FR2869793A1 - Main intraocular prosthetic lens for intraocular prosthetic lens implant system, has haptics comprising fixation units that permit to fix secondary intraocular prosthetic lens on main lens without degree of freedom - Google Patents

Abstract

The lens (1) has multiple haptics (11) allowing to fix the lens in an eye, where each haptic comprises of a fixation unit. The fixation unit permits to maintain fixed and without degree of freedom a secondary intraocular prosthetic lens on the lens (1). The haptics are constituted of two branches (112, 114) that are connected by a central branch (113). Each haptic has reinforcement zones (115) extended laterally by a support zone (110). An independent claim is also included for an intraocular prosthetic lens implant system comprising main and secondary intraocular prosthetic lenses.

Description

DOUBLE LENS INTRAOCULAR IMPLANT SYSTEM

  PERMITTING THE CORRECTION OF LOW AND HIGH ABERRATIONS

ORDERS IN PSEUDO PHAQUE

  The present invention relates to the field of implantation of intraocular lenses after partial extraction (extracapsular ablation) of an opaque crystalline lens (cataract) or clear.

  The present invention more particularly relates to an intraocular implant system comprising a main intraocular lens having an optics at the periphery of which haptics extend to fix the main intraocular lens in the eye, and a secondary intraocular lens having an optic at the periphery of which extend connection haptics for securing the secondary intraocular lens to the main intraocular lens.

  The correction of optical aberrations is currently one of the main research areas of ophthalmology.

  Classically defocus (myopia-hyperopia) and astigmatism aberrations are corrected by spectacle lenses, contact lenses, intraocular lenses and more recently by corneal refractive surgery.

  If the geometry of the defocus component (myopia-hyperopia) has a symmetry of revolution around the anteroposterior axis, it is not the same for the cylindrical component (astigmatism), its correction imposing the respect of the axis of the cylinder in the frontal plane, that is to say the absence of rotation of the lens relative to the anteroposterior axis. On the other hand, the position of the lens along the visual axis 2869793 2 anteroposterior (distance of the lens to the fovea) and its centering with respect to this same visual axis are also components of the effectiveness of the corrections. sphero-cylindrical defocus and astigmatism.

  For the past ten years, ophthalmology has been dealing with the measurement and correction of higher order aberrations. Apart from spherical aberrations (4th order and above), these aberrations impose a correction without rotation with respect to the anteroposterior axis.

  On the other hand they are all very sensitive to the respect of the distance lens-fovea and the centering of the corrective lens. The large dependence of a very precise position of the high-order aberration (AHO) corrective lens has restricted attempts to correct corneal surgery (Lasik and PRK). This corneal correction is under evaluation; it encounters the variation in the time of the AHO of the lens during accommodation and especially during aging. The correction of AHOs is more stable and durable applied to an aphaque eye (eye after removal of the lens).

  The correction of aphakia (absence of crystalline lens) is conventionally carried out by an intraocular lens (IOL) which aims only at the correction of the defocus and very recently of the spherical aberration of the same order (aberrations with symmetry of revolution). The IOL is introduced into the crystalline sac, the envelope emptied of its contents, the crystalline lens, by the operation of cataract. The placement of the lens is performed after removal of the lens in the same surgical procedure. The power of the IOL is determined approximately before surgery by using biometric data from the eye in calculation formulas. The use of an inappropriate IOL results in a residual refractive error postoperatively.

  The precise determination of the IOL suffers from several pitfalls: the imprecision of biometric measurements, the relative unpredictability of the exact location of the IOL in garlic, the impossibility to date to determine the AHO of the cornea (taking into account count the post face of this). The exact position of the IOL results from the fibrosis and retraction of the sac that secures the IOL; the relatively mobile IOL in the first few hours after the procedure can rotate around the anteroposterior axis making the correction of astigmatism and nonspherical AHOs risky and retraction of the sac can decenter the IOL and move it forward. Retraction of the bag is considered complete in the 3rd month postoperative.

