The present disclosure relates to ophthalmic surgery and, more specifically, to an intraocular lens (IOL) compressor adapted for use with an IOL injector and a method of compressing an IOL prior to injection of the IOL into an eye.
In ophthalmology, eye surgery, or ophthalmic surgery, saves and improves the vision of tens of thousands of patients every year. However, given the sensitivity of vision to even small changes in the eye and the minute and delicate nature of many eye structures, ophthalmic surgery is difficult to perform and the reduction of even minor or uncommon surgical errors or modest improvements in accuracy of surgical techniques can make an enormous difference in the patient's vision after the surgery.
Light enters the human eye through a clear cornea that is located on the outer part of the eye and covers the pupil and iris. The light travels through the pupil and then encounters the lens, located behind the iris. As the light travels through the lens, the lens refracts the light so that it focuses on the retina, located in the back of the eye. Special cells in the retina detect the light and transmit signals based on the light via the optic nerve to the brain, which interprets the signals as vision.
Vision quality is, therefore, influenced by a number of factors, including the transparency and refractive properties of the cornea and the lens. Unfortunately, as people age or due to trauma or disease, the lens may be become less transparent and a cataract develops. Cataracts cause deterioration of vision and are often surgically corrected. During some cataract surgeries, the lens is surgically removed and replaced with an artificial intraocular lens (IOL).
Many cataractous lenses are removed by a surgical technique called phacoemulsification. During this procedure, an opening is made in the anterior capsule and a phacoemulsification cutting tip is inserted into the diseased lens and vibrated ultrasonically. The vibrating cutting tip liquefies or emulsifies the lens so that the lens may be aspirated out of the eye. The diseased lens, once removed, is replaced by an artificial lens, also referred to as an intraocular lens (IOL).
The IOL is injected into the eye through a small incision, sometimes the same incision used to remove the diseased lens. An IOL injector is used to deliver an IOL into the eye.
An aspect of the present disclosure relates to an intraocular lens injector. The intraocular lens injector may include an injector body defining a bore; a nozzle coupled to the injector body, the nozzle including an opening in fluid communication with the bore; a plunger receivable into the bore and moveable therein; and an IOL compressor coupled to the injector body. The IOL compressor may include a housing; a compression chamber formed within the housing and adapted to receive an IOL; and a transversely depressible button extending through a slot formed in the housing, the transversely depressible button moveable within the slot. The transversely depressible button may include a pad located outside of the housing of the compression chamber; an internal portion located inside of the compression chamber, the internal portion having a compression surface adapted to compress the IOL disposed in the compression chamber; and a stem connecting the pad and the internal portion. The stem may be slideably disposed within the slot.
Another aspect is directed to a method of compressing an intraocular lens. The method may include applying a transverse compression force to an intraocular lens comprising a base, a trailing haptic coupled to the base, and a leading haptic coupled to the base; positioning a trailing haptic of the intraocular lens into a tucked configuration as the intraocular lens is compressed; restraining longitudinal displacement of the leading haptic as the intraocular lens is compressed; positioning the leading haptic into a tucked configuration as the compressed intraocular lens is longitudinally displaced; and maintaining both the leading haptic and the trailing haptic in a tucked configuration as the compressed intraocular lens continues to be longitudinally displaced.
The various aspects may include one or more of the following features. The housing of the compressor may include an exterior surface that defines a seat. The pad of the transversely depressible button may include a seating surface, and the seating surface may be adapted to contact the seat to stop movement of the transversely depressible button in a first transverse direction. At least one flexible wing may extend from the stem. The at least one wing may be adapted to flex inwardly when passing through the slot and to expand outwardly when the at least one flexible wing is received into the compression chamber. The compression chamber may define an interior surface. The at least one flexible wing may cooperate with the interior surface to form a lock that is adapted to hold the transversely depressible button into a depressed state when the at least one flexible wing is received into the compression chamber. The compression chamber may define a slot adapted to receive a leading haptic of the IOL and to restrain longitudinal movement of the leading haptic as the IOL is compressed within the compression chamber. The compression chamber may include and interior surface that includes a curved portion adapted to guide a trailing haptic of the IOL into a tucked configuration as the IOL is compressed within the compression chamber.
