EP3654879A1 - Method and device for fixation of a sinking intraocular lens in the eye field - Google Patents

Method and device for fixation of a sinking intraocular lens in the eye field

Info

Publication number
EP3654879A1
EP3654879A1 EP18746301.3A EP18746301A EP3654879A1 EP 3654879 A1 EP3654879 A1 EP 3654879A1 EP 18746301 A EP18746301 A EP 18746301A EP 3654879 A1 EP3654879 A1 EP 3654879A1
Authority
EP
European Patent Office
Prior art keywords
fixation
eye
intraocular lens
sinking
iris
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.)
Pending
Application number
EP18746301.3A
Other languages
German (de)
French (fr)
Inventor
Vytautas Jasinskas
Renata VAICIULIENE
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.)
Lietuvos Sveikatos Mokslu Universitetas
Original Assignee
Lietuvos Sveikatos Mokslu Universitetas
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 Lietuvos Sveikatos Mokslu Universitetas filed Critical Lietuvos Sveikatos Mokslu Universitetas
Publication of EP3654879A1 publication Critical patent/EP3654879A1/en
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/0008—Introducing ophthalmic products into the ocular cavity or retaining products therein
    • A61F9/0017—Introducing ophthalmic products into the ocular cavity or retaining products therein implantable in, or in contact with, the eye, e.g. ocular inserts
    • 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
    • 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
    • A61F2/148—Implantation instruments specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/167—Instruments for inserting intraocular lenses into the eye with pushable plungers
    • 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
    • A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics
    • A61F2002/16902—Separable from intraocular lens
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008—Fixation appliances for connecting prostheses to the body
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0065—Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped

