WO2009004147A2

WO2009004147A2 - Crystalline lens neocapsule

Info

Publication number: WO2009004147A2
Application number: PCT/FR2008/000711
Authority: WO
Inventors: Pascal Pietrini
Original assignee: Pascal Pietrini
Priority date: 2007-05-24
Filing date: 2008-05-23
Publication date: 2009-01-08
Also published as: WO2009004147A3; FR2916342B1; FR2916342A1

Abstract

Auxiliary intraocular implant designed to be inserted into the capsular bag before or during insertion of a main intraocular implant, the main intraocular implant comprising an optic lens designed to replace the natural crystalline lens of the eye, and characterized in that the auxiliary intraocular implant is composed of a thin plate (4) of substantially planar form.

Description

CRYSTALLINE NEOCAPSULE

The present invention relates to an implant intended to be implanted in the capsular bag of the lens of an eye, especially in humans. It is known to remove the natural crystalline lens of the eye, which is in the so-called capsular bag, and to replace this crystalline lens with an intraocular implant. Numerous intraocular implants replacing the natural lens of the eye are known, for example documents US Pat. No. 6,387,126, WO 96/29956, FR 2 786 686 or French Patent Application No. 06 04032 filed on October 5 May 2006 by the applicant of this application.

To implant in the capsular bag these intraocular implants with a lens, it is necessary to make an incision in the anterior portion of the capsular bag. The intraocular implant is then passed through the opening formed for insertion into the capsular bag, and then allowed to adhere to the inner surface of the posterior wall of the capsular bag. However, it may happen that when the incision is made in the anterior part of the capsular bag, the posterior wall of the envelope of the capsular bag can be pierced as well. This then results, on the one hand, a difficulty to empty the capsular bag of the natural lens that can escape by the other hole formed in the posterior wall, and secondly difficulties to position the intraocular implant.

The present invention aims to overcome the disadvantages of the prior art, by proposing an intraocular implant intended to be inserted into the capsular bag by an incision formed in the anterior wall of the capsular bag, which overcomes the disadvantages of the devices of the prior art, particularly in the case where the capsular bag has also been pierced in its posterior wall.

According to the invention, there is provided an ophthalmic assembly according to claim 1, improvements being defined in claims 2 to 9. The present invention also relates to a method according to claim 10.

Thus, before insertion of the main intraocular implant, an auxiliary intraocular implant is inserted in the form of a thin plate to "plug" the opening pierced by mistake in the capsular bag at its posterior wall. Once this plate is inserted, one can then insert the main intraocular implant. In particular, the insertion of this main implant is facilitated in certain cases.

• When the plate is a circular disk the dimension of the plate parallel to the imaginary line passing through the free ends of the two tabs furthest away from each other is the diameter of the plate. When the plate is circular, this dimension is the diameter. When the plate is rectangular this dimension is usually the long side of the rectangle. When the plate is elliptical it is the long axis of the ellipse. Preferably, the haptic tabs issuing from the lens are inclined relative to the plane of the lens, extending in the anterior direction from the anterior face of the lens, in particular at an angle of 5 to 15 °. Preferably, the plate comprises gripping and / or holding means for manipulating the plate to position it in the capsular bag and / or to hold it there. In particular, these gripping means consist of at least one hole formed in the plate, preferably substantially at its edge or on its periphery, the hole or holes for the passage d ⁷ a thread by means of which one can introduce and position the plate in the capsular bag, held in position, for example during implantation of the lens and possibly remove it from the capsular bag.

Preferably the gripping means and / or holding consist d ^/ a plurality of holes formed substantially - at the turn of the plate, preferably being at a regular distance from each other.

Preferably, the largest dimension of the plate is smaller than the largest dimension of the lens, for example the lens being a circular disk 5 to 7 mm in diameter while the plate is a circular disk 3 to 5 mm in diameter. diameter.

