CA2059623A1 - Means and method for facilitating folding of an intraocular lens - Google Patents
Means and method for facilitating folding of an intraocular lensInfo
- Publication number
- CA2059623A1 CA2059623A1 CA002059623A CA2059623A CA2059623A1 CA 2059623 A1 CA2059623 A1 CA 2059623A1 CA 002059623 A CA002059623 A CA 002059623A CA 2059623 A CA2059623 A CA 2059623A CA 2059623 A1 CA2059623 A1 CA 2059623A1
- Authority
- CA
- Canada
- Prior art keywords
- lens
- optic
- tips
- forceps
- supporting
- Prior art date
- Legal status (The legal status 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 status listed.)
- Abandoned
Links
- 238000000034 method Methods 0.000 title description 23
- 238000003780 insertion Methods 0.000 claims description 12
- 230000037431 insertion Effects 0.000 claims description 12
- 239000000463 material Substances 0.000 claims description 8
- 239000004033 plastic Substances 0.000 claims description 3
- 229920003023 plastic Polymers 0.000 claims description 3
- 229920001296 polysiloxane Polymers 0.000 claims description 3
- 238000001356 surgical procedure Methods 0.000 description 5
- 238000004806 packaging method and process Methods 0.000 description 4
- 238000003860 storage Methods 0.000 description 3
- 238000005299 abrasion Methods 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 230000003287 optical effect Effects 0.000 description 2
- 238000005096 rolling process Methods 0.000 description 2
- 238000000926 separation method Methods 0.000 description 2
- 230000008733 trauma Effects 0.000 description 2
- 239000004743 Polypropylene Substances 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 230000007812 deficiency Effects 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 230000004438 eyesight Effects 0.000 description 1
- 208000023414 familial retinal arterial macroaneurysm Diseases 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000007257 malfunction Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 230000003278 mimic effect Effects 0.000 description 1
- 239000005022 packaging material Substances 0.000 description 1
- -1 polypropylene Polymers 0.000 description 1
- 229920001155 polypropylene Polymers 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- BGRJTUBHPOOWDU-UHFFFAOYSA-N sulpiride Chemical compound CCN1CCCC1CNC(=O)C1=CC(S(N)(=O)=O)=CC=C1OC BGRJTUBHPOOWDU-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
- A61F2/1664—Instruments for inserting intraocular lenses into the eye for manual insertion during surgery, e.g. forceps-like instruments
Abstract
ABSTRACT OF THE INVENTION
A system (10, 100) for facilitating folding of a soft intraocular lens (18). A supporting and positioning structure (14, 16 or 112, 114) associated with a base or frame (12 or 102) presents the lens (18) so that forceps tips (20) are automatically positioned near opposite sides of the lens (18) and maintained in that position. A forming means (14, 16 and 28, 30 or 108, 110 and 112, 114) automatically moves the forceps tips (20) with respect to the lens (18) to fold the optic portion (32) of the lens (18) within the tips (20). The lens (18) is accurately and reliably folded in the forceps tips (20) to securely grip the lens (18) in a desired position with reduced risk of damage to the optic portion (32) of the lens (18).
A system (10, 100) for facilitating folding of a soft intraocular lens (18). A supporting and positioning structure (14, 16 or 112, 114) associated with a base or frame (12 or 102) presents the lens (18) so that forceps tips (20) are automatically positioned near opposite sides of the lens (18) and maintained in that position. A forming means (14, 16 and 28, 30 or 108, 110 and 112, 114) automatically moves the forceps tips (20) with respect to the lens (18) to fold the optic portion (32) of the lens (18) within the tips (20). The lens (18) is accurately and reliably folded in the forceps tips (20) to securely grip the lens (18) in a desired position with reduced risk of damage to the optic portion (32) of the lens (18).
Description
2~9~23 BACKGROUND OF TH~ INVENTION
The replacement of lens of a human eye generally utilizes a surgical procedure whereby an artificial replacement lens is inserted through an incision in the eye. Once inside the eye, the surgeon manipulates the lens into a position where it is then secured. To minimize trauma to the eye, it is most beneficial to minimize the size of the incision through which the lens is inserted.
This type of artificial lens, generally referred to as an intraocular lens, is usually comprised of a circular convex or plano-convex optic portion, with arms called haptics extending from the optic. The haptics are utilized to hold the lens in place.
A practical limitation on how small the incision in the eye can be is the diameter of the optic portion of the lens. Although tissue is somewhat pliable, a slit or incision has to be approximately, at a minimum, the length of the diameter of the lens.
One way to avoid this limitation is to manipulate the lens to reduce its cross-sectional diameter before insertion into the eye. An example would be to fold the lens over onto itself. This would reduce the required length of the incision by approximately one half.
The present invention relates to lens insertion and intraocular lens replacement surgery t and in particular, to an improvsd means and method for folding a lens in preparing it for insertion into the eye. The ~enefits of one smaller incision are less trauma to ~he eye.
The concept of folding or rolling a lens prior to insertivn is known in the art. See, for sxample, the following U.S. p~tents:
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2 ~ 2 3 Faulkner4,84~,065 Poley4,769,034 Patton4,836,201 Mazzocco4,702,24~
Bartell4,681,102 Willis4,759,359 Baccala~ 4,785,810 Patents such as Faulkner, Poley, Willis, and Baccala illustrate how the folding of a lens may be done, or disclose and claim instruments used in association with such folding. Patents such as Patton, Nazzocco and Bartell disclose rather complex instruments and associated hardware for rolling or otherwise manipulating the lens into a smaller cross sectional or diametric shape.
- It has been determined that although the above technology exists in the art, there is room for improvement as to how a lens can be reliably and accurately folded. Intraocular lens replacement is a highly technical and delicate surgery. It deals with replacing a natural part of the eye with an artificial implant. The value of eyesight is immeasurable. Therefore, it is critical that all possible steps be taken to insure the best possible lens replacement and procedures.
Room for improvement exists in the ability of precise, accurate, and reliable folding of lens, if that procedure is used. A surgeon needs to ha~e a good grip on a lens for its insertion. The lens cannot be damag~d or scratched. The folding needs to be accomplished quickly and easily. It is insufficient, or at least problema~ic, for a surgeon ~o accomplish such~delicate and minute folding without some standardized procedure or structure.
-" 2~5~623 Moreover, it is also disadvantageous ~o u-tilize complex procedure or methods. Complexity leads ~o the risk of malfunction or, at a minimum, difficulties in learning the pxocess or structure.
Additionally, the technology regarding the artificial intraocular lenses themselves has advanced. The optic portions of the lenses themselves may be made of several different materials. Some of these materials have characteristics which allow them to provide good optical qualities and durability~ Some of the materials, however, are not particularly easy to fold or manipulate. One problem deals with lenses which are made of substances like silicone which are resilient and very deformable. This makes it difficult to maintain a secure grip on the lens when folded as the lens has a tendency to return to its original position. The second problem exists in taking great care to avoid any damage to the lens optic. Any gripping of the lens, especially near the optical center, runs this risk.
The need therefore exists for a means and method of xeliably and accurately foldin~ a soft intraocular lens, including those lens optics which are made of a variety of different materials.
It is therefore the principal object of the present invention to provide a means and method for facilitating folding of a foldable intraocular lens which overcomes or improves o~er the problems and deficiencies in the art.
It is a further object of the present invention to provide a means and method as above described which presents an ea~y, accura~e, and reliable way to fol~ intraocular lenses.
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A still further ob~ect o~ the invention is to provide a means and method as above described which greatly reduces the risk of inaccurate folding and gripping of an intraocular lens.
A still further object of the present in~ention is to provide a means and method as above described which reduces the risk of damage to an intraocular lens which is folded.
A still further ob~ect o~ the present invention is to provide a means and method as above described which is noncomplex and easy to understand and adopt.
A still further object of the present invention is to provide a means and method as above described which is adaptable to a variety of intraocular lenses.
Another object of the pre~ent invention is to provide a means and method as above described which minimizes handling o$ the lens.
Another object of the present invention is described which minimizes the risk of upside down installation of the lens, as it will always be packaged, presented, and folded within the forceps tip in the correct position.
Another object of the present in~ention is to provide a means and method as above described which is economical and efficient.
These and other objects, features, and advantages of the presen~ invention will become more apparent with references to the accompanying specification and claims~
SUMMARY OF TH~ INVENTION
The present invention presents a ~ystem whereby the surgeon can confidently know ~hat lens can be quickly and accurately folded with forceps, with a 2~16~3 minimum risk of damage to the lens. The method involvss the st~ps of positioning and supporting ths lens to be folded so that forceps tips can easily and quickly be brought into presolected, desired positions near opposite diametrical sides of the optic portion of the lens. ~he tips are automatically located in optimal positions to grip the lens when it is folded.
