WO2003057101A1 - Expanding punctum plug - Google Patents

Expanding punctum plug Download PDF

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Publication number
WO2003057101A1
WO2003057101A1 PCT/FR2002/004530 FR0204530W WO03057101A1 WO 2003057101 A1 WO2003057101 A1 WO 2003057101A1 FR 0204530 W FR0204530 W FR 0204530W WO 03057101 A1 WO03057101 A1 WO 03057101A1
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WO
WIPO (PCT)
Prior art keywords
meatic
expansion
nail
cylindrical body
nail according
Prior art date
Application number
PCT/FR2002/004530
Other languages
French (fr)
Inventor
Philippe Tourrette
Pascal Bernard
Vincent Raquin
Jérôme LEBLANC
Original Assignee
Ioltechnologie-Production
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ioltechnologie-Production filed Critical Ioltechnologie-Production
Priority to AU2002364336A priority Critical patent/AU2002364336A1/en
Publication of WO2003057101A1 publication Critical patent/WO2003057101A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00772Apparatus for restoration of tear ducts

Definitions

  • the present invention relates to a meeat expansion nail used for filling a lacrimal meatus of a human eye.
  • this invention relates to a device for closing a lacrimal meatus.
  • This type of obturation device is commonly used in the pathology known as dry eyes, which corresponds to an insufficient production of lacrimal fluid by the lacrimal glands and results in insufficiently hydrated eyes, which causes unpleasantness in the patients concerned.
  • the usual treatment consists in regulating the natural evacuation of the lacrimal fluid by the upper and lower lacrimal ducts, being in the corner of each eye on the nasal side, thanks to the introduction of a obturation device making it possible to stop the evacuation of tear fluid.
  • This device is made of thermosensitive acrylic so that when it is placed above its glass transition temperature, it softens and deforms isovolumically.
  • this device When this device is placed in the lacrimal meatus, it responds to the increase in temperature and expands in width to adapt to the size and shape of the lacrimal meatus or the canaliculus.
  • the flange keeps the meatic nail in position so that it cannot slide inside the canaliculus, while the holding and positioning element makes it possible to prevent the meatic nail from coming out of the canaliculus.
  • This meatic nail consists of a hydrogel coated with a hydrophobic material, such as silicone.
  • the hydrogel can expand between a dehydrated state and a hydrated state, especially when placed inside the lacrimal meatus.
  • the positioning of such a meatic nail inside the canaliculus is hampered by the holding and positioning element which forms a large projection at the insertion end of the meatic nail in the canaliculus.
  • the object of the present invention is to solve the aforementioned drawbacks and to propose a meeatic nail the introduction of which into the lacrimal meatus is facilitated and the holding in position is particularly reliable.
  • the present invention thus relates to a meeat expansion nail for closing a lacrimal meatus of a human eye comprising a substantially cylindrical body comprising at a first end a flange and formed of a first material with a coefficient of zero or moderate expansion.
  • the cylindrical body comprises at a second end a portion formed of a second material with an expansion coefficient greater than the zero or moderate expansion coefficient of said first material.
  • this second portion greatly increases in volume so as to thus constitute a bulb making it possible to block the meatic nail in position.
  • this bulb is housed behind the sphincter of the lacrimal meatus and thus prevents any migration of the nail to the outside.
  • the cylindrical body has no protuberance in its second end corresponding to its insertion end inside the lacrimal meatus, so that the introduction of this meeatatic nail can be carried out easily, without having to dilate the canaliculus.
  • said portion formed of a second material is inserted inside a housing formed of said first material and constituting said second end of the cylindrical body.
  • the wall of the housing formed of the first material with a zero or moderate expansion coefficient can expand under the effect of the pressure exerted by the portion of second material inserted inside the housing and adapted to expand strongly.
  • the meatic nail comprises a longitudinal orifice in the cylindrical body, opening on the one hand at the first end of the cylindrical body, in the flange, and on the other hand, in the portion formed by 'a second matter.
  • This longitudinal orifice thus forms a channel adapted to conduct the tear fluid naturally present in the eye to the portion of second material capable of expanding in the presence of water.
  • this portion is made of hydrophilic acrylic with high water content suitable for expanding in the presence of water, so that the expansion of this portion and thus the expansion of the second end of the cylindrical body of the nail can be easily obtained from the positioning of this nail in the canaliculus, under the effect of the naturally present tear fluid.
  • FIGS. 1a and 1b illustrate a meatic nail according to a first embodiment of the invention, before and after expansion of this nail;
  • FIG. 2a and 2b illustrate a meatic nail according to a second embodiment of the invention, before and after expansion of this nail
  • - Figures 3a and 3b illustrate a meatic nail according to a third embodiment of the invention, before and after expansion of this nail.
  • This meatic nail comprises a substantially cylindrical body 10 comprising at a first end 10a a flange 11.
  • This cylindrical body 10 extends in its longitudinal direction along an axis A.
  • This cylindrical body 10 is further drilled in its longitudinal direction A so that it comprises a longitudinal orifice 12, also of cylindrical shape, which opens out from the body 10 at its first end 10a, in the collar 11.
  • This longitudinal orifice 12 is extended, in the direction of a second end 10b of the cylindrical body 10 by a housing 13.
  • This housing 13 thus extends between the longitudinal orifice 12 and the closed end 10b of the cylindrical body 10.
  • a portion of material 14 is inserted inside this housing 13, thus constituting with this housing a second end 10b of the cylindrical body 10.
  • the longitudinal orifice 12 opens into the portion 14 housed inside the housing 13.
  • this end 10b of the body 10 is rounded and of substantially hemispherical shape at the end of the cylinder 10.
  • the cylindrical body 10 and the flange 11 are formed from a first material, different from a second material constituting a portion 14 inserted inside the housing 13.
  • a hollow nail can be made from a first material and then place an insert made from a second material inside the nail.
  • These two materials constituting the meatic nail are notably different in terms of expansion coefficient.
  • the first material, constituting the cylindrical body 10 at the collar 11, has a coefficient of zero or moderate expansion, while the second material of the portion 14 has a high coefficient of expansion, and in any event greater than the coefficient of zero or moderate expansion of the material.
  • the portion 14 is made of hydrophilic acrylic with a high water content suitable for expanding in the presence of water, while the cylindrical body and the collar 11 are made of silicone.
  • hydrophilic acrylic with a high water content typically has a water content greater than 38% by weight. It thus has a high expansion coefficient, greater than or equal to 25% by volume.
  • this hydrophilic acrylic may be a copolymer of hydroxyethyl methacrylate (HEMA), and of vinylpyrrolidone.
