GR1009102B - Intraocular insert for the fixation of intraocular lenses - Google Patents

Abstract

The here disclosed intraocular insert which is meant for the fixation of intraocular lenses is composed of the elastic crown A, the mesh B and 2 or 3 strips C retaining the intraocular insert at the eye’s sclera. The invented intraocular insert is adequately designed to be kept in compressed form into a pen-like insert G until being utilized; during surgical intervention, it acquires its final position through a trans-scleral plug E placed on the pars plana region of the sclera through an incision the diameter of which does not exceed the 0,9mm; it is fixed at its final position by 2-3 strips C fixed via intra-scleral plugs D covered by sclera flap. After being set in place, the surgeon may introduce the preferred intraocular lens inside the intraocular insert and, more precisely, in the elastic crown A having the mesh B, following exactly the same technique, corneo-scleral incision and facility with which an intraocular lens is habitually inserted during every non-complicated phacoemulsification intervention in the natural capsule (elastic chamber) of the crystalline lens.

Description

Intrabulbar insert for supporting intraocular lenses

The invention refers to an intrabulbar insert that aims to replace the existing peripheresis of the crystalline lens in the event that it is breached or damaged during the operation of extraperipheral removal of the cataractous crystalline lens. The present insert consists of an elastic rim approximately 9.5 mm in diameter (figure 1, A) surrounded by a net (figure 1, B) so that the insert has the form and utility of the peripheries of the crystalline lens, when the cataract of the eye has been surgically removed. The rim has integrated 2 to 3 retention bands (figure 1, C) which aim to hold the insert-artificial periphery- in its correct anatomical position on the sclera of the eye through specially implanted interscleral plugs (figure 1, D).

When performing the phacoemulsification operation, the most common operation in the history of medicine, the surgeon tries to remove the cataractous crystalline lens without violating the "periphery" because the periphery is the best way to support and focus the phaeolens to be used in the operation (and anatomical) position of the crystalline lens. This has been done easily and non-traumatically and with minimal intra-operative manipulations for at least 50 years. The periscope takes on the role of supporting the intraocular lens in its correct anatomical position since, just as it preoperatively supported the crystalline lens of the eye, postoperatively it also supports the intraocular lens. However, in the case of complicated phacoemulsification or traumatic displacement of the intraocular lens preoperatively or intraoperatively, the surgeon must resort to other intraocular support solutions when the periscope cannot be used. For this reason, all organized surgeries also have special support lenses on hand, such as intraocular lenses designed to be placed in the anterior chamber, intraocular lenses for sulcus support, or specially designed intraocular lenses that allow them to be implanted in the iris without sutures, or interscleral intraocular lenses. Because the intraocular lenses used certainly have different dioptric power depending on the eye, the number of alternative lenses that must be in storage in the operating room and which are rarely used, is usually more than 100. These lenses usually lag significantly in some optical characteristics (e.g. asphericity) and for the most part it is practically never possible for them to have, e.g. the ability to correct astigmatism, multifocality, etc. The present invention refers to the situations where, for various reasons, the peripheries cannot be used to support the intraocular lens, such as of intraoperative rupture vol.

The advantages of the present invention are summarized, without limitation, below:

1/  The present intrabulbar insert has the utility of the classic rim. It therefore allows the placement of any intraocular lens for use in the pericapsule in cases of pre-operative, intra-operative or post-operative rupture/displacement of the pericapsular lens of the eye. In other words, in any case of violation of the peripherium, they allow the use of the intraocular lens that has been selected before the operation by the surgeon and which can usually only be used if the peripherium remains intact after the successful completion of phacoemulsification.

2/ this insert can be inserted into the eye through a small incision of 20G (0.9mm) and indeed from the pars plana area in the sclera which has never been attempted in the past for any intraocular lens or part thereof and this fact is a particular innovation of specific intrabulbar intraocular lens support insert.