  Given the inaccuracy of the IOL power calculations and the impossibility of predicting residual AHOs for lens removal, the correction is programmed in two surgical times separated by the duration of the stabilization of the main IOL. The main IOL is designed to accommodate the secondary IOL that, attached to the stable primary IOL, will not experience initial mobility and secondary displacement.

  The procedure therefore begins with a first intervention with removal of the lens by phacoemulsification and placement in the bag by a small incision of the main lens chosen according to power calculations. Three months later, after stabilization of the main lens in the sac, the residual refractive anomaly is determined by subjective study or by study of the wavefront, the position of the main IOL in the frontal plane (decentering) and on the anteroposterior axis is recorded. The secondary lens correcting the recorded optical aberrations (with excimer laser optics sculpture on the wavefront data if AHO correction is targeted) is performed by taking into account the position anomalies of the main lens. Finally, during the second intervention, the secondary IOL is inserted by the same incision as that of the main IOL and the secondary IOL is fixed on the main IOL.

  The prior art already knows such intraocular implant systems.

  International patent application WOO94 / 07435 discloses in particular an intraocular lens system, comprising: a solid, main intraocular lens formed of a biocompatible transparent material designed to be implanted in an eye in order to replace a crystalline lens; removed, - an additional, solid intraocular lens having a predetermined dioptric power, wherein the predetermined dioptric power produces a refractive correction and enhances the debugging ability of the implanted primary intraocular lens, - a means for selectively achieving a connection and disconnection between the supplemental intraocular lens and the main intraocular lens previously implanted in situ without removing the main intraocular lens to form a compound intraocular lens having refractive power different from that of the intraocular lens main.

  However, fixation of the secondary intraocular lens on the main intraocular lens described in WOO94 / 07435 is provided on connecting pieces inserted at the edges of the optics of the main lens. These irregularities of the edges of the optics are a recognized source of decentering of an IOL disposed in the crystalline sac; during the fibrosis and the retraction of this bag the edge of the opening of the bag can become trapped in these irregularities of the edges of the lens and cause a sometimes important shift of the main lens. Decentering is a cause of sometimes major optical aberration; the purpose of the implantation of a secondary lens being the correction of these aberrations their causes must be avoided and the irregularities of the edges of the main lens reduced.

  It is also proposed, in the patent application FR2796834, a multifocal intraocular lens implant intended to be fixed on a main implant previously implanted and forming main monofocal intraocular lens adapted to optically replace the lens. Said second implant is adapted to correct a possible residual ametropia resulting from the implanted first implant and to provide an additional correction allowing a clear vision of far and near according to the principle of multifocality. To do this, the haptic elements of the additional implant are adapted to cooperate with the haptic elements of the main implant. According to one embodiment of the invention, the haptic elements of the additional implant are open loops and adapted to intersect with the haptic elements of the main implant also in the form of open loops.

  The objective of the fixation of an additional implant on a main implant is to provide an additional correction to the main implant previously implanted so as to allow close-up vision and correct any residual ametropia resulting from the implant. main pre-implanted.

  However, the fixation of the secondary intraocular lens on the main intraocular lens described in FR2796834 has the major disadvantage that the implant can rotate around the anteroposterior axis. In addition, the absence at the haptic level of the main lens of a shape specifically dedicated to the reception of the haptics of the secondary lens compromises the optimal stability of this same secondary lens.

  The present invention intends to overcome the disadvantages of the prior art by proposing to reduce the risk of decentering related to irregularities of the edges of the optics of the main intraocular lens.

  The present invention also provides an intraocular implant system for which any movement of the second intraocular lens relative to the previously implanted primary intraocular lens is prevented.

  The aim of the present invention is ultimately to provide the aphakic eye with an optimal correction of low or high-order aberrations by implanting a secondary IOL whose position is predictable and stable fixation along all the axes of the eye.

  The present invention relates to a method of attaching the secondary lens to the main lens.