  • This hydrophilic acrylic copolymer thus has the advantage of being able to expand in the presence of water so that its water content in the hydrated state can be of the order of 70% by weight.
  • the HEMA copolymers sold under the following trade names can be used:
  • Coefficient of linear expansion 1.52 These compounds thus have linear expansion coefficients between 1.19 and 1.52 (that is to say that a diameter initially having a dimension of 0.3 mm, has, after expansion in the presence of water, a dimension may be between 0.35 and 0.45 mm)
  • the wall of the housing 13, made of silicone, can have a considerable mechanical resistance which, while expanding under the effect of the pressure exerted by the portion 14 during of its expansion, prevents maximum expansion of this hydrophilic acrylic, as illustrated in Figure 1b.
  • the lacrimal liquid can penetrate inside the cylinder 10 and come into contact with the portion 14 in order to hydrate this portion and cause it to swell.
  • the variation in volume of this hydrophilic material is also accompanied by a variation in hardness of this portion 14.
  • the meatic nail is hard in the dry and dehydrated state, and flexible in the hydrated state. This relative hardness of the meatic nail before hydration makes it possible to facilitate its penetration into the lacrimal meatus and to improve its resistance to the laying forces, in particular during the passage of the meatic sphincter.
  • the meatic nail softens so as to be better tolerated by the surrounding tissues.
  • FIGS. 1a and 1b The manufacture of a meatic nail as illustrated in FIGS. 1a and 1b can be carried out by molding the silicone nail, by leaving the housing 12 and a cavity 13 inside. Then, a hydrophilic acrylic insert 14 is housed inside the housing 13 so as to constitute the portion with a high coefficient of expansion.
  • a hydrophilic acrylic insert 14 is housed inside the housing 13 so as to constitute the portion with a high coefficient of expansion.
  • This meatic nail is similar to the meatic nail described above, except for the materials used which are modified.
  • the cylindrical body 20 and the flange 21 of this meatic nail are also made of silicone, by molding, providing inside the nail a longitudinal orifice 22 extended by a housing 23 in which a portion 24 made a second matter is integrated.
  • thermophilic hydrophilic acrylic is used to form the portion 24 at the end 20b of the cylinder 20 of the meatic nail.
  • thermodeformable hydrophilic component can be synthesized from oligomers of methyl methacrylate (M MA), of n-butyl acrylate (ABu) and of hydroxyethyl methacrylate (HEMA). classic radical.
  • M MA methyl methacrylate
  • ABu n-butyl acrylate
  • HEMA hydroxyethyl methacrylate
  • the portion 24 is hard at room temperature, and flexible at a temperature above its glass transition temperature.
  • the glass transition temperature should be lower than the temperature of the human body, for example between 25 ° C and 30 ° C.
  • the thermodeformable portion 24 deforms under the action of the heat delivered by the human body.
  • This deformation under the effect of heat is an isovolumic deformation allowing the portion 24 to pass from a stretched structure, as illustrated in FIG. 2a, to a retracted structure, as illustrated in dashed lines in the figure. 2b. Then the deformation of this portion 24 continues by hydration of the thermophilic hydrophilic acrylic material thanks to the presence of tear liquid penetrating inside this portion coming from the longitudinal orifice 22. After hydration, this portion 24 is presented in a bulb shape as shown in a strong line in Figure 2b.
  • the isovolumic thermal expansion coefficient of such a material is of the order of 2.
  • the overall expansion coefficient is therefore 2 to which is added the expansion coefficient linked to the hydrophilicity of the material.
  • this meatic nail thus blocks in the tissues thanks to the formation of a bulb at its end 20b thus preventing any risk of migration of this meatic nail outside the lacrimal meatus.
  • the meatic nail according to this second embodiment can be manufactured as described above, by molding in a first material, here silicone, of the cylindrical part 20 and the flange 21, then insertion of the portion 24 in a thermophilic hydrophilic acrylic in housing 23.
  • a first material here silicone
  • the portion 24 of hydrophilic acrylic with a high water content can be either bonded or polymerized inside the housing 23 of the meatic nail.
  • the portion of material with a high coefficient of expansion could also be produced in one embodiment in a hydrophobic thermodeformable acrylic, so that the formation of the bulb would only be obtained under the action of the heat delivered by the body. human, the presence of moisture not involved in the deformation of this portion of hydrophobic material.
  • the expansion is isovulomic and the linear expansion factor is approximately 2 (i.e. a diameter initially having a dimension of 0.3 mm has, after thermodilation, a dimension of 0, 6 mm).
  • This meatic nail is also in the form of a substantially cylindrical part 30 extended at one end 30a by a flange 31.
  • a longitudinal orifice 32 also extends along the longitudinal axis A of this meatic nail.
  • This cylindrical portion 30 is extended at its second end 30b, opposite the flange 31, by a portion 34 made of a material with a high coefficient of expansion.
  • cylindrical part 30 and the collar 31 can be made of a hydrophilic acrylic with a low water content, and for example with a water content of less than 38%.
  • PMMA polymethyl methacrylate
  • the portion 34 forming the end 30b of the cylindrical part 30 of the nail is made of hydrophilic acrylic with a high water content, for example greater than 38%.
  • hydrophilic copolymers given by way of examples previously, with reference to the first embodiment of the invention, can also be used here.
  • Such a one-piece meatic nail could in particular be produced by a process making it possible to stiffen part of a flexible material as described in particular in French patent application No. 98 07778 in the name of the Applicant.
  • This cylindrical portion 30 and the flange 31 are thus made of a rigid material resulting from a structural modification of the flexible material forming the end portion 34.
  • this structural modification comprises a phase of impregnation of the zone to be stiffened with reactive organic compounds and involves a chemical reaction and / or a polymerization reaction.
  • the zone thus modified, intended to constitute the rigid part of the meatic nail is modified in a lasting and irreversible manner, in particular by lowering the hydrophilicity of the acrylic used.
  • the end portion 34 absorbs the humidity and swells to form a bulb behind the meatic sphincter.
  • the present invention thus provides a meatic nail which in the dehydrated state and / or at room temperature is rigid and whose insertion end 10b, 20b, 30b is relatively fine, and in the dehydrated state and / or at temperature of the human body, softens and forms a bulb behind the meatic sphincter to prevent any displacement of this meatic nail out of the longitudinal meatus.
  • the flange 11, 21 and the cylindrical part 10, 20 can be made of any material other than silicone, of zero or moderate expansion coefficient. It suffices that the material used can expand under the effect of a pressure, and in particular the pressure exerted by the portion 14 during its expansion under the effect of heat and / or in the presence of moisture.