Structure surrounding the tips, and assisting in their placement, can then be moved by manual force to automatically cause the lens to accurately fold in two, and the forceps tips to be maintained in continuous contact with the optic portion of the lens as it is folded. As the tips are held in position, mechanical force is applied to the structure around the tips to urge the tips towards one another. The lens is supported in such a way that its center portion raises, and the structure basically ensures that the lens folds accurately upon itself and the forceps tips reliably grasp and hold the lens in ~he folded shape without the use of a second pair of forceps or a folding mandrel.
The apparatus according to the invention includes a base, a supporting structure associated with the base for supporting the lens, a positioning structure to position and maintain the forceps tips with respect to the lens, and moveable structure to cause, assist and guide ~he closing of the forceps tips concurrently with folding of the lens. The lens can basically be automatically folded in half. The forming structure is basically a vise which causes accurate positioning of $he forceps tips, and then accurate closing of the tips and folding of the lens in one quick/ easy, and accurate step. Once folded by the foldex, the lens i5 rsmoved by ~he forceps.
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2~623 The forcep~ does not fold the lens. That i8 accomplished by the folder.
The invention allows the surgeon to quickly, with only a few steps and with high assurance, fold the lens for insertion into the eye with reduced risk of damage to the lens. This is done with a noncomplex but reliable structure which is also economical and easy to understand and learn.
A BRI~5F DESCRIPTIO~ OF DRANING5 Fig. 1 i~ a perspective view of an embodiment according to the invention showing certain portions in an exploded fashion, and also illustrating an embodiment of a forceps which can be used with the invention.
Pig. 2 is a top plan view taken along line 2-2 of Fig. 1.
Fig. 3 is a top plan vi2w taken along line 3-3 of Fig. 1 also illustrating the elements (except the forceps) assembled and the position of a rubber band or other means to hold the elements together for shipping, if desired.
Fig. 4 is an enlarged sectional view taken along line 4-4 of Fig. 3 but showing the lens in a supported position.
Fig. 5 is an enlarged sectional view and partial cutaway view taken along line 5-5 of Fig. lo Fig. 6A is an enlarged perspectivè view illustrating the forceps tips of Fig. 1 gripping a folded intraocular lens.
Fig. 6B is an enlarged perspective view of an alternative embodiment of~forceps tips gripping a folded intraocular lens.
Fig. 7 is a sectional view generally similar to Fig. 4, but showing the normal position of an 2~623 intraocular lens maunted on the invention, and the initial positioniny of a forceps tips with re~pect to the lens. The shipping block 24 of Fig. 4 i~
completely removed in this Figure.
Fig. 8 is similar to Fig. 7 but shows how the invention operates to automatically begin reliable and accurate folding of the lens in the forceps tips.
Fig. 9 is similar to Fig. 8 but shows completion of the automatic folding process of the lens in the forceps tips in the invention.
Fig. 10 is similar to Fig. 9 but shows how the lens, folded and gripped by the forceps ~ips, can be separated from the invention.
Fig. 11 is a perspective view of a secon~
embodiment according to the present invention, showing in somewhat exploded fashion an intraocular lens and a forceps that can be used with the invention.
Fig. 12 is an enlarged perspective view and paxtial cutaway view of the invention shown in Fig.
11 .
Fig. 13 is an enlarged sectional view taken along lines 13-13 of Fig. 12 additionally showing the intraocular lens positioned in the invention and the forceps tips in position prior to the beginning o the folding of the lens.
Fig. 14 is similar to Fig. 13 but shows the process of beginning the automatic folding of the lens within the forceps tips.
Fig. 15 is similar to Fig. 14 but showing the completion of folding of the lens within the forceps tips.
Fig. lG is similar to Fig. 15 but showing the removal of the folded lens gripped within the forceps tips rom the invention.
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2 ~ 3 Fiy. 17 is a top plan ~iew taken generally along line 17-17 of Fig. 11.
DETAILED DESCRIPTION OF PREFERRED ~MBODIMENT
In order to assist in a better under6tanding o~
the invention, a detailed description of prefexred embodiments of the same will now be set forth. The description will be made with reference to the accompanying drawings. Reference numbers are utilized in the description and drawings to specify particular parts or locations in the dra~ings. The same reference numbers will be utilized for the same parts in all the drawings unless otherwise indicated.
Turning to the embodiment shown in Figs. 1-10, folder 10 includes a frame 12. In turn, frame 12 includes a gripping portion 14 and a supporting portion 16. As can be seen from Fig. 1, frame 12 consists basically of two mirror images along a longitudinal axis. When discussing gripping portion 14 and supporting portion 16/ both opposite mirror image sid~s of each portion are included. It is to be un~erstood that folder 10 not only facilitates the easy and reliable folding of an intraocular lens 18 within the tips 20 of a forceps 22, but also can serve as a storage device for the lens prior to insertion. Still further, it can serve as basically a packaging device whereby the lsns 18 can be mounted, secured, and thsn packagsd in mass quantities for shipping to desired locations. As is well within the skill and llnderstanding of those within the art, the sntire frame 12, including a lens and a block insert 24, could bs secured in place by a rubber band or the like on the supporting poxtion 16 of frams 12 (see Fig. 3~, and ~hen hygienically packaged ~ithin plastic packaging, or a box for 2~623 shipment. This eliminates the step of removing khe lens 18 from its container, placing it onto ~older lO, and then performing the folding function.
Obviously, however, folder 10 could be used in this manner if desired.
Fig. 2 illustrates how the lens 18 can be placed vn curved support jaws 28 and 30 at the supporting portion 16 o frame 12. In its normal position, the separation between the bottom lens supporting portions o~ jaws 28 and 30 is slightly less than the outside diameter of the optic portion of lens 18.
The separation between the portions of jaws 28 and 30 hold the lens in position on opposite sides of the perimeter of the lens which is slightly greater than the diameter of the lens. ~See Fig. 4). Note how the curvature of jaws 28 and 30 basically follows the curvature of the diameter of lens 18 (see Fig. 2).
As will be described in more detail later, a portion of jaws 28 and 30, however, supports lens 18 underneath its perimeter, whereas another curved portion of jaws 28 and 30 abut~ the perimeter or a portion of the perimeter of lens 18. This allows len~ 18 to be held in position within jaws 28 and 30.
The jaws 28 and 30 of supporting portion 16 basically cradle and support lens 18. It should be noted that it is supported only as to portions at or near the perimeter of lens 18. This reduces the risk of any damage to the center portion of lens 18. Fig. 2 also illustrates how the hap~ic portions 34 and 36 of lens 18 can be accommodated by the structure of frame 12.
The sides of jaws 28 and 30 have cut-out areas 50 and 52 that allow haptics 34 and 36 to enter unobstructad (as shown in Fig. 2 and 4). These areas 50 and 52 are cleared to allow space for the haptics when optic 32 is in position as shown in Fi~. 4. This structure .
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2~59~3 is also beneficial to the extent it helps hold the optic in position. Notice al~o how the stop~ 38 and 40 on the ~ripping portion 14 of frame 12 aro somewhat separated. The stops 38 and 40 determine how far the opposite sides of gripping portion 14 can move towards one another when manual pressure is applied inwardly. As will be further described below, such manual pressure causes jaws 28 and 30 to move together which controls the folding process o lens 18.
Fig. 3 is similar to Fig. 2 except i-t shows how block insert 24 and lens 18 can be packaged and sec~red in supporting portion 16 of frame 12. Lower legs 42 and 44 of blocking insert 24 matingly insert into a space above support jaws 28 and 30, abutting vertical walls 54 and 56 oE jaws 28 and 30 to prevent jaws 28 and 30 from moving towards one another which could damage or dislodge lens 18. Note also how block insert 24 includes circular opening 58 and spacing between legs 42 an 44 to avoid any potential damage to optic portion 32 o~ lens 18. Legs 42 and 44 prevent dislodging of the lens during shipping and handling. The center portion of optic 32 needs to be clear and free from abutment or abrasion with anything.
