U.S. patent number 3,913,148 [Application Number 05/536,358] was granted by the patent office on 1975-10-21 for intraocular lens apparatus.
Invention is credited to Ernst W. Potthast.
United States Patent |
3,913,148 |
Potthast |
October 21, 1975 |
**Please see images for:
( Certificate of Correction ) ** |
Intraocular lens apparatus
Abstract
An intraocular lens apparatus for insertion into a posterior
chamber adjacent the iris of an eye. The apparatus includes a lens
having a front face, a central portion and an outer periphery and a
plurality of cantilevered clips. Each clip is mounted to the
central portion, extends outwardly from the face and toward the
periphery. The clips are adapted to secure the iris to the front
face of the lens when the lens is positioned within the posterior
chamber of the eye immediately behind the iris. A surgical tool
includes a handle portion and a foot portion having a clip
retaining surface which serves to maintain the lens on the tool
when the lens is being positioned in the posterior of the eye. In
one embodiment the clips are comprised of a resilient springy
material which serves to bias the legs toward the face. In an
alternate embodiment, the clips are comprised of a deformable,
malleable material.
Inventors: |
Potthast; Ernst W. (Foster
City, CA) |
Family
ID: |
24138181 |
Appl.
No.: |
05/536,358 |
Filed: |
December 26, 1974 |
Current U.S.
Class: |
623/6.12; 65/31;
606/107; 623/6.38 |
Current CPC
Class: |
A61F
2/16 (20130101); A61F 2/1662 (20130101) |
Current International
Class: |
A61F
2/16 (20060101); A61F 001/16 (); A61F 001/24 ();
A61F 009/00 () |
Field of
Search: |
;3/13,1 ;128/33R
;351/160 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Frinks; Ronald L.
Attorney, Agent or Firm: Schatzel & Hamrick
Claims
What is claimed is:
1. An intraocular lens apparatus for insertion into a posterior
chamber adjacent the iris of an eye, comprising:
a lens having a front face, a central portion and an outer
periphery; and
a plurality of cantilevered clips, each mounted to said central
portion and extending outwardly from said face and toward said
periphery, said clips being adapted to secure the iris to the front
face of said lens when said lens is positioned within the posterior
chamber of the eye immediately behind the iris.
2. An intraocular lens apparatus as recited in claim 1 wherein said
face includes a plurality of recesses for respectively receiving
the securing portion of each of said plurality of clips.
3. An intraocular lens apparatus as recited in claim 1 wherein said
clip is comprised of a resilient material, said material serving to
bias said clip toward said face.
4. An intraocular lens apparatus as recited in claim 3 wherein each
clip includes a base portion mounted to said central portion, said
base portion being rotatable about an axis therethrough.
5. An intraocular lens apparatus as recited in claim 4 wherein said
central portion includes a plurality of apertures therethrough and
wherein said base portions extend through corresponding ones of
said apertures.
6. An intraocular lens apparatus as recited in claim 4 wherein each
said base portion includes a flange portion for securing said clip
to said lens.
7. An intraocular lens apparatus as recited in claim 1 wherein each
said clip is comprised of a deformable, malleable material such
that said clip may be formed into a predetermined shape.
8. An intraocular lens apparatus as recited in claim 7 wherein each
said base portion includes flanges at its respective ends for
securing said clip to said lens.
9. An intraocular lens apparatus as recited in claim 1 and further
including in combination, a lens carrying tool for use in inserting
said lens into the eye, said tool including a handle portion, and a
foot portion, said foot portion having a lens engaging surface
adapted to engage said front face, and means forming a clip
retainer for attaching said lens to said foot portion and for
retaining each said clip spaced from said face, whereby said tool
may be used to selectively position said lens in the posterior
chamber of the eye and may then be detached from said lens by
moving said clips from said clip retainer.
10. An intraocular lens apparatus comprising in combination:
a lens having a front face, a central portion and an outer
periphery, and a plurality of cantilevered clips, each mounted to
said central portion and extending outwardly from said face and
toward said periphery, said clips being movable from an
iris-receiving position to an iris engaging position; and
a lens carrying tool including a handle portion and a foot portion,
said foot portion having a face engaging surface for engaging said
front face, and means forming a clip retainer for attaching said
lens to said foot portion and for retaining said clips spaced from
said face in said iris-receiving position whereby, said tool may be
used to selectively position said lens in the posterior chamber of
the eye and may then be detached from said lens by moving said
clips from said iris-receiving position to said iris-engaging
position thereby securing said lens to the iris.
