CA2392393A1 - Intraocular lens implanter - Google Patents

Intraocular lens implanter Download PDF

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Publication number
CA2392393A1
CA2392393A1 CA002392393A CA2392393A CA2392393A1 CA 2392393 A1 CA2392393 A1 CA 2392393A1 CA 002392393 A CA002392393 A CA 002392393A CA 2392393 A CA2392393 A CA 2392393A CA 2392393 A1 CA2392393 A1 CA 2392393A1
Authority
CA
Canada
Prior art keywords
duct
lens
plunger
cross
axis
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.)
Granted
Application number
CA002392393A
Other languages
French (fr)
Other versions
CA2392393C (en
Inventor
Birger Hjertman
Jonas Fridholm
Hans Himbert
Carl-Goeran Crafoord
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
AMO Uppsala AB
Original Assignee
Pharmacia Ab
Birger Hjertman
Jonas Fridholm
Hans Himbert
Carl-Goeran Crafoord
Pfizer Health Ab
Healon Ab
Advanced Medical Optics, Inc.
Advanced Medical Optics Uppsala Ab
Amo Uppsala Ab
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 Pharmacia Ab, Birger Hjertman, Jonas Fridholm, Hans Himbert, Carl-Goeran Crafoord, Pfizer Health Ab, Healon Ab, Advanced Medical Optics, Inc., Advanced Medical Optics Uppsala Ab, Amo Uppsala Ab filed Critical Pharmacia Ab
Priority to CA2751099A priority Critical patent/CA2751099C/en
Publication of CA2392393A1 publication Critical patent/CA2392393A1/en
Application granted granted Critical
Publication of CA2392393C publication Critical patent/CA2392393C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1662Instruments for inserting intraocular lenses into the eye
    • A61F2/1667Instruments for inserting intraocular lenses into the eye with rotatable plungers
    • 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0013Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped

Abstract

A device for deforming and ejecting a deformable intraocular lens for insertion into a small incision in an eye, the device comprising a) a housing, b) a lens transporting duct in a front part of the housing defining a duct axis, the duct having a front end with a cross-section adapted to the lens in deformed state with small maximum dimensions transversal to the duct axis, a rear lens-receiving end with a cross-section adapted for the lens in un-deformed state, or less deformed state, than at the front end, with larger maximum dimensions lateral to the duct axis than at the front end and an intermediate convergent duct part between the front and rear ends with a varying cross-section shape, having decreasing maximum dimensions lateral to the duct axis when moving from rear to front in the duct and c) a plunger operative to displace the lens in the duct at least in the forward direction.
According to various aspects of the invention part of the duct has the overall shape of a crescent, the plunger is re-shapeable between different height to width ratios, the device has fixing structures for preventing lens rotation and the plunger is driven with a preprogrammed movement pattern. The invention also includes methods corresponding to the operational steps of the devices.

Claims (101)