  • this cylindrical body 10, 20 and the collar 11, 21 can be made of a hydrophilic acrylic with a low water content, and typically strictly less than 38%, or of a hydrophobic acrylic.

Abstract

The invention relates to an expanding punctum plug which is used to plug a lacrimal punctum of a human eye. The inventive plug consists of an essentially-cylindrical body (10) which comprises a flange (11) at a first end (10a) thereof and which is made from a first material having a zero or low expansion coefficient. The second end (10b) of the aforementioned cylindrical body (10) comprises a portion (14) which is made from a second material having an expansion coefficient which is greater than the aforementioned zero or low expansion coefficient of the first material. Once the punctum plug has been placed inside the lacrimal punctum, the volume of said plug increases such as to form a bulb which blocks the plug in position.

Description

"Clou méatique à expansion" "Expanding meatic nail"
La présente invention concerne un clou méatique à expansion utilisé pour obturation d'un méat lacrymal d'un œil humain.The present invention relates to a meeat expansion nail used for filling a lacrimal meatus of a human eye.
De manière générale, cette invention concerne un dispositif d'obturation d'un méat lacrymal.In general, this invention relates to a device for closing a lacrimal meatus.
Ce type de dispositif d'obturation est utilisé couramment dans la pathologie dite des yeux secs, qui correspond à une production insuffisante de fluide lacrymal par les glandes lacrymales et se traduit par des yeux insuffisamment hydratés, ce qui provoque des désagréments chez les patients concernés.This type of obturation device is commonly used in the pathology known as dry eyes, which corresponds to an insufficient production of lacrimal fluid by the lacrimal glands and results in insufficiently hydrated eyes, which causes unpleasantness in the patients concerned.
Le traitement habituel consiste à réguler l'évacuation naturelle du fluide lacrymal par les méats lacrymaux supérieurs et inférieurs, se trouvant dans le coin de chaque œil du côté nasal, grâce à l'introduction d'un dispositif d'obturation permettant de stopper l'évacuation du liquide lacrymal.The usual treatment consists in regulating the natural evacuation of the lacrimal fluid by the upper and lower lacrimal ducts, being in the corner of each eye on the nasal side, thanks to the introduction of a obturation device making it possible to stop the evacuation of tear fluid.
Un tel dispositif est décrit notamment dans le document US 6 234 175. II s'agit dans ce document d'un petit dispositif se présentant sous la forme d'un cylindre étroit de diamètre approprié pour l'insertion de ce dispositif à l'intérieur du canalicule prolongeant le méat lacrymal.Such a device is described in particular in document US 6,234,175. This document is a small device in the form of a narrow cylinder of diameter suitable for the insertion of this device inside of the canaliculus extending the lacrimal meatus.
Ce dispositif est en acrylique thermosensible de telle sorte que lorsqu'il est placé au-dessus de sa température de transition vitreuse, il ramollit et se déforme de manière isovolumique.This device is made of thermosensitive acrylic so that when it is placed above its glass transition temperature, it softens and deforms isovolumically.
Lorsque ce dispositif est placé dans le méat lacrymal, il répond à l'augmentation de température et se dilate en largeur pour s'adapter à la taille et la forme du méat lacrymal ou du canalicule.When this device is placed in the lacrimal meatus, it responds to the increase in temperature and expands in width to adapt to the size and shape of the lacrimal meatus or the canaliculus.
Cependant, la migration de ce dispositif tant à l'intérieur du canalicule en direction de la fosse nasale qu'à l'extérieur hors du méat lacrymal, est toujours possible puisque cette forme cylindrique du dispositif ne permet pas de garantir le maintien de celui-ci en position. On connaît également dans un document US 5 283 063 un dispositif en forme de clou, couramment appelé clou méatique (en anglais "punctum plug") qui se présente sous la forme d'une portion cylindrique munie à une de ses extrémités d'une collerette et à l'autre extrémité d'un élément de maintien et de positionnement.However, the migration of this device both inside the canaliculus in the direction of the nasal fossa and outside outside the lacrimal meatus, is always possible since this cylindrical shape of the device does not guarantee the maintenance of the latter. this in position. Also known in a document US Pat. No. 5,283,063 is a device in the form of a nail, commonly called a meatic nail (in English "punctum plug") which is in the form of a cylindrical portion provided at one of its ends with a flange. and at the other end of a holding and positioning element.
La collerette permet de maintenir le clou méatique en position de telle sorte qu'il ne peut pas glisser à l'intérieur du canalicule, alors que l'élément de maintien et de positionnement permet d'éviter que le clou méatique ne ressorte du canalicule. Ce clou méatique est constitué d'un hydrogel revêtu d'une matière hydrophobe, tel que du silicone.The flange keeps the meatic nail in position so that it cannot slide inside the canaliculus, while the holding and positioning element makes it possible to prevent the meatic nail from coming out of the canaliculus. This meatic nail consists of a hydrogel coated with a hydrophobic material, such as silicone.
L'hydrogel peut se dilater entre un état déshydraté et un état hydraté, en particulier lorsqu'il est placé à l'intérieur du méat lacrymal. Cependant, le positionnement d'un tel clou méatique à l'intérieur du canalicule est gêné par l'élément de maintien et de positionnement qui forme une saillie importante à l'extrémité d'introduction du clou méatique dans le canalicule.The hydrogel can expand between a dehydrated state and a hydrated state, especially when placed inside the lacrimal meatus. However, the positioning of such a meatic nail inside the canaliculus is hampered by the holding and positioning element which forms a large projection at the insertion end of the meatic nail in the canaliculus.
La présente invention a pour but de résoudre les inconvénients précités et de proposer un clou méatique dont l'introduction dans le méat lacrymal est facilitée et le maintien en position est particulièrement fiable. La présente invention vise ainsi un clou méatique à expansion pour obturer un méat lacrymal d'un œil humain comprenant un corps sensiblement cylindrique comportant à une première extrémité une collerette et formé d'une première matière de coefficient d'expansion nul ou modéré.The object of the present invention is to solve the aforementioned drawbacks and to propose a meeatic nail the introduction of which into the lacrimal meatus is facilitated and the holding in position is particularly reliable. The present invention thus relates to a meeat expansion nail for closing a lacrimal meatus of a human eye comprising a substantially cylindrical body comprising at a first end a flange and formed of a first material with a coefficient of zero or moderate expansion.
Selon l'invention le corps cylindrique comprend à une seconde extrémité une portion formée d'une seconde matière de coefficient d'expansion supérieur au coefficient d'expansion nul ou modéré de ladite première matière.According to the invention, the cylindrical body comprises at a second end a portion formed of a second material with an expansion coefficient greater than the zero or moderate expansion coefficient of said first material.
