The invention set forth in the appended claims relates generally to eye surgery. More particularly, but without limitation, the claimed subject matter relates to systems, apparatuses, and methods for inserting an implant into an eye.
The human eye can suffer a number of maladies, which can cause mild deterioration to complete loss of vision. While contact lenses and eyeglasses can compensate for some ailments, ophthalmic surgery may be required for others. In some instances, implants may be beneficial or desirable. For example, an intraocular lens may replace a clouded natural lens within an eye to improve vision.
While the benefits of intraocular lenses and other implants are known, improvements to delivery systems, components, and processes continue to improve outcomes and benefit patients.
New and useful systems, apparatuses, and methods for eye surgery are set forth in the appended claims. Illustrative embodiments are also provided to enable a person skilled in the art to make and use the claimed subject matter.
For example, some embodiments may comprise or consist essentially of an apparatus for delivering an implant, such as an intraocular lens. Such a delivery apparatus can be used to fold and compress an implant and deliver it into the eye through a narrow nozzle tip inserted into a small incision in various locations and using various surgical techniques. Some embodiments can be operated manually, using a single hand to advance the implant with a plunger or push rod. In some embodiments, the apparatus may comprise or consist of a means for smoothly, consistently, and predictably advancing an implant from an initial position to a dwell position, then from the dwell position into the eye. For example, an elastomeric ring can smoothen the implant advancement, dampen axial delivery resistance changes, and increase the consistency and controllability of implant delivery. In some examples, the apparatus may have a plunger disposed within a bore, and the ring can be compressed in the bore at different locations and/or at different rates to generate the right damping force at the right time or location during implant delivery. Additionally, the ring damping mechanism can also improve the smoothness of advancement of the implant from its initial position to a dwell position.
More generally, some embodiments of an apparatus for eye surgery may comprise a nozzle having a delivery lumen, an implant bay coupled to the nozzle, an implant disposed in the implant bay, and an actuator coupled to the implant bay. The actuator may comprise a housing, the housing having a first end proximate to the implant bay and a second end distal to the implant bay; a bore through the housing; a plunger having a first end and a second end, the first end disposed within the bore; and a compression ring disposed around the plunger within the bore between the plunger and the housing. The compression ring can be disposed between the first end and the second end of the plunger. The first end of the plunger can be configured to advance within the bore toward the first end of the housing, thereby advancing the implant from the implant bay through the delivery lumen, and the bore can be configured to compress the compression ring as the first end of the plunger moves through the bore. In some embodiments, the bore can be configured to increase compression on the compression ring as the first end of the plunger moves through the bore.
In more particular embodiments, at least a portion of the bore is tapered adjacent to the first end of the housing. For example, the bore may have a first width adjacent to the first end of the housing, the bore may have a second width adjacent to the second end of the housing, and the first width is less than the second width. In yet more particular embodiments, the bore may comprise a first region adjacent to the first end of the housing and a second region adjacent to the second end of the housing, the first region can have a width that decreases from the second width adjacent to the second region to the first width adjacent to the first end of the housing, and the second region can have a width that is substantially constant and equal to the second width.
The compression ring may comprise or consist essentially of an elastomer. For example, some embodiments of the compression ring may comprise or consist essentially of silicone, perfluoroelastomer (FFKM), nitrile rubber, fluorocarbon type A, chloroprene, polyurethane, or polytetrafluoroethylene. The housing may comprise or consist essentially of substantially rigid material, such as polypropylene (PP), polycarbonate (PC), acrylonitrile-butadlene-styrene (ABS), or polyoxymethylene (POM).
Some embodiments of an apparatus for delivering an implant to an eye may comprise a housing configured to be coupled to an implant bay, the housing having a first end and a second end; a bore passing longitudinally through the housing from the first end to the second end, and a tapered portion adjacent to the first end; a plunger having a first end and a second end, wherein the first end is disposed within the bore; and a compression ring coupled to the plunger within the bore between the plunger and the housing. The first end of the plunger can be configured to advance within the bore toward the first end of the housing, and the tapered portion can be configured to compress the compression ring as the first end of the plunger moves through the bore.