The various aspects may also include one or more of the following features. The compressed intraocular lens may be delivered from an intraocular lens injector. Applying a transverse compression force to an intraocular lens may include depressing a transversely depressible button to compress the intraocular lens between the button and an interior surface of an intraocular lens compressor. Positioning a trailing haptic of the intraocular lens into a tucked configuration as the intraocular lens is compressed may include engaging a tip of the trailing haptic with a curved surface to guide the trailing haptic into an abutting and conforming relationship with a base of the intraocular lens. Restraining longitudinal displacement of the leading haptic as the intraocular lens is compressed may include positioning the leading haptic in a slot that is adapted to define a path of travel of the leading haptic as the intraocular lens is compressed. Positioning the leading haptic into a tucked configuration as the compressed intraocular lens is longitudinally displaced may include longitudinally displacing the compressed intraocular lens while restraining longitudinal movement of the leading haptic such that the leading haptic abuts and conforms to the a shape of the base
For a more complete understanding of the present disclosure and the associated features and advantages, reference is now made to the following description, taken in conjunction with the accompanying drawings, which are not to scale, and in which:
In the following description, details are set forth by way of example to facilitate discussion of the disclosed subject matter. It should be apparent to a person of ordinary skill in the art, however, that the disclosed implementations are exemplary and not exhaustive of all possible implementations.
For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the implementations illustrated in the drawings, and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the disclosure is intended. Any alterations and further modifications to the described devices, instruments, methods, and any further application of the principles of the present disclosure are fully contemplated as would normally occur to one skilled in the art to which the disclosure relates. In particular, it is fully contemplated that the features, components, and/or steps described with respect to one implementation may be combined with the features, components, and/or steps described with respect to other implementations of the present disclosure.
The present disclosure relates to ophthalmic surgery, and more specifically, to intraocular lens (IOL) compressors adapted for use with an IOL injector and methods of compressing an IOL prior to injection of the IOL into an eye of a patient.
Following removal of a cataractous lens by phacoemulsification or by other surgical procedures, the cataractous lens is replaced by an artificial lens, referred to herein as an IOL. The IOL is typically injected into the eye through the same small incision used to remove the diseased lens. An IOL injector is used to deliver an into the eye.
In some implementations, various manipulations of the IOL injector 10, and various method steps, may be performed by one person, or by a plurality of persons. For example, some steps of methods described herein may be performed by a nurse, while other steps may be performed by an ophthalmic surgeon. For example, compression of an IOL 70 may be performed by a nurse, while injection of the IOL 70 into an eye may be performed by a surgeon.
The IOL injector 10 also includes a plunger 30 received within the bore 40 and moveable therein such that the plunger 30 is slideable within the bore 40. As the plunger 30 is displaced distally within bore 40, the plunger 30 engages and advances an IOL, such as IOL 70, contained in the compartment 80.
As shown in
In some implementations, the IOL 70 may be a one-piece IOL. That is, in some implementations, the IOL 70 may include an optic 460 and haptics 450, as shown in
In other implementations, the IOL 70 may be a multi-piece IOL. For example, in some implementations, the IOL 70 be include two or more separate components.
Occasionally, patients may require replacement of an IOL, and a procedure to replace an IOL may result in damage to the eye. With the use of a two-piece IOL, for example, a replacement procedure may involve replacement only of the optic, allowing the base to remain in place within the eye.
As explained above, in some implementations, the IOL 70 may be a two-piece IOL wherein the base 461 and the optic 460 are separately injected into the patient's eye. Accordingly, for two-piece IOLs, the base 461 and the optic 460 may be contained in separate IOL injectors 10 for insertion in the eye. In other implementations, the two components of a two-piece IOL may be inserted into an eye separately using a single IOL injector. For a single piece IOL, the optic 460 and haptics 450 form a unitary IOL and are inserted into an eye simultaneously with the use of a single IOL injector.
Accordingly, in some implementations, a user may place a one-piece IOL into an IOL injector, for example, by loading an IOL into the IOL storage compartment of the IOL injector, such as the IOL storage compartment 80 of the IOL injector described above. As also explained, the storage compartment may be accessed via a door, such as the door 90. In some implementations, the IOL may be manually folded into a compressed or folded configuration.
In the case of a two-piece IOL, in some implementations, a user may load the base (which may be similar to base 461) into an IOL storage compartment of an IOL injector, for example, via a door. The optic (which may be similar to optic 460) of may be introduced into the IOL storage compartment of separate IOL injector, for example, via a door. In some instances, the IOL storage compartment may be accessed through the door similar to door 90. In some implementations, one or both of the base and the optic may be manually folded into a compressed or folded configuration.
In some implementations, the IOL may be pre-loaded into the storage compartment of an IOL injector, for example, during manufacturing or otherwise prior to distribution to an end user. Accordingly, for the one-piece IOL, the one-piece IOL may be pre-loaded into the storage compartment an IOL injector prior to receipt by the end user. For a two-piece IOL, the base may be pre-loaded into a storage compartment of one IOL injector, while the optic may be pre-loaded into the IOL storage compartment of another IOL injector. The term “pre-loaded” as used herein means that an IOL, either in a one-piece or multi-piece configuration (including, for example, a two-piece configuration) is loaded into the IOL injector not by a user, but, rather, the IOL is installed in the IOL injector before and is already contained within the IOL injector when the IOL injector is received by the user. The IOL injector(s) may be packaged within sterile packaging when received by a user.
