EP1351600A1 - Implant pour determiner la pression intra-oculaire - Google Patents

Implant pour determiner la pression intra-oculaire

Info

Publication number
EP1351600A1
EP1351600A1 EP02715406A EP02715406A EP1351600A1 EP 1351600 A1 EP1351600 A1 EP 1351600A1 EP 02715406 A EP02715406 A EP 02715406A EP 02715406 A EP02715406 A EP 02715406A EP 1351600 A1 EP1351600 A1 EP 1351600A1
Authority
EP
European Patent Office
Prior art keywords
pressure sensor
pressure
implant according
data
implant
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP02715406A
Other languages
German (de)
English (en)
Inventor
Arthur Messner
Tim Use
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Humanoptics AG
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
Publication of EP1351600A1 publication Critical patent/EP1351600A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0031—Implanted circuitry
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/16—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring intraocular pressure, e.g. tonometers

Definitions

  • the invention relates to an implant for determining the pressure of the aqueous humor in an eye.
  • Previous options for capturing intraocular pressure non-invasively are based on applanation tonometry.
  • the cornea is deformed from the outside and the force required for this is correlated with the intraocular pressure.
  • This method has several disadvantages: First, the measurement result is influenced by inaccessible and individually fluctuating disturbance variables, such as the strength of the cornea.
  • the second disadvantage is the handling of the tonometer.
  • the intraocular pressure can usually only be recorded by trained personnel and this only discontinuously. To record a series of measurements that represent the course of the intraocular pressure over one or more days, it is normally necessary for the patient to stay in a clinic. As a result, the course of the intraocular pressure is hardly accessible under normal everyday living conditions. It is also not possible to record the course of the intraocular pressure with very short time intervals over a longer period of time.
  • the invention is therefore based on the object of providing an implant which enables the pressure of the aqueous humor to be recorded continuously.
  • the object is solved by the features of claim 1.
  • the essence of the invention is to provide at least one pressure sensor element on an implant. This pressure sensor element measures the internal pressure of the aqueous humor.
  • a second pressure sensor is provided which measures the ambient pressure. This can be provided on the implant or outside the eye. The pressure of the aqueous humor is determined using the data from the two pressure sensors.
  • FIG. 1 shows an implant according to the invention inserted into an eye according to a first embodiment
  • FIG. 3 shows a cross section through the implant according to section line III-III in FIG. 2, 4 shows a schematic circuit diagram of the implant according to FIG. 1,
  • FIG. 5 shows a schematic circuit diagram of an implant according to a second embodiment
  • FIG. 6 is a top view of an implant according to a third embodiment.
  • FIG. 7 shows a cross section through the implant according to section line VII-VII in FIG. 6.
  • An implant 1 for measuring the pressure of the aqueous humor in the anterior chamber of an eye has a cannula 2 which surrounds a supply channel 3.
  • the supply channel 3 is open to the environment at one end 4 of the cannula 2.
  • the pressure sensor unit 5 has a housing 6 with a circular base 7 designed as a supporting body and with a cylindrical wall 8 projecting upwards therefrom.
  • the bottom 7 has an opening 9 in the center, along the circumference of which the cannula 2 is connected to the bottom 7.
  • the channel 3 thus opens into the interior 10 of the housing 6.
  • the housing 6 is closed from above with a cover 11 which has a ring-cylindrical edge 12 which surrounds the wall 8 in a sealing manner and is connected to it by gluing or latching.
  • the cover 11 has an opening 13 in the center through which the atmospheric pressure acts on the interior 10.
  • a first pressure sensor element 14 and a second pressure sensor element 15 connected flatly to the latter, both of which are embedded in a plastic matrix 16.
  • the plastic matrix 16 is essentially in the form of a flat cylinder.
  • the plastic matrix 16 is supported on a flat sealing ring 17 on the bottom 7 of the housing 6, a measuring space 18 being delimited on the circumference by the sealing ring 17 and being connected to the channel 3 being formed between the matrix 16 and the bottom 7.
  • the diameter D M of the measuring chamber 18 is larger than the inner diameter D ⁇ of the cannula 2.
  • the structure of the pressure sensor elements 14 and 15 is described in more detail below.
  • the pressure sensor element 14 has a circular substrate
  • micromechanical pressure sensors 20 are commercially available micromechanical absolute pressure sensors that measure the pressure capacitively or piezoresistively. Adjacent to the membranes
  • the membranes 20 measure the ambient pressure absolutely, ie against a known pressure prevailing behind the membranes 20.
  • a further disk-shaped substrate 25 which has a plurality of sensor membranes 26, which are also designed as micromechanical absolute pressure sensors, for measuring the pressure of a liquid supplied through the channel 3. Because the diameter D M of the measuring space 18 is larger than the diameter D K of the channel 3, a comparatively large number of sensor Membranes 26 are arranged while the cannula 2 remains as thin as possible.
