U.S. patent application number 13/818595 was filed with the patent office on 2016-03-03 for advanced pushrod and pushrod assembly features.
This patent application is currently assigned to ABBOTT MEDICAL OPTICS INC.. The applicant listed for this patent is Steven R. Anderson, David W. Gaylord, Kevin R. Springer. Invention is credited to Steven R. Anderson, David W. Gaylord, Ahmed Helmy, Kevin R. Springer.
Application Number | 20160058554 13/818595 |
Document ID | / |
Family ID | 45724054 |
Filed Date | 2016-03-03 |
United States Patent
Application |
20160058554 |
Kind Code |
A1 |
Anderson; Steven R. ; et
al. |
March 3, 2016 |
ADVANCED PUSHROD AND PUSHROD ASSEMBLY FEATURES
Abstract
A pushrod tip having a top and bottom jaw, wherein the top and
bottom jaws are coupled together to form an opening, wherein the
top jaw is capable of flexing towards the bottom jaw when the
pushrod tip is passed through a lumen. A pushrod having a top and
bottom jaw, each with a first and second side along a longitudinal
axis of the pushrod; the top and bottom jaw are coupled together;
and the top jaw comprises a notch on the first side of the pushrod.
An insertion system having a handpiece with a channel(s); and a
pushrod assembly having a pushrod and a plunger; the pushrod having
a rail(s) that is configured to couple with the channel(s) of the
handpiece. An insertion system having a handpiece with a detent(s)
and a key(s); and a pushrod assembly having a pushrod, a plunger,
and a nut lock that has a series of radial keyways and a groove.
The groove of the nut lock is configured to mate with the
detent(s), and the series of radial keyways are configured to mate
with the key(s).
Inventors: |
Anderson; Steven R.; (Rancho
Santa Margarita, CA) ; Gaylord; David W.; (Mission
Viejo, CA) ; Helmy; Ahmed; (Palm Desert, CA) ;
Springer; Kevin R.; (Santa Ana, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Anderson; Steven R.
Gaylord; David W.
Springer; Kevin R. |
Rancho Santa Margarita
Mission Viejo
Santa Ana |
CA
CA
CA |
US
US
US |
|
|
Assignee: |
ABBOTT MEDICAL OPTICS INC.
Santa Ana
CA
|
Family ID: |
45724054 |
Appl. No.: |
13/818595 |
Filed: |
August 24, 2011 |
PCT Filed: |
August 24, 2011 |
PCT NO: |
PCT/US2011/049028 |
371 Date: |
September 25, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61376661 |
Aug 24, 2010 |
|
|
|
61467584 |
Mar 25, 2011 |
|
|
|
61500564 |
Jun 23, 2011 |
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Current U.S.
Class: |
606/107 |
Current CPC
Class: |
A61F 2/1678 20130101;
A61F 2/1662 20130101; A61F 2/1675 20130101; A61F 2/1667 20130101;
A61F 2/167 20130101; A61F 2002/1681 20130101; A61F 2/1672
20130101 |
International
Class: |
A61F 2/16 20060101
A61F002/16 |
Claims
1. A pushrod tip, comprising: a top jaw; and a bottom jaw; wherein
the top jaw and bottom jaw are coupled together to form an opening
configured and dimensioned to couple with an intraocular lens;
wherein the top jaw is capable of flexing towards the bottom jaw
when the pushrod tip is passed through a lumen.
2. The pushrod tip of claim 1, wherein the top jaw further
comprises a lip coupled to the bottom jaw, wherein the lip is
configured and dimensioned to flex the top jaw when the pushrod tip
is passed through the lumen.
3. The pushrod tip of claim 2, wherein the lip is located on a
periphery of the top jaw such that the tip comes in contact with
the lumen and not the top jaw.
4. The pushrod tip of claim 1, wherein the bottom jaw further
comprises a lip coupled to the bottom jaw, wherein the lip is
configured and dimensioned to flex the bottom jaw when the pushrod
tip is passed through the lumen.
5. The pushrod tip of claim 1, wherein the lumen is tapered.
6. The pushrod tip of claim 1, wherein the bottom jaw remains
substantially rigid when compared to the top jaw.
7. The pushrod tip of claim 1, wherein the top jaw is longer than
the bottom jaw.
8. The pushrod tip of the claim 1, wherein the top jaw and the
bottom jaw release the intraocular lens once the intraocular lens
exits the lumen.
9. An insertion system, comprising: a handpiece having a
longitudinal axis, a distal end, and a proximal end; and a pushrod
assembly having a distal end and a proximal end, wherein the
pushrod assembly comprises a pushrod and a plunger; wherein the
pushrod assembly couples with the handpiece body along the
longitudinal axis; wherein the pushrod is coupled with the plunger
and the pushrod is located on the distal end of the pushrod
assembly and the plunger is located on the proximal end of the
pushrod assembly; wherein the pushrod or the handpiece comprises
one or more guide rails, wherein the one or more guide rails are
configured and dimensioned to couple with one or more channels of
the pushrod or the handpiece.
10. The insertion system of claim 9, wherein the one or more guide
rails have a substantially rectangular shape.
11. The insertion system of claim 9, wherein the one or more
channels have a substantially rectangular shape.
12. The insertion system of claim 9, wherein there are two guide
rails and two channels and wherein one channel and one guide rail
are larger than the other rail and channel.
13. The insertion system of claim 9, wherein the handpiece
comprises the one or more channels and further comprises a holding
station and wherein at least a portion of the one or more channels
are located within the holding station.
14. The insertion system of claim 9, wherein the handpiece
comprises the one or more guide rails and the pushrod comprises the
one or more channels, and wherein the handpiece further comprises a
holding station wherein at least a portion of the one or more guide
rails are located within the holding station.
15. An insertion system, comprising: a handpiece comprising one or
more detents, and one or more keys; and a pushrod assembly
comprising a pushrod, a plunger, and a nut lock, wherein the nut
lock comprises a series of radial keyways and a groove, wherein the
groove of the nut lock is configured and dimensioned to mate with
the one or more detents of the handpiece, and wherein the series of
radial keyways are configured and dimensioned to mate with the one
or more keys of the handpiece.
16. The insertion system of claim 15, wherein the nut lock is
coupled between the pushrod and the plunger.
17. The insertion system of claim 15, wherein the plunger comprises
one or more detents located on a distal portion.
18. A method of preparing an insertion system, comprising:
providing an insertion system in a first position, wherein the
insertion system comprises a handpiece having a longitudinal axis,
a proximal portion, and a distal portion, and comprising a first
detent, a second detent, and one or more keys; and a pushrod
assembly comprising a pushrod, a plunger, and a nut lock, wherein
the nut lock comprises a series of radial keyways and a groove,
wherein the groove of the nut lock is configured and dimensioned to
mate with the first detent and the second detent of the handpiece,
and wherein the series of radial keyways are configured and
dimensioned to mate with the one or more keys of the handpiece; and
wherein the first position comprises the groove being mated with
the first detent located at the proximal portion of the handpiece,
wherein rotation of the plunger does not advance the pushrod along
the longitudinal axis; pushing the pushrod assembly to a second
position along the longitudinal axis in a distal direction, wherein
the second position is between the first detent and the second
detent, wherein rotation of the plunger does not advance the
pushrod along the longitudinal axis; pushing the pushrod assembly
to a third position along the longitudinal axis in the distal
direction, wherein in the third position the groove is mated with
the second detent of the handpiece; and rotating the plunger to
advance the pushrod along the longitudinal axis in the distal
direction to advance the intraocular lens through the handpiece,
wherein pushing the plunger does not advance the pushrod along the
longitudinal axis.
19. A pushrod, comprising: a top jaw having a first side and a
second side along a longitudinal axis of the pushrod; and a bottom
jaw having a first side and a second side along the longitudinal
axis of the pushrod; wherein the top jaw and the bottom jaw are
coupled together; and wherein the top jaw comprises a notch on the
first side along the longitudinal axis of the pushrod that is
configured and dimensioned to couple with an intraocular lens when
the pushrod tip is passed through a lumen.
20. The pushrod of claim 19, wherein the notch is L-shaped.
21. The pushrod of claim 19, wherein the notch extends beyond the
top jaw into a body of the pushrod.
22. The pushrod of claim 19, wherein the bottom jaw comprises a
notch along a longitudinal axis of the pushrod that is configured
and dimensioned to couple with an intraocular lens when the pushrod
tip is passed through a lumen.
23. The pushrod of claim 19, wherein the top jaw comprises a second
notch on the second side along the longitudinal axis of the
pushrod.
24. The pushrod of claim 19, wherein the bottom jaw is longer than
the top jaw.
25. The pushrod of claim 19, wherein the top jaw is configured and
dimensioned to engage a trailing haptic before the bottom jaw
engages a lens body.
26. The pushrod of claim 19, wherein the top jaw is configured and
dimensioned to couple with and ride along at least a portion of a
channel of a staging area of an insertion device.
27. The pushrod of claim 19, wherein the top jaw has a height that
is greater than the height of a haptic to ensure the top jaw
consistently engages the haptic.
28. The pushrod of claim 19, wherein the notch extends into a
portion of the bottom jaw.
