WO2004012631A1 - Device for implanting an intra-ocular lens - Google Patents

Device for implanting an intra-ocular lens Download PDF

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Publication number
WO2004012631A1
WO2004012631A1 PCT/EP2003/008257 EP0308257W WO2004012631A1 WO 2004012631 A1 WO2004012631 A1 WO 2004012631A1 EP 0308257 W EP0308257 W EP 0308257W WO 2004012631 A1 WO2004012631 A1 WO 2004012631A1
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WO
WIPO (PCT)
Prior art keywords
guide channel
tip
push
intraocular lens
folding
Prior art date
Application number
PCT/EP2003/008257
Other languages
German (de)
French (fr)
Inventor
Arthur Messner
Thomas Herberger
Original Assignee
Humanoptics 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 Humanoptics Ag filed Critical Humanoptics Ag
Priority to AU2003255298A priority Critical patent/AU2003255298A1/en
Publication of WO2004012631A1 publication Critical patent/WO2004012631A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1662—Instruments for inserting intraocular lenses into the eye
    • A61F2/1664—Instruments for inserting intraocular lenses into the eye for manual insertion during surgery, e.g. forceps-like instruments

Definitions

  • the invention relates to a device for folding and implanting an intraocular lens with a folding area, which has two pivotably connected half-shells, which can be pivoted from an open starting position into a closed end position, in which they form part of a guide channel having a proximal end and a distal end for the intraocular lens.
  • the device is part of an injection system for implanting a foldable intraocular lens (hereinafter referred to as IOL).
  • IOL foldable intraocular lens
  • the injection system is intended to implant a temporarily folded IOL through a small incision opening in the capsular bag of a patient suffering, for example, from cataracts.
  • An injection system in which a folding device and an injector form a unit is known, for example, from DE 36 10 925 A1.
  • This injection system has an injection channel, the distal end of which is inserted into the patient's eye during the operation.
  • the folding process is combined with this movement of the IOL towards the patient's eye.
  • the injection channel is conical, so that it tapers towards the distal end.
  • a thrust ram causing the IOL to advance as part of the injector is therefore not exactly adaptable to the internal geometry of the injection channel. Due to this fact, the IOL is destroyed (e.g. by being pinched between the injection channel wall and stamp tip of the push stamp) possible. In addition, there is a risk that damage to the IOL will not be recognized during the operation.
  • the object of the invention is to provide an implantation aid for an intraocular lens that is particularly easy to handle.
  • the device for folding and implanting an intraocular lens which is also referred to as a cartridge, is part of an injection system for inserting an intraocular lens into the eye of a person and has for folding the intraocular lens has a folding area which comprises two pivotably connected half-shells which can be pivoted from an open starting position into a closed end position, in which they have a part of a proximal end and a distal, ie Form the front end of the guide channel for the intraocular lens.
  • a push stamp tip formed from a flexible material is mounted in the guide channel, between the proximal end and the part that can be formed from the half-shells.
  • the push stamp tip is displaceable by a push stamp which can be inserted into the guide channel and thus can be attached to the push stamp tip.
  • the intraocular lens in the guide channel can be displaced towards the distal end thereof by the displacement of the push stamp tip.
  • the push stamp tip Due to the flexible design of the push punch tip, it can be easily adapted to a variable inner diameter of the guide channel. This avoids the risk of damage to the intraocular lens.
  • the push stamp tip is already mounted in the guide channel before the push stamp is attached, that is to say it is preassembled. When the thrust ram is inserted into the guide channel, the thrust ram inevitably hits the push ram tip which is displaceably mounted in the guide channel. The push stamp does not come into contact with the intraocular lens. In principle, incorrect operation is excluded.
  • the preassembly of the push stamp tip in the guide channel enables time-saving operation of the device for folding and implanting the intraocular lens.
  • the push stamp tip is preferably made of silicone.
  • this material is particularly suitable for the push punch tip.
  • the push punch tip thus has sufficient elasticity to adapt to different diameters in the guide channel. Due to the soft design of the pusher tip, the intraocular lens cannot be damaged when it is pushed towards the distal end of the guide channel. At the same time, however, the pusher stamp tip made of silicone is mechanically strong enough not to be damaged or destroyed by the pusher stamp, which is preferably made of metal. In particular, it is excluded that the pushing stamp penetrates the pushing punch tip and hits the intraocular lens directly.
  • the push punch tip points towards the proximal, i.e. a centering device at the rear end of the guide channel for centering the thrust ram.
  • the centering device can be designed, for example, as a conical or as a stepped depression.
  • the formation of a centering device in the push punch tip provides a defined type of force action of the push punch on the push punch tip and further the push punch tip on the intraocular lens when the push punch tip is advanced.
