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EP0886504A1 - Intraocular implant for correcting short-sightedness - Google Patents

Intraocular implant for correcting short-sightedness

Info

Publication number
EP0886504A1
EP0886504A1 EP97906223A EP97906223A EP0886504A1 EP 0886504 A1 EP0886504 A1 EP 0886504A1 EP 97906223 A EP97906223 A EP 97906223A EP 97906223 A EP97906223 A EP 97906223A EP 0886504 A1 EP0886504 A1 EP 0886504A1
Authority
EP
European Patent Office
Prior art keywords
posterior
extensions
implant
face
anterior
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP97906223A
Other languages
German (de)
French (fr)
Inventor
Joaquin Barraquer
Gilles Bos
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Corneal Laboratoires
Original Assignee
W K et Associes
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by W K et Associes filed Critical W K et Associes
Publication of EP0886504A1 publication Critical patent/EP0886504A1/en
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1602—Corrective lenses for use in addition to the natural lenses of the eyes or for pseudo-phakic eyes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics

Definitions

  • the present invention relates to an intraocular implant for correcting myopia. More specifically, the invention relates to an intraocular implant for correcting myopia which is intended to be placed in the posterior chamber of a phakic eye, that is to say of an eye whose did not remove the lens during a cataract removal operation.
  • intraocular implant intended to correct myopia.
  • the first type of implant it is intended to be placed in the anterior chamber of the eye.
  • Figure 1 attached there is shown in horizontal section a human eye therefore comprising the cornea 10, the iris 12 with the pupil 14 and the lens 16 contained in the capsular bag 18 itself fixed by zonules 21 on the wall internal of the eye.
  • the anterior chamber 20 is called the internal space of the eye which extends between the cornea 10 and the iris 12.
  • the entire internal part of the eye is posterior to the posterior chamber.
  • iris 14 This posterior chamber therefore comprises a zone 22 which extends between the iris 12 and the anterior face of the lens 16 and a zone 24 set back relative to the lens 16.
  • the optical part of the implant In the first type of myopic implant, it is placed in the anterior chamber 20.
  • the optical part of the implant In this case, one of the difficulties encountered is that, in order to be able to effectively correct myopia, the optical part of the implant necessarily has a relatively thick edge. Given the reduced dimensions of the anterior chamber, there is therefore a real risk that the edge of the optical part of the implant, placed in the anterior chamber, traumatizes the internal face of the cornea 10. Such trauma can lead to serious consequences since the cells of the internal face of the traumatized cornea cannot regenerate and this affection tends to develop towards the central part of the cornea, that is to say that which plays the most important role in vision.
  • the present invention relates to the second type of implant, that is to say a posterior chamber implant for the phakic eye.
  • the implant After being placed in zone 22 of the posterior chamber, the implant is subjected to pressure effects resulting from the aqueous humor and the vitreous humor present in the anterior chamber and the posterior chamber and external pressures that can be applied to the entire eye. It is necessary that, under the effect of these different pressures, the implant does not risk leaving the posterior chamber to pass into the anterior chamber.
  • An object of the present invention is to provide a myopic intraocular implant for posterior phakic chamber which better solves the problems stated above, in particular by better allowing the respective deformations of the lens and the iris, while ensuring a very good retention of the implant in the posterior chamber.
  • the posterior chamber intraocular implant for correcting myopia of a phakic eye comprising a substantially circular optical part limited by an anterior diopter and a posterior diopter and a haptic part
  • said part haptic comprises at least two extensions connected to the periphery of the optical part, the ends of which are separated by a diametrical distance greater than the diameter of an expanded pupil and at least two fixing elements on the wall of the chamber
  • the anterior face of each extension comprising a toric portion connected to the anterior diopter, said toric portions being capable of allowing the posterior face of the iris to slide on said implant
  • the posterior face of each extension comprising a toric portion connected to the posterior diopter and forming a bearing portion on the periphery of the lens and a connection portion
  • the posterior diopter and the toric portions of the posterior face of said extensions defining a recess relative to the surface (S) containing said portions connection to allow the free modification of the curvature of the anterior surface of the lens.
  • the intraocular implant is well maintained in the posterior chamber, whatever the degree of dilation of the pupil of the iris. It is also understood that, thanks to the presence of the recess formed in the posterior face of the optical part of the implant, a free modification of the curvature of the anterior face of the lens is authorized. It can also be seen that, thanks to the presence of the toric support portions, the implant is in contact with the anterior face of the lens only through a peripheral zone not directly interested in vision and over a very small annular zone.
