FR2843015A1 - IMPLANT FOR THE TREATMENT OF PRESBYTIA - Google Patents

Abstract

The present invention relates to an implant (1) for the treatment of presbyopia, of the type having means for indenting the ciliary body (2) of the eye (3), characterized in that it comprises at least one head circumferential (11) sub-scleral, intended to be positioned under the sclera (4), circumferentially and at least one intra-scleral fixing element (12), intended to be positioned in the thickness of the sclera (4).

Description

IMPLANT FOR THE TREATMENT OF PRESBYTIA

  The present invention relates to the field of the treatment of presbyopia and the restoration of accommodation of the eyes. The present invention relates more particularly to an implant for the treatment of presbyopia, of the type having means for inducing the

ciliary body of the eye.

  There are currently essentially two techniques for the restoration of accommodation, that is to say, the treatment of presbyopia: - anterior ciliary sclerotomy: this technique is based on making 4 scleral radiating incisions opposite the ciliary body. Implants are placed in the incisions so as to open outwards and prevent scarring; and - the circumferential segments: implants are placed inside the sclera, circumferentially around the cornea. Implants

  can be arranged more or less deeply.

  This latter technique has in particular been the subject of international patent applications N0 WO

  94/02084 WO 99/17684, and WO 00/21466.

  All the implants presented in the documents of the prior art are intended to be positioned in the sclera, which poses practical difficulties in placing

  work, so as not to damage the underlying ciliary body.

  However, it has been noted that the sclera and the ciliary body are separable and that it is possible to slide an element in the space between the sclera and the ciliary body called "supra-ciliary space" or

"sub-scleral space".

  The present invention thus intends to propose making use of this space in order to slide an implant therein having a head responsible for indenting the ciliary body. To ensure the stability of this implant, the present invention further proposes to associate this sub-scleral head with a fixing element intended to ensure

  maintenance and proper positioning of the scleral head.

  The present invention is of the type described above and it is remarkable, in its broadest sense, in that the implant comprises at least one circumferential sub-scleral head, intended to be positioned under the sclera, circumferentially and at least one element intra-scleral fixation, intended to be

  positioned in the thickness of the sclera.

  By indenting is meant to achieve a notch or hollow on the external surface of the ciliary body, which thus causes a repression or a bump of the face.

  internal to the lens of said ciliary body.

  To obtain the best indentation, it is advisable to have several implants in the eye to be treated, so that the circumferential heads substantially form a ring. A number of four

implant by eye seems ideal.

  Said intra-scleral fixation element is preferably composed of at least one radial body, positioned substantially perpendicular to the circumferential sub-scleral head and / or of a body

  circumferential, connected to the circumferential subcleral head by at least one radial bridge.

  Said radial bridge is preferably

  intended to be positioned under the sclera.

  Said circumferential head and said fixing element (s) are preferably curved by a radius of approximately 11 millimeters, in order to

  adapt to the curve of the sclera.

  Said fixing element (s)

  preferably has at least one suture hole.

  Said circumferential head, said at least one fixing element (s) and possibly said at least one radial bridge (s) are preferably made of material, but the implant may have characteristics

  different in different places.

  Said intrascleral attachment element (s) preferably has a thickness of approximately

0.6 millimeter.

  Said sub-scleral circumferential head preferably has a thickness Et of approximately 0.3 millimeter. The implant according to the invention presents,

  preferably an axis of radial symmetry.

  Advantageously, the present invention intends to propose a simple, effective and inexpensive means of producing an indentation of the ciliary body, in order to

allow to correct presbyopia.

  The invention will be better understood using the

  description, given below for purely explanatory purposes,

  of an embodiment of the invention, with reference to the appended figures: - Figure 1 illustrates a top view of an eye comprising four implants according to the first embodiment of the invention; - Figure 2 illustrates a partial sectional view along AA of Figure 1; - Figure 3 illustrates a side view of the first embodiment of the invention; - Figure 4 illustrates a top view of the first alternative embodiment of the invention; - Figure 5 illustrates a front view of the first alternative embodiment of the invention; FIG. 6 illustrates a top view of an eye comprising an implant according to the second variant embodiment of the invention; - Figure 7 illustrates a partial sectional view along BB of Figure 6; - Figure 8 illustrates a partial sectional view along CC of Figure 6; - Figure 9 illustrates a side view of the second alternative embodiment of the invention; - Figure 10 illustrates a top view of the second alternative embodiment of the invention; and - the figure it illustrates a front view

  of the second variant embodiment of the invention.

  The implant (1) according to the invention is an implant (1) for the treatment of presbyopia, of the type having means for indenting the ciliary body (2)

of the eye (3).

  This implant comprises at least one circumferential head (11) subclclement, intended to be positioned under the sclera (4), circumferentially and at least one fixing element (12) intrascleral, intended to be positioned inside the sclera (4 ), in

the thickness of the sclera (4).

  Thus, the circumferential head (11) subclcleal will cause a deformation of the ciliary body which will allow to correct the presbyopia and the element or the fixing elements (12) intra-scleral will or will allow to stabilize the implant in the eye and prevent movement with respect to the rest of the eye, as well

  centrifugal than lateral, after implantation.

  To perfect this blocking, said fixing element (s) (12) comprises (s) at least one suture hole (16, 16 ′) and at least one suture is made with the sclera at the level of the fixation (12) by passing a suture thread (17, 17 ') through each hole

suture (16, 16 ').