  • Contact of the thrust ram with the inner wall of the guide channel can be avoided by the centering device in the thrust ram tip.
  • the implantation process of the intraocular lens is reproducibly defined with regard to the geometric conditions in the injection system and the forces that occur.
  • the push stamp tip should only be able to move in the guide channel through the push stamp. An unintentional shifting of the push stamp tip, for example due to transport-related vibrations, should be avoided.
  • the push punch tip is preferably mounted in the guide channel with an interference fit. This means that the outer diameter of the pushing die tip, which is not mechanically loaded, is at least slightly larger than the inner diameter of the guide channel at the location provided for mounting the pushing die tip. The push stamp tip is now clamped in the guide channel.
  • a locking bracket can be provided in order to fix the push punch tip in the guide channel. hen.
  • the shear punch tip can snap into a groove in the inner wall of the guide channel.
  • thrust punch tip for example, between two bead-shaped webs running around in the guide channel or between individual locking lugs in the guide channel.
  • the latching connection between the push punch tip and the guide channel can only be released by advancing the push punch.
  • the advantage of the invention is, in particular, that a flexibly designed push stamp tip is preassembled in a guide channel of a cartridge for folding and implanting an intraocular lens. With the simplest handling of the cartridge, any damage to the intraocular lens by the pushing stamp is therefore excluded.
  • FIG. 1 shows a perspective view of a device for folding and implanting an intraocular lens
  • FIG. 2 shows the device according to FIG. 1 in a frontal view
  • FIG. 3 shows a section III-III through the device according to FIG. 2,
  • FIGS. 1 to 3 shows an injector for a device according to FIGS. 1 to 3.
  • a guide channel 2 extends over the entire length of the cartridge 1 and is composed of a proximal or rear part 2a, a middle part 2b and a front or distal part 2c.
  • the middle part 2b of the guide channel 2 is formed from two half-shells 3a, 3b, which are connected by a film hinge 4.
  • the intraocular lens is inserted into the folding area formed between the half-shells 3a, 3b and by collapsing the half-shells 3a, 3b folded.
  • the folded intraocular lens can be moved by means of a thrust ram 5 as part of an injector 6 (FIG. 4) towards the distal end 7 of the cartridge 1, which is designed in the form of a beveled tip.
  • the distal part 2c of the guide channel 2 tapers towards the distal end 7 in order to further compress the intraocular lens during advancement.
  • the distal end 7 of the cartridge 1 is inserted into the patient's eye during the implantation of the intraocular lens.
  • the proximal or rear part 2a adjoining the middle part 2b of the guide channel 2 in the direction of the proximal end 8 of the cartridge 1 is designed in the form of a hollow cylinder of constant diameter.
  • a thrust ram tip 9 made of silicone is embodied essentially as a rotationally symmetrical plate.
  • the push punch tip 9 is designed in a stepped manner in cross section (FIG. 3) in such a way that a recess is formed on its proximal side as a centering device 10 for centering a punch head 11 of the push punch 5.
  • the punch head 11 engaging in the centering device 10 displaces the pushing punch tip 9 in the direction of the distal end 7, so that a flat pushing surface 12 on the distal side of the pushing punch tip 9 conveys the intraocular lens through the guide channel 2.
  • the pushing punch tip 9 is clamped in the guide channel in such a way that a displacement of the pushing punch tip 9 is only possible by actuating the pushing punch 5.
  • the clamping force or - in the case of the formation of a latching connection - latching force between the pushing punch tip 9 and the proximal part 2a of the guide channel 2 is significantly greater than the weight of the pushing punch tip 9.
  • the pushing punch tip 9 is pre-assembled in the cartridge 1 and packaged sterilized together with the latter.
  • the cartridge 1 can also be used with other, not shown embodiments of injectors.
  • the cartridge 1 can be used as a disposable part in a frontal area 13 of the injector 6, which is designed as a resterilizable device.
  • the half shells 3a, 3b held in a slot 14 in the frontal area 13. The handling of the injection system is particularly facilitated in that the flexible pushing stamp tip 9 is already inserted in the proximal part 2a of the guide channel 2 before the cartridge 1 is inserted into the injector 13.

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  • 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

The invention relates to a device for folding and implanting an intra-ocular lens, comprising a folding area which is provided with two rotatable half shells (3a, 3b) which are connected together. Said half shells can be pivoted from an open initial position to a closed end position forming one part of a guide channel (2) comprising a proximal end (8) and a distal end (7) for the intra-ocular lens. The device is particularly simple to handle by virtue of the fact that a flexibly embodied thruster tip is provided in the guide channel (2) between the proximal end thereof (8) and the part formed by the half shells (3a, 3b), through which the intra-ocular lens can be displaced to the distal end (7) of the guide channel (2) by means of a thruster which can be attached by insertion into the guiding channel.

