NL2009934C2

NL2009934C2 - Iol injector and iol holder.

Info

Publication number: NL2009934C2
Application number: NL2009934A
Authority: NL
Inventors: Bernardus Franciscus Maria Wanders; Jeroen Nicolaas Peereboom
Original assignee: Oculentis B V
Priority date: 2012-12-05
Filing date: 2012-12-05
Publication date: 2014-06-10

Description

IOL injector and IOL holder FIELD OF THE INVENTION

The invention relates to an intra-ocular lens (IOL) injector system, comprising an 5 IOL injector with an injection channel. The invention further relates to an IOL holder for holding the IOL and for insertion into an IOL injector.

BACKGROUND OF THE INVENTION

Insertion of an IOL has seen many developments in the recent years. The IOL has 10 become a very flexible lens which can be folded and unfolded easily. In fact, the current IOL can be rolled into a relatively small tube. This allows easy insertion in an eye for replacing the natural lens, and even for providing an additional, artificial lens for correction the natural lens.

For these types of foldable IOL’s, very many IOL injector systems have been 15 developed and are known in the art, such as, for instance, WO 2012/015300 Al. In

some of the older systems, IOLs were provided packed in a sterile liquid in a container. The surgeon had to take the IOL out of the container, for instance, using a pair of tweezers, place it into a cassette, and insert the cassette into an injector for finally injecting it into the eye via a small incision. In many of these systems, an IOL is placed 20 into the cassette in an unfolded state. The cassette is provided into the injector. A

plunger subsequently urges the IOL out of the cassette into an injection channel where the IOL folds due to specially-shaped walls in the injection channel. The injection channel then ends in a nozzle with an outlet with a (generally circular) cross-section. Via this outlet with a relatively small cross-section, the lens in a folded state enters the 25 human eye where it finally unfolds. The last part of the injection channel will have a tapered configuration.

The IOL injectors comprise a plunger for moving the IOL towards and out of the outlet through the injection channel of the injector. A cushion like element is provided in between plunger and IOL to ensure that a forward moving contact is made with the 30 IOL. The cushion element essentially fills the transverse cross-section of the injection channel to prevent the IOL coming in between cushion element and a wall of the injection channel. The cushion element further provides an even pushing forces onto the IOL to prevent damaging. The cushion element will also enter into the tapered part 2 of the injection channel when the IOL is pushed towards the outlet. When entering the tapered part of the injection channel the cushion element will become compressed, which requires a surgeon handling the injector to exert a force on the plunger. To eject the intra-ocular lens. Known cushion elements require quite some force for 5 compressing and urging through the tapered part of the channel and nozzle. To allow delicate handling of the injector by the surgeon, especially for small incisions, such force is preferably limited, which is not achieved by known injectors.

Further, it quite often occurs that the cushion element tips over to one side in the tapered part of the injection channel, which then generally results in the cushion 10 element and the IOL getting stuck inside the injection channel and/or the IOL not being folded in the correct fashion. The injector and IOL generally have to be thrown away when this happens for various reasons: The injector can or may not be opened to bring it back into a non-obstructed state; The IOL can be damaged; etcetera.

IOL injector systems are known which comprise a container holding IOL holder 15 with the IOL positioned inside the holder in a sterile environment. The IOL holder can be taken out of the sterile container and placed into an injector.

It quite often occurs that the IOL has come to stick to a supporting wall of a recess of the IOL holder, in which the IOL is being held. This may especially occur for IOL having a relatively low optical strength. Such lenses are rather flat, and generally 20 rather thin and thus quite flexible. The flat lens sides will then easily get stuck to a supporting wall. Such state may be difficult to reverse when it is observed before use. The IOL can become damaged when one is trying to remove it from the wall of the IOL holder. In case the IOL holder is provided into the IOL injector for use, the cushion element can come in between IOL and opposing wall, and the system can become 25 stuck.

SUMMARY OF THE INVENTION

It is an object of the invention to provide an IOL injector that requires a restricted force to be exerted on the plunger for ejecting the intra-ocular lens.

30 It is another object of the invention to provide an IOL injector in which tipping over of a cushion element to one side or uneven compression of the cushion element is prevented to such extent that it will not endanger ejecting an IOL out of the IOL injector.