1. A device for deforming and ejecting a deformable intraocular lens for insertion into a small incision in an eye, the device comprising a) a housing, b) a lens transporting duct in a front part of the housing defining a duct axis, the duct having a front end with a cross-section adapted to the lens in deformed state with small maximum dimensions transversal to the duct axis, a rear lens-receiving end with a cross-section adapted for the lens in un-deformed state, or less deformed state, than at the front end, with larger maximum dimensions lateral to the duct axis than at the front end and an intermediate convergent duct part between the front and rear ends with a varying cross-section shape, having decreasing maximum dimensions lateral to the duct axis when moving from rear to front in the duct and c) a plunger operative to dis-place the lens in the duct at least in the forward direction, characterized in the im-provement comprising, that over at least a part of the duct axial length the duct cross-section has the overall shape of a crescent.
2. The device of claim 1, characterized in that the crescent has a convex roof line of substantially continuous curvature.
3. The device of claim 1, characterized in that the crescent has a concave floor line of substantially continuous curvature.
4. The device of claim 1, characterized in that the crescent has a concave floor line of substantially continuous curvature except for a guiding groove.
5. The device of claim 4, characterized in that the guiding groove has a lat-eral extension less than 1.5 mm, preferably less than 1 mm.
6. The device of claim 4, characterized in that the guiding groove terminates to the rear of the front end of the duct.
7. The device of claim 6, characterized in that the guiding groove terminates to the rear of a duct tip part dimensioned for insertion into the incision.
8. The device of claim 1, characterized in that the crescent is substantially mirror symmetrical around a height line centered through the duct axis.
9. The device of claim 8, characterized in that the symmetrical crescent is roughly "C" - shaped or a mirror image thereof.
10. The device of claim 1, characterized in that the crescent is substantially mirror asymmetrical around a height line centered through the duct axis.
11. The device of claim 10, characterized in that the asymmetrical crescent is roughly "6"-shaped or a mirror image thereof.
12. The device of claim 1, characterized in that the crescent has diminishing height between floor and roof when moving from duct axis and laterally outwards.
13. The device of claim 1, characterized in that the crescent edges at the lat-eral extremes from the duct axis are sharp, polygonal or preferably rounded.
14. The device of claim 1, characterized in that the duct is formed in at least two pieces of material joined along surfaces terminating along joining lines in the duct, the joining lines being located at the crescent edges at the lateral extremes from the duct axis.
15. The device of claim 14, characterized in that the joining lines converge in the front direction.
16. The device of claim 15, characterized in that the joining lines meet about where the crescent form terminates.
17. The device of claim 1, characterized in that the crescent circumference forms a closed line.
18. The device of claim 1, characterized in that the total cross-section area of the crescent shrinks when moving forwards in the duct over said at least part of the duct axial length.
19. The device of claim 1, characterized in that the total cross-section area of the crescent is substantially constant when moving forwards in the duct over said at least part of the duct axial length.
20. The device of claim 19, characterized in that the total cross-section area is substantially constant when continuing moving in the duct up to a lens ejecting end of the duct, adapted for insertion through the incision.
21. The device of claim 17 to 20, characterized in that the total cross-section area of the duct substantially corresponds to the maximum cross-section area of the lens under deformation.
22. The device of claim 21, characterized in that the duct cross-section area and shape substantially corresponds to the cross-section area and shape of the lens under de-formation.
23. The device of claim 1, characterized in that the plunger has a front part with an area larger than the largest circular shape that can be accommodated in the crescent by being laterally enlarged with respect to such a circular shape.
24. The device of claim -1, characterized in that the plunger is a re-shapeable between a first form with high lateral to height extension ratio and a second form with less such ratio.
25. The device of claim 1, characterized in any characteristic set forth in the following claims.
26. A device for deforming and ejecting a deformable intraocular lens for insertion into a small incision in an eye, the device comprising a) a housing, b) a lens transporting duct in a front part of the housing defining a duct axis, the duct having a front end with a cross-section adapted to the lens in deformed state with small maximum dimensions transversal to the duct axis, a rear lens-receiving end with a cross-section adapted for the lens in un-deformed state, or less deformed state, than at the front end, with larger maximum dimensions lateral to the duct axis than at the front end and an intermediate convergent duct part between the front and rear ends with a varying cross-section shape, having decreasing maximum di-mensions lateral to the duct axis when moving from rear to front in the duct and c) a plunger operative to displace the lens in the duct at least in the forward direction, character ized in the improvement comprising, that over at least a part of the duct axial length the duct cross-section area is substantially constant when moving forwards in the duct over said at least part of the duct axial length.
27. The device of claim 26, characterized in that the total cross-section area is substantially constant when continuing moving in the duct up to a lens ejecting end of the duct, adapted for insertion through the incision.
28. The device of claim 26 to 27, characterized in that the total cross-section area of the duct substantially corresponds to the maximum cross-section area of the lens under deformation.
29. The device of claim 28, characterized in that the duct cross-section area and shape substantially corresponds to the cross-section area and shape of the lens under de-formation.
30. The device of claim 26, characterized in any characteristic set forth in any of claims 1 to 25 or in the following claims.