Description

Beschreibung description
Vorrichtung zum Implantieren einer IntraokularlinseDevice for implanting an intraocular lens
Die Erfindung betrifft eine Vorrichtung zum Falten und Implantieren einer Intraokularlinse mit einem Faltungsbereich, der zwei schwenkbar miteinander verbundene Halbschalen aufweist, die von einer offenen Ausgangsstellung in eine geschlossene Endstellung verschwenkbar sind, in der sie einen Teil eines ein proximales Ende und ein distales Ende aufweisenden Führungskanals für die Intraokularlinse bilden.The invention relates to a device for folding and implanting an intraocular lens with a folding area, which has two pivotably connected half-shells, which can be pivoted from an open starting position into a closed end position, in which they form part of a guide channel having a proximal end and a distal end for the intraocular lens.
Die Vorrichtung ist Teil eines Injektionssystems zum Implantieren einer faltbaren Intraokularlinse (im Folgenden mit IOL bezeichnet). Mit dem Injektionssystem soll dabei die Implantation einer zeitweilig gefalteten IOL durch eine kleine Schnittöffnung in den Kapselsack eines beispielsweise am Grauen Star erkrankten Patienten erfolgen.The device is part of an injection system for implanting a foldable intraocular lens (hereinafter referred to as IOL). The injection system is intended to implant a temporarily folded IOL through a small incision opening in the capsular bag of a patient suffering, for example, from cataracts.
Bei Operationen der o. g. Art ist die Größe der zum Einbringen der faltbaren IOL in das Auge erforderlichen Inzision von großer Bedeutung. Um einen optimalen Heilungspro- zess zu gewährleisten, sollte diese möglichst klein (ca. 2,8 mm) sein. Nur durch die Möglichkeit des Faltens der IOL ist man in der Lage, dieser Anforderung gerecht zu werden. Als Injektionssysteme zum Einbringen der lOL werden häufig sterile Kunststoffteile, genannt Cartridges, in Kombination mit einem resterilisierbaren Injektor verwendet. Eine Aufgabe der Cartridge ist es, das Falten der lOL zu ermöglichen.In operations of the above The size of the incision required to insert the foldable IOL into the eye is of great importance. In order to ensure an optimal healing process, it should be as small as possible (approx. 2.8 mm). Only by folding the IOL is it possible to meet this requirement. Sterile plastic parts, called cartridges, in combination with a resterilizable injector are often used as injection systems for introducing the IOL. One of the tasks of the cartridge is to allow the IOL to fold.
Ein Injektionssystem, bei dem eine Faltvorrichtung und ein Injektor eine Einheit bilden, ist beispielsweise aus der DE 36 10 925 A1 bekannt. Dieses Injektionssystem weist einen Injektionskanal auf, dessen distales Ende während der Operation in das Patientenauge eingeführt wird. Der Faltvorgang ist mit dieser Bewegung der lOL in Richtung Patientenauge kombiniert. Zur weiteren Querschnittsreduzierung ist der Injektionskanal konisch ausgeführt, so dass sich dieser in Richtung distales Ende verjüngt. Ein den Vorschub der lOL bewirkender Schubstempel als Teil des Injektors ist daher nicht genau an die Innengeometrie des Injektionskanals anpassbar. Aufgrund dieser Tatsache sind Zerstörungen an der lOL (z. B. durch Einklemmen zwischen Injektionskanalwand und Stempelspitze des Schubstempels) möglich. Darüber hinaus besteht die Gefahr, dass eine Beschädigung der lOL während der Operation nicht erkannt wird.An injection system in which a folding device and an injector form a unit is known, for example, from DE 36 10 925 A1. This injection system has an injection channel, the distal end of which is inserted into the patient's eye during the operation. The folding process is combined with this movement of the IOL towards the patient's eye. To further reduce the cross-section, the injection channel is conical, so that it tapers towards the distal end. A thrust ram causing the IOL to advance as part of the injector is therefore not exactly adaptable to the internal geometry of the injection channel. Due to this fact, the IOL is destroyed (e.g. by being pinched between the injection channel wall and stamp tip of the push stamp) possible. In addition, there is a risk that damage to the IOL will not be recognized during the operation.
Der Erfindung liegt die Aufgabe zugrunde, eine besonders einfach handhabbare Im- plantationshilfe für eine Intraokularlinse anzugeben.The object of the invention is to provide an implantation aid for an intraocular lens that is particularly easy to handle.