3

At least one of these objects is achieved by an IOL injector constructed for injecting an intra-ocular lens into the human eye, the IOL injector comprising an injection channel constructed and arranged for holding and guiding the intra-ocular lens; an injection nozzle with an injector outlet opening for providing the intra-ocular 5 lens into the human eye, and being constructed and arranged for compressing and/or folding the intra-ocular lens when the intra-ocular lens is moved downstream the injector channel towards the injector outlet opening; a plunger movable downstream within the injection channel, and being constructed and arranged to move the intraocular lens downstream the injection channel for ejection from the injector outlet 10 opening into the human eye; and a deformable cushion element arranged downstream of the plunger such as to be positioned in between the intra-ocular lens and the plunger when moving the intra-ocular lens by the plunger downstream the injection channel and through the injector outlet opening into the human eye, wherein a downstream side face of the cushion element which faces downstream towards the injection nozzle and which 15 is arranged for contacting the intra-ocular lens is provided with a recess arranged at a central position of the downstream side face. The recess provides for less material that needs to be compressed and thus less force to be exerted on the plunger to urge the intra-ocular lens out of the IOL injector, while it is still guaranteed that the cushion element will push against the intra-ocular lens. Since a force for bending the cushion 20 element inward at the downstream face will be smaller than a force for outward bending, the cushion element will experience a symmetrical compression and no tipping over to one side.

In a preferred embodiment a transverse cross-section of the cushion element matches a transverse cross-section of the injection channel over a matching length of 25 the cushion element along the injection channel, which provides that the cushion element effectively lies against the wall of the injection channel to ensure that the intraocular lens does not come in between cushion element and lens.

In an advantageous embodiment a depth of the recess is substantially equal to the matching length, which provides for a volume of material taken away in the center over 30 substantially the whole length of the cushion element that lies against the wall of the injection channel, and which will be compressed when entering the tapered part of the injection channel. The compression force will thus be restricted over the whole matching length of the cushion element.

4

In effective embodiments the matching length is between 0.5 and 5 mm, especially between 1 and 3 mm, more especially between 1 and 2 mm, which provide ranges for the matching length that have proven to be effective.

In an advantageous embodiment a width of the cushion element is larger than a 5 height of the cushion element, a recess height of the recess being between 25% and 100% of the height of the cushion element, especially between 50% and 100%, more especially between 75% and 100%. Such a cushion element will be optimal for an injection channel having a smaller height than width The width of the injection channel will be chosen in accordance with the width of the intra-ocular lens, and the 10 height in accordance with the height of the intra-ocular lens, which is much smaller than its width. Over the height of the cushion element the recess can be quite extended, even over the full height, while still ensuring good pushing contact with the intra-ocular lens. The higher the recess, the larger the recess and the less force required for compressing the cushion element and advancing the plunger for ejecting the intra-15 ocular lens.

In another advantageous embodiment a recess width of the recess is between 10% and 75% of a width of the cushion element, especially between 15% and 60%, more especially between 15% and 40%. To provide a good contact with the intra-ocular lens and a low compression force required a balance is to be found between the width of the 20 recess and the amount of material of the cushion element over its transverse cross-section, which has proven to be the case for the ranges given.

In a preferred embodiment an effective length of the cushion element as measured in between its downstream side face and an end face of the plunger when, during use, in contact with the cushion element is larger than the matching length of the 25 cushion element, a transverse cross-section of the cushion element in a range outside of matching length being smaller than the transverse cross-section of the injection channel. The cushion element has proven to be most effective when tits effective length is larger than its matching length over which its transverse cross-section matches that of the injection channel. The matching length should be short while still providing enough 30 stability of the cushion element within the injection channel. A larger effective length has proven advantageous for a good compression and advancement of the cushion element through the tapered part of the injection channel.

It has shown to be most effective when the effective length of the cushion 5 element is between 2 and 10 times the matching length of the cushion element, especially between 2 and 6 times, more especially between 3 and 5 times, depending on actual dimensions and circumstances.

Most preferably a range of the cushion element corresponding to the matching 5 length is at a downstream side face end of the cushion element, which has proven to be most effective.

