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Claims  |
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I claim:
1. A lens cartridge for use in a surgical lens inserting device for
implantation of a deformable intraocular lens into the eye through a
relatively small incision made in the ocular tissue, said lens cartridge
comprising:
a lens holding portion; and
a nozzle portion connected to and extending from said lens holding portion,
said lens holding portion and said nozzle portion having a passageway
extending therethrough, said passageway having at least one groove
extending along at least a portion of the length of said passageway,
wherein the lens cartridge is configured to be accommodated in the surgical
lens inserting device and a tip of said nozzle portion is to be inserted
through the relatively small incision made in the ocular tissue for
insertion of the deformable intraocular lens into the eye.
2. A lens cartridge according to claim 1, wherein said at least one groove
is located in a portion of said passageway extending through said lens
holding portion of the lens cartridge.
3. A lens cartridge according to claim 2, wherein said portion of said
passageway having said at least one groove transitions to a groove-less
portion of said passageway extending through said nozzle portion.
4. A lens cartridge according to claim 3, wherein at least a portion of
said passageway tapers inwardly in a direction of insertion of the
deformable intraocular lens.
5. A lens cartridge according to claim 4, wherein said inwardly tapering
portion of said passageway is located in said nozzle portion.
6. A lens cartridge according to claim 2, wherein said at least one groove
ends before a distal end of said nozzle portion.
7. A lens cartridge according to claim 6, wherein at least a portion of
said passageway tapers inwardly in a direction of insertion of the
deformable intraocular lens.
8. A lens cartridge according to claim 7, wherein said inwardly tapering
portion of said passageway is located in said nozzle portion.
9. A lens cartridge according to claim 2, wherein at least a portion of
said passageway tapers inwardly in a direction of insertion of the
deformable intraocular lens.
10. A lens cartridge according to claim 9, wherein said inwardly tapering
portion of said passageway is located in said nozzle portion.
11. A lens cartridge according to claim 1, wherein said at least one groove
comprises a set of opposed grooves extending along at least a portion of
the length of said passageway.
12. A lens cartridge according to claim 11, wherein said set of opposed
grooves are located above a horizontal centerplane of said passageway.
13. A lens cartridge according to claim 12, wherein said set of opposed
grooves are provided adjacent to each other.
14. A lens cartridge according to claim 11, wherein said set of opposed
grooves are provided adjacent to each other.
15. A lens cartridge according to claim 11, wherein at least a portion of
said passageway tapers inwardly in a direction of insertion of the
deformable intraocular lens.
16. A lens cartridge according to claim 15, wherein said inwardly tapering
portion of said passageway is located in said nozzle portion.
17. A lens cartridge according to claim 1, wherein said at least one groove
varies in depth between said lens holding portion and said nozzle portion.
18. A lens cartridge according to claim 17, wherein at least a portion of
said passageway tapers inwardly in a direction of the deformable
intraocular lens.
19. A lens cartridge according to claim 18, wherein said inwardly tapering
portion of said passageway is located in said nozzle portion.
20. A lens cartridge according to claim 1, wherein said passageway is
continuous.
21. A lens cartridge according to claim 1, wherein at least a portion of
said passageway is inwardly tapering in a direction of insertion of the
deformable intraocular lens.
22. A lens cartridge according to claim 1, wherein said inwardly tapering
portion of said passageway is located in said nozzle portion.
23. A lens cartridge according to claim 1, wherein said nozzle portion
includes a beveled end for facilitating entry of the nozzle portion
through the incision in the ocular tissue.
24. A lens cartridge according to claim 1, wherein said lens cartridge is
configured to open for loading the deformable intraocular lens into said
lens cartridge, and closed for inserting said lens cartridge into the
surgical lens inserting device for insertion of the deformable intraocular
lens.
25. A lens cartridge according to claim 24, wherein said lens cartridge is
configured to deform the deformable intraocular lens when closing to
condense the configuration of the deformable intraocular lens to pass
through said passage in said nozzle portion for inserting the lens through
the incision in the ocular tissue.
26. A lens cartridge according to claim 25, wherein the deformable
intraocular lens is placed into a curved folded configuration within said
passageway in said lens cartridge leading to said nozzle portion when said
lens holder portion is closed.
27. A lens cartridge according to claim 26, wherein said lens holder
portion comprises a split tubular member defining a portion of said
passageway and connected to said nozzle portion, said split tubular member
can be opened to insert the deformable intraocular lens and closed to
insert the lens cartridge into the surgical lens inserting device for
insertion of the deformable intraocular lens.