As would be understood by persons of ordinary skill in the art, an IOL that is pre-loaded into an IOL injector has advantages over manual installation and folding of an IOL into the IOL injector that is performed by a user. For example, manual installation and folding of an IOL may allow more opportunity for errors, which have the potential to cause unnecessary secondary manipulation or correction during an already complex procedure. Manual installation and folding of an IOL may also introduce the possibility of contamination of the IOL, such as by human error or poor sterile technique. Contamination of the IOL may compromise the sterile environment for the patient and risk infection or other harm to the patient.
As would be understood by skilled persons, it is important for IOLs to be stored unfolded so as not to become permanently deformed over time. Accordingly, IOLs are not held in a folded condition over a long period of time e.g., in storage.
In the example shown in
In the example shown in
As indicated above, the IOL compressor 901 includes the compression chamber 904 that is adapted to receive an IOL or component thereof (hereinafter collectively referred to as “IOL”). The compression chamber 904 is adapted to house the IOL 70 in an unfolded state before compression of the IOL 70 occurs. The compression chamber 904 includes an interior surface 905 adapted to contact the IOL 70, an exterior surface 906, a first side 907, and a second side 908. A distance between the first side 907 and the second side 908 defines an interior width of the compression chamber 904. The interior width may be typically configured to accommodate the transverse width of an unfolded IOL. Referring to
The IOL compressor 901 also includes a transversely depressible button 911. The button 911 includes a pad 912 located outside the compression chamber 904; an internal portion 914 located inside of the compression chamber 904 and defining a compression surface 915; and a stem 916 connecting the pad 912 and the internal portion 914. The pad 912 includes a contact surface 913 accessible to a user. In some implementations, the contact surface 913 may have surface features, such as raised dots 940, to define a textured surface, that provides grip for the user's finger on the contact surface 913. The pad 912 is adapted to be depressible by a user, e.g., by a finger of the user. When depressed, the button moves into and transversely across the compression chamber 904 in the direction of arrow 79. The internal portion 914 includes a protrusion 802 located at a proximal end of the internal portion 914 and extending inwardly towards the longitudinal axis 75.
The compression surface 915 of the internal portion 914 is adapted to contact the IOL, such as, for example, a base of a two-piece IOL (which may be similar to the base 461 shown in
The stem 916 is slideably disposed within a slot 942 formed in the housing 800 of the compression chamber 904 and which defines an opening 970 in the housing 800. The slot 942 is adapted to allow smooth movement of the button 911 as the button 911 is depressed. As shown in
In some implementations, the IOL compressor 901 may include a door, similar to the door 90 as shown in
In some implementations, the exterior surface 906 of the housing 800 of the compression chamber 904 may include a seat 917, and the pad 912 may include a seating surface 918 opposite the contact surface 913. The seating surface 918 is operable to contact with the seat 917 of the compression chamber 904 to limit an amount by which the button 911 may be depressed by a user. A distance between the seating surface 918 and the seat 917 when the button 911 is in an initial, unactuated position (as shown in
In
Referring to
Referring to
Upon compression of the IOL 70 by the button 911, the slot 923 maintains a position and orientation of the leading haptic 920. While the IOL 70 remains compressed, the slot 923 substantially maintains a longitudinal position of the tip 921 of the leading haptic 920 as the IOL 70 is subsequent advanced towards the distal end 903 in response to a longitudinal axial force applied to the compressed IOL 70 by the plunger in the direction of arrow 78. The position of the tip 921 of the leading haptic 920 is substantially maintained because, as shown in
By containing the leading haptic 920 within the slot 923 as the compressed IOL 70 is advanced by the plunger, the leading haptic 920 is prevented from extending distally beyond a distal end of the compressed base or optic of the IOL 70. The slot 923 guides the leading haptic 920 and controls how the leading haptic 920 folds relative to the base or optic of the IOL 70. As the IOL 70 is advanced by the plunger, the interaction between the leading haptic 920 and the slot 921 results in the leading haptic 920 being folded about the optic or base of the IOL 70 and abutting an outer surface of the base or optic of the IOL 70.
By avoiding an untuck configuration of the leading haptic 920, i.e., a configuration in which the leading haptic 920 does not abut and conform to the exterior perimeter 952 of the base 461, a surgeon avoids additional interaction with the IOL 70 in an effort to insert successfully the IOL into a patient's eye, thereby reducing the time required for the surgical procedures; reducing the risk of injury to the patient's eye; and reducing or eliminating the risk of damage to the leading haptic 920 or other part of the IOL 70. With reduced risk of damage to the IOL 70, a surgeon also reduces or eliminates the need to remove and replace a damaged IOL 70 The leading haptic 920 maintains this orientation relative to the base 461 as the IOL 70 advances axially through the IOL injector 10 and is expelled from the opening 29 of the nozzle 25 of the IOL injector 10.