  • the iris can freely slide relative to the anterior face of the implant during dilation or contraction of the pupil without 'there is a risk of "sticking" of the iris on the implant.
  • FIG. 2 is a front elevational view of the myopic implant according to the invention.
  • FIG. 3 is a side view of the implant of Figure 2; - Figure 4 is a top view showing the placement of the myopic implant in the posterior chamber of the eye; and - Figure 5 is a detail view of the implant showing a handle for fixing the haptic part.
  • the myopic implant comprises a substantially circular optical part 30 of radius D.
  • this diameter is equal to 5.5 mm. More generally, the diameter D is between 4 and 6 mm.
  • the implant has an extension respectively referenced 32 and 34 which are connected to the periphery 30a of the optical part.
  • These extensions belong to the haptic part of the implant. In the example considered, the extensions are limited by a free edge 34a and 32a of substantially semi-circular shape.
  • the haptic part also comprises two lateral portions 36 and 38 which connect the extensions 32 and 34 on either side of the optical part 30.
  • the optical part 30 is of course limited by an anterior diopter 40 which , in the example considered, is planar, and by a posterior diopter 42 which is concave.
  • the front face of the extensions 32 and 34 is limited by a portion of toric surface 44 which is connected to the periphery of the front diopter 40. If we now consider the rear face of the extensions 32 and 34, we see that it is defined firstly by a toric surface portion 46 forming a bearing surface and then by a connection zone 48, which is also toric or frustoconical. It can also be seen that, with respect to the surface S which contains the connection surfaces 48 of the extensions 32 and 34, the posterior diopter 42 and the toric zone 46 define a posterior recess 50 whose function will be explained later.
  • the lateral portions 36 and 38 have anterior and posterior faces which extend the anterior and posterior faces of the extensions 32 and 34.
  • the diametrical distance between the ends of the extensions 32 and 34 referenced L in the figures , is substantially greater than the diameter D of the optical part.
  • L is equal to 8 mm. More generally, L is between 7 and 9 mm.
  • the haptic part of the implant comprises, in addition to the extensions 32 and 34 and preferably the lateral zones 36 and 38, two fixing handles 50 and 52 and 54, which have a connection end 52a, 54a on the extension 32 or 34 and a free end 54b, 52b.
  • the handles 52 and 54 are said to be of the "C" type.
  • each loop 52 and 54 has an angulation in a plane containing the axis optical.
  • the loop 54 is shown more particularly, it can be seen that the first portion 54 ′ of the loop closest to the end 54a forms an angle ⁇ with a plane orthogonal to the optical axis and that the second portion 54 "closer to the end 54b makes an angle b with this same direction.
  • the angulation corresponding to the angle a tends to separate the handle from the anterior face of the optical part while the angulation b This angulation means that, under the effect of stresses applied to the handles in the direction of the main plane of the implant, any axial displacement of the implant is substantially avoided.
  • the means for fixing the haptic part could have a shape other than the handles shown in FIG. 2.
  • a passage making the recess 50 communicate with the interior of the eye so to obtain a pressure equalization.
  • the total width L ′ of the implant at the level of the lateral zones 36 and 38 is also possible to provide for the total width L ′ of the implant at the level of the lateral zones 36 and 38 to be such that a natural passage takes place between the bearing zones of the lateral portions and the anterior face of the lens. In this case, the equi-pressure is obtained automatically.
  • the lateral size of the handles 52 and 54 is less than or equal to L ′.
  • the lateral portions of the haptic part each have a substantially straight free edge which is connected to the substantially semi-circular edges of said extensions.
  • Figure 4 shows the myopic implant placed in the posterior chamber 22 of the eye, the lens being at rest, that is to say without accommodating it.
  • This figure shows that the anterior face of the implant is in contact with the posterior face of the iris 12 via the toric surface 44, which allows the iris to slide on the anterior face of the implant. during dilations or contractions of the pupil.
  • FIG. 4 also shows that the posterior face of the implant is in contact with the anterior face of the lens 16a via the toric bearing surface 46 which effectively plays its role of support as the radius of curvature of the anterior surface of the lens decreases to achieve accommodation, Figure 4 showing the lens in its "non-accommodation" state.
  • the contact between the lens and the surface 46 is a contact between a sphere and a portion of toric surface.
  • the contact surface is therefore annular and very small. The first consequence of this is that this contact occurs on the peripheral zone of the lens and not on its central zone. This has the second consequence that the central part of the lens is opposite the recess 50 of the posterior face of the implant.
  • the projection of the handles on a plane orthogonal to the optical axis of the implant is entirely contained in the portion of said plane limited by the straight lines of the plane containing the projections on this plane of the free edges of the lateral portions of the haptic part. .

