EP1280480A1 - Dimensionnement d'une lentille refringente phakique - Google Patents
Dimensionnement d'une lentille refringente phakiqueInfo
- Publication number
- EP1280480A1 EP1280480A1 EP00984540A EP00984540A EP1280480A1 EP 1280480 A1 EP1280480 A1 EP 1280480A1 EP 00984540 A EP00984540 A EP 00984540A EP 00984540 A EP00984540 A EP 00984540A EP 1280480 A1 EP1280480 A1 EP 1280480A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- lens
- eye
- refractive lens
- phakic refractive
- phakic
- 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.)
- Withdrawn
Links
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 or corneal implants; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1602—Corrective lenses for use in addition to the natural lenses of the eyes or for pseudo-phakic eyes
Definitions
- This invention relates to an intraocular lens, in particular an intraocular phakic refractive lens, and a method of implanting a phakic refractive lens to correct the eyesight
- the present invention is also directed to sizing a phakic refractive lens.
- the present invention is directed to a sized phakic refractive lens and a
- Major ocular components of an eye include a retina and cornea.
- An anterior chamber is defined by the space between the cornea and the iris.
- a posterior chamber is defined by the space between the
- a natural crystalline lens is located behind the pupil as defined by the iris.
- the zonule attachments allow the natural crystalline lens to deform to different optical powers.
- the natural crystalline lens does not properly deform to achieve a required focus or the length of the eyeball is such that an image does not fall directly on
- An intraocular lens has an optical zone portion, and generally made of flexible material suitable for optical use such as silicone.
- At least two general problems are associated with implantation of an intraocular lens.
- the implantation method requires a relatively large incision, which can lead to complications such as infection, retinal detachment and laceration of the ocular tissue.
- a second problem relates to the intraocular environment. Intraocular tissue is extremely
- intraocular tissue differs from exterior eye tissue. At least one surface of exterior eye tissue is exposed to the
- the lens structure disclosed in the 4,573,990 and 4,702,244 patents comprises a deformable optical zone portion having prescribed memory characteristics.
- the lens can be deformed by compressing, rolling, folding, stretching or by a combination thereof to a small diameter for insertion through a small incision in the eye.
- the memory characteristics enable the lens to return to an original configuration with full size and fixed focal length after insertion.
- the optical zone portion of the lens is fabricated from a biologically inert material possessing elasticity and compression characteristics.
- a transition can be made that has a gradient of radius of curvature within very small dimensions. The transition forms a
- transition portion that defines an elliptically transcribed surface transition from the surface of the optic portion to the surface of the base portion.
- At least one groove can be provided in the outer surface of the phakic refractive lens.
- the groove is preferably in the arrangement of a circular groove located in the base portion and surrounding the optic portion.
- the circular groove allows for good circulation of eye fluid to facilitate lubrication between the phakic refractive lens and the back of the iris.
- Other groove configurations can be utilized.
- the passageway is provided in a variety of different forms.
- passageway can be in the form of a groove in the anterior surface and a groove in the posterior surface that connect to form a continuous channel or the passageway can be provided in the form of a hole through the thickness dimension of the phakic refractive
- Feingold also provides one or more through holes in the iris to place the anterior chamber and posterior chamber in fluid communication to allow equalization of pressure therebetween. This prevents the phakic refractive lens from being sucked into tight
- the tight contact effect is due to a differential pressure between the posterior and anterior eye chambers
- the through holes eliminate the differential pressure between the chambers
- Figure 25 is a partial side sectional view of a human eye showing a location of an implanted phakic refractive lens
- the lens is located in the posterior chamber and can be fixed in the chamber by a peripheral body member (haptic), which extends beyond the optic portion of the lens The body member accomplishes fixation by contacting the
- peripheral tissues of the eye posterior to the iris in the area of the ciliary sulcus The
- present invention is based in part on a finding that proper refractive correction can be
- phakic refractive lens implanted so as to form a spacing between the posterior surface of the phakic
- Fig 60 shows a deformable phakic refractive lens positioned in the posterior chamber between the natural
- STAAR Surgical AG of Switzerland has been developing a refractive phakic lens and refers to their phakic refractive lens under the trademark IMPLANTABLE CONTACT LENS or ICL.
- STAAR Surgical AG has been conducting significant clinical studies on the IMPLANTABLE CONTACT LENS, which studies indicate that the IMPLANTABLE CONTACT LENS is effective for refractive correction of the human
- the IMPLANTABLE CONTACT LENS has also been utilized as a phakic/pseudo- phakic lens in which the natural crystalline lens has been replaced with an intraocular lens
- a phakic refractive lens such as the IMPLANTABLE
- a first object of the invention is to provide an improved intraocular lens in the
- a second object is to provide a phakic refractive lens that forms a spacing with the natural crystalline lens of the eye when the phakic refractive lens is implanted into the eye.