Fig. 4 shows in more detail the exact structure of supporting portion 16 of frame 12. In particular, it shows how lens 18 sits directly on top of curved support jaws 28 and 30. Furthermore, raised curved ledges 46 and 48 exist on top of support jaws 28 and 80. These ledges serve as stops when block insert 24 is inserted, so that block insert 24 does not abut or damage lens-28. As described above, ledges 46 and 48 also serve to cradle or abut opposlte portions of the perimeter of optic portion 32 of lens 18 to hold i~
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` -- 2 ~ 2 3 in position. Note again how in the conven~ion~l normal position of frame 12, lens 18 is supported in its normal flat condition and absolutely no st~ucture abuts or is adjacent to the top or bottom center portion of optic 32 of lens 18.
Fig. 5 shows in more detail the exact structure of the supporting portion 16 of frame 1~, in an enlarged fashion. It is no~ed that there is no supporting structure i~nediately beneath the center of lens 18 when suppor$edO Also, there is no mandrel or other structure benea~h lens 18 to assist foiding of lens 18. This reduces risk of damage to lens 18 and distinguishes the present invention from some other lens folders. A better view of the curved nature of jaws 28 and 30, and raisad ledges 46 and 48 can be seen. Also note that channels 60 and Ç2 can be utilized to guide and Maintain a rubber band or other means around frame 12 if desired. A simi]ar channel can exist on insert 24 to cooperate with a rubber band.
Still further, Fig. 5 illustrates how jaws 28 and 30 support the lens in an intermediate position in fxame 12, both from either side of frame 12, and from the top and bottom of frame 12. This further facilitates the easy and secure packaging and shipping of frame 12 with a lens 18 in place, and also makes it easy for the surgeon to use when ready to fold and grasp the lens during surgery. Figure 6 illustrates tips 20, similar to those illustrated in Fig. 1, are unique in that they consist of an oval shaped frame 64 with an opening 66 in the middle.
Teeth 68 extend from the bottom of ovaI shaped xame 64 upwardly a~ spaced apart locations of each tip ~0.
As shown in Fig. 6A, when the optic portion 3~ of lens 18 is fQlded, portions of ~he folded lens 18 can ` 2~5~23 expand into openings 66. This i5 espeaially ~rue ~or the type of silicone len~es which tend to creep ou~
from within the grasp of the forceps. The abilit~ to conform and expand into opening 66 assists in insuring that the lens 18 can be reliably and accurately gripped and maintained in the accurately folded position. Still further, teeth 68, as optional features, can further this goal by providing assistance in gripping those portions of lens 18 that extend into openin~ 66.
Fig. 6A shows how a particular set of tips 20 of forceps 22 can be used to fold and grip a lens 18.
It is furthermore pointed out that tips 20 shown in Fig. 6A are configured to allow haptics 34 or 36 to be folded up inside tips 20, either through or between openings 66, or in other manners well within those ordinary skill in the art. Tips 20 could also include hooks, app~ndages, or other connection means for securing a haptic 34 or 36, if desired. This would facilitate the control of position of haptic 34 or 36 and prevent them from effecting the insertion process of lens 1~ into the eye.
Fig. 6B illustrates a more generic set of tips 20A for forceps 22A. In this embodiment tips 20A are merely flat, elongated members which are angled with respect to the body of forceps 22A. Each tip 20A
would be converged upon opposite sides of the folded lens 18 as can be well appreciated in the art. It is pointed out that the invention could be used with a variety of different forceps and forceps tips.
Figs~ 7-10 illustraEe the operation of folder 10. Each of these figures illustrates a par icular stage of the process of folding of lens 18. It is to be understood that the primary advantage of folder 10 is the ability to support lens 18 in the vic2-like - : ~ .
2 ~ 2 3 structure of jaws 28 and 30, which a~ the sam~ time allows virtually automatic po~itioning o:E tips 28 o-f forceps 22 in this vice-like structure. q'hereater, it i5 only a mattex of manually closing the jaws 28 and 30 of the vice-like structure of folder 10 As ~aws 20 and 30 converge, the portions underneath lens 18, prevents lens 18 from moving downwardly, and tho presence of forceps tips 20 on the perimeter edges of lens 18 causes lens 18 to fold upwardly inside the pre-positioned forceps tips 20. The process continues until forceps tips are pushed together to the point where the lens, now accurately and reliably folded into the tips, can be reliably gripped and removed, ready for insertion into the eye.
Fig. 7 is similar to Fig. 4, and shows how raised ledges 46 and 48 serve to automatically position tips 20 of forceps 22 immediately by the perimeter edge of the optic portion 32 of lens 18.
This allows the surgeon to quickly and easily position the tips so that they will accurately and reliably grasp and remove tha lens. There does not have to be any manual estimation or checking of positioning of the forceps tips 20.
Fig. 8 then shows that once tips 20 of orceps 22 are positioned, gripping portion 14 (see Fig. 1) is squeezed together to begin folding of lens 18 in tips 20. The movement of the opposite sides of gripping portion 14 in turn causes the movemant of opposite sides of supporting portion 16 to cause support jaws 28 and 30 ~o move towards one another ~illustrated by arrows 70 and 72). This automatically moves for~eps tips 20 towards one another while causing the optic portion of lens 18 to bow and fold upwardly. It also automatically controls the position that forceps tips 20 will grasp the lens.
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2 ~ r~3 ~ ~ ~ 3 Fig. 9 shows the completion o~ movement of the opposite 6ides of ~upporting portion 16 toward~ one another and the correct and accurate gripping of the lens 18 above the perimeter ed~e of the optic 32.
The forceps tips are then squeezed together prior to releasing pressure applied to portion 14.
Finally, Fig. 10 shows that when the gripping portion 14 is released to allow the opposite sides to resiliently move apart (back to their normal position) from one another, the opposîte parts of supporting portion 16 also move apart to allow the forceps tips to continue to reliàbly grip lens 18 and remove it from folder 10 for insertion into the eye during surgery.
The embodimen~ of Figs 1-10 san be made of a white polypropylene material. Optic portion 32 of lens 18 has a diameter of appro~imately .240 inches.
~The width of th portion of jaws 28 and 30 upon which lens 18 would be supported is approximately .02 inches.
Fig. ~11 shows a second embodiment of the present invention. Folder 100 comprises a base 102 of generally cylindrical shape but having a channel 104 ~. generally bisectin~ base 102 laterally. A circular bore 106 exists through the ~enter of base 102 along its vertical axis.
- Folder~100 works very similarly to folder 10 previously described with respect to Figs. 1-10 except it utilizes moveable arms 108 and 110 each havins beveled or notched inner ends 112 and 114.
The beveled inner ends 112 and 114 provide the support and positioning of lens 18 in holder 100.
Arms 108 and 110 are mateably insertahle and slideable through square bores 116 and 118 in bass 102. The outer ends of arms 108 and 110 are always . . , . - . , - .
2 ~ 2 3 gripable and manually mansuverable by a user to allow the user to move one or both arms 108 and 110 toward~
and away from one another. Fig. 11 shows how a lens 18 can be moved and inserted between arms 108 and 110 by either setting it upon horizontal ledges 124 and 126 of beveled ends 112 and 114 from above, or sliding it in through channel 104 sldeways onto ledges 124 and 126. The opening defined by channel 104 and bore 10~ then allows tips 20 of forceps 22 to be inserted downwardly into folder 100 and automatically positioned as shown in Fig. 13.
Fig. 12 shows in more detail the relationship of arms 108 and 118 and base 102. In a normal position, arms 108 and 110 are separated a sufficient distance so that a lens 18 in its normal unfolded state can be placed on ledges 124 and 126. Additionally, arms 108 and 110 are positioned so that the opposite perimeter edge of lens 18 abuts against the beveled inner ends 112 and 114 at the junction of upwardly angled portions 120 and 122 with ledges 124 and 126 respectively (see Fig. 13). Tha bevelled inner ends 112 and 114 therefore serve the dual purpose o~
supporting lens 18 and maintaining it in a secure position.
Note also that recesses 128 and 130 can be formed in the extra side wall of base 102 if desired to make gripping of the outer ends of arms 108 and 110 easier.
Turning to Figs. 13-16, the sequence of s~eps for folding of the lens are shown. These are essentially similar to those shown at Fig. 7-10. In this case, however, either one arm 108 or 118 r or both arms 108 and 118 can be moveable. As depicted in Fig. 13, set screws 132 and 134 could optionally be included to be threadably moveable in threaded ~. . . . . . .
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:... ~. : ' ' 2 ~ 2 3 bores 136 and 13B in the top of baso 102 in alignmen~ of arms 108 and 110. Set ~crews 132 and 134 could then be adjustable to either secure either arm 108 or 110 into a fixed position, or loosen to allow slideable, lateral movement. Set screws 132 and 134 are optional, and other types of securing means, either releaseable or not, could be utilized wi-th the invention. Therefore, it is to be understood that either arm can be releasably secured in any linear position by means known in the art such as a set screw or some other device.
