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EP1999675A2 - Procede de formation d'une poche corneenne - Google Patents

Procede de formation d'une poche corneenne

Info

Publication number
EP1999675A2
EP1999675A2 EP07825723A EP07825723A EP1999675A2 EP 1999675 A2 EP1999675 A2 EP 1999675A2 EP 07825723 A EP07825723 A EP 07825723A EP 07825723 A EP07825723 A EP 07825723A EP 1999675 A2 EP1999675 A2 EP 1999675A2
Authority
EP
European Patent Office
Prior art keywords
lens
corneal pocket
corneal
forming
pocket
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Withdrawn
Application number
EP07825723A
Other languages
German (de)
English (en)
Other versions
EP1999675A4 (fr
Inventor
Vladimir Feingold
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biovision AG
Original Assignee
Biovision AG
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 Biovision AG filed Critical Biovision AG
Publication of EP1999675A2 publication Critical patent/EP1999675A2/fr
Publication of EP1999675A4 publication Critical patent/EP1999675A4/fr
Withdrawn legal-status Critical Current

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
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • 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
    • A61F2/145—Corneal inlays, onlays, or lenses for refractive correction
    • 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
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/013—Instruments for compensation of ocular refraction ; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea

Definitions

  • the present invention generally relates to methods of forming a corneal pocket to receive intracorneal refractive lenses and, more particularly to configurations of corneal pockets to receive such lenses.
  • Intraocular or intracorneal refractive lenses provide a viable alternative to spectacles and extra-ocular contact lenses for correcting deficiencies in visual acuity and refractive errors.
  • Intraocular lenses (lOLs) of the prior art typically comprise an optical portion for refraction and a haptic portion for supporting the IOL in the anterior or posterior chamber of the eye. All or part of an IOL may be constructed from a deformable or flexible material.
  • a deformable IOL has the advantage that it can be inserted in the eye via a smaller incision than an incision required to insert a non-deformable or rigid IOLs of comparable dimensions. Larger incisions in the eye have many disadvantages, including longer patient recovery times, astigmatism and increased risk of infection. [004] However, the flexible nature of deformable IOLs typically presents problems both in maneuvering the IOL during an insertion procedure, and in retaining the IOL in the correct position within the eye. To prevent the risk of damage or necrosis of ocular tissue following contact with, or penetration by, a portion of an IOL, rigid and/or pointed structures should be avoided.
  • the intraocular lens is attached to the iris by a staple.
  • US Patent Application Publication No. US 2004/008551 1 A1 discloses an intraocular lens having at least one pore near the center of the optical part of the lens, and a plurality of grooves in the back surface of the lens in a region that will make contact with the crystalline lens. The grooves allow fluid to flow towards the pores, and the pores allow fluid to flow through the lens.
  • the diameter of the pores is restricted by potential deterioration in optical characteristics of the optical portion, e.g., reflection of light incident on the periphery of the pores.
  • the location of the protrusions is limited by their potential to interfere with or restrict deformability of the lens for insertion in the eye.
  • US Patent No. 6,106,553 to Feingold discloses an intraocular lens having a shape that is predetermined with respect to a shape of the crystalline lens to form a spacing between at least part of the IOL and the crystalline lens.
  • the radius of arc of the posterior surface of an optic portion of the IOL may be smaller than the radius of arc of the posterior surface of a body portion of the IOL, so that the optic portion has a vaulted relationship to the anterior surface of the crystalline lens in the location of the pupil.
  • the body portion of the IOL is in contact with the crystalline lens at a position radially outward from the pupil.
  • the IOL may have a circular groove that allows circulation of fluid in the eye ( Figures 20 and 21 of the '553 patent).
  • lntracorneal refractive lenses offer a number of advantages for correcting deficiencies in visual acuity.
  • An intracorneal lens may be inserted into an opening in the cornea of an eye having visual abnormalities.
  • Some previous cornea-based techniques have involved the surgical reshaping of inner portions of the cornea to correct visual deficiencies.
  • surgical reshaping is not reversible, resulting in some risk of creating permanent visual aberrations for the patient.
  • the procedures used with intracorneal lenses are reversible.
  • an entire flap of the cornea is lifted to permit access for further surgical modification of the cornea.
  • a flap of the cornea is not lifted, but rather a pocket is formed in the corneal tissue, which leaves more of the corneal surface intact thereby simplifying healing. Nevertheless, the surgical preparation of such a pocket for an intracorneal lens is difficult to perform accurately. Also, some lenses which are available for such vision correction are not entirely satisfactory for a variety of reasons, including a tendency to shift out of position after placement, to impair transcorneal gas diffusion, to be excessively thick, or to be unable to correct presbyopis or astigmatism.
  • US Patent 6,599,305 to Feingold discloses a corneal-pocket keratome device to create a corneal pocket and a lens to be inserted and retained in the corneal pocket to effect correction.