- a third object is to provide a phakic refractive lens that cooperates with the natural crystalline lens to correct eyesight.
- a fourth object of the present invention is to provide a phakic refractive lens that
- a fifth object of the present invention is to provide an improved method of implantation of a phakic refractive lens.
- the invention relates to a method of implanting an intraocular phakic refractive
- the method comprises steps of providing a phakic refractive lens and inserting the phakic refractive lens into a
- the invention also relates to a phakic refractive lens implanted in a posterior chamber of an eye in a vicinity of the natural crystalline lens.
- the phakic refractive lens implanted in a posterior chamber of an eye in a vicinity of the natural crystalline lens.
- the invention also relates to a phakic refractive lens for implanting in the vicinity
- the phakic refractive lens comprises a shape that
- phakic refractive lens is predetermined with respect to a shape of the natural crystalline lens to form a spacing between a posterior surface of the phakic refractive lens and an anterior surface of the natural crystalline lens when the phakic refractive lens is implanted into the eye.
- a first object of the present invention is to provide an improved phakic refractive
- a second object of the present invention is to provide a sized phakic refractive
- a third object of the present invention is to provide a sized phakic refractive lens
- a fourth object of the present invention is to provide a phakic refractive lens
- a fifth object of the present invention is to provide a phakic refractive lens custom designed to fit to the inner dimensions of the inner structure of an eye.
- a sixth object of the present invention is directed to a method of sizing a phakic refractive lens for an eye.
- a seventh object of the present invention is directed to a method of sizing a phakic refractive lens for an eye previously measured.
- the present invention is directed to a sized phakic refractive lens and a method of
- the phakic refractive lens according to the present invention is a sized phakic refractive lens. Specifically, the structure of the eye is carefully measured to determine its shape, conformation and size dimensions of the inner structure of the eye, and
- the eye is measured by any suitable technique for providing details of the shape, confirmation and/or size dimensions of the inner structure of the eye. Specifically, the
- ICL IMPLANTABLE CONTACT LENS
- the edges of the IMPLANTABLE CONTACT LENS along its major axis are located on the zonules and/or located in the ciliary sulcus.
- the shape, conformation, and size dimensions of the zonules and/or sulcus is important with respect to sizing the length and width dimensions of the IMPLANTABLE CONTACT LENS along its major and minor axes. Further, the actual detailed shape of the zonules and/or sulcus must be determined along one or more axis in the eye along which the major axis of the intraocular contact lens will be aligned, since the zonule-to-zonule and/or sulcus-to-sulcus dimensions can change at different angles of orientation within each eye
- IMPLANTABLE CONTACT LENS dimensions of the haptic portion, shape of the haptics, shape of the edges, shape and size o ⁇ the footpads, and other important design parameters of the IMPLANTABLE CONTACT LENS are all specified based on the shape, confirmation and size prescription of a patient's particular eyes after precisely and accurately measuring
- each footpad designed to contact with the zonules and/or sulcus must be precisely and accurately be specified for proper and comfortable fit of the implantable contact lens in the eye
- One preferred method of measuring the eye for designing and sizing an implantable contact lens is by measuring the exterior white-to-white measurements of the eye particularly along an axis of the eye along which the major axis of the implantable contact
- Another preferred method of measuring an eye involves use of ultrasonic radiation for measuring the exact shape, confirmation and size dimensions of the inner structures
- the exact shape and location of the zonules and/or sulcus can be any shape and location of the zonules and/or sulcus.
- ultrasonic radiation, emission and detection is based on emitting ultrasonic waves into the eye with some of the ultrasonic waves reflecting at the interface between the inner structure of the eye and the fluid medium within the eye, which provides a reflected image
- the ultrasonic apparatus can scan the
- the preferred method of mapping the eye including determining the shape, confirmation and size dimensions of the inner structure of the eye can be accomplished by using one or more beams of ultrasonic radiation generated by an ultrasonic transducer
- the one or more beams can scan an sweep the entire inner structure of the eye to provide a reflected image that is captured on a detector
- the detected image can be displayed on a cathode ray tube (CRT), which can be scaled to
- Figure 1 is a cross-sectional view of a positive intraocular phakic refractive lens
- Figure 2 is a cross-sectional view of the phakic refractive lens in Figure 1, as indicated in Figure 3
- Figure 3 is a top planar view of the positive phakic refractive lens as shown in
- Figures 1 and 2 Figure 4 is a cross-sectional view of another embodiment of a positive phakic refractive lens as indicated in Figure 6.