It can be appreciated, the depictions in ~igs.
13-16 ~as in Fi~s. 7-10~ illustrate forceps tips 22 of the particular type of forceps 20, where the tips 22 have the shape and configuration shown in more detail in Fig. 6A (see also Fig. 17). The cross sectional views o~ Figs. 13-16 (and 6-10) show that the tips 22 are bowed or curved along a longitudinal axis. Therefore, in these figures, only the first portions of tips 22 which are diverging are seen. As can be more fully appreciated with reference to Fiy.
17, these particular forceps tips 22 from a top view have an inside concave shape and an outside convex ~hape. It is to be clearly understood, however, that alternative types of forceps and forceps tips can be utilized as has been previously explained.
Fig. 14 illustrates that manual force against one or both of arms 108 and/or 110 inwardly ~as indicated by arrows 138 or 140) will in turn move beveled inner ends 112 andlor 114 towards one another. Similarly to jaws 28 and 30 of folder 10 in - Fig. 1, the forceps tips 22 are automatically positioned and the lens is folded within the tips automatically by this system. One difference between beveled inner ends 112 and 1l4 and jaws 23 and 30 is .. :
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that the beveled inner ends 112 and 114 a~e no-t cur~ed to mimic the perimeter of lens 18. However, a~
can be appreciated with reference to Fig. 18, the upward bowing of lens 18 when arms 108 and/or 110 is/are moved inwardly lifts the bottom 5ur~ace of lens 118 so that there again is a reduced risk of any damage, abrasion, or abutment of the middle portion of optic 32 with the structure of folder 10~.
Fig. 15 shvws the further step of brin~ing arms 108 and 110 into further convergence accurately and automatically folding lens 18 within tips 22. Fig.
16 shows how arms 108 and 110 can then be retracted and the forceps can be raised from folder 100 with the accurately folded lens particularly gripped in tips 22.
Fig. 17 shows the top plan view of folder 100.
It further illustrates how forceps tips 20 are automatically positioned with respect to optic 32 by the configuration of beveled inner ends of 112 and 114 or arms 108 and 110 when they are in what is called their "normal'l position supporting lens 18 in its unfolded stated. Note further how the curved segments of bore 106 allow haptics 34 and 36 to be positioned under supporting arms 108 and 110 in generally normal position when lens 18 is supported in an unfolded stata on ~older 100. Note also that the beveled inner ends 112 and 114 only support a relatively small portion near the perimeter of optic . 32. Channel 104 basically steers the forceps 22 into a position perpendicular to arms 108 and 110. By referring back to Fig. 13-16, it can also be seen that a space exists underneath inner beveled ends 112 and 114 to accomoda-te the haptics without damage during storage and folding.
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2 ~ % 3 _ 18 -Folder 100 can be made of a variety of different materials. For example, ba~e 102 can be made of a variety of different types o~ plastics, as can arms 108 and 110. Arms 108 and 110 can alternatively be made of metal or other materials if de~ired.
Fig. 18 shows a sti]l different embodiment o~
the invention. The folder lOA is quite similar to folder 10. In fact, its supports jaws 28A and 30A
are exactly the same as jaws 28 and 30 of folder 10.
Lens 18 is supported and folded in exac~ly the same manner because of this identity of structure.
Additionally, a block insert 24A can be used for storage and/or packaging and~or shipping, as explained with regard to folder 10.
The major difference between folder lOA and folder 10 is the configuration of frame 12A (except for jaws 28A and 30A). Instead of having an explicit gripping portion 14 and supporting portion 16, as described with respect to folder 10, folder lOA
basicall~ has an oval shaped outer frame with the jaws 28A and 30A extending inwardly towards each other at the center of this frame. The resilient natur~ of frame 12A would allow the user to basically push the sides of frame l~A together in line with jaws 28 and 30 on opposite sides to allow the ~aws 28A and 30A to move towards each other once block insert 24A is removed. This embodiment represents a more simplified version but one which still would adequately protect lens 18 from all sides, when block insert 24A i5 used and the entire folder lOA is boxed or packaged for shipment.
It can therefore be seen that the invention achieves at least all of its stated ob~ectives. I~
will be appreciated that the present invention can take many forms in embodiments. The true essence and . .
- 2~5~3 spirit of this inventlon are defined in the appended claims, and it i5 not intended that the embodlment o the invention herein should limit the scope thereo~.
The invention presents a lens folding device which is economical~ from a variety of standpoints, including but not limited to manufacturing, packaying, and use. Its economical nature can allow it to be packaged with individual lenses so that all the surgeon has to do is open the sterilized package, remove any block inserts or other packaging materials, automatically have the lens folded within the forceps tips, and throw the folder away.
Alternatively, of course, the folder could be re-utilized if sterilized.
The folder is relatively small in size, has few critical toleranc~s and moving parts, if any depending upon the embodiment, and improves the ability of the surgeon to quickly but accurately and reliably fold and grasp a foldable intraocular lens.
The invention basically operates as a~ automatic forceps tips positioner with respect to the lens and then as a vise which automatically maintain~ the accurate gripping position of the forceps tips while the lens is folded within them. It eliminates the surgeon having to manually estimate the correct gripping location or having to utilize two forceps o~
other instruments to assist in the folding processO
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The replacement of lens of a human eye generally utilizes a surgical procedure whereby an artificial replacement lens is inserted through an incision in the eye. Once inside the eye, the surgeon manipulates the lens into a position where it is then secured. To minimize trauma to the eye, it is most beneficial to minimize the size of the incision through which the lens is inserted.
This type of artificial lens, generally referred to as an intraocular lens, is usually comprised of a circular convex or plano-convex optic portion, with arms called haptics extending from the optic. The haptics are utilized to hold the lens in place.
A practical limitation on how small the incision in the eye can be is the diameter of the optic portion of the lens. Although tissue is somewhat pliable, a slit or incision has to be approximately, at a minimum, the length of the diameter of the lens.
One way to avoid this limitation is to manipulate the lens to reduce its cross-sectional diameter before insertion into the eye. An example would be to fold the lens over onto itself. This would reduce the required length of the incision by approximately one half.
The present invention relates to lens insertion and intraocular lens replacement surgery t and in particular, to an improvsd means and method for folding a lens in preparing it for insertion into the eye. The ~enefits of one smaller incision are less trauma to ~he eye.
The concept of folding or rolling a lens prior to insertivn is known in the art. See, for sxample, the following U.S. p~tents:
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2 ~ 2 3 Faulkner4,84~,065 Poley4,769,034 Patton4,836,201 Mazzocco4,702,24~
Bartell4,681,102 Willis4,759,359 Baccala~ 4,785,810 Patents such as Faulkner, Poley, Willis, and Baccala illustrate how the folding of a lens may be done, or disclose and claim instruments used in association with such folding. Patents such as Patton, Nazzocco and Bartell disclose rather complex instruments and associated hardware for rolling or otherwise manipulating the lens into a smaller cross sectional or diametric shape.
- It has been determined that although the above technology exists in the art, there is room for improvement as to how a lens can be reliably and accurately folded. Intraocular lens replacement is a highly technical and delicate surgery. It deals with replacing a natural part of the eye with an artificial implant. The value of eyesight is immeasurable. Therefore, it is critical that all possible steps be taken to insure the best possible lens replacement and procedures.
Room for improvement exists in the ability of precise, accurate, and reliable folding of lens, if that procedure is used. A surgeon needs to ha~e a good grip on a lens for its insertion. The lens cannot be damag~d or scratched. The folding needs to be accomplished quickly and easily. It is insufficient, or at least problema~ic, for a surgeon ~o accomplish such~delicate and minute folding without some standardized procedure or structure.
-" 2~5~623 Moreover, it is also disadvantageous ~o u-tilize complex procedure or methods. Complexity leads ~o the risk of malfunction or, at a minimum, difficulties in learning the pxocess or structure.
Additionally, the technology regarding the artificial intraocular lenses themselves has advanced. The optic portions of the lenses themselves may be made of several different materials. Some of these materials have characteristics which allow them to provide good optical qualities and durability~ Some of the materials, however, are not particularly easy to fold or manipulate. One problem deals with lenses which are made of substances like silicone which are resilient and very deformable. This makes it difficult to maintain a secure grip on the lens when folded as the lens has a tendency to return to its original position. The second problem exists in taking great care to avoid any damage to the lens optic. Any gripping of the lens, especially near the optical center, runs this risk.
