WO2012105839A1 - Cartridge for intraocular lens injector - Google Patents

Cartridge for intraocular lens injector Download PDF

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Publication number
WO2012105839A1
WO2012105839A1 PCT/NL2012/050058 NL2012050058W WO2012105839A1 WO 2012105839 A1 WO2012105839 A1 WO 2012105839A1 NL 2012050058 W NL2012050058 W NL 2012050058W WO 2012105839 A1 WO2012105839 A1 WO 2012105839A1
Authority
WO
WIPO (PCT)
Prior art keywords
cartridge
eye
intraocular lens
injection chamber
lens
Prior art date
Application number
PCT/NL2012/050058
Other languages
French (fr)
Inventor
Aleksey Nikolaevich Simonov
Michiel Christiaan Rombach
Original Assignee
Akkolens International B.V.
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 Akkolens International B.V. filed Critical Akkolens International B.V.
Publication of WO2012105839A1 publication Critical patent/WO2012105839A1/en

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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
    • A61F2/1678—Instruments for inserting intraocular lenses into the eye with a separate cartridge or other lens setting part for storage of a lens, e.g. preloadable for shipping
    • 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
    • A61F2/1648—Multipart lenses

Landscapes

  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

Cartridge for injection of an intraocular lens into an eye comprising a loading chamber adapted to hold a folded intraocular lens, an injection chamber with an aperture to release the lens in the eye and a compression chamber connecting said chambers. The cartridge is combined with an injector handpiece which urges the lens through the cartridge and expels the lens in the eye. The cartridge is such that only the, substantially cylindrical, injection chamber enters the eye and provides release of at least one haptic of the intraocular lens directly in a sector of the eye opposite the incision through which the injection chamber enters the eye.