Grâce à la portion formée d'une seconde matière fortement dilatable, après positionnement du clou méatique conforme à l'invention dans le canalicule, cette seconde portion augmente fortement de volume de manière à constituer ainsi un bulbe permettant de bloquer le clou méatique en position. En particulier, ce bulbe vient se loger derrière le sphincter du méat lacrymal et empêche ainsi toute migration du clou à l'extérieur. En outre, le corps cylindrique ne comporte pas d'excroissance dans sa seconde extrémité correspondant à son extrémité d'introduction à l'intérieur du méat lacrymal, de telle sorte que l'introduction de ce clou méatique peut être réalisée facilement, sans avoir à dilater le canalicule. Selon une caractéristique préférée de l'invention, ladite portion formée d'une seconde matière est insérée à l'intérieur d'un logement formé de ladite première matière et constituant ladite seconde extrémité du corps cylindrique.Thanks to the portion formed of a second highly expandable material, after positioning the meatic nail according to the invention in the canaliculus, this second portion greatly increases in volume so as to thus constitute a bulb making it possible to block the meatic nail in position. In particular, this bulb is housed behind the sphincter of the lacrimal meatus and thus prevents any migration of the nail to the outside. In addition, the cylindrical body has no protuberance in its second end corresponding to its insertion end inside the lacrimal meatus, so that the introduction of this meeatatic nail can be carried out easily, without having to dilate the canaliculus. According to a preferred characteristic of the invention, said portion formed of a second material is inserted inside a housing formed of said first material and constituting said second end of the cylindrical body.
Ainsi, la paroi du logement formée de la première matière de coefficient d'expansion nul ou modéré peut se dilater sous l'effet de la pression exercée par la portion de seconde matière insérée à l'intérieur du logement et adaptée à s'expanser fortement.Thus, the wall of the housing formed of the first material with a zero or moderate expansion coefficient can expand under the effect of the pressure exerted by the portion of second material inserted inside the housing and adapted to expand strongly. .
Selon une autre caractéristique avantageuse de l'invention, le clou méatique comprend un orifice longitudinal dans le corps cylindrique, débouchant d'une part à la première extrémité du corps cylindrique, dans la collerette, et d'autre part, dans la portion formée d'une seconde matière.According to another advantageous characteristic of the invention, the meatic nail comprises a longitudinal orifice in the cylindrical body, opening on the one hand at the first end of the cylindrical body, in the flange, and on the other hand, in the portion formed by 'a second matter.
Cet orifice longitudinal forme ainsi un canal adapté à conduire le liquide lacrymal naturellement présent dans l'œil jusqu'à la portion de seconde matière susceptible de se dilater en présence d'eau. Selon une caractéristique particulièrement pratique de l'invention, cette portion est en acrylique hydrophile à haute teneur en eau adaptée à se dilater en présence d'eau, de telle sorte que l'expansion de cette portion et ainsi la dilation de la seconde extrémité du corps cylindrique du clou peuvent être facilement obtenues dès le positionnement de ce clou dans le canalicule, sous l'effet du liquide lacrymal naturellement présent.This longitudinal orifice thus forms a channel adapted to conduct the tear fluid naturally present in the eye to the portion of second material capable of expanding in the presence of water. According to a particularly practical characteristic of the invention, this portion is made of hydrophilic acrylic with high water content suitable for expanding in the presence of water, so that the expansion of this portion and thus the expansion of the second end of the cylindrical body of the nail can be easily obtained from the positioning of this nail in the canaliculus, under the effect of the naturally present tear fluid.
D'autres particularités et avantages de l'invention apparaîtront encore dans la description ci-après.Other features and advantages of the invention will appear in the description below.
Aux dessins annexés, donnés à titre d'exemples non limitatifs :In the appended drawings, given by way of nonlimiting examples:
- les figures 1a et 1b illustrent un clou méatique selon un premier mode de réalisation de l'invention, avant et après dilation de ce clou ;- Figures 1a and 1b illustrate a meatic nail according to a first embodiment of the invention, before and after expansion of this nail;
- les figures 2a et 2b illustrent un clou méatique selon un deuxième mode de réalisation de l'invention, avant et après dilatation de ce clou ; et - les figures 3a et 3b illustrent un clou méatique selon un troisième mode de réalisation de l'invention, avant et après dilation de ce clou.- Figures 2a and 2b illustrate a meatic nail according to a second embodiment of the invention, before and after expansion of this nail; and - Figures 3a and 3b illustrate a meatic nail according to a third embodiment of the invention, before and after expansion of this nail.
On va décrire tout d'abord en référence aux figures 1a et 1b un clou méatique à expansion conforme à un premier mode de réalisation de l'invention.We will first describe with reference to Figures 1a and 1b a meatic expansion nail according to a first embodiment of the invention.
Ce clou méatique comprend un corps 10 sensiblement cylindrique comportant à une première extrémité 10a une collerette 11.This meatic nail comprises a substantially cylindrical body 10 comprising at a first end 10a a flange 11.
Ce corps cylindrique 10 s'étend dans sa direction longitudinale selon un axe A. Ce corps cylindrique 10 est en outre percé dans sa direction longitudinale A de telle sorte qu'il comprend un orifice longitudinal 12, de forme également cylindrique, qui débouche du corps 10 à sa première extrémité 10a, dans la collerette 11.This cylindrical body 10 extends in its longitudinal direction along an axis A. This cylindrical body 10 is further drilled in its longitudinal direction A so that it comprises a longitudinal orifice 12, also of cylindrical shape, which opens out from the body 10 at its first end 10a, in the collar 11.
Cet orifice longitudinal 12 se prolonge, en direction d'une seconde extrémité 10b du corps cylindrique 10 par un logement 13. Ce logement 13 s'étend ainsi entre l'orifice longitudinal 12 et l'extrémité fermée 10b du corps cylindrique 10.This longitudinal orifice 12 is extended, in the direction of a second end 10b of the cylindrical body 10 by a housing 13. This housing 13 thus extends between the longitudinal orifice 12 and the closed end 10b of the cylindrical body 10.
Une portion de matière 14 est insérée à l'intérieur de ce logement 13, constituant ainsi avec ce logement une seconde extrémité 10b du corps cylindrique 10.A portion of material 14 is inserted inside this housing 13, thus constituting with this housing a second end 10b of the cylindrical body 10.
Ainsi, l'orifice longitudinal 12 débouche dans la portion 14 logée à l'intérieur du logement 13.Thus, the longitudinal orifice 12 opens into the portion 14 housed inside the housing 13.