The need therefore exists for a means and method of xeliably and accurately foldin~ a soft intraocular lens, including those lens optics which are made of a variety of different materials.
It is therefore the principal object of the present invention to provide a means and method for facilitating folding of a foldable intraocular lens which overcomes or improves o~er the problems and deficiencies in the art.
It is a further object of the present invention to provide a means and method as above described which presents an ea~y, accura~e, and reliable way to fol~ intraocular lenses.
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A still further ob~ect o~ the invention is to provide a means and method as above described which greatly reduces the risk of inaccurate folding and gripping of an intraocular lens.
A still further object of the present in~ention is to provide a means and method as above described which reduces the risk of damage to an intraocular lens which is folded.
A still further ob~ect o~ the present invention is to provide a means and method as above described which is noncomplex and easy to understand and adopt.
A still further object of the present invention is to provide a means and method as above described which is adaptable to a variety of intraocular lenses.
Another object of the pre~ent invention is to provide a means and method as above described which minimizes handling o$ the lens.
Another object of the present invention is described which minimizes the risk of upside down installation of the lens, as it will always be packaged, presented, and folded within the forceps tip in the correct position.
Another object of the present in~ention is to provide a means and method as above described which is economical and efficient.
These and other objects, features, and advantages of the presen~ invention will become more apparent with references to the accompanying specification and claims~
SUMMARY OF TH~ INVENTION
The present invention presents a ~ystem whereby the surgeon can confidently know ~hat lens can be quickly and accurately folded with forceps, with a 2~16~3 minimum risk of damage to the lens. The method involvss the st~ps of positioning and supporting ths lens to be folded so that forceps tips can easily and quickly be brought into presolected, desired positions near opposite diametrical sides of the optic portion of the lens. ~he tips are automatically located in optimal positions to grip the lens when it is folded.
Structure surrounding the tips, and assisting in their placement, can then be moved by manual force to automatically cause the lens to accurately fold in two, and the forceps tips to be maintained in continuous contact with the optic portion of the lens as it is folded. As the tips are held in position, mechanical force is applied to the structure around the tips to urge the tips towards one another. The lens is supported in such a way that its center portion raises, and the structure basically ensures that the lens folds accurately upon itself and the forceps tips reliably grasp and hold the lens in ~he folded shape without the use of a second pair of forceps or a folding mandrel.
The apparatus according to the invention includes a base, a supporting structure associated with the base for supporting the lens, a positioning structure to position and maintain the forceps tips with respect to the lens, and moveable structure to cause, assist and guide ~he closing of the forceps tips concurrently with folding of the lens. The lens can basically be automatically folded in half. The forming structure is basically a vise which causes accurate positioning of $he forceps tips, and then accurate closing of the tips and folding of the lens in one quick/ easy, and accurate step. Once folded by the foldex, the lens i5 rsmoved by ~he forceps.
: .
2~623 The forcep~ does not fold the lens. That i8 accomplished by the folder.
The invention allows the surgeon to quickly, with only a few steps and with high assurance, fold the lens for insertion into the eye with reduced risk of damage to the lens. This is done with a noncomplex but reliable structure which is also economical and easy to understand and learn.
A BRI~5F DESCRIPTIO~ OF DRANING5 Fig. 1 i~ a perspective view of an embodiment according to the invention showing certain portions in an exploded fashion, and also illustrating an embodiment of a forceps which can be used with the invention.
Pig. 2 is a top plan view taken along line 2-2 of Fig. 1.
Fig. 3 is a top plan vi2w taken along line 3-3 of Fig. 1 also illustrating the elements (except the forceps) assembled and the position of a rubber band or other means to hold the elements together for shipping, if desired.
Fig. 4 is an enlarged sectional view taken along line 4-4 of Fig. 3 but showing the lens in a supported position.
Fig. 5 is an enlarged sectional view and partial cutaway view taken along line 5-5 of Fig. lo Fig. 6A is an enlarged perspectivè view illustrating the forceps tips of Fig. 1 gripping a folded intraocular lens.
Fig. 6B is an enlarged perspective view of an alternative embodiment of~forceps tips gripping a folded intraocular lens.
Fig. 7 is a sectional view generally similar to Fig. 4, but showing the normal position of an 2~623 intraocular lens maunted on the invention, and the initial positioniny of a forceps tips with re~pect to the lens. The shipping block 24 of Fig. 4 i~
completely removed in this Figure.
Fig. 8 is similar to Fig. 7 but shows how the invention operates to automatically begin reliable and accurate folding of the lens in the forceps tips.
Fig. 9 is similar to Fig. 8 but shows completion of the automatic folding process of the lens in the forceps tips in the invention.
Fig. 10 is similar to Fig. 9 but shows how the lens, folded and gripped by the forceps ~ips, can be separated from the invention.
Fig. 11 is a perspective view of a secon~
embodiment according to the present invention, showing in somewhat exploded fashion an intraocular lens and a forceps that can be used with the invention.
Fig. 12 is an enlarged perspective view and paxtial cutaway view of the invention shown in Fig.
11 .
Fig. 13 is an enlarged sectional view taken along lines 13-13 of Fig. 12 additionally showing the intraocular lens positioned in the invention and the forceps tips in position prior to the beginning o the folding of the lens.
Fig. 14 is similar to Fig. 13 but shows the process of beginning the automatic folding of the lens within the forceps tips.
Fig. 15 is similar to Fig. 14 but showing the completion of folding of the lens within the forceps tips.
Fig. lG is similar to Fig. 15 but showing the removal of the folded lens gripped within the forceps tips rom the invention.
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2 ~ 3 Fiy. 17 is a top plan ~iew taken generally along line 17-17 of Fig. 11.
DETAILED DESCRIPTION OF PREFERRED ~MBODIMENT
In order to assist in a better under6tanding o~
the invention, a detailed description of prefexred embodiments of the same will now be set forth. The description will be made with reference to the accompanying drawings. Reference numbers are utilized in the description and drawings to specify particular parts or locations in the dra~ings. The same reference numbers will be utilized for the same parts in all the drawings unless otherwise indicated.
Turning to the embodiment shown in Figs. 1-10, folder 10 includes a frame 12. In turn, frame 12 includes a gripping portion 14 and a supporting portion 16. As can be seen from Fig. 1, frame 12 consists basically of two mirror images along a longitudinal axis. When discussing gripping portion 14 and supporting portion 16/ both opposite mirror image sid~s of each portion are included. It is to be un~erstood that folder 10 not only facilitates the easy and reliable folding of an intraocular lens 18 within the tips 20 of a forceps 22, but also can serve as a storage device for the lens prior to insertion. Still further, it can serve as basically a packaging device whereby the lsns 18 can be mounted, secured, and thsn packagsd in mass quantities for shipping to desired locations. As is well within the skill and llnderstanding of those within the art, the sntire frame 12, including a lens and a block insert 24, could bs secured in place by a rubber band or the like on the supporting poxtion 16 of frams 12 (see Fig. 3~, and ~hen hygienically packaged ~ithin plastic packaging, or a box for 2~623 shipment. This eliminates the step of removing khe lens 18 from its container, placing it onto ~older lO, and then performing the folding function.
Obviously, however, folder 10 could be used in this manner if desired.
Fig. 2 illustrates how the lens 18 can be placed vn curved support jaws 28 and 30 at the supporting portion 16 o frame 12. In its normal position, the separation between the bottom lens supporting portions o~ jaws 28 and 30 is slightly less than the outside diameter of the optic portion of lens 18.
The separation between the portions of jaws 28 and 30 hold the lens in position on opposite sides of the perimeter of the lens which is slightly greater than the diameter of the lens. ~See Fig. 4). Note how the curvature of jaws 28 and 30 basically follows the curvature of the diameter of lens 18 (see Fig. 2).
As will be described in more detail later, a portion of jaws 28 and 30, however, supports lens 18 underneath its perimeter, whereas another curved portion of jaws 28 and 30 abut~ the perimeter or a portion of the perimeter of lens 18. This allows len~ 18 to be held in position within jaws 28 and 30.
The jaws 28 and 30 of supporting portion 16 basically cradle and support lens 18. It should be noted that it is supported only as to portions at or near the perimeter of lens 18. This reduces the risk of any damage to the center portion of lens 18. Fig. 2 also illustrates how the hap~ic portions 34 and 36 of lens 18 can be accommodated by the structure of frame 12.