- Figure 5 is a cross-sectional view of the positive phakic refractive lens shown in
- Figure 6 is a top planar view of the positive phakic refractive lens as shown in
- Figure 7 is a table of examples of positive phakic refractive lenses directed to the
- Figure 8 is a cross-sectional view of a negative phakic refractive lens according
- Figure 9 is a cross-sectional view of the negative phakic refractive lens shown in Figure 8, as indicated in Figure 10.
- Figure 10 is a top planar view of the negative phakic refractive lens shown in
- Figure 11 is another embodiment of a negative phakic refractive lens according to
- Figure 12 is a cross-sectional view of the phakic refractive lens shown in Figure
- Figure 13 is a top planar view of the negative phakic refractive lens shown in
- Figure 14 is a table of examples of negative phakic refractive lenses directed to the
- Figure 15 is a top planar view of another embodiment of a positive phakic refractive lens according to the present invention.
- Figure 16 is a cross-sectional view of the positive phakic refractive lens, as
- Figure 17 is a partial detailed cross-sectional view of a portion of the positive
- Figure 18 is a table indicating the detailed curvature as an example of the
- Figure 19 is another embodiment of a negative phakic refractive lens according to the present invention.
- Figure 20 is a top planar view of another negative phakic refractive lens according to the present invention with a circular groove in the lens body portion thereof.
- Figure 21 is a cross-sectional view of the negative phakic refractive lens, as
- Figure 22 is a cross-sectional view of an eye having an phakic refractive lens according to the present invention implanted therein.
- Figure 23 is a cross-sectional view the eye with a prior art phakic refractive lens implanted therein.
- Figure 24 is a cross-sectional view of another embodiment of a phakic refractive
- Figure 25 is a partial side sectional view of a human eye with a phakic refractive
- Figures 26-28 are partial side sectional views of a human eye with phakic refractive lenses illustrating lens implants according to the present invention.
- Figure 29 is a detailed perspective view of an eye.
- Figure 30 is a detailed cross-sectional view of an eye containing an IMPLANTABLE CONTACT LENS type of phakic refractive lens.
- the intraocular phakic refractive lens (“prl”) according to the present invention can be provided with a concave posterior face that is shaped substantially complementary to the convex shape of the anterior surface of the natural crystalline lens.
- refractive lens is adapted to provide a face to face relationship with the anterior surface
- the natural crystalline lens to form a spacing between the phakic refractive lens and the natural crystalline lens.
- the spacing is formed at a location between the phakic refractive lens and the pupil of the eye.
- FIG. 1 An embodiment of a positive phakic refractive lens according to the present invention is shown in Figures 1-3.
- the phakic refractive lens 10 is defined by an oval-shaped lens body portion 12
- the lens portion 14 has a thickness Tc and the lens body portion 12 has an edge
- the lens portion 14 has a curvature SRfr, and
- the lens body portion 12 has an outer curvature SRo and an inner curvature SRi
- FIG. 4 Another embodiment of a positive phakic refractive lens according to the present invention as shown in Figures 4-6
- the phakic refractive lens 20 is defined by an oval-shaped lens body portion 22
- the lens portion 24 has a thickness Tc and the lens body portion 22 has an edge
- the lens portion 24 has a curvature SRfr and
- the lens body portion 22 has an outer curvature SRfr2 (SRo) and an inner curvature SRi
- the phakic refractive lens 30 is defined by an oval-shaped lens body portion 32
- major axis diameter DM and minor axis diameter Dm and having a radius R2
- a circular shaped lens portion 34 having a diameter Do.
- the lens portion 34 has a thickness Tc and the lens body portion 32 has an edge
- the lens portion 34 has a curvature SRfr and
- the lens body portion 32 has an outer curvature SRo and an inner curvature SRi.
- the phakic refractive lens 40 is defined by an oval-shaped lens body portion 42 defined by major axis diameter DM and minor axis diameter Dm, and having a radius R2,
- the lens portion 44 has a thickness Tc and the lens body portion 42 has an edge
- the lens portion 44 has a curvature SRfr and
- the lens body portion 42 has an outer curvature SRfr2 (SRo) and an inner curvature SRi.
- FIG. 15-17 A further embodiment of a positive intraocular refractive lens 50 is shown in Figures 15-17.
- the phakic refractive lens 50 is defined by an oval-shaped lens body portion 52
- the lens portion 54 has a thickness
- Tc and the lens body portion 52 has an edge thickness Te, as shown in Figure 16.