  • the sensor membranes 26 also measure the pressure against a known pressure prevailing behind them, ie the absolute pressure.
  • the absolute pressures measured by the membranes 20 and 26 are subtracted from one another by the CPU 23, so that the pressure of the liquid in the cannula 2 is determined in relation to the ambient pressure, ie the excess pressure of the aqueous humor.
  • an external control device 27 which has a program transmission unit 28, an energy transmission unit 29 and a measurement data transmission unit 30, which are connected to a transmitter coil 32 via a controller 31.
  • the transmitter coil 24 assigned to the transmitter coil 32 for the telemetric transmission of data and energy is connected to the controller 22, which in turn is connected to a program transmission unit 33, an energy transmission unit 34 and a measurement data transmission unit 35.
  • the energy transmission unit 34 is connected via lines 36 via an energy storage unit 37 to the CPU 23 for the energy supply thereof.
  • the program transmission unit 33 is connected via a line 38 to the measurement program memory 39 and the measurement control unit 40, which receive data from the sensor signal unit 41 at time intervals ⁇ t and determine the relative pressure ⁇ p therefrom in a downstream measurement data processing unit 42 and in a measured value Store memory 43 or 21, which in turn is connected to measurement data transmission unit 35 via line 44.
  • the implantation of the implant 1 into the eye is described below with reference to FIG. 1.
  • the area between the cornea 45 or cornea and the iris plane is referred to as the anterior chamber 48, in which aqueous humor is located.
  • the rear chamber is located between the iris plane and the vitreous body 49, which is located behind the lens 47.
  • In the back chamber is also filled with aqueous humor.
  • the lens 47 is connected to the zillary body 51 via zonular fibers 50.
  • the implant 1 is inserted in the edge area of the eye or limbal area 52, the cannula 2 being guided through the limbus from the outside, so that aqueous humor can pass from the anterior chamber 48 through the channel 3 to the membranes 26.
  • the pressure sensor unit 5 is located outside the anterior chamber 45 in the episcleral tissue under the conjunctiva.
  • the mode of operation of the implant 1 is described below.
  • the aqueous humor of the anterior chamber 48 passes through the channel 3 to the membranes 26.
  • the pressure is measured compared to a known pressure.
  • the ambient pressure is measured by the membranes 20 compared to a known pressure.
  • the medically relevant differential pressure is calculated in the measurement data processing unit 42 from the signals.
  • the implant 1 is a long-term implant.
  • the control device 27 is brought up to the implant 1. This can be done, for example, by accommodating the control device 27 in glasses.
  • the energy store 37 is charged by the energy transmission unit 29, the controller 31, the transmitter coils 32 and 24, the controller 22 and the energy transmission unit 34.
  • the capacity of the Energy store 37 is designed so that the energy supply to the implant is ensured over a longer period of time and the time interval for recharging the energy store can be kept as large as possible.
  • the program program memory 39 can be changed by the program transmission unit 28, the controller 31, the transmitter coils 32 and 24, the controller 22 and the program transmission unit 33. In this way, the time interval .DELTA.t in which the measured values are recorded can be changed from the outside.
  • the differential pressure determined by the measurement data processing unit 42 is stored in the measurement value memory 43.
  • the data are transmitted from the measurement value memory 43 via the measurement data transmission unit 35, the controller 22, the transmitter coils 24 and 32, the controller 31 to the measurement data transmission unit 30 where they can be read out and used for medical purposes.
  • the measured value memory 43 is selected such that when the memory overflows, the data that were stored first are also deleted first. In the event that the time interval for reading out is exceeded, the most recent course of the intraocular pressure is retained.
  • the use of an optical or acoustic signal transmitter enables the patient to be informed of a pathological increase in intraocular pressure, so that suitable therapeutic measures can be initiated immediately.
  • a second embodiment of the invention is described below with reference to FIG. 5. Identical parts are given the same reference numerals as in the first embodiment, to the description of which reference is hereby made. Functionally similar but structurally different parts are given the same reference numerals with a th line.
  • the main difference from the first embodiment is that the units 33, 34 and 35 are not connected to the transmitter coil 24 via a common controller 22, but that each unit has its own transmitter coil.
  • the telemetric program is transmitted from an external programming device 54 to the measurement program memory 39.
  • the telemetric transmission of energy from an external energy supply 56 to the energy store 37 takes place.
  • a third exemplary embodiment of the invention is described below with reference to FIGS. 6 and 7. Structurally identical parts are given the same reference numerals as in the first exemplary embodiment, to the description of which reference is hereby made. Parts that are structurally different but functionally the same are given the same reference numbers with two prime lines.