  FIGS. 1 and 2 illustrate a first alternative embodiment of the invention in which said intra-scleral fixing element (12) is composed of at least one radial body (13), positioned substantially perpendicular to a mean plane of the head

  circumferential (11) sub-scleral.

  Figures 6, 7 and 8 illustrate a second alternative embodiment of the invention in which said fixing element (12) intra-scleral is composed of a circumferential body (14), connected to the circumferential head (11) scleral by at least one

radial bridge (15, 15 ').

  This or these radial bridges (15) is or are intended to be positioned under the sclera (4) In the two variants, said circumferential head (11) and said fixing element (12) are curved according to a longitudinal curve radius Ril and along a transverse radius of curvature Rit of approximately 11 millimeters, in order to adapt to the curve of the sclera (4), as can be seen in FIGS. 3 and 5 for the first variant and 9 and 11 for the second variant. Also in the two variants, the implant (1) has a radial axis of symmetry (18), as illustrated in FIGS. 4 and 10. However, it can also be imagined that the radial body (13) for the first variant and the or the radial bridge (s) (15, 15 ′) for the second variant, are offset laterally and the implant (1) no longer has an axis of

radial symmetry.

  In both variants also, said circumferential head (11) is curved according to a radius of curvature proximal Rip, less than the radii of longitudinal curvature Ril and transverse Rit. The proximal radius of curvature Rip is approximately 7 millimeters. In the second variant, the fixing element (12) intra-scleral formed by the circumferential body (14) is also curved according to the radius

Rip proximal curvature.

  In both variants also, said intrascleral fastening element (12) has a thickness Ef of about 0.6 millimeter; which corresponds to a thickness less than the thickness of the sclera, which

  is generally about 0.8 millimeters.

  Also in the two variants, said circumferential head (11) has a thickness Et of approximately half the thickness Ef of the fixing element (12),

or about 0.3 millimeter.

  In both variants also, said circumferential head (11) has a width lt overall of approximately 6 millimeters and a length Lt overall

about 1.5 millimeters.

  In the first variant, the overall length Lc of the radial body (13) is approximately 2 millimeters and the radial body (13) and the circumferential head (11) are connected together over a connection length Lr of approximately 0, 5 millimeter. The radial body (13) has

  a width lc of about 0.6 millimeter.

  In the second variant, the overall length Lp of the radial bridge (15, 15 ') is approximately 2 millimeters and the radial bridge (15, 15') has an overall width lp of approximately 0.5 millimeters. The thickness Ep of the bridge (15,

  ') radial is about 0.3 millimeters.

  In this second variant, the overall length Ld of the circumferential body (14) is approximately 2 to 6 millimeters and the circumferential body (14) has an overall width ld of approximately 6 millimeters, substantially equal to the width lt excluding all from the head

circumferential (11).

  Said circumferential head (11), said fastening element (12) and possibly said one or more radial bridges (15, 15 ′) for the second variant are preferably made of material, that is to say that is, they make a single piece, made, for example, by molding plastic like PMMA. However, the implant may have different characteristics from

different places.

  As can be seen in Figures 1 and 6, for the implantation of the first alternative embodiment of the implant according to the invention, it is necessary to make a single radial incision (10) and for the implantation of the first variant embodiment of the implant according to the invention, it is necessary to operate

  a single circumferential incision (10 ').

  To make the incision (10, 10 ') and implant the implant (1) according to the invention, it is possible to use a cutting device such as that known from the international patent application filed under the number

PCT / FR01 / 0423404234.

  The invention is described in the foregoing by way of example. It is understood that the person skilled in the art is able to produce different variants of the invention

  without going beyond the scope of the patent.

Claims (10)

  1. Implant (1) for the treatment of presbyopia, of the type presenting means for indenting the ciliary body (2) of the eye (3), characterized in that it comprises at least one circumferential head (11) sub-scleral , intended to be located under the sclera (4), circumferentially and at least one fixing element (12) intra-scleral, intended to be positioned   in the thickness of the sclera (4).   2. Implant (1) according to claim 1, characterized in that said fixing element (12) intrascleral is composed of at least one radial body (13), positioned substantially perpendicularly   to the circumferential head (11) sub-scleral.   3. Implant (1) according to claim 1 or claim 2, characterized in that said fixing element (12) intrascleral is composed of a circumferential body (14), connected to the circumferential head (11) scleral by at least one radial bridge (15, 15 ').   4. Implant (1) according to claim 3, characterized in that said radial bridge (15) is intended to be positioned under the sclera (4) 5. Implant (1) according to any one of   claims 1 to 4, characterized in that said head   circumferential (11) and said fixing element (12) are curved by a radius of approximately 11 millimeters,   in order to adapt to the curve of the ciliary body (2).   6. Implant (1) according to any one of   claims 1 to 5, characterized in that said or   said fixing element (s) (12) comprises (s) at least a suture hole (16, 16 ').   7. Implant (1) according to any one of   claims 1 to 6, characterized in that said head   circumferential (11), said at least one fixing element (s) (12) and possibly said at least one   radial bridge (s) (15, 15 ') came from the material.   8. Implant (1) according to any one of   claims 1 to 7, characterized in that said or   said intra-scleral fixation element (s) (12)   has a thickness of about 0.6 millimeter.   9. Implant (1) according to any one of   claims 1 to 8, characterized in that said head   circumferential (11) sub-scleral presents a   thickness And about 0.3 millimeter.   10. Implant (1) according to any one of   claims 1 to 9, characterized in that it has a radial axis of symmetry (18).