  • the corneal-pocket keratome creates a pocket of precise dimensions in the cornea.
  • the corneal-pocket keratome includes a drive unit having cutting head elements which contact the subject eye during corneal pocket formation, and also includes a blade assembly that oscillates laterally while extending forward into the cornea to form the pocket.
  • Intracorneal lenses are also disclosed in US Patent 6,599,305 which may include a feature to impede accidental lens movement after the lens is disposed within the corneal pocket, such features may include a swelling after insertion or a circumferential irregularity.
  • a method for correcting vision of a patient comprising providing a refractive intracorneal lens, wherein the intracorneal lens comprises an optical portion and a haptic portion, and wherein the haptic portion is corrugated; forming a corneal pocket in an eye of the patient; and inserting the intracorneal lens in the corneal pocket.
  • a method for correcting vision of a patient comprising providing a refractive intracorneal lens; forming with a laser a corneal pocket in a cornea of the patient; and inserting the lens in the corneal pocket.
  • a corneal pocket comprises an arced portion; and a straight portion adjacent the arced portion.
  • a corneal pocket in a cornea comprises a straight portion extending across an entirety of the cornea.
  • Figure 1 is a sectional view of the anterior portion of an eye having a corrugated lens disposed within the cornea of the eye, according to an embodiment of the invention
  • Figure 2 is a sectional view of the anterior portion of an eye having an lens disposed within the cornea of the eye, according to another embodiment of the invention.
  • Figure 3 schematically represents a series of steps involved in a method for inserting an lens in the cornea of a patient, according to another embodiment of the invention.
  • Figure 4 is a cross-sectional view of a corneal pocket according to an embodiment of the present invention.
  • Figures 5A-5I depict exemplary configurations of a corneal pocket according to various embodiments of the present invention.
  • the present invention relates to methods for correction of a visual deficiency of a patient.
  • the present invention also relates to methods for insertion of an intracorneal lens in a corneal pocket in a patient's eye.
  • the present invention still further relates to corneal pockets configured to facilitate the insertion of an intracorneal lens therein.
  • a variety of different corneal pocket shapes may be employed to further enhance the ease of insertion of an intracorneal lens, and to maximize the surface of the cornea which is left intact thereby facilitating healing.
  • Figure 1 is a sectional view of the anterior portion of an eye 100'" having a corrugated intracorneal lens 10 disposed therein, according to an embodiment of the invention.
  • lens 10 may be disposed within cornea 1 10, which may partially enclose the anterior chamber 1 14.
  • iris 108 Also shown in Figure 1 is an iris 108.
  • lens 10 may be inserted within cornea 1 10 following formation of a corneal pocket, which may be formed, e.g., using a laser or corneal-pocket keratome device as disclosed in the aforementioned US Patent No. 6,599,305, the disclosure of which is incorporated by reference herein in its entirety.
  • lens 10 may have a haptic portion 30, which may be opaque and may be located outside the optical zone of the eye 100'", whereby interference with the vision of the patient by haptic portion 30 may be avoided.
  • the haptic portion may be eliminated, whereby lens 10/10" may consist essentially of optical portion 20 (see, e.g., Figure 2).
  • Optical portion 20 is not restricted to the configuration shown in the drawings, but may have various shapes, such as circular or oval, wherein optical portion 20 may be elongated in the horizontal direction (x axis) or shortened in the vertical direction (y axis).
  • optical portion 20 may have a doughnut-like configuration.
  • the size and shape of the lens 10 may, in some cases, determine the size and shape of the corneal pocket. Various embodiment of such cornea pockets are described below and shown in Figures 5A-5I.
  • the lens 10 preferably may be formed of a biocompatible material that permits sufficient gas diffusion to allow adequate oxygenation of internal eye tissues. Such materials may include silicone, hydrogels, urethanes or acrylics. It also may be desirable that the lens be made of a hydrophilic material which swells somewhat when hydrated. Such materials, for example, hydrogels, are well known and are used in some present contact lenses.
  • the optical characteristics of optical portion 20 may be selected for correcting various visual deficiencies, including without limitation: myopia (short sightedness), hypermetropia (long sightedness), presbyopia and astigmatis. As an example, optical portion 20 may have a diopter power or value in the range of from +15 to -30.
  • Optical portion 20 may be customized for a particular patient to provide optical characteristics to correct a specific visual defect of a patient.
  • Optical portion 20 may be multi-focal.
  • Lens 10 may also be provided as an off- the-shelf unit with pre-determined optical characteristics. It is to be understood that the present invention is not limited to treatment of the aforementioned visual defects, and that treatment of other eye conditions is also within the scope of the invention.
  • Haptic portion 30 may surround optical portion 20 and may be corrugated. Haptic portion 30 may vary in the number and configuration of corrugations and may be adapted for supporting optical portion 20 and for holding lens 10 in a desired position in the cornea 1 10. Typically, the number of corrugations within haptic portion 30 may be in the range of from 1 to about 5.