Advantageously, an edge area of the downstream side face of the cushion element comprises a substantially rounded, tapered or beveled configuration, which prevents edges from folding over.

10 Preferable, the cushion element is attached to the plunger, provides stability for the positioning of the cushion element within the injection channel and an effective transfer of pushing force onto the cushion element.

In an advantageous embodiment an end of the cushion element facing the plunger comprises a cavity for receiving a matching end of the plunger, which provides for an 15 easy and effective attachment.

In yet a further advantageous embodiment the cavity has a first part and a second part, the first part having a larger cross-section than the second part, the first part being located more towards the downstream side face than the second part, and the first and second parts matching corresponding parts of the matching end of the plunger, which 20 further secures the cushion element to the plunger when positioned in place.

In preferred embodiments the cushion element comprises a compressible material and/or a resilient material.

It is another object of the invention to provide an IOL holder that prevents sticking of an IOL to a supporting wall of a cavity of the holder.

25 At least such object is achieved by an IOL holder constructed for holding an intra-ocular lens and for insertion into an IOL injector, the IOL holder comprising a cavity constructed for holding the intra-ocular lens, the cavity comprising a wall for supporting a lens side of the intra-ocular lens, wherein the wall comprises protrusions constructed and arranged for supporting the lens side of the intra-ocular lens, since the 30 protrusion will prevent a large continuous contact between intra-ocular lens and a wall of the cavity.

In advantageous embodiments the protrusion are formed as one or more of ribs, pimples, squares, rectangles, circles, and ovals.

6

In preferred embodiments a width of the protrusions is in the range of 0.05 to 5 mm, especially in the range of 0.1 to 3 mm, which width ranges have proven to be effective.

In further preferred embodiments a height of the protrusions is in the range of 5 0.05 to 1 mm, especially in the range of 0.1 to 0.8 mm, which height ranges have proven to be effective.

To prevent damaging of the intra-ocular lens the protrusions comprise rounded edges of surfaces for contacting the intra-ocular lens.

In a practically effective embodiment the cavity is configured as a channel 10 comprising opposing walls for supporting lens sides of the intra-ocular lens, the walls being provided with protrusions constructed and arranged for supporting the lens sides of the intra-ocular lens.

In yet a further effective embodiment the channel comprises openings at opposing ends of the channel, and the protrusions are configured as ribs extending in a 15 direction between the openings. Such ribs show not to obstruct the intra-ocular lens when the IOL holder with lens is inserted in an injector, and the lens is subsequently ejected from the injector, while preventing sticking of the lens within the cavity.

BRIEF DESCRIPTION OF THE DRAWINGS

20 The invention will be further explained by reference to the accompanying drawings, in which same or like reference symbol denote same, like or related parts, and in which

Figure 1 shows a perspective view of an IOL injector with IOL holder in place and ready to inject an IOL into a human eye; 25 Figure 2 shows a perspective, exploded view of figure 1;

Figure 3 shows a detailed view of a part of figure 2, showing the IOL holder in detail;

Figure 3a shows an enlarged perspective view on the channel of the IOL holder of figure 3;

30 Figure 3b shows an enlarged perspective view on the channel of another IOL

holder according to the invention;

Figure 4 shows a top view of figure 1;

Figure 5 shows a longitudinal cross-section as indicated in figure 4; 7

Figure 5 a shows a detail of figure 5 in a partially cut-away view;

Figures 6a shows a perspective view of the cushion element of figures 5 and 5a;

Figures 6b shows a top view of the cushion element of figures 5 and 5a, and a top view of an end part of the plunger; 5 Figures 6c shows a side view of the cushion element of figures 5 and 5a;

Figure 7 shows the perspective view of figure 1 with one halve of the IOL injector removed; and

Figures 8a, 8b and 8c show various situations of a cushion element pushed towards the injection nozzle.

10

DETAILED DESCRIPTION OF EMBODIMENTS

Figure 1 shows a perspective view of an IOL injector 2 with an IOL holder 3 in place and ready to inject an IOL into an eye. The IOL injector 2 is provided with an end part 8. It has a push rod 5 for operating the IOL injector 2, and has an injector body 6 15 provided with handles 7 for holding the injector 2.