Description

Cartridge for intraocular lens injector
Intraocular lenses (henceforth also: lenses) are implanted in the human eye to restore the refraction of the eye after surgical removal of the natural lens. Such lenses comprise, at least one, optical component, for example, a single lens, for the at least one optical function, for example to correct refraction of the eye, and at least one mechanical component (haptic) for at least one mechanical function, for example to position and anchor the optics the eye, and to, in the case of accommodating lenses, transfer movement from driving means in the eye to at least one optical component which can provide multiple functions, for example correct refraction and accommodation of the eye. Intraocular lenses are, generally, foldable and injected in the eye with an intraocular lens injector (lens injector or injector). Such injector generally comprises a hand-piece including a, for example, thumb-driven piston for transporting the lens through an injector cartridge (cartridge), which can be either loaded manually during surgery, for example with forceps by the surgeon, or can be loaded automatically from a lens holder attached to the cartridge during surgery, for example, by pushing a loading component attached to the cartridge by the surgeon during surgery, or can be fully preloaded which does not require significant additional handling related to loading of the cartridge during surgery. The cartridge is designed for receiving, compressing, and releasing the lens in the eye.
Traditional cartridges release the lens near the centre of the eye, or, alternatively, directly at the main surgical incision (incision) being the incision through which the tip of the, generally tapered, cartridge enters the posterior chamber of the eye. After release the lens unfolds in the eye followed by positioning of the haptics by surgical tools, in, for example, the capsular bag or, alternatively, in the sulcus of the eye.
The cartridge disclosed in the present document comprises a loading chamber adapted to receive, hold a folded intraocular lens, and, a substantial cylindrical injection chamber having a diameter smaller than the loading chamber and comprising an aperture adapted to release the folded intraocular lens into the eye, and, a compression chamber connecting the loading chamber and the injection chamber and being adapted to compress the folded intraocular lens such that the folded lens fits in the injection chamber, with the cartridge being adapted to be combined with an injector handpiece comprising urging means adapted to urge the folded intraocular lens from the loading chamber to the compression chamber and from the compression chamber to the injection chamber and to release the intraocular lens from the injection chamber through the aperture into the eye, with the cartridge adapted such that only the injection chamber enters the eye to release at least one haptic of the intraocular lens directly in at least one sector of the eye opposite the incision through which the injection chamber enters the eye. This feature offers the possibility to directly locate the intraocular lens on the location in the eye where it is to be retained, thus obviating later manipulation of the intraocular lens to position it in its final position.
[2, 3] The injector cartridge can be adapted to either release at least one haptic of the lens directly in a sector of the sulcus opposite the incision through which only the injection chamber of the cartridge enters the eye. Alternatively, the injector cartridge can be adapted to release at least one haptic of the lens directly in a sector of the capsular bag opposite the incision through which only the injection chamber of the cartridge enters the eye. Said adaptations to the cartridge can include adaptations to the dimensions of the injection chamber and adaptations to the aperture of the injections chamber, for example adaptations which provide release of the first haptics in a certain direction.
So, the cartridge comprises a combination of chambers including at least three chambers including at least one wide loading chamber to receive and hold a folded lens, at least one tapered compression chamber to compress the folded lens and transport the lens to the injection chamber, and, at least one narrow cylindrical injection chamber to transport the lens and release the lens in the eye. The cartridge is such that penetration of the eye is restricted to the, largely cylindrical, injection chamber which provides release of at least one haptic of the lens directly in a sector of the eye opposite the incision. So, the cartridge tip largely crosses the eye from the location of the incision to a location opposite the incision followed by release of the first haptic directly and precisely at the intended location. This is in contrast to release of haptics by traditional cartridges, which release the haptic in, for example, indirectly and approximately the centre of the eye followed by positioning by the surgeon of the haptic at the intended location, for example by forceps or by Sinskey hook. The lens is loaded in cartridge in a relatively wide, loading chamber which receives and holds the, folded, lens. Low viscosity gliding agent (lubricant) is applied to the loading chamber and lens to facilitate transport of the lens through the cartridge. Secondly, the lens is compressed by the piston which pushes the lens through a, tapered, compression chamber. Thirdly, following transport through the, narrow, injection chamber the lens is released from the cartridge tip into the eye. Traditional cartridges have a relatively long compression chamber followed by a relatively short injection chamber. Consequently, a large incision is required because a significant section of the tapered compression chamber has to enter the eye to allow crossing the eye from the incision to a sector opposite the incision. The present invention discloses cartridges with a relatively short tapered compression chamber followed by a relatively long cylindrical injection chamber so a small incision is required to allow the injection chamber to cross the eye from the incision to a sector opposite the incision, generally located in the capsular bag or, alternatively, in the sulcus. At least one haptic is released, directly, in a sector opposite the incision, followed by withdrawal of the injector and release of the optics in the centre of the eye, followed by release of at least one haptic at a sector of the bag or sulcus close to the incision, followed by removal of the injection chamber from the eye. To facilitate positioning of haptics in the sulcus, or, alternatively, the capsular bag, the injection chamber can be filled with high viscosity lubricant prior to injection. The lubricant will expand the sulcus prior to release of the haptic and so facilitate positioning of the haptic at the intended location.
Crossing the eye from an incision to a sector opposite the incision generally involves crossing a distance of, at least, 5 mm. So, the length of the substantially cylindrical injection chamber must be at least 5 mm. However, depending on the size of the eye and in particular of the distance between the locations where the two extreme parts of the lens, the haptics should be positioned, the length of the cylindrical injection chamber may deviate, for instance to values of at least 4 mm, at least 6 mm of even at least 7 mm.