Definitions

  • the present disclosure relates to an intraocular lens (IOL) fixation device that can be inserted into an eye through a standard cataract surgery incision (up to 3 mm).
  • the ring affixing the lens is elastic and is let out of the device through an opening on the side of the distal part of its tube.
  • an intraocular lens In cataract surgery, an intraocular lens (IOL) is implanted into the capsular bag, which in an eye is held by lens zonules. If the lens zonules weaken (e. g. due to an injury, Fuchs dystrophy, pseudoexpholiative syndrome etc.), the implanted IOL starts vibrating together with the capsular bag and can sink or descend into the vitreous. Loosening of IOL can cause ocular hypertension, microbleeds in the eye or uveitis (UGH syndrome). Sinking of IOL results in vision problems: deterioration of visual acuity, double vision, dysphotopsia.
  • Cataract surgery is one of the most common surgeries performed to treat eye diseases.
  • cataract surgery the patient's lens is replaced with an artificial intraocular lens made of a plastic or hydrogel material.
  • cataract surgery the patient's lens is replaced with an artificial intraocular lens made of a plastic or hydrogel material.
  • some complications can lead to vision problems.
  • One of such complications is post-operative lens dislocation or sinking, due to which IOL becomes decentered away from the visual axis or descends into the vitreous. Sinking can produce such extreme decentration that only a small portion of the IOL optic covers the visual axis.
  • IOL must be stabilized. It can be achieved by suturing IOL to the iris or stabilizing it using metal clips.
  • Stabilization using metal clips is only possible in cases of corneal transplantation, when there is direct access to an iris (the open-sky method), and the clip is pushed through an opening on the distal part of the instrument's tube.
  • the fixation device for metal clips cannot be used in small cavities, e. g. anterior chamber of the eye (without removing the cornea) as it injures the surrounding sensitive tissue - corneal endothelium (the device is intended for neurosurgery, not ophthalmology).
  • a known patent RU2408336 describes stabilization of an intraocular lens affixing it iridovitreally during complicated extracapsular or intracapsular cataract extraction.
  • a 10-00 suture is used to tie knots around the optical cylinder, where a double knot is tied first and then a single knot and after that the intraocular lens is affixed with a double stitching.
  • Application US20160022488 describes a new method and instrument for repositioning an intraocular lens (IOL) that became dislocated.
  • the instrument is placed through the eye wall near the ciliary body until the distal tip of the instrument is near the intraocular target to be moved.
  • a clip or other engagement structure at the end of the instrument is manipulated to engage a portion of the IOL, such as a haptic.
  • the instrument is then manipulated to reposition the target to a desired position, and sutures can be used to secure the target to the external surface of the eye.
  • Application US20120316644 describes an IOL fixation instrument including a deformable, medically inert clip that affixes a haptic of an intraocular lens to a patient's iris.
  • the method of affixing an intraocular lens, having haptics, within a patient's eye includes piercing the iris in at least two locations that closely flank a portion of one of the haptics, inserting an arm of a biologically inert deformable clip through each of the piercings in the iris until a distal end of each arm is located on opposing sides of the haptic, and applying a force to each of the arms to deploy the clip by causing the distal ends of the arms to approach each other and substantially surround and constrain both a section of the iris that is between the arms and a portion of the haptic.
  • US20080147083 describes a method and device, which includes using an implantable ocular clip to fix an intraocular lens to an iris, all without having to use a suture to permanently hold the lens in place.
  • Articlechevris Fixation of Intraocular Lens (Jonathan H Tzu, BS; Neel R. Desai, MD; Esen K. Akpek, MD. ARCH OPHTHALMOL/VOL 128, No. 1 , Jan 2010, p. 1 14-1 16) describes an intraocular lens fixation method (an experiment) using neurovascular clips and performing an open-sky intraocular lens fixation.
  • the known methods and devices of repositioning the dislocated IOL in the eye demand a lot of effort and are challenging. It has therefore become necessary to find a simpler intraocular lens fixation device and method.
  • the purpose of this invention is a device to affix a sinking intraocular lens to the iris.
