CH709039A1 - Apparatus for receiving an intraocular lens and method for folding an intraocular lens. - Google Patents

Abstract

Shown and described is a device for receiving an intraocular lens having a first and a second half-shell (13, 15) which are hinged together by a first hinge (29) and can be moved relative to each other from an open position to a closed position in which - the half shells (13, 15) form an open chamber in the open position, and - the half shells (13, 15) form an enclosed chamber in the closed position. According to the invention, provision is made for a cover member (45) to be arranged on the first of the two half-shells (13) on the longitudinal side, which in the open position limits the open chamber and is positioned in the closed position substantially outside the enclosed chamber. Shown and described is a method for folding an intraocular lens using said device.

Description

TECHNICAL FIELD OF THE INVENTION

The present invention relates to a device for receiving an intraocular lens and a method for folding an intraocular lens.

BACKGROUND OF THE INVENTION

In cataract surgery nowadays by default artificial lenses, so-called intraocular lenses, are used in the capsular bag of the eye

In the operation, an ocular incision of typically 2 to 4 mm is now made, by which the natural eye lens is first removed and then the implant is inserted. For insertion, the artificial lens is inserted in the folded state through the incision in the capsular bag. Once the folded lens is inserted into the capsular bag, it unfolds back to its original shape.

The usual artificial lenses today consist of an optical lens body and two or more of this transversely to the optical axis of the lens body peripherally protruding haptics, which serve as position springs for the lens body in the capsular bag. For example, two haptics, which are arranged opposite one another on the lens body, project from the lens body in a spirit-like manner.

Improved surgical tools and implants allow surgeons to make the incisions noticeably smaller. The removal of the natural eye lens can already be done today by incisions of less than 2 mm. However, this makes sense only if the intraocular lens can be inserted through such a small incision.

For the insertion of an intraocular lens lens carriers or cartridges have been developed in recent years, in which a lens can be loaded and then ejected by means of an injector from the lens carrier.

Examples of such lens carriers or cartridges and injectors are, for example, from the patents US 6 267 768, US 5 810 833, US 6 283 975, US 6 248 111, US 4 681 102, US 5 582 614, US 5 499 987, US Pat. No. 5,947,975, US Pat. No. 6,355,046 and EP 1 290 990 B1, as well as the disclosures US 2004/0199 174 A1 and WO 03/045 285 A1.

In the injector according to US 4,681,102, the cartridge, which is designed as a folding device for the lens, and the injector nozzle are separate parts. The cartridge can be inserted into the injector housing, whereupon the injector nozzle can be screwed on the front of the injector housing.

In the injector device according to US 5 582 614 and most prior art injector devices, such as e.g. US 6,267,768, US 5,810,833, US 6,283,975 and US 6,248,111, the cartridge is integrally formed of a folding device and an injector nozzle.

Intraocular lenses are sterile packaged by the manufacturer and optionally supplied in a liquid bath. Depending on the lens material, storage in a liquid may be necessary to protect the lens from dehydration. During surgery, the lens must be removed in the sterile area of the package and inserted or loaded into a cartridge or directly into an injector. Since these lenses are very small and resilient structures, there is a risk when loading the cartridge or the injector that the lens is dropped or jumps off while folding and thereby loses its sterility. In addition, the lenses are very delicate structures that can be easily damaged when folding, injecting and reloading into a cartridge. The risk of damage is particularly great for the so-called haptic, which surrounds the optical part of the lens. It is also possible that the optical part is damaged, for example, by the tweezers when inserted into the cartridge. These dangers are particularly great in cartridges according to US 4 681 102, which does not provide any measures for detecting the edges of the lens when folding. In contrast, US Pat. No. 5,582,614 proposes that the cartridges be provided with grooves at the free ends of their half-shells, which grooves detect the lens edges when the lens is folded. US 5,499,987 provides a special formation of the grooves. Namely, it is proposed to make the grooves less deep against the nozzle so as to facilitate their transport into the nozzle (Figs. 34, 39, 40 and 41 in US 5,499,987). The disadvantage, however, is that cartridges with such grooves can not reliably grasp the lens edges when the lens has a relatively large diameter and the cartridge must be opened wide for insertion of the lens, ie a large opening angle exists. This disadvantage does not have the cartridge according to US 5,947,975 or US 6,355,046, because it has two hinges, so that there is a different folding geometry than in cartridges with a single hinge. However, it is disadvantageous that a cartridge corresponding to this size is necessary for each lens size. A further disadvantage is that the folding of the lens is not optimal (FIGS. 11 and 15 in US Pat. No. 5,947,975 or US Pat. No. 6,355,046), so that the diameter of the injector tip must be kept relatively large. Therefore, an undesirably large ocular incision is necessary to insert the lens into the capsular bag of the eye.

As EP 1 290 990 B1 and WO 03/045 285 A1 show, in later years the original cartridge construction, which has two shells connected by a single hinge, with or without grooves for detecting the lens edges, was retained ,

The disclosure WO 03/045 285 A1, for example, shows a method for introducing an intraocular lens into the capsular bag of the eye, in which an overpressure is generated to expel a floating in a lubricant recorded lens from the injector nozzle. A compressible and deformable piston continuously adapts to the forward narrowing nozzle channel. The lens is folded further on its way and has a very small diameter at the end of its path. Due to the deformability of the piston, the end of the nozzle channel can be kept very narrow, so only a very small incision is necessary. A set for carrying out the method includes a lens carrier and a lens. The lens is in a tension-free state in the lens carrier. Lens and lens wearers are preferably carried by a holder and packaged sterile in a package until use, in the case of a hydrophilic lens in a liquid which protects the lens from drying out. During surgery, the lens wearer, together with the lens stored therein, is removed from the package, inserted into the injector and folded. Then a lubricant is filled through the channel. The lens can now be injected into the capsular bag of the eye to be treated.

