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WO2013004590A1 - Implant cornéen - Google Patents

Implant cornéen Download PDF

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Publication number
WO2013004590A1
WO2013004590A1 PCT/EP2012/062591 EP2012062591W WO2013004590A1 WO 2013004590 A1 WO2013004590 A1 WO 2013004590A1 EP 2012062591 W EP2012062591 W EP 2012062591W WO 2013004590 A1 WO2013004590 A1 WO 2013004590A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
mark
corneal implant
corneal
light
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.)
Ceased
Application number
PCT/EP2012/062591
Other languages
German (de)
English (en)
Inventor
Gregor Stobrawa
Michael Bergt
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.)
Carl Zeiss Meditec AG
Original Assignee
Carl Zeiss Meditec 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 Carl Zeiss Meditec AG filed Critical Carl Zeiss Meditec AG
Priority to CN201280032938.0A priority Critical patent/CN103687573A/zh
Publication of WO2013004590A1 publication Critical patent/WO2013004590A1/fr
Anticipated expiration legal-status Critical
Ceased 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
    • 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
    • A61F2/142—Cornea, e.g. artificial corneae, keratoprostheses or corneal implants for repair of defective corneal tissue
    • 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
    • A61F2/147—Implants to be inserted in the stroma for refractive correction, e.g. ring-like implants
    • 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
    • A61F2/148—Implantation instruments specially adapted therefor
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Definitions