  • this suggested IOL fixation device can be inserted into the eye through a standard cataract surgery incision (up to 3mm) (open-sky method is not needed) and the fixation ring is elastic and is let out of the device through an opening on the side of the distal part of its tube.
  • the device is inserted into an eye through a small incision (2 - 3 mm) in the peripheral cornea, so it is used in cataract surgery in the cases of a sinking IOL.
  • fixation is only possible having removed the cornea, i. e. in penetrating keratoplasty.
  • This present invention suggests using plastic compression molded rings made of polymethyl methacrylate, for fixation.
  • Fig. 1 shows the device for fixation of a sinking intraocular lens in the eye comprising a) an elongated casing (1 ), in which the ring push-out control/mechanism (1 a) is fitted; b) an extending from the casing (1 ) elongated flat tube (2) having, on the rounded tip, an opening (3), through which the ring (4) is pushed out; and c) a fixation ring (4), which is pushed out by piston (6) through the piston's opening (3) on the distal part of the tube of the mentioned device.
  • Fig. 2 shows the fixation ring (4) of the device for fixation of a sinking intraocular lens in the eye, which is an elastic plastic compression molded ring, preferably made of polymethyl methacrylate.
  • the inner diameter of the fixation ring (4) is about 1 mm.
  • Fig. 3 shows the tube (2) extending from the casing of the device which length is about 2.5 cm and its diameter is about 2 mm, inside of which is piston (6) and the opening in the rounded tip
  • the device (1 ) for fixation of a sinking intraocular lens in the eye is intended to be used to affix a sinking intraocular lens (IOL) to the iris in cases of zonular insufficiency (phacodonesis) detected before or during a surgery or when UGH syndrome or IOL dislocation of first or second degree is diagnosed.
  • IOL sinking intraocular lens
  • a method of fixation of a sinking intraocular lens in the eye in which a) through a small incision (up to 3 mm) in the peripheral cornea, the device (1 )of claim 1 - 4 is inserted into the eye and pushed towards the distal IOL haptics; b) the crescent-shaped end of the spatula-type instrument is raised so that the IOL haptic is prominent through the iris; and c) through the opening on the distal part of the device, by means of a piston (6), the fixation ring (4) is pushed out. It surrounds the IOL haptic through the iris and affixes it to the iris.
  • the ring has a cut (5), its ends are deformable. The ring is kept close to the iris on the side of the anterior chamber. Being pressed from the posterior surface, the haptic is pushed into the ring together with the iris.
  • FIG. 1 device for fixation of a sinking intraocular lens in the eye
  • Fig. 2 the fixation ring
  • Fig. 3 the tube (2), extending from the casing of the device with piston.
  • Phacoemulsification is performed in a traditional way, using the temporal incision.
  • IOL is implanted endocapsularly into the capsular bag and rotated so that the haptics are on the horizontal meridian (along the cataract incision).
  • a thin instrument with a crescent-shaped 2-mm-long end, attached perpendicularly to a rod is inserted into an eye.
  • the instrument is inserted into the posterior chamber of the eye and placed under the proximal part of the IOL distal haptic (in the "axillar" area).
  • the herein suggested device is inserted into the eye and pushed until it reaches the distal haptic of the IOL.
  • the instrument's crescent-shaped end is raised so that the IOL haptic is prominent through the iris.
  • the device (1 ) is pressed to the haptic and, through the opening (3) on the distal part of the device, an elastic ring (4) is pushed out. It surrounds the IOL haptic through the iris and affixes it to the iris.
  • the herein suggested instrument is inserted into the eye and pushed until it reaches the distal haptic of the IOL. Then the instrument's crescent-shaped end is raised so that the IOL haptic is prominent through the iris.
  • the device (1 ) is pressed to the haptic and, through the opening (3) at the distal part of the device, an elastic ring (4) is pushed out. It surrounds the IOL haptic through the iris and affixes it to the iris.
  • the device described in this disclosure is intended to be used to affix a sinking intraocular lens (IOL) to the iris.
  • IOL intraocular lens
  • This device is used in cases of zonular insufficiency (phacodonesis) detected before or during a surgery, having implanted an IOL in the capsular bag and affixing the IOL haptic(s) to the iris during the first surgery, also to affix a sinking lOL to the iris when UGH (uveitis-glaucoma-hyphema) syndrome or lOL dislocation of first or second degree is diagnosed.
  • UGH uveitis-glaucoma-hyphema