Because cartridge with grooves for detecting the lens edges in the folding not satisfied, in US 204/0 199 174 a cartridge is proposed, which also has in a conventional manner, two half-shells. Therein, in particular, an injector device is shown in which the injector housing consists of a cylinder for receiving the piston, a folding device for the lens and an injector nozzle. In addition, a band is provided which leads from the first half-shell to the second half-shell and can be pulled through a slot at the edge thereof. An intraocular lens is inserted between a loop of the tape and the half-shells. By pulling on the belt, the half-shells can be moved towards each other and the lens (which protrudes unfolded over the edge of the half-shells) is pressed into the half-shells, thereby folding the intraocular lens. When folding, the lens is thus held by the band. The band acts as a folding aid. A disadvantage is the complex construction of the cartridge and. their complicated handling. In addition, the feel of e.g. be clamped between the band and slot.

There are preloaded systems. These are already loaded in the factory with a lens in unfolded state (so-called pre-loaded systems, i.e. pre-loaded systems), so that the previous delicate charging process before the operation is no longer necessary. The surgeon only needs to perform the folding process and introduce the lubricating fluid. For preloaded systems, brackets are known which hold a preloaded lens in its storage position during transport. These brackets are removed before the lens can be injected into an eye, or they fall off when the lens is folded. The removal of a holder represents an additional manipulation step. A sloping part can have a disruptive effect; for example, by catching it and removing it from the operating area.

Generally, in the prior art, systems for prefolded lenses and systems for unfolded lenses can be distinguished. In the systems without prefolded lenses, the lenses are folded for injection only during the impact process. For this purpose, systems are used in particular in which the lens is loaded from behind, still unfolded or unfolded into a loading chamber (as shown, for example, in US Pat. No. 5,810,833). Systems for non-prefolded lenses disadvantageously require relatively large ocular incisions, because the impact process can not be folded arbitrarily small for various reasons. In the pre-folded lens systems, the lenses are folded for injection prior to the impact process. In particular, wing cartridges (such as disclosed in US 6,267,768, US 5,947,975 or US 4,681,102) are used. The lens is folded when closing the wing cartridge and is in the loading chamber in pre-folded state. Systems with wing cartridges advantageously require only small incisions. The disadvantage is that the lens, in particular its feel, are pinched when inserting and folding or the haptic can assume an unfavorable position.

None of the aforementioned documents discloses a system which is always error-free manipulated and / or completely eliminates the risk of pinching the feel of the lens when folding. A trapped or unfavorably trapped haptic may break at the latest when injecting the lens. If many manipulation steps are necessary to prepare the lens and the injector, they can represent a corresponding number of sources of error.

TASK

It is therefore an object of the present invention to provide a device for easy loading with an intraocular lens, which avoids the disadvantages of the known systems and methods described. In addition, a device is to be created which folds an intraocular lens without damaging it during folding and / or injecting and is suitable for use with small incisions. In addition, a device is to be provided which optimizes the manipulation steps for the preparation of the lens and the injector is. In particular, as few manipulation steps as possible should be necessary, which must be carried out after delivery of the lens and the injector or which must be performed on the device immediately before the surgical procedure. This should reduce sources of error. Another object is to provide a device which requires only small incisions in the eye in the application.

These and other objects are achieved by the features of the independent claims. Further developments and / or advantageous embodiments of the invention are the subject of the dependent claims.

SUMMARY OF THE INVENTION

According to the invention the object is achieved by a device for receiving an intraocular lens having a first and a second half-shell, which are hinged together by a first joint and can be moved relative to each other from an open position to a closed position, wherein Half shells in the open position form an open chamber, and the half shells in the closed position form an enclosed chamber, and wherein according to the invention on the first side of the two half shells, a cover member is pivotally mounted, which defines the open chamber in the open position and in the closed position outside (or substantially outside) of the enclosed chamber is or is positioned. The cover member is (and remains) arranged in the open position and in the closed position on the first half-shell or connected to the first half-shell.

With the above device pinching of the lens and in particular their feel when closing the half-shells can be avoided. When using the inventive device, it is visually recognizable to the user where the lens is positioned in the cartridge. The starting position of the lens before the folding process can thus be checked visually. A faulty insertion of the lens can be excluded. Accordingly, the cover member also acts as a positioning aid and as a cover during storage and maintenance of the lens.

The device according to the invention can be used in the application with relatively small incisions (in particular for incisions having a diameter of less than 2.5 mm, preferably less than 2.2 mm, more preferably less than 2 mm, more preferably less than 1.5 mm) on the eye become. This is achieved because the device according to the invention has a loading chamber enclosing a jacket-like manner and thus (longitudinally) closed for a folded lens to be injected. The lens is prefolded therein to a particularly small cross-sectional diameter and can be injected through a narrow cannula and through a very small incision, as described. The named device is used particularly advantageously with a deformable stamp, in particular a silicone stamp (for example according to the disclosure WO 03/045 285 A1).

The below-mentioned advantageous embodiments lead alone or in combination with each other, to further improvements of the inventive device and its application.

Pivotally arranged may mean that the lid member is integrally formed on the first half-shell. Manufacturing technology is particularly advantageous if the lid member is configured integrally with the first half-shell and optionally further together with the second half-shell. A one-piece cartridge may e.g. be produced inexpensively by injection molding.

Advantageously, at least the first half-shell and the lid member, preferably the first half-shell, the second half-shell and the lid member are not detachably connected to each other; i.e. not soluble under conditions of normal use. The normal use here includes in particular the charging, storing, folding and ejecting or injecting a lens.

According to the invention, the lid member is in particular at the longitudinal edge of the first half-shell, i. on the first joint facing away from the longitudinal side of the first half-shell, pivotally mounted.

Conveniently, the lid member is connected via a second hinge which is e.g. is formed as a hinge, in particular as a film hinge, connected to the first half-shell. The cover member is in particular pivotable about the second joint.

