NIIOS - NIIOS Portfolio

NIIOS Portfolio

The NIIOS designed and developed various surgical techniques and medical devices products for use in ophthalmology. These concepts may be catagorized as outlined below.

I. Vital dyes for intraocular use

Since the normal eye is basically a globe filled with fluid, intraocular structures are usually surgically approached in a ‘watery’ environment. Considering the eye’s purpose to transfer and refract incoming light, quite a few tissues are transparent by nature. Submerged, transparent tissue structures with a refractive index close to water are barely visible. In ophthalmology however, a clear visualization and discrimination of tissues is often the key to uncomplicated surgical manouvres. Therefore, the NIIOS R&D introduced several techniques to enhance the visualization of intraocular structures by the use of vital dyes. This NIIOS research field has been so promising that these staining procedures are now routinely used throughout the world.

I.1 – Trypan blue anterior lens capsule staining (VisionBlueTM; VisionBlueTM 0.06%Trypan blue Ophthalmic Solution)
I.2 – Trypan blue epiretinal membrane staining (MembraneBlueTM)
I.3 – Trypan blue stained viscoelastic (ViscoBlueTM)

II. Advanced surgical techniques for corneal transplantation

Since the 1930s, the golden standard for corneal transplantation has been penetrating keratoplasty (PK), ie. a full-thickness graft by which all corneal layers are replaced. Although an improvement of the best corrected visual acuity may be achieved in a majority of cases, PK surgery is frequently complicated by high astigmatism (irregular corneal contour), suture-related problems and late wound dehiscence. Thus, the concept of PK surgery may be considered clinically unacceptable. Since most often only a particular layer of the cornea is affected, the NIIOS R&D introduced various concepts to visualize various corneal layers during surgery, and surgical techniques to selectively replace these layers. This NIIOS research field has been so promising that advanced techniques for lamellar corneal transplantation have changed the consensus for management of corneal disorders rendering PK surgery now obsolete for leading corneal surgeons.

II.1 Deep anterior lamellar keratoplasty (DALK)

II.2 Posterior lamellar keratoplasty (PLK)

II.2.a - Mushroom- / Hat- / Double punch keratoplasty
II.2.b - Deep lamellar endothelial keratoplasty (DLEK)
II.2.c - ‘Small incision’ deep lamellar endothelial keratoplasty (small incision DLEK)
II.2.d - Descemet stripping endothelial keratoplasty (DSEK)
II.2.e - Descemet membrane endothelial keratoplasty (DMEK)

III – Alternative surgical settings and logistics

(Micro)surgical procedures are currently performed under sterile conditions in a fully equiped operating theatre. The rationale for using an operating theatre is that sterile air conditioning – apart from sterile instrumentation, draping and clothing – provides an environment with a minimal bacterial load, so that the risk of postoperative infections is also minimized. The NIIOS R&D showed that the efficacy of a ceiling based air plenum, a so called ‘laminar downflow’ may be overestimated. In microsurgical procedures, no effective sterile air flow may be achieved over the surgical field and the instrument tables, because the air flow is disrupted by heat sources, blocked by the operating microcope and it passes the head-neck area of the surgical team. To overcome these flaws, a Surgical Intervention Unit was designed and developed.

III.1 Surgical Intervention Unit (SurgiCubeTM)

IV. Miscellaneous

IV.1 – Donor cornea suspension device (CorneaClawTM)
IV.2 – Cosmetic extraocular implant (JeweleyeTM)

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Products

Tissues & Bioimplants