28. A lens cartridge according to claim 27, wherein said split tubular
member is defined by a fixed tubular portion and a movable tubular portion
connected together at a hinge, and said fixed tubular portion is connected
to said nozzle portion while said movable tubular portion moves relative
to said nozzle portion.
29. A lens cartridge according to claim 28, wherein said hinge is defined
by a decrease in wall thickness at a joint between said fixed tubular
portion and said movable tubular portion.
30. A lens cartridge according to claim 28, wherein said fixed tubular
portion includes an extension and said movable tubular portion includes an
extension, said extensions are moved apart to open said lens holding
portion for loading the deformable intraocular lens and moved together to
fold the deformable intraocular lens and close said lens holding portion
for inserting the lens cartridge into the surgical lens inserting device
for insertion of the deformable intraocular lens.
31. A lens cartridge according to claim 1, wherein the lens cartridge is
made of disposable surgically acceptable plastic.
32. A lens cartridge according to claim 1, wherein a cross section of said
nozzle portion is selected from the group consisting of circular, oval and
two half circles set apart and connected together.
33. A lens cartridge according to claim 1, wherein a tip of said nozzle
portion is provided with slots for allowing expansion of said passageway.
34. A lens cartridge according to claim 1, wherein said lens holding
portion and said nozzle portion have a one-piece construction.
35. A lens microcartridge according to claim 1, wherein said nozzle portion
is provided with a heat deformed tip for increasing the strength and
reducing the cross section of the tip to facilitate insertion through a
smaller incision.
36. A lens cartridge for use in a surgical lens inserting device for
implantation of a deformable intraocular lens into the eye through a
relatively small incision in the ocular tissue, said lens cartridge
comprising:
a lens holding portion; and
a nozzle portion connected to and extending from said lens holding portion,
said lens holding portion and said nozzle portion having an inwardly
tapering passageway of decreasing cross-sectional size extending
therethrough for further folding or compressing the deformable intraocular
lens when moving through said inwardly tapering passageway,
wherein the lens cartridge is configured to be accommodated in the lens
inserting device and a tip of said nozzle portion is to be inserted
through the relatively small incision in the ocular tissue for insertion
of the deformable intraocular lens into the eye.
37. A lens cartridge according to claim 36, wherein only a portion of said
passageway is an inwardly tapering passageway portion.
38. A lens cartridge according to claim 37, wherein said inwardly tapering
passageway portion is located in said nozzle portion.
39. A lens cartridge according to claim 43, wherein said at least one
groove is configured for further folding the deformable intraocular lens
when moving through said passageway.
40. A lens cartridge according to claim 41, wherein said at least one
groove is configured for further folding the deformable intraocular lens
when moving through said passageway.
41. A lens cartridge according to claim 37, wherein said passageway is
provided with at least one groove extending along at least a portion of
the length of said passageway.
42. A lens cartridge according to claim 41, wherein said at least one
groove is located in a portion of said passageway extending through said
lens holding portion of the lens cartridge.
43. A lens cartridge according to claim 36, wherein said passageway is
provided with at least one groove extending along at least a portion of
the length of said passageway.
44. A lens cartridge according to claim 43, wherein said at least one
groove is located in a portion of said passageway extending through said
lens holding portion of the lens cartridge.
45. A lens cartridge according to claim 44, wherein said portion of said
passageway having said at least one groove transitions to a groove-less
portion of said passageway extending through said nozzle portion.
46. A lens cartridge according to claim 44, wherein said at least one
groove ends before a distal end of said nozzle portion.
47. A lens cartridge according to claim 43, wherein said at least one
groove comprises a set of opposed grooves extending along at least a
portion of the length of said passageway.
48. A lens cartridge according to claim 43, wherein said at least one
groove varies in depth in a direction along the length of said passageway.
49. A lens cartridge according to claim 43, wherein said passageway is
continuous.
50. A lens cartridge for use in a surgical lens inserting device for
manipulation of a deformable intraocular lens into the eye through a
relatively small incision made in the ocular tissue, said lens cartridge
comprising:
a lens holding portion; and
a nozzle portion connected to and extending from said lens holding portion,
said lens holding portion and said nozzle portion having a passageway
extending therethrough, said passageway having at least one inwardly
tapering groove for folding the deformable intraocular lens,
wherein the lens cartridge is configured to be accommodated in the lens
injecting device and a tip of said nozzle portion is to be inserted
through the relatively small incision in the ocular tissue for insertion
of the deformable intraocular lens into the eye.
