Patent Application
20230337983
This application claims priority to Chinese Patent Application No. 202210432869.8, filed on Apr. 24, 2022, the content of all of which is incorporated herein by reference.
The present disclosure relates to the technical field of medical devices, in particular to an intraocular pressure (TOP) sensor.
As the first irreversible blindness disease in the world, glaucoma seriously affects people's quality of life. Intraocular pressure is always an important indicator for glaucoma condition, which is of vital importance to the diagnosis and postoperative observation by doctors.
At present, the measurement of TOP is mainly indirect measurement, which is used to measure corneal deformation mainly by utilizing various sensing principles, such as Imbert-Fick principle, electromagnetic induction probe rebound principle and PASCAL principle and then obtain the value of TOP by utilizing the relationship between corneal deformation and TOP. A comparative analysis on the currently commonly used TOP detection equipment is hereby made.
In 1954, Goldmann, an American, designed the Goldmann applanation tonometer (GAT). At present, GAT is regarded as the tonometer with the highest measurement accuracy and is the internationally recognized “gold standard” for TOP measurement, whose measurement results often serve as a standard for clinically measuring the accuracy of other tonometers. In order to avoid the decrease of TOP caused by indentation, measure only once and record the results. Although the measurement of GAT is accurate, it cannot be widely used in clinical practice due to the need for topical anesthesia, the need for patients to have certain cooperation ability, and the high technical requirements for examiners.
At present, ICare rebound tonometer (RBT) is a popular handheld tonometer in the market, which is newly developed based on the theory of inductive rebound proposed by Antti Kontiola. For each measurement, patients need to adjust the probe to the appropriate distance from the cornea, take the correct sitting position, look ahead and fully relax. The accuracy of RBT measurement results has great relevance to the proficiency of the operator, operation method and the location where the single-use probe hits the cornea.
NCT is one of the most widely used tonometers in clinical practice in China, which, together with GAT, falls into the scope of applanation tonometers. NCT is suitable for large-scale census and outpatient owing to simple operation, good repeatability for repeated measurements and easy acceptance by patients. However, it's not suitable for the measurement of TOP in patients with high astigmatism, corneal opacity and poor fixation, and patients having received corneal transplantation. In addition, studies have shown that the stability of NCT in the measurement of high TOP area is low, and since NCT is a large bench device, patients can only be measured in sitting position. Therefore, NCT is not suitable for patients with mobility difficulties and elderly patients.
Triggerfish CLS is a contact-type TOP sensor. When TOP of human is changed, the corneal curvature will be changed, which is the physiological characteristic of human eye serving as the basis for the design of Triggerfish CLS. The biggest advantage of Triggerfish CLS is non-invasive continuous monitoring for simple, fast and convenient operation. However, it also has the significant disadvantage that it can only provide the relative change of TOP but not the absolute TOP, which causes inconvenience for the diagnosis of doctors. In addition, Triggerfish CLS has a certain impact on the field of view when being worn for the presence of built-in induction coil, chip, etc.
At present, the above products are commonly used tonometers in clinical practice, all of which have the disadvantages of incapability of continuous measurement or low measurement accuracy.
The technical problem to be solved by the present disclosure is as follows: In order to solve the problem that tonometers in the prior art can be only used for single measurement or have low measurement accuracy, the present disclosure provides an IOP sensor intended to be implanted into the anterior chamber of eyes for continuous detection of IOP, with direct measurement method and high measurement accuracy, which solves the problem that tonometers in the prior art can be only used for single measurement, and improves the accuracy of measurement results.
The technical scheme adopted by the present disclosure to solve the technical problem is as follows. The IOP sensor includes a transmission film component, which is in direct contact with intraocular aqueous humor and configured to sense pressure fluctuations in the intraocular aqueous humor; a reflective film component set on an inner side of the transmission film component; and an adhesion layer component set on an inner layer of the reflective film component and configured to connect to an attachment device. An enclosed space formed by the reflective film component and the transmission film component constitutes a resonance chamber, which is filled with a filling medium. When a pressure in the intraocular aqueous humor is changed, the transmission film component is deformed, resulting in a change in a near-infrared (NIR) spectrum reflected by the reflective film component; the TOP is detected according to the change of the NIR spectrum.