29. The pushrod of claim 28, wherein the top jaw comprises a second
notch on the second side along the longitudinal axis of the
pushrod.
30. The pushrod of claim 29, wherein the second notch extends into
a portion of the bottom jaw.
31. An insertion system, comprising: a handpiece having a
longitudinal axis, a distal end, and a proximal end, a pushrod
assembly having a distal end and a proximal end, wherein the
pushrod assembly comprises a pushrod and a plunger; wherein the
pushrod assembly couples with the handpiece along the longitudinal
axis; wherein the pushrod is coupled with the plunger and the
pushrod is located on the distal end of the push rod assembly and
the plunger is located on the proximal end of the pushrod assembly;
wherein the plunger is configured and dimensioned to advance the
pushrod toward the distal end of the handpiece along the
longitudinal axis by rotation of the plunger and translational
movement of the plunger; wherein the plunger comprises threads and
one or more safety detents, wherein the one or more safety detents
are located on a distal end of the plunger on one or more of the
threads; and wherein the one or more safety detents are configured
and dimensioned to prevent advancement of pushrod with rotation of
the plunger until such rotation is desired.
32. The insertion system of claim 31, wherein the one or more
safety detents are located within the first two or three threads
from the distal end of the plunger.
33. The insertion system of claim 32, wherein the threads comprise
one to six safety detents.
34. The insertion system of claim 32, wherein the threads comprise
four safety detents.
Description
CROSS-REFERENCE TO RELATED PATENTS AND APPLICATIONS
[0001] This application claims priority to U.S. Provisional
Application Nos. 61/376,661, filed on Aug. 24, 2010; 61/467,584,
filed on Mar. 25, 2011; and 61/500,564, filed on Jun. 23, 2011,
each of which is hereby incorporated by reference in its
entirety.
TECHNICAL FIELD OF THE INVENTION
[0002] The present invention relates to devices, systems, and
methods for delivering an intraocular lens (IOLs) into an eye. More
particularly, the invention relates to devices, systems, and
methods in which advanced features are incorporated into insertion
devices to aid in ease of insertion of IOLs.
BACKGROUND OF THE INVENTION
[0003] It is estimated that 73% of Americans between the ages of 65
to 74 get cataracts. A cataract is a clouding of the eye's lens
that impairs a person's vision and, if left untreated, causes
blindness. As a result, each year approximately 1.4 million people
in the United States alone undergo cataract surgery, whereby the
clouded natural crystalline lens is removed and replaced with an
intraocular lens (IOL) implant.
[0004] Surgeons implant IOLs not only as a replacement for the
natural crystalline lens but also to alter the optical properties
of (provide vision correction to) an eye with an existing IOL or in
which the natural lens remains. IOLs often include an optically
clear disk-like optic of about 6 mm in diameter, and preferably at
least one flexible fixation member or haptic which extends radially
outward from the optic and becomes affixed in the eye to secure the
lens in position.
[0005] The optics may be constructed of rigid biocompatible
materials such as polymethyl methacrylate (PMMA) or deformable
materials such as silicone polymeric materials, acrylic polymeric
materials, hydrogel polymeric materials, and the like. The
deformable materials allow the IOL to be rolled or folded for
insertion through an injector or insertion cartridge and an
incision into the eye. Once within the chamber of the eye, the IOL
is expulsed from the injector and returns to its original
shape.
[0006] Injectors or inserters for delivering IDLs into the eye
typically employ a handpiece and a removable cartridge that
receives the IOL and has a hollow insertion tube or cannula through
which the folded IOL is passed using a pushrod. Some inserters do
without the cartridge. The inserter may be wholly or partly
reusable, in which case the inserter or handpiece is usually made
of some type of metal alloy that can be sterilized. Alternatively,
disposable inserters made of less expensive materials, such as
plastics, remain in a sterile package until ready for use. In some
cases, the IOL is stored separately and transferred to a load
chamber in the inserter or cartridge just prior to delivery. One
particularly useful arrangement wherein the cartridge folds over an
IOL is disclosed in U.S. Pat. No. 4,681,102 to Bartell. A cartridge
opens to receive an IOL in a load chamber, and then folds closed
and fits into an injector. A syringe-like plunger in the injector
pushes the IOL from the load chamber through a tapered tube into
the eye. The IOL unfolds as it emerges from the tip of the tapered
tube. Another such insertion system is disclosed in Makker et al.,
U.S. Pat. No. 5,942,277. An example of storing an IOL in an
inserter component is seen in U.S. Pat. No. 7,156,854, filed May
28, 2003. In the '854 patent, a nozzle portion 12 along with a
removable stop 26 retains the IOL therein during storage and has
internal ramps that assist in folding the IOL optic during an
implant procedure. Also, U.S. Patent Publication No. 2008/0058830,
filed Jul. 17, 2007, discloses a number of configurations for
pre-loading IOLs for transfer to an insertion apparatus, and is
expressly incorporated herein. Another preloaded insertion system
is illustrated in U.S. Patent Publication No. 2009/0318933, filed
Jun. 23, 2008, which is hereby incorporated by reference in its
entirety.
[0007] Despite the advances in the area of insertion devices, there
remains a need for devices and systems that increase the ease of
use of inserters, including facilitating the insertion of IOLs,
while reducing the risk of damage to both the insertion device and
the IOL.
SUMMARY OF THE INVENTION
[0008] The present inventions disclose an insertion system,
comprising a handpiece having a longitudinal axis, a distal end,
and a proximal end, a pushrod assembly having a distal end and a
proximal end, wherein the push rod assembly comprises a pushrod and
a plunger; wherein the pushrod assembly couples with the handpiece
along the longitudinal axis; wherein the pushrod is coupled with
the plunger and the pushrod is located on the distal end of the
push rod assembly and the plunger is located on the proximal end of
the pushrod assembly; a cartridge comprising a delivery tube at a
distal end; wherein the cartridge is configured and dimensioned to
couple with the distal end of the handpiece; a cap comprising a
window and a port; wherein the cap is configured and dimensioned to
couple with the distal end of the cartridge. According to an
embodiment, the cartridge may further comprise one or more wings
and the cap may further comprise one or more clips, wherein the one
or more clips are configured and dimensioned to couple with the one
or more wings. According to another embodiment, the cap may further
comprise an internal bevel inside the cap at a distal end, wherein
the internal bevel is configured and dimensioned to couple with a
bevel at the distal end of the delivery tube.
[0009] In an embodiment, a device comprises a cap have a
longitudinal axis, a distal end, and a proximal end, wherein the
cap comprises window and a port; wherein the window comprises a
fill indicator. According to an embodiment, the port may be located
at the distal end. In an embodiment, the cap may further comprise
one or more clips, wherein the clips are configured and dimensioned
to couple with one or more wings of a cartridge. In another
embodiment, the cap may further comprise an internal bevel inside
the cap near the distal end, wherein the internal bevel is
configured and dimensioned to couple with a bevel at a distal end
of a delivery tube.
[0010] According to an embodiment, an insertion system comprises a
handpiece having a longitudinal axis, a distal end, and a proximal
end, a pushrod assembly having a distal end and a proximal end,
wherein the push rod assembly comprises a pushrod and a plunger;
wherein the pushrod assembly couples with the handpiece along the
longitudinal axis; wherein the pushrod is coupled with the plunger
and the pushrod is located on the distal end of the push rod
assembly and the plunger is located on the proximal end of the
pushrod assembly; wherein the plunger comprises a marker configured
and dimensioned to indicate axially translation of the pushrod
assembly within the handpiece; and a cartridge comprising a
delivery tube at a distal end; wherein the cartridge is configured
and dimensioned to couple with the distal end of the handpiece.
[0011] According to another embodiment, an insertion system
includes a handpiece having a longitudinal axis, a distal end, and
a proximal end; and a pushrod assembly having a distal end and a
proximal end, wherein the pushrod assembly comprises a pushrod and
a plunger; wherein the pushrod assembly couples with the handpiece
body along the longitudinal axis; wherein the pushrod is coupled
with the plunger and the pushrod is located on the distal end of
the pushrod assembly and the plunger is located on the proximal end
of the pushrod assembly; and wherein the pushrod or the handpiece
comprises one or more guide rails, wherein the one or more guide
rails are configured and dimensioned to couple with one or more
channels of the pushrod or the handpiece. In an embodiment, the one
or more guide rails have a substantially rectangular shape. In
another embodiment, the one or more channels have a substantially
rectangular shape. In an embodiment, there are two guide rails and
two channels and wherein one channel and one guide rail are larger
than the other rail and channel. In another embodiment, the
handpiece comprises the one or more channels and further comprises
a holding station and wherein at least a portion of the one or more
channels are located within the holding station; or the handpiece
comprises the one or more guide rails and the pushrod comprises the
one or more channels, and wherein the handpiece further comprises a
holding station wherein at least a portion of the one or more guide
rails are located within the holding station.