Comme illustré à la figure 1a, cette extrémité 10b du corps 10 est arrondie et de forme sensiblement hémisphérique à l'extrémité du cylindre 10. Conformément à l'invention, le corps cylindrique 10 et la collerette 11 sont formés d'une première matière, différente d'une seconde matière constituant une portion 14 insérée à l'intérieur du logement 13.As illustrated in FIG. 1a, this end 10b of the body 10 is rounded and of substantially hemispherical shape at the end of the cylinder 10. According to the invention, the cylindrical body 10 and the flange 11 are formed from a first material, different from a second material constituting a portion 14 inserted inside the housing 13.
Ainsi, on peut fabriquer un clou creux en une première matière et placer ensuite à l'intérieur du clou un insert réalisé en une seconde matière. Ces deux matières constituant le clou méatique sont notamment différentes en terme de coefficient d'expansion. La première matière, constituant le corps cylindrique 10 à la collerette 11 , présente un coefficient d'expansion nul ou modéré, alors que la seconde matière de la portion 14 présente un coefficient d'expansion élevé, et en tout état de cause supérieur au coefficient d'expansion nul ou modéré de la matière.Thus, a hollow nail can be made from a first material and then place an insert made from a second material inside the nail. These two materials constituting the meatic nail are notably different in terms of expansion coefficient. The first material, constituting the cylindrical body 10 at the collar 11, has a coefficient of zero or moderate expansion, while the second material of the portion 14 has a high coefficient of expansion, and in any event greater than the coefficient of zero or moderate expansion of the material.
Dans cet exemple de réalisation, la portion 14 est en acrylique hydrophile à haute teneur en eau adaptée à se dilater en présence d'eau, alors que le corps cylindrique et la collerette 11 sont réalisés en silicone.In this embodiment, the portion 14 is made of hydrophilic acrylic with a high water content suitable for expanding in the presence of water, while the cylindrical body and the collar 11 are made of silicone.
La portion 14 en acrylique hydrophile à haute teneur en eau présente typiquement une teneur en eau supérieure à 38% en poids. Elle présente ainsi un coefficient d'expansion élevé, supérieur ou égal à 25% en volume. A titre d'exemple, cet acrylique hydrophile peut être un copolymère de méthacrylate d'hydroxyéthyle (HEMA), et de vinylpyrrolidone.The portion 14 of hydrophilic acrylic with a high water content typically has a water content greater than 38% by weight. It thus has a high expansion coefficient, greater than or equal to 25% by volume. By way of example, this hydrophilic acrylic may be a copolymer of hydroxyethyl methacrylate (HEMA), and of vinylpyrrolidone.
Ce copolymère acrylique hydrophile présente ainsi l'avantage de pouvoir s'expanser en présence d'eau de telle sorte que sa teneur en eau à l'état hydraté peut être de l'ordre 70% en poids. A titre d'exemples non limitatifs, les copolymères HEMA commercialisés sous les dénominations commerciales suivantes peuvent être utilisés :This hydrophilic acrylic copolymer thus has the advantage of being able to expand in the presence of water so that its water content in the hydrated state can be of the order of 70% by weight. By way of nonlimiting examples, the HEMA copolymers sold under the following trade names can be used:
Vistagel 38 : Taux d'hydratation 38,4 %Vistagel 38: Hydration rate 38.4%
Coefficient de dilatation linéaire : 1 ,19 Vistagel 42 : Taux d'hydratation 41 ,5 %Coefficient of linear expansion: 1.19 Vistagel 42: Hydration rate 41.5%
Coefficient de dilatation linéaire : 1 ,20 Vistagel 67 : Taux d'hydratation 68 %Coefficient of linear expansion: 1.20 Vistagel 67: 68% hydration rate
Coefficient de dilatation linéaire : 1 ,44 D'autres types de copolymères peuvent également être utilisés, tels que :Coefficient of linear expansion: 1.44 Other types of copolymers can also be used, such as:
Vistagel Plus : Taux d'hydratation 40 %Vistagel Plus: 40% hydration rate
Coefficient de dilatation linéaire : 1 ,25 Snoflex 50 : Taux d'hydratation 52,5 %Coefficient of linear expansion: 1.25 Snoflex 50: Hydration rate 52.5%
Coefficient de dilatation linéaire : 1 ,32 Vistagel 75 : Taux d'hydratation 72,3 %Coefficient of linear expansion: 1.32 Vistagel 75: Hydration rate 72.3%
Coefficient de dilatation linéaire : 1 ,52 Ces composés présentent ainsi des coefficients de dilatation linéaire compris entre 1,19 et 1,52 (c'est-à-dire qu'un diamètre ayant initialement une cote de 0,3 mm, possède, après dilatation en présence d'eau, une cote pouvant être comprise entre 0,35 et 0,45 mm) La paroi du logement 13, en silicone, peut présenter une résistance mécanique non négligeable qui, tout en se dilatant sous l'effet de la pression exercée par la portion 14 lors de son expansion, empêche une expansion maximale de cet acrylique hydrophile, tel qu'illustré à la figure 1b.Coefficient of linear expansion: 1.52 These compounds thus have linear expansion coefficients between 1.19 and 1.52 (that is to say that a diameter initially having a dimension of 0.3 mm, has, after expansion in the presence of water, a dimension may be between 0.35 and 0.45 mm) The wall of the housing 13, made of silicone, can have a considerable mechanical resistance which, while expanding under the effect of the pressure exerted by the portion 14 during of its expansion, prevents maximum expansion of this hydrophilic acrylic, as illustrated in Figure 1b.
On choisira de préférence un silicone offrant le moins de résistance à la dilatation de l'acrylique hydrophile.Preferably choose a silicone offering the least resistance to expansion of hydrophilic acrylic.
Grâce à l'orifice longitudinal 12, lorsque le clou méatique est en position dans le méat lacrymal, le liquide lacrymal peut pénétrer à l'intérieur du cylindre 10 et venir en contact avec la portion 14 afin d'hydrater cette portion et provoquer son gonflement. La variation de volume de cette matière hydrophile s'accompagne également d'une variation de dureté de cette portion 14. Ainsi, le clou méatique est dur à l'état sec et déshydraté, et souple à l'état hydraté. Cette relative dureté du clou méatique avant hydratation permet de faciliter sa pénétration dans le méat lacrymal et d'améliorer sa résistance aux efforts de pose, notamment lors du passage du sphincter méatique.Thanks to the longitudinal orifice 12, when the meatic nail is in position in the lacrimal meatus, the lacrimal liquid can penetrate inside the cylinder 10 and come into contact with the portion 14 in order to hydrate this portion and cause it to swell. . The variation in volume of this hydrophilic material is also accompanied by a variation in hardness of this portion 14. Thus, the meatic nail is hard in the dry and dehydrated state, and flexible in the hydrated state. This relative hardness of the meatic nail before hydration makes it possible to facilitate its penetration into the lacrimal meatus and to improve its resistance to the laying forces, in particular during the passage of the meatic sphincter.