51. A lens cartridge according to claim 50, wherein said at least one
inwardly tapering groove is located in a portion of said passageway
extending through said lens holding portion.
52. A lens cartridge according to claim 51, wherein said portion of said
passageway having said inwardly tapering groove transitions to a
groove-less portion of said passageway extending through said nozzle
portion.
53. A lens cartridge according to claim 50, wherein said at least one
inwardly tapering groove comprises a set of opposed inwardly tapering
grooves extending along at least a portion of the length of said
passageway for continuously folding edges of the deformable intraocular
lens inwardly.
54. A lens cartridge according to claim 50, wherein a portion of said
passageway extending through said nozzle portion is an inwardly tapering
passageway portion.
55. A lens cartridge according to claim 50, wherein said lens holding
portion is defined by a split tubular member having a fixed tubular
portion fixed relative to said nozzle portion and a movable tubular
portion movable relative to said nozzle portion for opening and closing
the lens cartridge, and said split tubular member including alignment
means for aligning said movable tubular member with said fixed tubular
member upon closing the lens cartridge.
56. A lens cartridge according to claim 55, further comprising one
extension connected to said fixed tubular member and another extension
connected to said movable tubular member, said alignment means being part
of said extensions.
57. A lens cartridge according to claim 56, wherein said alignment means is
defined by an alignment rib on one said extension cooperating with a
groove in the other said extension. |
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Claims  |
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Description  |
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BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to improved lens cartridges for use with surgical
instruments for the implantation of deformable intraocular lenses into the
eye.
2. Prior Art
Intraocular lenses have gained wide acceptance in replacement of human
crystalline lenses after a variety of cataract removal procedures. The
human crystalline lens is generally recognized to be a transparent
structure having a thickness of about five (5) millimeters and a diameter
of about nine (9) millimeters. The lens is suspended behind the iris by
zonula fibers which connect the lens to the ciliary body. A lens capsule
surrounds the lens, the front portion of the capsule being commonly known
as the anterior capsule and the back portion commonly known as the
posterior capsule.
Numerous procedures for the removal of cataracts have been developed in
which the lens is removed from the eye and replaced by an artificial lens
implant. The extraction procedure may generally be categorized as
intracapsular (in which the lens is removed together with the lens
capsule) and extracapsular (in which the anterior capsule is removed with
the lens, and the posterior capsule is left intact).
Since Ridley implanted the first artificial lens in about 1949, the
problems associated with cataract extraction and lens implantation have
received a great deal of attention from ophthalmic surgeons. Various types
of artificial lenses have been proposed, and appropriate surgical
procedures have been developed which strive to reduce patient discomfort
and to reduce postoperative complications. Reference is made in this
connection to Pseudophakos by N. Jaffe et al., "History of Intraocular
Implants" by D. P. Choyce (Annals of Ophthalmology, October 1973); U.S.
Pat. No. 4,251,887 issued to Anis on Feb. 24, 1981; U.S. Pat. No.
4,092,743 issued to Kelman on Nov. 8, 1977; "Comparison of Flexible
Posterior Chamber Implants", presented at the American Intraocular Implant
Society Symposium Apr. 23, 1982, by Charles Berkert, M.D.; and "the Simcoe
Posterior Lens" (Cilco, Inc. 1980); U.S. Pat. No. 4,573,998 issued to
Mazzocco on Mar. 4, 1986, U.S. patent application Ser. No. 400,665 for
"Improved Fixation System for Intraocular Lens Structures", filed Jul. 22,
1982, U.S. Pat. No. 4,702,244 issued to Mazzocco on Oct. 27, 1987; and
U.S. Pat. No. 4,715,373 issued to Mazzocco et al. on Dec. 29, 1987, which
disclosures are hereby incorporated by reference.
Of particular interest in the context of the present invention is the
development of surgical techniques requiring relatively small incisions in
the ocular tissue for the removal of cataracts as disclosed in U.S. Pat.
Nos. 4,002,169 and 3,996,935. A number of skilled artisans have disclosed
intraocular lens structures comprising an optical zone portion generally
made of rigid materials such as glass or plastics suitable for optical
use.
However, one of the principal disadvantages of the conventional rigid
intraocular lens is that implantation of the lens requires large incisions
in the ocular tissue. This type of surgical procedure leads to a
relatively high complication rate, among other disadvantages. For
instance, the serious dangers associated with implantation of a rigid lens
structure include increased risk of infection, retinal detachment, and
laceration of the ocular tissue, particularly with respect to the pupil.