A bending groove may be formed on the inner surface of the first half-shell repellent lid member surface.

For stabilization in the open position of the device is advantageous if the longitudinal edge of the second half-shell, a lid member support, preferably with Einrastrille is formed

Optionally, each half-shell is equipped with a support. The overlay may e.g. be formed in the form of at least one slide.

The device is advantageously designed such that when closing the two half-shells, the lid member slips over the longitudinal edge of the second half-shell from the closing chamber addition.

To ensure the function as a charging channel, the enclosed chamber in the closed position of the half-shells forms a channel, in particular a cylindrical charging channel.

For better handling, wings (i.e., wing grips) are arranged on both half shells, in particular on the respective longitudinal edge of the half shells.

It may be advantageous if a closure, in particular a snap closure, is formed on the wings.

According to the invention, in the closed position of the half-shells, the lid member is arranged substantially outside the enclosed chamber, preferably it lies between the wings, if appropriate, it may be clamped between the wings.

The cover member is preferably carried out self-supporting or dimensionally stable, in particular as platelets. The cover member is dimensionally stable or self-supporting, in particular under conditions of normal use. The normal use of the device here includes in particular the charging, storing, folding and ejecting or injecting a lens. The lid member is thus not bendable under normal use, i. not bendable in itself, thus does not deform significantly, and behaves essentially stiff. As a result, the cover member is pivotable in particular about the second joint. A band (which by definition is bendable) is not suitable as a lid member.

The cover member may have an opening which serves to fill the still open chamber and the cartridge tip with lubricant.

It is useful if the lid member has a stopper for the lens. The stopper is preferably arranged on the front of the cartridge on the cover member, in particular integrally formed. Conveniently, the lens, including its front feel, is prevented by the stopper from leaking forward and possibly falling out of the device. Further, by means of this stopper, the front haptic can be deliberately placed against the optic when the lens is pushed forward against the stopper. This results in a better emergence of the lens.

In particular, it may be useful if the lid member has two stoppers, i. a first stopper and a second stopper, the first stopper (as indicated above) for limiting the front haptic and the second stopper for limiting the rear haptic. This embodiment with two stoppers is particularly advantageous in that a lens stored in liquid, which is preloaded in the cartridge according to the invention, can be removed from the storage container and inserted into the injector, without the lens being moved over it the two sides of the cartridge (ie, the front or the rear face of the cartridge) may fall out.

Advantageously, the lid member is made shorter in relation to the half-shells in the longitudinal direction, preferably shortened and stepped.

In accordance with an injector can be formed on one of the half shells, a plug-in device for insertion into a receiving opening of the injector. Preferably, the plug-in device is provided on the second half-shell.

Manufacturing technology, it is advantageous if the device is in one piece and preferably consists of plastic. Injection molding technology can be used in this case.

It is particularly advantageous if the device is designed as a cartridge for insertion into an injector.

Further herein disclosed is an injector having an injector housing and a plunger longitudinally displaceable in the injector housing for use with a cartridge-shaped device as described above

According to the invention, the above-mentioned object is achieved by a method for folding an intraocular lens, which comprises the following steps:

Preferably, at least one haptic of the lens is pushed towards the lens body. When the front stopper is present, the front haptic can be pressed against the lens body under the pressure of a pestle on the lens. Furthermore, it may be advantageous to push the rear haptics of the lens, directly over a plunger, in particular a flexible plunger, towards the lens body. In this way, the haptics are prefolded.

It is advantageous that the lens can be introduced into the cavity in a de-energized state. This means that the lens can be inserted into the device (in particular by hand) without externally applied mechanical stress, in particular without bending or folding the lens.

Conveniently, the lens - in particular after insertion by hand - (at least partially) on the inner surfaces of the two half-shells. This means that the lens rests at least on the inner surface of each half-shell at one point.

Conveniently, the lens is bordered at its edges by the two half-shells and is folded together with the half-shells (preferably in approximately the same direction). The lid member is not in contact with the lens or touches the folding process. The lid member does not affect the folding of the lens, so it is not a folding aid.

Preferably, when merging the two half-shells is brought together until the mutual contact of the two longitudinal edges of the two half-shells, wherein the lid member is clamped. The lid member may be clamped between the two longitudinal edges. Advantageously, the edges are fitted with wings which clamp the lid member in the closed position of the half shells and thereby secure and fix. It is ensured that the lid member slides out of the closing chamber and at the same time is fixed outside the closing chamber, in particular between the wings, so that the lid member in the subsequent ejection of the lens neither in the enclosed chamber nor outside this the ejection of the lens, e.g. for injection into an eye. The pivotable cover member preferably slides along the second wing during pivoting and out of the forming closing half-shells.

Further disclosed is an apparatus for receiving an intraocular lens having a first and a second half-shell which are hinged together by a first hinge and can be moved relative to each other from an open position to a closed position, wherein the half-shells in form the open position an open chamber, which serves for inserting a lens, and the half shells in the closed position form an enclosed chamber which defines a Ausstosspassage and used to expel the lens, which device according to the invention, at least characterized in that at the at least one stopper element (ie a stopper) is displaceably arranged on the first half of the two half shells, which in the open position limits the open chamber in the ejection direction and is positioned laterally of the ejection passage in the closed position, essentially outside the enclosed chamber. This further device can be combined with the features as defined above. The feature of a lid member may be in combination with the at least one stopper element, but need not exist. Features which were previously mentioned in combination with the cover member can be combined with the stopper element even in the absence of a cover member, insofar as the features are not mutually exclusive.

Additional advantages and objects of the present invention will become apparent from the following description.