Landscapes

  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

A posterior-chamber intraocular implant for correcting short-sightedness in a phakic eye is disclosed. The implant includes a substantially circular optical portion (30) consisting of a front dioptric surface (40), a rear dioptric surface (42) and a haptic portion. The haptic portion includes two extensions (32, 34) joined to the edge of the optical portion, of which the ends are spaced apart by a distance greater than the diameter of a dilated pupil, and two attachment portions (52, 54). The front surface of each extension comprises a toroidal portion (44) joined to the front dioptric surface, the rear surface of each extension comprises a toroidal portion (46) engaging the lens circumference and joined to the rear dioptric surface, and a connecting portion (48), and the rear dioptric surface and the toroidal portions on the rear surfaces of the extensions define a recess (50) for freely altering the curvature of the front lens surface.

Description

Implant intraoculaire myopique Myopic intraocular implant
La présente invention a pour objet un implant intraoculaire pour corriger la myopie. De façon plus précise, l'invention a pour objet un implant intraoculaire de correction de la myopie qui est destiné à être mis en place dans la chambre postérieure d'un oeil phaque, c'est-à-dire d'un oeil dont on n'a pas enlevé le cristallin lors d'une opération de l'ablation de la cataracte. On peut citer deux grands types d'implant intraoculaire destinés à corriger la myopie. Dans le premier type d'implant, celui-ci est destiné à être mis en place dans la chambre antérieure de l'oeil. Sur la figure 1 annexée, on a représenté en coupe horizontale un oeil humain comportant donc la cornée 10, l'iris 12 avec la pupille 14 et le cristallin 16 contenu dans le sac capsulaire 18 lui-même fixé par des zonules 21 sur la paroi interne de l'oeil.The present invention relates to an intraocular implant for correcting myopia. More specifically, the invention relates to an intraocular implant for correcting myopia which is intended to be placed in the posterior chamber of a phakic eye, that is to say of an eye whose did not remove the lens during a cataract removal operation. There are two main types of intraocular implant intended to correct myopia. In the first type of implant, it is intended to be placed in the anterior chamber of the eye. In Figure 1 attached, there is shown in horizontal section a human eye therefore comprising the cornea 10, the iris 12 with the pupil 14 and the lens 16 contained in the capsular bag 18 itself fixed by zonules 21 on the wall internal of the eye.
De façon classique, on appelle chambre antérieure 20 l'espace interne à l'oeil qui s'étend entre la cornée 10 et l'iris 12. En revanche, on appelle chambre postérieure toute la partie interne de l'oeil en arrière de l'iris 14. Cette chambre postérieure comprend donc une zone 22 qui s'étend entre l'iris 12 et la face antérieure du cristallin 16 et une zone 24 en retrait par rapport au cristallin 16.Conventionally, the anterior chamber 20 is called the internal space of the eye which extends between the cornea 10 and the iris 12. On the other hand, the entire internal part of the eye is posterior to the posterior chamber. iris 14. This posterior chamber therefore comprises a zone 22 which extends between the iris 12 and the anterior face of the lens 16 and a zone 24 set back relative to the lens 16.
Dans le premier type d'implant myopique, celui-ci est mis en place dans la chambre antérieure 20. Dans ce cas, une des difficultés rencontrées est que, pour pouvoir corriger effectivement la myopie, la partie optique de l'implant a nécessairement un bord relativement épais. Compte tenu des dimensions réduites de la chambre antérieure, il existe donc un risque réel que le bord de la partie optique de l'implant, mis en place dans la chambre antérieure, ne traumatise la face interne de la cornée 10. Un tel traumatisme peut entraîner des conséquences graves puisque les cellules de la face interne de la cornée traumatisée ne peuvent se régénérer et que cette affectation tend à se développer vers la partie centrale de la cornée, c'est-à-dire celle qui joue le rôle le plus important dans la vision. C'est pourquoi, dans le deuxième type d'implant myopique, on propose une implantation de celui-ci dans la chambre postérieure et, dans le cas de l'oeil phaque, dans la zone 22 de la chambre postérieure, c'est-à-dire celle qui s'étend entre l'iris et la face antérieure du cristallin 16.In the first type of myopic implant, it is placed in the anterior chamber 20. In this case, one of the difficulties encountered is that, in order to be able to effectively correct myopia, the optical part of the implant necessarily has a relatively thick edge. Given the reduced dimensions of the anterior chamber, there is therefore a real risk that the edge of the optical part of the implant, placed in the anterior chamber, traumatizes the internal face of the cornea 10. Such trauma can lead to serious consequences since the cells of the internal face of the traumatized cornea cannot regenerate and this affection tends to develop towards the central part of the cornea, that is to say that which plays the most important role in vision. This is why, in the second type of myopic implant, an implantation thereof is proposed in the posterior chamber and, in the case of the phakic eye, in zone 22 of the posterior chamber, that is to say that which extends between the iris and the anterior face of the lens 16.