Abstract

The present disclosure relates to an intraocular lens (IOL) fixation device that can be inserted into an eye through a standard cataract surgery incision (up to 3mm). The ring affixing the lens is elastic and is let out of the device through an opening on the side of the distal part of its tube. The invention is intended to be used when IOL is implanted in cases of zonular insufficiency during first surgery or for treatment of complications caused by dislocation of the intraocular lens.

Description

METHOD AND DEVICE FOR FIXATION OF A SINKING INTRAOCULAR LENS IN
THE EYE FIELD
The present disclosure relates to an intraocular lens (IOL) fixation device that can be inserted into an eye through a standard cataract surgery incision (up to 3 mm). The ring affixing the lens is elastic and is let out of the device through an opening on the side of the distal part of its tube.
BACKGROUND
In cataract surgery, an intraocular lens (IOL) is implanted into the capsular bag, which in an eye is held by lens zonules. If the lens zonules weaken (e. g. due to an injury, Fuchs dystrophy, pseudoexpholiative syndrome etc.), the implanted IOL starts vibrating together with the capsular bag and can sink or descend into the vitreous. Loosening of IOL can cause ocular hypertension, microbleeds in the eye or uveitis (UGH syndrome). Sinking of IOL results in vision problems: deterioration of visual acuity, double vision, dysphotopsia.
Cataract surgery is one of the most common surgeries performed to treat eye diseases. In cataract surgery, the patient's lens is replaced with an artificial intraocular lens made of a plastic or hydrogel material. Despite uneventful surgery, some complications can lead to vision problems. One of such complications is post-operative lens dislocation or sinking, due to which IOL becomes decentered away from the visual axis or descends into the vitreous. Sinking can produce such extreme decentration that only a small portion of the IOL optic covers the visual axis.
To prevent the mentioned complications, IOL must be stabilized. It can be achieved by suturing IOL to the iris or stabilizing it using metal clips.
Suturing using a 10-0 Prolene suture and a long needle is technically challenging and brings about emotional stress in surgeons. This procedure is really complex and can be followed by complications such as suture biodegradation, fibrotic changes in the iris or erosion of the knot area, which lead to iris atrophy, iris ischemia etc.
Stabilization using metal clips is only possible in cases of corneal transplantation, when there is direct access to an iris (the open-sky method), and the clip is pushed through an opening on the distal part of the instrument's tube. The fixation device for metal clips cannot be used in small cavities, e. g. anterior chamber of the eye (without removing the cornea) as it injures the surrounding sensitive tissue - corneal endothelium (the device is intended for neurosurgery, not ophthalmology).
A known patent RU2408336 describes stabilization of an intraocular lens affixing it iridovitreally during complicated extracapsular or intracapsular cataract extraction. In this surgery, a 10-00 suture is used to tie knots around the optical cylinder, where a double knot is tied first and then a single knot and after that the intraocular lens is affixed with a double stitching.
Application US20160022488 describes a new method and instrument for repositioning an intraocular lens (IOL) that became dislocated. The instrument is placed through the eye wall near the ciliary body until the distal tip of the instrument is near the intraocular target to be moved. A clip or other engagement structure at the end of the instrument is manipulated to engage a portion of the IOL, such as a haptic. The instrument is then manipulated to reposition the target to a desired position, and sutures can be used to secure the target to the external surface of the eye.
Application US20120316644 describes an IOL fixation instrument including a deformable, medically inert clip that affixes a haptic of an intraocular lens to a patient's iris. The method of affixing an intraocular lens, having haptics, within a patient's eye includes piercing the iris in at least two locations that closely flank a portion of one of the haptics, inserting an arm of a biologically inert deformable clip through each of the piercings in the iris until a distal end of each arm is located on opposing sides of the haptic, and applying a force to each of the arms to deploy the clip by causing the distal ends of the arms to approach each other and substantially surround and constrain both a section of the iris that is between the arms and a portion of the haptic.
US20080147083 describes a method and device, which includes using an implantable ocular clip to fix an intraocular lens to an iris, all without having to use a suture to permanently hold the lens in place.
Article„Use of a Microvascular Clip for Iris Fixation of Intraocular Lens" (Jonathan H Tzu, BS; Neel R. Desai, MD; Esen K. Akpek, MD. ARCH OPHTHALMOL/VOL 128, No. 1 , Jan 2010, p. 1 14-1 16) describes an intraocular lens fixation method (an experiment) using neurovascular clips and performing an open-sky intraocular lens fixation. The known methods and devices of repositioning the dislocated IOL in the eye demand a lot of effort and are challenging. It has therefore become necessary to find a simpler intraocular lens fixation device and method.
BRIEF DESCRIPTION OF THE INVENTION
The purpose of this invention is a device to affix a sinking intraocular lens to the iris.
The difference between this suggested IOL fixation device and the brain aneurysm clipping device is that this device can be inserted into the eye through a standard cataract surgery incision (up to 3mm) (open-sky method is not needed) and the fixation ring is elastic and is let out of the device through an opening on the side of the distal part of its tube.
The device is inserted into an eye through a small incision (2 - 3 mm) in the peripheral cornea, so it is used in cataract surgery in the cases of a sinking IOL. In the nearest analogue, fixation is only possible having removed the cornea, i. e. in penetrating keratoplasty.