[0012] According to an embodiment, a pushrod includes a top jaw
having a first side and a second side along a longitudinal axis of
the pushrod; and a bottom jaw having a first side and a second side
along the longitudinal axis of the pushrod; wherein the top jaw and
the bottom jaw are coupled together; and wherein the top jaw
comprises a notch on the first side along the longitudinal axis of
the pushrod that is configured and dimensioned to couple with an
intraocular lens when the pushrod tip is passed through a lumen. In
an embodiment, the notch is L-shaped. In another embodiment, the
notch extends beyond the top jaw into a body of the pushrod. In
another embodiment, the bottom jaw comprises a notch along a
longitudinal axis of the pushrod that is configured and dimensioned
to couple with an intraocular lens when the pushrod tip is passed
through a lumen. In another embodiment, the top jaw comprises a
second notch on the second side along the longitudinal axis of the
pushrod. In another embodiment, the bottom jaw is longer than the
top jaw. In an embodiment, the notch extends into a portion of the
bottom jaw. In another embodiment, the top jaw comprises a second
notch on the second side along the longitudinal axis of the
pushrod. In another embodiment, the second notch extends into a
portion of the bottom jaw.
[0013] According to an embodiment, an insertion system includes a
handpiece having a longitudinal axis, a distal end, and a proximal
end, a pushrod assembly having a distal end and a proximal end,
wherein the pushrod assembly comprises a pushrod and a plunger;
wherein the pushrod assembly couples with the handpiece along the
longitudinal axis; wherein the pushrod is coupled with the plunger
and the pushrod is located on the distal end of the push rod
assembly and the plunger is located on the proximal end of the
pushrod assembly; wherein the plunger is configured and dimensioned
to advance the pushrod toward the distal end of the handpiece along
the longitudinal axis by rotation of the plunger and translational
movement of the plunger; wherein the plunger comprises threads and
one or more safety detents, wherein the one or more safety detents
are located on a distal end of the plunger on one or more of the
threads; and wherein the one or more safety detents are configured
and dimensioned to prevent advancement of pushrod with rotation of
the plunger until such rotation is desired. In an embodiment, the
one or more safety detents are located within the first two or
three threads from the distal end of the plunger. In another
embodiment, the threads comprise one to six safety detents. The
threads may also comprise four safety detents.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] The present invention is best understood with reference to
the following detailed description of the invention and the
drawings in which:
[0015] FIG. 1 is an assembled perspective view of an insertion
system according to an embodiment of the invention;
[0016] FIG. 1A is an assembled perspective view of an insertion
system according to an embodiment of the invention;
[0017] FIG. 2 is a top view of an insertion system according to an
embodiment of the invention;
[0018] FIG. 2A is a top view of an insertion system according to an
embodiment of the invention;
[0019] FIG. 3 is a side view of an insertion system according to an
embodiment of the invention;
[0020] FIG. 3A is a side view of an insertion system according to
an embodiment of the invention;
[0021] FIG. 4 is a bottom view of an insertion system according to
an embodiment of the invention;
[0022] FIG. 4A is a bottom view of an insertion system according to
an embodiment of the invention;
[0023] FIG. 5 is an exploded view of the insertion system according
to FIGS. 1 and 1A;
[0024] FIG. 6 is a perspective view of a puller cap according to an
embodiment of the invention;
[0025] FIG. 7 is a perspective view of a puller cap according to an
embodiment of the invention;
[0026] FIG. 8 is cross-sectional view of a puller cap and insertion
system according to an embodiment of the invention;
[0027] FIG. 9 is cross-sectional view of a puller cap and insertion
system according to an embodiment of the invention;
[0028] FIG. 10 is an assembled perspective view of an insertion
system with a puller cap according to an embodiment of the
invention;
[0029] FIG. 11 is an assembled perspective view of an insertion
system with a puller cap according to an embodiment of the
invention;
[0030] FIG. 12 is an assembled perspective view of an insertion
system with a puller cap according to an embodiment of the
invention;
[0031] FIG. 13 is an assembled perspective view of an insertion
system with a puller cap according to an embodiment of the
invention;
[0032] FIGS. 14A-E are multiple views of a pin according to an
embodiment of the invention;
[0033] FIG. 15 is a cross-sectional perspective view of a puller
cap and insertion system according to an embodiment of the
invention;
[0034] FIG. 15A is a cross-sectional view of a pin, puller cap, and
insertion system according to an embodiment of the invention;
[0035] FIG. 16 is a cross-sectional perspective view of a puller
cap and insertion system according to an embodiment of the
invention;
[0036] FIG. 17 is a cross-sectional perspective view of a puller
cap and insertion system according to an embodiment of the
invention;
[0037] FIGS. 18A-C are cross-sectional views of an alternate
embodiment of the puller cap;
[0038] FIG. 18D is a perspective view of the alternative embodiment
of the puller cap shown in FIGS. 18A-C;
[0039] FIG. 19A is a side view of a pushrod according to an
embodiment;
[0040] FIG. 19B is a side view of a pushrod according to an
embodiment;
[0041] FIG. 19C is a side view of a pushrod according to an
embodiment;
[0042] FIG. 19D is a perspective view of pushrod according to an
embodiment of the invention;
[0043] FIG. 19E is a side view of a pushrod according to an
embodiment;
[0044] FIG. 20 is a cross-sectional perspective view of the pushrod
in FIG. 19D;
[0045] FIG. 21 is a cross-sectional view of a puller cap and
insertion system according to an embodiment of the invention;
[0046] FIG. 22A is a perspective view of the protective cap
according to an embodiment;
[0047] FIG. 22B is a top view of the protective cap according to an
embodiment;
[0048] FIG. 22C is a side view of the protective cap according to
an embodiment;
[0049] FIG. 22D is a front view of the protective cap according to
an embodiment;
[0050] FIG. 22E is a side view of the protective cap according to
an embodiment;
[0051] FIG. 22F is a rear view of the protective cap according to
an embodiment;
[0052] FIG. 22G is bottom view of the protective cap according to
an embodiment;
[0053] FIG. 23A is a cross-sectional view of the protective cap
shown in FIG. 22F;
[0054] FIG. 23B is a cross-sectional view of the protective cap
shown in FIG. 22D;
[0055] FIG. 24A is a cross-sectional view of the protective cap
shown in FIG. 22B;
[0056] FIG. 25 is an assembled perspective view of an insertion
system with a protective cap according to an embodiment of the
invention;
[0057] FIG. 26 is an assembled perspective view of an insertion
system with a protective cap according to an embodiment of the
invention
[0058] FIGS. 27A-F are additional embodiments of a protective
cap;
[0059] FIGS. 28A-F are additional embodiments of a protective
cap;
[0060] FIGS. 29A-F are additional embodiments of a puller cap;
[0061] FIGS. 30A-F are additional embodiments of a puller cap;
[0062] FIG. 31A is a side view of an insertion system according to
an embodiment;
[0063] FIG. 31B is a side view with a cutout portion of an
insertion system according to an embodiment;
[0064] FIG. 31C is a side view of an insertion system according to
an embodiment;
[0065] FIG. 32 is a cross-sectional view of a rails and channels
embodiment;
[0066] FIG. 33 is a perspective view of a nut lock according to an
embodiment;
[0067] FIG. 33A is a cross-sectional view of a nut lock according
to an embodiment;
[0068] FIG. 33B is a cross-sectional view of a nut lock according
to an embodiment; and
[0069] FIG. 34 is a perspective view of a detent safety
embodiment.
DETAILED DESCRIPTION OF THE INVENTION
[0070] Reference will now be made in detail to embodiments of the
invention, examples of which are illustrated in the accompanying
drawings. While the invention will be described in conjunction with
the embodiments, it will be understood that they are not intended
to limit the invention to those embodiments. On the contrary, the
invention is intended to cover alternatives, modifications, and
equivalents, which may be included within the spirit and scope of
the invention as defined by the appended claims.
[0071] FIGS. 1-4 illustrate varying views of an exemplary IOL
insertion system 20 of the present invention comprising a
twist/syringe-style device having, generally, a handpiece 22, a
plunger 24, and a delivery tube 26 on a distal end/portion thereof.
As illustrated in FIGS. 1-3, IOL insertion system 20 may also
include puller pin 100, which will be described in greater detail
below. As illustrated in FIG. 4, system 20 also may comprise port
21 to enable application or insertion of a fluid, such as water,
balance salt solution, and/or viscoelastic. FIGS. 1A-4A illustrates
an alternative IOL insertion system 20 of the present invention.
The IOL insertion system 20 illustrated in FIGS. 1A-4A does not
include puller pin 100 or port 21. It is also envisioned that IOL
insertion system 20 may include only one of the puller pin 100 or
the port 21. The system 20 is also shown in an exploded view in
FIG. 5.
[0072] IOL 31 is shown in FIG. 5 and may be positioned between two
halves of a holding station 30. IOL 31 may comprise a central
circular optic 32 having a leading haptic 34 and a trailing haptic
36 generally spirally extending therefrom. One exemplary IOL as
illustrated is a one piece acrylic Tecnis.RTM. brand of aspheric
IOL available from Abbott Medical Optics Inc. of Santa Ana, Calif.
It is also envisioned that any IOL may be used with the insertion
system disclosed herein.