Diese Aufgabe wird erfindungsgemäß gelöst durch eine Vorrichtung zum Falten und Implantieren einer Intraokularlinse mit den Merkmalen des Anspruchs 1. Die auch als Cartridge bezeichnete Vorrichtung zum Falten und Implantieren einer Intraokularlinse IsTälsTeil eines Injektionssystems zum Einbringen einer intraokularlinse in das Auge eines Menschen nutzbar und weist zum Falten der Intraokularlinse einen Faltungsbereich auf, welcher zwei schwenkbar miteinander verbundene Halbschalen umfasst, die von einer offenen Ausgangsstellung in eine geschlossene Endstellung verschwenkbar sind, in der sie einen Teil eines ein proximales Ende und ein distales, d.h. vorderes En- de aufweisenden Führungskanals für die Intraokularlinse bilden. Im Führungskanal ist zwischen dessen proximalem Ende und dessen aus den Halbschalen bildbarem Teil eine aus einem flexiblen Material gebildete Schubstempelspitze gelagert. Die Schubstempelspitze ist durch einen in den Führungskanal einführbaren und damit an der Schubstempelspitze ansetzbaren Schubstempel verschiebbar. Durch die Verschiebung der Schubstempelspitze ist die Intraokularlinse im Führungskanal zu dessen distalem Ende hin verlagerbar.This object is achieved according to the invention by a device for folding and implanting an intraocular lens with the features of claim 1. The device for folding and implanting an intraocular lens, which is also referred to as a cartridge, is part of an injection system for inserting an intraocular lens into the eye of a person and has for folding the intraocular lens has a folding area which comprises two pivotably connected half-shells which can be pivoted from an open starting position into a closed end position, in which they have a part of a proximal end and a distal, ie Form the front end of the guide channel for the intraocular lens. In the guide channel, between the proximal end and the part that can be formed from the half-shells, a push stamp tip formed from a flexible material is mounted. The push stamp tip is displaceable by a push stamp which can be inserted into the guide channel and thus can be attached to the push stamp tip. The intraocular lens in the guide channel can be displaced towards the distal end thereof by the displacement of the push stamp tip.
Durch die flexible Ausbildung der Schubstempelspitze ist diese gut an einen variablen Innendurchmesser des Führungskanals anpassbar. Dadurch ist die Gefahr einer Be- Schädigung der Intraokularlinse vermieden. Die Schubstempelspitze ist bereits vor dem Ansetzen des Schubstempels in dem Führungskanal gelagert, d.h. vormontiert. Beim Einführen des Schubstempels in den Führungskanal trifft der Schubstempel zwangsläufig auf die im Führungskanal verschiebbar gelagerte Schubstempelspitze. Der Schubstempel kommt somit nicht mit der Intraokularlinse in Kontakt. Eine Fehlbedie- nung ist prinzipbedingt ausgeschlossen. Zudem ist durch die Vormontage der Schubstempelspitze im Führungskanal eine Zeit sparende Bedienung der Vorrichtung zum Falten und Implantieren der Intraokularlinse ermöglicht. Die Schubstempelspitze ist vorzugsweise aus Silikon hergestellt. Insbesondere aufgrund der mechanischen Eigenschaften von Silikon ist dieses Material in besonderer Weise für die Schubstempelspitze geeignet. Die Schubstempelspitze hat damit eine ausreichende Elastizität, um sich verschiedenen Durchmessern in dem Führungskanal anzupassen. Aufgrund der weichen Ausbildung der Schubstempelspitze kann die Intraokularlinse beim Vorschieben in Richtung zum distalen Ende des Führungskanals nicht beschädigt werden. Gleichzeitig ist die aus Silikon gebildete Schubstempelspitze jedoch mechanisch belastbar genug, um nicht ihrerseits durch den vorzugsweise aus Metall gebildeten Schubstempel beschädigt oder zerstört zu werden. Insbesondere ist ausgeschlossen, dass der Schubstempel die Schubstempelspitze durchdringt und direkt auf die Intraokularlinse trifft.Due to the flexible design of the push punch tip, it can be easily adapted to a variable inner diameter of the guide channel. This avoids the risk of damage to the intraocular lens. The push stamp tip is already mounted in the guide channel before the push stamp is attached, that is to say it is preassembled. When the thrust ram is inserted into the guide channel, the thrust ram inevitably hits the push ram tip which is displaceably mounted in the guide channel. The push stamp does not come into contact with the intraocular lens. In principle, incorrect operation is excluded. In addition, the preassembly of the push stamp tip in the guide channel enables time-saving operation of the