- a further embodiment of a negative phakic refractive lens 60 is shown in Figure
- the phakic refractive lens 70 is defined by an oval-shaped lens body portion 72
- major axis diameter DM and minor axis diameter Dm defined by major axis diameter DM and minor axis diameter Dm, and a circular shaped
- the lens portion 74 having a diameter Do.
- the lens portion 74 has a thickness Tc and the lens
- body portion 72 has an edge thickness Te, as shown in Figure 21.
- the circular groove G allows for
- the groove G can be used for lens manipulation during surgery, and facilitates the equalization of intraocular pressure.
- lens portion 84 is shown in Figs. 22 and 23.
- an air passageway 86 is shown in Figs. 22 and 23.
- This air passageway 86 allows for equalization of pressure between the anterior
- the phakic refractive lens 80 is provided with a pair of indents 92, as shown in
- Figure 25 illustrates a lens implantation according to the prior art Figure 25
- FIG. 1 shows a natural eye 100 with posterior chamber 102 and natural crystalline lens 104 with
- a phakic refractive lens 108 is shown implanted into the posterior
- a dimension of the eye is determined and the phakic refractive
- the lens is provided according to the eye dimension so that the phakic refractive lens forms a spacing when inserted into the posterior chamber.
- curvature of the natural crystalline lens can be determined by methodology known in the art.
- the arc of radius of curvature of the phakic refractive lens is then determined according to the arc of radius of curvature of the natural crystalline lens If a phakic refractive lens is provided that has an arc of radius of curvature less than the arc of
- the implanted phakic refractive lens will form a
- the arc from a location on the ciliary body of the natural crystalline lens over an arc of radius of curvature of the natural crystalline lens to another location on the ciliary body
- the implanted phakic refractive lens will form a spacing with the anterior surface of the natural crystalline lens.
- a phakic refractive lens according to any of Figures 1-24 can be implanted in a natural eye by the method of the present invention.
- the artificial intraocular phakic refractive lens is inserted into a posterior chamber of the eye to a position anterior to and in a vicinity of the natural crystalline lens to provide a spacing between the phakic
- spacing is a separation between the posterior surface of the phakic refractive lens and the anterior surface of the natural crystalline lens of between 50 ⁇ m and 150 ⁇ m.
- Figure 26 illustrates one embodiment wherein the phakic refractive lens 102 rests
- curvature of the arc of the posterior surface 108 of the phakic refractive lens 102 is less
- the spacing 114 is located between phakic refractive lens 102 and the
- the phakic refractive lens 102 does not contact either
- the natural crystalline lens 112 or the iris at any point on the lens 112 or the iris.
- the phakic refractive lens 122 includes
- a vaulted phakic refractive lens describes a phakic refractive lens having a concave posterior
- the radius of the arc of the lens body 156 can be the
- the posterior surface 160 of the lens body portion 156 resides on the surface of the lens
- anterior surface 162 of the crystalline lens 164 in a face to face relationship.
- the of the invention is formed by a combination of the vaulted optic portion and a cavity
- the phakic refractive lens of the present invention can be deformable in accordance with the lenses of the Mazzocco patents so that the lens can be implanted through a small incision made in the ocular tissue.
- These phakic refractive lenses have prescribed memoiy characteristics.
- the phakic refractive lenses can be deformed by compressing, rolling, folding, stretching or the like or by a combination thereof, to a diameter of 80% or less of the cross-sectional diameter of the optic.
- the prescribed memory characteristics permit the lenses to restore to their original configuration, full size and fixed focal length after insertion into the eye.
- the phakic refractive lens body of the present invention can be a silicon
- copolymers are particularly advantageous.
- the acrylic collagen polymer lens is permeable to both gases and nutrients.
- the lens has significant water content and permits free
- phakic refractive lens permits a permeation of ocular fluid through the lens body and into the spacing formed between the implanted phakic refractive lens body posterior surface
- a reaction may take place within the spacing.
- an interphase zone is formed in the spacing. The interphase zone enhances wearing comfort of the implanted phakic refractive lens.
- interphase provides a transition between the natural crystalline lens and implanted phakic refractive lens that permits adjustment of light transmission properties of the phakic refractive lens to light transmission properties of the natural crystalline lens
- the arch that forms the spacing can be a result of an elongated haptic lens portion that is seated so as to extend from a zonule attachment at the lens periphery so as to form an ached structure separated
- a haptic portion is
- the haptic portion may coincide with the base portion or the haptic may be considered only a part of a larger base portion that extends with the transition portion and
- optic portion to form the vault over the natural crystalline lens.
- Figure 29 shows a detailed perspective view of an eye.