Accordingly, those skilled in the art have recognized a significant need
for surgical tools for implantation of deformable intraocular lens
structures which afford the clinical advantages of using relatively small
incision techniques, which provide a safer and more convenient surgical
procedure. In particular, those skilled in the art of deformable
intraocular lenses and methods and devices for implantation, have also
recognized a significant need for surgical tools which do not require
widening of the wound made in the ocular tissue during or after
implantation, but will deform the intraocular lens to a predetermined
cross section in a stressed state and which allow the ophthalmic surgeon
to inspect the lens prior to implantation without manipulation in the eye.
The present invention fulfills these needs.
The present invention was derived by improving the methods and devices in
the above-identified patents, specifically the methods of U.S. Pat. No.
4,573,998 and the devices of U.S. Pat. No. 4,702,244.
SUMMARY OF THE INVENTION
An object of the present invention is to provide an improved lens cartridge
for use with a surgical instrument for implantation of deformable
intraocular lenses.
Another object of the present invention is to provide a lens cartridge for
use with a surgical lens injecting device for implantation of a deformable
intraocular lens into the eye through a relatively small incision made in
the ocular tissue, the lens cartridge comprising a lens holding portion, a
nozzle portion connected to and extending from the lens holding portion,
the lens holding portion and the nozzle portion having a continuous
passageway extending therethrough, the passageway having at least one
groove extending along at least a portion of the length of the passageway
for manipulating the deformable intraocular lens as it passes through the
lens cartridge.
A further object of the present invention is to provide a lens cartridge
for receiving a lens comprising a split tubular member having a fixed
portion with an extension, and a movable portion with an extension for
opening and closing the lens cartridge, which extensions prevent rotation
between the lens cartridge and lens injecting device when installed in the
lens injecting device.
An even further object of the present invention is to provide a lens
cartridge having a nozzle portion provided with slots for rotating the
lens as it exits the nozzle portion.
Another further object of the present invention is to provide a surgical
implantation device comprising a lens cartridge and a lens injecting
device, the lens injecting device comprising a receiver for the lens
cartridge and a plunger for inserting the deformable intraocular lens.
Another object of the present invention is to provide a lens cartridge
defined by a cylindrical tubular member with an opening through the wall
of the tubular member defining a receiver for the lens cartridge, and a
plunger having a tip for contacting with and moving a deformable
intraocular lens contained in the lens cartridge.
A further object of the present invention is to provide a plunger with a
faceted tip that provides clearance for a trailing haptic in a passageway
through the lens cartridge during the implantation process to prevent
damage to the trailing haptic.
An even further object of the present invention is to provide a plunger
having a tip with a concave conical surface at the tip thereof for
grabbing the lens during the implantation process.
Another further object of the present invention is to provide improved
methods of implanting deformable intraocular lenses.
Another object of the present invention is to provide a method including
loading a deformable intraocular lens into a lens cartridge having an
implantation nozzle, condensing the intraocular lens within the lens
cartridge, and implanting the lens into the eye.
The present invention concerns methods and devices for implantation of
intraocular lenses into the eye, in particular improved microcartridges.
The surgical implantation device according to the present invention
includes the combination of a lens cartridge and a lens inserting or
injecting device for holding the lens cartridge. The preferred lens
cartridge comprises the combination of a lens holding portion and an
implantation nozzle portion. The lens holding portion is preferably
defined by a split tubular member having a fixed tubular portion with an
extension connected to a movable tubular portion with an extension, at a
hinge. This configuration allows the lens cartridge to be opened to accept
a deformable intraocular lens, and closed to condense the deformable
intraocular lens into the passageway. The lens holding portion is
connected to the nozzle portion with a continuous passageway passing
through the lens holding portion and the nozzle portion.
The lens cartridge is inserted into the lens injecting device having means
for driving or manipulating the deformable intraocular lens from the lens
cartridge into the eye. In the preferred embodiment, the lens injecting
device is provided with a plunger for driving the deformable intraocular
lens from the lens cartridge into the eye. Further, the lens injecting
device is configured to receive a lens cartridge having a nozzle portion.