In some embodiments, the transmission film component, the reflective film component and the adhesion layer component are made of light curing materials.
In some embodiments, the outer surface of the transmission film component has a surface plasmon structure.
In some embodiments, the surface plasmon structure is a lattice or boss structure.
In some embodiments, the reflective film component is provided with a total reflection structure.
In some embodiments, the total reflection structure is in pyramid array.
In some embodiments, the reflective film component is made of the material with high refractive index greater than 1.5.
In some embodiments, the material with high refractive index is doped with inorganic nanoparticles.
In some embodiments, the inorganic nanoparticles are selected from at least one of Ge, Bi, SiN and SiO2.
In some embodiments, the filling medium is liquid or gas.
In some embodiments, the liquid is selected from any one of uncured light curing material (i.e., a light curing material that has not been cured) or glycerin; the gas is selected from any one of air, oxygen and inert gas.
In some embodiments, when the filling medium is not made of the uncured light curing material, the adhesion layer component is provided with a blocked drainage hole.
The present disclosure has the following beneficial effects: the IOP sensor provided by the present disclosure is simple in structure and convenient in operation, and has the ability of continuous non-invasive detection of IOP. The sensor is intended to be implanted into the anterior chamber of patients' eyes to directly measure the pressure of anterior aqueous humor by utilizing the principle of multibeam interference according to the change in pressure difference between the aqueous humor and the filling medium, which, on the one hand, reflects the real IOP of patients and improves the accuracy of measurement results, and on the other hand, enables patients to conduct self-detection at any time without the operation of doctors and solves the problem that tonometers in the prior art can be only used for single measurement, thus improving the comprehensive performance of the IOP sensor.
The present disclosure is further explained in combination with the drawings and embodiments.
The present disclosure is hereby further described in detail. The embodiments described below are exemplary, which are intended to explain the present disclosure and cannot to be construed as limitations to the present disclosure. Based on the embodiments of the present disclosure, all other embodiments obtained by ordinary technicians in the field without creative work fall within the scope of protection of the present disclosure.
In order to solve the problem that tonometers in the prior art can be only used for single measurement or have low accuracy, the present disclosure provides an TOP sensor, as shown in
During use, the TOP sensor can be implanted into the anterior chamber of the patient's eye to make the transmission film component come into contact with the aqueous humor in the eye, so that the intraocular aqueous humor and the filling medium are located on both sides of the transmission film component. When the pressure of the aqueous humor in the eye is changed, the pressure difference between the filling medium in the resonance chamber and the aqueous humor in the eye will also be changed due to the constant pressure of the filling medium in the chamber, which causes deformation of the transmission film component, thus resulting in the change of the thickness of the resonance chamber, that is, the distance between the transmission film component and the reflective film component and the change of reflection spectrum. As shown in
The transmission film component constitutes the external profile of the TOP sensor, and the transmission film component, reflective film component and adhesion layer component are all of annular structure. The adhesion layer component has an internal columnar cavity. The specific structure and size can be set according to demand.
The TOP sensor provided by the present disclosure is simple in structure and convenient in operation, and has the ability of continuous non-invasive detection of TOP. The sensor is intended to be implanted into the anterior chamber of the patient's eye to directly measure the pressure of anterior aqueous humor by utilizing the principle of multibeam interference according to the change in pressure difference between aqueous humor and a filling medium, which, on the one hand, reflects the real TOP of patients and improves the accuracy of measurement results, and on the other hand, enables patients to conduct self-detection at any time without the operation of doctors and solves the problem that tonometers in the prior art can be only used for single measurement, thus improving the comprehensive performance of the TOP sensor.