Some embodiments of an apparatus for eye surgery may comprise a nozzle having a delivery lumen, an implant bay coupled to the nozzle, an implant disposed in the implant bay, and an actuator coupled to the implant bay. The actuator may comprise a housing consisting essentially of polypropylene, the housing having a first end proximate to the implant bay and a second end distal to the implant bay; a bore through the housing, the bore having a tapered portion adjacent to the first end of the housing, and a fixed width between the tapered portion and the second end, the tapered portion reducing a width of the bore from the second end of the housing to the first end of the housing; a plunger having a first end and a second end, the first end disposed within the bore; an implant interface coupled to the first end of the plunger and configured to engage the implant; and a compression ring coupled to the plunger adjacent to the first end, the compression ring consisting essentially of silicone. The first end of the plunger can be configured to advance within the bore toward the first end of the housing, thereby advancing the implant from the implant bay through the delivery lumen, and the tapered portion of the bore can be configured to compress the compression ring as the first end of the plunger moves through the tapered portion.
Features, elements, and aspects described in the context of some embodiments may also be omitted, combined, or replaced by alternative features. Other features, objectives, advantages, and a preferred mode of making and using the claimed subject matter are described in greater detail below with reference to the accompanying drawings of illustrative embodiments.
The accompanying drawings illustrate some objectives, advantages, and a preferred mode of making and using some embodiments of the claimed subject matter. Like reference numbers represent like parts in the examples.
The following description of example embodiments provides information that enables a person skilled in the art to make and use the subject matter set forth in the appended claims, but it may omit certain details already well known in the art. The following detailed description is, therefore, to be taken as illustrative and not limiting.
The example embodiments may also be described herein with reference to spatial relationships between various elements or to the spatial orientation of various elements depicted in the attached drawings. In general, such relationships or orientation assume a frame of reference consistent with or relative to a patient in a position to receive an implant. However, as should be recognized by those skilled in the art, this frame of reference is merely a descriptive expedient rather than a strict prescription.
The nozzle 105 generally comprises a tip 120 adapted for insertion through an incision into an eye. The size of the tip 120 may be adapted to surgical requirements and techniques as needed. For example, small incisions are generally preferable to reduce or minimize healing times. Incisions of less than 2 millimeters may be preferable in some instances, and the tip 120 of the nozzle 105 may have a width of less than 2 millimeters in some embodiments. For example, in more particular embodiments, the tip 120 may have a width between about 1.5 millimeters and about 2 millimeters.
The implant bay 110 generally represents a wide variety of apparatuses that are suitable for storing an implant prior to delivery into an eye. In some embodiments, the implant bay 110 may additionally or alternatively be configured to prepare an implant for delivery. For example, some embodiments of the implant bay 110 may be configured to be actuated by a surgeon or other operator to prepare an implant for delivery by subsequent action of the actuator 115. In some instances, the implant bay 110 may be configured to actively deform, elongate, extend, or otherwise manipulate features of the implant before the implant is advanced into the nozzle 105. For example, the implant bay 110 may be configured to fold, tuck, extend or splay one or more features, such as haptics, of an intraocular lens.
The actuator 115 is generally configured to advance an implant from the implant bay 110 into the nozzle 105, and thereafter from the nozzle 105 through an incision and into an eye. The actuator 115 of
In general, components of the apparatus 100 may be coupled directly or indirectly. For example, the nozzle 105 may be directly coupled to the implant bay 110 and may be indirectly coupled to the actuator 115 through the implant bay 110. Coupling may include fluid, mechanical, thermal, electrical, or chemical coupling (such as a chemical bond), or some combination of coupling in some contexts. For example, the implant bay 110 may be mechanically coupled to the actuator 115 and may be mechanically and fluidly coupled to the nozzle 105. In some embodiments, components may also be coupled by virtue of physical proximity, being integral to a single structure, or being formed from the same piece of material.
The plunger rod 130 may be disposed at least partially within the bore 205. For example, as illustrated in
A compression ring 245 may be disposed within the bore 205 between the housing 125 and the plunger rod 130 or the plunger 230. In some embodiments, the compression ring 245 can be disposed around the plunger 230 as illustrated in the example of
An implant 250 may be stored initially in the implant bay 110. In some embodiments, the implant bay 110 may additionally or alternatively be configured to prepare the implant 250 for delivery. For example, some embodiments of the implant bay 110 may be configured to be actuated by a surgeon or other operator to prepare the implant 250 for delivery by subsequent action of the actuator 115. In some instances, the implant bay 110 may be configured to actively deform, elongate, extend, or otherwise manipulate features of the implant 250 before the implant 250 is advanced into a delivery lumen 255 of the nozzle 105. For example, some embodiments of the implant bay 110 may be configured to orient or fold the implant 250. Some embodiments of the implant 250 may comprise one or more haptics, which can be oriented for delivery.
