional Patent Application Ser. No.
61/247,818, filed Oct. 1, 2009 which is incorporated herein by
reference in its entirety.
TECHNICAL FIELD
[0002] This invention relates to wound closure devices and methods
to facilitate healing after an incision. Specifically, this
invention relates to wound closure devices and methods for use in
conjunction with ophthalmic surgery.
BACKGROUND
[0003] After some ophthalmic surgical procedures the small
incision, or wound, leaks after the surgical instrument is removed
from the incision. One common procedure to reduce or stop leakage
is to suture the incision. Knots tied in common suturing can be
uncomfortable for the patient, and can be difficult and tedious for
the surgeon. As with any difficult procedure there is some degree
of risk to the patient. It can also be difficult to see where the
wound is due to the small size of the wound.
[0004] What is needed is a device that aids in visualization of
ophthalmic wounds. What is also needed is a device an method to
reduce leakage through incisions following vitreous surgery that is
easier, and more reliable. What is also needed is a device an
method to reduce risk to the patient.
BRIEF DESCRIPTION OF THE DRAWINGS
[0005] FIG. 1A shows a portion of an ophthalmic procedure according
to an embodiment of the invention.
[0006] FIG. 1B shows another portion of an ophthalmic procedure
according to an embodiment of the invention.
[0007] FIG. 2 shows forming a suture according to an embodiment of
the invention.
[0008] FIG. 3A-3D show example sutures according to embodiments of
the invention.
[0009] FIG. 4 shows use of a suture according to an embodiment of
the invention.
[0010] FIG. 5 shows example sutures in place on a wound according
to embodiments of the invention.
[0011] FIG. 6 shows a visualization device according to an
embodiment of the invention.
[0012] FIG. 7 shows another visualization device according to an
embodiment of the invention.
[0013] FIG. 8 shows another visualization device according to an
embodiment of the invention.
[0014] FIG. 9 shows an example of an eye after a procedure using
devices and methods according to an embodiment of the
invention.
DETAILED DESCRIPTION
[0015] In the following detailed description, reference is made to
the accompanying drawings which form a part hereof, and in which is
shown, by way of illustration, specific embodiments in which the
invention may be practiced. In the drawings, like numerals describe
substantially similar components throughout the several views.
These embodiments are described in sufficient detail to enable
those skilled in the art to practice the invention. Other
embodiments may be utilized and structural, mechanical, logical
changes, etc. may be made without departing from the scope of the
present invention.
[0016] FIG. 1A shows a portion of a procedure utilizing wound
closure devices as described above. An eye 100 is shown. During a
procedure, a cannula 110 is inserted into the eye through an
incision 112 to reach a location 114 internal to the eye. Usually,
an instrument is inserted through the cannula 110 to the location
114 in order to perform the desired procedure. Examples of
instruments include, but are not limited to fiber optic probes,
laser guides, suction/cutting tools, forceps, scissors, etc.
[0017] During a procedure, if the instrument (not shown) is removed
from the cannula 110, a small plastic plug is inserted to control
leakage from the cannula. However at the end of the procedure, the
cannula 110 is removed. FIG. 1B shows the eye 100 as shown in FIG.
1A after removal of the cannula 110. A wound 120 is shown where the
cannula 110 passed through the sclera into the eye. In some
procedures, the wound 120 leaks, and requires closure. Various
configurations of devices are illustrated below to facilitate the
closure.
[0018] FIG. 2 shows a standard round cross section suture 210. In
the figure, one method of forming a modified suture is show. A
wheel 212 or pair of wheels 212, 214 are used to flatten the suture
210 and form modified suture 220. In one example, a plain gut
suture 210 is used. In one example, the flattening process provides
a modified cross section that will crinkle or otherwise fold over
on itself as it is drawn into tissue. The added friction of the
modified suture provides a pullout resistance without the need for
tying knots on the tissue. In one example the rolling process
further opens up a fiber structure within the suture and provides
increased surface area to further increase friction and/or pullout
resistance. In one example shown in FIG. 2, a pattern is pressed
into the suture 210 to form modifies suture 220 with the pattern
pressed into the suture 210 for added pullout resistance. An
example of a procedure using a modified suture as shown in FIG. 2
or other figures is discussed in more detail below.
[0019] FIG. 3A shows one example of a modified suture 310 according
to an embodiment of the invention. A number of features such as
one-way barbs 312 are shown on a side of the modified suture 310.
FIG. 3B shows another example of a modified suture 320 according to
an embodiment of the invention. A number of pressed features 322
such as knurls or other patterns are rolled into a surface of the
suture to form a flattened, patterned modified suture 320. FIG. 3C
shows another example of a modified suture 330 according to an
embodiment of the invention. A number of knots 332 are pre-tied at
various spacing along a length of the suture 330. The knots can be
easily tied before a procedure, away from a patient, or they can be
manufactured in place. Although knots 332 are described, other
protrusions such as formed knobs, etc. may take the place of knots
332. FIG. 3C shows another example of a modified suture 340
according to an embodiment of the invention. A number of features
such as one-way barbs 344 similar to those described in FIG. 3A are
shown. A knot 342 or other protrusion is also shown at a distal end
of the modified suture 340.
