CN101578079A - “w”形可调节型人工晶状体 - Google Patents

“w”形可调节型人工晶状体 Download PDF

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CN101578079A
CN101578079A CNA2007800492964A CN200780049296A CN101578079A CN 101578079 A CN101578079 A CN 101578079A CN A2007800492964 A CNA2007800492964 A CN A2007800492964A CN 200780049296 A CN200780049296 A CN 200780049296A CN 101578079 A CN101578079 A CN 101578079A
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crystalline lens
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J·斯图尔特·卡明
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C&C Vision International Ltd
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    • 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
    • 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
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • 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
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A61F2/1624—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside
    • A61F2/1629—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside for changing longitudinal position, i.e. along the visual axis when implanted
    • 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
    • A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics
    • A61F2002/1689—Intraocular lenses having supporting structure for lens, e.g. haptics having plate-haptics
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0091—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type

Abstract

一种可调节的人工晶状体，其包括：柔性的本体；柔性的光学部，其能够相对于晶状体的本体前后移动；以及铰接部，其沿纵向将光学部连接至该本体。该本体可具有延伸的中央部分以及在其末端上的固定环。

Description

“W”形可调节型人工晶状体
背景技术
多年来，人工晶状体一直沿用具有环的单光学部的设计，所述环附接至所述光学部以将晶状体居中并将晶状体固定在人眼的空囊袋中。在80年代中期出现了板式晶状体，其包括具有6毫米的光学部且长度为10.5毫米的硅酮晶状体。这些晶状体能够折叠但却不能很好地固定在囊袋中，而是居于前囊膜和后囊膜之间的凹穴中。这种最初的可折叠晶状体全部由硅酮制成。在20世纪90年代中期提出了将丙烯酸树脂材料作为晶状体光学部。丙烯酸树脂晶状体包括具有直边的双凸面光学部，环插插入其中以将晶状体在眼中居中并将晶状体固定在囊袋内。
最近市场上出现了可调节型人工晶状体，这种晶状体总体上为改型的襻板式晶状体。襻板式晶状体可以定义为具有两个或更多个襻板的人工晶状体，所述襻板与光学部的组合连接处占据光学部外周的四分之一或更多。
柔性丙烯酸树脂材料明显受到眼科医生的青睐。例如，在2003年超过50％的植入人工晶状体具有丙烯酸树脂光学部。目前也出现了水凝胶晶状体。丙烯酸树脂材料不能在不产生破碎的情况下进行多次弯曲。
可调节晶状体的出现在某种程度上限制了能够制成晶状体的材料，这种晶状体通过经由反复弯曲以沿眼睛的轴线移动光学部而起作用。硅酮是理想的材料，因为它是柔性的并且能够弯曲大约数百万次而不会出现任何损坏。另外，相邻于光学部能够横跨板设置有一个或多个槽或铰链而作为晶状体设计的一部分，以便于光学部相对于襻板的外端移动。以J.Stuart Cumming署名的美国专利6,387,126中公开了这种性质的示例性可调节型晶状体。
发明内容
