US2516804A - Artificial eye implant - Google Patents

Description

9 19% D. E, RIF ET AL I ARTIFICIAL EYE; IMPLANT Filed. March 16,, 1949 INVENTOR5 DAVID E. EOLF THOMAS SJ GER H Byfl SPA CHER UDSON .0. F0 WLER, =12.

v My 4 A TTOENEVS Patented July 25, 1950 ARTIFICIAL EYE IMILAN T David E. Rolf, University Heights, Hudson D. Fowler, Jr., Euclid, and Thomas S. Gerspacher,

Cleveland, Ohio Application March 16, 1949, Serial No. 81,652

3 This invention relates to a prosthesis for use following ocular enucleation, particularly a prosthetic base of the nature of an eye implant. In the past, eye implants have been known which have consisted in the main of a ball member and a muscle ring, the latter being mounted in a peripheral groove in the ball parallel to but removed from a plane passing through the middle of theball.

are familiar have not been entirely satisfactory because of the difiiculty involved in efiecting firm :suturing, lack of which may permit the ring to ,comeloose at one or more points with attendant prolapse of the implant. The present invention has for, its principal object to provide an improved implant which will facilitate the making of firm sutures. Other objects of the invention will be apparent as the description of the invention proceeds. ,A preferred embodiment of the invention is illustrated in the accompanying drawings, in which Figure 1 is a simplified representation of the nature of an elevation showing the implant of the invention in place in the muscle cone, Tenons capsule being shown unattached. Figures 2 and 3 represent, respectively, a perspective and a, front elevation illustrating the method of attachment of Tenons capsule. Figure 4 is a perspective of the assembled implant, omittin any representation of the tissues in which it is located. Figure 5 is a corresponding side view the upper half of the figure being in section andthe lower half in elevation. Figure 6 is an exploded perspective showing the parts of which the implant is made. The scale in each of Figures 1 to 6, inclusive, is approximately twice normal size. I ,As appears from Figures 1, 4 and 5, the imlplant takes the form of a generally globular body having in its periphery a series of spaced openings in which may be received and held, as byfs uturing, certain of the extrinsic ocular muscles. Following enucleation, the isolated rectus muscles are pulled into the several openings, folded over onto themselves with their out ends outward, and suitably aifixed, conveniently by multiple suturing, to a device or devices provided for the purpose. Tenons capsule is fastened to a different part of the implant, but at a somewhat later stage. 7 v

. In Figure 1, such generally lobular body, designated 'I, i s-shown in place in muscle cone 2 made, up of superior rectus muscle 3, inferior rectu's'muscle 4', lateral rectus muscle 5, and, on the opposite side, medial rectus muscleii.

9 Claims.

Prior implants with which we an opening I I.

Investing the implant much as it would the eyeballis Tenons capsule l, to be attached. to the implant by the method hereinafter described.

Projecting from the implant is a mounting stud l3 (hereinafter called the muscle ring) presenting four exposed portions 14, each of which takes the form of a rail-like member of arcuateshape, located in and spaced from the interior wall of It is to these exposed portions I4 of muscle ring I3 that the four rectus muscles are attached as indicated in Figure 1.

From the foregoing, it is apparent that the implant of the present invention may be regarded as consisting of a fenestrated spheroid having therein a rail-like member lending itself to easy attachment of the ocular muscles. 1

As indicated in Figures 4', 5 and 6, the implant includes a posterior or inner generally hemispherical member I5 that is characterized, as a result of the presence of openings II, by a crossshaped central portion I6. The terminal plane I! of posterior hemispherical member I5 has therein a central opening I8 and a series of arcuate grooves I9, the latter for. receiving the concealed or embedded portions of muscle ring I3. Spaced at QO-degree intervals around the periphery of posterior hemispherical member I5 are four slots 20, each paralleling the longitudinal axis of the implant and located opposite the middle of one of the four openings II. The purpose of slots 20 is to facilitate manipulation by the surgeon of the needle or needles employed to draw the rectus muscles into openings II, over exposed portions I4 of muscle ring I3, and thence to the rear for suturing.

Ring I3 is clamped in place in arcuate grooves I9 of posterior hemispherical member I5 and corresponding grooves in anterior hemispherical member 2| and thus is positioned approximately centrally of globular member I.

Anterior or outer generally hemispherical member ZI conforms to and registers with posterior hemispherical member I5 where their terminal planes adjoin. As indicated in Figure 6, it consists of three separate parts of which one is a spheroidal frustum 22 having a positioning stud 26 adapted to extend into opening I8 in posterior hemispherical member I5, such stud projecting from the terminal plane of anterior hemispherical member 21. The other two parts which, together with frustum 22, go to make up anterior hemispherical member 21 comprise a convex annular screen 24 and, immediately adjoining frustum 22, an annular screen support 23, the latter having a collar 23a surrounded by a grooved or cut-away portion 231) which forms a recess 23c beneath the convex portion of screen 24 (see Figure Because the ends of the mesh might cause irritation of the tissues, peripheral edge 25 of screen 24 is turned inward and held in place between support 23 and frustum 22 as shown in Figure 5.

Apart from mounting stud 8, the implant itself may therefore be considered as consisting of a generally ball-like member having a flat face on which is mounted a convex cap taking the form of a screen support member and a screen overlying said support and internally reinforced thereby.