Figure 2 shows the IOL injector of figure 1 in exploded view. In figure 2, the construction of the IOL injector is more clearly visible. The end part 8 is provided with an injection nozzle 9 and can be snapped into receiving opening 10 of the injector body 6. The receiving end 10 is provided with guiding means and snap in provisions which 20 cooperate with similar provisions on the end part 8. In this drawing, also the IOL holder 3 is more clearly visible. It can be snapped into the injector body 6 in holder receiving space 11, in the direction indicted by the arrow. Furthermore, an IOL 4 is depicted next to the IOL holder 3. The push shaft 5 is provided with a plunger 23 which is shaped to be movable up and down the injector body 6 through channel 16, and to advanced IOL 25 4 out of the IOL holder 3 down the end part 8 and finally downstream through nozzle 9.

Figure 3 shows the downstream end of injector body 6 as well as the IOL holder 3 in more detail. The holder receiving space 11 is shaped to receive the IOL holder 3. It is shaped to provide side walls and a bottom wall, and opposite rims 12 which snap around the tube body 14 of the IOL holder 3 which is to be snapped into the holder 30 receiving space 11. Tube body 14 tightly fits into holder receiving space 11.

Tube body 14 is further provided with a notch 24 which remains open when the IOL holder 3 is snapped into receiving space 11. It thus provides an acces, here about 1 mm square, to the channel 16a in IOL holder 3. Thus, before injecting the IOL 4 a 8 lubricating liquid, for instance a visco-elastic liquid known to the person skilled in the art, can be added to facilitate transport and injection of the IOL 4. When the IOL holder 3 is snapped into place, the channel 16a of the IOL holder forms part of the channel 16 through the IOL injector 2.

5 The holder receiving space 11 is further provided with slots 13 which cooperate with cams 19 on the IOL holder 3 for correctly inserting the IOL holder 3 into holder receiving space 11. Downstream of the slots 13, further cuts are provided to make the end walls of the holder receiving space 11 function as snap lips, for snapping around a tube body 14 forming a channel part.

10 IOL holder 3 has a tube body 14 which has a downstream opening 15 and an

upstream opening 17. A straight channel 16a runs through tube part 14. A finger grip 20 is provided and extends in transverse direction of the channel 16a to allow proper handling of the IOL holder 3. The IOL 4 is again indicated and an arrow shows how it is to be placed into the channel 16a. The tube part 14 is further provided with small 15 opposite slots or notches 18 which allow the IOL 4, when positioned in the IOL

holder 3, in particular in the channel 16a of the IOL holder 3, to be taken out of the IOL

holder and/or to be manipulated via a set of pincers if needed.

The very simple construction of the IOL holder 3 as well as the very simple snap in way of snapping it into position in the injector 2 provides a very simple IOL injector 20 assembly for injecting an IOL 4 into an eye. The very simple straight open channel 16a which has no further folding provisions or provisions for retaining an IOL, makes the IOL holder 3 very simple to produce. Furthermore, the IOL 4 remains perfectly seated in the channel 16a and no stress is exerted on IOL 4 when seated in channel 16a. In this embodiment the IOL holder is produced as one injection molded part. It may be 25 possible, in an embodiment, to provide two symmetric or asymmetric parts which can hinge together to form the IOL holder 3, or as two separate parts that can be snapped together.

The walls 16b of the channel 16a in the IOL holder 3, which support the intraocular lens (IOL) 4, are provided with protrusions 16b taking the form of ribs extending 30 in between openings 15, 17 of channel 16a in the embodiment shown, especially in figure 3 a. Alternatively, the protrusion may take the form of pimples, squares, rectangles, circles, ovals and the like, as is shown in figure 3b. A width W16c of the protrusions is in the range of 0.05 to 5 mm, in an embodiment in the range of 0.1 to 9 3 mm. A height H16c of the protrusions is in the range of 0.05 to 1 mm, in an embodiment in the range of 0.1 to 0.8 mm. The protrusions support lens sides of the IOL 4 and comprise rounded edges of surfaces for contacting the intra-ocular lens. The protrusions 16c prevent sticking of the IOL to the channel wall 16b. Especially IOLs 5 with relatively low optical strength, which mostly are quite thin, show a risk of sticking to a wall 16b of the IOL holder channel 16a, and remain stuck in the IOL holder 3 when the IOL is to be injected into the eye. This is prevented by having the protrusions 16c. The channel 16a provides for a cavity in the IOL holder.