[0073] With reference to FIGS. 1-5 and FIGS. 1A-4A, the system 20
defines a longitudinal axis from an end cap 40 of a pushrod
assembly 60 at a proximal end to the delivery tube 26 at a distal
end. The pushrod assembly 60 includes a plunger 24, an end cap 40,
a nut lock 102, and a pushrod 61. Pushrod 61 may have a distal tip
62. In an embodiment, a portion of distal tip 62 may be flexible as
described in greater detail below. In the illustrated embodiment,
the distal tip 62 is forked to enable reliable capture of a
proximal edge of the IOL optic 32 and/or trailing haptic 36. The
plunger 24 and/or pushrod 61 translates axially through an elongate
passage defined within the inserter handpiece 22 and is configured
to urge the IOL from a holding station 30 through the distal
delivery tube 26. In a general sense, the plunger 24 represents any
actuator capable of displacing the IOL from the holding station 30
in a distal direction through a delivery tube or other such device.
The plunger 24 therefore may be generally termed an actuator so as
to encompass other prime movers that can perform the same function,
such as a rotary actuators, threaded actuators, levers, etc.
[0074] FIG. 5 is an exploded view of the components of the system
20 in the orientation in which they will be assembled. However, a
preferred mold configuration results in a total of six (or possibly
fewer) components for the entire system, not counting the IOL. It
is also envisioned that the mold configuration results in a total
of seven or more components for the entire system, not counting the
IOL depending upon many factors, including but not limited to
manufacturing requirements. The six components shown in FIG. 5
include the plunger 24, the pushrod 61, the cartridge 28, the nut
lock 102, the upper body 56, and the lower body 57. Lower body 57
may include the holding station 30 and base portion 52. Cartridge
28 comprises delivery tube 26 and wings 27. It is possible that the
handpiece upper body 56 could be formed along with the remainder of
the handpiece, though the mold would be fairly complicated and
expensive. Likewise, the cartridge 28 could be incorporated into
the handpiece 22, but again for reasons of manufacturing economy
they are separate.
[0075] The one half of the holding station 30 comprises a base 50
that, in a preferred embodiment, forms a distal extension of a base
portion 52 of the handpiece 22. The upper half of the holding
station 30 comprises a cover 54 that abuts the upper body 56 of the
inserter handpiece 22. In the illustrated embodiment, as seen in
FIG. 5, the cover 54 and upper body 56 fit directly over the base
50 and base portion 52 to form the elongated handpiece 22. The
overall shape of handpiece 22 may be of any shape to accommodate
proper gripping of the device. According to an embodiment, the
holding station cover 54 may be connected by a pair of living
hinges 80a, 80b to the base 50. The base 50 includes a pair of
bifurcated fingers 82a, 82b that meet a similar pair of bifurcated
fingers 84a, 84b extending from the cover 54 at the living hinges
80a, 80b. The opposed pairs of aligned fingers 82, 84 are shaped so
as to form slots therebetween when folded about the living hinges
80 and a central cavity 86 (shown in FIG. 5) for receiving a
delivery tube 26, the combination of which is best seen in the
assembled view of FIGS. 1 and 1A. In this regard, the delivery tube
26 desirably comprises a rear-loading cartridge as shown, and as
described in co-pending U.S. Patent Publication No. 2009-0270876,
filed on Apr. 28, 2008, which is hereby incorporated by reference
in its entirety. In an embodiment, hinges 80a and 80b may be a snap
feature instead of living hinges. In such an embodiment, holding
station cover 54 may be molded as a separate part from base portion
52 and base 50.
[0076] The handpiece may further include a pair of proximal finger
tabs 60a, 60b, one on the base portion 52 and one on the upper body
56. When an operator desires to depress the plunger 24, he or she
places the thumb of one hand on the end cap 40, and index and
middle fingers on respective finger tabs 60a, 60b. Squeezing the
hand closed depresses the end cap 40 and moves the rest of pushrod
assembly 60 along a lumen of the IOL insertion system 20 toward the
distal end of the delivery tube 26.
[0077] Puller Cap
[0078] FIGS. 10-13 illustrate different views of system 20 with
puller cap 70. Puller cap 70 fits over the holding station 30 and
cartridge 28 in order to protect these components, and in
particular the delivery tube 26, while also facilitating the
insertion of fluid as further described below.
[0079] FIGS. 6 and 7 show two views of puller cap 70 of the present
invention. In FIG. 6, puller cap 70 has a top 72, a bottom 73, a
proximal end 75, and a distal end 85. Puller cap 70 includes lock
95A, 95B, grips 93, snap 90, and port 87. Puller cap 70 may be made
of any material known in the art, but preferably polypropylene,
polycarbonate, polyethylene, or polyethylene terephthalate; more
preferably polypropylene and polycarbonate; most preferably
polypropylene. Puller cap 70 may also be of any color, preferably
translucent or clear to enable a user to visualize the features
inside puller cap 70 and anything housed within puller cap 70.
Puller cap 70 may be the shape as illustrated in the embodiment in
FIG. 6, but the invention also envisions that puller cap 70 may be
of any shape or size to accommodate the needs of the insertion
system the puller cap is used with or the needs of the user the
puller cap is designed for. For example, the puller cap may be of
an arrow shape as illustrated in the embodiment in FIG. 6, may be
more of a round shape, triangular shape, square shape, or shaped to
meet the needs for shipping and/or handling. The puller cap may
also include one or more hook features (not shown) to aid in the
removal of the puller cap from an inserter. The hook feature may be
located on any location on the puller cap, including but not
limited to the top, bottom, on or near the snap, or near the distal
or proximal ends. The hook feature may be of any shape or size to
accommodate for the shape or size of the puller cap and may be of
any shape or size to accommodate the fingers of a user.
[0080] The lock 95A and 95B may be of any design or configuration
known in the art. According to an embodiment of the present
invention, a portion 96 of locks 95A, 95B are configured and
dimensioned to cam outwardly when external pressure is placed on
the snaps in a perpendicular plane with respect to the longitudinal
plane of system 20 from proximal end 75 to distal end 85. (See FIG.
7). Locks 95A, 95B may comprise a texture design or feature to ease
gripping and/or actuation of the snaps and removal of puller cap 70
from an insertion system, such as insertion system 20 as
illustrated in FIGS. 1-5 and 1A-4A. In an embodiment, puller cap 70
may have one or more grips having a texture design or feature and
the lock 95A and 95B are separated from the one or more grips, such
that squeezing of the grips does not deactivate locks 95A and
95B.
[0081] As shown in FIG. 6, the snap 90 is designed and configured
to couple with pin 100 (see FIGS. 14 and 15). Snap 90 may be of any
shape or size as long as it is configured and dimensioned to mate
with pin 100. According to the embodiment in FIG. 6, snap 90
comprises a canopy 92 and a keyway 94. In another embodiment, snap
90 does not have a canopy and only has keyway 94.
[0082] Puller cap 70 may include one or more ports 87 to aid in the
insertion of a fluid, including but not limited to balanced salt
solution, water, and/or viscoelastic. The one or more ports 87 mate
with ports located on the insertion system 20 to assist with
filling a portion of the system with fluid to provide lubrication
to the internal features of the insertion system to aid in delivery
of the IOL. With respect to port 87 as illustrated in FIG. 6, port
87 acts a funnel mechanism into the distal end of delivery tube 26.
FIG. 7 illustrates a bottom view of puller cap 70 comprising port
88 and a window 89. The puller cap may also comprise one or more
windows to provide the users with a visual indicator of the amount
of fluid inserted into a portion of the insertion system, as well
as provide viewing of the distal end of a cannula tip, which is
typically used to inject a fluid. In an embodiment, the one or more
windows may be located on the top, bottom or sides of the puller
cap, preferably on the top or the bottom. The one or more windows
may also comprise a measuring devise such as a ruler to allow a
user to measure or see the amount of fluid inserted into the
inserter. The window 89 may also have a fill indicator 99 such that
a user fills a portion of the insertion system until the fluid
reaches fill indicator 99 indicating a proper and/or maximum fill
has been reached. The one or more windows may also comprise a
material such that when a fluid is inserted into the insertion
system and viewed through the window light that is emitted through
the window to the fluid is polarized providing a visual indicator
of the fluid within the inserter.
[0083] As is well known in the art, the small nature of the ports
of insertion systems known in the art can make it very difficult
for doctors, nurses, and/or staff to locate openings for inserting
fluids. The puller cap of the present invention solves this problem
by providing a larger port with a funnel feature that leads into
the smaller ports of the insertion system. This enables a user to
more easily direct a cannula tip 101 into a delivery tube 26 or
ports 87, 88 as illustrated in FIGS. 8 and 9.
[0084] Pin and Haptic Sweep Slot
[0085] FIGS. 14A-E shows pin 100 which includes top 105, stem 107,
key 109, and lock 113. Top 105 comprises key 109 that may be of any
shape or configuration so as to mate with snap 90. Lock 113 may be
of any shape or size and is configured to mate with grove 115 of
haptic sweep slot 117 of cover 54 (see FIG. 16). Lock 113 may also
be located anywhere along stem 107 and the present invention also
envisions more than one lock feature. Haptic sweep slot 117 may
also be of any shape or size as long as it is configured to mate
with pin 100. According to an embodiment, haptic sweep slot 117
runs along the same longitudinal axis of system 20. In an
embodiment, the length of the haptic sweep slot is longer in length
than the width the slot. In an embodiment, the length of the haptic
sweep slot is between about 0.150 inches (in.) (3.81 millimeters
(mm)) to about 0.170 in. (4.318 mm), preferably about 0.153 in.