This present invention suggests using plastic compression molded rings made of polymethyl methacrylate, for fixation.
Fig. 1 shows the device for fixation of a sinking intraocular lens in the eye comprising a) an elongated casing (1 ), in which the ring push-out control/mechanism (1 a) is fitted; b) an extending from the casing (1 ) elongated flat tube (2) having, on the rounded tip, an opening (3), through which the ring (4) is pushed out; and c) a fixation ring (4), which is pushed out by piston (6) through the piston's opening (3) on the distal part of the tube of the mentioned device.
Fig. 2 shows the fixation ring (4) of the device for fixation of a sinking intraocular lens in the eye, which is an elastic plastic compression molded ring, preferably made of polymethyl methacrylate. The inner diameter of the fixation ring (4) is about 1 mm.
Fig. 3 shows the tube (2) extending from the casing of the device which length is about 2.5 cm and its diameter is about 2 mm, inside of which is piston (6) and the opening in the rounded tip
The device (1 ) for fixation of a sinking intraocular lens in the eye is intended to be used to affix a sinking intraocular lens (IOL) to the iris in cases of zonular insufficiency (phacodonesis) detected before or during a surgery or when UGH syndrome or IOL dislocation of first or second degree is diagnosed.
In one of the embodiments of the invention, a method of fixation of a sinking intraocular lens in the eye is described, in which a) through a small incision (up to 3 mm) in the peripheral cornea, the device (1 )of claim 1 - 4 is inserted into the eye and pushed towards the distal IOL haptics; b) the crescent-shaped end of the spatula-type instrument is raised so that the IOL haptic is prominent through the iris; and c) through the opening on the distal part of the device, by means of a piston (6), the fixation ring (4) is pushed out. It surrounds the IOL haptic through the iris and affixes it to the iris. The ring has a cut (5), its ends are deformable. The ring is kept close to the iris on the side of the anterior chamber. Being pressed from the posterior surface, the haptic is pushed into the ring together with the iris.
In embodiments described by specialists of the area, modifications can be created within the scope of this present invention as provided in the claims below.
BRIEF DESCRIPTION OF FIGURES
Fig. 1 - device for fixation of a sinking intraocular lens in the eye; Fig. 2 - the fixation ring;
Fig. 3 - the tube (2), extending from the casing of the device with piston.
DETAILED DESCRIPTION OF THE INVENTION
To illustrate and describe this invention, a description of the most suitable embodiments is provided above. It is not an exhaustive or limiting description aiming to determine an exact form or embodiment. The description provided above should be viewed as an example and should not be taken as a limitation. Naturally, numerous modifications and variations can be obvious to the specialists of the area. This particular embodiment has been chosen and described to empower the specialists of the area to explore the principles of implementation and the best ways to translate them into clinical practice in different embodiments with different modifications suitable for a particular use or application. It is intended that the scope of the invention is defined by the appended claims and their equivalents, in which all the mentioned terms have a meaning within wide limits, unless provided otherwise. Fixation of the lOL to the iris during the first surgery (phacoemulsification)
Phacoemulsification is performed in a traditional way, using the temporal incision. IOL is implanted endocapsularly into the capsular bag and rotated so that the haptics are on the horizontal meridian (along the cataract incision). Via paracentesis, a thin instrument with a crescent-shaped 2-mm-long end, attached perpendicularly to a rod, is inserted into an eye. Through the pupil, the instrument is inserted into the posterior chamber of the eye and placed under the proximal part of the IOL distal haptic (in the "axillar" area). Through the main cataract incision, the herein suggested device is inserted into the eye and pushed until it reaches the distal haptic of the IOL. Then the instrument's crescent-shaped end is raised so that the IOL haptic is prominent through the iris. The device (1 ) is pressed to the haptic and, through the opening (3) on the distal part of the device, an elastic ring (4) is pushed out. It surrounds the IOL haptic through the iris and affixes it to the iris.
Fixation of the IOL to the iris (second surgery)
With maximum pupil dilation, it is determined on which meridian the IOL haptics are. At 180 degrees from the planned IOL fixation place, an incision (up to 3 mm) is done in the limbal area and at 30 degrees from it, a 2 mm paracentesis is done. The anterior chamber of the eye is filled with a viscoelastic material (e. g. Healon). Via paracentesis, a thin instrument with a crescent-shaped 2-mm-long end attached perpendicularly to a rod is inserted into the eye. Through the pupil, the instrument is inserted into the posterior chamber of the eye and placed under the proximal part of the IOL distal haptic (in the "axillar" area). Through the 3 mm incision, the herein suggested instrument is inserted into the eye and pushed until it reaches the distal haptic of the IOL. Then the instrument's crescent-shaped end is raised so that the IOL haptic is prominent through the iris. The device (1 ) is pressed to the haptic and, through the opening (3) at the distal part of the device, an elastic ring (4) is pushed out. It surrounds the IOL haptic through the iris and affixes it to the iris.
The device described in this disclosure is intended to be used to affix a sinking intraocular lens (IOL) to the iris. This device is used in cases of zonular insufficiency (phacodonesis) detected before or during a surgery, having implanted an IOL in the capsular bag and affixing the IOL haptic(s) to the iris during the first surgery, also to affix a sinking lOL to the iris when UGH (uveitis-glaucoma-hyphema) syndrome or lOL dislocation of first or second degree is diagnosed.