  • the invention relates to a corneal implant, in particular for placement in a corneal pocket, and to a device for placing such an implant.
  • corneal material can be purposefully vaporized and thus removed by means of an excimer laser, and so the refractive effect of the cornea can be changed so that the defective vision is compensated.
  • Another method is based on using a femtosecond laser to separate a substantially lense-shaped piece of tissue within the cornea and by a
  • Myopia myopia
  • ICR Intracorneal Ring
  • ICRS Intracorneal Ring Segment
  • biocompatible plastic and are used in z. B. produced by femtosecond laser "pockets" in the cornea (see US 6 875 232) .These, however, can only correct low-vision disorders.
  • EP 1 871 298 discloses a method for the treatment of presbyopia by introducing corneal inlays into the cornea which have the effect of a diaphragm, in addition means for detecting the depth of insertion are provided.
  • the invention is therefore based on the object to overcome the disadvantages of the prior art and to provide a corneal implant can be treated with the non-radially symmetric error higher order.
  • the cornea implant has at least one marking, by means of which a clear orientation of the implant in the cornea is possible, for the correction of defective vision, in particular of a higher order.
  • the marking is designed so that the visual impression is not disturbed.
  • the implant may be designed such that it can only be recognized outside the visible light spectrum for the human eye, which lies between approximately 380 nm and 780 nm or a partial region of the visual spectral range between approximately 450 nm and 750 nm.
  • This makes it possible to attach permanent markings on the implant, which on the one hand do not affect the light transmission of the implant in the visual spectral range and on the other fluoresce or absorb outside of the human visible light spectrum, so that with a corresponding illumination of the implant reliable and reliable detection of the Position and / or identification of the implant on the basis of the marking without influencing or impairing the visual perception of vision of the implant carrier is made possible.
  • the implant may be designed such that it can only be recognized outside the visible light spectrum for the human eye, which lies between approximately 380 nm and 780 nm or a partial region of the visual spectral range between approximately 450 nm and 750 nm.
  • Marking have a corresponding coding, e.g. for right / left,
  • a fluorescent dye from one of the structural classes may contain the cyanines,
  • Salicylic acid esters resorcinol monobenzonates, oxalic acid anilides, cinnamic acid ester derivatives, p-hydroxybenzoic acid esters and / or an IR absorber from one of these structural classes.
  • Other fluorescent or absorbing dyes are also useful for preparing the labels.
  • the at least one mark can be temporary and disappear, in particular, solely by the passage of time or external influence. Then it could also be designed so that it is visible in the visible spectral range.
  • a dye could be water-soluble and removed, for example, by the tear fluid.
  • the mark can also be made, for example, with a "Removable Ink Skin Marker” from Viscot Medical LLC (www.viscot.com/PSRpMarkers.html).
  • mark may also be given by a special one, in general
  • the corneal implant consists of a biocompatible artificial or natural material (for example, corneal material of a donor or even its own cornea).
  • This corneal material has been advantageously obtained by means of a femtosecond laser.
  • the corneal implants according to the invention make it possible to reliably and reliably display their position and position, for example, during or after a surgical procedure by means of a suitable observation system.
  • the invention also includes a device for placing a corneal implant which has an arrangement for observation and at least one illumination system for illuminating and exciting at least one marking of the one placed in an eye
  • this device furthermore has at least one camera for recording the fluorescent light emitting outside of the visible light spectrum for the human being or absorbent marking and at least one evaluation unit or display unit for at least one image taken by the camera of the marking.
  • the observation system according to the invention enables a reliable and safe
  • the illumination system comprises at least one light source, wherein the light source emits white light or an excitation light for the dye of the marker in a predetermined wavelength range.
  • the detection method according to the invention ensures reliable and reliable detection of the position and position and / or identification of the implant. In addition, it is ensured that the application of the method does not impair the visual vision of an implant carrier, since the mark irradiated by white light or an excitation light in a predetermined waveband emits or absorbs outside of the human visible light spectrum.
  • Fig. 1 is a section through the cornea
  • Fig. 2 is a plan view of the cornea with correctly inserted implant according to the invention
  • Fig. 3 shows a first variant of the introduction of the implant according to the invention
  • Fig. 4 shows a second variant of the introduction of the implant according to the invention
  • Fig. 5 is a plan view of the cornea with incorrectly inserted implant according to the invention
  • FIG. 6 shows a second embodiment of the implant according to the invention
  • Fig. 7 shows a third embodiment of the implant according to the invention
  • Fig. 8 shows an embodiment of the device for placing a corneal implant according to the invention.
  • FIG. 1 schematically shows a cross-section of a cornea 1. This has a pocket 2 produced with a femtosecond laser, in which an implant 3 has been placed by inserting the implant 3 into the pocket 2 through the access 4.
  • a method of creating the pocket 2 in the cornea 1 by means of a femtosecond laser is
  • the implant 3 can be obtained from the cornea of a donor eye.
  • the implant 3 has precisely such a shape that the refractive power of the cornea 1 locally changed by the introduction of the implant 3 into the cornea 1 corrects the imaging properties of the eye in the desired manner, wherein the implant 3 has a thin (smaller 200 ⁇ ) in the Generally has flexible structure, must be transparent and is adapted in its refractive index of the refractive index of the cornea 1, so that it is difficult to detect by conventional means. So that non-radially symmetric aberrations of the eye can be corrected, the implant must also have a shape deviating from the radial symmetry.
  • the orientation of the implant in the pocket 2 becomes an important size, which must be strictly adhered to in order to correct the imaging properties of the eye.
  • the implant 3 has one or more markings 5, which permit an accurate insertion of the implant 3 through the access 4 (see FIG. 2).
  • the implant 3 must be placed in the bag 2 so that the mark 5 at a
  • the markings 5 additionally make it possible to check whether the implant 3 has been unfolded or unfolded correctly.
  • Figures 3 and 4 each still show the wrong state of incorporation of the implant, which is clearly visible in the wrong position of the mark 5.
  • 5 shows by way of example the case that the placement of the implant did not take place correctly, the marker 5 is not in the correct position, the implant is twisted. Thus, the imaging properties of the eye are not corrected as desired, it can even lead to the generation of additional errors.
  • the marker 5 is attached at the previous preparation or provision of the implant 3 at a defined location.
  • Fig. 6 shows a variant of the invention, in which the marking of the correct orientation by the shaping of the circumference of the implant 3 takes place, here as an elliptical shape.
  • FIG. 7 shows a further variant of the marking by shaping the circumference, here by a bulge 6 of the implant 3.
  • Fig. 8 shows a schematic representation of a device for placing a
  • the device 7 in this case comprises a microscope 8 with a microscope optics, a
  • Illumination system 9 for illuminating the marking 5 consisting of one or more dyes of the implant 3 arranged in the eye 10 via a partial beam path 17. Furthermore, the device 7 has a camera 11 for recording the fluorescent or absorbing markings 5 emitting outside the light spectrum visible to the human eye and at least one evaluation unit 12 for at least one image of the marking or markings 5 taken by the camera 11.
  • the markings 5 consist of a near-infrared fluorescent dye, for example, the dye indocyanine green. It is clear from FIG. 8 that the illumination system 9 radiates light of a specific wavelength and also white light via a beam splitter 13 to the eye 10 with the implant 3.
  • the radiation emitted by the implant 3 or the markings 5 is in turn sent to the camera 11 via the beam splitter 13 and a second beam splitter 14 via a partial beam path 15. Via a further partial beam path 16, the image recorded by the eye 10 or the implant 3 is made available to the eye 18 of a viewer via the microscope 8 with the microscope optics.
  • the beam splitter 13 as
  • the images taken by the camera 11 are transmitted as image data via a data line 19 to the evaluation unit 12.
  • Evaluation unit 12 has a coupling system 19 for coupling the recorded images of the marking 5 into the microscope optics of the microscope 8.
  • the coupling system 19 in this case comprises a beam splitter or deflecting mirror 20 which is designed as a partially transmissive mirror and transmits the image taken by the camera 11 and evaluated by the evaluation unit 12 to the eye 18 of the observer. This makes it possible to get one Superimposed image consisting of the image taken by the camera 11
  • Evaluation unit 12 an automatic tracking system for detecting movements and / or the position and position changes of the marking 5 and the implant 3 have. Furthermore, it is possible that the evaluation unit comprises an autofocus system, the focusing of the microscope optics on the implant 3 taking place by means of the images of the marking 5 taken by the camera 11 and their evaluation.
  • the illumination system 9 comprises a light source, wherein the light source is white light or an excitation light for the dye of the marker 5 in a predetermined
  • Wavelength range radiates.
  • light sources for example, halogen lamps or laser light sources can be used. Furthermore, it is possible that the
  • Illumination system 9 is designed as a gap lighting system (not shown).
  • the device 7 as well as the implants 3 described in the embodiments according to FIGS. 2 to 7 can be used in surgical procedures which are intended to correct aberrations of the eye by inserting a corneal implant 3 into the cornea 1 of the patient.
  • a position and position control of the implant 3 into the cornea 1 can be used in surgical procedures which are intended to correct aberrations of the eye by inserting a corneal implant 3 into the cornea 1 of the patient.
  • Implant 3 made or make the surgeon appropriate corrections. As a result, a secure and accurate positioning of the implant 3 is ensured.