Referring again to
With the trailing haptic 924 oriented as described above, the risk of the trailing haptic 924 being displaced from an abutting relationship with the base 961 and trailing behind the tip of the plunger (i.e., being disposed proximally relative to the tip of the plunger) as the plunger advances the compressed IOL 70 through the IOL injector 10 is eliminated or substantially reduced. As a result, a surgeon avoids additional interaction with the IOL 70 in an effort to insert successfully the IOL 70 into a patient's eye, reducing the time required for the surgical procedures; reducing the risk of injury to the patient's eye; and reducing or eliminating the risk of damage to the trailing haptic. With reduced risk of damage to the IOL, a surgeon also reduces or eliminates the need to remove and replace a damaged IOL.
Compression of the IOL 70 shown in
The present disclosure also relates to methods of compressing an IOL or component thereof. An example method 1000 is shown in
Other methods may include additional, fewer, or different steps. For example, in other implementations, the IOL may be contained in an IOL compression chamber (which may be similar to IOL compression chamber 904, described above) when the IOL is compressed. The transverse compression force may be applied to the IOL by a button (which may be similar to button 911, described above). The button may be displaced transversely relative to a longitudinal axis of the compression chamber, thereby decreasing a transverse width of the IOL. In some implementations, the button may include a stem that slideable within a slot formed in the compression chamber. In some implementations, the button 911 may also include an internal portion having a compression surface operable to compress the IOL between the compression surface and an interior surface of compression chamber. In some implementations, depression of the button may be limited by contact between a portion of the button and a surface of the compression chamber, such as, for example, an exterior surface.
In some implementations, the method 1000 may include locking the IOL compression chamber in a compressed configuration. For example, locking the IOL compression chamber in a compressed configuration may include preventing withdrawal of the button from a fully depressed position. Preventing withdrawal of the button from a fully depressed position may include generating interference between flexible wings of the button and a surface of the compression chamber, such as, for example, an interior of the compression chamber.
The transverse compression force applied in the direction of arrow 79 (shown, for example, in
In some implementations, the application of the transverse compression force may decrease a transverse width of the IOL. In some instances, compression of the IOL may reduce a width of the IOL to less than 50% of the uncompressed width of the IOL. The uncompressed width of the IOL may be a width dimension in a direction perpendicular to a longitudinal axis of an IOL injector. In some implementations, compression of the IOL results in changing a shape of the IOL from an approximately circular shape into an approximately oval shape, as shown, for example, in
Application of a transverse compression force to the IOL may decrease the risk of buckling of the IOL upon the application of the longitudinal axial force to the IOL by a plunger. Buckling may occur as a result of axial loading of an IOL by a plunger when the IOL is in an uncompressed condition. Accordingly, compression applied to an IOL, e.g., by a compressor similar to compressor 901, described above, provides increased stability when applying axial loading to the compressed IOL along a longitudinal axis of an IOL injector by a plunger during delivery of the IOL into an eye of a patient. Consequently, compressing an IOL prior to axial loading by a plunger decreases the possibility that the axial loading will result in buckling of the IOL.
Various implementations of an IOL compressor and methods of compressing an IOL described herein and within the scope of the present disclosure may be used in or otherwise applicable to an IOL injector configured to inject an IOL base and/or an IOL optic of a multi-piece IOL. Various implementations of an IOL compressor and associated methods of compressing an IOL described herein may be used with an IOL base and/or the IOL optic that are manually loaded into a compression chamber by a user or preloaded thereinto prior to delivery to a user.
Non-limiting examples of IOL injectors that may be adapted for use with the IOL compressor as described herein include those described in U.S. Pat. No. 7,156,854 and U.S. Patent Application Publication No. 2016/0256316, the disclosures of each being incorporated herein by reference in their entireties.
Advantages of the IOL compressors s described herein include the ability easily and reliably to compress a single-piece IOL or the separate components of a multi-piece IOL into a compressed state prior to advancement by a plunger and delivery into an eye.
The above-disclosed subject matter is to be considered illustrative, and not restrictive, and the appended claims are intended to cover all such modifications, enhancements, and other implementations that fall within the true spirit and scope of the present disclosure. Thus, to the maximum extent allowed by law, the scope of the present disclosure is to be determined by the broadest permissible interpretation of the following claims and their equivalents and shall not be restricted or limited by the foregoing detailed description.
This application claims the benefit of U.S. Provisional Application No. 62/696,072, filed Jul. 10, 2018, the entire contents of which are incorporated herein by reference.
Number | Date | Country | |
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62696072 | Jul 2018 | US |