La présente invention concerne le deuxième type d'implant, c'est-à-dire un implant de chambre postérieure pour oeil phaque.The present invention relates to the second type of implant, that is to say a posterior chamber implant for the phakic eye.
La mise en place d'un tel implant soulève également certaines difficultés. En effet, l'espace entre la face postérieure de l'iris et la face antérieure du cristallin 16 est relativement réduit. Il en résulte que l'implant sera en contact à la fois avec la face postérieure de l'iris et la face antérieure du cristallin. Ce problème est encore rendu plus complexe, du fait que la pupille 14 se dilate et se rétracte selon les conditions d'éclairement auxquelles est soumis l'oeil et que, d'autre part, selon l'accomodation souhaitée ou nécessaire, le cristallin 16 et en particulier sa face antérieure 16a voit sa forme modifiée et donc en particulier la courbure de la face antérieure 16a du cristallin.The installation of such an implant also raises certain difficulties. Indeed, the space between the rear face of the iris and the front face of the lens 16 is relatively small. As a result, the implant will be in contact with both the posterior surface of the iris and the anterior surface of the lens. This problem is made even more complex by the fact that the pupil 14 expands and retracts according to the lighting conditions to which the eye is subjected and that, on the other hand, according to the desired or necessary accommodation, the lens 16 and in particular its front face 16a sees its modified shape and therefore in particular the curvature of the front face 16a of the lens.
En outre, après sa mise en place dans la zone 22 de la chambre postérieure, l'implant est soumis à des effets de pression résultant de l'humeur aqueuse et de l'humeur vitrée présentes dans la chambre antérieure et la chambre postérieure et des pressions externes qui peuvent être appliquées à l'ensemble de l'oeil. Il est nécessaire que, sous l'effet de ces différentes pressions, l'implant ne risque pas de sortir de la chambre postérieure pour passer dans la chambre antérieure.In addition, after being placed in zone 22 of the posterior chamber, the implant is subjected to pressure effects resulting from the aqueous humor and the vitreous humor present in the anterior chamber and the posterior chamber and external pressures that can be applied to the entire eye. It is necessary that, under the effect of these different pressures, the implant does not risk leaving the posterior chamber to pass into the anterior chamber.
Un objet de la présente invention est de fournir un implant intraoculaire myopique pour chambre postérieure d'oeil phaque qui résolve mieux les problèmes énoncés ci-dessus, notamment en autorisant mieux les déformations respectives du cristallin et de l'iris, tout en assurant un très bon maintien en place de l'implant dans la chambre postérieure.An object of the present invention is to provide a myopic intraocular implant for posterior phakic chamber which better solves the problems stated above, in particular by better allowing the respective deformations of the lens and the iris, while ensuring a very good retention of the implant in the posterior chamber.
Pour atteindre ce but, l'implant intraoculaire de chambre postérieure pour la correction de la myopie d'un oeil phaque comprenant une partie optique sensiblement circulaire limitée par un dioptre antérieur et un dioptre postérieur et une partie haptique, se caractérise en ce que ladite partie haptique comprend au moins deux extensions raccordées à la périphérie de la partie optique dont les extrémités sont séparées par une distance diamétrale supérieure au diamètre d'une pupille dilatée et au moins deux éléments de fixation sur la paroi de la chambre, la face antérieure de chaque extension comportant une portion torique raccordée au dioptre antérieur, lesdites portions toriques étant aptes à permettre le glissement de la face postérieure de l'iris sur ledit implant, la face postérieure de chaque extension comprenant une portion torique raccordée au dioptre postérieur et formant portion d'appui sur la périphérie du cristallin et une portion de raccordement, le dioptre postérieur et les portions toriques de la face postérieure desdites extensions définissant un évidement par rapport à la surface (S) contenant lesdites portions de raccordement pour permettre la libre modification de la courbure de la face antérieure du cristallin.To achieve this goal, the posterior chamber intraocular implant for correcting myopia of a phakic eye comprising a substantially circular optical part limited by an anterior diopter and a posterior diopter and a haptic part, is characterized in that said part haptic comprises at least two extensions connected to the periphery of the optical part, the ends of which are separated by a diametrical distance greater than the diameter of an expanded pupil and at least two fixing elements on the wall of the chamber, the anterior face of each extension comprising a toric portion connected to the anterior diopter, said toric portions being capable of allowing the posterior face of the iris to slide on said implant, the posterior face of each extension comprising a toric portion connected to the posterior diopter and forming a bearing portion on the periphery of the lens and a connection portion, the posterior diopter and the toric portions of the posterior face of said extensions defining a recess relative to the surface (S) containing said portions connection to allow the free modification of the curvature of the anterior surface of the lens.