The preferred lens injecting device includes means to prevent the lens
cartridge from rotating within the lens injecting device, and means for
preventing the plunger from rotating within the lens injecting device. The
means for preventing rotation of the lens cartridge within the lens
injecting device can be defined by providing the lens cartridge with one
or more extensions that cooperate with the opening of the lens cartridge
receiver of the lens injecting device to prevent rotation. The means for
preventing the plunger from rotating within the lens injecting device can
be defined by providing both the plunger and a sleeve within the lens
injecting device with a particular cross-sectional shape that prevents
relative rotation, for example, a half-circle shape.
The preferred lens injecting device includes a plunger with a threaded cap
cooperating with a threaded sleeve of the body of the lens injecting
device for dialing the plunger forward within the lens injecting device
for precise and accurate movement of the lens during the implantation
process. The lens injecting device is configured so that the plunger can
be moved a predetermined distance by sliding motion within the body of the
lens injecting device followed by engagement of the threaded cap of the
plunger with the threaded sleeve of the body of the lens injecting device
to continue the forward progress of the plunger tip.
The preferred plunger tip is defined by a faceted tip having various
surfaces for moving and manipulating the lens from the lens cartridge and
within the eye. The tip is designed to provide a clearance between the tip
and the inner surface of the passageway through lens cartridge to
accommodate the trailing haptic and prevent damage thereto. Once the lens
is inserted into the eye, the tip can be used to push and rotate the lens
into proper position within the eye.
A method according to the present invention includes lubricating the
surface of a deformable intraocular lens with a surgically compatible
lubricant, and loading the lens into a lens cartridge in the opened
position. The lens cartridge is closed while condensing the lens by a
folding action into a shape so that it can be forced through the
passageway in the lens cartridge. The lens cartridge is inserted into the
lens injecting device with the plunger retracted.
The plunger is moved forward in a sliding manner by pushing the plunger
forward while holding the body of the lens injecting device still. This
action forces the deformable intraocular lens from the lens holding
portion of the lens cartridge into the nozzle portion. At this point the
threads of the threaded end cap of the plunger engage with the threads of
the threaded sleeve. The threaded end cap is rotated slightly to engage
the threads. The device is now ready for the implantation process.
The nozzle of the microcartridge is placed through a small incision in the
eye. The threaded end cap of the plunger is rotated or dialed to further
advance the lens forward through the nozzle and into the eye. The threaded
end cap is further dialed to exposed the tip of the plunger within the eye
and push the lens into position. The tip can be used to also rotate the
lens within the eye for positioning of the haptics.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of one embodiment of the surgical implantation
device according to the present invention with a lens holding
microcartridge positioned in the lens injecting device for implantation of
a deformable intraocular lens into the eye.
FIG. 2 is a perspective view of the surgical implantation device shown in
FIG. 1 with the plunger retracted, and with the lens holding
microcartridge removed.
FIG. 3 is a side view of the surgical implantation device shown in FIG. 2
with the plunger in the extended position.
FIG. 4 is a side elevational view of the surgical implantation device shown
in FIG. 1.
FIG. 5 is a detailed longitudinal cross-sectional view of the surgical
implantation device shown in FIG. 4.
FIG. 6 is a detailed transverse cross-sectional view of the surgical
implantation device, as indicated in FIG. 5.
FIG. 7 is a detailed end view of the surgical implantation device, as
indicated in FIG. 5.
FIG. 8 is an enlarged detailed left side elevational view of the tip of the
plunger in the spatial orientation as shown in FIG. 1.
FIG. 9 is an enlarged detailed end view of the tip shown in FIG. 8.
FIG. 10 is an enlarged detailed top planar view of the tip of the plunger.
FIG. 11 is an enlarged detailed right side elevational view of the tip of
the plunger in the spacial orientation, as shown in FIG. 4.
FIG. 12 is an enlarged detailed bottom view of the tip of the plunger in
the spacial orientation, as shown in FIG. 1.
FIG. 13 is a perspective view of a deformable intraocular lens for use in
the present invention.
FIG. 14 is a perspective view of another type of deformable intraocular
lens for use in the present invention.
FIG. 15 is a side view of the deformable intraocular lens shown in FIG. 13.
FIG. 16 is a perspective view of a lens holding microcartridge shown in the
open position to allow a deformable intraocular lens to be loaded therein.
FIG. 16A is another perspective view of the lens holding microcartridge
shown in the open position.
FIG. 17 is a rear end elevational view of the lens holding microcartridge
shown in the open position.
FIG. 18 is a front end elevational view of the lens holding microcartridge
shown in the open position.
FIG. 19 is a rear end elevational view of the lens holding microcartridge
shown in the closed position.