(3.8862 mm), more preferably about 0.165 in. (4.191 mm). In an
embodiment, the width of the haptic sweep slot is about 0.028 in.
(0.7112 mm) to about 0.040 in. (1.016 mm), preferably about 0.030
in. (0.762 mm), more preferably about 0.035 in. (0.889 mm) Pin 100
is configured and dimensioned to be inserted into haptic sweep slot
117 such that lock 113 and groove 115 are coupled together securing
the two parts together, but still enabling the pin 100 to move
within haptic sweep slot 117. Groove 115 may also be of any shape
or size as long as it is configured to mate with lock 113. In an
embodiment, there may be more than one groove in the haptic sweep
slot. Groove 115 enables pin 100 to maintain a substantially
perpendicular orientation with respect to the longitudinal axis of
system 20. According to an embodiment, the substantially
perpendicular orientation assists with sweeping or folding of
trailing haptic 36 as further described below.
[0086] Pin 100 may comprise leg feature 125 (see FIG. 14A-14E);
such that pushrod 61 is capable of passing step 107 once pin 100
has been advanced forward to sweep trailing haptic 36. The leg
feature 125 results in stem 107 having a cut out or offset portion
as shown in FIGS. 14A, B, C and E. To ensure that this leg feature
125 is in the correct orientation during manufacture, lock 109 may
comprise a one-way directional snap feature or poke-oke as
illustrated in an embodiment in FIGS. 14C and D.
[0087] In an embodiment, pin 100 is configured and dimensioned to
penetrate or extend through cover 54 and base 50 or another portion
of system 20 or similar device to sweep or fold a trailing or
leading haptic or similar feature of an IOL.
[0088] Puller Cap and Pin Function
[0089] As shown in FIGS. 10 and 15, as puller cap 70 is placed on
system 20 to cover cartridge 28 and delivery tube 26, snap 90 mates
or couples with pin 100 via key 109 and keyway 94. See FIG. 15A for
a cross-sectional view showing pin 100 coupled with snap 92 in
keyway 94 and lock 113 coupled with groove 115. In addition to the
functions described above, puller cap 70 with pin 100 function to
fold or sweep the trailing haptic 36 in the distal direction prior
to folding or moving the IOL in the distal direction to insert the
IOL into the eye. Folding or sweeping trailing haptic 36 in the
distal direction controls the location of the haptic and prevents
damage to the haptic during delivery of the IOL. Pin 100 may also
sweep the trailing haptic 36 over a portion of optic 32 such that
during movement of the IOL down the lumen of tube 26 at least a
portion of the trailing haptic 36 is captured in the fold or folds
of the optic 32. Prior to the present invention a user would have
to manually use the distal end of a cannula to fold or sweep the
trailing haptic, which was difficult to do due to the small nature
of the slot. Moreover, it was difficult to visualize whether the
haptic was in fact in place once the cannula moved the haptic. The
present invention overcomes these problems. Once puller cap 70 is
coupled with pin 100 a user may use the easy to access one or more
ports 87, 88 to insert/inject fluid into system 20. Next, to sweep
trailing haptic 36 a user may grasp and squeeze locks 95A, 95B to
release the internal lock features, e.g. portion 96 of lock 95A, B
from wings 27. As puller cap 70 is advanced distally from system 20
along the longitudinal axis of system 20 pin 100 slides along
haptic sweep slot 117 and lock 113 slides in groove 115 as shown in
FIG. 16. When pin 100 reaches the end of haptic sweep slot 117, pin
100 will release from snap 90, releasing puller cap 70 from system
20 as shown in FIG. 17. At this point, trailing haptic 36 has been
swept or folded into the proper position without the use of another
tool and the TOL is now ready for insertion into the eye.
[0090] In an alternate embodiment, pin 100 may release from cover
54 with puller cap 70. It is also envisioned that pin 100 may be
connected to one or more arms and one or more hinges to aid in its
connection to puller cap 70 and its release from system 20. FIG.
18A shows such an alternate embodiment of the present invention. In
FIGS. 18A-D, pin 100 is connected to arm 123 which is connected to
arm 124 via hinge 122. Arms 123 and 124 may further be coupled with
puller cap 70 with hinge 126 and 127 (as shown in FIGS. 18C and
18D) or by any other mechanism known in the art. As puller cap 70
is moved distally along the longitudinal axis of system 20 to sweep
trailing haptic 36 pin 100 is advanced along haptic sweep slot 117.
When pin 100 reaches the end of haptic sweep slot 117, further
advancement of puller cap 70 causes arm 124 to lift up thereby
lifting arm 123 and lifting pin 100 from haptic sweep slot 117 and
releasing puller cap 70 from system 20. In an embodiment, haptic
sweep slot 117 may comprise a ramp at one or both ends of the slot.
In particular, a haptic sweep slot 117 may comprise a ramp at the
distal end 121 of the slot to aid in the release of pin 100 and/or
puller cap 70 after trailing haptic 36 has been swept or folded.
According to another embodiment, only a single arm or a single
hinge may be used with pin 100. In another embodiment, one or more
arms or one or more hinges may used with pin 100.
[0091] In an embodiment, pin 100 maintains trailing haptic 36 in
the proper orientation for delivery and even if a user decides to
place puller cap 70 back onto system 20, the internal features of
system 20 still maintain trailing haptic 36 in the proper
orientation. This allows a user to determine when she would like to
use and/or the order in which she will use the haptic sweep
feature, the port features, and the tip protection feature, which
will be described further below.
[0092] Pushrod
[0093] FIG. 19A illustrates a pushrod capable of being used with
the system 20. Pushrod 61 comprises a top jaw 63 and a bottom jaw
64 that form mouth 67. Top jaw 63 may also comprise a lip 65 that
protrudes from an upper portion 66 of top jaw 63. In an embodiment,
lip 65 is configured and dimensioned to help catch trailing haptic
36 and keep trailing haptic 36 in a swept/folded configuration.
FIG. 19D illustrates an exemplary pushrod of the present invention
modifying the features of FIG. 19A. In FIG. 19D a portion of the
distal end of pushrod 61 is removed resulting in cutout portion or
notch 68 to allow room for the IOL as it is folded and/or
compressed during insertion of the IOL into an eye. The cutout
portion 68 of pushrod 61 provides for less force on the walls of
delivery tube 26 and less force on the IOL as it delivered
preventing damage to the IOL and delivery tube 26. In an
embodiment, cutout portion 68 comprises approximately half the
diameter of the top jaw 63 for a portion of the distal end
including the lip 65, while bottom jaw 63 remains intact. Cutout
portion 68 may extend proximally beyond top jaw 63 into the body of
pushrod 61. In an embodiment, a notch or cutout portion may also
extend or be placed into bottom jaw 64. It is also envisioned that
an additional notch or cutout similar to notch 68 can be made on
the opposite side of top jaw 63. Bottom jaw 64 may also have one or
more notches. In an embodiment, a cross-section view of cutout
portion 68 shows an L-shaped seat (see FIG. 20).
[0094] In an embodiment, lip 65 is configured to ride along at
least a portion of an internal channel or groove located within
handpiece 22. Lip 65 provides more stability for the pushrod 61 as
it is advanced within a lumen of the handpiece 22 towards the
distal end of the handpiece. By having the lip 65 engage at least a
portion of the internal channel, the distal end of the pushrod is
less likely to move from its desired location within the lumen as
the pushrod is advanced towards the distal end of the
handpiece.
[0095] According to an embodiment, the distal end of pushrod 61 may
have a top jaw 63 and a bottom jaw 64 that form mouth 67 as
illustrated in FIG. 19E-19H. As shown in FIG. 19E, top jaw 63 is
shorter in length than bottom jaw 64 and includes cutout portion
68. For such an embodiment sweeping of the trailing haptic by pin
100 or another means is unnecessary because the design of the
distal end of pushrod 61 causes the trailing haptic of an IOL to be
swept or folded over the optic as the pushrod assembly 60 travels
down the lumen of the insertion system towards the distal end of
the delivery tube. In an embodiment, the top jaw is designed to
engage the trailing haptic of an IOL before the bottom jaw engages
the lens body or edge of the optic. In an embodiment, the height of
the top jaw is such that it configured to couple with at least a
portion of an internal channel of the handpiece, preferably the top
jaw is configured to couple with at least a portion of an internal
channel located in the staging area, more preferably the top jaw is
configured to couple with an internal channel extending through the
staging area. In another embodiment, the blunt tip may a height
that is larger than the height of a haptic, e.g. a trailing
haptic.