  • the main difference compared to the first exemplary embodiment is the design of the housing 6 ′′ and in particular the fact that all electronic components are provided on a conductor film 59.
  • the implant 1 ′′ has a conductor film 59 as a supporting body, which consists of a flat surface , essentially rounded rectangular main section 60 and a web-shaped outwardly projecting front chamber section 61.
  • the conductor foil 59 is in a one-piece plastic housing 6 "made of biocompatible material. poured rial.
  • the housing 6 ′′ consists of a main housing 64 enclosing the main section 60 of the conductor foil 59 and a housing arm 65 with a pointed tip, which extends downward at an angle a of approximately 120 ° and encloses the section 61 of the conductor foil 59 outer end 62.
  • Arm 65 tapers toward outer end 62 to facilitate pushing arm 65 through the skin of the eye 63.
  • the length L H of the main housing 64 corresponds substantially to the length L A of the housing - Poor 65. However, it is also possible to provide other dimensions.
  • Various electronic elements are formed on the conductor foil 59 by means of a conventional microtechnical structure, for example the so-called flip-chip technology.
  • the measuring section 21, the controller 22, the central data processing unit 23 and a first pressure sensor element 14 ′′ with sensor membranes 20 ′′ are provided on the main section 60.
  • the transmitter coil 24" is located on the opposite side of the conductor foil 59.
  • the housing 6 ′′ has an area 66 of reduced thickness.
  • This area for forwarding the ambient pressure to the sensor membranes 20 " is selected such that the membranes 20" are adequately protected from the tissue and the tissue fluid of the surroundings and, on the other hand, the ambient pressure is passed on to the membranes 20 "essentially unchanged and there It is also possible to provide the further electronic elements known from the first and second exemplary embodiments on the conductor film 59.
  • the second pressure sensor element 15 "with the associated sensor membranes 26” is provided on section 61 of the conductor film 59 Here too is adjacent to the membranes 26 "a pressure transmission area 67 of reduced thickness is provided in the housing 6" so that the membranes 26 "are adequately protected from the tissue and the aqueous humor on the one hand and on the other hand the internal pressure of the aqueous humor can be measured as error-free as possible.
  • the pressure sensor element 15" and the other elements 20 ′′, 21, 22, 23 on the main section 60 of the conductor foil 59 are connected to one another via conductor tracks 68 on the conductor foil 59 for the transmission of data and for the voltage supply.
  • the length L A of the housing arm 65 is selected in this way that the outer third in the anterior chamber 48 is surrounded by aqueous humor.
  • the arm 65 has a thickness DM in the region of its middle third, which is greater than the thickness D A of the arm 65 in the region of the main housing 64. In this way, the arm 65 is prevented from slipping out of the anterior chamber 48 of the eye.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Public Health (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Pathology (AREA)
  • Ophthalmology & Optometry (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Eye Examination Apparatus (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un implant servant à déterminer la pression de l'humeur aqueuse dans un oeil et comprenant un corps support, une unité capteur de pression (5, 5") placée sur le corps support et présentant un premier élément capteur de pression (14, 14") servant à mesurer la pression de l'humeur aqueuse et à générer des premières données de capteur de pression, une unité de traitement de données (23) placée sur le corps support, reliée à l'unité capteur de pression (5, 5") de façon à transmettre des données et servant à traiter les premières données de capteur de pression et à générer des premières données de transmission, ainsi qu'une première unité émettrice-réceptrice placée sur le corps support, reliée à l'unité de traitement de données (23) de façon à transmettre des données et servant à transmettre les premières données de transmission et à recevoir des deuxièmes données de transmission, respectivement à destination et en provenance d'une deuxième unité émettrice-réceptrice placée à l'extérieur de l'oeil.
EP02715406A 2001-01-17 2002-01-10 Implant pour determiner la pression intra-oculaire Withdrawn EP1351600A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE10101780 2001-01-17
DE10101780 2001-01-17
PCT/EP2002/000160 WO2002056758A1 (fr) 2001-01-17 2002-01-10 Implant pour determiner la pression intra-oculaire

Publications (1)

Publication Number Publication Date
EP1351600A1 true EP1351600A1 (fr) 2003-10-15

Family

ID=7670733

Family Applications (1)

Application Number Title Priority Date Filing Date
EP02715406A Withdrawn EP1351600A1 (fr) 2001-01-17 2002-01-10 Implant pour determiner la pression intra-oculaire

Country Status (6)

Country Link
US (1) US20040059248A1 (fr)
EP (1) EP1351600A1 (fr)
JP (1) JP2004520119A (fr)
CN (1) CN1486158A (fr)
DE (1) DE10200617A1 (fr)
WO (1) WO2002056758A1 (fr)

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Also Published As

Publication number Publication date
US20040059248A1 (en) 2004-03-25
DE10200617A1 (de) 2002-07-18
WO2002056758A1 (fr) 2002-07-25
JP2004520119A (ja) 2004-07-08
CN1486158A (zh) 2004-03-31

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