TW587934B - Improved scleral prosthesis for the treatment of presbyopia and other eye disorders - Google Patents
Improved scleral prosthesis for the treatment of presbyopia and other eye disorders Download PDFInfo
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- TW587934B TW587934B TW089111047A TW89111047A TW587934B TW 587934 B TW587934 B TW 587934B TW 089111047 A TW089111047 A TW 089111047A TW 89111047 A TW89111047 A TW 89111047A TW 587934 B TW587934 B TW 587934B
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- prosthesis
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- sclera
- bag
- eyeball
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- 201000010041 presbyopia Diseases 0.000 title abstract description 8
- 208000030533 eye disease Diseases 0.000 title abstract 2
- 210000003786 sclera Anatomy 0.000 claims abstract description 25
- 210000005252 bulbus oculi Anatomy 0.000 claims abstract description 14
- 230000001886 ciliary effect Effects 0.000 claims abstract description 11
- 210000003205 muscle Anatomy 0.000 claims abstract description 11
- 230000000087 stabilizing effect Effects 0.000 claims abstract 4
- 210000001508 eye Anatomy 0.000 claims description 13
- 210000001519 tissue Anatomy 0.000 claims description 5
- 238000001356 surgical procedure Methods 0.000 claims description 4
- 230000006641 stabilisation Effects 0.000 claims description 3
- 238000011105 stabilization Methods 0.000 claims description 3
- 239000003381 stabilizer Substances 0.000 claims 1
- 238000009941 weaving Methods 0.000 claims 1
- 238000000034 method Methods 0.000 description 9
- 239000012528 membrane Substances 0.000 description 3
- 210000004240 ciliary body Anatomy 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 230000037431 insertion Effects 0.000 description 2
- 101100264195 Caenorhabditis elegans app-1 gene Proteins 0.000 description 1
- 241000282326 Felis catus Species 0.000 description 1
- 206010030348 Open-Angle Glaucoma Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 235000013399 edible fruits Nutrition 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 239000010985 leather Substances 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 230000005855 radiation Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 239000013598 vector Substances 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/147—Implants to be inserted in the stroma for refractive correction, e.g. ring-like implants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