  To do this, the present invention relates, in its general acceptance, to an intraocular lens for the eye adapted to receive a second intraocular lens, comprising an optic at the periphery of which haptics extend to fix the intraocular lens in the eye. garlic, and it is remarkable, in its broadest sense, in that said intraocular lens comprises at least one haptic having attachment means for maintaining fixed and without degree of freedom the second intraocular lens on said first intraocular lens.

  Thus, the second intraocular lens is placed in front of the first intraocular lens in a predictable position.

  Preferably, said haptic of the intraocular lens constitutes a female socket adapted to a male plug member of said second intraocular lens so as to allow said second intraocular lens to snap onto said first intraocular lens.

  Advantageously, said haptic of the main intraocular lens has the shape of a closed loop, adapted to receive connection haptics of the second complementary shaped intraocular lens.

  Advantageously, said intraocular lens comprises four haptics distributed on the periphery of the optics and respectively having relative to each other an angular spacing of about 90 degrees.

  According to a particular embodiment of the invention, said intraocular lens further comprises at least one complementary receiving element located on the periphery of the optics and intended to be engaged with a connection haptic of the second intraocular lens.

  The present invention also relates to an intraocular implant system comprising a main intraocular lens having optics at the periphery of which haptics extend to fix the intraocular lens in garlic, and a secondary intraocular lens having an optic at the periphery of which connecting haptics extend for fixing the secondary lens to the main lens, characterized in that at least one haptic of the main lens is configured to receive the connection haptics of the secondary lens of in order to keep the secondary lens on the main lens fixed and without degree of freedom.

  Preferably, the connection haptics of the secondary lens are configured to plug into the fixing haptics (11) of the main lens.

  Advantageously, the haptics of the secondary lens consist of a head forming a plug connected to the optics by an arm.

  Advantageously, the arm is formed of a flexible bent zone.

  Advantageously, the haptics of said secondary lens have dimensions smaller than the incision formed at the periphery of the cornea.

  Advantageously, the haptics of said secondary lens have a width of the order of 3 millimeters.

  Advantageously, the haptics of the secondary lens are provided with an annular zone.

  Advantageously, said main lens comprises four haptics distributed over the periphery of the optics and respectively having relative to each other an angular spacing of about 90 degrees.

  Advantageously, said secondary lens comprises two connection haptics disposed at 180 from one another.

  According to a particular embodiment of the invention, the main intraocular lens further comprises at least one receiving element located on the periphery of the optics and intended to receive a connection haptic of the secondary lens, the other element of receiving being on the edge of the optics of the main lens (here the number of receiving element on the edge of the optics being reduced to one).

  The intraocular implant system previously described is intended for the correction of low and high order aberrations.

  The invention will be better understood from the description, given purely for explanatory purposes, of an embodiment of the invention, with reference to the appended figures: FIG. 1 illustrates a partial view from above of a main intraocular lens according to the invention; Figure 2 illustrates a sectional view of the haptic of the intraocular lens of Figure 1 along the axis AA1; Figure 3 illustrates a sectional view of the haptic of the intraocular lens of Figure 1 along the axis BB1; FIG. 4 illustrates a partial view from above of a secondary intraocular lens intended to be fixed on the intraocular lens of FIG. 1; FIG. 5 illustrates a sectional view of the connection haptic of the intraocular lens of FIG. the CCl axis; and FIG. 6 illustrates a sectional view of the connection haptic of the intraocular lens of FIG. 4 along the axis DD1.

  FIG. 1 illustrates a partial view from above of a main intraocular lens (1) according to the invention, hereinafter called LIO1.

  Said L101 comprises an optic (10) at the periphery of which haptics (11) extend for fixing said LIO1 in the eye. In order to simplify the figure, only one haptic (11) has been shown. However, in order to provide good support in the eye, said LIO1 will comprise at least two haptics (11).

  In a preferred embodiment of the invention, said LIO1 comprises four haptics (11).

  These haptics (11) are advantageously distributed over the periphery of the optics (10) so as to have, with respect to each other, an angular spacing of the order of 90 degrees.