On comprend que, grâce à la présence des extensions, l'implant intraoculaire est bien maintenu dans la chambre postérieure, quel que soit le degré de dilatation de la pupille de l'iris. On comprend également que, grâce à la présence de l'évidement formé dans la face postérieure de la partie optique de l'implant, on autorise une libre modification de la courbure de la face antérieure du cristallin. On voit également que, grâce à la présence des portions d'appui torique, l'implant n'est en contact avec la face antérieure du cristallin que par une zone périphérique non directement intéressée par la vision et sur une zone annulaire très réduite. Enfin, on comprend également que, grâce à la présence de la portion torique raccordée au dioptre antérieur de l'implant, l'iris peut librement glisser par rapport à la face antérieure de l'implant lors des dilatation ou contraction de la pupille sans qu'il existe de risque de "collage" de l'iris sur l'implant.It is understood that, thanks to the presence of the extensions, the intraocular implant is well maintained in the posterior chamber, whatever the degree of dilation of the pupil of the iris. It is also understood that, thanks to the presence of the recess formed in the posterior face of the optical part of the implant, a free modification of the curvature of the anterior face of the lens is authorized. It can also be seen that, thanks to the presence of the toric support portions, the implant is in contact with the anterior face of the lens only through a peripheral zone not directly interested in vision and over a very small annular zone. Finally, we also understand that, thanks to the presence of the toric portion connected to the anterior diopter of the implant, the iris can freely slide relative to the anterior face of the implant during dilation or contraction of the pupil without 'there is a risk of "sticking" of the iris on the implant.
D'autres caractéristiques et avantages de l'invention apparaîtront mieux à la lecture de la description qui suit d'un mode préféré de réalisation de l'invention donné à titre d'exemple non limitatif. La description se réfère aux figures annexées sur lesquelles : - la figure 1, déjà décrite, montre les différentes parties de l'intérieur de l'oeil humain;Other characteristics and advantages of the invention will appear better on reading the following description of a preferred embodiment of the invention given by way of non-limiting example. The description refers to the appended figures in which: - Figure 1, already described, shows the different parts of the interior of the human eye;
- la figure 2 est une vue en élévation de face de l'implant myopique selon l'invention;- Figure 2 is a front elevational view of the myopic implant according to the invention;
- la figure 3 est une vue de côté de l'implant de la figure 2; - la figure 4 est une vue de dessus montrant la mise en place de l'implant myopique dans la chambre postérieure de l'oeil; et - la figure 5 est une vue de détail de l'implant montrant une anse de fixation de la partie haptique.- Figure 3 is a side view of the implant of Figure 2; - Figure 4 is a top view showing the placement of the myopic implant in the posterior chamber of the eye; and - Figure 5 is a detail view of the implant showing a handle for fixing the haptic part.
En se référant tout d'abord aux figures 2 et 3, on va décrire un mode préféré de réalisation de l'implant myopique. Celui-ci comprend une partie optique 30 sensiblement circulaire de rayon D. Dans l'exemple particulier décrit, ce diamètre est égal à 5,5mm. Plus généralement, le diamètre D est compris entre 4 et 6 mm. A chaque extrémité de la zone optique 30 selon la direction de l'axe vertical XX', l'implant comporte une extension respectivement référencée 32 et 34 qui sont raccordées à la périphérie 30a de la partie optique. Ces extensions appartiennent à la partie haptique de l'implant. Dans l'exemple considéré, les extensions sont limitées par un bord libre 34a et 32a de forme sensiblement semi-circulaire. Dans l'exemple représenté, la partie haptique comporte également deux portions latérales 36 et 38 qui raccordent les extensions 32 et 34 de part et d'autre de la partie optique 30. La partie optique 30 est bien sûr limitée par un dioptre antérieur 40 qui, dans l'exemple considéré, est plan, et par un dioptre postérieur 42 qui est concave. La face antérieure des extensions 32 et 34 est limitée par une portion de surface torique 44 qui est raccordée à la périphérie du dioptre antérieur 40. Si l'on considère maintenant la face postérieure des extensions 32 et 34, on voit qu'elle est définie tout d'abord par une portion de surface torique 46 formant surface d'appui puis par une zone de raccordement 48, qui est également torique ou tronconique. On voit également que, par rapport à la surface S qui contient les surfaces de raccordement 48 des extensions 32 et 34, le dioptre postérieur 42 et la zone torique 46 définissent un évidement postérieur 50 dont on exposera ultérieurement la fonction. Les portions latérales 36 et 38 présentent des faces antérieure et postérieure qui prolongent les faces antérieure et postérieure des extensions 32 et 34. Comme le montre mieux la figure 2, la distance diamétrale entre les extrémités des extensions 32 et 34, référencées L sur les figures, est sensiblement supérieure au diamètre D de la partie optique. Dans l'exemple