device for folding and implanting the intraocular lens. The push stamp tip is preferably made of silicone. In particular due to the mechanical properties of silicone, this material is particularly suitable for the push punch tip. The push punch tip thus has sufficient elasticity to adapt to different diameters in the guide channel. Due to the soft design of the pusher tip, the intraocular lens cannot be damaged when it is pushed towards the distal end of the guide channel. At the same time, however, the pusher stamp tip made of silicone is mechanically strong enough not to be damaged or destroyed by the pusher stamp, which is preferably made of metal. In particular, it is excluded that the pushing stamp penetrates the pushing punch tip and hits the intraocular lens directly.
Nach einer bevorzugten Ausgestaltung weist die Schubstempelspitze in Richtung zum proximalen, d.h. hinteren Ende des Führungskanals eine Zentriervorrichtung zum Zen- frieren des Schubstempels auf. Die Zentriervorrichtung kann beispielsweise als konische oder als abgestufte Vertiefung ausgebildet sein. Durch die Ausbildung einer Zentriervorrichtung in der Schubstempelspitze ist beim Vorschub der Schubstempelspitze durch den Schubstempel eine definierte Art der Krafteinwirkung des Schubstempels auf die Schubstempelspitze und weiter der Schubstempelspitze auf die Intraokularlinse ge- geben. Ein Kontakt des Schubstempels mit der Innenwandung des Führungskanals ist durch die Zentriervorrichtung in der Schubstempelspitze vermeidbar. Der Implantationsvorgang der Intraokularlinse ist hinsichtlich der geometrischen Verhältnisse im Injektionssystem sowie der auftretenden Kräfte reproduzierbar festgelegt.According to a preferred embodiment, the push punch tip points towards the proximal, i.e. a centering device at the rear end of the guide channel for centering the thrust ram. The centering device can be designed, for example, as a conical or as a stepped depression. The formation of a centering device in the push punch tip provides a defined type of force action of the push punch on the push punch tip and further the push punch tip on the intraocular lens when the push punch tip is advanced. Contact of the thrust ram with the inner wall of the guide channel can be avoided by the centering device in the thrust ram tip. The implantation process of the intraocular lens is reproducibly defined with regard to the geometric conditions in the injection system and the forces that occur.
Die Schubstempelspitze sollte im Führungskanal ausschließlich durch den Schubstempel beweglich sein. Ein unbeabsichtigtes Verschieben der Schubstempelspitze, beispielsweise durch transportbedingte Erschütterungen, sollte vermieden werden. Hierzu ist die Schubstempelspitze bevorzugt mit einer Übermaßpassung im Führungskanal gelagert. D.h. der Außendurchmesser der mechanisch nicht belasteten Schubstempel- spitze ist zumindest geringfügig größer als der Innendurchmesser des Führungskanals an der Stelle, die zur Lagerung der Schubstempelspitze vorgesehen ist. Die Schubstempelspitze ist damit im Führungskanal festgeklemmt. Zusätzlich oder alternativ kann zur Fixierung der Schubstempelspitze im Führungskanal eine Rasthalterung vorgese- hen sein. Beispielsweise kann die Schubstempelspitze insgesamt in eine Nut in der Innenwandung des Führungskanals einrasten. Ebenso ist es möglich, die Schubstempelspitze beispielsweise zwischen zwei im Führungskanal umlaufenden wulstförmigen Stegen oder zwischen einzelnen Rastnasen im Führungskanal zu fixieren. Die Rastver- bindung zwischen Schubstempelspitze und Führungskanal ist ausschließlich durch Vorschub des Schubstempels lösbar.The push stamp tip should only be able to move in the guide channel through the push stamp. An unintentional shifting of the push stamp tip, for example due to transport-related vibrations, should be avoided. For this purpose, the push punch tip is preferably mounted in the guide channel with an interference fit. This means that the outer diameter of the pushing die tip, which is not mechanically loaded, is at least slightly larger than the inner diameter of the guide channel at the location provided for mounting the pushing die tip. The push stamp tip is now clamped in the guide channel. Additionally or alternatively, a locking bracket can be provided in order to fix the push punch tip in the guide channel. hen. For example, the shear punch tip can snap into a groove in the inner wall of the guide channel. It is also possible to fix the thrust punch tip, for example, between two bead-shaped webs running around in the guide channel or between individual locking lugs in the guide channel. The latching connection between the push punch tip and the guide channel can only be released by advancing the push punch.