Although the existing Triggerfish CLS can also be used for continuous monitoring of IOP, it cannot be implanted and may affect patients' field of view when being worn. Moreover, the TOP sensor is used for measuring TOP according to the change of corneal curvature with the change of the TOP, which cannot be used for direct measurement of TOP, with low accuracy of measurement results.
The TOP sensor provided by the present disclosure can be used not only for continuous measurement but also for direct measurement of TOP, which improves the accuracy of measurement results, thereby improving the comprehensive performance of the TOP sensor.
The TOP sensor provided by the present disclosure can be manufactured by such methods as light curing micro-nano printing, gas phase precipitation, mold forming, and two-photon printing, which is preferred for integrated printing molding for the present disclosure. The transmission film component, the reflective film component and the adhesion layer component are preferably made of light curing material, which can be any light curing material in the prior art suitable for implantation in the patient's eye, such as the material made by curing with light-cured resin, the material made by curing with light-cured resin and monomer, or the material made by curing with various light-cured resins.
In order to improve the sensitivity of detection, the external surface of the preferred transmission film component is of surface plasmon structure for the present disclosure to increase the amplitude of reflected light.
The surface plasmon structure is a lattice or boss structure which can be nano-gold lattice formed by gold printing.
In order to ensure the detection effect, the diameter range of each dot in the lattice structure preferred for the present disclosure is 300 nm to 800 nm, and the lattice range corresponds to the position of the reflective film component.
In order to further improve the sensitivity of detection, the reflective film component preferred for the present disclosure is designed with a total reflection structure to enhance the reflection ability, so as to improve the sensitivity of detection.
The total reflection structure preferred for the present disclosure is in pyramid array.
For the IOP sensor provided by the present disclosure, the refractive index of the reflective film component can also be increased by choosing a material with high refractive index for it, so as to improve the sensitivity of detection. Specifically, the material with high refractive index for the present disclosure refers to the material whose refractive index is greater than 1.5.
In order to further improve the refractive index, the material doped with inorganic nanoparticles is preferred for the reflective film component in the present disclosure, and the material doped with inorganic nanoparticles with high refractive index is more preferred. The inorganic nanoparticles can be selected from at least one of Ge, Bi, SiN and SiO2.
The filling medium in the resonance chamber in the present disclosure can be any liquid or gas that can exist stably in the resonance chamber for the convenience of measuring the change of aqueous humor pressure in the eye.
When the filling medium is a liquid, the liquid may be selected from either an uncured light-curing material or glycerol; when the filling medium is a gas, the gas can be selected from any one of the air, oxygen and inert gas.
Specifically, the uncured light-curing material can be an uncured light-curing material for printing the overall structure of the TOP sensor, that is, a printed material.
Specifically, as a certain amount of fluid is needed to serve as the filling medium in the resonance chamber, a certain amount of printing material may be retained in the resonance chamber in the printing process of the TOP sensor. The printing material is the uncured light curing material, which can directly serve as the filling medium.
If a fluid other than the printing material, such as glycerin, air or inert gas, is selected as the filling medium, it is necessary to set a drainage hole on the adhesion layer component to be connected with the resonance chamber in the manufacturing process of the TOP sensor for discharging the printing material retained in the resonance chamber in printing process and for filling required filling medium into the resonance chamber. The diameter range of the drainage hole preferred for the present disclosure is 10 μm to 50 μm.
Besides, after filling the filling medium into the resonance chamber, it is also necessary to seal and block the drainage hole to have it disconnected with the resonance chamber. To be specific, the drainage hole can be blocked by making a cylinder matching the inner cavity of the adhesion layer component and externally painted with a photosensitive adhesive to be inserted into the inner cavity of the adhesion layer component and fitted closely with the inner cavity of the adhesion layer component by aid of light. The cylinder inserted into the adhesion layer component can be extended axially beyond the TOP sensor, while the extended part can be secured on the tissue.