considéré, L est égal à 8 mm. Plus généralement, L est compris entre 7 et 9 mm. Enfin, la partie haptique de l'implant comprend, outre les extensions 32 et 34 et de préférence les zones latérales 36 et 38, deux anses de fixation 50 et 52 et 54, qui comportent une extrémité de raccordement 52a, 54a sur l'extension 32 ou 34 et une extrémité libre 54b, 52b. Dans l'exemple particulier considéré, les anses 52 et 54 sont dites du type en "C". Comme cela est bien connu, les extrémités libres des anses 52b etReferring first to Figures 2 and 3, we will describe a preferred embodiment of the myopic implant. This comprises a substantially circular optical part 30 of radius D. In the particular example described, this diameter is equal to 5.5 mm. More generally, the diameter D is between 4 and 6 mm. At each end of the optical zone 30 in the direction of the vertical axis XX ', the implant has an extension respectively referenced 32 and 34 which are connected to the periphery 30a of the optical part. These extensions belong to the haptic part of the implant. In the example considered, the extensions are limited by a free edge 34a and 32a of substantially semi-circular shape. In the example shown, the haptic part also comprises two lateral portions 36 and 38 which connect the extensions 32 and 34 on either side of the optical part 30. The optical part 30 is of course limited by an anterior diopter 40 which , in the example considered, is planar, and by a posterior diopter 42 which is concave. The front face of the extensions 32 and 34 is limited by a portion of toric surface 44 which is connected to the periphery of the front diopter 40. If we now consider the rear face of the extensions 32 and 34, we see that it is defined firstly by a toric surface portion 46 forming a bearing surface and then by a connection zone 48, which is also toric or frustoconical. It can also be seen that, with respect to the surface S which contains the connection surfaces 48 of the extensions 32 and 34, the posterior diopter 42 and the toric zone 46 define a posterior recess 50 whose function will be explained later. The lateral portions 36 and 38 have anterior and posterior faces which extend the anterior and posterior faces of the extensions 32 and 34. As best shown in FIG. 2, the diametrical distance between the ends of the extensions 32 and 34, referenced L in the figures , is substantially greater than the diameter D of the optical part. In the example considered, L is equal to 8 mm. More generally, L is between 7 and 9 mm. Finally, the haptic part of the implant comprises, in addition to the extensions 32 and 34 and preferably the lateral zones 36 and 38, two fixing handles 50 and 52 and 54, which have a connection end 52a, 54a on the extension 32 or 34 and a free end 54b, 52b. In the particular example considered, the handles 52 and 54 are said to be of the "C" type. As is well known, the free ends of the handles 52b and
54b sont destinées à venir en appui sur la paroi interne de la chambre postérieure pour maintenir en place l'implant de telle manière que la partie optique 30 reste correctement centrée, notamment par rapport à la pupille 14. Pour éviter que, sous l'action des pressions ou d'une contrainte externe, la partie optique de l'implant ne se déplace selon la direction de l'axe optique de l'oeil, de préférence, chaque anse 52 et 54 présente une angulation dans un plan contenant l'axe optique. Sur la figure 5, on a représenté plus particulièrement l'anse 54, on voit que la première portion 54' de l'anse la plus proche de l'extrémité 54a fait un angle a avec un plan orthogonal à l'axe optique et que la deuxième portion 54" plus proche de l'extrémité 54b fait un angle b avec cette même direction. L'angulation correspondant à l'angle a tend à écarter l'anse de la face antérieure de la partie optique alors que l'angulation b tend à la rapprocher. Cette angulation fait que, sous l'effet de contraintes appliquées aux anses dans la direction du plan principal de l'implant, on évite sensiblement tout déplacement axial de l'implant.54b are intended to come to bear on the internal wall of the posterior chamber to hold the implant in place so that the optical part 30 remains correctly centered, in particular with respect to the pupil 14. To avoid that, under the action pressure or external stress, the optical part of the implant does not move in the direction of the optical axis of the eye, preferably, each loop 52 and 54 has an angulation in a plane containing the axis optical. In FIG. 5, the loop 54 is shown more particularly, it can be seen that the first portion 54 ′ of the loop closest to the end 54a forms an angle α with a plane orthogonal to the optical axis and that the second portion 54 "closer to the end 54b makes an angle b with this same direction. The angulation corresponding to the angle a tends to separate the handle from the anterior face of the optical part while the angulation b This angulation means that, under the effect of stresses applied to the handles in the direction of the main plane of the implant, any axial displacement of the implant is substantially avoided.