  In the prediction of a subsequent insertion of a secondary intraocular lens on the LIO1, the haptics (11) are configured to have the shape of a loop whose ends are closed on the peripheral portion of the optic (10) of the IOL. More particularly, said haptics (11) consist of two branches (112, 114) interconnected by a central branch (113), the free ends of said legs (112, 114) being fixed on the periphery of the optics (10). ) of said LOI.

  Advantageously, said haptics (11) comprise at the intersection respectively of the branches (112, 114) with the central branch (113) a reinforcement zone (115).

  The reinforcement zone (15) is extended laterally by a bearing zone (110) (see FIGS. 1 and 3).

  Furthermore, the lower face (posterior face in anatomical language) of the central branch (113) of said haptics (11) comprises an opening (111) preferably arranged centrally, as illustrated in FIG.

  The haptics (11) of the LIO1 thus formed constitute means for receiving and maintaining fixed on the LIO1 a secondary intraocular lens provided with connection haptics complementary to the haptics of the LIO1.

  A secondary intraocular lens adapted to be disposed on the IOL is partially illustrated in Figures 4 to 6.

  The secondary intraocular lens (2), hereinafter called LIO2, has an optic (20) on the periphery of which connection haptics (21) extend for the attachment of the LIO2 on the LIO1. In order to simplify the figure, only one connection haptic (21) has been shown. However, in order to offer a good maintenance of the IOL2 on the IOL1, said IOL2 will comprise at least two haptics (11). It is, of course, obvious that the number of LIO2 connection haptics will be less than or equal to the number of LIO1 haptics.

  The haptic connection (21) of the LIO2 consists of an arm (210) having at one of these ends a plug head (211), the other end of said arm (210) being fixed on the periphery of the optics (20) of said LIO2.

  In a preferred embodiment, said LIO1 comprises four haptics (11) and said LIO2 two connection haptics (21), the stability of the LIO2 on the LIO1 being ensured by the width of the heads of the connection haptics (21). In addition, the insertion by the small corneal incision is facilitated by an arrangement of the two connection haptics (21) at 180 degrees.

  Figure 5 illustrates a sectional view of the plug forming head (211) along the axis CC1.

  Advantageously, said head (211) comprises two square portions, said portions defining a peripheral portion (212) and a central portion (213).

  Advantageously, the central portion (213) of said head (211) has lateral flanges (214) as illustrated in FIG. 6.

  Thus, when the LIO2 is positioned on the LIO1, and thus the connection haptics (21) of the LIO2 inserted into the haptics (11) of the LIO1, the peripheral portion (212) of the head (211) constituting the haptic connection (21) of the LIO2 is disposed in the opening (111) formed in the branch (113) of the haptic (11) of said LIO1, the edges (214) of the head (211) of the haptic connection (21) of said LIO2 resting on the support zone (110) of the haptic (11) of said LIOl.

  Said arm (210) advantageously has a bent zone (215) elastic. The arm (210) thus configured facilitates the installation of the LIO2 on the LIO1. In addition, when the IOL2 is placed on the IOL1 (in anatomical language in front of the IOL1), the haptics of connection (21) of the IOL2 being engaged on the haptics (11) of the IOL1, the arms (210) of the haptics of the connection (21) undergo a compressive stress resulting in head pressure on the haptics of the IOL1 balanced by the resistance of the latter. Thus the LIO2 is maintained in position in front of the LIO1 any risk of disengagement and movement (including rotation) being prevented. To disengage the LIO2 from the LIO1, it will then be necessary to exert a backpressure force on the head of at least one of the connection haptics (21).

  Advantageously, said arm (210) comprises an annular zone, or ring, (216) intended to receive an instrument for manipulating the connection haptic (21) of the LIO2 for its snapping into the corresponding haptic of the LIO1. It may be for example a hook-type instrument.