  • haptic portion 30 may have corrugations oriented in directions other than those shown in Figure 1 .
  • Increased rigidity of haptic portion 30 may provide improved retention of lens 10 in a desired intracorneal location. Deformation of lens 10 allows its insertion into the cornea of a patient via a small (about 3 mm) incision. Corrugation of haptic portion 30 may cause lens 10 to behave like a spring when distorted, from a relaxed configuration to a flexed configuration.
  • Figure 2 is a sectional view of the anterior portion of an eye 100'" having a lens 10" disposed therein, according to another embodiment of the invention.
  • Lens 10" may comprise an optical portion 20. At least a portion of haptic portion 30 (e.g., Figure 1 ) may be missing or removed in lens 10". As an example, lens 10" may have either no haptic portion, or a vestigial haptic portion 30 ( Figure 2). Lens 10" may be inserted within cornea 1 10 following formation of a corneal pocket, for example, as described with reference to Figure 1 .
  • Optical portion 20 in the embodiment of Figure 2 may have various features, characteristics, and elements in common with other embodiments of the present invention as described hereinabove.
  • an optical portion 20 for insertion in cornea 1 10 may have a doughnut-like configuration comprising a peripheral optic zone 22 having optical power and an inner non-optic zone 24 having no optical power.
  • FIG. 3 schematically represents a series of steps involved in a method 400 for inserting a lens in the cornea of a patient, according to another embodiment of the invention, wherein step 402 may involve providing a lens.
  • the lens e.g., an intracorneal lens provided in step 402
  • the lens provided in step 402 may include an optical portion having a peripheral optic zone having optical power, and an inner non-optic zone having no optical power.
  • the lens provided in step 402 may lack a haptic portion, e.g., the lens may consist essentially of an optical portion.
  • the lens may be inserted in the cornea for correcting vision of the patient.
  • Step 404 may involve forming an incision in the cornea of the eye.
  • Step 404 may involve forming a corneal flap or a corneal pocket.
  • the formation of corneal flaps and corneal pockets are known in the art of eye surgery.
  • a corneal flap may be formed using a laser. The laser may be used and guided under computer control, as is well known in the art.
  • a corneal flap may be formed by methods similar to those used during LASIK (laser-assisted in-situ keratomileusis) procedures.
  • a corneal pocket may be formed by tunneling in the cornea, for example, using a microkeratome having an oscillating metal blade.
  • a corneal-pocket keratome device was disclosed in US Patent No. 6,599,305, the disclosure of which is incorporated by reference herein in its entirety.
  • a corneal pocket may be formed by a laser.
  • a corneal pocket may be formed manually by the surgeon using hand-held instruments.
  • An exemplary corneal pocket 1 16 formed by an incision is depicted in cross-section in Figure 4.
  • Step 406 may involve inserting the lens in the cornea (see, for example, Figure 2).
  • step 406 may involve inserting the lens within a corneal pocket.
  • Step 406 may further involve temporarily deforming the lens preparatory to introducing the lens into the eye.
  • the lens may be deformed by rolling, folding, and the like.
  • the lens of the invention may have prescribed memory characteristics that allow the lens to return to its original size and configuration after insertion in the eye, while retaining the optical characteristics of the optical portion.
  • Corrugations of the haptic portion of the lens may facilitate maneuvering the lens during step 406 by providing rigidity to the lens and by allowing the surgeon to grasp the haptic portion by the corrugations.
  • the lens may be made of a hydrophilic material which swells when hydrated. The lens may be inserted fully hydrated to elastically fit into a corneal pocket, or while at least partly dehydrated such that subsequent hydration helps secure the fit in the pocket.
  • corneal pockets may be employed in the present invention, such as those pockets 1 16 depicted in Figures 5A to 5I which are top views of the pockets 1 16 formed in the cornea 1 10.
  • the various configurations are adapted to be used with lenses of various shapes and sizes.
  • the corneal pockets 1 16 also are configured to facilitate the insertion of the lens and to minimize the size of the incision for improved post-surgical healing of the cornea.
  • the corneal pockets shown in Figures 5A to 5G and 5I include an arced portion 1 18 near a center of the pocket, in addition to a straight portion 120 adjacent to the arced portion 1 18.
  • the corneal pocket includes a straight portion 122 extending across the entirety of the cornea.
  • a release area 124 (depicted in Figures 5D-5H as arced lines) may be optionally provided in the cornea 1 10 so as to provide a means of expansion and contraction when inserting and positioning the lens in the corneal pocket.
  • the arcuate incision in combination with the pocket may also reduce the induced astigmatism Release areas 124 may comprise incisions made into the cornea 1 10. These arcuate incisions are made by the laser at the same time as the pocket being created, so that the patient may not need to come back to the surgeon to enhance its vision due to astigmatism.
  • the present invention may provide a method for correcting the vision of a patient with a refractive intracorneal lens that may be easily inserted into a corneal pocket.
  • the intracorneal lens may be effectively positioned and held in place by the use of corrugated haptic region.
  • a variety of corneal pocket configurations may be used accommodate various corneal lens shapes and sizes.