11. An intraocular lens apparatus as recited in claim 10 wherein
said foot portion includes a plurality of notches extending between
said lens engaging surface and said clip retainer for receiving
respective ones of said plurality of clips.
12. An intraocular lens apparatus as recited in claim 11 wherein
said foot portion in plan view has a major axis and a minor axis,
said major axis having a length greater than, and said minor axis
having a length less than the length of a corresponding diameter of
said central portion and wherein said plurality of clips lie in the
periphery of said central portion such that the lens may be
inserted into the posterior chamber of the eye.
13. An intraocular lens apparatus as recited in claim 11 wherein
said notches lie on a circle having a diameter substantially equal
to the diameter of said central portion.
14. An intraocular lens apparatus as recited in claim 13 wherein
the distance between said notch and the outer boundary of said foot
portion is less than the outwardly extending length of said
clip.
15. An intraocular lens apparatus as recited in claim 10 wherein
said foot portion includes first means responsive to an actuating
force and operative to move said clip retainer away from said front
face, and wherein said handle portion comprises means for actuating
said first means, whereby actuation of said first means moves said
clip retainer away from said front face, thus forcing said clips
away from said clip retainer which thereby releases said lens from
said tool and moves said clips into engagement with the iris.
16. An intraocular lens apparatus as recited in claim 15 wherein
said handle portion comprises first and second lever arms
configured as a lever, said first arm carrying said foot portion
and said second arm carrying said first means, whereby movement of
said lever arms toward one another actuates said first means.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates generally to introcular lens
apparatus and, more particularly to intraocular lens apparauts
including a lens having a plurality of clips mounted thereto for
securing the lens to the iris of an eye, and a surgical tool which
may be released from the lens when the lens is inserted into the
posterior chamber.
2. Description of the Prior Art
For several years intraocular lenses, or artificial lenses, have
been implanted by eye surgeons in the eyes of patients who have had
cataracts removed. Historically, the first implants were large and
had projections that tended to mechanically contact, and thus
irritate the iris and ciliary body within the interior of the eye.
More recent lenses have been made smaller to avoid mechanical
contact with the interior walls of the eye.
An example of one of the newer lenses is a lens known as the
Medallion lens. The Medallion lens has an aperture formed near its
outer edge for receiving a suture therethrough. The lens is
positioned in the anterior chamber of the eye and then sutured to
the iris with a single suture. Eye operations involving Medallion
lenses are relatively difficult since the suture must be brought
through the posterior chamber of the eye before the lens can be
secured to the iris. In addition, as is the case with most lenses
that are inserted into the anterior chamber, should the lens become
displaced and touch the endothelium inside the cornea of the eye,
edema may be caused. Moreover, the lens is subject to rotational
displacement about the single suture.
Another artificial lens is a lens known as the Binkhorst-Federov
lens which includes a pair of nylon double loops formed in the
shape of a cross. When inserting the lens into the anterior chamber
of the eye, one double loop is disposed behind the iris and the
other disposed in front of the iris. The lens is held in place by
the constriction of the pupil. Thus, the patient is required to
take myotic eye drops daily to maintain the lens in position.
Generally, the drops are not a problem for older patients who are
usually taking medications of one sort or another, but serve as a
hindrance to younger patients. In addition, should the pupils
dialate, the lens can subluxate and require reinsertion.
Still another example of an artificial lens is a lens having an
X-shape, which similarly to the Binkhoist-Federov lens, has one set
of opposite legs which fits over the iris and another set of
opposite legs which fits under the iris such that the lens may be
inserted into the plane of the iris. However, since the legs are
not secured to the iris, this lens is also subject to dislocation
upon dilation of the pupils.
SUMMARY OF THE PRESENT INVENTION
It is therefore an object of the present invention to provide an
intraocular lens which is inserted into the posterior chamber of an
eye and secured to the iris with clips.
Still another object of the present invention is to provide an
intraocular lens having a front face and an outer periphery with a
plurality of clips extending outwardly from the face and toward the
periphery for securing the lens to the iris of the eye when the
lens is inserted into the posterior chamber.
Still another object of the present invention is to provide in
combination with the intraocular lens, a surgical tool to
facilitate insertion of the lens into the posterior chamber and
which may be easily released from the lens after insertion.