- A61F2009/00865—Sclera
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
- A61F2009/00868—Ciliary muscles or trabecular meshwork
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00885—Methods or devices for eye surgery using laser for treating a particular disease
- A61F2009/00895—Presbyopia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/0008—Introducing ophthalmic products into the ocular cavity or retaining products therein
- A61F9/0017—Introducing ophthalmic products into the ocular cavity or retaining products therein implantable in, or in contact with, the eye, e.g. ocular inserts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/00781—Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment
Landscapes
- Health & Medical Sciences (AREA)
- Ophthalmology & Optometry (AREA)
- Public Health (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Transplantation (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Surgery (AREA)
- Prostheses (AREA)
Description
587934 五、發明說明(l) 圖解簡述 本發明優良具體實施例可參考附圖及其說明了解,其中 相應的數字代表相應的物體,其中: 圖1說明根據本發明原理的優良具體實施例的頂端平面 觀; 圖2說明圖1之鞏膜假體具體實施例的側面觀; 圖3說明圖1及2之鞏膜假體具體實施例的底端平面觀; 圖4說明圖1及3之鞏膜假體具體實施例的頂端側面等容 觀; 圖5說明圖1及4之鞏膜假體具體實施例的一端之頂端平 面觀;及 圖6說明圖1及5之鞏膜假體具體實施例的一底邊等容 觀。 本發明詳述 本發明原理介紹並說明於1 9 9 7年1 0月8日歸檔的美國專 利編號為 0 8/ 9 4 6, 9 75及標題為"SCLERAL PROTHESIS FOR TREATMENT OF PRESBYOPIA AND OTHER EYE DISORDERS" (即"’ 9 75 App 1 i cat i onn )所教導及介紹的鞏膜假體之改 良;及1 9 9 8年4月1 6日歸檔的美國專利編號為〇 9 / 0 6 1, 1 6 8 及標題為"SCLERAL PROTHESIS FOR TREATMENT OF PRESBYOPIA AND OTHER EYE DISORDERS1,(即,9 75巾請案 之部分專利權)之改良。此二專利文件及其中的發明揭示 都被指定為本發明人所有,今一併都附上供參考並作為充 分說明之用。
O:\64\64682.ptd 第5頁 發明說明(2) 根據上述所附> 奎^ f 方面,老—月 文件所介紹的及教導的本發明的某些 放角青光ί广眼壓Ϊΐ 眼 離而作適宜的心^ 阿4)耩增加睫狀肌的有效工作距 距離作適举、、Λ :〜,、三此可藉增加睫狀肌及晶體中緯線間的 鞏膜擴張)治療、。乂仏疋藉增加睫狀體區的鞏膜直徑(即 根據較佳且體音 睛鞏膜内外二方二列,睫狀肌的有效工作距離可藉於眼 凸而增加。每一俨^ ί的袋内植入多個假體使睫狀體區外 第二端及一Ϊ( 包括一長形基底,此基底有第一端及 膜產;i ^二ndge)或峰(CI"eSt )。此植入後的假體對鞏 肌因而升高此部分的輩膜以增加眼睫狀 鞏膜產生外向的::所以’ Λ多個假體須設計成能共同對 太^所附專利文件所揭示的假體較佳具體實施例有一基 週體。此圓週體有一頂端表…此頂端表面適 外的I革膜内外科所形成的袋的外璧上,在外璧上產生向 =幸的是,由於圓週體形狀的關係,此假體的底部表面 外,形長的鞏膜袋的内壁的接觸表面是有限的,一般而 ;第及第一纟而的面積接觸。至少部分是由於假體 j端表面的接觸面與假體底部表面不成比例,此假體可 =二(1 )在鞏膜袋内前後滑動,因而導致假體治療老花眼 士放果降低,及Qi)在鞏膜袋内轉動或向前倒下,因 本上對治療老花眼無效。 土