[0096] In an embodiment, the distal end of pushrod 61 may comprise
another cutout portion 69 on the opposite side of the first cutout
portion. The second cutout portion 69 may also provides for less
force on the walls of delivery tube 26 and less force on the IOL as
it delivered preventing damage to the IOL and delivery tube 26. For
example, as the IOL is advanced down the delivery tube, the IOL is
compressed. The second cutout portion 69 provides space for an edge
of the IOL to wrap around the top jaw 63 and tuck into the second
cutout portion 69. The second cutout portion may be shorter or
longer in length than the first cutout portion 68, preferably
shorter than the first cutout portion 68. The width of the second
cutout portion may be larger or smaller than the width of the first
cutout portion, preferably small that the width of the first cutout
portion. The second cutout portion 69 may create a substantially
L-shaped seat. In an embodiment, a notch or cutout portion may also
extend or be placed into bottom jaw 64. It is also envisioned that
an additional notch or cutout similar to cutout portion 68 and 69
can be made on one or both sides of bottom jaw 64.
[0097] Similar to the lip 65 discussed above, in an embodiment, the
top jaw 63 illustrated in FIG. 19E-19H is configured to ride along
at least a portion of an internal channel or groove located within
handpiece 22. Coupling of the top jaw 63 with at least a portion of
an internal channel provides more stability for the pushrod 61 as
it is advanced within a lumen of the handpiece 22 towards the
distal end of the handpiece. By having the at least a portion of
top jaw 63 engage at least a portion of the internal channel, the
distal end of the pushrod is less likely to move from its desired
location within the lumen as the pushrod is advanced towards the
distal end of the handpiece. The forces generated by moving the IOL
down the lumen of the staging area and/or lumen of the cartridge
can have a tendency to push or offset the distal end of the
pushrod. Coupling the top jaw 63 with at least a portion of the
internal channel or groove helps to counter this movement and
maintain the distal end of the pushrod in proper alignment, e.g.
maintaining the distal end of the pushrod substantially on center
of the lumen of the handpiece. In an embodiment, the internal
channel or groove runs the length of the staging area.
[0098] In an embodiment, the top jaw 63 may have a blunt tip 71 and
a rounded top portion 74. The blunt tip 71 sweeps or folds the
trailing haptic of an IOL over the optic as the pushrod assembly 60
travels down the lumen of the insertion system towards the distal
end of the delivery tube. The top jaw 63 and the bottom jaw 64 may
have a rounded leading edge 76. Rounding the leading edge prevents
damage to an IOL as it is moved down the lumen of an insertion
system.
[0099] In an embodiment, pushrod 61 has a tapered portion around
the circumference of the pushrod starting at or near the back of
mouth 67 and extends a long a length of the pushrod. In an
embodiment, the tapered portion extends approximately 2/3 the total
length of pushrod 61. As shown in FIG. 19F, beginning at or
proximally near the back of the mouth 67, the diameter of the
tapered portion gradually gets smaller until approximately the
midline of the tapered portion and then begins to gradually get
larger until it reaches the largest diameter of the pushrod 68. The
smallest diameter of the tapered portion may occur at the halfway
point of the entire length of the tapered portion. In an
embodiment, the smallest diameter occurs beyond the halfway point
of the entire length of the tapered portion in the proximal
direction. The length of the tapered portion may be between about
0.280 in. (7.122 mm) and about 0.325 in. (8.255 mm). The diameter
of the pushrod at its largest diameter may be between about 0.080
in. (2.032 mm) and about 0.060 in. (1.524 mm), preferably 0.070 in.
(1.778 mm); and the smallest diameter of the tapered portion may be
between about 0.045 in. (1.143 mm) and about 0.060 in. (1.524 mm).
The tapered portion provides for space and/or allows for a trailing
haptic to wrap around the pushrod should the haptic not fold over
the optic, which prevents the IOL from being damaged or broken off
from the rest of the IOL.
[0100] In an embodiment, cutout portion or notch 68 may extend into
a portion of the tapered portion. Cutout portion 68 is designed as
a safety feature to (1) provide space for the folding IOL as it is
advanced down a tapered lumen; (1) allow for a trailing haptic to
wrap around the pushrod and/or guide the trailing haptic around the
tapered portion should the haptic not fold over the optic; (3)
allow for extension of a trailing haptic that does not get folded;
and/or (4) allow space for shoulder or bend that is created near
the optic-haptic junction when the trailing haptic is folded over
the optic, which prevents the IOL from being damaged or broken off
from the rest of the IOL. In an embodiment, the cutout portion 68
may have a length between about 0.150 in. (3.81 mm) and about 0.300
in. (7.62 mm), a height between about 0.030 in. (0.762 mm) and
about 0.050 in. (1.27 mm), and a width between about 0.040 in.
(1.016 mm) and about 0.065 in. (1.651 mm). The length of the cutout
portion 68 may also be longer or shorter than the full extension of
an TOL haptic. Cutout portion 68 may begin at or near the tip of
pushrod 61 or at or near the back of the mouth 67 and continue a
length of the pushrod 61. The cutout portion 68 may continue a
length of the pushrod 61 with its width gradually tapering out or
becoming smaller until it meets the side of the pushrod (see FIG.
19G).
[0101] The features of pushrod 61 as shown in FIGS. 19A-19D may
have various dimensions. The length of the cutout portions 68 may
be between about 0.145 in. (3.683 mm) to about 0.165 in. (4.191
mm), preferably between about 0.149 in. (3.7846 mm) to about 0.160
in. (4.064 mm), more preferably about 0.149 in. (3.7846 mm) or
about 0.160 in. (4.068 mm). The width of upper portion 66 of top
jaw 63 may range from about 0.015 in. (0.381 mm) to about 0.030 in.
(0.762 mm), preferably about 0.023 in. (0.5842 mm). The diameter or
width A of cutout portion 68 as shown in FIG. 20 may be between
about 0.015 in. (0.381 mm) to about 0.025 in. (0.635 mm),
preferably about 0.019 in. (0.4826 mm). According to an embodiment,
the diameter A of cutout portion 68 may be inversely proportional
to the width of the upper portion 66 of top jaw 63. The height of
lip 65 that protrudes up may be between about 0.003 in. (0.0762 mm)
to about 0.012 in. (0.3048 mm), preferably about 0.006 in. (0.1524
mm). In an embodiment, there may be a radius on the back side of
lip 65 where lip 65 and upper portion 66 meet. The radius may be
sharp to 0.010R. In an embodiment, the radius of mouth 67 that
engages a lens may range between 0.012R-0.020R, preferably about
0.014R. The length of top jaw 63 and the bottom jaw 64 from the
back of mouth 67 may be between about 0.045 in. (1.143 mm) and
about 0.070 in. (1.778 mm). In an embodiment the length of top jaw
63 is preferably about 0.054 in. (1.3716 mm). The top jaw length
may have a relationship (ratio) to the bottom jaw which is about
1.3 to 1 (Top to Bottom). In an embodiment, the relationship may be
1 to 1 or 1 to 1.3 (Top to Bottom).
[0102] The features of pushrod 61 as shown in FIGS. 19E-19H may
have various dimensions. The length of the cutout portions 68 may
be between about 0.150 in. (3.81 mm) to about 0.300 in. (7.62 mm),
preferably between about 0.190 in. (4.826 mm) to about 0.250 in.
(6.35 mm), more preferably about 0.190 in. (4.826 mm). The diameter
or width of cutout portion 68 as shown may be between about 0.020
in. (0.508 mm) to about 0.030 in. (0.762 mm), preferably about
0.025 in. (0.635 mm) In an embodiment, the radius of mouth 67 that
engages a lens may range between 0.010R-0.018R, preferably about
0.013R. The width of the top jaw may be between about 0.020 in.
(0.508 mm) and about 0.030 in. (0.762 mm) and the width of the
bottom jaw may be between about 0.060 in. (1.524 mm) and about
0.040 in. (1.016 mm). The top jaw may be offset from a centerline
along the longitudinal axis of the pushrod. The top jaw length may
have a relationship (ratio) to the bottom jaw which is about 1 to 2
(Top to Bottom). In an embodiment, the relationship may be 1 to 1
or 1 to 1.3 (Top to Bottom). The width of the top jaw may have a
relationship to the width of the bottom jaw which is about 1 to 2
(Top to Bottom). In an embodiment, where the top portion of the top
jaw meets the side wall of the notch, the radius of curvature or
blending may be about 0.010R. Also, in another embodiment the
length of the notch may be about 60% of the total length of the
pushrod.
[0103] Pushrod Flex Tip
[0104] As discussed above, FIG. 5 shows an exploded view of pushrod
assembly 60 which comprises pushrod 61, plunger 24, and nut lock
102.
[0105] According to an embodiment of the present invention, pushrod
61 comprises distal tip 62 at the distal end of pushrod 61 that has
a top jaw 63 and a bottom jaw 64, which is shown in FIG. 19A. Top
jaw 63 of distal tip 62 is capable of flexing toward bottom jaw 64
shown by arrow "B" to allow the distal tip 62 (or distal end) of
pushrod 61 to pass through the tapered lumen of delivery tube 26.