The cartridge can be fitted with an aperture which is smooth, or, alternatively, the cartridge can be fitted with an aperture which is fitted with a lip or a spring or a notch adapted to guide said haptic to the intended position, for example, a notch which bends the components of the lens slightly downwards to provide positioning in, for example, the sulcus. So, adaptation of the cartridge can include a lip or, alternatively, a spring or, alternatively, a notch or any other mechanical adaptation designed to guide the lens haptics or lens body to the intended position. In Figure 1 a cartridge with such a lip, at the top of the aperture, is illustrated.
Preferably the outer diameter section of the injection chamber is only slightly larger than the cross section of the intraocular lens in its folded position augmented by the wall of the injection chamber, allowing to make the diameter as small as possible so that the incision to be made in the eye can be made as small as possible.
To allow the a proper positioning of the intraocular lens the length of the injection chamber is equal to or longer than the distance between the two opposite ends of the two opposite haptics of the intraocular lens ,as this allows the manipulation of the end of the injection chamber and hence of the aperture therein to the extreme position of the intraocular lens away from the incision. By subsequently retracting the injection chamber and the expelling the parts of the intraocular lens the parts of the intraocular lens are directly positioned at their final location.
The present invention can be included in, for example, butterfly type cartridges, which type comprise the combination of chambers described above as well as two flaps adapted to provide ease of opening and closing of the loading chamber and to provide a tight fit of the cartridge into the injector hand-piece.
The surgical method to inject an intraocular lens through an injector with a cartridge disclosed in the present document comprises a method to inject an intraocular lens into an eye through a cartridge for injection of an intraocular lens which cartridge is adapted to load, to hold and to transport a folded lens into the eye with the cartridge including a substantially cylindrical injection chamber adapted to be partially inserted into the eye through an incision made in the eye and from which the intraocular lens is released through an aperture with the cartridge adapted to combined with an injector handpiece adapted to receive the cartridge and urge the lens through the cartridge into the eye, with the injection chamber inserted into the eye until said aperture is positioned in a sector of the eye opposite the incision through which the injection chamber of the cartridge enters the eye at which sector at least one haptic of the intraocular lens is released and, after releasing the at least one haptic of the intraocular lens, retraction of the injection chamber while releasing additional components of the intraocular lens. So, initially a first haptic of the intraocular lens is released from the injection chamber, subsequently the optical part of the intraocular lens is released and finally a second haptic located opposite the first haptic of the intraocular lens is released. The method can be adapted to release at least one haptic of the lens directly in at least one sector of the sulcus of the eye opposite the incision through which only the injection chamber of the cartridge enters the eye, or, alternatively, the method is adapted to release at least one haptic of the lens directly in at least one sector of the capsular bag of the eye opposite the incision through which only the injection chamber of the cartridge enters the eye.
The method can further include filling the injection chamber in front of the folded lens with a volume of, for example high viscosity, gliding agent prior to transport of the lens from the compression chamber to the injection chamber. Said volume of high viscosity gliding agent will be injected in the sulcus prior to release of the lens haptic and expand the sulcus for easy positioning of the haptic.
Subsequently the present invention will be elucidated with the help of the
accompanying drawings. In the drawings show:
Figure 1 : a perspective view of a cartridge according to the invention, wherein the cartridge is of the butterfly type with the flaps folded out;
Figure 2: a perspective view of the cartridge of figure 1 with the flaps folded in; and
Figure 3 : an elevational view of a human eye.
The cartridge according to the invention as depicted in figure 1 comprises a loading chamber 1, shown in its open position, a compression chamber 2 and an injection chamber, 3. The cartridge also comprises the cartridge tip with a stiff upper lip 4 and two cartridge flaps 5. The walls of the loading chamber 1 comprises two halves hingedly connected, while each of the halves is rigidly connected with one of the flaps 5. The cartridge illustrated comprises a cylindrical injection chamber 1 of 1.7mm in diameter and 5.7mm in length. This diameter allows for a small main surgical incision of 2.8mm and the length of the injection chamber allows crossing the eye to a sector of the sulcus opposite the incision.
In figure 2 the flaps 5 together with the halves of the loading chamber 1 are shown folded to the closed position. Further the figure shows a hand piece 6 connected with the cartridge. The hand piece 6 comprises an urging element not depicted in the drawings to urge an intraocular lens loaded in the loading chamber 1 to the compression chamber 2, to the injection chamber 3 and out of the aperture of the injection chamber into the eye. Further the two flaps 5 provide for a tight fit in the hand piece 6.
Finally figure 3 shows a human eye with an eyebrow 7, an eyelid 8, a pupil 9 and the iris 10.
Further this image shows an incision 11, the path 12 from the incision to the sector 13 of the sulcus opposite the incision.
According to the method according to the invention initially the incision 11 is made, the injection chamber 1 is inserted into the incision 11, and is further moved of the path 12 by manipulation of the hand piece 6 to the sector 13 of the sulcus. Having arrived there the handle of the handpiece 6 is actuated so that a first haptic of the intraocular lens is expelled through the aperture of the injection chamber 3, and further the injection chamber 3 is retracted during expel of further parts of the intraocular lens. This process continues until the aperture of the injection chamber 3 has reached the incision and the second haptic is expelled. Finally the injection chamber is removed from the eye. This method obviates further manipulation of the intraocular lens.
It will be clear that within the terms of the claims variations can be applied to the methods and apparatuses as described in the above embodiment. Hence it is possible to locate both extreme parts of the intraocular lens on a distance from the incision.

