LT6598B - Method and device for fixing of sinking intraocular lens in the eye - Google Patents

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

The present invention relates to an intraocular lens (IOL) fixation device that can be inserted into the eye through a standard cataract surgery incision (up to 3mm). The lens locking eyelet is elastic and is discharged from the device through a side opening in the distal portion of the device tube.

TECHNICAL LEVEL DESCRIPTION

During cataract surgery, the intraocular lens (IOL) is implanted into a capsule pouch, which is held in the eye by a Knowledge Link. When the Knowledge Bands are weakened (eg due to trauma, Fuchs syndrome, etc.), the implanted IOL together with the capsule bag begins to tremble and may dip or fall into the vitreous. IOL tremor in the eye may be the cause of increased intraocular volume, micro-bleeding or uveitis (UGH syndrome). Immersion of IOL causes visual disturbances: reduced visual acuity, duplicity, dysphotopsis.

Cataract surgery is one of the most common operations in the treatment of eye diseases. During this process, the patient's lens is replaced with an artificial intraocular lens made of hydrogel or plastic material. Despite the success of the operation, complications can cause visual impairment. One of the complications is postoperative lens dislocation or immersion, which causes the IOL optics to deviate from the visual axis or to fall into the vitreous. Immersed IOLs can deviate significantly from the visual axis with only a small coverage of the visual axis.

The IOL needs to be stabilized to avoid the above complications. This is achieved by attaching or securing the IOL to the iris with a metal clip (clip).

Sewing using 10/0 prolene thread with a long needle is technically difficult, causing emotional stress to the surgeon. This procedure is quite complex, which can lead to complications such as biodegradation, iris fibrotic lesions or nodular erosion leading to iris atrophy, iris ischemia, and so on.

Metal clamping is only possible during corneal transplant surgery with direct access to the iris (open-air technique), and the clamp is pushed through the opening at the distal end of the tube. The device that secures the metal clip should not work in small cavities, eg. without traumatizing the sensitive surrounding tissue-corneal endothelium (device adapted for neurosurgery, not ophthalmology) in the anterior chamber of the eye.

Patent RU2408336 discloses the maintenance of a stable position of an intraocular lens during fixation by iridovitreal complication of extracapsular or intracapsular cataract. For this purpose, a suture 10-00 is used to tie the nodes around the optical cylinder, the first being a double unit, the second a single unit, and then securing the intraocular lens to a double suture.

US2016022488 describes a novel method and instrument for the repair of an IOL that has moved out of place after cataract surgery. The instrument is introduced through the eye wall near the drum until the tip of the instrument is near an object to be moved. A clamp or other fastener on the back of the instrument grips the IOL part e.g. support element. With the instrument, the IOL is reset to the desired position and can be attached with threads attached to the outer lining.

US2012316644 describes an IOL fixation device comprising a flexible, insertion clip that fixes a haptic portion of an IOL to a patient's iris. The method of fixing the IOL involves puncturing the patient's iris at at least two locations near one of the support members and inserting a flexible clip into the iris through the formed apertures until its distal ends are on the other side of the haptic. The clamp is then clamped so that the distal ends around the haptic element converge and embrace the iris and support member together.

A known method is described in US2008147083, which includes an implantable eye "paperclip" for fixation of an intraocular lens to the iris to permanently hold the lens in place without the use of sutures.

Jonathan H Tzu, BS; Neel R. Desai, MD; Esen K. Akpek, MD, "Usa of a Microvascular Clip for Iris Fixation of Intraocular Lens", ARCH OPHTHALMOLA / OL 128, No. 1, Jan 2010, pp. 114-116) describes a method of IOL lens fixation (experimentally) using neurovascular clamps and open-field artificial lens fixation.

Known techniques for correcting IOL dislocation in the eye require effort and are quite complex. Therefore, there was a need to discover a simpler way to fix IOL.

BRIEF DESCRIPTION OF THE INVENTION

It is an object of the present invention to provide a device for fixing a submerged intraocular lens to the iris.

The proposed IOL locking device differs from the cerebral vascular clamping device in that it can be inserted into the eye through a standard cataract surgery incision (up to 3mm) (no open skeleton technique required) and the locking ring is elastic and vented through the lateral opening in the distal device. part.

The device is introduced into the eye through a small incision (2-3 mm) in the periphery of the cornea and is therefore used during cataract surgery to detect a submerged lens. In the nearest analog, fixation is possible only after removal of the cornea, i.e. only during keratoplasty.

It is suggested to use plastic rings made of polymethyl methacrylate by means of compress melted carbon for fixing.

The immobilized intraocular lens fixation device comprises (a) an elongated body (1) having a ring ejector / mechanism; b) an elongated flat portion (2) projecting from the housing (1) having an opening (3) at its rounded end through which the ring (4) is disposed; and c) a locking ring (4) which is pushed with a piston through an opening (3) located in the distal portion of the tube of said device.

The retaining ring (4) of the eye fixation device of the submerged intraocular lens is an elastic plastic ring made by compression molding, preferably of polymethyl methacrylate. The locking ring (4) has an inside diameter of about 1 mm.

The tube exiting the device body is about 2.5 cm long and about 2 mm in diameter.