Briefly, the present invention is directed to an intraocular lens
apparatus for inserting a lens into the posterior chamber adjacent
the iris of an eye. The apparatus includes in combination a lens
and a surgical tool for carrying the lens. The lens has a front
face, a central portion, and an outer periphery and a plurality of
cantilevered clips. Each clip is mounted to the central portion and
extends outwardly from the face and toward the periphery. The clips
are movable from an iris-receiving position to an iris-engaging
position. The surgical tool has a handle portion and a foot portion
with a face engaging surface for engaging the front face and a clip
retaining surface for attaching the lens to the tool and for
retaining the clips spaced from the face when the clip is in the
iris-receiving position. When the clips are disposed on the
retaining surface, the lens is secured to the tool. After the lens
is selectively positioned in the posterior of the eye the clips are
moved from the iris-receiving position to the iris-engaging
position which detaches the lens from the tool and secures it to
the iris. In a first embodiment the clips are comprised of a
resilient material which serves to bias the clips toward the front
face.
In a second embodiment, the clips are comprised of a deformable,
malleable material, and are formed into the iris-receving position
by bending each clip over the foot portion of the tool. Once the
lens is inserted in its desired position, the foot portion is
forced away from the front face. This movement forces the clips to
move outwardly toward the periphery which detaches the lens from
the tool and secures the lens to the iris.
A principal advantage of the present invention is that the
intraocular lens is firmly and safely secured to the iris of the
eye.
Another advantage of the present invention is that the intraocular
lens apparatus facilitates insertion of the lens into the posterior
chamber of the eye and allows the tool to be easily detached from
the lens once the lens is in the desired position.
The foregoing and other objects, features and advantages of the
invention will be apparent from the following detailed description
of the preferred embodiments illustrated in the several figures of
the drawing.
IN THE DRAWING
FIG. 1 is a plan view of the intraocular lens apparatus in
accordance with the present invention.
FIG. 2 is a side elevational view of the intraocular lens apparatus
of FIG. 1 with the eye illustrated in phantom.
FIG. 3 is a perspective view illustrating the lens inserted into
the posterior chamber of the eye with a portion of the eye broken
away for clarity.
FIG. 4 is a cross-sectional view taken through the lines 4--4 of
FIG. 3.
FIG. 5 is a cross-sectional view of an alternative embodiment of
the intraocular lens in accordance with the present invention.
FIG. 6 is a side elevational view of an alternative embodiment of
the intraocular lens assembly with the lens shown in cross-section
in accordance with the present invention.
FIGS. 7 and 8 are side elevational views illustrating the
positioning of the intraocular lens apparatus of FIG. 6 into the
posterior chamber of the eye.
FIG. 9 is an enlarged partial side elevational view similar to
FIGS. 7 and 8 illustrating the movement imparted to the clips by
the foot portion.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to the drawings and more particularly to FIGS. 1 and
2 thereof, an intraocular lens apparatus, generally designated by
the numeral 10, in accordance with a preferred embodiment of the
present invention is illustrated in plan and side elevational
views, respectively. The intraocular lens apparatus 10 includes a
lens 12 and a surgical lens carrying tool 13.
The lens 12 includes a front face 14, a central portion 16 and an
outer edge 18, or periphery. In plan view, the face 14 is
substantially oval, forming two elongated ends, so as to define a
major axis 19 and a minor axis 20 (shown in dashed lines in FIG. 1)
disposed perpendicular to one another and passing through the
center. The corners of the intersections of the edges 18 are
rounded for safety. The lens 12 is also oval in side elevation
view. Three apertures 21 are disposed through the central portion
16 of the lens 12. Since three points determine a circle, the
centers of the apertures 21 lie on a circle having its center at,
or near, the intersection of the major and minor axes 19 and 20,
respectively. Moreover, with reference to the eye into which the
lens 12 is inserted, the circle on which the apertures 21 are
located has a diameter that is slightly less than that of the
smallest size of the pupil. A plurality of recesses 24 are formed
in the face 14 near the edge 18. In the preferred embodiment, the
lens 12 is formed from pure methyl methacrylate which is the same
material that is used in forming contact lenses. Alternatively, it
is believed that other transparent materials may also be used in
forming the lens.