In figure 4, a top view of the IOL injector 2 with IOL holder 3 of the previous 10 drawings is shown. Figure 5 shows a cross-section in longitudinal direction as indicated in figure 4. In the cross-section, it is shown how the IOL holder 4 is seated in the holder receiving space 11 and how the straight channel 16 forms a continuous channel with channel 21 in the end part 8. The channel part 21 in end part 8 runs tapered and has provisions for folding or rolling the IOL when advanced through the channel via push 15 rod 23 and folding or rolling it into a very small folded tube or roll, allowing it to pass the substantial circular or oval cross sectional area of nozzle 9. It is to be noted that the scale of this drawing is almost 1:1.

In the injector body 6, a soft cushion element 22 of soft elastomeric material is provided between the plunger 23 and the receiving space 11. For optimal properties the 20 soft cushion element 22 is made from a closed cell polythene foam, thermoplastic elastomer (TPE) or silicone rubber and preferable, as is shown in figure 5a in the encircled part, connected to the plunger tip 23 to avoid dislocation between the plunger 23 and cushion element 22. In an embodiment, the strength of the foam cushion element 22 to compression at 10% lies between about 15 and 50 kPa, and preferably 25 equal to about 35 kPa, when measured according to the standard ISO 844. It can have a compression ratio of about 50%. According to the same ISO standard, the strength of the foam lies between about 80 and 150 kPa, and preferably equal with about 130 kPa.

The longitudinal elongation of the cushion element 22, according to the standard ISO 1926, is between about 40 and 275%, and preferably about 200%. The longitudinal 30 tensile strength is about 600-800 kPa and preferably about 700 kPa, when measured according to the standard ISO 1926. In an embodiment, the hardness of the thermoplastic elastomer (TPE) or silicone cushion element is between about 5 and 40 Shore A. Test method ASTM D2240 (4mm) Shore A or D.

10

Figure 6a, 6b and 6c show the cushion element 22 having a first range 22a with a transverse cross-section that matches a transverse cross-section of the injection channel. This part of the cushion element fits into the channel and its cross-section may even be slightly smaller than the cross-section of the channel such that the cushion element 5 exerts minimal pressure on the walls of the channel 16. The sides of the cushion element in the first range 22a are essentially in contact with the walls of the channel over a matching length ML. The transverse cross-section of the cushion element matches the transverse cross-section of the injection channel in the first range 22a. The matching length is between 0.5 and 5 mm, in an embodiment between 1 and 3 mm, in 10 another embodiment between 1 and 2 mm. Having the matching length in these ranges provides for a stable sliding of the cushion element in channel 16 and not having to exert a large pressure on the cushion element for compression and to advance for ejecting the IOL 4.

The cushion element has a recess 22c in its downstream side face 22d that faces 15 downstream towards the injection nozzle. The downstream side face contacts the IOL when it is being ejected out of the injector. The recess 22c is arranged at a central position of the downstream side face and has a width W22c as shown in figure 6b. Central is to be understood as about in the middle of the downstream side face or that a longitudinal axis of the injection channel and/or the cushion element passes through the 20 recess. The width W22c of the recess 22c is between 10% and 75% of the width W22 of the cushion element, in an embodiment between 15% and 60%, in another embodiment between 15% and 40%. In the embodiment shown in figures 6a, 6b and 6c the recess width W22c is 1.5 mm and the width W22 of the cushion element is about 7 mm 25 The height H22c of the recess extends over the full height H22 of the cushion element in the embodiment shown. In other embodiments the height H22c is between 25% and 100% of the height H22 of the cushion element, in another embodiment between 50% and 100% and in another embodiment between 75% and 100%. The depth D22c of the recess 22c is about equal to the matching length ML of the cushion 30 element. Especially figures 6b and 6c further shows that the downstream side face 22d of cushion element 22 has a rounded configuration of the edge area, which may also be tapered or beveled. The downstream side face 22d also shows to have a slight depression 22e over a large part of the downstream side face, which assists in centering 11 the intra-ocular lens when it is being moved down the injection channel through a pushing force by the plunger 23 and the cushion element 22.