31. A device for deforming and ejecting a deformable intraocular lens for insertion into a small incision in an eye, the device comprising a) a housing, b) a lens transporting duct in a front part of the housing defining a duct axis, the duct having a front end with a cross-section adapted to the lens in deformed state with small maximum dimensions transversal to the duct axis, a rear lens-receiving end with a cross-section adapted for the lens in un-deformed state, or less deformed state, than at the front end, with larger maximum dimensions lateral to the duct axis than at the front end and an intermediate convergent duct part between the front and rear ends with a varying cross-section shape, having decreasing maximum di-mensions lateral to the duct axis when moving from rear to front in the duct and c) a pushing plunger operative to push the lens in the duct at least in the forward direction, character ized in the improvement comprising, that the plunger is re-shapeable at least in its front between a first form with an elongation degree larger than 1 and a second form with an elon-gation degree less than in the first form, the elongation degree being the lateral to height ex-tension ratio.
32. The device of claim 31, characterized in that the elongation degree in the first form is at least 1.5.
33. The device of claim 32, characterized in that the elongation degree in the first form is at lest 2 and preferably at least 2.5.
34. The device of claim 31, characterized in that the elongation degree in the second form is less than 2, preferably less than 1.5 or about 1.
35. The device of claim 31, characterized in that the change in elongation degree between the first form and the second form, expressed as the quotient between the two elongation degrees, is at least 1.5, preferably at least 2 and most preferably at least 2.5.
36. The device of claim 31, characterized in that the plunger comprises two or more individual parts arranged to provide a change in elongation degree by mutual rear-rangement between the individual parts.
37. The device of claim 36, characterized in that in that the plunger com-prises sections joined along axially extending fold lines in a bellows like manner.
38. The device of claim 36, characterized in that the individual parts are elongated finger structures extending substantially in the axial direction.
39. The device of claim 31, characterized in that the plunger comprises a multitude of fingers forming a brush type of plunger.
40. The device of claim 39, characterized in that the fingers are joined at a point to the rear of the plunger front to allow rearrangement in front of the joint.
41. The device of claim 38, characterized in that the number of fingers are at most ten, preferably at most six and most preferably at most four.
42. The device of claim 41, characterized in that the fingers are joined with hinges having a hinge axis essentially in the axial direction, guiding the fingers into a folding rearrangement pattern.
43. The device of claim 42, characterized in that the hinges are living hinges in a thin material.
44. The device of claim 42, characterized in that the hinges are arranged close to the front of the fingers.
45. The device of claim 42, characterized in that hinges are present to the rear of the plunger front.
46. The device of claim 42, characterized in that the hinges connects the fin-gers into a single layer.
47. The device of claim 46, characterized in that the finger fronts are of dif-ferent shapes or size.
48. The device of claim 47, characterized in that at least one finger has a larger front area than at least one other finger.
49. The device of claim 38, characterized in that at least one finger has non-uniform cross-section over its axial length.
50. The device of claim 48, characterized in that behind the front the finger is smaller in at least one dimension to form a neck with increased space between finger and duct.
51. The device of claim 31, characterized in that the plunger front area is smaller than the duct cross-section area.
52. The device of claim 50, characterized in that the difference in front area and duct area is adapted for accommodation of a trailing lens haptic.
53. The device of any of claims 31 to 52, characterized in that the plunger material is substantially rigid and able to sustain axial pushing forces without substantial axial shrinking and lateral swelling.
54. The device of any of claims 31 to 52, characterized in that the plunger material is elastic with an elongation degree of at least 1.5 in un-stressed condition.
55. The device of claim 31, characterized in any characteristic set forth in claims 1 to 30 or in the following claims.
56. A device for deforming and ejecting a deformable intraocular lens for insertion into a small incision in an eye, the device comprising a) a housing, b) a lens transporting duct in a front part of the housing defining a duct axis, the duct having a front end with a cross-section adapted to the lens in deformed state with small maximum dimensions transversal to the duct axis, a rear lens-receiving end with a cross-section adapted for the lens in un-deformed state, or less deformed state, than at the front end, with larger maximum dimensions lateral to the duct axis than at the front end and an intermediate convergent duct part between the front and rear ends with a varying cross-section shape, having decreasing maximum di-mensions lateral to the duct axis when moving from rear to front in the duct and c) a plunger operative to displace the lens in the duct at least in the forward direction, character ized in the improvement comprising, a lens receiving chamber at the rear end of the duct having a seat for the lens in un-deformed or slightly deformed state in a position adapted to be abutted and pushed by the plunger, and fixture structures arranged for preventing lens rota-tion.
57. The device of claim 56, characterized in that the fixture structures com-prises a seat shaped into a bent lens cavity, adapted to a slightly bent lens optic part.
58. The device of claim 57, characterized in that the lens cavity is bent along a fold axis parallel with the duct axis.
59. The device of claim 58, characterized in that the bent lens cavity has the overall shape of a crescent as defined.
60. The device of claim 59, characterized in that the cross-section area of the crescent is substantially the same as the cross-section of the duct from rear end to front end.
61. The device of claim 56, characterized in that the fixture structures com-prises at least one delimiter, arranged with respect to the seat next to a position to be occupied by a haptic part of the lens and so that a rotation of the lens abuts the haptic against the de-limiter.
62. The device of claim 61, characterized in that the delimiter runs at least partly in a normal direction with respect to the seat corresponding to the lens optic plane.
63. The device of claim 61, characterized in at least two delimiters arranged for prevention of lens rotation in opposite directions.
64. The device of claim 63, characterized in that the two delimiters are ar-ranged next to opposite sides of one haptic seat position.
65. The device of claim 64, characterized in that each lens haptic position is provided with at least two delimiters.