Preferably, the auxiliary intraocular implant is made of a material comprising a hydrophilic acrylic. It is thus particularly flexible, so that after the primary intraocular lens was inserted and was well ^• grafted to the inner part of the capsular bag, it can - easily remove the auxiliary intraocular implant that deforms easily . According to a preferred embodiment of the invention, the thickness of the thin plate is between 0.05 mm and 0.30 mm, preferably between 0.07 mm and 0.15 mm, in particular between 0, 09 mm and 0.12 mm. Preferably, the plate has a constant thickness. Preferably, the largest dimension of the planar plate is substantially between 5 and 10 mm. In particular, it may be a disc having a diameter of between 5 and 10 mm. It can also be an elliptical surface plate having a large axis between 5 and 10 mm and a minor axis between 2 and 5 mm. It may also be a rectangular plate having a length dimension of between 5 and 10 mm and a width dimension of between 2 and 5 mm.

Preferably, the edge portion or periphery of the flat membrane plate has a rounded shape.

The present invention also relates to the assembly of an auxiliary intraocular implant according to the invention and a main intraocular implant, the main intraocular implant comprising in particular a disk-shaped central portion comprising a circular disk-shaped optics. and at least two haptic tabs spaced apart from each other radially projecting from the optic. In particular, the end edges of the at least two haptics can be interconnected by ring segments, so that the outer end edges and the ring segments form a ring which, in projection in the plane of optics, extends all around the periphery of the optics at a distance from it.

In the figures, there is shown a preferred embodiment of the invention. In Figure 1, we see, in sectional view, a crystalline bag of an eye comprising the combination of a main optical implant and an auxiliary optical implant according to the invention;

In Figure 2, there is shown a portion of Figure 1 on a larger scale;

In Figure 3, there is shown an assembly according to the invention seen from above the rear side;

In Figure 4, it is shown in perspective, seen from the front side, the assembly of Figure 3; and In Figure 5, there is shown all of Figures 3 and 4, seen from the side.

In Fig. 1, we can see the sagittal section of an eye, which has in its anterior part a capsular sac which has been opened in its anterior part (on the external side) and from which has been extracted the natural crystalline lens. When performing the opening of the anterior side of the capsular bag 5, it has also inadvertently been pierced with an opening 2 on the posterior side. It was then inserted, before inserting the main optical implant 3, a flat plate 4, an implantable material and preferably transparent (optically inactive), which is intended to come to plug the opening 2. Then, the 3 main implant has been inserted. This main implant 3 comprises an optical disk portion 6 and two haptic tabs 7.

Preferably, the edge of the flat plate is rounded, the plate is in particular circular or elliptical. It can, however, also be square or ^rectangular. Its thickness dimension is between 0.05 mm and 0.30 mm. Its length dimension can be between 6 and 10 mm. Its width dimension can be between 3 and 10 mm. In particular, it is made from a hydrophilic acrylic or a hydrophobic acrylic. In the case of a hydrophobic acrylic, it is a priori intended to remain in the bag in perpetual manner. On the other hand, in the case of a hydrophilic acrylic material, it is conceivable, at the end of the procedure, to remove the flat plate. FIG. 2 shows the distance L between the two free ends of the two diametrically opposed tabs 7 facing the diameter D of the plate 4. D is smaller than L.

The anterior side of the lens or optical disc 6 is the left side in Figures 1 and 2, while the back side is the right side. When the lens is inserted into the capsular bag, the posterior side is towards the back of the eye and the anterior side is towards the front of the eye. The plate 4 is directly in front of the posterior side of the lens, that is to say without interposition of anything.

As hydrophilic acrylic, there may be a polymer or a copolymer whose monomer is in particular hydroxyethyl methacrylate (HEMA) or hydroxypropyl acrylate (HPA) or hydroxypropyl methacrylate.

As hydrophobic acrylic, one can provide one of those described in US Patent 5,693,095 and in particular a polymer or a copolymer whose monomer is 2-phenylethyl acrylate or 4-phenylbutyl methacrylate.