第6頁 587934 五、發明說明(3) 現在回到圖1,圖1說明根據本發明原理的改良的鞏膜假 體的較佳具體實施例的頂端平面觀。為要克服上述圓週體 假體的缺點,本發明改良的假體(一般指丨〇 〇 )有第一端及 第二端(一般分別指l〇5a及i〇5b),此假體適用於擴大接觸 到的鞏膜以增加眼睛睫狀肌的有效工作距離,同時提供假 體對所觸的鞏膜的安定方法。此體i〇〇包括頂面110,此表 面可接觸眼球鞏膜内的外科作的袋(或環)的眼組織。適宜 的作鞏膜袋的外科方法於上述所附文件中已有敘述,就本 發明目的言已不需進一步說明。頂表面丨丨〇的例以凸平面 表示。 頂表面1 0 0包括週邊丨丨5,此週邊,根據說明性具體實施 ΐ凸起的’斜的,或不銳利的邊緣以防切割、撕裂或 t及輩膜’特別是外科作的鞏膜袋。應注意到,體丨〇 〇的 第一及第二端105a,b包括較頂表面110其他部分更斜的面 (下面將詳述)。 圖2說明圖1之鞏膜假體具體實施例的侧面凸起觀。此假 ^ ^ 及第二端I05a,b,頂表面110,不銳 =的緣115及底表面120。舉例性的底表面120顯示有較頂 面110基士上為直的平面狀。較佳是,底表面丨2 〇較假體 100之最大高度還要寬。 f /主思到’舉例性的頂表面11 0及底表面1 2 0的形狀只用 作况=目的。/精於此技藝者會了解,體1 0 0可以是任何形 狀/、要/、幵少狀與體表面能共同適用於置於鞏膜袋内時產 生向外的力’以使聯接的鞏膜部分升高,增加眼球睫狀肌
587934 五、發明說明(4) 的有效工作距離即可,此表面為凸形、凹形、 他形狀都無所謂。 週形或其 還應了解到,此處所提及的較佳及舉例性 度也是以說明為目的的。可使用任何根據本 〇〇的, 度的合適的體平面。在這一方面,舉例性的 另^且量 i〇5a,b與頂及底表面u〇,丨2〇共同構 二端 袋内安定的方",使假體的上 +鞏膜衣水遂產生向外的力,以提高f膜接觸 位,從而增加睫狀肌的有效工作距離。 的邙 在這方面,舉例性的底表面12〇,與前述所附 所述的假體具體實施例相比,適於增加於外科所形 代 内的眼組織的接觸面積。此增加的眼組織加觸至少太衣 可排除假體在鞏膜袋内的翻轉、前傾或其他轉動,^ ^ 保老花眼的有效治療。 而確 f表面1 2 0與眼組織的接觸量較適宜是至少基 ,表面,在外科形成的鞏膜接觸袋内與 ^ 變。例如,底表議的面積可大於頂表體面的 在第&第一端105a,b,每-舉例性的端都是用以 在外科形成的袋内經由(i)較頂表面110主要部分13〇小 :了!表面no的斜部分125 ’及⑴)溝135的物理組合/合作 口疋體1GG。此舉例性的物理組合/合作至少基本上使 T固定於外科形成的鞏膜袋内,從而確保老花眼的有效 ✓ 口療。 587934 五、發明說明(5) 應注意到,雖則第一及第二端i 0 5a,b於頂表面11 〇有部 分凹陷部125,及溝135a,b形成部分凹底表面120,其他 的具體實施例可包括至少一端1 〇 5,而此端可於適宜時包 括至少一為部分的凸形的部分。 無論如何,此種假體1 〇 〇的表面及端的各量度及特點(例 如’平滑、粗裢、完工的、磨光的等)的物理合作,適於 將假體固定於眼球鞏膜内外科形成的袋内。 是以’圖1及圖2的舉例性具體實施例說明其優點,其中 頂表面110於第一端l〇5a起始形成約75〇微米的凹表面 1 2 5 ’然後逐漸形成四毫米的平滑凸起曲線,然後於第二 端l〇5b形成另一 750微米的另一凹表面125 一 -其總頂表面 Π 0長^度為5.5毫米。主要凸起表面的輻射半徑為約9毫 米’又互聯接曲線之半徑約為1 5 3微米,凹形表面之半徑 約為500微米。&凹形表面形成圓形部》,其曲率半徑約 為125微米,耳葬於底表面12〇上。底表面12〇有一部分是直 :止長f 5 〇 〇微米’達於凹部,此凹部的曲率半徑約為5 0 0 ϋίΐ二約150微米。此凹形成一溝沿伸整個體100的底表 *乎(Π?0的主要部分於第一及第二溝間延伸約3· 5 本上與第一溝相同)。 夕麻^ J 者為圖1及圖2之鞏膜假體具體實施例 相同,就是說,例=广ΐ 度或其他一般向量不必 的面積。回至圖4,C20可適宜地大於頂表面110 實施例之頂側等容觀兄门明者為圖1至圖3之鞏膜假體具體 規。同樣,顯示舉例性的非銳利緣。回
第9頁 587934 五、發明說明(6) 至圖5,戶斤說明者為圖1至圖4之鞏膜假體具體實施例 平面觀。最後,回至圖6,所說明者為圖}至圖5之 體具體實施例之底側等容觀。 、# 上述具體實施例之其他舉例性安定方法丨〇 5a,b及 120(結合了頂表面11〇)之重要特點是體1〇〇的寬度較佳σ 大於其最大高度一於過去假體具體實施例中,寬^产 其最大高度’是以導致翻轉等現象。此外,除了&仏 其他於鞏膜内固定假體100的適宜方法(例如鉤,固一, 夹等)夕卜,底表面120較扁平。所卩,舉例性的溝135有 j假體100滑動的作用--溝丨35可與形成鞏膜袋的切口置於 條線上,這樣,因對溝形成壓力可使切口 "上捲 curve up"),從而防止假體向任何方向滑動。 第二或第二端105a,b包括一下陷以便装入鞏膜袋内了 間言之,端105a,b合作以便於插入鞏膜袋,並且一曰 置入後即可使之固定。其他的固定,或更普通地說,安一 $體的方法包括於假體主體内作一孔,將假體縫 體的一面或多面聯於鞏膜袋或多個鞏膜袋(或吏假 …有總主體質量或"厚度"的另一優點是,本發明俨_ =所附專利文件所述的從前的假體有更長: 發明假體的主要目的。 P 此局本 ^述假體可根據上述所附專利文件所述方法或其他方法 可:上L:上Ϊ所附專利文件所述物料或其他已知物料, 了用上述所附專利文件所述方法或其他已知方法作 ’例如庄射’其中可將假體插入,然後可裝入液體,塑
第10頁 587934
第11頁
Claims (1)