Par ailleurs, après hydratation, le clou méatique s'assouplit de manière à être mieux toléré par les tissus environnants.Furthermore, after hydration, the meatic nail softens so as to be better tolerated by the surrounding tissues.
Grâce à cette variation de volume du clou méatique, celui-ci se bloque dans le canalicule. En outre, la déformation importante de la portion 14, et ainsi de la seconde extrémité 10b du corps cylindrique 10 du clou permet de former un bulbe venant se loger derrière le sphincter du méat lacrymal et empêchant ainsi toute migration du clou méatique en dehors du canalicule.Thanks to this variation in volume of the meatic nail, it becomes blocked in the canaliculus. In addition, the significant deformation of the portion 14, and thus of the second end 10b of the cylindrical body 10 of the nail makes it possible to form a bulb coming to lodge behind the sphincter of the lacrimal meatus and thus preventing any migration of the meeatic nail outside the canaliculus. .
La fabrication d'un clou méatique tel qu'illustré aux figures 1a et 1b peut être réalisée par moulage du clou en silicone, en ménageant à l'intérieur le logement 12 et une cavité 13. Ensuite, un insert en acrylique hydrophile 14 est logé à l'intérieur du logement 13 de manière à constituer la portion à fort coefficient d'expansion. On va décrire à présent en référence aux figures 2a et 2b un deuxième mode de réalisation d'un clou méatique conforme à l'invention.The manufacture of a meatic nail as illustrated in FIGS. 1a and 1b can be carried out by molding the silicone nail, by leaving the housing 12 and a cavity 13 inside. Then, a hydrophilic acrylic insert 14 is housed inside the housing 13 so as to constitute the portion with a high coefficient of expansion. We will now describe with reference to Figures 2a and 2b a second embodiment of a meatic nail according to the invention.
Ce clou méatique se présente sensiblement comme le clou méatique décrit précédemment, hormis les matériaux utilisés qui sont modifiés. Comme précédemment, le corps cylindrique 20 et la collerette 21 de ce clou méatique sont également réalisés en silicone, par moulage, en ménageant à l'intérieur du clou un orifice longitudinal 22 prolongé d'un logement 23 dans lequel une portion 24 réalisée une seconde matière est intégrée.This meatic nail is similar to the meatic nail described above, except for the materials used which are modified. As before, the cylindrical body 20 and the flange 21 of this meatic nail are also made of silicone, by molding, providing inside the nail a longitudinal orifice 22 extended by a housing 23 in which a portion 24 made a second matter is integrated.
Ici, on emploi un acrylique hydrophile thermodeformable pour constituer la portion 24 à l'extrémité 20b du cylindre 20 du clou méatique.Here, a thermophilic hydrophilic acrylic is used to form the portion 24 at the end 20b of the cylinder 20 of the meatic nail.
A titre d'exemple non limitatif, le composant hydrophile thermodeformable peut être synthétisé à partir d'oligomères de methacrylate de methyle (M MA), d'acrylate de n-butyle (ABu) et de methacrylate d'hydroxyéthyle (HEMA) par polymérisation radicalaire classique. Dans ce mode de réalisation, la portion 24 est dure à température ambiante, et souple à une température supérieure à sa température de transition vitreuse.By way of nonlimiting example, the thermodeformable hydrophilic component can be synthesized from oligomers of methyl methacrylate (M MA), of n-butyl acrylate (ABu) and of hydroxyethyl methacrylate (HEMA). classic radical. In this embodiment, the portion 24 is hard at room temperature, and flexible at a temperature above its glass transition temperature.
Idéalement, la température de transition vitreuse doit être inférieure à la température du corps humain, soit comprise par exemple entre 25°C et 30°C. Ainsi, comme illustré à la figure 2b, lorsque ce clou méatique est posé à l'intérieur du méat lacrymal, la portion 24 thermodeformable se déforme sous l'action de la chaleur délivrée par le corps humain.Ideally, the glass transition temperature should be lower than the temperature of the human body, for example between 25 ° C and 30 ° C. Thus, as illustrated in FIG. 2b, when this meatic nail is placed inside the lacrimal meatus, the thermodeformable portion 24 deforms under the action of the heat delivered by the human body.
Cette déformation sous l'effet de la chaleur est une déformation isovolumique permettant à la portion 24 de passer d'une structure étirée, telle qu'illustrée à la figure 2a, à une structure rétractée, telle qu'illustrée en traits mixtes à la figure 2b. Puis la déformation de cette portion 24 se poursuit par hydratation de la matière acrylique hydrophile thermodeformable grâce à la présence de liquide lacrymal pénétrant à l'intérieur de cette portion provenant de l'orifice longitudinal 22. Après hydratation, cette portion 24 se présente sous une forme de bulbe tel qu'illustré en trait fort à la figure 2b. Le coefficient de dilatation thermique isovolumique d'un tel matériau est de l'ordre de 2. Le coefficient d'expansion globale est donc de 2 auquel s'ajoute le coefficient d'expansion liée à l'hydrophilie du matériau.This deformation under the effect of heat is an isovolumic deformation allowing the portion 24 to pass from a stretched structure, as illustrated in FIG. 2a, to a retracted structure, as illustrated in dashed lines in the figure. 2b. Then the deformation of this portion 24 continues by hydration of the thermophilic hydrophilic acrylic material thanks to the presence of tear liquid penetrating inside this portion coming from the longitudinal orifice 22. After hydration, this portion 24 is presented in a bulb shape as shown in a strong line in Figure 2b. The isovolumic thermal expansion coefficient of such a material is of the order of 2. The overall expansion coefficient is therefore 2 to which is added the expansion coefficient linked to the hydrophilicity of the material.
Comme précédemment, ce clou méatique se bloque ainsi dans les tissus grâce à la formation d'un bulbe à son extrémité 20b empêchant ainsi tout risque de migration de ce clou méatique en dehors du méat lacrymal.As before, this meatic nail thus blocks in the tissues thanks to the formation of a bulb at its end 20b thus preventing any risk of migration of this meatic nail outside the lacrimal meatus.