In Figures 3 to 5 is described another embodiment of the invention. The plate 4 'is a circular disk while the main intraocular implant consists of an optical disk 6' forming a substantially circular lens which protrudes four legs 7 'haptic. Each haptic leg is pierced with a hole 8 'to give it more flexibility. With respect to the center 9 'of the circle of the disc 6', the haptics are distributed two by two diametrically opposite, the two diameters each corresponding to a pair of haptics forming between them an angle of about 60 °. The circular thin plate 4 'has at its periphery a series of holes 11', in particular 8 or 10, distributed angularly in a regular manner.

As best seen in Figure 3, the plate 4 'is directly in front of the posterior side of the lens, without interposition of anything between they, and in particular and in contact with the posterior face of the intraocular implant, in particular is in contact with the lens.

With respect to the passing horizontal plane defined by the circle or perimeter of the lens optical disc 6 ', the haptic tabs 7 are inclined at an angle of about 10 °, being oriented towards the anterior direction. The optical disc 6 'forming a lens may be substantially flat disk-shaped, or have its concave and / or convex anterior and / or posterior surfaces depending on the optical properties that one wishes to have. However, such a lens always has an anteroposterior sense according to which it must be implanted. In general, when looking through the lens in the postero-anterior direction the image appears convergent, while when looking through the lens in the other direction, the image appears divergent.

The largest dimension between ends of. two opposite haptics is about 12 to 15 mm, especially about 13.5 mm, while the optical disk has a diameter of about 6 mm. In Figure 3, the plate 4 'has a diameter of 9mm, while the holes 11' have a diameter of 0.5 mm. According to another embodiment not shown but particularly advantageous, the plate 4 'may have a smaller diameter than the optical disk, and in particular have a diameter of 5 to 6 mm. In such a case, it is also preferable to provide fewer peripheral holes, for example 4 or 5.

Claims

1. Ophthalmic assembly comprising

a main intraocular implant comprising an optical lens (6; 6 ') for replacing a natural lens, from which at least two legs (7; 7') forming haptics start, the optical lens having an anterior face and a posterior face, and

- A solid plate, an implantable material, characterized in that the solid plate is disposed directly opposite the rear face of the lens.

2. An assembly according to claim 1, characterized in that the distance (L) between free ends of the two tabs (7; 7 ') farthest from each other is greater than the dimension, parallel to the imaginary line passing through these free ends of the plate (4; 4 ').

3. An assembly according to claim 2, characterized in that parallel to said imaginary line the dimension of the lens is larger than the size of the plate.

4. Assembly according to one of claims 1 to 3, characterized in that, relative to the horizontal plane passing through the circle or the perimeter of the optical disc (6; 6 ') forming a lens, the tabs (7; 7') haptics are inclined towards the anterior direction, in particular at an angle of 5 to 15 °.

5. An assembly according to one of claims 1 to 4, characterized in that the plate comprises gripping means and / or holding for handling the plate to position it in the capsular bag and / or to maintain it and / or to extract it.

6. An assembly according to claim 5, characterized in that the gripping means are constituted by at least one hole formed in the plate, preferably substantially at its edge or its periphery, the hole or holes allowing the passage of a wire by means of which it is possible to position the plate in the capsular bag, hold it in position, for example during implantation of the lens and possibly remove it from the capsular bag.

7. The assembly of claim 5, characterized in that the lens is convergent in the postero-anterior direction.

8. An assembly according to any one of the preceding claims, characterized in that the anterior face of the plate (4 ') is in contact with the posterior face of the intraocular implant, in particular with the posterior surface of the lens.

9. An assembly according to any one of the preceding claims, characterized in that the end edges of the at least two haptics can be interconnected by ring segments, so that the outer end edges and the segments ring form a ring which, in projection in the optical plane, extends all around the optical periphery at a distance from it.

10. Method of placing an intraocular implant in the capsular bag in which

- At the bottom of the bag is placed a plate (4; 4 ') of an implantable material, then introduced into the bag in front of the plate an intraocular implant comprising an optical lens of the lens replacement and at least two legs forming haptic.