Top jaw 63 may comprise a lip 65 that protrudes from an upper
portion 66 of top jaw 63 and is capable of making contact with the
lumen of delivery tube 26. FIG. 19B illustrates lip 65 coming in
contact with the lumen 70 of delivery tube 26 and top jaw 63
flexing toward bottom jaw 64. Lip 65 may make continuous or
substantially continuous contact with the lumen of delivery tube 26
while pushrod 61 is moved longitudinal through delivery tube 26 to
eject the IOL out the distal end of the delivery tube. FIG. 19C
illustrates that once lip 65 of top jaw 63 exits delivery tube 26
at the distal end, top jaw 63 will flex substantially back into its
original position. Lip 65 can be any configuration or shape that
will allow for the flexing of top jaw 63 toward bottom jaw 64.
Preferably top jaw 63 is slightly longer or longer than bottom jaw
64 to prevent the IOL from being captured between the two jaws and
held after the IOL exits from the delivery tube. According to an
embodiment, bottom jaw 64 may remain substantially stationary with
respect to the rest of pushrod 61. In an embodiment, the flexible
top jaw 63 allows for further folding of the trailing haptic of the
IOL over the optic during implantation of the IOL. The distal tip
keeps the trailing haptic in a stable position.
[0106] In an embodiment, lip 65 may be located on the bottom jaw 64
depending upon the geometry of the IOL and/or haptic. For example,
if instead of the trailing haptic being in a "C" configuration if
you look at the IOL in an insertion device from the top, the
trailing haptic is in reversed "C" configuration, the lip 65 may
function better or properly if it is located on the bottom jaw
64.
[0107] In an embodiment, the bottom jaw 64 may also flex or be
capable of flexing toward top jaw 63 to allow the distal tip (or
distal end) of pushrod 61 to pass through the tapered lumen of
delivery tube 26. It is also envisioned that both the top jaw 63
and bottom jaw 64 flex towards each other as the pushrod 61 is
passed through the tapered lumen of delivery tube 26.
[0108] Tip Protector
[0109] An advantage of puller cap 70 is it acts as a tip protector
to prevent damage or deformation. As illustrated in FIG. 21, a
certain amount of clearance or space is provided around the distal
end of delivery tube 26 when puller cap 70 is placed onto system
20. The clearance or space 130 is maintained by contact between the
internal structures of puller cap 70 at the proximal end and system
20. In an embodiment, clearance or space 130 between delivery tube
26 and the distal end of puller cap 70 is maintained by contact
between wall 98 through window 97 shown in FIG. 15 and wings 27 and
portion 96 of lock 95A, B shown in FIG. 7. It is also envisioned
that other similar structures may be used to maintain clearance 130
to protect the tip of delivery tube 26.
[0110] Protective Cap
[0111] FIGS. 22A-G, 23A-B, 24, 25, and 26 illustrate a protective
cap 200 of the present invention. Protective cap 200 has similar
advantages of puller cap 70 of protecting the tip from damage or
deformation. Protective cap 200 may be used instead of puller cap
70 when the trailing haptic is swept or folded by means of the
pushrod or the trailing haptic does not require sweeping or
folding. Protective cap 200 comprises finger grips 280, window 289,
and port 287. Protective cap 200 may also comprise one or more of
the following: clips (or snaps) 220, relief slots 225, and/or
guides 235. Protective cap 200 may also comprise a fill indicator
255 and/or a material relief 265.
[0112] Protective cap 200 may be made of any material known in the
art, preferably polypropylene, polycarbonate, polyethylene, or
polyethylene terephthalate; more preferably polypropylene and
polycarbonate; most preferably polypropylene. Protective cap 200
may also be of any color, preferably translucent or clear to enable
a user to visualize the features inside protective cap 200 and
anything housed within protective cap 200. Protective cap 200 may
be the shape as illustrated in the embodiment in FIGS. 22A-G, but
the invention also envisions that protective cap 200 may be of any
shape or size to accommodate the needs of the insertion system the
protective cap is used with or the needs of the user the puller cap
is designed for. For example, the protective cap may be of an arrow
shape as illustrated in the embodiment in FIG. 22B, may be more of
a round shape, triangular shape, square shape, or shaped to meet
the needs for shipping or handling.
[0113] The finger grips 280 may be of any design or configuration
known in the art. According to an embodiment of the present
invention, finger grips 280 may comprise a texture design or
feature to ease gripping or actuation of the clip 220 and removal
of protective cap 200 from an insertion system, such as system 20
as illustrated in FIGS. 1-5 and 1A-4A. The protrusion 282 of finger
grips 280 may also be of any shape, including but not limited to
square, rounded, triangle, and any other shape known in the art
that may assist in grasping protective cap 200. Finger grips 280
may have inner walls that are sized and shaped to couple with at
least a portion of the wings 27 that run along the longitudinal
axis of cartridge 28. The inner walls are configured and
dimensioned to avoid damaging the distal end of the tip of the
delivery tube 26 when protective cap 200 is placed on the insertion
device. In an embodiment, finger grips 280 may have a radius of
curvature that is similar to or mirrors the curvature of a user's
finger to assist with gripping and removal of the protective cap
200.
[0114] In an embodiment, protective cap 200 comprises tapered
portion 245 (shown in FIGS. 22B, 22G, 25, and 26). Tapered portion
245 may be configured and dimensioned to mirror or substantially
mirror the shape and size of the cartridge and/or insertion device.
In an embodiment, tapered portion 245 comprises a bevel 247 which
mirrors bevel 23 (shown in FIGS. 2, 2A, and 5). The internal and
external walls of tapered portion 245 may also remain uniform or
substantially uniform with respect to each other from the beginning
of the tapered portion to at or near the distal end of cartridge
such that the walls run parallel to each other. It is also
envisioned that the internal walls of the tapered portion mirror
the external features of the cartridge or distal end of the
insertion device and the external walls of the tapered portions
remain substantial linear, for example without a bevel.
[0115] As shown in FIG. 24, the distal end 285 of protective cap
200 may comprise internal bevel 270. Internal bevel 270 is
configured and dimensioned to match or substantially match or mate
with the bevel of the tip (at the distal end) of delivery tube 26
of cartridge 28. When protective cap 200 is placed on system 20,
internal bevel 270 is coupled with the bevel of the tip of delivery
tube 26 of cartridge 28 and port 287, and with its funnel feature
it creates a larger opening As discussed above, the small nature of
ports can make it very difficult for doctors, nurses, and/or staff
to locate openings for inserting fluids. Port 287 with internal
bevel 270 enables a user to more easily direct a cannula tip 101
into a delivery tube 26 or port 87 as illustrated in FIG. 8.
[0116] As illustrated in FIGS. 22A, C, E, and G, the distal end of
protective cap 200 may also comprise a material relief 265.
Material relief 265 helps prevent distortion of the tip at the
distal end of protective cap 200 during the molding process. It is
also envisioned, that the distal end of the protective cap 200 does
not comprise a material relief.
[0117] As illustrated in FIG. 23A, protective cap 200 may also have
inner walls comprising one or more internal guides 235 that run
along at least a portion of the longitudinal axis and are
configured and dimensioned to mate or couple with features on the
outer portions of the insertion device. Internal guides 235 help
keep the protective cap substantially aligned in a horizontal and
vertical direction when the cap is placed on or removed. This helps
to protect the distal end or tip of cartridge 28 or insertion
system 20. The internal guides 235 may be of any width or of any
length suitable to couple with external features of the insertion
system and/or cartridge. According to an embodiment, there may be
two internal guides on the internal wall of the protective cap
along the longitudinal axis, and the distance between each of the
guides may be any distance as long as it matches the external
features on the insertion system. In an embodiment, the distance
between the guides may be about 0.374 in. (9.4996 mm) apart. The
width of a guide may be between about 0.023 in. (0.5842 mm) and
about 0.028 in. (0.7112 mm), preferably about 0.025 in (0.635 mm).
In an embodiment, the length of a guide may be between about 0.318
in. (8.0772 mm) and about 0.386 in. (9.8044 mm). The length of a
guide may also be between about 0.318 in. (8.0772 mm) and about
0.328 in. (8.3312 mm), preferably about 0.323 in. (8.2042 mm) The
length of the guide may also be between about 0.376 in. (0.5504 mm)
and 0.386 in. (9.8044 mm), preferably about 0.381 in. (9.6774 mm)
In another embodiment, one or more guides may begin at or near the
distal end of relief slot 225 (see FIG. 23A) and extend for a
distance toward the distal end of the protective cap.
[0118] As discussed above, the small nature of ports can make it
very difficult for doctors, nurses, and/or staff to locate openings
for inserting fluids. The protective cap 200 of the present
invention solves this problem by providing a larger port 287 with a
funnel feature that leads into the smaller port of the insertion
device. This enables a user to more easily direct a cannula tip 101
into a delivery tube 26 or port 87 as illustrated in FIG. 8. The
protective cap may also include one or more additional ports.
[0119] Protective cap 200 may also have one or more windows 289 to
provide the users with a visual indicator of the amount of fluid
inserted into the insertion system, as well as provide viewing of
the distal end of a cannula tip. The one or more windows may be
located on the top, bottom or sides of the protective cap,
preferably on the top or the bottom. The one or more windows may
also comprise a measuring devise such as a ruler to allow a user to
measure the amount of fluid inserted into the inserter. The one or
more windows may also comprise a material such that when a fluid is
inserted into the inserter and viewed through the window light that
is emitted through the window to the fluid is polarized providing a
visual indicator of the fluid within the inserter. The window 289
may also comprise a fill indicator 255 to provide a maximum fill
line.