FIG. 20 is a front end elevational view of the lens holding microcartridge
shown in the closed position.
FIG. 20A is a detailed end view of the nozzle portion showing three (3)
slots of different length equally spaced about the circumference of the
tip.
FIG. 20B is a detailed perspective view of the tip showing the three (3)
slots of different length.
FIG. 21 is a top planar view of the lens holding microcartridge shown in
the open position.
FIG. 22 is a side elevational view of the lens holding microcartridge shown
in the closed position.
FIG. 23 is a rear end elevational view of the lens holding microcartridge
shown in the closed position.
FIG. 24 is a broken away side view of the surgical implantation device
showing the lens holding microcartridge in relationship to the plunger in
the retracted position.
FIG. 25 is a broken away side view of the surgical implantation device
showing the lens holding microcartridge in relationship to the plunger in
a partially extended position.
FIG. 26 is a broken away side view of the surgical implantation device
showing the lens holding microcartridge in relationship to the plunger in
a fully extended position.
FIG. 27 is a perspective view showing the surgical implantation device
positioning a deformable intraocular lens within the eye.
FIG. 28 is a cross-sectional view of an eye showing the positioning of the
deformable intraocular lens into position in the eye by the surgical
device.
FIG. 29 is a cross-sectional view of an eye showing the positioning of the
deformable intraocular lens into a different position in the eye by the
surgical device.
FIG. 30 is a side elevational view of an alternative embodiment of the lens
holding microcartridge provided with a beveled tip.
FIG. 31 is a rear end elevational view of another alternative embodiment of
the lens holding microcartridge provided with grooves in the passageway to
facilitate folding the deformable intraocular lens in an open position.
FIG. 32 is a rear end elevational view of another alternative embodiment of
the lens holding microcartridge provided with grooves in the passageway to
facilitate folding the deformable intraocular in a closed position.
FIG. 33A is a front end elevational view of the nozzle portion of an
alternative embodiment of the lens holding microcartridge.
FIG. 33B is a front end elevational view of the nozzle portion of a further
alternative embodiment of the lens holding microcartridge.
FIG. 34 is a side elevational view of another embodiment of the lens
holding microcartridge according to the present invention inserted in a
lens injecting device.
FIG. 35 is a top planar view of the lens holding microcartridge inserted in
a lens injecting device, as shown in FIG. 34.
FIG. 36 is a bottom planar view of the lens holding microcartridge shown in
FIGS. 34 and 35, but removed from the lens injecting device.
FIG. 37 is a rear end elevational view of the lens holding microcartridge
shown in FIGS. 34 and 35, but removed from the lens injecting device.
FIG. 38 is a rear end elevational view of the lens holding microcartridge
inserted in a lens injecting device, as shown in FIGS. 34 and 35.
FIG. 39 is a cross-sectional view of the lens holding microcartridge as
indicated at 39--39 in FIG. 34.
FIG. 40 is a cross-sectional view of the lens holding microcartridge as
indicated at 40--40 in FIG. 34.
FIG. 41 is a cross-sectional view of the lens holding microcartridge as
indicated at 41--41 in FIG. 34.
FIG. 42 is a side elevational view of a lens holding microcartridge
according to the present invention with a heat deformed and beveled tip.
FIG. 43 is a cross-sectional view of the tip as indicated at 43--43 in FIG.
42.
FIG. 44 is a side elevational view of a further alternative embodiment of
the lens holding microcartridge provided with at least one groove in the
passageway, an inwardly tapering passageway, and slots in the tip of the
nozzle portion.
DESCRIPTION OF PREFERRED EMBODIMENTS
The present invention is directed to a system including methods and devices
for implantation of deformable intraocular lens structures for surgical
placement in the eye.
A surgical implantation device according to the present invention comprises
a lens injecting device having a lens cartridge receiver, a lens cartridge
(e.g., "microcartridge") that can be removably inserted into the lens
cartridge receiver of the lens injecting device, and means such as a
movable plunger disposed within the lens injecting device to force and
manipulate the lens from the lens cartridge into the eye.
Preferably, the lens cartridge is defined by a lens holding microcartridge
for receiving the lens structure. Further, the microcartridge is
preferably a structure configured to be opened and closed. The preferred
embodiment of the microcartridge receives a lens having prescribed memory
characteristics when in the open position, and performs the function of
folding or deforming the lens structure into a condensed configuration
when closed. Alternatively, the microcartridge can be a structure having a
passageway defined by a continuous walled annulus, and a lens can be
inserted into the passageway from the end of microcartridge by
compressing, rolling, folding, or combination of these techniques prior to
insertion into the microcartridge.