Three clips 25 are mounted to the lens 12. Each clip 25 includes a
base portion 26, a leg portion 28 and an arcuate portion 30
integral with and interconnecting the base and leg portions. The
clips 25 are substantially circular in cross section with the
diameter of the base portion 26 being slightly smaller than the
diameter of the apertures 21. This relationship facilitates
mounting the clips 25 in a cantilever manner within the apertures
21 and yet enables the clips to be rotatable about an axis through
the base portion 26. The diameter of the base portion 26 may be
smaller than the diameter of the arcuate portion 30 to further
facilitate rotation. The distal ends of the base portion 26
includes flanges 32 to prevent removal of the clip 25 from the lens
12. The leg portion 28 extends above the front face 14 in a
direction towards the edge 18 and includes a distal end 34 which is
aligned to be receivable by the recess 24. Preferably the end 34 is
formed into a needle point which serves to cut into and thus grasp
the iris of an eye when placed in contact therewith. Alternatively,
the end 34 may extend toward and beyond the edge 18, in which case
the recesses 24 are not required. In this embodiment the clip 25 is
comprised of a resilient material such as inert steel, titanium,
vanadium or other suitable tempered metals. Because of the
resilient property of the material, the leg portion 28 is normally
biased towards the front face 14.
The surgical tool 13 comprises an integrally formed handle portion
42 and a foot portion 44. The foot portion 44 includes a
cylindrical portion 45 which is substantially circular in plan
view, and a flange or arm portion 47. In plan view the foot 44 is
elongated somewhat elliptical and thus may be described as having a
major axis extending across the flanged portion 47 and a minor axis
extending across the diameter of the cylindrical portion 45. The
cylindrical portion 45 includes a lens engaging surface 46 which is
slightly concave and is adapted to mate with the front face 14
within the central portion 16. The flange portion 47 is formed
integral with the foot portion 44 and has a top surface which
defines a clip retaining surface 48. The retaining surface 48
serves to attach the lens 12 to the tool 13 and to space the clip
25 from the face 14 such that an iris-receiving recess is formed
therebetween. The intersection between the foot portion 44 and the
flange portion 47 define notches 49 which serve to receive the
arcuate portion 30 of the clips 25. The distance between the notch
49 and the outermost end of the arms 47 is less than the length of
the leg portion 28 such that the end 34 is able to be received in
the recess 24. The tool 13 is preferably formed from stainless
steel.
The lens 12 is mounted to the tool 13 with the lens-engaging
surface 46 positioned against the central portion 16 of the front
face 14. The leg portions 28 of the clips 25 are pivoted about the
axis through the base portion 26 and positioned over the flange
portion 47 in an iris-receiving position (see FIG. 1). Due to the
resiliency and bias of the stainless steel, the clips 25 bear
against the retaining surface 48. Surgical tweezers may be used to
mount the clips 25 over the retaining surface 48.
Referring now to FIG. 3, the lens 12 is illustrated in perspective
view as being inserted into an eye 50. Only portions of the eye 50
are shown for clarity. With reference also to FIGS. 7 and 8, the
eye 50 includes a posterior chamber 52 and an anterior chamber 54
(see FIGS. 7 and 8) which are separated by an iris 56. The iris 56
is comprised of a spongy tissue and includes a central opening or
pupil 60. When the iris 56 dilates, the pupil 60 becomes larger.
Conversely, when the iris constricts the pupil 60 becomes smaller.
Also referring to FIGS. 7 and 8, a cornea 62 defines a boundary of
the anterior chamber 54. During eye surgery a cut is made in the
cornea 62 and the cornea is carefully lifted away so as to allow
the surgeon entry into the interior of the eye 50.