Der Vorteil der Erfindung liegt insbesondere darin, dass eine flexibel ausgebildete Schubstempelspitze in einem Führungskanal einer Cartridge zum Falten und Implantie- ren einer Intraokularlinse vormontiert ist. Damit ist bei einfachster Handhabung der Cartridge jegliche Beschädigung der Intraokularlinse durch den Schubstempel ausgeschlossen.The advantage of the invention is, in particular, that a flexibly designed push stamp tip is preassembled in a guide channel of a cartridge for folding and implanting an intraocular lens. With the simplest handling of the cartridge, any damage to the intraocular lens by the pushing stamp is therefore excluded.
Nachfolgend wird ein Ausführungsbeispiel der Erfindung anhand einer Zeichnung näher erläutert. Hierin zeigen:An exemplary embodiment of the invention is explained in more detail below with reference to a drawing. Show here:
Fig. 1 in perspektivischer Darstellung eine Vorrichtung zum Falten und Implantieren einer Intraokularlinse, Fig. 2 die Vorrichtung nach Fig. 1 in Frontalansicht, Fig. 3 einen Schnitt lll-lll durch die Vorrichtung nach Fig. 2,1 shows a perspective view of a device for folding and implanting an intraocular lens, FIG. 2 shows the device according to FIG. 1 in a frontal view, FIG. 3 shows a section III-III through the device according to FIG. 2,
Fig. 4 einen Injektor für eine Vorrichtung nach Fig. 1 bis 3.4 shows an injector for a device according to FIGS. 1 to 3.
Einander entsprechende Teile sind in allen Figuren mit den gleichen Bezugszeichen versehen.Corresponding parts are provided with the same reference symbols in all figures.
Die Fig. 1 bis 3 zeigen eine auch als Cartridge 1 bezeichnete Vorrichtung zum Falten und Implantieren einer nicht dargestellten Intraokularlinse. Die Cartridge 1 ist einstückig als Kunststoff-Spritzgussteil hergestellt. Ein Führungskanal 2 erstreckt sich über die gesamte Länge der Cartridge 1 und setzt sich zusammen aus einem proximalen oder hinteren Teil 2a, einem mittleren Teil 2b und einem vorderen oder distalen Teil 2c. Der mittlere Teil 2b des Führungskanals 2 ist gebildet aus zwei Halbschalen 3a,3b, welche durch ein Filmscharnier 4 verbunden sind. Die Intraokularlinse wird in den zwischen die Halbschalen 3a,3b gebildeten Faltungsbereich eingelegt und durch Zusammenklappen der Halbschalen 3a,3b gefaltet. Dieser Faltvorgang kann entweder ohne Hilfsmittel oder mit Hilfe einer zusätzlichen nicht dargestellten Vorrichtung erfolgen. Die gefaltete Intraokularlinse ist mittels eines Schubstempels 5 als Teil eines Injektors 6 (Fig. 4) zum distalen Ende 7 der Cartridge 1 hin, welches in Form einer abgeschrägten Spitze aus- gebildet ist, verschiebbar. Der distale Teil 2c des Führungskanals 2 verjüngt sich zum distalen Ende 7 hin, um die Intraokularlinse beim Vorschub weiter zu komprimieren. Das distale Ende 7 der Cartridge 1 wird bei der Implantation der Intraokularlinse in das Auge des Patienten eingeführt.1 to 3 show a device, also referred to as a cartridge 1, for folding and implanting an intraocular lens, not shown. The cartridge 1 is made in one piece as a plastic injection molded part. A guide channel 2 extends over the entire length of the cartridge 1 and is composed of a proximal or rear part 2a, a middle part 2b and a front or distal part 2c. The middle part 2b of the guide channel 2 is formed from two half-shells 3a, 3b, which are connected by a film hinge 4. The intraocular lens is inserted into the folding area formed between the half-shells 3a, 3b and by collapsing the half-shells 3a, 3b folded. This folding process can take place either without aids or with the aid of an additional device, not shown. The folded intraocular lens can be moved by means of a thrust ram 5 as part of an injector 6 (FIG. 4) towards the distal end 7 of the cartridge 1, which is designed in the form of a beveled tip. The distal part 2c of the guide channel 2 tapers towards the distal end 7 in order to further compress the intraocular lens during advancement. The distal end 7 of the cartridge 1 is inserted into the patient's eye during the implantation of the intraocular lens.