The sides of jaws 28 and 30 have cut-out areas 50 and 52 that allow haptics 34 and 36 to enter unobstructad (as shown in Fig. 2 and 4). These areas 50 and 52 are cleared to allow space for the haptics when optic 32 is in position as shown in Fi~. 4. This structure .
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2~59~3 is also beneficial to the extent it helps hold the optic in position. Notice al~o how the stop~ 38 and 40 on the ~ripping portion 14 of frame 12 aro somewhat separated. The stops 38 and 40 determine how far the opposite sides of gripping portion 14 can move towards one another when manual pressure is applied inwardly. As will be further described below, such manual pressure causes jaws 28 and 30 to move together which controls the folding process o lens 18.
Fig. 3 is similar to Fig. 2 except i-t shows how block insert 24 and lens 18 can be packaged and sec~red in supporting portion 16 of frame 12. Lower legs 42 and 44 of blocking insert 24 matingly insert into a space above support jaws 28 and 30, abutting vertical walls 54 and 56 oE jaws 28 and 30 to prevent jaws 28 and 30 from moving towards one another which could damage or dislodge lens 18. Note also how block insert 24 includes circular opening 58 and spacing between legs 42 an 44 to avoid any potential damage to optic portion 32 o~ lens 18. Legs 42 and 44 prevent dislodging of the lens during shipping and handling. The center portion of optic 32 needs to be clear and free from abutment or abrasion with anything.
Fig. 4 shows in more detail the exact structure of supporting portion 16 of frame 12. In particular, it shows how lens 18 sits directly on top of curved support jaws 28 and 30. Furthermore, raised curved ledges 46 and 48 exist on top of support jaws 28 and 80. These ledges serve as stops when block insert 24 is inserted, so that block insert 24 does not abut or damage lens-28. As described above, ledges 46 and 48 also serve to cradle or abut opposlte portions of the perimeter of optic portion 32 of lens 18 to hold i~
.:
` -- 2 ~ 2 3 in position. Note again how in the conven~ion~l normal position of frame 12, lens 18 is supported in its normal flat condition and absolutely no st~ucture abuts or is adjacent to the top or bottom center portion of optic 32 of lens 18.
Fig. 5 shows in more detail the exact structure of the supporting portion 16 of frame 1~, in an enlarged fashion. It is no~ed that there is no supporting structure i~nediately beneath the center of lens 18 when suppor$edO Also, there is no mandrel or other structure benea~h lens 18 to assist foiding of lens 18. This reduces risk of damage to lens 18 and distinguishes the present invention from some other lens folders. A better view of the curved nature of jaws 28 and 30, and raisad ledges 46 and 48 can be seen. Also note that channels 60 and Ç2 can be utilized to guide and Maintain a rubber band or other means around frame 12 if desired. A simi]ar channel can exist on insert 24 to cooperate with a rubber band.
Still further, Fig. 5 illustrates how jaws 28 and 30 support the lens in an intermediate position in fxame 12, both from either side of frame 12, and from the top and bottom of frame 12. This further facilitates the easy and secure packaging and shipping of frame 12 with a lens 18 in place, and also makes it easy for the surgeon to use when ready to fold and grasp the lens during surgery. Figure 6 illustrates tips 20, similar to those illustrated in Fig. 1, are unique in that they consist of an oval shaped frame 64 with an opening 66 in the middle.
Teeth 68 extend from the bottom of ovaI shaped xame 64 upwardly a~ spaced apart locations of each tip ~0.
As shown in Fig. 6A, when the optic portion 3~ of lens 18 is fQlded, portions of ~he folded lens 18 can ` 2~5~23 expand into openings 66. This i5 espeaially ~rue ~or the type of silicone len~es which tend to creep ou~
from within the grasp of the forceps. The abilit~ to conform and expand into opening 66 assists in insuring that the lens 18 can be reliably and accurately gripped and maintained in the accurately folded position. Still further, teeth 68, as optional features, can further this goal by providing assistance in gripping those portions of lens 18 that extend into openin~ 66.
Fig. 6A shows how a particular set of tips 20 of forceps 22 can be used to fold and grip a lens 18.
It is furthermore pointed out that tips 20 shown in Fig. 6A are configured to allow haptics 34 or 36 to be folded up inside tips 20, either through or between openings 66, or in other manners well within those ordinary skill in the art. Tips 20 could also include hooks, app~ndages, or other connection means for securing a haptic 34 or 36, if desired. This would facilitate the control of position of haptic 34 or 36 and prevent them from effecting the insertion process of lens 1~ into the eye.
Fig. 6B illustrates a more generic set of tips 20A for forceps 22A. In this embodiment tips 20A are merely flat, elongated members which are angled with respect to the body of forceps 22A. Each tip 20A
would be converged upon opposite sides of the folded lens 18 as can be well appreciated in the art. It is pointed out that the invention could be used with a variety of different forceps and forceps tips.
Figs~ 7-10 illustraEe the operation of folder 10. Each of these figures illustrates a par icular stage of the process of folding of lens 18. It is to be understood that the primary advantage of folder 10 is the ability to support lens 18 in the vic2-like - : ~ .
2 ~ 2 3 structure of jaws 28 and 30, which a~ the sam~ time allows virtually automatic po~itioning o:E tips 28 o-f forceps 22 in this vice-like structure. q'hereater, it i5 only a mattex of manually closing the jaws 28 and 30 of the vice-like structure of folder 10 As ~aws 20 and 30 converge, the portions underneath lens 18, prevents lens 18 from moving downwardly, and tho presence of forceps tips 20 on the perimeter edges of lens 18 causes lens 18 to fold upwardly inside the pre-positioned forceps tips 20. The process continues until forceps tips are pushed together to the point where the lens, now accurately and reliably folded into the tips, can be reliably gripped and removed, ready for insertion into the eye.
Fig. 7 is similar to Fig. 4, and shows how raised ledges 46 and 48 serve to automatically position tips 20 of forceps 22 immediately by the perimeter edge of the optic portion 32 of lens 18.
This allows the surgeon to quickly and easily position the tips so that they will accurately and reliably grasp and remove tha lens. There does not have to be any manual estimation or checking of positioning of the forceps tips 20.
Fig. 8 then shows that once tips 20 of orceps 22 are positioned, gripping portion 14 (see Fig. 1) is squeezed together to begin folding of lens 18 in tips 20. The movement of the opposite sides of gripping portion 14 in turn causes the movemant of opposite sides of supporting portion 16 to cause support jaws 28 and 30 ~o move towards one another ~illustrated by arrows 70 and 72). This automatically moves for~eps tips 20 towards one another while causing the optic portion of lens 18 to bow and fold upwardly. It also automatically controls the position that forceps tips 20 will grasp the lens.
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2 ~ r~3 ~ ~ ~ 3 Fig. 9 shows the completion o~ movement of the opposite 6ides of ~upporting portion 16 toward~ one another and the correct and accurate gripping of the lens 18 above the perimeter ed~e of the optic 32.
The forceps tips are then squeezed together prior to releasing pressure applied to portion 14.
Finally, Fig. 10 shows that when the gripping portion 14 is released to allow the opposite sides to resiliently move apart (back to their normal position) from one another, the opposîte parts of supporting portion 16 also move apart to allow the forceps tips to continue to reliàbly grip lens 18 and remove it from folder 10 for insertion into the eye during surgery.
The embodimen~ of Figs 1-10 san be made of a white polypropylene material. Optic portion 32 of lens 18 has a diameter of appro~imately .240 inches.
~The width of th portion of jaws 28 and 30 upon which lens 18 would be supported is approximately .02 inches.
Fig. ~11 shows a second embodiment of the present invention. Folder 100 comprises a base 102 of generally cylindrical shape but having a channel 104 ~. generally bisectin~ base 102 laterally. A circular bore 106 exists through the ~enter of base 102 along its vertical axis.
- Folder~100 works very similarly to folder 10 previously described with respect to Figs. 1-10 except it utilizes moveable arms 108 and 110 each havins beveled or notched inner ends 112 and 114.
The beveled inner ends 112 and 114 provide the support and positioning of lens 18 in holder 100.
Arms 108 and 110 are mateably insertahle and slideable through square bores 116 and 118 in bass 102. The outer ends of arms 108 and 110 are always . . , . - . , - .
2 ~ 2 3 gripable and manually mansuverable by a user to allow the user to move one or both arms 108 and 110 toward~
and away from one another. Fig. 11 shows how a lens 18 can be moved and inserted between arms 108 and 110 by either setting it upon horizontal ledges 124 and 126 of beveled ends 112 and 114 from above, or sliding it in through channel 104 sldeways onto ledges 124 and 126. The opening defined by channel 104 and bore 10~ then allows tips 20 of forceps 22 to be inserted downwardly into folder 100 and automatically positioned as shown in Fig. 13.