Landscapes

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

Abstract

L'invention concerne un implant cornéen, en particulier à mettre en place dans une poche cornéenne, ainsi qu'un dispositif pour mettre un tel implant en place. A cet effet, l'implant cornéen comporte, pour corriger une amétropie, en particulier d'ordre supérieur, un repère permettant une orientation univoque de l'implant dans la cornée, ledit repère étant conçu de manière à ne pas altérer la sensation visuelle. Ledit dispositif comprend un système d'observation et au moins un système d'éclairage pour éclairer et stimuler au moins un repère de l'implant cornéen mis en place dans un œil.
PCT/EP2012/062591 2011-07-01 2012-06-28 Implant cornéen Ceased WO2013004590A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201280032938.0A CN103687573A (zh) 2011-07-01 2012-06-28 角膜植入物

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102011106289A DE102011106289A1 (de) 2011-07-01 2011-07-01 Hornhautimplantat
DE102011106289.4 2011-07-01

Publications (1)

Publication Number Publication Date
WO2013004590A1 true WO2013004590A1 (fr) 2013-01-10

Family

ID=46397271

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2012/062591 Ceased WO2013004590A1 (fr) 2011-07-01 2012-06-28 Implant cornéen

Country Status (3)

Country Link
CN (2) CN108992205A (fr)
DE (1) DE102011106289A1 (fr)
WO (1) WO2013004590A1 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106466203B (zh) * 2015-08-14 2020-04-03 爱博诺德（苏州）医疗器械有限公司 一种具备应力变形纹理结构的眼内植入物
US20240350254A1 (en) * 2021-08-25 2024-10-24 Carl Zeiss Meditec Ag Systems for computer-assisted verification, and positioning and position analysis of intraocular lenses