Landscapes

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

Abstract

La présente invention concerne des procédés de correction de la vision d'un patient qui comprennent l'utilisation de lentilles cornéennes réfractives pouvant être facilement insérées dans une poche cornéenne. Ladite lentille comprend une région haptique ondulée qui facilite son insertion et son maintien dans la position souhaitée à l'intérieur de la cornée. Une diversité de configurations de poches cornéennes peut être utilisée pour s'adapter à diverses formes et tailles de lentilles cornéennes.
EP07825723A 2006-02-21 2007-02-21 Procede de formation d'une poche corneenne Withdrawn EP1999675A4 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US77560706P 2006-02-21 2006-02-21
PCT/IB2007/003610 WO2008023274A2 (fr) 2006-02-21 2007-02-21 procédé de formation d'une poche cornéenne

Publications (2)

Publication Number Publication Date
EP1999675A2 true EP1999675A2 (fr) 2008-12-10
EP1999675A4 EP1999675A4 (fr) 2010-04-07

Family

ID=39107181

Family Applications (1)

Application Number Title Priority Date Filing Date
EP07825723A Withdrawn EP1999675A4 (fr) 2006-02-21 2007-02-21 Procede de formation d'une poche corneenne

Country Status (10)

Country Link
EP (1) EP1999675A4 (fr)
JP (1) JP2009527312A (fr)
KR (1) KR20080112238A (fr)
AU (1) AU2007287354A1 (fr)
BR (1) BRPI0708135A2 (fr)
CA (1) CA2643106A1 (fr)
IL (1) IL193588A0 (fr)
MX (1) MX2008010706A (fr)
RU (1) RU2008137469A (fr)
WO (1) WO2008023274A2 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2539662C1 (ru) * 2013-06-13 2015-01-20 Государственное бюджетное учреждение "Уфимский научно-исследовательский институт глазных болезней Академии наук Республики Башкортостан" Способ лечения буллезной кератопатии
KR101662902B1 (ko) 2014-10-28 2016-10-06 순천향대학교 산학협력단 보안 패치를 이용한 결제 시스템 및 방법
KR101617100B1 (ko) 2014-11-06 2016-04-29 순천향대학교 산학협력단 온라인 결제 시스템 및 방법
KR20160072580A (ko) 2014-12-15 2016-06-23 순천향대학교 산학협력단 스마트폰 결합 형태의 보안패치를 이용한 결제 시스템 및 방법

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4976732A (en) * 1984-09-12 1990-12-11 International Financial Associates Holdings, Inc. Optical lens for the human eye
US5114627A (en) * 1986-10-16 1992-05-19 Cbs Lens Method for producing a collagen hydrogel
FR2723691B1 (fr) * 1994-08-22 1997-01-24 Philippe Crozafon Implant intra-oculaire
US7628810B2 (en) * 2003-05-28 2009-12-08 Acufocus, Inc. Mask configured to maintain nutrient transport without producing visible diffraction patterns

Also Published As

Publication number Publication date
JP2009527312A (ja) 2009-07-30
IL193588A0 (en) 2009-08-03
RU2008137469A (ru) 2010-03-27
MX2008010706A (es) 2008-10-31
WO2008023274A2 (fr) 2008-02-28
BRPI0708135A2 (pt) 2011-05-17
KR20080112238A (ko) 2008-12-24
WO2008023274A4 (fr) 2009-01-29
EP1999675A4 (fr) 2010-04-07
CA2643106A1 (fr) 2008-02-28
WO2008023274A3 (fr) 2008-11-27
AU2007287354A1 (en) 2008-02-28

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