Le clou méatique selon ce second mode de réalisation peut être fabriqué comme décrit précédemment, par moulage dans une première matière, ici du silicone, de la partie cylindrique 20 et de la collerette 21 , puis insertion de la portion 24 en un acrylique hydrophile thermodeformable dans le logement 23.The meatic nail according to this second embodiment can be manufactured as described above, by molding in a first material, here silicone, of the cylindrical part 20 and the flange 21, then insertion of the portion 24 in a thermophilic hydrophilic acrylic in housing 23.
La portion 24 en acrylique hydrophile à haute teneur en eau peut être soit collée, soit polymérisée à l'intérieur du logement 23 du clou méatique.The portion 24 of hydrophilic acrylic with a high water content can be either bonded or polymerized inside the housing 23 of the meatic nail.
Bien entendu, la portion de matière à coefficient d'expansion élevé pourrait également être réalisé dans un mode de réalisation en un acrylique hydrophobe thermodeformable, de telle sorte que la formation du bulbe serait uniquement obtenue sous l'action de la chaleur délivrée par le corps humain, la présence d'humidité n'intervenant pas dans la déformation de cette portion en matière hydrophobe. Dans cette configuration, la dilatation est isovulomique et le facteur de dilatation linéaire est d'environ 2 (c'est-à-dire qu'un diamètre ayant initialement une cote de 0,3 mm a, après thermodilatation, une cote de 0,6 mm).Of course, the portion of material with a high coefficient of expansion could also be produced in one embodiment in a hydrophobic thermodeformable acrylic, so that the formation of the bulb would only be obtained under the action of the heat delivered by the body. human, the presence of moisture not involved in the deformation of this portion of hydrophobic material. In this configuration, the expansion is isovulomic and the linear expansion factor is approximately 2 (i.e. a diameter initially having a dimension of 0.3 mm has, after thermodilation, a dimension of 0, 6 mm).
On va décrire enfin, en référence aux figures 3a et 3b, un troisième mode de réalisation de l'invention dans lequel le clou méatique est monobloc.Finally, a third embodiment of the invention will be described, with reference to FIGS. 3a and 3b, in which the meatic nail is in one piece.
Ce clou méatique se présente également sous la forme d'une partie sensiblement cylindrique 30 prolongée à une extrémité 30a par une collerette 31.This meatic nail is also in the form of a substantially cylindrical part 30 extended at one end 30a by a flange 31.
Un orifice longitudinal 32 s'étend également suivant l'axe longitudinal A de ce clou méatique. Cette portion cylindrique 30 se prolonge sur sa seconde extrémité 30b, à l'opposé de la collerette 31 , par une portion 34 réalisée en une matière à coefficient d'expansion élevé.A longitudinal orifice 32 also extends along the longitudinal axis A of this meatic nail. This cylindrical portion 30 is extended at its second end 30b, opposite the flange 31, by a portion 34 made of a material with a high coefficient of expansion.
Ici, la partie cylindrique 30 et la collerette 31 peuvent être réalisées en un acrylique hydrophile à faible teneur en eau, et par exemple à teneur en eau inférieure à 38%.Here, the cylindrical part 30 and the collar 31 can be made of a hydrophilic acrylic with a low water content, and for example with a water content of less than 38%.
Elles pourraient également être réalisées en polyméthacrylate de méthyle (PMMA), c'est-à-dire en une matière relativement rigide.They could also be made from polymethyl methacrylate (PMMA), that is to say from a relatively rigid material.
La portion 34 formant l'extrémité 30b de la partie cylindrique 30 du clou est composée en acrylique hydrophile à haute teneur en eau, par exemple supérieure à 38%.The portion 34 forming the end 30b of the cylindrical part 30 of the nail is made of hydrophilic acrylic with a high water content, for example greater than 38%.
Les copolymères hydrophiles donnés à titre d'exemples précédemment, en référence au premier mode de réalisation de l'invention, peuvent également être utilisés ici. Un tel clou méatique monobloc pourrait notamment être réalisé grâce à un procédé permettant de rigidifier une partie d'un matériau souple tel que décrit notamment dans la demande de brevet français n° 98 07778 au nom de la Demanderesse.The hydrophilic copolymers given by way of examples previously, with reference to the first embodiment of the invention, can also be used here. Such a one-piece meatic nail could in particular be produced by a process making it possible to stiffen part of a flexible material as described in particular in French patent application No. 98 07778 in the name of the Applicant.
On peut ainsi à partir d'une préforme du clou méatique réalisé en un matériau souple, tel qu'en un acrylique hydrophile à forte teneur en eau, modifier la partie du clou correspondant à la partie cylindrique 30 et la colleretteIt is thus possible from a preform of the meatic nail made of a flexible material, such as a hydrophilic acrylic with a high water content, to modify the part of the nail corresponding to the cylindrical part 30 and the flange
31 par au moins une réaction choisie parmi les réactions chimiques et des réactions de polymérisation.31 by at least one reaction chosen from chemical reactions and polymerization reactions.
Cette portion cylindrique 30 et la collerette 31 sont ainsi constituées d'un matériau rigide résultant d'une modification structurelle du matériau souple formant la portion d'extrémité 34.This cylindrical portion 30 and the flange 31 are thus made of a rigid material resulting from a structural modification of the flexible material forming the end portion 34.
En pratique, cette modification structurelle comprend une phase d'imprégnation de la zone à rigidifier par des composés organiques réactifs et met en jeu une réaction chimique et/ou une réaction de polymérisation. La zone ainsi modifiée, destinée à constituer la partie rigide du clou méatique est modifiée de façon durable et irréversible, notamment par abaissement de l'hydrophilie de l'acrylique utilisé. Comme précédemment, lorsque ce clou méatique est introduit à l'intérieur du méat lacrymal, en présence d'humidité créée par le liquide lacrymal s'introduisant à l'intérieur de l'orifice longitudinal 32, la portion d'extrémité 34 absorbe l'humidité et gonfle de manière à former un bulbe derrière le sphincter méatique.In practice, this structural modification comprises a phase of impregnation of the zone to be stiffened with reactive organic compounds and involves a chemical reaction and / or a polymerization reaction. The zone thus modified, intended to constitute the rigid part of the meatic nail is modified in a lasting and irreversible manner, in particular by lowering the hydrophilicity of the acrylic used. As before, when this meatic nail is introduced inside the lacrimal meatus, in the presence of moisture created by the lacrimal liquid entering inside the longitudinal orifice 32, the end portion 34 absorbs the humidity and swells to form a bulb behind the meatic sphincter.