At the end of the cushion element turned away from the downstream side face 22d the cushion element 22 has a cavity 22m. The overall shape of the cavity 22m 5 matches the overall shape of an end part 23m of the plunger 23. The end part 23m of the plunger has a thick part 23ml and a neck part 23m2, which fit a wide part 22ml and thinner part 22m2, respectively, of the cavity 22m in the cushion element. The wide part 22ml is positioned more toward the downstream side face 22d than the thinner part 22m2. This configuration allows the cushion element to be attached to the 10 plunger. In the attached configuration the plunger extends over an attachment length AL into the cushion element 22.

The length of the cushion element in between the plunger in the attached configuration and the downstream side face is referred to as the effective length of the cushion element. The range of the effective length EL comprises the first part 22a 15 discussed above and a second part having a smaller cross-section. In the embodiment shown the smaller cross-section of the second part 22b has a smaller width than the transverse cross-section of the first part 22a. Heights of first and second parts 22a, 22b are about equal. In an embodiment the height of the second part 22b is smaller than the height of the first part 22a. It has proven to be advantageous to have the effective 20 length EL larger than the matching length. In the embodiment shown the matching length ML is 1.5 mm and the effective length is 6 mm. Preferably, the effective length EL is between 2 and 10 times the matching length ML, in embodiment between 2 and 6 times, and in another embodiment between 3 and 5 times.

Figures 8a, 8b and 8c show a cushion element that has partly been moved into the 25 end part 8 of the IOL injector 2. The figures 8a and 8b show situations that may occur for known cushion elements, in which the cushion element has tipped over to one side. Compression is not symmetrical. Such situation are to be prevented since it endangers ejecting the IOL out of the injection nozzle 9. Cushion element 22 and IOL 4 may become stuck in the end part 8. Figure 8c shows the situation achieved by the IOL 30 injector according to the invention. It shows a symmetrical compression of the cushion element, which will be achieved when the cushion element 22 is provided with the recess 22 in its downstream side face as described. Further, the force required to move the plunger and cushion element down the injection channel into the tapered part 12 towards the nozzle and outlet is much less than for known cushion elements. It requires between 4 and 20 N, typically less than 12 N, to push the cushion element according to the invention through the tapered part of the injection channel.

To improve sliding of the cushion element 22 inside the injection channel 16 5 (including 16a and 21) the cushion element and/or the channel can be provided with a lubricating coating layer. This coating can for instance be a low friction coating such as, but not limited to, PTFE. The cushion element 22 and the possible lubricating coating, must be compatible with the usual methods of sterilization, such as the sterilization with for instance ethylene oxide.

10 The above description and drawings disclose some embodiments of the invention, and do not to limit the scope of protection. Starting from this disclosure, many more embodiments will be evident to a skilled person, which are within the scope of protection of the accompanying claims.

Claims

An IOL injector (2) constructed for injecting an intraocular lens (4) into the human eye, which IOL injector comprises: 5. an injection channel (16) constructed and arranged for receiving and guiding the intraocular ocular lens; - an injection nozzle (9) with an injector outlet opening for providing the intraocular lens in the human eye, and being constructed and arranged to compress and / or collapse the intraocular lens when the intraocular lens flows downstream the injection channel is moved to the injector outlet port; - a plunger (23) movable downstream within the injection channel, and being constructed and arranged for moving the intraocular lens downstream into the injection channel for ejection from the injector outlet port into the human eye; and - a deformable pad member (22) disposed downstream of the plunger (23) to be positioned between the intraocular lens and the plunger when the intraocular lens passes through the plunger downstream into the injection channel and through the injector outlet port into the human eye is moved, with a downstream side face (22d) of the cushion element (22) pointing downstream to the injection spout (9) and arranged to contact the intraocular lens (4) having a recess (22c) disposed at a central position of the downstream side surface.