- the white-to-white measurement is somewhat mathematically related to the dimensions of the inner structure of the eye including the dimensions of the zonules-to-zonules and/or sulcus-to-sulcus measurements.
- the white-to-white measurement is a fast and easy method for sizing a phakic refractive lens.
- a phakic refractive lens into the eye.
- the crystalline lens 200 is enclosed within the capsular bag 202.
- the capsular bag 202 is
- zonules 204 supported within the eye by zonules 204.
- the zonules 204 sunound the entire periphery
- the zonules 204 are connected to
- the congentiva 206 which is a muscular portion of the eye.
- the iris 208 is located in front
- the natural crystalline lens 200 and the pupil 210 is defined by an opening through the
- the base of the iris 208 connects with the congentiva 206 and defines an annular
- this space 216 is filled with nourishing eye fluid which continues to
- the IMPLANTABLE CONTACT LENS 214 is defined by a lens
- the haptic portion 214b is provided with four
- crystalline lens 200 is defined by the dimension D,.
- the dimension D ⁇ defines the inner
- the dimension Dzi is less than the dimension D b since the zonules 204 connect somewhat
- the dimension D s defines the outer dimension of the sulcus 212.
- Z, j and Z 12 define the length of the zonules on the left side and right side, respectively, of the natural crystalline lens 200.
- the dimension Z tripod and the dimension Z 12 can vary with
- the dimensions S u and S 12 define the depth of the sulcus 212. These are the macroscopic dimensions of the eye of interest in sizing the implantable contact lens
- connections of the outer portion of the zonules to the congentiva 206 may be of interest
- the implantable contact lens 214 may vault too much and force the anterior surface of the implantable contact lens 214
- a back portion of the iris e.g. rubbing off pigment located on posterior side of iris 208.
- overvaulting of the implantable contact lens 214 may cutoff natural fluid flow
- the implantable contact lens is undersized, it may cause undesirable contact
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
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US42263899A | 1999-10-22 | 1999-10-22 | |
| US422638 | 1999-10-22 | ||
| PCT/US2000/041252 WO2001030273A1 (fr) | 1999-10-22 | 2000-10-19 | Dimensionnement d'une lentille refringente phakique |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| EP1280480A1 true EP1280480A1 (fr) | 2003-02-05 |
| EP1280480A4 EP1280480A4 (fr) | 2009-03-25 |
Family
ID=23675754
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP00984540A Withdrawn EP1280480A4 (fr) | 1999-10-22 | 2000-10-19 | Dimensionnement d'une lentille refringente phakique |
Country Status (4)
| Country | Link |
|---|---|
| EP (1) | EP1280480A4 (fr) |
| AU (1) | AU2114201A (fr) |
| CA (1) | CA2401862A1 (fr) |
| WO (1) | WO2001030273A1 (fr) |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR2835177B1 (fr) * | 2002-01-25 | 2004-11-19 | Biotech | Lentille intraoculaire refractive de chambre posterieure |
| US20050131534A1 (en) * | 2003-11-14 | 2005-06-16 | Rozakis George W. | Posterior chamber phakic intraocular lens |
| WO2005058204A1 (fr) * | 2003-12-15 | 2005-06-30 | Pharmacia Groningen Bv | Lentille intraoculaire phakique aux proprietes de circulation de fluide ameliorees |
| US10524898B2 (en) * | 2015-03-18 | 2020-01-07 | Medennium, Inc. | Self-centering phakic refractive lenses with parachute design |
Family Cites Families (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4585456A (en) * | 1984-03-12 | 1986-04-29 | Ioptex Inc. | Corrective lens for the natural lens of the eye |
| US5133747A (en) * | 1990-03-16 | 1992-07-28 | Feaster Fred T | Epiphakic intraocular lens and process of implantation |
| ES2214507T3 (es) * | 1994-10-06 | 2004-09-16 | Staar Surgical Company | Lente de contacto intraocular. |
| WO1998005273A1 (fr) * | 1996-08-06 | 1998-02-12 | Chiron Vision Corporation | Cristallin artificiel pouvant se plier |
-
2000
- 2000-10-19 CA CA002401862A patent/CA2401862A1/fr not_active Abandoned
- 2000-10-19 WO PCT/US2000/041252 patent/WO2001030273A1/fr not_active Ceased
- 2000-10-19 AU AU21142/01A patent/AU2114201A/en not_active Abandoned
- 2000-10-19 EP EP00984540A patent/EP1280480A4/fr not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| AU2114201A (en) | 2001-05-08 |
| CA2401862A1 (fr) | 2001-05-03 |
| WO2001030273A1 (fr) | 2001-05-03 |
| EP1280480A4 (fr) | 2009-03-25 |
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