根据本发明，提出了一种具有晶状体本体和光学部的新式可调节型人工晶状体，所述晶状体在光学部和晶状体本体之间设置有多个--优选为两个--带状部，以允许光学部响应于随调节产生的压力梯度而前后移动。该晶状体本体优选具有中央铰链。该结构使得其尤其得益于随调节产生的玻璃体压力变化。
因此，本发明的特征在于提供一种新式可调节型晶状体。
附图说明
图1a为根据本发明的晶状体的正面或前侧的立体图。
图1b为替代方案的立体图。
图2为所述前侧的俯视图。
图3为晶状体的背面或后侧的俯视图。
图4为侧视图。
图5为端视图。
图6为沿图2的线6-6的横截面图。
图7为晶状体的背面或后侧的立体图。
图8为远距视觉时的侧视图。
图9为近距视觉时的侧视图。
具体实施方式
现在参照附图，图1a为本发明的晶状体10的立体图，其包括晶状体本体或板12及光学部14。本体12包括襻15。本体12和光学部14由硅酮或其它适合的柔性材料形成。在本体12和光学部14的外围或外径之间设置有带状部16。每个带状部都优选地在晶状体的前侧包括一个或两个铰链17，或者没有铰链。带状部可以沿径向长度为0.5毫米并且厚度为0.25毫米，以由带状部16来支撑光学部14。光学部14通常能够具有4.5-5.0毫米的直径，整个晶状体10的短边通常宽度为6.1毫米，在长边上端到端(不包括固定指状部)通常长度为10.5-11.5毫米。通常光学部的厚度为0.4-1.3毫米。
本体12和光学部14以及外部加厚的底板端部20均由硅酮或其它适合的柔性材料形成。晶状体10还优选地包括由聚酰亚胺或类似材料制成的固定环24。通常环至环的外部长度为11.0-12.5毫米。加厚的端部20将固定环24完全包容在硅酮中从而提供牢固的基体以保持所述环24。板的这些加厚区域还有另外的功能。它们也用于在移除白内障和植入晶状体后，抬高人体晶状体的前囊膜使其离开光学部并离开后囊膜。这样可以起到减少囊膜浑浊和收缩的作用。襻15可为任意通常的形状，如本发明附图中的矩形、三角形等。
带状部16和铰链17的作用为允许光学部前后移动。大约1.0-2.0毫米宽的带状部是包围光学部14的晶状体本体12的平面中相对较弱的点，因此允许整个光学部14通过向前平移运动而从其较远的后位前向(向前)突出。如下所述，通过将光学部14的质量保持最小而加强了这一特征。这种新机制可以增强晶状体其它特征的效果。本发明的晶状体包括通过所述板或本体12的铰接区域16前后移动的可变形固体光学部，而不是如一些现有晶状体中那样通过孔进行推压的充满流体的液囊。本体12的前侧上用于铰接襻15的中央铰链18进一步方便了光学部随睫状肌收缩的移动。图1b示出了替代方案，该方案具有如图所示的与光学部的边成直线的一对铰链51而不是铰链18。
在从远距视觉到近距视觉的调整过程中光学部14和襻15的移动方式具有重要性，该方式已经在图8和图9中相对于这些图中的前参考线A和后参考线B具体示出。该情况下与平时一样，襻15的端部或环24能够被植入囊袋中，使得用以远距视觉时，光学部14向后拱，如图8所示。如图9所示，用于近距视觉时，光学部14随睫状肌收缩而前移。具体来说，如图9所示，整个晶状体略有前移，且襻板15沿箭头44的方向向中央和向后轻微移动，导致睫状肌收缩引起的压力进一步提高了光学部14上的推动光学部进一步前移的压力，原因为一个或多个铰链17较薄且稍有绷紧及光学部有轻微变形。这使得增加了光学部随光学部变形的前移。并且，如图9中箭头46所指，随玻璃体压力的增加，襻15的端部向后推靠着后囊膜。
铰链的宽度为1.0-3.0毫米，厚度为0.1-0.3毫米。
使本发明的晶状体可调节的另一个特征在于，光学部14能够是可变形的，并且能够构造成具有的硬度低于以前置于任何晶状体中的光学部的硬度。与Eyeonics Inc.的AT45型晶状体(其硬度为48)相类似，周围的板12优选地由较高的标准硬度的材料制成。光学部14本身不必对晶状体的结构稳定性做出贡献，因此光学部14可以非常柔软。除沿轴向向前平移外，具有可调节性的光学部14的弯曲或变形还将导致光焦度(power)变化。这可能导致光学部的弯曲加重。通过将光学部保持得非常薄进一步加强了这一特征，原因为在所施加的任何给定级别的力的情况下，较薄的光学部将比厚的光学部弯曲得更厉害。对于10至33的屈光度范围，光学部14中心厚度的示例范围为大约0.4毫米至1.3毫米。本发明晶状体的光学部的通常常见的屈光度是22个屈光度，并且光学部的厚度为0.73mm。作为比较，在22个屈光度时前面提到的AT45的厚度为0.88毫米，更新的AT-45SE为0.98毫米。
可以设置例如直径为4.5毫米且边缘厚度减少为0.1至0.2毫米的光学部14。折射率能够增加并且这样会进一步加强此特征。
能够用镊子或注射器容易地折叠本发明的晶状体。预装载的系统是优选的。
如图3和图7所示的情况，另一个特征在于板12的背面(后侧)和/或襻板臂上包含一个或多个脊状部40。这些脊状部横贯所述板并且绕晶状体本体的周缘完全围绕光学部。邻近光学部的带状部，在横贯所述板的第一脊状部中央处具有另一脊状部。这些脊状部的目的在于防止晶状体上皮细胞增殖到所述板或光学部后面的区域内。对于板式晶状体而言，这能够显著降低囊收缩的发生率。上皮细胞将不会迁移到板下并且不会经受纤维性收缩。另外，环的直角边缘、襻板以及光学部的直角边缘进一步起保护作用以防止细胞从板的侧部迁移进入。
尽管示出和描述了本发明的实施方式，但是在不脱离本发明的范围的情况下可以做出多种变型，并且本发明意在覆盖所有这些变型及其等同物。