Claims

Claims
1. Cartridge for injection of an intraocular lens into an eye, with the cartridge comprising:
- a loading chamber adapted to receive and hold a folded intraocular lens,
- a substantially cylindrical injection chamber having a diameter smaller than the loading chamber and comprising an aperture adapted to release the folded intraocular lens into the eye,
- a compression chamber connecting the loading chamber and the injection chamber and being adapted to compress the folded intraocular lens such that the folded lens fits in the injection chamber,
- the cartridge being adapted to be combined with an injector handpiece comprising urging means adapted to urge the folded intraocular lens from the loading chamber to the compression chamber and from the compression chamber to the injection chamber and to release the intraocular lens from the injection chamber through the aperture into the eye,
characterized in that the cartridge is adapted such that only the injection chamber enters the eye to release at least one haptic of the intraocular lens directly in at least one sector of the eye opposite the incision through which the injection chamber enters the eye.
2. Cartridge as claimed in claim 1 characterized in that the cartridge is adapted to release at least one haptic of the lens directly in at least one sector of the sulcus opposite the incision through which the injection chamber of the cartridge enters the eye.
3. Cartridge as claimed in claim 1, characterized in that the cartridge is adapted to release at least one haptic of the lens directly in at least one sector of the capsular bag opposite the incision through which only the injection chamber of the cartridge enters the eye.
4. Cartridge as claimed in claim 1-3, characterized in that the length of the substantially cylindrical injection chamber is at least 5 mm.
5. Cartridge as claimed in any of the claims 1-4 characterized in that the cartridge is fitted with an aperture which is smooth.
6. Cartridge as claimed in any of the claims 1-4 characterized in that the cartridge is fitted with an aperture which is fitted with a lip or a spring or a notch adapted to guide said haptic to the intended position.
7. Combination of a cartridge as claimed in any of the claims 1-6 and an intraocular lens, characterized in that, the outer cross section of the injection chamber is only slightly larger than the cross section of the intraocular lens in its folded position augmented by the wall of the injection chamber.
8. Combination as claimed in claim 7, characterized in that the length of the injection chamber is equal to or longer than the distance between the two opposite ends of the two opposite haptics of the intraocular lens.
9. Method to inject an intraocular lens into an eye through a cartridge for injection of an intraocular lens which cartridge is adapted to load, to hold and to transport a folded lens into the eye with the cartridge including a substantially cylindrical injection chamber adapted to be partially inserted into the eye through an incision made in the eye and from which the intraocular lens is released through an aperture with the cartridge adapted to combined with an injector handpiece adapted to receive the cartridge and urge the lens through the cartridge into the eye, characterized in that the injection chamber is inserted into the eye until said aperture is positioned in a sector of the eye opposite the incision through which the injection chamber of the cartridge enters the eye at which sector at least one haptic of the intraocular lens is released.
10. Method as claimed in claim 9, characterized in that after releasing the at least one haptic of the intraocular lens the injection chamber is retracted while releasing additional components of the intraocular lens.
11. Method is claimed in claim 10, characterized in that initially a first haptic of the intraocular lens is released from the injection chamber, subsequently the optical part of the intraocular lens is released and finally a second haptic located opposite the first haptic of the intraocular lens is released.
12. Method as claimed in any of the claims 9-11, characterized in that the method is adapted to release at least one haptic of the lens directly in at least one sector of the sulcus of the eye opposite the incision through which only the injection chamber of the cartridge enters the eye.
13. Method as claimed in any of the claims 9-12, characterized in that the method is adapted to release at least one haptic of the lens directly in at least one sector of the capsular bag of the eye opposite the incision through which only the injection chamber of the cartridge enters the eye.
PCT/NL2012/050058 2011-02-02 2012-02-02 Cartridge for intraocular lens injector WO2012105839A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL2006120 2011-02-02
NL2006120 2011-02-02

Publications (1)

Publication Number Publication Date
WO2012105839A1 true WO2012105839A1 (en) 2012-08-09

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Family Applications (1)

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PCT/NL2012/050058 WO2012105839A1 (en) 2011-02-02 2012-02-02 Cartridge for intraocular lens injector

Country Status (1)

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050065534A1 (en) * 2001-11-30 2005-03-24 Emil Hohl Set for implanting an intra-ocular lens
US20060142781A1 (en) * 2004-12-29 2006-06-29 Joel Pynson Preloaded IOL injector and method
US20070005135A1 (en) * 2005-07-01 2007-01-04 Harish Makker Intraocular lens insertion plunger with low stimulus soft tip

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050065534A1 (en) * 2001-11-30 2005-03-24 Emil Hohl Set for implanting an intra-ocular lens
US20060142781A1 (en) * 2004-12-29 2006-06-29 Joel Pynson Preloaded IOL injector and method
US20070005135A1 (en) * 2005-07-01 2007-01-04 Harish Makker Intraocular lens insertion plunger with low stimulus soft tip

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