This invention relates to intraocular lens inserters, and more specifically to haptic protection structures in cartridges for intraocular lens inserters.
The techniques of cataract surgery are experiencing continuous, impressive progress. Subsequent generations of phacoemulsification platforms and newly invented surgical lasers keep increasing the precision of the placement of intraocular lenses (IOLs) and keep reducing the unwanted medical outcomes.
In a typical cataract procedure, an IOL is placed and folded into a cartridge, which is then inserted into a tip of an inserter. Subsequently, the cartridge at the tip of the inserter is inserted into the eye through a surgically created incision, reaching the capsule of the eye. Then the IOL is pushed out of the cartridge through its insertion channel by a push-rod into the eye-capsule, where it is oriented according to the surgical planning, and then stabilized.
IOLs typically have two haptics attached to them. These are thin flexible arms that press against the wall of the capsule after the insertion of the IOL, thereby stabilizing the IOL at the center of the capsule. When the IOL is still in the insertion channel, one of its haptics is typically positioned in front of the IOL, the other behind, trailing the IOL. The push-rod is pushed by the surgeon to force the IOL forward through the same insertion channel where the trailing haptic is positioned. Therefore, in some cases, the push-rod may hit the trailing haptic in the insertion channel, bending and damaging it. Damaged haptics cannot stabilize the IOL in its centered and oriented position. Thus, if the haptic damage is discovered before the insertion of the IOL, then the cartridge with the damaged haptic has to be replaced with a new cartridge with a new IOL. If the damage is discovered only after the insertion, then the surgeon has to remove the deployed damaged IOL from the capsule of the eye with a quite invasive and undesirable procedure, and insert a new one. This takes time and effort, and carries a certain degree of risk. Therefore, there is a profound need for cartridges, which reduce or even eliminate the probability of the push-rod damaging the trailing haptic.
The above-described needs are addressed by a cartridge of an intraocular lens inserter, that comprises an insertion nozzle, having a distal insertion channel; an intra-ocular lens (IOL)-folding stage, proximal to the insertion nozzle, having a proximal insertion channel; and a haptic protection structure to protect a trailing haptic of the IOL from damage by a push-rod of the IOL inserter. The haptic protection structure can include a proximal guiding groove, formed in the IOL-folding stage, or a distal guiding groove, formed in the insertion nozzle. The haptic protection structure can further include a trailing-haptic notch, to guide a trailing haptic protruding from one of the proximal guiding groove and the distal guiding groove, out of the proximal insertion channel; and a trailing-haptic retainer, to secure the trailing haptic out of the proximal insertion channel.
Some embodiments include an intraocular lens inserter that comprises an inserter cylinder; a push-rod, at least partially in the inserter cylinder; a cartridge-receiving insertion tip, to receive a cartridge that includes an insertion nozzle, having a distal insertion channel; an intra-ocular lens-folding stage, proximal to the insertion nozzle, having a proximal insertion channel; and a haptic protection structure.
This document describes embodiments of ophthalmic inserters and their cartridges that provide improvements regarding the above described medical needs.
Embodiments of the here-described cartridge 200 are designed to reduce, to minimize and possibly to eliminate the probability of the push-rod 110 damaging the trailing haptic 30.
In some embodiments, the haptic protection structure 240 can include a proximal guiding groove 240g-p2, formed in the IOL-folding stage 230. This guiding groove 240g-p2 can guide and thus protect the trailing haptic 30 of the IOL 10, as described below in detail.
The haptic protection structure 240 can further include a proximal guiding groove 240g-p1, formed in the IOL folding stage 230, and a distal guiding groove 240g-d1, formed as shown. These guiding grooves can guide the front haptic 20, and can guide the IOL 10 as well. The guiding grooves 240g-d1, 240g-p1 and 240g-p2 together will be referenced as guiding grooves 240g.
The IOL-folding stage 230 can include a foldable IOL-folding wing 231, to partially receive the IOL 10, and a fixed IOL-folding wing 232, to partially receive the IOL 10. In some embodiments, the proximal guiding groove 240g-p1 can be formed in the foldable IOL-folding wing 231, and the proximal guiding groove 240g-p2 can be formed in the fixed IOL-folding wing 232.
Further, also prior to confining and folding the IOL 10, the trailing haptic 30 is guided into the proximal guiding groove 240g-p2, and its proximal end is tucked into the trailing haptic notch 240n. These steps guide the trailing haptic 30 out of the way of the push rod 110, and thus prevent the bending or breaking of the trailing haptic 30 by the push rod 110. After the positioning of the front haptic 20 guiding grooves 240g-p1 and 240g-d1, and the trailing haptic 30 into the guiding groove 240g-p2, the folding of the foldable IOL-folding wing 231 can be carried out, which folds the IOL 10 and confines it into the proximal insertion channel 220-p.