Claims

1. A device for fixation of a sinking intraocular lens in the eye, where fixation element is pushed through an opening on the distal part of the instrument's tube, characterized in that the it comprises:
a) an elongated casing (1), in which the ring push-out control/mechanism (1a) is fitted; b) an extending from the casing (1 ) elongated flat tube (2) having, on the rounded tip, an opening (3), through which the ring (4) is pushed out;
c) a fixation ring (4), which is pushed out through the piston's opening (3) on the distal part of the tube of the mentioned device.
2. The device for fixation of a sinking intraocular lens in the eye of claim 1, characterized in that the fixation ring (4) is an elastic plastic compression molded ring, preferably made of polymethyl methacrylate, and has a cut (5).
3. The device for fixation of a sinking intraocular lens in the eye of claim 1 or 2, characterized in that the inner diameter of the fixation ring (4) is about 1 mm.
4. The device for fixation of a sinking intraocular lens in the eye of claim 1, characterized in that the length of the tube extending from the casting is about 2.5 cm and its diameter is about 2 mm.
5. The device for fixation of a sinking intraocular lens in the eye of any claim above, for use to fix a sinking intraocular lens (IOL) to the iris.
6. The device for fixation of a sinking intraocular lens in the eye of any claim above, for use to fix a sinking intraocular lens (IOL) to the iris in cases of zonular insufficiency (phacodonesis) detected before or during a surgery, when UGH syndrome or IOL dislocation of first or second degree is diagnosed.
7. A method for fixing a sinking intraocular lens in the eye, when device is inserted into an eye through a standard cataract surgery incision, characterized in that said method comprises: a) insertion of the device of claim 1 - 4 is inserted into the eye through a small incision (up to 3 mm) in the peripheral cornea, and pushed towards the distal lOL haptics;
b) raising of the crescent-shaped end of the spatula-type instrument (5) so that the lOL haptic is prominent through the iris;
c) pushing out of the device through the opening on the distal part, by the fixation ring (4) which surrounds the lOL haptic through the iris and fixes it to the iris.
EP18746301.3A 2017-07-20 2018-07-12 Method and device for fixation of a sinking intraocular lens in the eye field Pending EP3654879A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
LT2017519A LT6598B (en) 2017-07-20 2017-07-20 Method and device for fixing of sinking intraocular lens in the eye
PCT/IB2018/055141 WO2019016648A1 (en) 2017-07-20 2018-07-12 Method and device for fixation of a sinking intraocular lens in the eye field

Publications (1)

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EP3654879A1 true EP3654879A1 (en) 2020-05-27

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LT (1) LT6598B (en)
WO (1) WO2019016648A1 (en)

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WO2019016648A1 (en) 2019-01-24
LT2017519A (en) 2019-01-25

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