3/ the specific insert has the important innovation of being able to be placed in its final position with minimal intra-bulbar manipulations since the adjustment of the focus of the insert is designed to be done with (easier) manipulations outside the eye.

4/  the intrabulbar insert for supporting intraocular lenses is held in place without suturing in the sclera by means of special plugs which are easily placed in an extrabulbar position in places very easily accessible by the surgeon.

5/ our insert allows the use of any intraocular lens, including intraocular lenses that allow the correction of astigmatism (toric intraocular lenses) and the correction of presbyopia (multifocal intraocular lenses) in cases of complicated phacoemulsification where there is no periscope.

6/ the insert is inserted through a small incision in the sclera. The intraocular lens is also inserted through a small sclerokeratal incision, which is often impossible when intraocular lenses are used, such as iris support lenses. The effect of microscopic incisions is almost negligible in introducing postoperative astigmatism to the eye and reduces the disastrous complications of an intraoperative hemorrhage.

7/  The present intraocular insert is designed to be packed into a pen-type insert (figure 2) and with minimal movements it can be placed in its final position as described below. Figure 1 shows diagrammatically the plan view of the final position of the insert in the eye.

During the operation the surgeon places 2 to 3 T-shaped plugs (figure 3, D and E) under small scleral flaps transscleral of the eye in a manner similar to that of conventional vitrectomy. In detail, the surgeon removes the conjunctiva at two antidiametric points of the ocular surface centered on the cornea. e.g. At 3 and 9 o'clock, one to three thousandths from the sclerocorneal border. Then the surgeon creates small scleral flaps (flap) similar to those of the glaucoma trabeculectomy operation at these points. With the microsurgical lancet (0.9 mm) the surgeon makes antidiametrical incisions in the sclera 2.5 mm from the sclerocorneal border. T-shaped plugs are placed in these sections (figure 3, D and E). Through one plug, the surgeon first inserts the retaining band (figure 1.2 C) as a guide, which is extracted from the eye with another microsurgical tool through the antidiametric plug. Then the compressed insert inside the pen inserter (fig. 2, G) is inserted in turn into the inside of the bulb applying pressure f unfolds to its uncompressed circular shape if necessary it is possible to hold the insert to present a greater focus insert tightening or loosening Then the surgeon cuts the extra parts covered with scleral flaps that have a conventional way, i.e. from a separate incision the guide tape that has now been externalized, and measuring 9-10 mm intrabulbar, unfolds to its final position inside the insert (figure 1.2 A). In

and a third incision so that through one more tape the stability. Then the surgeon can

of the 2-3 retaining bands (figure 1, 2 C).

n retaining tapes and caps

be prepared initially. Then completely

sclerocorneal border the selected intraocular lens a.

Claims (5)

Claims 1.  The intraocular lens support insert consists of a rim (A) and net (B) with two or three retaining bands (C ) assembled on the sclera of the eye through two or three specially shaped plugs (D). 2. The intraocular lens support insert as described in claim 1 is compressible and stored in a pen insert (G) with a removable cap (H) and is designed so that insertion into the eye is possible through the sclera from the pars plana area of the eye through a small incision up to 0.9mm. 3.  The intrabulbar intraocular lens support insert as defined in claim 1 is supported by two or three retention bands (C) which alternatively of intrascleral plugs can support the insert by burying them in the sclera of the eye. 4. The plugs (D) as intrascleral retention parts of the insert, as described in claim 1 allow the interscleral retention and easy centering of the insert even if it is not visible under the iris from the special marking of the retention strips (C) so that to know the specific distance of each point on the retention strips (C) that is outside the eye from the edge of the rim (A) 5. The intrabulbar support insert. as described in claim 1, having an elastic rim (A) with mesh or transparent material without discontinuities (B) for supporting the intraocular lens which is complete or discontinuous in the center of the rim. In case the transparent net is continuous and covers the entire surface inside the rim, it is made of a material that can be pierced with a conventional YAG capulotomy laser.