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001015779A1 (fr) * 1999-08-27 2001-03-08 Anamed, Inc. Implant corneen et procede de fabrication
US6650357B1 (en) * 1997-04-09 2003-11-18 Richardson Technologies, Inc. Color translating UV microscope
US6855163B2 (en) 2002-07-19 2005-02-15 Minu, Llc Gradual correction of corneal refractive error using multiple inlays
US20060235428A1 (en) * 2005-04-14 2006-10-19 Silvestrini Thomas A Ocular inlay with locator
DE102006053120A1 (de) 2006-11-10 2008-05-15 Carl Zeiss Meditec Ag Behandlungsvorrichtung zur operativen Fehlsichtigkeitskorrektur eines Auges, Verfahren zum Erzeugen von Steuerdaten dafür und Verfahren zur operativen Fehlsichtigkeitskorrektur eines Auges
DE102008017592A1 (de) * 2008-04-07 2009-10-08 Carl Zeiss Meditec Ag Ophthalmologisches Implantat, Mikroskopiesystem und optisches Nachweisverfahren zur Detektion und/oder Identifikation eines ophthalmologischen Implantats
US7776086B2 (en) 2004-04-30 2010-08-17 Revision Optics, Inc. Aspherical corneal implant

Family Cites Families (7)

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Publication number Priority date Publication date Assignee Title
WO1998025547A1 (fr) * 1996-12-09 1998-06-18 Lee Joseph Y Procede et dispositif pour ajuster la courbure de la cornee au moyen d'un anneau corneen avec un materiau biocompatible enleve
US6102946A (en) * 1998-12-23 2000-08-15 Anamed, Inc. Corneal implant and method of manufacture
DE10333794A1 (de) * 2003-07-24 2005-03-03 Technovision Gmbh Verfahren und Vorrichtung zur Online-Kontaktlinsenbewertung
US20060287721A1 (en) * 2004-10-05 2006-12-21 David Myung Artificial cornea
EP2227714B1 (fr) * 2007-12-12 2013-06-19 Neoptics AG Lentille intracornéenne percée d'un trou central
CN201160919Y (zh) * 2008-03-05 2008-12-10 黄一飞 新型分体式人工角膜
EP2337523B1 (fr) * 2008-06-27 2017-08-16 AMO Development, LLC Système de modification d'un profil de réfraction à l'aide d'une incrustation de cornée

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6650357B1 (en) * 1997-04-09 2003-11-18 Richardson Technologies, Inc. Color translating UV microscope
US6875232B2 (en) 1998-12-23 2005-04-05 Anamed, Inc. Corneal implant and method of manufacture
WO2001015779A1 (fr) * 1999-08-27 2001-03-08 Anamed, Inc. Implant corneen et procede de fabrication
US6855163B2 (en) 2002-07-19 2005-02-15 Minu, Llc Gradual correction of corneal refractive error using multiple inlays
US7776086B2 (en) 2004-04-30 2010-08-17 Revision Optics, Inc. Aspherical corneal implant
US20060235428A1 (en) * 2005-04-14 2006-10-19 Silvestrini Thomas A Ocular inlay with locator
EP1871298A1 (fr) 2005-04-14 2008-01-02 Acufocus, Inc. Inlay oculaire a localisateur
DE102006053120A1 (de) 2006-11-10 2008-05-15 Carl Zeiss Meditec Ag Behandlungsvorrichtung zur operativen Fehlsichtigkeitskorrektur eines Auges, Verfahren zum Erzeugen von Steuerdaten dafür und Verfahren zur operativen Fehlsichtigkeitskorrektur eines Auges
DE102008017592A1 (de) * 2008-04-07 2009-10-08 Carl Zeiss Meditec Ag Ophthalmologisches Implantat, Mikroskopiesystem und optisches Nachweisverfahren zur Detektion und/oder Identifikation eines ophthalmologischen Implantats

Also Published As

Publication number Publication date
DE102011106289A1 (de) 2013-01-03
CN108992205A (zh) 2018-12-14
CN103687573A (zh) 2014-03-26

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