Der sich an den mittleren Teil 2b des Führungskanals 2 in Richtung zum proximalen Ende 8 der Cartridge 1 anschließende proximale oder hintere Teil 2a ist in Form eines Hohlzylinders konstanten Durchmessers ausgebildet. Im proximalen Teil 2a des Führungskanals 2 ist eine im Wesentlichen als rotationssymmetrisches Plättchen ausgebildete Schubstempelspitze 9 aus Silikon gelagert. Die Schubstempelspitze 9 ist im Quer- schnitt (Fig. 3) derart abgestuft ausgebildet, dass auf deren proximaler Seite eine Vertiefung als Zentriervorrichtung 10 zum Zentrieren eines Stempelkopfes 11 des Schubstempels 5 ausgebildet ist. Der in die Zentriervorrichtung 10 eingreifende Stempelkopf 11 verschiebt die Schubstempelspitze 9 in Richtung zum distalen Ende 7, so dass eine plane Schubfläche 12 auf der distalen Seite der Schubstempelspitze 9 die Intrao- kularlinse durch den Führungskanal 2 fördert. Dabei liegt ein Formschluss zwischen dem Stempelkopf 11 und der Zentriervorrichtung 10 vor. Die Schubstempelspitze 9 ist im Führungskanal derart geklemmt, dass eine Verschiebung der Schubstempelspitze 9 ausschließlich durch Betätigung des Schubstempels 5 möglich ist. Die Klemmkraft beziehungsweise - im Fall der Ausbildung einer Rastverbindung - Rastkraft zwischen der Schubstempelspitze 9 und dem proximalen Teil 2a des Führungskanals 2 ist wesentlich größer als die Gewichtskraft der Schubstempelspitze 9. Die Schubstempelspitze 9 ist in der Cartridge 1 vormontiert und zusammen mit dieser sterilisiert verpackt.The proximal or rear part 2a adjoining the middle part 2b of the guide channel 2 in the direction of the proximal end 8 of the cartridge 1 is designed in the form of a hollow cylinder of constant diameter. In the proximal part 2a of the guide channel 2, a thrust ram tip 9 made of silicone is embodied essentially as a rotationally symmetrical plate. The push punch tip 9 is designed in a stepped manner in cross section (FIG. 3) in such a way that a recess is formed on its proximal side as a centering device 10 for centering a punch head 11 of the push punch 5. The punch head 11 engaging in the centering device 10 displaces the pushing punch tip 9 in the direction of the distal end 7, so that a flat pushing surface 12 on the distal side of the pushing punch tip 9 conveys the intraocular lens through the guide channel 2. There is a positive connection between the stamp head 11 and the centering device 10. The pushing punch tip 9 is clamped in the guide channel in such a way that a displacement of the pushing punch tip 9 is only possible by actuating the pushing punch 5. The clamping force or - in the case of the formation of a latching connection - latching force between the pushing punch tip 9 and the proximal part 2a of the guide channel 2 is significantly greater than the weight of the pushing punch tip 9. The pushing punch tip 9 is pre-assembled in the cartridge 1 and packaged sterilized together with the latter.
Der in Fig. 4 dargestellte Injektor 6 bildet zusammen mit der die Schubstempelspitze 9 umfassenden Cartridge 1 ein Injektionssystem für eine faltbare Intraokularlinse. Alternativ ist die Cartridge 1 auch mit anderen, nicht dargestellten Ausführungsformen von Injektoren nutzbar. Die Cartridge 1 ist als Einwegteil in einen Frontalbereich 13 des als resterilisierbares Gerät ausgebildeten Injektors 6 einsetzbar. Dabei werden die Halb- schalen 3a,3b in einem Schlitz 14 im Frontalbereich 13 gehalten. Die Handhabung des Injektionssystem ist insbesondere dadurch erleichtert, dass bereits vor dem Einsetzen der Cartridge 1 in den Injektor 13 die flexible Schubstempelspitze 9 im proximalen Teil 2a des Führungskanals 2 eingelegt ist. The injector 6 shown in FIG. 4, together with the cartridge 1 comprising the pushing stamp tip 9, forms an injection system for a foldable intraocular lens. Alternatively, the cartridge 1 can also be used with other, not shown embodiments of injectors. The cartridge 1 can be used as a disposable part in a frontal area 13 of the injector 6, which is designed as a resterilizable device. The half shells 3a, 3b held in a slot 14 in the frontal area 13. The handling of the injection system is particularly facilitated in that the flexible pushing stamp tip 9 is already inserted in the proximal part 2a of the guide channel 2 before the cartridge 1 is inserted into the injector 13.
BezugszeichenlisteLIST OF REFERENCE NUMBERS
Vorrichtung, CartridgeDevice, cartridge
Führungskanal a proximaler Teil b mittlere Teil c distaler Teil a,b HalbschalenGuide channel a proximal part b middle part c distal part a, b half shells
Filmscharnierfilm hinge
Schubstempelthrust jacks
Injektor distales Ende proximales EndeInjector distal end proximal end
Schubstempelspitze 0 Zentriervorrichtung 1 Stempelkopf 2 Schubfläche 3 Frontalbereich 4 Schlitz Push stamp tip 0 Centering device 1 stamp head 2 push surface 3 frontal area 4 slot