In operation, after the cornea 62 has been surgically cut, the tool
13 having the lens 12 mounted thereto is inserted into the anterior
chamber 54 and manipulated so as to position one of the elongated
ends of the lens 12 into the posterior chamber 52 (see FIG. 7). In
this position, the iris 56 is disposed in the iris-receiving recess
formed between the face 16 and the clip 25. The tool is manipulated
upwardly such that the inner perimeter of the iris 56 is in contact
with or slightly spaced from the arcuate portion 30. Thereafter,
the other elongated end of the lens 12 is moved into the posterior
chamber 52 and positioned such that the opposite portion of the
iris 56 is disposed in the iris-receiving recess formed by the
lower clip 25 and the face 16. Consequently, the lens 12 is
disposed in an iris-receiving position with its front face 14
adjacent the iris 56 and with the clips 25 disposed in the anterior
chamber 54. With the lens in the desired position, the clips 25 are
individually lifted off the retaining surface 48 and rotated about
the axis through the base portion 26 until they are free of the
flanged portion 47 as shown in FIG. 3. Once the clip 25 is
released, the resiliency of the material urges the end 34 of the
clip toward and into a clamping engagement with the iris 56 in an
iris-receiving position. Depending upon the spring force associated
with the resilient material and the sharpness of the end 34, the
clip may cut through the iris 56 and enter the corresponding recess
24. The clamping engagement in which the clips 25 secure the iris
56 to the front face 14 is further illustrated in cross-section in
FIG. 4. After all of the clips 25 have been removed from the
retaining surface 48 of the tool 13, the tool is detached from the
lens and may be removed. After the lens 12 is secured to the iris
56 the cornea is sutured to close the entry into the anterior
chamber 54 and the operation is complete.
It should be recognized that in some instances it may be desirable
to surgically cut the iris 56 to allow the ends 34 to pass through
the iris and into the recess 24.
Referring now to FIGS. 5-9, a second embodiment the lens 12 is
similar to the lens previously described but differs in that it
includes four clips 25. However, the clips 25 are comprised of a
malleable deformable material, such as platinum, gold, or iridium,
which enables them to be easily formed into a desired shape. A
surgical lens carrying tool 70 includes a lever-like handle 72
comprising lever arms 74 and 76. Integral with the lever arm 74 is
a foot 78 having a bore 80 centrally therethrough and having an
outer surface formed to define a concave lens engaging surface 84.
The outer wall of the foot 78 is curved inwardly toward the axis
through the bore 80 and defines a clip retaining surface 90 which
serves to attach the four clips 25 to the surgical tool 70 in a
manner as will be subsequently described. Hingedly connected to the
distal end of the lever arm 76 is a plunger 86 which is slidably
disposed within the bore 80 of the foot 78.
With reference to FIG. 6, the lens 12 is mounted to the tool 70
with the lens engaging surface 84 matingly disposed against the
central portion 16 and with the arcuate portions 30 of the clips 25
deformed inwardly against the retaining surface 90 such that the
clip 25 is spaced from the face 14. Accordingly, the clip 25 and
the face 14 form a recess therebetween which is adapted to receive
the iris 56. Because the arcuate portion 30 of the clip 25 is
disposed over the foot 78, the lens is secured to the tool 70.
With reference to FIGS. 7 and 8, the lens 12 is inserted into the
posterior chamber 52 in the manner previously described. Once the
lens 12 is placed adjacent the iris 56 in the desired position, the
lever arms 74 and 76 are actuated, or squeezed together, thereby
forcing the plunger 86 through the bore 80 and against the front
face 14 which forces the foot 78 to move away from the face 14. As
the foot 78 moves away from the face 14 the retaining surfaces 90
transmit an outwardly directed force against the arcuate portion 30
of the malleable clips 25 (see FIG. 9). Consequently, the clips 25
are moved outwardly away from the foot 78 and toward the front face
14. Continued movement of the foot 78 eventually releases the lens
12 from the tool 70 and forces the ends 34 into engagement with the
iris 56 as shown by the dashed lines in FIG. 9.
It should be realized that in some instances the surgeon may prefer
to bend the end 34 against and into the iris 56 prior to actuating
the lever arms 74 and 76. This assures that the lens 12 is clamped
to the iris 56 before detaching the lens from the tool 13.
Although the tool 70 has been described as comprising a plunging
mechanism, it should be recognized that other reciprocating
mechanical movements may be employed to free the lens from the
tool. Moreover, should it be desired, the ends 34 may be formed
into a hook shape to facilitate a clamping engagement with the iris
56. In addition, the shape of the lens and the number of clips may
vary as will be easily seen by those skilled in the art.
From the above description it can be seen that an intraocular lens
apparatus has been described which fulfills all of the objects and
advantages set forth above.
While the invention has been particularly shown and described with
reference to certain preferred embodiments, it will be understood
by those skilled in the art that various alterations and
modifications in form and in detail may be made therein.
Accordingly, it is intended that the following claims cover all
such alterations and modifications as fall within the true spirit
and scope of the invention.
* * * * *