DEVICES AND METHODS TO PROVIDE HANDS FREE SCLERAL DEPRESSION AND ILLUMINATION DURING OPHTHALMIC PROCEDURES
The devices and methods of the present invention provide a means to depress the sclera in such a fashion as to provide single point, multiple point, semicircular or 360° circumferential scleral tissue depression and light without the need for manual manipulation of the scleral depressor. The device comprises a shaped depressor for insertion between the sclera and the orbit of the eye and a holding means for positioning the depressor. In some embodiments the device can be integrated with a speculum. Use of the device eliminates the need to have a second person manipulate the depressor during the procedure and directly enables bimanual surgery.
1 . A device for scleral depression comprising:
a solid depressor having a constant thickness of from 2 mm to 8 mm, a height of from 2 mm to 8 mm, a fixed arc length of between 30 and 360 degrees, sized to fit in a fornix;
a vertical arm having a length between 6 and 14 mm attached to the depressor; and
a handle attached to the vertical arm for holding the depressor in position in the fornix on of an eye;
wherein the depressor is shaped to follow a general curvature of a globe of the eye, and wherein the depressor further comprising a light guide for applying light to an outside of a sclera of the eye, at, or along areas of depression, such that the light is visible inside the globe of the eye and is used to illuminate anatomical features inside the eye; and
wherein the depressor once positioned in the fornix, remains in position until removed and creates a fixed predetermined scleral depression along an arc between 30° and 360° along the fornix of the eye.
2 . The device of claim 1 wherein the light guide connects to an external light source.
3 . The device of claim 1 wherein the light guide further comprises a light source.
4 . The device of claim 1 wherein the light guide serves as the handle.
5 . The device of claim 3 wherein the light source comprises at least one light inside the depressor.
6 . The device of claim 5 wherein the at least one light is incandescent, fluorescent or LED.
7 . (canceled)
8 . The device of claim 3 wherein the light source is a single light source.
9 . The device of claim 3 wherein the light source comprises a plurality of light sources.
10 . The device of claim 1 wherein the depression is applied to at least one point on a circumference of the globe of the eye.
11 . The device of claim 10 wherein the depressor covers an arc from 30-135 degrees and is from 4-5 mm in thickness.
12 . The device of claim 10 wherein the depressor covers an arc from 80-120 degrees.
13 . The device of claim 10 wherein the depressor covers an arc of 90 degrees.
14 . The device of claim 1 in which the device is designed to interface with a lid speculum in order to maintain the desired device position within the fornix.
15 . (canceled)
16 . (canceled)
17 . The device of claim 1 wherein the vertical arm for holding the depressor is a circumferential ring, or portion thereof, intended to rest on the outside of the sclera around the eye having at least one opening in the ring for holding a depressor.
18 . The device of claim 1 in which the depressor has a constant or a fixed variable cross section.
19 . (canceled)
20 . (canceled)
21 . (canceled)
22 . (canceled)
23 . (canceled)
24 . (canceled)
25 . (canceled)
26 . (canceled)
27 . The device of claim 1 for providing scleral depression by use of an inflatable member.
28 . The device of claim 27 in which the inflatable member is a hydrostatically or pneumatically inflatable member which provides semicircular (180° or less) scleral depression.
29 . The device of claim 28 in which the inflatable member is selectively inflatable to achieve a range of depth of the scleral depression.
30 . The device of claim 28 in which the inflatable member has a fixed outer diameter.
31 . The device of claim 28 further comprising a rigid, semi-rigid or flexible internal element within the inflatable member to aid in placement, removal and provision of internal structure of the inflatable member.
32 . (canceled)
33 . (canceled)
34 . (canceled)
35 . (canceled)
36 . (canceled)
37 . (canceled)