Tomsk scientists are designing a surgical device for the mechanical destruction of a lens which will help to conduct less traumatic surgeries on cataract extraction.
Nowadays there are expensive and mostly imported devices in the market which destroy opaque lenses by ultrasound or laser. Both means have their own disadvantages: the ultrasonic wave affects not only the lens, but also surrounding tissues, and laser exposure can lead to burning of ocular tissues without grinding the lens to the required degree.
“The idea of creating of a mechanical phakoaspirator was suggested by Igor V. Zapuskalov in the 1990s. The very first version of the device wasn’t efficient enough. Then, the construction and the principle of the device’s operation was changed, and now we optimize the construction taking into account the gained experience,” says Ekaterina Ivanova, a postgraduate student at Siberian State Medical University’s Department of Ophthalmology.
The device on which specialists from SSMU, the ophthalmological clinic of Zapuskalov and the Scientific Development and Production Center “Tomsk Medical Instrument” and Tomsk Polytechnic University (TPU) are working, is a handle where a mechanism of nucleus destruction along with an aspiration system, removing the destroyed lens, are located. The device is powered by an electric motor.
The mechanism of nucleus destruction is a disposable needle with a new functional principle. If we have an aspiration needle in the currently existing ultrasonic handles making longitudinal movements, thus grinding lenses’ dense structure, then in the mechanical phakoaspirator the needle makes mechanical side motions (without a back-and-forth component) which gives a “cutting” effect without making repulsion force. The needle is inserted into the eye through a micro incision (1.2-1.5 mm), the mechanism destroys the opaque lens and removes the lens masses by means of the aspiration system. Then, the needle is removed, and an intraocular lens is implanted through the same incision. Depending on the surgeon’s experience, the operation lasts from 7 to 45 minutes and is less traumatic for the eye.
The handle itself resembles a manipulator of a device for an ultrasonic cataract phakoemulsification – it is a convenient and ergonomic device which can be held by a surgeon in one hand.
“The cooperation of a handle destructive device and an aspiration system is still being worked on in order to make the operational process convenient and efficient. Definite characteristics like infusion speed, vacuum size and the speed of fluctuations could be controlled by a surgeon with a help of a foot-switch,” Ekaterina Ivanova added.
Now scientists are working on the improvement of a prototype of a phakofragmenter. Doctors expect that the device will bring about an increase in the affordability of ophthalmological assistance for the population by means of cost reduction and increasing the quality of operations. Moreover, it can be used in rural hospitals, in inpatient and outpatient departments. Currently, there are no analogues of mobile mechanic surgeon complexes registered and applied practically for pharmofragmentation.
“Soon we will test the new version of a device – first on animals, and then with the involvement of volunteers with cataracts. Provided that there is enough money for financing, this job will require about two years,” specified the representative of SSMU.
The device is registered. The independent research and development work was conducted under the auspices of automatization and robotisation in TPU’s machinery department by associate professor Alexey Gavrilin in cooperation with Professor Igor Zapuskalov as the client for the invention.
Cataracts are one of the most widely spread eye diseases among the elderly, but it also happens among patients of all ages. During cataract formation, a fragmentary or complete opacity of an eye’s lens occurs, it loses its transparency. Just a small amount of sun rays get into an eye, which is why eyesight worsens, and a person sees partially and blurred. Over the years, the disease progresses: the opaque area increases, the lens becomes dense and the vision becomes worse. If untreated at the appropriate times, a cataract can lead to blindness. In addition, in recent years surgeries on transparent lens exchange on intraoccular lenses with a refraction purpose are being practiced. In other words, it is done for the correction of myopia and far-sightedness for people who are unsuitable for other kinds of operations.