However, embodiments of the cartridge 200 include the haptic protection structure 240 in the form of the proximal guiding grooves 240g-p1 and 240g-p2, and the distal guiding groove 240g-d1. As described earlier, when the IOL 10 is loaded into the IOL folding stage 230, the trailing haptic 30 is positioned, or guided, into the proximal guiding groove 240g-p2, and the front haptic 20 is guided into the proximal guiding groove 240g-p1 and into 240g-d1 by elastic forces, due to the elasticity of the haptic material and the its mechanical design, and by the surgeon, so that it occupies a space physically separate from the push-rod 110. For this reason, the haptic protection structure 240 can reduce, minimize, or eliminate the push-rod 110 damaging the trailing haptic 30, as well as the unwanted bending of the front haptic 20, and thus solves the urgent medical need described in the background section.
Also, the trailing haptic 30 is safely guided into the proximal guiding groove 240g-p2, and is clearly positioned outside the path of the push-rod 110 that occupies much of the insertion channels 220-p, and is therefore unlikely to be damaged by the push-rod 110.
As described, the primary function of these guiding groove(s) 240g-p1/240g-d1 and 240g-p2 is (1) haptic protection for the trailing haptic 30, and (2) haptic protection for the front haptic 20. Beyond this, the guiding grooves 240g can have additional functions. (3) The guiding grooves 240g-p1/240g-d1 and 240g-p2 are able to catch corresponding edges of the IOL 10, thereby preventing a rotation of the IOL 10 as it moves along the proximal insertion channel 220-p, and then along the distal insertion channel 220-d during the insertion of the IOL 10. Preventing the rotation of the IOL 10 can be of substantial medical benefit, as for many of the advanced, “patient pay” IOLs, such as for astigmatic and for toric IOLs, the eventual orientation of the IOL in the eye-capsule is key for delivering the planned vision correction. Accordingly, a rotated toric IOL 10 delivers markedly lower vision improvements—a medical outcome to be avoided. Therefore, in some embodiments the grooves 240g-p1/240g-d1 and 240g-p2 can perform both haptic protection and IOL rotation prevention.
(4) Finally, in some embodiments, the proximal guiding grooves 240g-p1 and 240g-p2 can be configured to help folding the IOL 10 by catching an edge of the IOL 10 as part of the folding process. Indeed, in some typical cases, the insertion of the initially flat IOL 10 starts with simply placing the IOL 10 on, or over, the two semi-cylinders of the proximal insertion channel 220-p1 and 220-p2. Then, an operator can start folding the foldable IOL-folding wing 231. Without a mechanical constraint, or coupling, the IOL 10 may pop out, or slide out, from the proximal insertion channels 220-p1 and 220-p2, preventing the controlled folding of the IOL 10. This challenge can be brought under control by the proximal guiding groove 240g-p1, or 240g-p2, or both, catching an edge of the IOL 10, and thus preventing the pop-out, or slide-out, and enabling a well-controlled folding of the IOL 10.
The trailing-haptic retainer 240rt can secure the trailing haptic 30 out of the proximal insertion channel 220-p and thus out of the way of the push-rod 110. After the surgeon places the IOL 10 into the open proximal insertion channel 220-p1 and 220-p2, she can weave the trailing haptic 30 into the trailing haptic notch 240n out of the way of the push-rod 110 which will be pushed through the same proximal insertion channel 220-p after the foldable IOL folding-wing 231 has been folded and the cartridge 200 has been closed. The trailing haptic retainer 240rt, often a protrusion or a bump, can secure the trailing haptic 30 to remain in the trailing haptic notch 240n safely.
Another embodiment can be a functional mirror-image of the above described cartridge 200, wherein the trailing haptic notch 240n and the trailing haptic retainer 240rt are formed in the fixed IOL folding wing 232. Further variant embodiments can be formed by inverting the IOL 10, in which case the proximal guiding groove 240g-p1 would guide the trailing haptic 30. Mirroring, or inverting parts of the system of the cartridge 200 impact its overall functionality, such as the positioning and orienting the IOL 10. Thus, variant embodiments can mirror or invert all corresponding parts of the system of the cartridge 200, but only in configurations that preserve its functionality. This includes the orientation of the IOL 10 as well. If the IOL 10 is positioned in a mirrored or inverted position, it may get inserted into the eye in a backward, or otherwise undesirable position.
All the above embodiments of the haptic protection structure 240, including the guiding grooves 240g-p1/240g-p2 and 240g-d1; the guiding ribs 240r-p1/240r-p2 and 240r-d1; the trailing-haptic notch 240n, and the trailing-haptic retainer 240rt can reduce or eliminate the risk of the push-rod 110 bending or damaging the trailing haptic 30 of the IOL, as well as reduce the risk of the front haptic getting entangled or bent. Therefore, in various embodiments, they can be used in any combination towards their shared goal.
While this document contains many specifics, details and numerical ranges, these should not be construed as limitations of the scope of the invention and of the claims, but, rather, as descriptions of features specific to particular embodiments of the invention. Certain features that are described in this document in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable subcombination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to another subcombination or a variation of a subcombinations.
Number | Date | Country | |
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Parent | 15406715 | Jan 2017 | US |
Child | 17534131 | US |