Fig. 12 shows in more detail the relationship of arms 108 and 118 and base 102. In a normal position, arms 108 and 110 are separated a sufficient distance so that a lens 18 in its normal unfolded state can be placed on ledges 124 and 126. Additionally, arms 108 and 110 are positioned so that the opposite perimeter edge of lens 18 abuts against the beveled inner ends 112 and 114 at the junction of upwardly angled portions 120 and 122 with ledges 124 and 126 respectively (see Fig. 13). Tha bevelled inner ends 112 and 114 therefore serve the dual purpose o~
supporting lens 18 and maintaining it in a secure position.
Note also that recesses 128 and 130 can be formed in the extra side wall of base 102 if desired to make gripping of the outer ends of arms 108 and 110 easier.
Turning to Figs. 13-16, the sequence of s~eps for folding of the lens are shown. These are essentially similar to those shown at Fig. 7-10. In this case, however, either one arm 108 or 118 r or both arms 108 and 118 can be moveable. As depicted in Fig. 13, set screws 132 and 134 could optionally be included to be threadably moveable in threaded ~. . . . . . .
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:... ~. : ' ' 2 ~ 2 3 bores 136 and 13B in the top of baso 102 in alignmen~ of arms 108 and 110. Set ~crews 132 and 134 could then be adjustable to either secure either arm 108 or 110 into a fixed position, or loosen to allow slideable, lateral movement. Set screws 132 and 134 are optional, and other types of securing means, either releaseable or not, could be utilized wi-th the invention. Therefore, it is to be understood that either arm can be releasably secured in any linear position by means known in the art such as a set screw or some other device.
It can be appreciated, the depictions in ~igs.
13-16 ~as in Fi~s. 7-10~ illustrate forceps tips 22 of the particular type of forceps 20, where the tips 22 have the shape and configuration shown in more detail in Fig. 6A (see also Fig. 17). The cross sectional views o~ Figs. 13-16 (and 6-10) show that the tips 22 are bowed or curved along a longitudinal axis. Therefore, in these figures, only the first portions of tips 22 which are diverging are seen. As can be more fully appreciated with reference to Fiy.
17, these particular forceps tips 22 from a top view have an inside concave shape and an outside convex ~hape. It is to be clearly understood, however, that alternative types of forceps and forceps tips can be utilized as has been previously explained.
Fig. 14 illustrates that manual force against one or both of arms 108 and/or 110 inwardly ~as indicated by arrows 138 or 140) will in turn move beveled inner ends 112 andlor 114 towards one another. Similarly to jaws 28 and 30 of folder 10 in - Fig. 1, the forceps tips 22 are automatically positioned and the lens is folded within the tips automatically by this system. One difference between beveled inner ends 112 and 1l4 and jaws 23 and 30 is .. :
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that the beveled inner ends 112 and 114 a~e no-t cur~ed to mimic the perimeter of lens 18. However, a~
can be appreciated with reference to Fig. 18, the upward bowing of lens 18 when arms 108 and/or 110 is/are moved inwardly lifts the bottom 5ur~ace of lens 118 so that there again is a reduced risk of any damage, abrasion, or abutment of the middle portion of optic 32 with the structure of folder 10~.
Fig. 15 shvws the further step of brin~ing arms 108 and 110 into further convergence accurately and automatically folding lens 18 within tips 22. Fig.
16 shows how arms 108 and 110 can then be retracted and the forceps can be raised from folder 100 with the accurately folded lens particularly gripped in tips 22.
Fig. 17 shows the top plan view of folder 100.
It further illustrates how forceps tips 20 are automatically positioned with respect to optic 32 by the configuration of beveled inner ends of 112 and 114 or arms 108 and 110 when they are in what is called their "normal'l position supporting lens 18 in its unfolded stated. Note further how the curved segments of bore 106 allow haptics 34 and 36 to be positioned under supporting arms 108 and 110 in generally normal position when lens 18 is supported in an unfolded stata on ~older 100. Note also that the beveled inner ends 112 and 114 only support a relatively small portion near the perimeter of optic . 32. Channel 104 basically steers the forceps 22 into a position perpendicular to arms 108 and 110. By referring back to Fig. 13-16, it can also be seen that a space exists underneath inner beveled ends 112 and 114 to accomoda-te the haptics without damage during storage and folding.
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2 ~ % 3 _ 18 -Folder 100 can be made of a variety of different materials. For example, ba~e 102 can be made of a variety of different types o~ plastics, as can arms 108 and 110. Arms 108 and 110 can alternatively be made of metal or other materials if de~ired.
Fig. 18 shows a sti]l different embodiment o~
the invention. The folder lOA is quite similar to folder 10. In fact, its supports jaws 28A and 30A
are exactly the same as jaws 28 and 30 of folder 10.
Lens 18 is supported and folded in exac~ly the same manner because of this identity of structure.
Additionally, a block insert 24A can be used for storage and/or packaging and~or shipping, as explained with regard to folder 10.
The major difference between folder lOA and folder 10 is the configuration of frame 12A (except for jaws 28A and 30A). Instead of having an explicit gripping portion 14 and supporting portion 16, as described with respect to folder 10, folder lOA
basicall~ has an oval shaped outer frame with the jaws 28A and 30A extending inwardly towards each other at the center of this frame. The resilient natur~ of frame 12A would allow the user to basically push the sides of frame l~A together in line with jaws 28 and 30 on opposite sides to allow the ~aws 28A and 30A to move towards each other once block insert 24A is removed. This embodiment represents a more simplified version but one which still would adequately protect lens 18 from all sides, when block insert 24A i5 used and the entire folder lOA is boxed or packaged for shipment.
It can therefore be seen that the invention achieves at least all of its stated ob~ectives. I~
will be appreciated that the present invention can take many forms in embodiments. The true essence and . .
- 2~5~3 spirit of this inventlon are defined in the appended claims, and it i5 not intended that the embodlment o the invention herein should limit the scope thereo~.
The invention presents a lens folding device which is economical~ from a variety of standpoints, including but not limited to manufacturing, packaying, and use. Its economical nature can allow it to be packaged with individual lenses so that all the surgeon has to do is open the sterilized package, remove any block inserts or other packaging materials, automatically have the lens folded within the forceps tips, and throw the folder away.
Alternatively, of course, the folder could be re-utilized if sterilized.
The folder is relatively small in size, has few critical toleranc~s and moving parts, if any depending upon the embodiment, and improves the ability of the surgeon to quickly but accurately and reliably fold and grasp a foldable intraocular lens.
The invention basically operates as a~ automatic forceps tips positioner with respect to the lens and then as a vise which automatically maintain~ the accurate gripping position of the forceps tips while the lens is folded within them. It eliminates the surgeon having to manually estimate the correct gripping location or having to utilize two forceps o~
other instruments to assist in the folding processO
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Claims (17)
1.
A means for facilitating folding of an intraocular lens having a lens optic to prepare the lens for insertion through a small incision in the eye, comprising:
a base means;
translatable supporting means associated with the bass means for supporting at least a portion of the perimeter of a lens optic;
positioning means associated with the supporting mean generally for receiving and positioning opposite tips of a forceps near opposite sides of the perimeter of the lens optic when the lens optic is supported on the supporting means;
manually moveable means associated with the base means for translatable moving the supporting and positioning means towards one another, folding the lens optic within the forceps tips, while simultaneously maintaining the forceps tips in a desired position to the lens optic as the lens optic is folded.
A means for facilitating folding of an intraocular lens having a lens optic to prepare the lens for insertion through a small incision in the eye, comprising:
a base means;
translatable supporting means associated with the bass means for supporting at least a portion of the perimeter of a lens optic;
positioning means associated with the supporting mean generally for receiving and positioning opposite tips of a forceps near opposite sides of the perimeter of the lens optic when the lens optic is supported on the supporting means;
manually moveable means associated with the base means for translatable moving the supporting and positioning means towards one another, folding the lens optic within the forceps tips, while simultaneously maintaining the forceps tips in a desired position to the lens optic as the lens optic is folded.
2.
The means of claim 1 wherein the supporting and positioning means comprises curved jaws adaptable to be adjacent to opposite diametric sides of the optic, and the manually moveable means comprises extension means for allowing mechanical force to be transferred to the curved jaws to converge the forceps tips towards one another to allow the opposite sides of the lens optic to be folded onto one another and the forceps tips to grip the lens optic at a desired position.