Once a lens is loaded into the microcartridge, the microcartridge is loaded
into the lens injecting device. The assembled surgical implantation device
maintains the lens in its condensed configuration during insertion into
the eye yet permits the deformed lens to return to its original
configuration, size and fixed focal length once implanted in the eye,
thereby providing a safe, convenient, and comfortable surgical procedure.
A preferred embodiment of a surgical implantation device 10 according to
the present invention is shown in FIGS. 1, 2 and 3. The surgical
implantation device 10 comprises a microcartridge 12 (i.e., "lens
cartridge") disposed within a lens injecting device 13 comprising a body
14 with a lens cartridge receiver 15, and a movable plunger 16. In FIG. 1,
the lens cartridge receiver 15 is defined by an opening 17 through the
wall of the body 14 of the size and shape shown in FIGS. 1 and 2. The
opening 17 is defined by parallel edges 17a, 17a, which are sufficiently
spaced apart to allow the microcartridge 12 to be loaded into the lens
cartridge receiver 15 of the lens injecting device 13, tapered edges 17b,
17b, clamping edges 17c, 17c, and stop edge 17d. In FIG. 1, the
microcartridge 12 is positioned in the receiver 15 between the clamping
edges 17c, 17c with the plunger 16 extending through the microcartridge 12
in a position, for example, after a lens implantation procedure.
In FIG. 2, the lens holding microcartridge 12 is shown removed from the
lens injecting device 13 with the plunger 16 in a retracted position for
allowing the microcartridge 12 containing a loaded lens and its haptics to
be inserted within the lens injecting device 13. In FIG. 3, the lens
injecting device 13 is shown with the plunger 16 in the extended position
without the microcartridge 12 for purposes of illustration of the
components.
The plunger 16 is fitted with a threaded end cap 18 at one end, and fitted
with a tip 20 at an opposite end. The threaded end cap 18 is provided with
a plurality of grooves 22 to allow a person to tightly grip the cap 18
with his or her finger tips. The threaded end cap 18 is received within a
threaded sleeve 24 of the body 14. The threaded end cap 18 can be a
separate component attached to the lens injecting device 13, or integral
therewith, as shown in the construction in FIG. 5.
The plunger 16 is installed within the lens injecting device 13 in a manner
to allow the plunger to be reciprocated therein. In the illustrated
embodiment, the plunger 16 is supported for sliding movement within the
lens injecting device 13 by guide 26, as shown in FIGS. 5 and 6. The outer
dimension of the guide 26 is approximately the same size as the inner
dimensions of the lens injecting device 13 to allow the guide to be
inserted within the lens injecting device 13. During construction, the
guide 26 is inserted within the lens injecting device 13, and locked into
position by pin 28 inserted into a predrilled hole in both the wall of the
lens injecting device 13 and guide 26.
The cross-sectional shape of the plunger 16 as well as the shape of the
inner surface of the guide 26 are approximately a half-circle, as shown in
FIG. 6. This arrangement prevents the plunger 16 from rotating within the
lens injecting device 13 to maintain the orientation of the tip 20
relative to the lens injecting device 13 during operation.
The threaded end cap 18 is connected to the plunger 16 in a manner to allow
the threaded end cap 18 to be rotated relative to the plunger 16. For
example, the left end of the plunger 16 (FIG. 5) is provided with a
threaded extension 30, which is secured to the threaded end cap 18 by a
nut 32. Specifically, the threaded end cap 18 is manufactured with
external threads 34 and a longitudinal center bore 36 that ends on the
right side of the threaded end cap 18 leaving an end wall 38.
The end wall 38 is provided with a hole slightly larger than the outer
diameter of the threaded extension 30 to allow the threaded end cap 18 to
freely rotate on the plunger 16 while being secured to the end of the
plunger 16. During construction, the nut 32 is inserted through the center
bore 36 and threaded onto the threaded extension 30 to secure the threaded
end cap 18 to the plunger 16. A curved end cap 40 is press fitted into the
end of the center bore 36 to seal the center bore 36 and prevent debris
from entering therein during use.