BRIEF DESCRIPTION OF THE FIGURES

Further preferred embodiments of the invention will become apparent from the following description with reference to FIGS. It shows schematically, in an off-scale representation: <Tb> FIG. 1: <SEP> an oblique view of the device according to the invention in the open position with the intraocular lens received; <Tb> FIG. 2a: <SEP> is a front view of the device according to the invention in an open position <Tb> FIG. 2b: <SEP> position; a section of Figure 2a showing the support connection between the free end of a lid member and the edge of a second half-shell. <Tb> FIG. 3: <SEP> a front view of the device according to the invention in the closed position; <Tb> FIG. 4: <SEP> a front view of the device according to the invention in the closed position with the intraocular lens received; <Tb> FIG. 5a: <SEP> an optical lens with folded-in first and second or front and rear haptics; <Tb> FIG. 5b: <SEP> an optical lens having a first folded-in feel and a second opened feel; <Tb> FIG. 6: <SEP> an oblique view of an injector with inserted device according to the invention in the open position; <Tb> FIG. 7: <SEP> a further oblique view of an injector with inserted device according to the invention in the open position; <Tb> FIG. 8 shows a further oblique view of an injector with inserted device according to the invention in the open position; <Tb> FIG. 9: <SEP> an oblique view of an injector with inserted device according to the invention in the closed position.

DETAILED DESCRIPTION OF THE FIGURES

In the following, the same reference numerals for the same or functionally identical elements (in different figures). An additional apostrophe can be used to distinguish between several identical, similar, functionally identical or functionally similar elements.

FIGS. 1-4 show an apparatus according to the invention in the form of a cartridge 3 which can be inserted into an injector housing 1. Alternatively, the device according to the invention can be part of an injector or can be integrated or formed in the injector.

In Fig. 6 - 9, an injector with inserted cartridge 3 is shown.

The injector is an operation tool with a sleeve-like housing 1 and a housing axially movably received plunger 9. Preferably, the plunger 9 is an elastic stamp placed. In the shell of the housing is preferably a recess, e.g. Slot, into which a lens carrier, i. in particular the cartridge 3 described herein, is loadable. The lens carrier or the cartridge 3 has a preferably cylindrical charging channel 39, to which an axially adjoining the tip of the injector nozzle 11 (distal end of the lens carrier) connects the lens carrier or the cartridge 3 is inserted or held in the injector 1, that the plunger 9 is aligned with the charging channel. During feed, the plunger 9 penetrates into the charging channel 39 and pushes the lens out of the injector nozzle 11.

The cartridge 3 has a front end 5 and a rear end 7. Inserted into an injector 1 from the rear end 7 forth the plunger 9 in and through the cartridge 3 towards the front end 5 of the cartridge 3 and further into an injection cannula eleventh be pushed.

The cartridge 3 includes two half-shells 13 and 15, which are hinged together via a first joint 29. The two hinged half shells 13 and 15 together form a double half shell. Each half shell 13, 15 has on the inside an open half channel with an inner surface 17 and 19, respectively. The inner surfaces 17 and 19 together form a loading area 20. The loading area 20 is bounded on the longitudinal side by a first edge 21 and a second edge 23. In other words, each half-shell 13, 15 has an edge 21, 23 on a side facing away from the first joint 29. At each edge 21, 23 a wing 25, 27 is arranged. The half shells 13 and 15 are connected via the first joint 29, which expediently is e.g. designed as a hinge or film hinge, hinged together in the longitudinal direction. The two half-shells 13 and 15 are thereby strung together in such a way that the inner surfaces 17 and 19 of the two half shells 13 and 15 are adjacent to each other, in particular in the longitudinal direction contiguous (or merge into each other via the first joint 29) and form a common loading area 20. Longitudinal or longitudinal here means in alignment along the extent or orientation of the half channels. The cartridge 3 can be transferred from an open position to a closed position due to the joint 29. In the open position (FIGS. 1 and 2), the two half-shells 13 and 15 form a type of loading surface 20 onto which an intraocular lens 33 can be placed and on which the lens 33 can optionally be stored without tension. The lens 33 lies between the longitudinal edges 21, 23 preferably on a guide structure, which consists here for example of slide rails 35,37. When closing, the longitudinal edges 25 and 27 of the two half-shells 13 and 15 approach each other, and an artificial intraocular lens 33 resting on the loading surface 20 is grasped and folded. In the closed position (Figures 3 and 4), the two half shells 13 and 15 together form a closed channel 39 which serves to hold the lens 33 ready for injection into an eye when folded.

Intraocular lenses 33 essentially consist of an optical lens body 41 and one or more haptics 43, preferably a first and a second haptic 43, 43 (FIG. 5), which are usually located in the lens plane from the periphery of the lens body 41 spirally (in particular rectified spirally) protrude and are resilient. In order to avoid pinching the lens 33 and in particular its feel 43 when closing the half-shells, the cartridge 3 according to the invention is equipped with a cover member 45.

The cover member 45 is movable at the longitudinal edge 21 of the first half-shell 13 in particular displaceable or hinged (similar to a single-wing swinging door), arranged or fixed. The cover member 45 is advantageously designed as a cover plate, in particular as a flat, dimensionally stable cover plate. In an open position of the cartridge 3, the cover member 45 spans the loading surface 20 from the longitudinal edge 21 of the first half-shell 13 to the longitudinal-side edge 23 of the second half-shell 15.

The cover member 45 is advantageously at the longitudinal edge 21 of the first half-shell 13 movably fixed via a second hinge 47. Conveniently, the hinge 47 is a hinge, in particular a film hinge, and is designed as a bending groove or folding area.

The axes of rotation of the first and second hinges 29 and 47 are preferably aligned parallel to each other.