The means of claim 1 wherein the supporting and positioning means comprises curved jaws adaptable to be adjacent to opposite diametric sides of the optic, and the manually moveable means comprises extension means for allowing mechanical force to be transferred to the curved jaws to converge the forceps tips towards one another to allow the opposite sides of the lens optic to be folded onto one another and the forceps tips to grip the lens optic at a desired position.
3.
The means of claim 1 wherein the extension means of the manually moveable means comprises rigid frame members connected to the base, which is comprised of resilient frame members, so that manual inward pressure on the resilient frame members of the base causes convergence of the rigid frame members which in turn causes folding of the lens optic within the forceps tips.
The means of claim 1 wherein the extension means of the manually moveable means comprises rigid frame members connected to the base, which is comprised of resilient frame members, so that manual inward pressure on the resilient frame members of the base causes convergence of the rigid frame members which in turn causes folding of the lens optic within the forceps tips.
4.
The means of claim 1 wherein the manually moveable means comprises moveable members within the base means to simultaneously push opposite sides of the lens towards one another as forceps tips axe closing upon one another to fold the lens optic within the forceps tips.
The means of claim 1 wherein the manually moveable means comprises moveable members within the base means to simultaneously push opposite sides of the lens towards one another as forceps tips axe closing upon one another to fold the lens optic within the forceps tips.
5.
The means of claim 1 further including an intraocular lens optic received in the supporting means, the optic being a plano-convex member.
The means of claim 1 further including an intraocular lens optic received in the supporting means, the optic being a plano-convex member.
6.
The means of claim 1 further including an intraocular lens optic received in the supporting means, the optic being foldable.
The means of claim 1 further including an intraocular lens optic received in the supporting means, the optic being foldable.
7.
The means of claim 6 further including an intraocular lens optic received in the supporting means, the optic being soft.
The means of claim 6 further including an intraocular lens optic received in the supporting means, the optic being soft.
8.
The means of claim 7 further including an intraocular lens optic received in the supporting means, the optic being made of silicone.
The means of claim 7 further including an intraocular lens optic received in the supporting means, the optic being made of silicone.
9.
The means of claim 7 further including an intraocular lens optic received in the supporting means, the optic being made of a plastic material.
The means of claim 7 further including an intraocular lens optic received in the supporting means, the optic being made of a plastic material.
10.
A means for folding a soft intraocular lens wherein the lens is folded within forceps tips that are then used to insert the lens into the eye, comprising:
a base means;
opposite jaw members associated with a base means including:
first means to position and hold a lens, and second means to allow insertion of and to position the forceps tips with respect to a desired position on top of the lens near opposite diametrical sides of the lens when the lens is positioned in the first means; and manually moveable means connected to the jaw means to manually converge the jaw means to guide the forceps tips with respect to the lens as it is being folded in the forceps tips by movement of the jaw means towards one another.
A means for folding a soft intraocular lens wherein the lens is folded within forceps tips that are then used to insert the lens into the eye, comprising:
a base means;
opposite jaw members associated with a base means including:
first means to position and hold a lens, and second means to allow insertion of and to position the forceps tips with respect to a desired position on top of the lens near opposite diametrical sides of the lens when the lens is positioned in the first means; and manually moveable means connected to the jaw means to manually converge the jaw means to guide the forceps tips with respect to the lens as it is being folded in the forceps tips by movement of the jaw means towards one another.
11.
The means of claim 10 wherein the manually moveable means are integrally connected and formed with the base means, and the base means has at least portions which are resilient to allow manual movement of the resilient portion of the base means to move the jaw means.
The means of claim 10 wherein the manually moveable means are integrally connected and formed with the base means, and the base means has at least portions which are resilient to allow manual movement of the resilient portion of the base means to move the jaw means.
12.
The means of claim 10 wherein the first means of the opposite jaw means comprises a stepped and curved portion which can position and support a portion of the bottom perimeter of the optic of a lens.
The means of claim 10 wherein the first means of the opposite jaw means comprises a stepped and curved portion which can position and support a portion of the bottom perimeter of the optic of a lens.
13.
The means of claim 10 wherein the second means comprises a raised member from the first means to provide a landing for the vertical insertion of forceps tips to an area adapted to be adjacent opposite diametrical portions of the top of an optic portion of a lens when the lens is positioned in the first means.
The means of claim 10 wherein the second means comprises a raised member from the first means to provide a landing for the vertical insertion of forceps tips to an area adapted to be adjacent opposite diametrical portions of the top of an optic portion of a lens when the lens is positioned in the first means.
14.
The means of claim 10 wherein the first and second means are curved to conform generally to curvature of an optic portion of a lens.
The means of claim 10 wherein the first and second means are curved to conform generally to curvature of an optic portion of a lens.
15.
The means of claim 10 wherein the first and second means are flat surfaces.
The means of claim 10 wherein the first and second means are flat surfaces.
16.
The means of claim 10 wherein the manually moveable means are independent arms extending through bores in the base means along an axis, the arms moving the jaw means when manually moved along the axis.
The means of claim 10 wherein the manually moveable means are independent arms extending through bores in the base means along an axis, the arms moving the jaw means when manually moved along the axis.
17.
A device for folding a soft intraocular lens within forceps tips comprising:
a frame means including a closed resilient rail means defining an interior area, and aligned inwardly extending arms connecting to the rail means;
spaced apart jaw members positioned at the facing ends of the arms including, first curved inwardly extending ledge means for supporting opposite bottom portions of a lens near the perimeter of the lens;
second concentric curved ledge means positioned on top of the first curved ledge means and extending inwardly but less than the first curved ledge means for abutting opposite portions of the perimeter of the lens and providing a landing for placement of forceps tips;
the spacing between jaw members being such that in a first normal position the diametrical distance between opposite first curved ledge means is less than the diameter of the lens, the diametrical distance between opposite second curved ledge means being slightly greater than the diameter of the lens, and converging movement of the jaw members urging a lens received between the jaw members to fold upwardly along a center axis which is generally perpendicular to an axis between jaw members and midway between jaw members, the converging movement also folding the lens within the forceps tips.
A device for folding a soft intraocular lens within forceps tips comprising:
a frame means including a closed resilient rail means defining an interior area, and aligned inwardly extending arms connecting to the rail means;
spaced apart jaw members positioned at the facing ends of the arms including, first curved inwardly extending ledge means for supporting opposite bottom portions of a lens near the perimeter of the lens;
second concentric curved ledge means positioned on top of the first curved ledge means and extending inwardly but less than the first curved ledge means for abutting opposite portions of the perimeter of the lens and providing a landing for placement of forceps tips;
the spacing between jaw members being such that in a first normal position the diametrical distance between opposite first curved ledge means is less than the diameter of the lens, the diametrical distance between opposite second curved ledge means being slightly greater than the diameter of the lens, and converging movement of the jaw members urging a lens received between the jaw members to fold upwardly along a center axis which is generally perpendicular to an axis between jaw members and midway between jaw members, the converging movement also folding the lens within the forceps tips.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/647,517 | 1991-01-28 | ||
| US07/647,517 US5100410A (en) | 1991-01-28 | 1991-01-28 | Means and method for facilitating folding of an intraocular lens |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2059623A1 true CA2059623A1 (en) | 1992-07-29 |
Family
ID=24597283
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002059623A Abandoned CA2059623A1 (en) | 1991-01-28 | 1992-01-17 | Means and method for facilitating folding of an intraocular lens |
Country Status (5)
| Country | Link |
|---|---|
| US (1) | US5100410A (en) |
| EP (1) | EP0497505A1 (en) |
| JP (1) | JPH04309348A (en) |
| AU (1) | AU1039692A (en) |
| CA (1) | CA2059623A1 (en) |
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-
1991
- 1991-01-28 US US07/647,517 patent/US5100410A/en not_active Expired - Fee Related
-
1992
- 1992-01-17 CA CA002059623A patent/CA2059623A1/en not_active Abandoned
- 1992-01-22 AU AU10396/92A patent/AU1039692A/en not_active Abandoned
- 1992-01-23 EP EP92300592A patent/EP0497505A1/en not_active Withdrawn
- 1992-01-24 JP JP4034383A patent/JPH04309348A/en active Pending
Also Published As
| Publication number | Publication date |
|---|---|
| EP0497505A1 (en) | 1992-08-05 |
| JPH04309348A (en) | 1992-10-30 |
| US5100410A (en) | 1992-03-31 |
| AU1039692A (en) | 1992-07-30 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FZDE | Discontinued |