Devices and methods to provide hands free scleral depression 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 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 180 degrees, sized to fit in a fornix; and
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 of an eye;
wherein the depressor is shaped to follow a general curvature of a globe of 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 180° along the fornix of the eye.
2. The device of claim 1 wherein the depressor comprises a first end having a portion sized for fitting in between a sclera and an orbit of the eye.
3. The device of claim 1 wherein the handle is at least partially circular.
4. The device of claim 1 wherein the depressor covers an arc from 120-135 degrees and is from 4-5 mm in thickness.
5. The device of claim 1 which provides for the scleral depression in a temporal, nasal, superior or inferior regions of the eye.
6. The device of claim 1 in which the depressor has a constant or a fixed variable cross section.
7. The device of claim 1 for providing scleral depression by use of an inflatable member.
8. The device of claim 7 in which the inflatable member is a hydrostatically or pneumatically inflatable member which provides semicircular (180° or less) scleral depression.
9. The device of claim 7 in which the inflatable member is selectively inflatable to achieve a range of depth of the scleral depression.
10. The device of claim 7 in which the device is designed to interface with a lid speculum in order to maintain the fixed predetermined scleral depression within the fornix.
11. The device of claim 1 in which a level of depression is varied by interchanging different sized depressors.
12. The device of claim 1 in which the depressor can deliver at least one drug delivered via immediate or controlled release wherein the drug is contained within at least one of the depressor, a surface of the depressor, or a sleeve placed on the depressor.
13. The device of claim 1 wherein the device is integrated into an eyelid speculum.
14. The device of claim 1 further comprising a means for applying light to an outside of a sclera, 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.
15. A kit for hands free scleral depression comprising the device of claim 1 having more than one size of the device.