The invention relates to intraocular lenses and more especially the problem of centering the lens in the eye, both in the capsular bag as well as outside of said bag. The object of the invention is to provide increased refractive stability and predictability to the lens with a reduction of risk of cellular migration for the lenses that are designed to be implanted in the capsular bag.
It is known that an intraocular lens consists of an optical portion, designed in use to be centered on the optical axis of the eye, and a haptic portion, connected to the periphery of the optical portion whose role is to maintain the centered position of the latter by enclosing the deformations undergone by the eye during the process of accommodation and aging thereof. Because of this essential function, the haptic portion of an intra-ocular lens should meet numerous constraints:
For about 10 years, numerous solutions have been proposed, and a large variety of forms of haptics have been seen to emerge both at the level of their support portion as well as their connecting portion to the optical portion.
Thus, patent U.S. Pat. No. 5,716,403, which relates to a one-piece flexible lens, proposes open-loop haptics with a connecting portion that has a smaller thickness, on the front side, than that of the support portion and an elbow of this support portion above the connecting portion. This lens, however, exhibits the drawback of a relatively high rate of opacification of the capsular bag in comparison to the preceding generation. Actually, the design of its haptics concentrates the entire deformation on the minimum section point, but is overall too rigid, which does not allow it to adapt to the different shapes of patients' eyes and causes a capsular fold that promotes the cellular proliferation in patients having small eyes. In contrast, the weakening of the axial thickness of the haptic at the connecting portion brings about a risk of imbalance in the two ansae and an alternation of the optic that the surgeons refer to by the name “Z Syndrome.” Finally, the large width of the connection portion, which extends over an angular sector of about 45° at the periphery of the optic, constitutes, because of the absence of inclination of the haptics relative to the optical plane, a springboard for the epithelial cells that interfere between this connection portion and the rear capsule of the capsular bag and thereby can proliferate in the direction of the optical axis.
The patent WO 97/41 805, also relating to a one-piece flexible lens, proposes closed-loop haptics with a connection portion that is even larger than that of the lens of patent U.S. Pat. No. 5,716,403, encompassed between 60° and 90° of the angular sector, and reduction of the thickness of the haptics in the connection zone. This lens therefore exhibits the same design defects as the preceding lens.
The flexible lens that is described in WO 00/53124 comprises haptics that consist of support portions that are triangular as a whole and that are connected to the optical portion by two arms. The fixation points of said arms to the optical portion are spaced from one another; consequently, the connection zone of each haptic in the optical portion extends over about 90°. This lens therefore exhibits the drawbacks that are described above.
A flexible lens whose haptic portions are in the shape of a split loop so as to constitute hooking clamps of the lens to the stationary portion of the eye is also known from US 2003/0195622. The implementation of such clamps increases the risks of injuring the eye receiving said lens.
This invention proposes a new form of haptic for an intraocular lens that is characterized by the fact that its support portion, elevation view, has the shape of a flat, semi-circular closed loop with a constant thickness at rest, the proximal portion of said loop originating on the distal portion of a connecting peduncle that is oriented essentially tangentially to the periphery of the optical portion and parallel to the vertical diameter of said optical portion, whereby the support portion of said haptic forms an angle of about 30° with the horizontal diameter of said optical portion. This particular shape of the support portion of the haptic, which can be compared to that of an elastic bracelet, exhibits the capacity of deforming into an infinity of overall circular shapes, which, in its application to an intra-ocular lens haptic, ensures uncompromising adaptation to the morphology of the patient's eye and a drastic reduction of the projection forces along the optical axis created in the lens during its installation, consequently the compression of the haptics along the optical plane of the lens.
According to an advantageous characteristic, the bracelet that forms the support portion of the haptic has a general arc shape with an aperture angle of said arc of between 30° and 60°, and preferably 40°.
The bracelet also has the following advantageous characteristics:
Other characteristics and advantages of the invention will emerge from the following description of two embodiments of an intraocular lens of a capsular bag, equipped with haptics according to the invention. This description, given by way of non-limiting example, will refer to the accompanying drawings in which:
a and 1b are schematic diagrams of a first embodiment of the invention over a half-plan view of an intraocular lens,
a is a diagram that illustrates the general characteristics of the support portion of the haptic according to the invention,
b is a cutaway view along line III-III of
a and 5b are schematic diagrams of a second embodiment of the invention on a half-plan view of an intraocular lens, whereby 5a is the view of the lens in its compressed form (inside the eye), and whereby 5bis a view of the lens before its introduction into the eye,
a is a view of the front face of a one-piece lens with a capsular bag produced according to the diagrams of
b is a profile view of the lens shown in
c is a view of the rear face of the lens shown in
a and 8b diagrammatically illustrate the projection of an intraocular lens haptic according to the invention before (
c is a comparative diagram showing the behavior in the capsular bag of a lens of the prior art and of the lens according to the invention at the connection of the haptic portion to the optical portion.
a shows a diagrammatic half-view of the front face of an intraocular lens 1 with its overall circular optical portion 2 and its haptic portion 3 that breaks down into a support portion 4 and a connecting portion 5. The circular line 6 shows the inscribed circle that is defined by the lens 1 at rest.