Immersed intraocular lens fixation device is intended to fix the immersed intraocular lens (IOL) to the iris in the presence of lens defects (phacodonesis), detected prior to or during surgery, in the diagnosis of UGH syndrome or IOL Grade I or II dislocation.

In one embodiment of the invention, there is described a method of fixating an immersed intraocular lens in the eye, wherein (a) a small incision (up to 3 mm) in the periphery of the cornea is introduced into the device according to any of claims 1-4 and pushed up to the IOL distal support haptics); b) raising the crescent-shaped end of the curved sling-like instrument (5) to promote the IOL support member through the iris; and c) a plunger is pushed through a hole in the back of the device by a plunger that surrounds the IOL support member through the iris and secures the latter to the iris. The ring is incised and its ends flex. The ring is held against the iris on the front side of the chamber. By pressing on the back surface, the support element is pushed into the ring with the iris.

Embodiments described by those skilled in the art can be made without departing from the scope of the present invention as defined in the following definition.

DETAILED DESCRIPTION OF THE INVENTION

In order to illustrate and describe the present invention, the following description of preferred embodiments is provided. It is not a detailed or restrictive description to determine the exact form or embodiment. The description above should be viewed as an illustration rather than a limitation. Obviously, many modifications and variations may be apparent to those skilled in the art. An embodiment is selected and described so that those skilled in the art will readily understand the principles of the invention and their best practical application for different embodiments with different modifications suitable for a particular application or application. The scope of the invention is intended to be defined by the appended definition and its equivalents, in which all the foregoing terms have the widest possible meaning, unless otherwise stated.

IOL fixation to the iris during the first (phacoemulsification) operation

Phacoemulsification is performed in a conventional manner using a temporal incision. The IOL is implanted endocapsularly and rotated so that the supporting members are in a horizontal meridian (coincident with the cataract incision). A thin instrument with a crescent-shaped tip 2 mm long perpendicular to the rod is introduced into the eye through paracentesis. The instrument is inserted through the pupil into the posterior chamber of the eye and placed under the proximal portion of the IOL distal abutment (in the "armpit" region). The proposed device is introduced into the eye through the main cataract incision and pushed up to the IOL distal abutment. The crescent-shaped end of the instrument is then raised to promote the IOL support element through the iris. A device is attached to the latter and a resilient ring is pushed through the opening at its rear, which wraps the IOL support member through the iris and secures the latter to the iris.

Immersed IOL fixation to the iris (second operation)

Maximizing the pupil determines which meridian contains the supporting elements of the IOL. An incision is made 180 degrees from the intended location of the IOL fixation (up to 3mm) and 30 degrees away from it with 2mm paracentesis. The anterior chamber of the eye is filled with viscoelastic material (eg Healon). During paracentesis, a thin instrument with a crescent-shaped tip 2mm long perpendicular to the rod is introduced into the eye. The instrument is inserted through the pupil into the posterior chamber of the eye and placed under the proximal portion of the IOL distal abutment (in the "armpit" region). The proposed device is introduced into the eye through a 3 mm incision and pushed up to the IOL distal support. The crescent-shaped end of the instrument is then raised to promote the IOL support element through the iris. A device is attached to the latter and a resilient ring is pushed through the opening at its rear, which wraps the IOL support member through the iris and secures the latter to the iris.

The device of the present invention is intended to fix a submerged intraocular lens (IOL) to the iris. This device is used to detect lens ligament weakness (phacodonesis) before or during surgery, implantation of an IOL into a capsule bag, and fixation of the IOL support member (s) to the iris during first surgery, as well as to fix the IOL to the iris after diagnosis of uveitis-glaucoma-hyphae syndrome or fix the IOL to the iris after diagnosis of IOL Grade I or II dislocation.

Claims (7)

DEFINITION OF INVENTION 1. A device for fixing a submerged intraocular lens in an eye, comprising: (a) an elongated body (1) having a ring ejector / mechanism; b) an elongated flat tube (2) protruding from the housing (1) having an opening (3) at its rounded end through which the ring (4) is disposed; c) a locking ring (4) which is pushed through a piston side opening (3) located in the distal portion of said device tube. A device for fixing an ocular submerged intraocular lens according to claim 1, characterized in that the locking ring (4) is an elastic plastic ring made by compression molding, preferably made of polymethyl methacrylate and having a cut. A submerged intraocular lens fixation device according to any one of claims 1 to 2, characterized in that the locking ring (4) has an internal diameter of about 1 mm. The submersible intraocular lens fixation device of claim 1, wherein the tube exiting the body is about 2.5 cm in length and about 2 mm in diameter. An immersion intraocular lens fixation device according to any one of the preceding claims for fixing an immersed intraocular lens (IOL) to the iris. The submersible intraocular lens fixation device according to any one of the preceding claims, for fixing the submerged intraocular lens (IOL) to the iris in the presence of lens defect (phacodonesis), detected prior to or after surgery, in the diagnosis of UGH syndrome or IOL Grade I or II dislocation. . 7. A method of fixing an ocular submerged intraocular lens, characterized in that: a) introducing a device into the eye through a small incision (up to 3 mm) in the periphery of the cornea according to any one of claims 1 to 4 and pushing it up to the IOL distal support member; b) raising the crescent end of the instrument (5) to promote the IOL support member through the iris; c) A retaining ring is pushed through the aperture on the back of the device which wraps the IOL support member through the iris and secures the latter to the iris.