The lid member 45 closes to the longitudinal edge 23 out due to its gravity and / or a spring force in the second hinge 47. Since the lid member 45 is self-supporting (ie sufficiently rigid), in the open position of the cartridge 3 is a covered chamber 46 between first half-shell 13, second half-shell 15 and cover member 45. The second hinge 47 is preferably arranged on a protruding from the longitudinal edge 21 of the first half-shell 13 bar 49. On the opposite side, i. At the longitudinal edge 23 of the second half-shell 15, a second protruding strip 51 is preferably integrally formed, which serves as a support for the cover member 45 when the cartridge 3 is open. The strips 49 and 51 are both suitably curved and optionally designed with tapered ends, which merge into a film hinge. The curvature of the strips 45, 51 is such that, when the cartridge is closed, the two strips complement one another to form a semicircular bulge which extends into the closed channel 39. The strips 49,51 form in lateral continuation of the inner surfaces 17, 19 on the respective longitudinal edge 21, 23 a counter surface to the respective inner surface 17, 19, whereby on both sides a kind of inside groove 53, 55 on the respective longitudinal edge 21, 23 is formed (Fig. 3). Groove 53 or 55 and slide rails 35 and 37 can cooperate as a guide system for the introduction of a lens 33. The strips 49, 51 may be formed longitudinally (as shown in the figures) or interrupted (not shown). The control system is expediently aligned parallel to the longitudinal extent of the half-shells 13, 15.

The strip 49 is preferably formed on the chamber outer side with a concave bending groove. The bending groove in particular has a line-shaped material displacement in the longitudinal direction of the first half-shell 13, whereby a bending ability of the material is generated. As a result, the cover member 45 can be folded articulated to the first wing 25.

The strip 51 is preferably provided on the chamber outer side with a concave groove 56. In this groove 56, the cover member 45 and its free end 58 can engage with a corresponding configuration of the free end 58 of the cover member 45. Groove 56 and free end 58 are configured such that upon depression (i.e., by manual operation) of the two wings 25, 27, the lid member 45 and its free end 58, respectively, are pushed out of the groove 56 to slide along the wing surface 28. For this purpose, the free end 58 of the cover member 45 is expediently configured on the inside of the chamber with a tapering convex curve 60 which preferably ends with a bead-like seam 62. The strip 51 thus forms a kind of lid member support 63 with Einrastrille 56th

When the lid member 45 is shortened in the longitudinal direction with respect to the half-shells, or its inner surfaces 17, 19, the free or uncovered part 57 of the loading surface 20 can serve as a storage space for the lens 33, on which the lens, e.g. by hand, can be stored before this is the loading area 20 pushed along under the cover member 45.

In order for a lens 33 inserted from the storage space 57 into the covered chamber 46 not to escape on the front end face 5 of the cartridge 3, the cover member 45 is equipped with a stopper 59. This also serves to apply the distal feel to the optic body of the lens. The stopper is preferably at or near the cartridge front 5, i. proximal to the cartridge. The stopper 59 may be formed as a protuberance, which in the open cartridge (especially when the free end of the lid member 45 rests on the second edge 23 and the second bar 51) from the plane of the lid member inside surface side (ie on the side of the inner surfaces 17, 19 ) protrudes.

Conveniently, the second wing 27 has a passage or on the cartridge front side a recess 61 in or on which the stopper 59 can slide along when the lid member 45 when closing the cartridge 3 via the second wing out of the forming chamber 39 becomes.

In the longitudinal direction of the half-shells 13, 15, the dimension of the wing 27 of the second half-shell 15 preferably corresponds approximately to or exceeds the dimension of the cover member 41.

The cover member 45 optionally has an opening 64. This is preferably in the front region of the lid member 45 and optionally in a region of the lid member 45, which is opposite to the second inner surface 19 or - in other words - which abuts the second edge 23. The opening 64 is expediently less than half a diameter, preferably less than one third of the diameter, of a lens body 41 spaced from the front end face 5 of the cartridge 3 or the stopper 59 in the longitudinal direction

Through this opening 64, lubricating fluid can be introduced for the lens 33, in particular thereby also the front part of the cartridge 3, i. in front of the lens 33, and the injection nozzle 11 filled with lubricating fluid. The lubricating fluid may thereby be e.g. are filled after the lens has been inserted under the lid member 45.

The cover member 45 is compared to the half-shells 13, 15 shortened in the longitudinal direction at the rear cartridge member, preferably shortened and stepped, formed in particular, the cover member 45 in a rear portion 65 of the cover member 45, which is mainly the second inner surface 19 opposite or - different expressed - which abuts the second edge 23, compared to the half-shells 13, 15 shortened. In a rear portion 67 of the lid member 45, which is the first inner surface 17 opposite or - in other words - which abuts the first edge 21, the lid member 45 may also be compared to the half-shells 13, 15 shortened, but this need not. Preferably, in the region 67 above the first inner surface 17, the cover member 45 is shorter than in the region 65 above the second inner surface 19. In particular, the region 65 of the lid member which adjoins the loose end of the lid is opposite the length of the cartridge 3 Shorter than the region 67, which adjoins the second joint 47 Due to the shortening, a recess may result on one side at the rear part of the cover member 45, in which a plunger 9 of an injector up to the stop 69 and thus up to an inserted lens 33, possibly the lens body 41, can be inserted without the lid member 45 must be raised or otherwise moved. The width of the lid member portion 67, is dimensioned such that during the closing process of the cartridge 3 of the lid member portion 67 slides over the pushed up to the stop 69 of the recess plunger 9 away, without the free end 71 (esp., The hem 62) of the cover member 45 thereby loses contact with the wing (especially the wing inside).

In the closed position of the cartridge 3 (Figure 3), the lid member 45 lies substantially outside the enclosed chamber 39 formed from the chamber 46 and preferably between the vanes 25, 27. At the wings 25, 27 is a closure 73, in particular a snap closure is formed

On the half-shell 15, a plug-in device 75 is formed. This plug-in device 75 is used for insertion into an opening of an injector 1. As a blocking means serve as struts 77, 77 with barbs. As a result, a solid connection between these parts is created after inserting the cartridge 3 in the injector 1.