[0120] In order to secure protective cap 200 to an insertion
system, such as the system 20 shown in FIGS. 1 and 1A, clip 220 may
be used. Clip 220 is configured and dimensioned to mate with a
distal portion of wings 27 of cartridge 28 (cartridge 28 is shown
in FIG. 5). In an embodiment illustrated in FIG. 25, relief slots
225 of protective cap 200 couple with the vertical elements 29
(shown in FIG. 5) of wings 27 of cartridge 28. Relief slots 225 may
be of any shape or size to couple with the shape or size of the
vertical elements 29. Clip 220 may also extend beyond the proximal
end of finger grips 280 as illustrated in FIG. 22B.
[0121] In an embodiment, when the protective cap 200 is placed on
the distal end of the system 20, clips 220 act as a cantilever snap
by riding along the vertical elements 29 of the wings 27 of
cartridge 28 until the clips 220 are over center and then snapping
down over the end of the wings 27. In an embodiment, the clip 220
is not located on the grip 280 to allow for easier removal of the
protective cap. It is also envisioned that clip 220 may be located
or coupled with the grip 280 depending upon the design and/or
function of the clip 220 and whether the grip 280 is an extension
of the clip 220.
[0122] FIGS. 27A-F and 28A-F illustrate additional embodiments of a
protective cap with similar features as shown in FIGS. 22A-22G,
23A-23B, and 24. FIGS. 29A-F and FIGS. 30A-F illustrate additional
embodiments of a puller cap with similar features as shown in FIGS.
6-13.
[0123] Plunger Marker
[0124] As illustrated in FIGS. 31A and 31B, plunger 24 may comprise
a marker or indicator 310. As discussed above, the plunger 24
and/or pushrod 61 (pushrod assembly 60) translates axially through
an elongate passage defined within the inserter handpiece 22 and is
configured to urge the IOL from a holding station 30 through the
distal delivery tube 26. In an embodiment, system 20 may operate in
a push and/or twist fashion. With a push and twist mechanism, the
plunger 24 may first be advanced axially along the longitudinal
axis to a predetermined point and then the plunger 24 may be
rotated for further advancement. Such a further advancement via
rotation may provide additional control in the delivery of the IOL.
In such a scenario, it would be helpful to provide an indication of
when the axial translation of the plunger 24 or pushrod assembly 60
has reached the predetermined point. In such an embodiment, a
marker 310 is placed on plunger 24 such that when the plunger 24 is
advanced or displaced along the longitudinal axis of the system 20
a user will be able to visualize that the plunger has reached the
predetermined point when marker 310 lines up with the proximal end
320 of handpiece 22 (see FIG. 31B) or disappears within handpiece
22 (see FIG. 31C). Marker 310 may be placed on any location on
plunger 24 and may be of any shape, size or color. The
predetermined point may be the proximal end 320 as described in the
above embodiment, but it is also envisioned to be any location
along the handpiece 22. This may be possible if handpiece 22 is
made of a translucent or transparent material such that marker 310
is visible through handpiece 22.
[0125] Pushrod Supports
[0126] According to an embodiment, the present invention provides
one or more guide rails to provide support for the pushrod on the
distal end of the inserter body. FIG. 32 shows a cross-sectional
view of insertion system 20 with pushrod 61 and handpiece 22.
According to an embodiment, pushrod 61 may comprise one or more
guide rails 395, preferably a guide rail on opposite sides of
pushrod 61. To mate with guide rails 395, one or more channels 396
on the upper and/or lower portions of lens holding station 30 may
be included. The top and/or bottom channels 396 may be of any shape
to mate with the shape of the one or more guide rails. Preferably
the guide rails and channels are substantially rectangular in
shape. Preferably, the lower channel is wider than the upper
channel, although the width of the channels can be of any size and
the channels can be of any shape. The guide rails on the pushrod
mate to the channels and may have substantially the same shape. The
guide rails may be on any portion of the pushrod and may make up
any percentage of the pushrod. The channels may be located on other
locations of the handpiece 22, including but not limited to base 52
and/or delivery tube 26.
[0127] According to an embodiment, it is also envisioned that one
or more guide rails may be located on the handpiece 22 and
corresponding channels may be located on the pushrod 61. In an
embodiment, the channels may be located a long a portion of the
pushrod 61 and may be found on any location around the
circumference of the pushrod. The one or more guide rails may be
located anywhere within the handpiece such that the guide rails are
configured and dimensioned to mate with the one or more channels
located on the pushrod 61.
[0128] Nut Lock
[0129] In insertion systems, advancing an IOL through a delivery
tube involves a significant amount of force. To allow for
advancement of an IOL from a lens storage area/holding station to a
loading area the same mechanism described above can be used. For
ease of use a pushing mechanism may be used to advance a lens from
a storage/holding station into a delivery tube for insertion and
then the same mechanism can be used to insert the IOL using a
twisting mechanism. To allow for the push and twist and accommodate
the high amount of force, the present invention incorporates a nut
lock to prevent the pushrod from moving proximally as the pushrod
is rotated to move the IOL distally.
[0130] FIG. 33 illustrates an embodiment of the present invention.
Nut lock 102 may have an internal thread of a load bearing quality.
Nut lock 102 may be cylindrical in shape and have a centrally
located groove 401 that allows interlock and/or detent with
external/internal features of handpiece 22. On the distal portion
of nut lock 102 there may be a series of radial keyways 402 that
are capable of mating with keys (not shown) protruding inward from
handpiece 22 that prevent it from counter rotating. Nut lock 102
may be made of any material known in the art, including but not
limited to plastic, metal, and ceramic. Nut lock 102 may be coupled
with the plunger 24 via load bearing threads and is sandwiched
between plunger 24 and pushrod 61, which may be snapped together or
coupled together in any way known in the art.
[0131] According to an embodiment, nut lock 102 may comprise a
single lead thread, but may comprise more (multiple). Nut lock 102
may also have varying thread pitch.
[0132] According to an embodiment, when the insertion system is
delivered to a physician's office, pushrod assembly 60 is in a
first position. In this first position, the pushrod assembly 60 is
in its most proximal position and groove 401 of nut lock 102 mates
with one or more proximal detents 407 located at or near the most
proximal end of handpiece 22 and prevents accidental movement of
pushrod assembly 60. At this point, plunger 24 can be rotated in
any direction without causing longitudinal movement of pushrod 61.
When the pushrod assembly is moved into a second position between
the most proximal detent 407 and a second distal detent 406,
pushrod assembly 60 is movable in a longitudinal direction between
detents, but rotation of plunger 24 in any direction does not
longitudinally move pushrod 61. When pushrod assembly 60 is moved
distally in a longitudinal direction to a third position, wherein
groove 401 of nut lock 102 mates with one or more distal detents
406 (second detent position) (see FIG. 33A), pushrod assembly 60 is
prevented from further distal or proximal movement by pushing or
pulling on end cap 40. Once in the second detent position, the
pushrod assembly cannot be pulled from this position back to the
first proximal position. At this point the only way to advance
pushrod 61 longitudinally to insert the IOL is to rotate plunger 24
via end cap 40 in either a clockwise or counter-clockwise direction
(depending upon the configuration of the threads). This is to
prevent reuse of a one time use insertion system and/or improper
activation of the pushrod.
[0133] The detents are one way snaps (cantilever snaps) that
provide the strength to prevent the pushrod assembly 60 from being
pulled back from the second detent 406 (see FIG. 33A). The proximal
detent(s) 407 also provide biasing for the proximal end of the
plunger 24 as it is advanced longitudinally or rotated and provide
a little resistance (see FIG. 33B). The proximal detents 407 may be
the same or similar to the second detent 406. The proximal detents
407 may have a different configuration or shape from the second
detent 406. The detents may be of any shape or size suitable for
its function.
Safety Detent for Plunger Threads
[0134] According to an embodiment, to help prevent advancing the
pushrod with rotation of plunger 24 until desired, detents 405 are
added to the plunger. Detents 405 are located on the distal end or
portion of plunger 24. According to an embodiment, the detents are
located within the first two to three threads of plunger 24. FIG.
34 illustrates detents 405 at the distal end or portion of plunger
24. The number of detents can range between 1-6, preferably 4.
[0135] All references cited herein are hereby incorporated by
reference in their entirety including any references cited
therein.
[0136] The above presents a description of the best mode
contemplated of carrying out the present invention, and of the
manner and process of making and using it, in such full, clear,
concise, and exact terms as to enable any person skilled in the art
to which it pertains to make and use this invention. This invention
is, however, susceptible to modifications and alternate
constructions from that described above which are fully equivalent.
Consequently, it is not the intention to limit this invention to
the particular embodiments disclosed. On the contrary, the
intention is to cover modifications and alternate constructions
coming within the spirit and scope of the invention as generally
expressed by the following claims, which particularly point out and
distinctly claim the subject matter of the invention.
* * * * *