Claims

AnsprücheExpectations
Vorrichtung zum Falten und Implantieren einer Intraokularlinse mit einem Faltungsbereich, der zwei schwenkbar miteinander verbundene Halbschalen (3a,3b) aufweist, die von einer offenen Ausgangsstellung in eine geschlossene Endstellung verschwenkbar sind, in der sie einen Teil eines ein proximales Ende (8) und ein distales Ende (7) aufweisenden Führungskanals (2) für die Intraokularlinse bilden, gekennzeichnet durch eine im Führungskanal (2) zwischen dessen proximalem Ende (8) und dessen aus den Halbschalen (3a,3b) bildbarem Teil gelagerte, flexibel ausgebildete Schubstempelspitze (9), durch welche mittels eines durch Einführung in den Führungskanal ansetzbaren Schubstempels die Intraokularlinse zum distalen Ende (7) des Führungskanals Device for folding and implanting an intraocular lens with a folding area which has two half-shells (3a, 3b) which are pivotally connected to one another and which can be pivoted from an open starting position into a closed end position in which they form part of a proximal end (8) and a Form a guide channel (2) having a distal end (7) for the intraocular lens, characterized by a flexible push stamp tip (9) mounted in the guide channel (2) between its proximal end (8) and its part that can be formed from the half-shells (3a, 3b). , through which the intraocular lens is pushed to the distal end (7) of the guide channel by means of a push ram that can be inserted into the guide channel
(2) verschiebbar ist.(2) is movable.
Vorrichtung nach Anspruch 1 , dadurch gekennzeichnet, dass die Schubstempelspitze (9) aus Silikon gebildet ist.Device according to claim 1, characterized in that the pusher tip (9) is made of silicone.
3. Vorrichtung nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass die Schubstempelspitze (9) eine Zentriervorrichtung (10) zum Zentrieren des Schubstempels im Führungskanal (2) aufweist.3. Device according to claim 1 or 2, characterized in that the thrust ram tip (9) has a centering device (10) for centering the thrust ram in the guide channel (2).
4. Vorrichtung nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass die Schubstempelspitze (9) mit einer Übermaßpassung im Führungskanal (2) gelagert ist.4. Device according to one of claims 1 to 3, characterized in that the thrust ram tip (9) is mounted with an interference fit in the guide channel (2).
5. Vorrichtung nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, dass die im Führungskanal (2) gelagerte Schubstempelspitze (9) in diesem eingerastet ist. Vorrichtung nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, dass die im Führungskanal (2) gelagerte Schubstempelspitze (9) zusammen mit diesem sterilisiert ist. 5. Device according to one of claims 1 to 4, characterized in that the push ram tip (9) mounted in the guide channel (2) is locked in this. Device according to one of claims 1 to 5, characterized in that the pusher tip (9) mounted in the guide channel (2) is sterilized together with it.
PCT/EP2003/008257 2002-07-26 2003-07-25 Device for implanting an intra-ocular lens WO2004012631A1 (en)

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DE2002134290 DE10234290A1 (en) 2002-07-26 2002-07-26 Device for implanting an intraocular lens

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BE1016692A3 (en) * 2005-07-25 2007-04-03 Physiol Supple intraocular lens injector cartridge has loading zone in form of cartridge body cavity that receives lens in uncompressed state
US8475526B2 (en) 2005-12-22 2013-07-02 Bausch & Lomb Incorporated Apparatus and methods for loading of an IOL injector
US20070150054A1 (en) 2005-12-22 2007-06-28 Joel Pynson Apparatus and methods for loading of an IOL injector
WO2007128886A1 (en) * 2006-05-05 2007-11-15 Xcelens S.A. Improved cartridge for an intraocular implant

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JP3459664B2 (en) * 1993-07-15 2003-10-20 キヤノンスター株式会社 Deformable intraocular lens insertion device
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US8932351B2 (en) 2007-05-29 2015-01-13 Steven J. Dell Accommodative intraocular lens having a haptic plate
US9084673B2 (en) 2007-05-29 2015-07-21 Steven J. Dell Accommodative intraocular lens having a haptic plate
US9468523B2 (en) 2007-05-29 2016-10-18 Bausch & Lomb Incorporated Accommodative intraocular lens having a haptic plate

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DE10234290A1 (en) 2004-02-05

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