66. The device of claim 61, characterized in that the delimiter is located to provide a contact point with the haptic close to the anchoring point of haptic to optic.
67. The device of claim 61, characterized in that the delimiter and seat are arranged movable in relation to each other, allowing disengagement of the delimiter with re-spect to the haptic.
68. The device of claim 67, characterized in that the delimiter is fixed in re-lation to the housing, the seat is movable with respect to the housing.
69. The device of claim 68, characterized in that the seat is movable with at least a component in a normal direction relative the optic plane position.
70. The device of claim 69, characterized in that the seat is also movable with at least a component in an axial direction in or into the duct.
71. The device of claim 70, characterized in that the seat is fixed in relation to the housing and the delimiter is movable with respect to the housing.
72. The device of claim 71, characterized in that the delimiter is arranged to be disengaged by removal or deflection.
73. The device of claim 72, characterized in that the delimiter is externally accessible for manual disengagement.
74. The device of claim 72, characterized in that the delimiter is arranged to be disengaged by forward movement of the plunger.
75. The device of claim 72, characterized in that the delimiter is arranged to be disengaged by closing a closure part of the lens receiving chamber.
76. The device of claim 56, characterized in any feature set forth in claims 1 to 55 or in the following claims.
77. An device for at least ejecting a deformable intraocular lens for insertion into a small incision in an eye, the device comprising a) a housing, b) a lens transporting duct in a front part of the housing defining a duct axis, the duct having a front end with a cross-section adapted to the lens in deformed state with small maximum dimensions transversal to the duct axis, suitable for insertion through the incision in the eye, a rear end and an intermediate duct part between the front and rear ends and c) a plunger system comprising a plunger, operative to displace the lens in the duct at least in the forward direction, and a driver for the plunger, characterized in the improvement comprising at least one track and at least one fol-lower, one of said track and follower being arranged, directly or indirectly, on the housing and the other of said track and follower being arranged, directly or indirectly, on said driver, the track and follower being arranged to cooperate to give a programmed movement between the driver and housing, the program requiring a rotational movement of the driver for advancing the plunger front in a rear part of the duct and allowing a substantially axial movement of the driver for advancing the plunger front in a front part of the duct.
78. The device of claim 77, characterized in that the program requires a sub-stantially axial movement of the driver for advancing the plunger in a front part of the duct.
79. The device of claim 78, characterized in that the track for the substan-tially axial movement comprises a substantially straight part parallel to the axis.
80. The device of claim 77, characterized in that the program provides a stop for the rotational movement before the substantially axial movement of the driver.
81. The device of claim 80, characterized in that the track for the stop com-prises a knee-formed section.
82. The device of claim 77, characterized in that the track for the rotational movement comprises a screw-threaded part.
83. The device of claim 82, characterized in that the screw-threaded part has substantially uniform pitch.
84. The device of claim 82, characterized in that the screw-threaded has non-uniform pitch, preferably decreasing pitch to give force amplification under forward move-ment of the plunger.
85. The device of claim 77, characterized in that the track comprises a groove and the follower comprises a point protrusion.
86. The device of claim 77, characterized in that over at least part of the track a parallel track is provided, cooperating with at least one additional follower.
87. The device of claim 77, characterized in that the housing and the driver comprises generally tubular parts arranged at least partially concentric and overlapping in a telescoping manner and that the track and follower are arranged at least partially between the overlapping surfaces.
88. The device of claim 87, characterized in that the track is arranged on the interior surface of one of the tube parts and the follower on the exterior surface of the other tube part.
89. The device of claim 88, characterized in that the driver comprises the outer of the overlapping tube parts.
90. The device of claim 77, characterized in that the driver is arranged for manual actuation and comprises a part accessible outside the housing.
91. The device of claim 77, characterized in that the front part of the duct in-cludes a part of the duct extending from a release position, close to the front end of the duct, and said front end.
92. The device of claim 91, characterized in that the front part of the duct in-cludes a distance beyond the lens ejecting end.
93. The device of claim 77, characterized in that the rear part of the duct in-cludes at least a part of the duct between the rear lens-receiving end and a release position, close to the lens ejecting end of the duct.
94. The device of claim 93, characterized in that the rear part of the duct in-cludes a lens deforming part of the duct.
95. The device of claim 94, characterized in that the lens deforming part of the duct comprises a convergent channel type duct.
96. The device of claim 95, characterized in that the rear part of the duct in-cludes a transportation duct part up to the release position.
97. The device of claim 77, characterized in any characteristic set forth in claims 1 to 76 or in any of the following claims.
98. A method for deforming a deformable intraocular lens, characterized in that the method comprises the steps of displacing the lens in a duct as set forth in any of claims 1 to 30.
99. A method for deforming a deformable intraocular lens, characterized in that the method comprises the step of displacing the lens in a duct and by a plunger as set forth in any of claims 31 to 55.
100. A method for stabilizing a deformable intraocular lens against rotation, charac terized in that the method comprises the step of localizing the lens with respect to fixing structures as set forth in any of claims 56 to 76.
101. A method for deforming a deformable intraocular lens, characterized in that the method comprises the steps of displacing the lens by a preprogrammed movement pattern for a driver as set forth in any of claims 77 to 97.
CA2392393A 1999-11-30 2000-11-29 Intraocular lens implanter Expired - Fee Related CA2392393C (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA2751099A CA2751099C (en) 1999-11-30 2000-11-29 Intraocular lens implanter