In use, the plunger rod 130 may be advanced within the bore 205 toward the first end 210 of the housing 125, thereby advancing the plunger 230, which can advance the implant 250 from the implant bay 110 through the delivery lumen 255. In the example of
In the example of
In each of the three states of
In the first state of the apparatus 100 illustrated in
In the second state of the apparatus 100 illustrated in
As the plunger 230 is advanced further through the bore 205, a tapered portion can compress the compression ring 245. As illustrated in
As
At position X2, the implant has generally been advanced from the implant bay into the delivery lumen and advancement of the plunger is paused, which can allow the implant to be inspected for proper orientation before delivery. Consequently, the delivery force represented in each of Line 405 and Line 410 drops as the result allowing the implant to dwell briefly in this period. The position of the compression ring at position X2 is generally represented in
As the plunger is advanced beyond the position X2, the delivery forces continue to increase as illustrated by Line 405 and Line 410, which is generally the result of the implant entering the delivery lumen (see, e.g., delivery lumen 255 of
Thus, as
After the incision 505 is made, the nozzle 105 can be inserted through the incision 505 so that the width of the tip 120 aligns with the length of the incision 505, allowing the nozzle 105 to extend into an interior portion 525 of the eye 500. The apparatus 100 can then eject the implant 250 through the nozzle 105 into the capsular bag 520 of the eye 500, substantially as described with reference to
In some embodiments, the implant 250 may comprise an intraocular lens having a shape similar to that of a natural lens of an eye, and it may be made from numerous materials. Examples of suitable materials may include silicone, acrylic, and combinations of such suitable materials. In some instances, the implant 250 may comprise an intraocular lens that is fluid-filled, such as a fluid-filled accommodating intraocular lens. The implant 250 may also comprise an intraocular lens that includes one or more features, such as haptics, for positioning the intraocular lens within an eye. In the example of
The implant 250 may be delivered in a folded configuration and can revert to a resting state with the leading haptic 535 and the trailing haptic 540 being at least partially curved around the optic body 530, within the capsular bag 520, as shown in
The systems, apparatuses, and methods described herein may provide significant advantages. Some embodiments may be particularly advantageous for improving the delivery of intraocular lenses, making it smoother, more consistent, and more predictable throughout the delivery procedure. For example, the compression ring 245 and the bore 205 may be configured to dampen delivery forces as a lens or other implant is delivered. In more particular examples, the compression ring 245 can be compressed in the bore at different locations and/or at different rates to generate the right damping force at the right time and/or location to substantially reduce the risk of sudden movement throughout the procedure. Significantly, the position of the compression ring 245 can be modified for different embodiments to optimize the timing and location of the damping force as desired.
While shown in a few illustrative embodiments, a person having ordinary skill in the art will recognize that the systems, apparatuses, and methods described herein are susceptible to various changes and modifications that fall within the scope of the appended claims. Moreover, descriptions of various alternatives using terms such as “or” do not require mutual exclusivity unless clearly required by the context, and the indefinite articles “a” or “an” do not limit the subject to a single instance unless clearly required by the context. Components may also be combined or eliminated in various configurations for purposes of sale, manufacture, assembly, or use. For example, in some configurations, the nozzle 105, the implant bay 110, and the actuator 115 may each be separated from one another or combined in various ways for manufacture or sale.
The claims may also encompass additional subject matter not specifically recited in detail. For example, certain features, elements, or aspects may be omitted from the claims if not necessary to distinguish the novel and inventive features from what is already known to a person having ordinary skill in the art. Features, elements, and aspects described in the context of some embodiments may also be omitted, combined, or replaced by alternative features serving the same, equivalent, or similar purpose without departing from the scope of the invention defined by the appended claims.
This application claims the benefit of priority of U.S. Provisional Pat. Application Serial No. 63/263,948 titled “SURGICAL IMPLANT DELIVERY WITH DAMPING,” filed on Nov. 12, 2021, whose inventors are Harlen Hoang, Yinghui Wu, R. Mitchell Sherry, Douglas Brent Wensrich and Tuoqi Li, which is hereby incorporated by reference in its entirety as though fully and completely set forth herein.
Number | Date | Country | |
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63263948 | Nov 2021 | US |