[0020] In selected examples such as modified sutures 320 and 330,
an increased friction is provided in any direction to increase
pullout resistance. In other selected examples such as modified
sutures 310 and 340, the increased friction or pullout resistance
is unidirectional. Barbs 312, 344 for example make the modified
sutures 310, 340 easy to insert in one direction, and hard to pull
back, once inserted.
[0021] In one example a biodegradable material is used for the
modified suture, such as plain gut suture. Other materials such as
PGA, etc. may also be used.
[0022] FIG. 4 shows an example procedure using a modified suture
according to an embodiment of the invention. A needle 410 is shown
pulling a modified suture 412, through a location in the middle of
a wound 402 in an eye 400. Although only one suture will be
sufficient in many cases, the invention is not so limited.
[0023] FIG. 5 shows examples of modified sutures such as those
shown in previous Figures. A first suture 510 is flattened to
provide increased pullout resistance, and is pulled in from one
side of a wound 502 in an eye 500 to the other side. No knot is
tied. Only the increased pullout resistance holds the modified
suture in place. Because ophthalmic wounds in such procedures do
not require large forces to hold them closed, the addition of
modified pullout resistance is enough to hold the modified sutures
in place without a knot. In procedures where the modified suture is
placed beneath the conjunctiva, the absence of a knot is more
comfortable for the patient. Further, the absence of a knot makes
the procedure much simpler for the surgeon to perform.
[0024] FIG. 5 also shows other examples of modified sutures in
place. Modified suture 520 is shown with unidirectional barbs on
side surfaces. Modified suture 530 shows a number of spaced knot to
provide the increased pullout resistance. Modified suture 540 shows
the unidirectional barbs in combination with a knot at a distal
end. The modified suture 540 is therefore easy to install, and
holds tight one in place due to the knot, and the barbs.
[0025] FIG. 6 shows a visualization tool that is used to view a
wound 602, and can be used by itself with standard suture
practices, or can be used in conjunction with modified sutures as
described above. The Figure illustrates a glass or plastic
transparent portion 610 and a handle 612. It can often be difficult
to visualize a small wound 602 due to fluids or blood present in
the area, and the wound 602 itself being normally closed without
any external pressure.
[0026] Using the visualization tool, pressure is put on the eye 600
in the general area of the wound 602. The pressure causes the
fluids and/or blood to move away from the wound 602, and makes the
wound 602 easier to visualize. Once the wound is located, the
surgeon can proceed with suturing.
[0027] FIG. 7 illustrates another example of a visualization tool
that is particularly useful with the modified sutures described
above. A transparent portion 710 is shaped thinner in the middle,
for example as an hourglass shape. The wound 702 in the eye 700 is
still visible as described in FIG. 6 above. However, due to the
thinner middle of the transparent portion 710, a modified suture
720 can easily be inserted to close the wound 702 without having to
remove the transparent portion 710. A needle 722 is shown pulling
in the modified suture 720. An optional handle 712 is shown to
better hold the transparent portion 710 and to put pressure on the
eye 700.
[0028] FIG. 8 shows another example of a visualization tool that is
particularly useful with the modified sutures described above. A
transparent portion 810 is shown with an optional handle 812.
Although an elongated handle 812 is illustrated, any number of
handle configurations are within the scope of the invention.
Likewise, a rectangular shape of the transparent portion 810 is
shown, however shapes such as an hourglass shape described above,
or other shapes are within the scope of the invention.
[0029] A number of teeth 814 or other frictional protrusions are
shown on surface of the transparent portion 810 that is to be
adjacent to the eye. By using teeth 814, a surgeon may grip the
sclera of the eye with one hand to prevent rotation of the eye and
aid in visualizing the wound simultaneously while the sutures are
being placed with the other hand. The ability to grip the sclera is
particularly useful in embodiments described above because of
increased friction of the sutures in selected embodiments.
[0030] FIG. 9 shows an example of an eye 10 days after a procedure
as described above. Arrow 902 indicates the wound, while arrows 904
indicate sutures placed as described above.
[0031] Using embodiments described above, a number of advantages
are realized. One advantage of wound closure devices and methods
described above includes a simple and inexpensive alternative to
knot tying after suturing to prevent leakage. Another advantage
includes a biocompatible material that degrades over time to allow
healing of the incision. Although suture procedures involving the
eye are disclosed, any other suture location would benefit from the
devices and methods disclosed.
[0032] Although selected advantages are detailed above, the list is
not intended to be exhaustive. Although specific embodiments have
been illustrated and described herein, it will be appreciated by
those of ordinary skill in the art that any arrangement which is
calculated to achieve the same purpose may be substituted for the
specific embodiment shown. This application is intended to cover
any adaptations or variations of the present invention. It is to be
understood that the above description is intended to be
illustrative, and not restrictive. Combinations of the above
embodiments, and other embodiments will be apparent to those of
skill in the art upon reviewing the above description. The scope of
the invention includes any other applications in which the above
structures and fabrication methods are used. The scope of the
invention should be determined with reference to the appended
claims, along with the full scope of equivalents to which such
claims are entitled.
* * * * *