The details of the tip arrangement are shown in FIGS. 7 to 12. The plunger
16 is manufactured with an extension 42 supporting tip 20. The tip 20
structure provides means for inserting the deformable intraocular lens
into the eye and manipulating the lens within the eye after the insertion
step. For example, the tip 20 is faceted in the manner shown in the
figures. Specifically, the left side of the tip 20 shown in FIG. 8 is
provided with a flat surface facet, 44 conical surface 46, and cylindrical
surface 48. The right side of the tip 20 shown in FIG. 11 is provided with
a concave surface facet 50.
The end face of the tip 20 is designed to push the lens into position once
inserted into the eye. For example, the end face is defined by a concave
cylindrical surface 52 shown in FIG. 8.
Suitable deformable intraocular lens for use in the present invention are
shown in FIGS. 13-15. The deformable intraocular lens 54 shown in FIGS. 13
and 15 includes a lens body 56 with attachment means defined by a pair of
haptics 58 each having one end anchored in the lens portion 56 and a free
end for attachment to the eye tissue. The deformable intraocular lens 60
shown in FIG. 14 includes a lens body 62 and attachment means defined by a
pair of lateral lobes 64 of the lens portion 62.
The details of the preferred lens holding microcartridge 12 are shown in
FIGS. 16-20. The microcartridge 12 comprises a split tubular member 66
extending to a continuous tubular member 67 (i.e., "lens holding portion")
and an implantation nozzle portion 68. When the microcartridge is in a
closed position, a continuous circular or oval passageway of the same
diameter extends through the split tubular member 66 through the
continuous tubular member 67 and through the implantation nozzle portion
68. The microcartridge 12 is preferably made of injection molded plastic
such as polypropylene. The split tubular member 66 is defined by a fixed
portion 70 and a movable portion 72. The fixed portion 70 is fixed
relative to the implantation nozzle portion 68, and is defined by a
tubular portion 74 and extension 72. The movable portion 72 is movable
relative to the fixed portion 70 for opening and closing the split tubular
member 66. The movable portion 72 is defined by a tubular portion 78 and
extension 80. A hinge 82 is provided between the fixed portion 70 and
movable portion 72. The hinge 82 is defined by reducing the thickness of
the walls of the tubular portion 74 and 75 at the hinge 82, as shown in
FIGS. 17, 18 and 19. The hinge 82 runs the length of the split tubular
member 66 to allow the extensions 76 and 78 to be split apart, or brought
together to open and close, respectively, the split tubular member 66.
The tubular portion 78 of the movable portion 72 is provided with a sealing
edge 84, which is exposed when the lens holding microcartridge 12 is
opened, as shown in FIG. 16A, and seals with a similar sealing edge 86
(See FIGS. 17 and 21) of the continuous tubular member 67 when the lens
holding microcartridge 12 is closed.
The end of the tip 69 is provided with three (3) equally spaced slots 87a,
87b and 87c of different length provided about the circumference thereof,
as shown in FIGS. 20A and 20B. The slot 87a positioned at the top of the
tip 69 is the shortest, slot 87c on the right side of the tip 20 is the
longest, and slot 87b on the left side is of medium length. The slots 87a,
87b, 87c cause the lens 54 to rotate as it exits the tip 20.
Other embodiments of the microcartridge 12 according to the present
invention are shown in FIGS. 30-33.
The microcartridge 12' shown in FIG. 30 is provided with a beveled tip 94
to facilitate entry of the tip through the incision in the eye during
implantation. The beveled tip 94 can be set at approximately forty-five
(45) degrees relative to the passageway through the microcartridge 12'.
The embodiment of the microcartridge 12' shown in FIGS. 31 and 32 is
provided with a set of grooves 96 provided inside the passageway
therethrough. The grooves accommodate the edges of the lens being loaded
into the microcartridge to facilitate bending of the lens. Specifically,
the edges of the lens are placed in the grooves 96 to prevent relative
slippage of the edges with the inner surface of the passageway through the
microcartridge when the microcartridge is being folded into the closed
position.
The embodiments of the microcartridge shown in FIGS. 33A and 33B each have
a tip 69' and 69" having an oval cross-section with slots 87" and 87"
differently positioned as shown, respectively, again to facilitate entry
through an incision in the eye. Alternatively, the cross-section can be
two half circles set apart and connected together rather than oval.
The various features of the microcartridges shown in FIGS. 16-21 and 30-33
can be used in various combinations to achieved an optimum design for a
particular application. However, all of these features are typically
considered improvements of the basic combination. For example, FIG. 44
shows a further embodiment which combines the features of at least one
groove in the passageway, an inwardly tapering passageway, and slots in
the tip of the nozzle portion.
The components of the device 10, except for the microcart | | |