The injector shown in FIGS. 6 to 9 essentially consists of the injector housing 1 and the displaceable in this plunger 9 for transporting and ejecting the lens 33. In the illustrated embodiment, the cartridge 3 and possibly the injector nozzle 11 separate can be used in the injector 1 parts, but they can also be designed as one part. FIGS. 6 and 7 show an injector with a cartridge 3 inserted in the injector housing 1 and occupied by a lens 33 (only the rear haptic 43 of the lens 33 can be seen). The plunger 9 is mounted in a starting position in the injector (not visible in Fig. 6), preferably locked so that it is not in the way when inserting the cartridge 3. At the rear end 7 (proximal) of the cartridge 3, i. The half-shells 13, 15, optionally may be formed to the inner surfaces 17, 19 circumferentially a slope 78, 78, which may serve to introduce a ram 9. In Fig. 8, the plunger 9 is seen in the injector in teilvorgeschobener position. In this teilvorgeschobenen position, the plunger 9 extends to the rear edge or stop 69 of the cover member 45. In this position, the plunger 9, the lens 33 with front and rear haptics 43, 43 optionally collided in itself. Lens 33 and haptics 43, 43 are positioned below the lid member 45 in the chamber 46; i.e. the haptics are nowhere before. An axial displacement of the lens 33 is prevented on the one hand by the stopper 59 and on the other hand by the plunger 9. The plunger 9 may optionally be locked in the injector 1. It is thus possible to provide the injector with the lens 33 to be used already in the factory. This can e.g. be an option for dry lenses. Thus, prior to the operation, only the cartridge is to be closed by the surgeon or his assistant by moving the first wing 25 against the second wing 27 to thereby fold the lens 33 and push the cover member 45 out of the channel 46.

In another embodiment (not shown in the figures), the cartridge has stoppers on two sides of the lid member 45 (particularly at or near the front end and at or near the rear end of the cartridge). The stoppers are preferably located on the lid member itself, with respect to the orientation of the cartridge expediently a stopper at the front edge and a stopper at the trailing edge of the lid member is arranged. This allows e.g. storing the lens in the cartridge (i.e., preloaded lens). Such a preloaded lens may optionally be stored in a container filled with sterile liquid without the lens being able to fall out of the cartridge. After opening the container, the cartridge is removed from this container and inserted into the injector 1. Again, now only the cartridge must be closed as described above, with lid member 45, and push the two stoppers to both ends of the cartridge from the channel.

If the lens 33 with lens body 41 and haptics 43, 43 are positioned below the cover member 45 in the case of partially protruding plunger 9, the cartridge 3 can advantageously be closed without the lens body 41 or the haptics 43, 43 being closed during the closing process the wings 25 and 27 of the cartridge are clamped. The closing process of the cartridge proceeds in particular as follows: Preferably, by hand, the wings 25, 27 of the cartridge 3 are brought together. In this case, the cover member 45 slides from its locking position on the edge 23, in particular from the groove 56 on the inside wing surface 28 of the second wing 27 and this wing surface 28 along the closing cavity 46 and from the forming cavity 39 out.

In Fig. 9, the injector with closed cartridge 3 and teilingeschobenem plunger 9 can be seen. The fact that the plunger 9 is only partially inserted into the cartridge 3 can be recognized by the fact that the plunger end 81 projects out of the injector housing 1 with an unchanged length. In this position, the lens 33 is ready for injection. By pushing the pusher 9, the lens 33 is ejected through the cannula (injector nozzle) 11 to be e.g. to be injected into an eye.

In summary, the following can be stated:

An apparatus for folding an intraocular lens 33 has two halves 13, 15 connected by a hinge 29, which can be moved relative to each other by means of wings 25, 27 formed on the half shells 13, 15 and closed against one another in order to produce an inserted intraocular To fold lens 33 and at the same time in a loading carrier channel, which forms by the closure of the half-shells 13, 15 to keep injectable. Furthermore, the device for folding a lid member 45 in an open position of the half-shells 13, 15 from a first longitudinal edge 21 on the first half-shell 13 to a second longitudinal edge 23 on the second half-shell 15, a bridge over the inner surfaces 17, 19th the half-shells 13 and 15 forms. Jamming of the lens 33, in particular of the lens body 41 or the haptics 43, 43, can be prevented by the cover member 45 lying above the lens before and during folding, securing the lens on the half shells and thereby preventing the lens from doing so ( especially during folding, ie when closing the two half-shells) in the space between the wings 25, 27 to penetrate. In this case, the groove-like configuration (groove 53, 55) of the half-shells 13, 15 acts on the two longitudinal edges 21, 23 which partially frame the lens. When closing the two half shells 13, 15, the cover member 45, and optionally stopper 59 slips out of the forming loading channel (ie cavity 36), so as not to hinder the subsequent ejection of the folded lens or its injection into an eye. The invention will be explained below with reference to examples.

APPLICATION EXAMPLE 1

[0081] Use Case and Problem:

Due to the simple, low-defect loading of an injection cartridge from behind into a self-contained cartridge, this type of injection cartridge is preferred by many users. However, with injection cartridges loaded from the back, rigid piston ends must be used to inject the lens into the eye. The problem with rigid piston ends is that they can damage the lens, especially when a lens is to be transplanted through a small incision into an eye to be operated, because the thinner the piston end, the risk that the piston end may erroneously increase in the Lens can penetrate or at least scratched.

When using an injection cartridge equipped from the rear, the intraocular lens can not be prefolded, which is why the lens must be folded by the internal geometry of the injection nozzle during advancement through the punch. Due to the geometry tapering from the lens cross-section to the incision diameter, no piston (also referred to herein as a ram) with a flexible and shape-adapting end (punch) can be used. A flexible punch would have to form a positive fit with the cartridge, otherwise there would be a very high risk that the posterior lens haptics between the punch and cartridge wall is clamped when advancing the punch. However, the volume of such a flexible punch would be so great that it would have to compress strongly when advancing the piston and as a result can lead to a penetration of the punch by the piston tip and to deformation and shearing of the punch. The forces needed to compress the punch would also increase the injection force for the user to an unacceptable level.