The overall structure of the TOP sensor in the present disclosure can be of prism, cylinder and other geometric structure. One structure for the TOP sensor is as follows: the front segment is cylindrical, with a diameter of 250 μm to 500 μm, a wall thickness of 50 μm to 100 μm, and a length of 250 μm to 1000 μm; the middle segment is polyhedral or cylindrical, with the envelope of polyhedral edge located in the external profile of the front segment and spaced 2 μm to μm apart; the end segment is of round table structure with a certain gradient, whose large end is in contact with the middle segment, with a wall thickness of 50 μm to 100 μm, a height of 250 μm to 1000 μm, and a slope of 5° to 30°; the reflective film component is polygonal with single feature or of a closed structure formed by feature polygons. Another structure for the TOP sensor is as follows: The TOP sensor has an external square cylinder structure and an internal cylindrical cavity. See the above descriptions for specific sizes.
The TOP sensor provided by the present disclosure is small in size and can be implanted into the eye through minimally invasive surgery with little damage to human body.
For embodiment, of the existing TOP sensors, EYEMATE is an implantable TOP sensor for in situ measurement. The sensor is equipped with a special integrated chip (MEMS-ASIC) and integrated with an antenna, an induction coil, etc., which can directly sense TOP through the pressure sensor and wirelessly transmit the TOP data. The sensor power supply powers the sensor under the principle of magnetic induction. The encapsulated EYEMATE has an inner diameter of 7 mm and outer diameters of 11.3 mm, 11.7 mm and 12.1 mm. ASIC has a thickness of 0.9 mm, or otherwise 0.5 mm around the microcoil. Its surface is in lenticular round shape for smoothly accommodating the curved sclera shape. The second-generation EYEMATE is structurally improved compared with the first-generation EYEMATE, with the size of 7.5×3.3 mm, the peripheral thickness of 0.9 mm, and the central thickness of 2.2 mm. Due to its large size, EYEMATE needs to be surgically implanted, which brings a certain risk of infection and inconvenience for replacement and maintenance if it's damaged.
Compared with the existing EYEMATE TOP sensor, the TOP sensor provided by the present disclosure is reduced in size by 1 to 2 orders of magnitude, which can be implanted into the eye by minimally invasive method to reduce the harm to human body.
In addition, the TOP sensor provided by the present disclosure can also be connected with a drainage device with the function of drainage of aqueous humor through the attachment device to make the TOP sensor highly scalable.
In order to make the above purposes, characteristics and advantages of the present disclosure more obvious and easily understandable, the specific embodiments of the present disclosure are explained in detail in combination with the drawings below.
The embodiment provides an TOP sensor suitable for minimally invasive implantation into the anterior chamber of the patient's eye, as shown in
The TOP sensor in the embodiment is printed integrally by two-photon printing technology, and the filling medium in the resonance chamber is printing material, with no need for drainage hole.
The embodiment provides an IOP sensor suitable for minimally invasive implantation into the anterior chamber of the patient's eye, as shown in
As shown in
Detection Example
In the detection example, the IOP sensor provided in Embodiment 1 is used for detection according to the detection method shown in
The specific calculation process of IOP is as follows:
According to the calculation formula of the cavity length (resonance cavity thickness) of Fabry-perot (F-P) Cavity: fsr=λ2/2 nL.
Wherein, fsr is the distance between two troughs; λ is the mean wavelength between two troughs; n is the refractive index of the filling medium; and L is the thickness of the resonance cavity. The characteristic cavity thickness of the resonance cavity is calculated according to the spectral analysis results in
Inspired by the above ideal embodiments according to the present disclosure, the relevant staff can make various changes and modifications without deviating from the technical idea of the present disclosure based on the above descriptions. The technical scope of the present disclosure is not limited to the contents in the specification, and the technical scope must be determined according to the scope of the claims.
| Number | Date | Country | Kind |
|---|---|---|---|
| 202210432869.8 | Apr 2022 | CN | national |