Il va de soi que les moyens de fixation de la partie haptique pourraient avoir une forme autre que les anses montrées sur la figure 2. II faut également noter que, pour éviter un effet de ventouse de l'implant par rapport au cristallin, du fait des portions d'appui 48 des extensions et des zones latérales 36 et 38, on prévoit, soit dans ces zones des extensions, soit dans ces zones des parties latérales un passage faisant communiquer l'évidement 50 avec l'intérieur de l'oeil afin d'obtenir une mise en équi-pression. Il est également possible de prévoir que la largeur totale L' de l'implant au niveau des zones latérales 36 et 38 soit telle qu'il se produit un passage naturel entre les zones d'appui des portions latérales et la face antérieure du cristallin. Dans ce cas, la mise en équi-pression est obtenue automatiquement. De préférence également, afin de faciliter l'introduction de l'implant dans l'oeil, l'encombrement latéral des anses 52 et 54 est inférieur ou égal à L'.It goes without saying that the means for fixing the haptic part could have a shape other than the handles shown in FIG. 2. It should also be noted that, to avoid a suction effect of the implant relative to the lens, due to the fact bearing portions 48 of the extensions and of the lateral zones 36 and 38, provision is made, either in these zones for the extensions, or in these zones for the lateral parts, a passage making the recess 50 communicate with the interior of the eye so to obtain a pressure equalization. It is also possible to provide for the total width L ′ of the implant at the level of the lateral zones 36 and 38 to be such that a natural passage takes place between the bearing zones of the lateral portions and the anterior face of the lens. In this case, the equi-pressure is obtained automatically. Preferably also, in order to facilitate the introduction of the implant into the eye, the lateral size of the handles 52 and 54 is less than or equal to L ′.
Plus précisément, les portions latérales de la partie haptique présentent chacune un bord libre sensiblement rectiligne qui se raccorde aux bords sensiblement semi-circulaires desdites extensions.More specifically, the lateral portions of the haptic part each have a substantially straight free edge which is connected to the substantially semi-circular edges of said extensions.
La figure 4 montre l'implant myopique mis en place dans la chambre postérieure 22 de l'oeil, le cristallin étant au repos, c'est-à-dire sans qu'il accomode. Cette figure montre que la face antérieure de l'implant est en contact avec la face postérieure de l'iris 12 par l'intermédiaire de la surface torique 44, ce qui permet le glissement de l'iris sur la face antérieure de l'implant lors des dilatations ou des contractions de la pupille.Figure 4 shows the myopic implant placed in the posterior chamber 22 of the eye, the lens being at rest, that is to say without accommodating it. This figure shows that the anterior face of the implant is in contact with the posterior face of the iris 12 via the toric surface 44, which allows the iris to slide on the anterior face of the implant. during dilations or contractions of the pupil.
La figure 4 montre également que la face postérieure de l'implant est en contact avec la face antérieure du cristallin 16a par l'intermédiaire de la surface d'appui torique 46 qui joue effectivement son rôle d'appui au fur et à mesure que le rayon de courbure de la face antérieure du cristallin diminue pour réaliser l'accomodation, la figure 4 montrant le cristallin dans son état de "non-accomodation". De plus, le contact entre le cristallin et la surface 46 est un contact entre une sphère et une portion de surface torique. La surface de contact est donc annulaire et très réduite. Cela a pour première conséquence que ce contact se produit sur la zone périphérique du cristallin et non sur sa zone centrale. Cela a pour deuxième conséquence que la partie centrale du cristallin est en regard de l'évidement 50 de la face postérieure de l'implant. Cet évidement autorise donc une modification du rayon de courbure de la face antérieure 16a du cristallin sans qu'il y ait de contact entre le cristallin et la face postérieure 42 de l'optique de l'implant. Cela permet donc une libre modification de la courbure du cristallin. De préférence, la projection des anses sur un plan orthogonal à l'axe optique de l'implant est entièrement contenue dans la portion dudit plan limitée par les droites du plan contenant les projections sur ce plan des bords libres des portions latérales de la partie haptique. FIG. 4 also shows that the posterior face of the implant is in contact with the anterior face of the lens 16a via the toric bearing surface 46 which effectively plays its role of support as the radius of curvature of the anterior surface of the lens decreases to achieve accommodation, Figure 4 showing the lens in its "non-accommodation" state. In addition, the contact between the lens and the surface 46 is a contact between a sphere and a portion of toric surface. The contact surface is therefore annular and very small. The first consequence of this is that this contact occurs on the peripheral zone of the lens and not on its central zone. This has the second consequence that the central part of the lens is opposite the recess 50 of the posterior face of the implant. This recess therefore allows a modification of the radius of curvature of the anterior face 16a of the lens without there being any contact between the lens and the posterior face 42 of the optics of the implant. This therefore allows a free modification of the curvature of the lens. Preferably, the projection of the handles on a plane orthogonal to the optical axis of the implant is entirely contained in the portion of said plane limited by the straight lines of the plane containing the projections on this plane of the free edges of the lateral portions of the haptic part. .