La présente invention propose ainsi un clou méatique qui à l'état déshydraté et/ou à une température ambiante est rigide et dont l'extrémité d'introduction 10b, 20b, 30b est relativement fine, et à l'état déshydraté et/ou à température du corps humain, s'assouplit et forme un bulbe derrière le sphincter méatique pour empêcher tout déplacement de ce clou méatique hors du méat longitudinal.The present invention thus provides a meatic nail which in the dehydrated state and / or at room temperature is rigid and whose insertion end 10b, 20b, 30b is relatively fine, and in the dehydrated state and / or at temperature of the human body, softens and forms a bulb behind the meatic sphincter to prevent any displacement of this meatic nail out of the longitudinal meatus.
Bien entendu, de nombreuses modifications peuvent être apportées aux exemples de réalisation décrits ci-dessus sans sortir du cadre de l'invention. En particulier, dans les premier et deuxième modes de réalisation, La collerette 11, 21 et la partie cylindrique 10, 20 peuvent être réalisées en toute autre matière qu'en silicone, de coefficient d'expansion nul ou modéré. Il suffit que la matière utilisée puisse se dilater sous l'effet d'une pression, et en particulier de la pression exercée par la portion 14 lors de son expansion sous l'effet de la chaleur et/ou en présence d'humidité.Of course, numerous modifications can be made to the embodiments described above without departing from the scope of the invention. In particular, in the first and second embodiments, the flange 11, 21 and the cylindrical part 10, 20 can be made of any material other than silicone, of zero or moderate expansion coefficient. It suffices that the material used can expand under the effect of a pressure, and in particular the pressure exerted by the portion 14 during its expansion under the effect of heat and / or in the presence of moisture.
Ainsi, ce corps cylindrique 10, 20 et la collerette 11 , 21 peuvent être réalisés en un acrylique hydrophile à faible teneur en eau, et typiquement strictement inférieure à 38%, ou en un acrylique hydrophobe. Thus, this cylindrical body 10, 20 and the collar 11, 21 can be made of a hydrophilic acrylic with a low water content, and typically strictly less than 38%, or of a hydrophobic acrylic.

Claims

REVENDICATIONS
1. Clou méatique à expansion pour obturer un méat lacrymal d'un œil humain comprenant un corps sensiblement cylindrique (10, 20, 30) comportant à une première extrémité (10a, 20a, 30a) une collerette (11 , 21, 31) et formé d'une première matière de coefficient d'expansion nul ou modéré, caractérisé en ce que le corps cylindrique (10, 20, 30) comprend à une seconde extrémité (10b, 20b, 30b) une portion (14, 24, 34) formée d'une seconde matière de coefficient d'expansion supérieur au coefficient d'expansion nul ou modéré de ladite première matière.1. Expanding meatic nail for closing a lacrimal meatus of a human eye comprising a substantially cylindrical body (10, 20, 30) comprising at a first end (10a, 20a, 30a) a flange (11, 21, 31) and formed from a first material with zero or moderate expansion coefficient, characterized in that the cylindrical body (10, 20, 30) comprises at a second end (10b, 20b, 30b) a portion (14, 24, 34) formed of a second material with an expansion coefficient greater than the zero or moderate expansion coefficient of said first material.
2. Clou méatique à expansion conforme à la revendication 1, caractérisé en ce que ladite portion (14, 24) formée d'une seconde matière est insérée à l'intérieur d'un logement (13, 23) formé de ladite première matière et constituant ladite seconde extrémité (10b, 20b) du corps cylindrique (10, 20). 2. meatic expansion nail according to claim 1, characterized in that said portion (14, 24) formed of a second material is inserted inside a housing (13, 23) formed of said first material and constituting said second end (10b, 20b) of the cylindrical body (10, 20).
3. Clou méatique à expansion conforme à l'une des revendications3. meatic expansion nail according to one of the claims
1 ou 2, caractérisé en ce qu'il comprend un orifice longitudinal (12, 22, 32) dans le corps cylindrique (10, 20, 30), débouchant d'une part à la première extrémité (10a, 20a, 30a) du corps cylindrique, dans ladite collerette (11, 21, 31), et d'autre part, dans ladite portion (14, 24, 34) formée d'une seconde matière. 1 or 2, characterized in that it comprises a longitudinal orifice (12, 22, 32) in the cylindrical body (10, 20, 30), opening on the one hand at the first end (10a, 20a, 30a) of the cylindrical body, in said collar (11, 21, 31), and on the other hand, in said portion (14, 24, 34) formed of a second material.
4. Clou méatique à expansion conforme à l'une des revendications4. meatic expansion nail according to one of the claims
1 à 3, caractérisé en ce que ladite portion (14, 24, 34) est en acrylique hydrophile à haute teneur en eau adapté à se dilater en présence d'eau.1 to 3, characterized in that said portion (14, 24, 34) is made of hydrophilic acrylic with a high water content suitable for expanding in the presence of water.
5. Clou méatique à expansion conforme à l'une des revendications 1 à 3, caractérisé en ce que ladite portion (14, 24, 34) est réalisée en un copolymère acrylique hydrophile ou hydrophobe thermodeformable ou hydrophyle thermodeformable.5. meatic expansion nail according to one of claims 1 to 3, characterized in that said portion (14, 24, 34) is made of a hydrophilic acrylic hydrophobic or hydrophobic thermodeformable copolymer or hydrophyle thermodeformable.
6. Clou méatique à expansion conforme à l'une des revendications 1 à 5, caractérisé en ce que le corps cylindrique (10, 20) est réalisé en silicone.6. meatic expansion nail according to one of claims 1 to 5, characterized in that the cylindrical body (10, 20) is made of silicone.
7. Clou méatique à expansion conforme à l'une des revendications 1 à 5, caractérisé en ce que le corps cylindrique (30) est réalisé en un copolymère acrylique hydrophile à faible teneur en eau. 7. meatic expansion nail according to one of claims 1 to 5, characterized in that the cylindrical body (30) is made of a hydrophilic acrylic copolymer with low water content.
8. Clou méatique à expansion conforme à l'une des revendications 1 à 7, caractérisé en ce que le coefficient d'expansion élevé de ladite seconde matière est supérieur ou égal à 25% en volume.8. meatic expansion nail according to one of claims 1 to 7, characterized in that the high expansion coefficient of said second material is greater than or equal to 25% by volume.
9. Clou méatique à expansion conforme à l'une des revendications 1 à 8, caractérisé en ce que le coefficient de dilatation linéaire de ladite seconde matière est compris entre 1 ,19 et 1 ,52. 9. meeat expansion nail according to one of claims 1 to 8, characterized in that the coefficient of linear expansion of said second material is between 1, 19 and 1, 52.
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