  Moreover, said arm (210) of the connection haptic (21) of the LIO2 is fixed at the periphery of the optic (20) and has an angle with the frontal plane of the optic (20) such that the The optics of the IOL2 (20) is disposed, after insertion, above the optics of the IOL1 (10) (in anatomical language in front of the optics of the IOL1) and without contact with it. Advantageously, the angle is between 0 and 20.

  The invention is described in the foregoing by way of example. It is understood that the skilled person is able to realize different variants of the invention without departing from the scope of the patent.

Claims (15)

  1. Intraocular lens (1) for the eye adapted to receive a second intraocular lens (2), comprising an optic (10) on the periphery of which haptics (11) extend to fix the intraocular lens (1) in the millet, characterized in that the intraocular lens (1) comprises at least one haptic (11) having fixing means for maintaining fixed and without degree of freedom of the second intraocular lens (2) on said first intraocular lens (1) - 2. Intraocular lens (1), characterized in that the haptic (11) constitutes a female socket adapted to a plug-forming element of said second intraocular lens (2) so as to allow said second intraocular lens (2) to snap into place. ) on said first intraocular lens (1).   3. Intraocular lens (1) according to claim 1 or claim 2, characterized in that said haptic (11) has the shape of a closed loop, adapted to receive haptics (21) connecting the second intraocular lens ( 2) of complementary shape.   4. Intraocular lens according to any one of claims 1 to 3, characterized in that it comprises four haptics (11) distributed on the periphery of the optics (10) and respectively having relative to each other an angular spacing about 90 degrees.   5. Intraocular lens according to any one of the preceding claims, characterized in that it further comprises at least one complementary receiving element situated on the periphery of the optic (10) and intended to be engaged with a haptic connection of the second intraocular lens (2).   An intraocular implant system comprising a main intraocular lens (1) having an optic (10) at the periphery of which haptics (11) extend for fixing the intraocular lens (1) in hair, and an intraocular lens. secondary cell (2) having an optic (20) on the periphery of which connection haptics (21) extend for fixing the secondary lens (2) to the main lens (1), characterized in that at least a haptic fixing (11) of the main lens (1) is configured to receive the connection haptics (21) of the secondary lens (2), so as to maintain fixed and without degree of freedom of said secondary lens (2) on said main lens (1).   Intraocular implant system according to claim 6, characterized in that the connection haptics (21) of the secondary lens (2) are configured to engage in the fixing haptics (11) of the main lens (1). ).   Intraocular implant system according to claim 6 or claim 7, characterized in that the connection haptics (21) of the secondary lens (2) consist of a plug head (211) connected to the optical (20) by an arm (210).   9. Intraocular implant system according to the preceding claim, characterized in that the arm (210) is formed of an elastic bent zone (215), said bent zone exerting on the haptic (11) of the main lens. (1), when the secondary lens (2) is positioned on the main lens (1), a pressure such that said secondary lens (2) is held in position on said main lens (1).   10. Intraocular implant system according to any one of claims 6 to 9, characterized in that the haptics (21) of said secondary lens (2) have dimensions smaller than the incision formed at the periphery of the cornea.   11. Intraocular implant system according to any one of claims 6 to 10, characterized in that the haptics (21) of said secondary lens (2) have a width of the order of 3 millimeters.   Intraocular implant system according to any one of claims 6 to 11, characterized in that the connection haptics (21) of the secondary lens (2) are provided with an annular zone (216).   13. Intraocular implant system according to any one of claims 6 to 12, characterized in that said main lens (1) comprises four haptics (11) distributed on the periphery of the optic (10) and having respectively the compared to the others an angular spacing of about 90 degrees.   14. Intraocular implant system according to any one of claims 6 to 13, characterized in that said secondary lens (2) comprises two connecting haptics {21) disposed at 180 from one another.   2869793 17 Intraocular implant system according to any one of claims 6 to 14, characterized in that the main intraocular lens (1) further comprises at least one receiving element located on the periphery of the optic (10) and intended to receive a connection haptic (21) of the secondary lens (2).