[0084] Problem solution according to the invention: According to the invention, a loading chamber with integrated lens holder with lens cover (cover member) is used as part of an injection system.

The loading chamber is open in the described application, a system loaded from the back, and allows the user to load the loading chamber with the intraocular lens from behind. The lens cover acts as an insertion aid for the lens. After insertion of the lens and the application of a visco-elastic as a sliding aid, the loading chamber is closed, the lens pre-folded and the lens cover folded automatically by a hinge mechanism between the two wings of the loading chamber. By this pre-folding, the cross-section is significantly reduced compared to a back-loaded from the injection cartridge according to the current state of the art and thus a positive, non-violating the lens flexible punch can be used. This flexible stamp is advanced after the folding process, allowing the lens to be injected into the eye.

APPLICATION PART 2

[0086] Use Case and Problem: In a preloaded system, the intraocular lens must be protected during shipping and storage from slipping and sliding out of the injection cartridge or the loading chamber. This is realized by a lens holder. However, a commercially available lens holder has the disadvantage that the user has to remove it himself. Careless removal may result in dislocation of the lens. Since the user in a preloaded system does not make or make any manipulation of the lens, it may lead to jamming of the lens or their haptics in the subsequent closing process of the loading chamber or during the subsequent advancement of the punch. In addition, removal of the lens holder is an additional step for the user. To make the system as easy and comfortable for the user as possible, this additional step of removing the lens holder should be eliminated as much as possible.

[0087] Problem solution according to the invention: According to the invention, a loading chamber with integrated lens holder with lens cover (cover member) is used as part of an injection system.

The loading chamber is in the described application, a preloaded system, to the rear, above and also to the front for storage and transport protection completely or at least partially closed. In the case of dry-mounted lenses, the loading chamber according to the invention is already inserted into the injector. When stored in liquid lenses, the loading chamber according to the invention is stored in a container filled with liquid. From this it is removed by the user and inserted into the injector. For both types of lenses, after injection of VisioIastic, the loading chamber is closed, the lens is pre-folded, and the lens cover is folded by a hinge mechanism between the two wings of the loading chamber. Following this, the flexible punch can be advanced and the lens injected into the eye. The integration of the lens holder and its automatic folding has the advantage that the user saves a step and thus time, thereby also potential errors are excluded by the previously necessary removal of the lens holder and also the risk of slipping out during folding and between the two wings nipping haptics is eliminated.

While specific embodiments have been described above, it will be apparent that various combinations of the illustrated embodiments may be used so far as the embodiments are not mutually exclusive.

While the invention has been described above with reference to specific embodiments, it is obvious that changes, modifications, variations and combinations may be made without departing from the spirit of the invention.

LIST OF REFERENCE NUMBERS

[0091] <Tb> 1 <September> injector <Tb> 3 <September> cartridge <tb> 5 <SEP> front end (or front end) of the cartridge <7> rear end of the cartridge <tb> 9 <SEP> Plunger (also called piston) <tb> 11 <SEP> Injection cannula or nozzle <tb> 13 <SEP> first half shell <tb> 15 <SEP> second half shell <tb> 17 <SEP> first inner surface, i. Inner surface of the first half shell <tb> 19 <SEP> second inner surface, i. Inner surface of the second half shell <Tb> 20 <September> loading <tb> 21 <SEP> longitudinal edge of the cargo bed at the first half-shell, i. first longitudinal edge <tb> 23 <SEP> longitudinal edge of the cargo bed at the second half-shell, i. second longitudinal edge <tb> 25 <SEP> first wing <tb> 27 <SEP> second wing <tb> 28 <SEP> Wing area of the second wing <tb> 29 <SEP> first joint, in particular film hinge <tb> 33 <SEP> intraocular lens <tb> 35 <SEP> first slide rail or lens support <tb> 37 <SEP> second slide rail or lens support <tb> 39 <SEP> enclosed chamber, charging channel formed as a closed channel <tb> 41 <SEP> optical lens body <tb> 43,43 <SEP> haptics <Tb> 45 <September> lid member <tb> 46 <SEP> Open chamber, possibly covered with lid member <47> second joint, in particular film hinge <tb> 49 <SEP> first sidebar, i. Edge strip on the longitudinal edge of the first half shell <tb> 51 <SEP> second sidebar, i. Edge strip on the longitudinal edge of the second half-shell <tb> 53 <SEP> first groove <tb> 55 <SEP> second groove <tb> 56 <SEP> concave channel <tb> 57 <SEP> uncovered part of the cargo bed (storage) <tb> 58 <SEP> free end of the lid member <tb> 59 <SEP> Stopper or stopper element <tb> 60 <SEP> convex rounding, esp. (chamber inside) at the free end of the cover member <tb> 61 <SEP> swath or recess <tb> 62 <SEP> Hem at the free end of the lid member <Tb> 63 <September> lid member Edition <Tb> 64 <September> breakthrough <tb> 65 <SEP> on the hinge side (i.e., near the hinge 47) rear portion of the lid member <tb> 67 <SEP> hinge remover (i.e., far from the hinge 47) rear portion of the lid member <Tb> 69 <September> stop <tb> 71 <SEP> free end 71 of the lid member <Tb> 75 <September> plug-in device <tb> 77.77 <SEP> struts <tb> 78,78 <SEP> Slanting, especially inside slope at the proximal end of the cartridge <Tb> 81 <September> stem end

Claims (28)