It is seen in these figures that the connecting portion 5 forms a peduncle that is connected to the periphery of the optical portion 2 over an angular distance that is relatively small relative to the circumference of the implant. This angular distance will preferably be on the order of 15° to 20°. It is also seen that the peduncle 5 extends in a general direction that is virtually parallel to the vertical diameter dl of the optical portion 2 and that its outside edge 5′ is essentially tangential to the periphery of the optical portion 2.
On the distal portion of the peduncle 5, the support portion 4 of the haptic 3 originates in a general direction d2 that forms an angle a of about 30° with the horizontal diameter d3 of the optical portion 2. The support portion 4 has the shape of a flat semi-circular closed loop with a constant thickness at rest, analogous to that of an elastic bracelet. In
As indicated above, this particular form of the support portion 4 of the haptic 3 has the property of deforming uniformly along infinite loops that are coplanar to the initial loop around the median axis ml of the loop, as
Thanks to these arrangements, it is ensured that the compression forces that are exerted on the haptic of the lens after its installation in the eye are concentrated on the median axis ml of the loop 4 parallel to the optical plane of the lens, which both makes it possible for the support portion 4 to assume the contour of its housing over a great length and without rough spots and to reduce the projection forces of the optical portion 2 on the optical axis.
In practice, for an intraocular lens whose overall diameter at rest (reference 6 in
height 8 of the loop: from 0.6 to 3 mm, preferably 1.4 mm, length 9 of the loop: from 1.2 to 6 mm, preferably 5 mm,
Preferably, a strip section with a thickness 12 that is equal to or greater than its width 11 will be adopted so as to promote the homogeneous deformation of the two superposed fragments of the loop 4 and to avoid inducing torsion components that would have an adverse effect on the stability of the haptics.
The peduncle 5 will have virtually the same thickness as that of the thread or strip that constitutes the loop, either from 0.2 to 0.8 mm and preferably 0.4 mm, while its height relative to the circumference of the optical portion will be on the order of 0.4 to 2 mm and preferably 0.6 mm. These arrangements ensure that the peduncle 5 does not interfere significantly with the homogeneous deformation of the support portion 4.
In the case of an intraocular lens with a capsular bag, it is recommended to provide to the haptic portion, profile view in the optical plane, an inclination relative to said plane so as to create during the compression of the haptics a force displacing the optical portion in the direction of the window along the optical axis, which has the result of flattening the rear diopter of the optical portion against the rear wall of the crystalline bag. As is seen in
Thus, by the combination of the flat elastic bracelet form of the support portion of the haptic, its inclination along an angle of about 30° on its peduncle for attachment, and implantation of said peduncle on the periphery of the front diopter of the optical portion with an inclination of about 15°, the intraocular lens according to the invention produces the following performances:
a and 5b represent an advantageous variant embodiment of a capsular bag implant according to the invention. It is seen in these figures that a strut 13 designed to improve the deformation homogeneity of the support portion 4 was added under the support portion 4 of the haptic 3 and close to its proximal end, essentially parallel to the peduncle 5. By its position, this strut 13 avoids any flexion of the support portion 4 that would not be due to a deformation of the latter as well as any flexion of the peduncle 5.
The lens 1 exhibits a particular configuration of the periphery of its optical portion, designed to reinforce the prevention against the cellular proliferation. Actually, the diameter of the rear diopter 14 is smaller than that of the body 15 and the connection between the edge 16 that is thus created and the narrow peripheral edge 17 of the optic is made by a concave neck mold 19 that defines a second edge 18 with said narrow edge. Said edge 18 also extends over the entire periphery of the narrow edge 17, including in the connecting portions of the peduncles 5 and struts 13. In addition, the implantation of peduncles 5 and struts 13, whereby they are inclined at about 15°, is done with looping on the front edge between the front diopter 15 and the edge 18 of the narrow edge 17 such that in this connecting zone, the rear face of the peduncles 5 and struts 13 is found in the extension of the concave neck mold 19.
The purpose of this arrangement is to produce a transition in softness from the embedding of the rear portion of the implant in the capsular bag by orienting the tension forces that are exerted on the bag in parallel to the rear face of the peduncles and struts, which has the effect of preventing the formation of folds on the edge 18 as is illustrated diagrammatically in
In
The curvature radius of the neck mold 19 is preferably on the order of 0.2 to 0.6 mm, and its maximum depth is 0.1 mm.
The embodiments that are described above relate to an intraocular lens with a capsular bag. The invention, however, covers all the types of intraocular lenses, whether they are implanted in or outside of the capsular bag.
Number | Date | Country | Kind |
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0403615 | Apr 2004 | FR | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/FR05/00809 | 4/4/2005 | WO | 00 | 10/5/2006 |