- 58^4 號 89111047t、申請專利範圍 1 . 一種用 第一端及第 之平面形,以增 體進 成之袋中的 以接 二端 步包含一 包括 的袋 3. 呈圓 該袋4. 包含 5. 包含 眼組 6 . 表面 之眼7. 包含 體於8. 一端 根據申 一頂端 中接觸 根據申 周形, 之部分 根據申 比該主 根據申 一底部 織。 根據申 之眼組 組織接 根據申 至少該 該外科 根據申 及第二 假體 請專 表面 眼組 請專 且係 ,從 請專 體之 請專 表面 觸眼球鞏膜的假體,該假體係包含一具有 之主體,該主體具有用以擴大該接觸鞏膜 加眼球睫狀肌之有效工作距離,其中該主 種用以安定該於眼球鞏膜中以外科手術形 之裝置。 利範圍第1項之假體,其中該主體進一步 ,其係以於該眼球鞏膜内以外科手術形成 織。 利範圍第2項之假體,其中該頂端表面係 以施加一向外之力於鞏膜袋,以提高接觸 而增加眼球睫狀肌的有效工作距離。 利範圍第2項之假體,其中該安定裝置係 最大高度還寬之底部表面。 利範圍第1項之假體,其中該安定裝置係 ,其係用以接觸該外科手術形成之袋内的 圍第5項之假體,其中該主體之底部 至少實質上相當於該主體之頂部表面 請專利範 織接觸係 觸。 請專利範圍第1項之假體,其中該安定裝置係 第一端及該第二端中之一端,其係以固定該主 形成的袋内。 請專利範圍第7項之假體,其中該所包含之第 端中至少一端具有部分凹陷之頂端表面。O:\64\64682-930331.ptc 第13頁 587934 _案號89111047_Θ年2月 日 修正_L 六、申請專利範圍 9 .根據申請專利範圍第7項之假體,其中該所包含之第 一端及第二端中至少一端具有部分凸起之頂端表面。 1 0 .根據申請專利範圍第7項之假體,其中該所包含之第 一端及第二端中至少一端具有部分凹陷之底部表面。 1 1 .根據申請專利範圍第7項之假體,其中該所包含之第 一端及第二端中至少一端具有部分凸起之底部表面。 1 2 . —種用以接觸眼球鞏膜的假體,該假體係包含一具 有第一端及第二端之主體,該主體具有用以擴大該接觸鞏 膜之平面形,以增加眼球睫狀肌之有效工作距離,以及一 用以安定該於眼球鞏膜中以外科手術形成之袋中的假體之 裝置,該安定裝置包含一比該主體之最大高度為寬之底部 表面。 1 3 .根據申請專利範圍第1 2項之假體,其中該底部表面 係以接觸該外科手術形成之袋内的眼組織。O:\64\64682-930331.ptc 第14頁
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TW089111047A TW587934B (en) | 1999-06-07 | 2000-06-07 | Improved scleral prosthesis for the treatment of presbyopia and other eye disorders |
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EP (2) | EP1754453B1 (zh) |
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KR (1) | KR100614209B1 (zh) |
CN (1) | CN1250176C (zh) |
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AU (2) | AU5599300A (zh) |
BR (1) | BR0011361A (zh) |
CA (1) | CA2376322C (zh) |
DE (2) | DE60027290T2 (zh) |
EA (1) | EA200200006A1 (zh) |
ES (2) | ES2351515T3 (zh) |
HK (1) | HK1043723B (zh) |
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IL (2) | IL146887A0 (zh) |
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FR2838955A1 (fr) * | 2002-04-30 | 2003-10-31 | Bernard Gambini | Pont d'expansion sclerale |
ATE518499T1 (de) | 2002-05-20 | 2011-08-15 | Refocus Group Inc | System und verfahren zur bestimmung einer position für eine skleratasche für eine skleraprothese |
FR2844703B1 (fr) * | 2002-09-25 | 2005-07-08 | Alain Nicolas Gilg | Dispositif intraoculaire pour restaurer l'accommodation de l'oeil atteint de presbytie |
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ES2538551B1 (es) | 2013-12-20 | 2016-01-13 | Eurocanarias Oftalmológica, Sl | Composición Oftálmica para la corrección de la presbicia |
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