Claims

REVENDICATIONS
1. Implant intraoculaire de chambre postérieure pour la correction de la myopie d'un oeil phake comprenant une partie optique (30) sensiblement circulaire limitée par un dioptre antérieur (40) et un dioptre postérieur (42) et une partie haptique, caractérisé en ce que ladite partie haptique comprend au moins deux extensions (32, 34) raccordées à la périphérie de la partie optique dont les extrémités sont séparées par une distance diamétrale (L) supérieure au diamètre d'une pupille dilatée et au moins deux éléments de fixation (52, 54) sur la paroi de la chambre, la face antérieure de chaque extension comportant une portion torique (44) raccordée au dioptre antérieur, lesdites portions toriques étant aptes à permettre le glissement de la face postérieure de l'iris sur ledit implant, la face postérieure de chaque extension comprenant une portion torique (46) d'appui sur la périphérie du cristallin raccordée au dioptre postérieur et une portion de raccordement (48), le dioptre postérieur et les portions toriques de la face postérieure desdites extensions définissant un évidement (50) par rapport à la surface (S) contenant lesdites portions de raccordement pour permettre la libre modification de la courbure de la face antérieure du cristallin.1. Posterior chamber intraocular implant for the correction of myopia of a phakic eye comprising an optical part (30) substantially circular limited by an anterior diopter (40) and a posterior diopter (42) and a haptic part, characterized in that that said haptic part comprises at least two extensions (32, 34) connected to the periphery of the optical part, the ends of which are separated by a diametrical distance (L) greater than the diameter of a dilated pupil and at least two fixing elements ( 52, 54) on the wall of the chamber, the front face of each extension comprising a toric portion (44) connected to the anterior diopter, said toric portions being capable of allowing the posterior face of the iris to slide on said implant, the rear face of each extension comprising a toric portion (46) bearing on the periphery of the lens connected to the posterior diopter and a connection portion nt (48), the posterior diopter and the toric portions of the posterior face of said extensions defining a recess (50) relative to the surface (S) containing said connecting portions to allow the free modification of the curvature of the anterior face of the crystalline.
2. Implant intraoculaire selon la revendication 1, caractérisé en ce qu'il comprend deux extensions (32, 34) diamétralement opposées par rapport à la partie optique.2. Intraocular implant according to claim 1, characterized in that it comprises two extensions (32, 34) diametrically opposite with respect to the optical part.
3. Implant intraoculaire selon la revendication 2, caractérisé en ce que chaque extension (32, 34) présente un bord libre sensiblement en forme de demi-cercle, lesdites extensions étant raccordées entre elles par des portions latérales (36, 38) raccordées à la périphérie de la partie optique, les faces antérieure et postérieure desdites portions latérales (36, 38) prolongeant respectivement les portions toriques (44, 46) des faces antérieures et postérieures desdites extensions et les portions de raccordement (48) desdites extensions par quoi la face postérieure de l'implant s'appuie seulement sur la périphérie du cristallin. 3. Intraocular implant according to claim 2, characterized in that each extension (32, 34) has a free edge substantially in the form of a semicircle, said extensions being connected together by lateral portions (36, 38) connected to the periphery of the optical part, the anterior and posterior faces of said lateral portions (36, 38) respectively extending the toric portions (44, 46) of the anterior and posterior faces of said extensions and the connection portions (48) of said extensions whereby the face posterior of the implant rests only on the periphery of the lens.
4. Implant intraoculaire selon la revendication 3, caractérisé en ce que, au moins une des extensions et/ou au moins une des portions latérales de la partie haptique présente une ouverture (28) ménagée dans la face postérieure de l'implant pour faire communiquer ledit évidement (50) avec le reste de la chambre postérieure (22) par quoi on évite un phénomène de ventouse.4. Intraocular implant according to claim 3, characterized in that at least one of the extensions and / or at least one of the lateral portions of the haptic part has an opening (28) formed in the posterior face of the implant to communicate said recess (50) with the rest of the posterior chamber (22) whereby a suction cup phenomenon is avoided.
5. Implant intraoculaire selon l'une quelconque des revendications 3 et 4, caractérisé en ce qu'il comprend deux éléments de fixation (52, 54), chaque élément ayant la forme d'une anse courbe présentant une première extrémité de raccordement au bord libre de l'extension correspondante et une extrémité libre.5. Intraocular implant according to any one of claims 3 and 4, characterized in that it comprises two fixing elements (52, 54), each element having the shape of a curved loop having a first connection end at the edge free from the corresponding extension and a free end.
6. Implant intraoculaire selon la revendication 5, caractérisé en ce chaque anse présente, en projection sur un plan contenant l'axe optique de l'implant, une première portion proche de sa première extrémité, faisant un angle a avec un plan orthogonal à l'axe optique de telle manière que ladite première portion aille en s'écartant de la face antérieure de la partie optique, et une deuxième portion proche de la deuxième de l'anse, faisant un angle b avec un plan orthogonal à l'axe optique de telle manière que ladite deuxième portion aille en se rapprochant de la face antérieure de la partie optique, par quoi ladite partie optique ne se déplace sensiblement pas selon la direction de l'axe optique sous l'effet des contraintes appliquées à l'implant.6. intraocular implant according to claim 5, characterized in that each loop has, in projection on a plane containing the optical axis of the implant, a first portion close to its first end, forming an angle a with a plane orthogonal to l optical axis in such a way that said first portion goes away from the front face of the optical part, and a second portion close to the second of the handle, forming an angle b with a plane orthogonal to the optical axis in such a way that said second portion goes closer to the anterior face of the optical part, whereby said optical part does not move substantially in the direction of the optical axis under the effect of the stresses applied to the implant.
7. Implant intraoculaire selon l'une quelconque des revendications 3 à 6, caractérisé en ce que lesdites portions latérales (36, 38) de la partie haptique présente chacune un bord libre (36a, 38a) sensiblement rectiligne qui se raccorde aux bords sensiblement semi- circulaires desdites extensions.7. intraocular implant according to any one of claims 3 to 6, characterized in that said lateral portions (36, 38) of the haptic part each have a free edge (36a, 38a) substantially rectilinear which is connected to the edges substantially semi - circulars of said extensions.
8. Implant intraoculaire selon les revendications 5 et 7, caractérisé en ce que la projection desdites anses sur un plan orthogonal à l'axe optique de l'implant, est entièrement contenues dans la portion dudit plan limitée par les droites du plan contenant les projections sur ce plan des bords libres (36a, 38a) des portions latérales de la partie haptique.8. Intraocular implant according to claims 5 and 7, characterized in that the projection of said handles on a plane orthogonal to the optical axis of the implant, is entirely contained in the portion of said plane limited by the straight lines of the plane containing the projections sure this plane of the free edges (36a, 38a) of the lateral portions of the haptic part.
9. Implant intraoculaire selon l'une quelconque des revendications 1 à 8, caractérisé en ce que le diamètre (D) de la partie optique est compris entre 4 et 6 mm.9. Intraocular implant according to any one of claims 1 to 8, characterized in that the diameter (D) of the optical part is between 4 and 6 mm.
10. Implant intraoculaire selon l'une quelconque des revendications 1 à 9, caractérisé en ce que la distance diamétrale (L) entre les extrémités des extensions est comprise entre 7 et 9 mm. 10. Intraocular implant according to any one of claims 1 to 9, characterized in that the diametral distance (L) between the ends of the extensions is between 7 and 9 mm.
EP97906223A 1996-02-20 1997-02-19 Intraocular implant for correcting short-sightedness Ceased EP0886504A1 (en)

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FR9602053A FR2744908B1 (en) 1996-02-20 1996-02-20 MYOPIC INTRAOCULAR IMPLANT
FR9602053 1996-02-20
PCT/FR1997/000306 WO1997030657A1 (en) 1996-02-20 1997-02-19 Intraocular implant for correcting short-sightedness

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EP (1) EP0886504A1 (en)
JP (1) JP2000504612A (en)
CA (1) CA2246764A1 (en)
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JP2000504612A (en) 2000-04-18
WO1997030657A1 (en) 1997-08-28
US6110202A (en) 2000-08-29
FR2744908B1 (en) 1998-06-12
FR2744908A1 (en) 1997-08-22
CA2246764A1 (en) 1997-08-28

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