A device for receiving an intraocular lens (33) having a first and a second half-shell (13, 15), which are hinged together by a first hinge (29) and can be moved relative to each other from an open position to a closed position , in which - The half-shells (13, 15) in the open position form an open chamber (46), and The half-shells (13, 15) in the closed position form an enclosed chamber (36), characterized, in that a cover member (45) is arranged on the first of the two half-shells (13) on the longitudinal side, which in the open position limits the open chamber (46) and is positioned in the closed position substantially outside the enclosed chamber (39). 2. Device according to the preceding claim, characterized in that the cover member (45) on the longitudinal edge (21) of the first half-shell (13) is arranged pivotably A device according to any one of the preceding claims, characterized in that the lid member (45) is articulated (47) via a second linkage, e.g. is formed as a hinge, in particular as a film hinge, is connected to the first half-shell (13) 4. Device according to the preceding claim 3, characterized in that a bending groove on the inner surface (17) of the first half-shell (13) repellent lid member surface is formed. 5. Device according to one of the preceding claims, characterized in that on the longitudinal edge (23) of the second half-shell (15) has a lid member support (63), preferably with Einrastrille (56) is formed. Device according to any one of the preceding claims, characterized in that each half-shell (13, 15) is provided with a support (35, 37), e.g. designed as slide rails, is equipped. 7. Device according to one of the preceding claims, characterized in that when closing the two half-shells (13, 15), the cover member (45) over the longitudinal edge (23) of the second half-shell (15) from the closing chamber (46) also slips. 8. Device according to one of the preceding claims, characterized in that the enclosed chamber (39) in the closed position of the half-shells (13, 15) forms a channel, in particular a loading channel. 9. Device according to one of the preceding claims, characterized in that on both half shells (13, 15), in particular on the respective longitudinal edge (21,23) of the half-shells (13, 15), wings (25, 27) are arranged. 10. Device according to the preceding claim 8, characterized in that on the wings (25, 27) a closure (73), in particular a snap closure, is formed. 11. Device according to one of the preceding claims 8 or 9, characterized in that in the closed position the lid member (45) substantially outside the enclosed chamber (39) and preferably between the wings (25, 27). 12. Device according to one of the preceding claims, characterized in that the cover member (41) is designed to be self-supporting, in particular as platelets. 13. Device according to one of the preceding claims, characterized in that the cover member (45) has an opening (64). 14. Device according to one of the preceding claims, characterized in that the cover member (45) has a stopper (59) for the lens (33), in particular its front haptic. 15. Device according to one of the preceding claims, characterized in that the cover member (45) has two stoppers (59) for the lens (33), in particular a first stopper for the front haptic and a second stopper for the rear haptic. 16. Device according to one of the preceding claims, characterized in that the cover member (45) relative to the half shells shortened in the longitudinal direction, preferably shortened and stepped, is. 17. Device according to one of the preceding claims, characterized in that on one of the half-shells (13, 15) is formed a plug-in device (73) for insertion into a receiving opening of an injector housing (1). 18. Device according to one of the preceding claims, characterized in that it is in one piece and preferably consists of plastic. 19. Device according to one of the preceding claims, characterized in that it is designed as a cartridge for insertion into an injector, in particular in an injector (1) 20. Injector with an injector housing (1) and a longitudinally displaceable in the injector housing plunger (9) for use with a device designed as a cartridge according to claim 19. 21. A method of folding an intraocular lens (33) comprising the steps of: - Providing a covered cavity (46) whose casing is designed at least three parts, comprising as a first part a first half-shell 13, as a second part a second half-shell (15) and as a third part a cover member (45), wherein the first half-shell (13) on one side via a first joint (29) with the second half-shell (15) is hingedly connected and on the opposite side via a second joint (47) with a cover member (45) is hingedly connected, wherein the cover member (45) with the longitudinal edge (23) of the second half-shell (15) is slidably in contact, Inserting a lens (33) into the cavity (46) by inserting the entire lens body (41) of the lens (33) into the cavity, - Merging the two half-shells (13, 15) over the first articulated (29) by the side of the first half-shell (13) with the lid member (45) by rotation about the first hinge (29) the edge (23) of the second half-shell (15), wherein at the same time the lid member (45) over the edge (23) of the second half-shell (15) from a closing between the two half-shells forming cavity (39) slides, which at the same time rotation of the cover member (45) to the second joint (47) means. 22. The method according to the preceding claim 21, characterized in that when using a lens (33) with two haptics, the front haptic (43) of the lens (33), via a stopper (59) and the rear haptic (43). is pushed over a plunger (9) to the lens body (41) out or become. 23. The method according to any one of the preceding claims 21 or 22, characterized in that the lens (33) is introduced into the cavity (46) in a de-energized state. 24. The method according to any one of the preceding claims 21-23, characterized in that the lens (33) on the inner surfaces (17, 19) of the two half-shells (13, 15) rests. 25. The method according to any one of the preceding claims 21-24, characterized in that the lens (33) at its edges by the two half-shells (13, 15) is bordered and with the half-shells (13, 15) together, in particular approximately the same Direction, is folded. 26. The method according to any one of the preceding claims 21-25, comprising in the step of merging the two half-shells (13, 15) a merging to the mutual contact of the two longitudinal edges (21, 23) of the two half-shells, wherein the lid member (45) is trapped. 27. A device for receiving an intraocular lens (33) having a first and a second half-shell (13, 15), which by a first joint (29) are hinged together and can be moved relative to each other from an open position to a closed position , in which - The half-shells (13, 15) in the open position form an open chamber (46), which serves for inserting a lens, and - The half-shells (13, 15) in the closed position form an enclosed chamber (39) which defines a Ausstosspassage and used to expel the lens, characterized, in that at least one stopper element (59) is displaceably arranged on the first of the two half shells (13), which in the open position limits the open chamber (46) in the ejection direction and laterally in the closed position outside the enclosed chamber (39) Ausstosspassage is positioned 28. Device according to the preceding claim in conjunction with one of the features according to claims 2-19 with or without the feature of a cover member (45).