The injector according to claim 1, wherein a cross section of the cushion element (22) corresponds to a cross section of the injection channel (16) over a correspondence length (ML) of the cushion element along the injection channel.

3. The injector according to claim 2, wherein a depth (D22c) of the recess (22c) is substantially equal to the match length (ML). The injector according to claim 3, wherein the correspondence length (ML) is between 0.5 and 5 mm, in particular between 1 and 3 mm, more in particular between 1 and 2 mm.

The injector according to one or more of the preceding claims, wherein a width (W22) of the cushion element (22) is greater than a height (H22) of the cushion element, and a recess height (H22c) of the recess (22c) is between 25% and 100% of the height (H22) of the cushion element, in particular between 50% and 100%, more in particular between 75% and 100%.

The injector according to one or more of the preceding claims, wherein a recess width (W22c) of the recess (22c) of the recess (22c) is between 10% and 75% of a width (W22) of the cushion element (22) , in particular between 15% and 60%, more in particular between 15% and 40%.

The injector according to one or more of the preceding claims, wherein an effective length (EL) of the cushion element (22) as measured between a downstream side surface (22d) thereof and an end face of the plunger (23) when, in use, in contact with the pad element is greater than the match length (ML) of the pad element, and a cross section of the pad element in a range outside the match length is smaller than the cross section of the injection channel. (16).

8. The injector according to claim 7, wherein the effective length (EL) of the cushion element (22) is between 2 and 10 times the match length (ML) of the cushion element, in particular between 2 and 6 times, more in particular between 2 and 5 times. The injector according to one or more of the preceding claims and claim 2, wherein a range of the cushion element (22) corresponding to the correspondence length (ML) is located at a downstream side surface end of the cushion element.

The injector according to one or more of the preceding claims, wherein an edge region of the downstream side surface (22d) of the cushion element (22) has a substantially rounded, tapered or oblique configuration. 5

The injector according to one or more of the preceding claims, wherein the cushion element (22) is attached to the plunger (23).

12. The injector according to claim 11, wherein an end of the cushion element (22) pointing to the plunger (23) comprises a cavity (22m) for receiving a fitting end (23m) of the plunger.

13. The injector according to claim 12, wherein the cavity (22 m) has a first part (22 ml) and a second part (22 m 2), which first part has a larger cross-section than the second part, and which first part more in the direction from the downstream side surface (22d) then lies the second portion, the first and second portions (22ml, 22m2) matching with corresponding portions (23ml, 23m2) of the matching end (23m) of the plunger (23).

The injector according to one or more of the preceding claims, wherein the cushion element (22) comprises a compressible material.

The injector according to one or more of the preceding claims, wherein the cushion element (22) comprises a resilient material. 25

An IOL holder (3) constructed for receiving an intraocular lens (4) and for insertion into an IOL injector (2), which IOL holder constructed a cavity (16a) for receiving the intraocular lens, which cavity comprises a wall (16b) for supporting a lens side of the intraocular lens 30, the wall being provided with protrusions (16c) constructed and arranged for supporting the lens side of the intraocular lens .

The IOL holder according to claim 16, wherein the protrusions (16c) are formed as one or more of ribs, pimples, squares, rectangles, circles, and ovals.

The IOL holder according to claim 16 or 17, wherein a width (W16c) of the protrusions (16c) is in the range of 0.05 to 5 mm, in particular in the range of 0.1 to 3 mm.

The IOL holder according to one or more of claims 16-18, wherein a height (H16c) of the protrusions (16c) is in the range of 0.05 to 1 mm, in particular in the range of 0, 1 to 0.8 mm

The IOL holder according to one or more of claims 16-19, wherein the protrusions (16c) are provided with rounded corners of surfaces 15 for contacting the intraocular lens.

21. The IOL holder according to one or more of claims 16-20, wherein the cavity is configured as a channel (16a) comprising opposing walls (16b) for supporting lens sides of the intraocular lens, which walls are provided with protrusions (16c) constructed and arranged to support the lens sides of the intraocular lens (4).

22. The IOL holder according to claim 21, wherein the channel (16a) is provided with openings (15,16) at opposite ends of the channel, and the protrusions are configured as ribs (16c) extending in one direction between the openings.