Claims (18)

1.一种可调节型人工晶状体，其包括：柔性的本体，使得所述本体的近端板随睫状肌的收缩而后移；以及柔性的光学部，所述光学部由所述本体围绕并且由铰接的带状部安装至所述本体，并且所述光学部随所述睫状肌的收缩和松弛而相对于所述晶状体的本体前后移动。
2.如权利要求1中所述的晶状体，其中，所述本体具有至少一个横穿所述本体的铰链。
3.如权利要求2中所述的晶状体，其中，所述铰链横穿所述本体的中部。
4.如权利要求1中所述的晶状体，其中，各带状部沿所述晶状体的本体的纵向位于所述光学部的相对侧，且各带状部均具有一个铰链。
5.如权利要求1中所述的晶状体，其中，各带状部沿所述晶状体的本体的纵向位于所述光学部的相对侧，且各带状部均具有两个铰链。
6.如权利要求1中所述的晶状体，其中，各带状部具有两个铰链，每一个所述铰链位于所述带状部不同侧。
7.如权利要求5中所述的晶状体，其中，所述本体具有位于所述本体的前侧上的中央铰链。
8.如权利要求5中所述的晶状体，其中，所述本体具有两对铰链。
9.如权利要求1中所述的晶状体，进一步包括从所述本体的外端延伸的环。
10.如权利要求1中所述的晶状体，其中，所述本体的后侧包括脊状部。
11.一种可调节型人工晶状体，其包括柔性的本体和柔性的光学部，所述柔性的光学部通过薄的柔性的带状部沿纵向安装至所述本体，所述带状部在所述光学部和所述本体之间设置在所述光学部的各侧，所述带状部沿径向长约0.5毫米，厚约0.25毫米，且所述晶状体包括多个附接到所述本体的端部上的固定环。
12.如权利要求11所述的晶状体，所述晶状体包括位于所述晶状体的本体内的具有弱化变薄部分或铰接部分的襻，从而使所述晶状体的光学部、环绕所述光学部并且相对于铰链居中的晶状体本体部分相对于所述襻的外端前后移动。
13.如权利要求12所述的晶状体，其中，所述铰链位于所述本体的前侧的中间。
14.如权利要求12所述的晶状体，所述晶状体包括两对铰链。
15.如权利要求12所述的晶状体，其中，所述襻的外端包括环，以便牢固地固定晶状体并使所述晶状体居中。
16.如权利要求12所述的晶状体，其中，所述光学部构造成随睫状肌收缩和玻璃体压力而发生光学变形以改善近距视觉。
17.如权利要求12所述的晶状体，其中，所述晶状体的本体在前侧具有中央铰链。
18.如权利要求12所述的晶状体，其中，所述晶状体的本体在前侧具有两对铰链。
CNA2007800492964A 2007-01-05 2007-12-20 “w”形可调节型人工晶状体 Pending CN101578079A (zh)

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US11/620,488 2007-01-05
US11/620,488 US8163015B2 (en) 2006-07-25 2007-01-05 “W” accommodating intraocular lens

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JP2010515485A (ja) 2010-05-13
SG2012071783A (en) 2014-04-28
CA2674057A1 (en) 2008-07-17
ES2385205T3 (es) 2012-07-19
US8163015B2 (en) 2012-04-24
KR101138528B1 (ko) 2012-04-25
AU2007342127A1 (en) 2008-07-17
EP2101684B1 (en) 2012-03-28
ATE551019T1 (de) 2012-04-15
US20080319545A1 (en) 2008-12-25
TW200831061A (en) 2008-08-01
EP2101684A4 (en) 2010-07-14
EP2101684A2 (en) 2009-09-23
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AU2007342127B2 (en) 2012-09-06
WO2008085699A2 (en) 2008-07-17

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