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
SE9904338-2 1999-11-30
SE9904338A SE9904338D0 (en) 1999-11-30 1999-11-30 Intraocular lens implants
PCT/SE2000/002372 WO2001039701A1 (en) 1999-11-30 2000-11-29 Intraocular lens implanter

Related Child Applications (1)

Application Number Title Priority Date Filing Date
CA2751099A Division CA2751099C (en) 1999-11-30 2000-11-29 Intraocular lens implanter

Publications (2)

Publication Number Publication Date
CA2392393A1 true CA2392393A1 (en) 2001-06-07
CA2392393C CA2392393C (en) 2012-01-17

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Application Number Title Priority Date Filing Date
CA2392393A Expired - Fee Related CA2392393C (en) 1999-11-30 2000-11-29 Intraocular lens implanter
CA2751099A Expired - Fee Related CA2751099C (en) 1999-11-30 2000-11-29 Intraocular lens implanter

Family Applications After (1)

Application Number Title Priority Date Filing Date
CA2751099A Expired - Fee Related CA2751099C (en) 1999-11-30 2000-11-29 Intraocular lens implanter

Country Status (21)

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US (1) US6558395B2 (en)
EP (1) EP1233730B1 (en)
JP (1) JP4409804B2 (en)
KR (1) KR20020071872A (en)
CN (1) CN1402625A (en)
AT (1) ATE429873T1 (en)
AU (2) AU777150B2 (en)
BR (1) BR0016007A (en)
CA (2) CA2392393C (en)
DE (1) DE60042126D1 (en)
EA (1) EA003591B1 (en)
EE (1) EE200200269A (en)
HK (1) HK1052626A1 (en)
HU (1) HUP0203854A2 (en)
IL (1) IL149571A0 (en)
MX (1) MXPA02005359A (en)
NO (1) NO20022568L (en)
PL (1) PL355905A1 (en)
SE (1) SE9904338D0 (en)
TW (1) TW471964B (en)
WO (1) WO2001039701A1 (en)

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