Mounting stud 8, which carries the visible part of the prosthesis; i. e. shell in, is stepped as indicated in Figure 5 so as to provide an intermediate neck portion 29 which terminates at its posterior end in step 28. Stud is normally projects through mesh or screen 24, through support 23, and into frustum 22, in all of which are central openings adapted to receive the shank of the stud. When the latter is in place, step 23 rests against the portion of screen 24 immediately surrounding the central opening therein. Thus the ends of the mesh which make up the screen are clamped in place in such manner as to preclude irritation of the conjunctiva associated with Tenons capsule, which, in the final stages of implantation, is drawn into close-fitting relation with neck 29. Stud 8 terminates within frustum 22 at a point only slightly removed from the plane of muscle ring [3.

I In assembling theimplant, the parts shown in Figure 6 are cemented together to give a unitary or substantially integral structure; via, globular bod; I.

In the course of the enucleation which precedes implantation, Tenons capsule, which normally comprises a continuous sheath investing the entire eyeball except for the cornea, will have been severed from the anterior portion of the eyeball and slit laterally: after healing, it presents the appearance suggested in Figures 1 and 2. To efl'ect the contemplated substitution, the opposed portions of Tenons capsule are drawn back and globular body I is inserted in muscle cone 2, being made fast as already described to rectus muscles 3, 5 and 6. Thereupon sutures 3| are applied by the surgeon, working from the posterior end to the anterior end of one of the lateral slits in Tenons capsule and continuing repeatedly across screen 24 both above and below mounting stud 8, the needle or needles passing through the edge of Tenons capsule, through screen 24, into cavity 230 underlying. the screen, backthrough screen 24 at a point spaced laterally from'the point of entry, and thence again to the edge of Tenons capsule. On attaining the anterior end of the lateral slit on the opposite side of the implant, suturing continues until the posterior end of the slit is reached, when sutures 3| are drawn tight and knotted. On completion of this step, the opposed edges of Tenons capsule immediately overlying screen 24 should fit snugly around the neck portion 29 of stud 8, as indicated in Figure 3.

The visible parts of the prosthesis; i. e., shell I 0, are then inserted, as by pin 9, in non-circular opening 30 in mounting stud 8 (Figure 1). Pin 9 is retained in opening 30 as by friction or other suitable detachable holding means.

Advantages of the invention which derive from novel characteristics of the above-described implant and method of implantation include the fact that the location of and opportunity for ready access to muscle ring l3 make for firm suturing of the rectus muscles, with little or no likelihood of later prolapse of the implant; the fact that the manner of forming and positioning screen 24 permits closing Tenons capsule around the neck 29 of mounting stud 8 without likelihood of irritation of the tissues by either the inner or outer peripheral edge of the screen; and the fact that the implant, although made up of several parts, may he cemented together to form a structure that, once assembled, will be and remain unitary, undergoing no tendency to come apart as a result of the action of body fluids. Other advantages will be apparent to those skilled in the art to which the invention relates.

In general, the materials of which the implant is made are highly inert plastics, metals, etc., that are known to be tolerated by the human body. Tantalum is an example of a metal known to be tolerated by the body and for this and other reasons is used in making u screen 24. Either tantalum or gold may be used for pin 9, The various other parts, including muscle ring I3, may be individually molded of suitable plastic in the shapes respectively illustrated in Figure 6. These parts and their precise shapes may, however, be simplified, elaborated or otherwise modified without departing from the spirit of the invention.

It is intended that the patent shall cover, by suitable expression in the appended claims, what ever features of patentable novelty reside in the invention.

I claim: 7

l. A prosthetic base of the nature of an eye implant comprising a first generally-hemispherical member; a second generally-hemispherical member; a ring-like member clamped between the two hemispherical members in such manner as to divide it into four exposed portionsseparated by four concealed portions; and a positioning system comprising a plurality of axially aligned studs, at least one of said studs projecting from one of said hemispherical members.

2. A base as in claim 1 in which one of the hemispherical members receives a stud projecting thereinto and supports a stud projecting therefrom.

3. A base as in claim 1 in which the stud projecting into oneof the hemispherical members also extends in the opposite direction to a point removed from the base itself.

4. A prosthetic base of the nature of an eye implant comprising a ball having a flat side; a ball-embedded ring, the plane of the ring paralleling the flat side of the ball; a cap for the ball comprising a screen support and a screen overlying said support and having its outer edge disposed between the support and the flat side of the ball; and, projecting through the cap into the ball, a stud to which are afiixed the visible parts of the prosthesis.

5. A base as is claim 4 in which the screen is clamped between the support and the stud.

6. A base as in claim 4 in which the support has an annular recess immediately underlying the screen.

'7. A base as in claim 4 in which the stud projects into the ball.

8. A base as in claim 4 in which the stud has a non-circular opening therein for receiving a non-circular pin on the inside of an artificial eye. 5

9. A prosthesis for use following ocular enucleation comprising a ball; a ball-embedded ring having four exposed portions to which to attach the four rectus muscles, the four exposed portions being separated by four concealed portions; an internally supported screen to which to attach Tenons capsule, the support for the screen having an annular recess immediately underlying the screen; and, mounted from the ball, a shell-like representation of a human eye.

DAVID E. ROLF. HUDSON D. FOWLER, JR. THOMAS S. GERSPACHER.

15 #2, February 1949, p. 253.

6 REFERENCES CITED The following references are of record in the file of this patent:

American Journal Ophthalmology, August 1946, volume 29, #8, Plastic Eye Implant by A. D. Ruedemann, pp. 947-951.

American Journal Ophthalmology, April 1948, p. XVI. Advertisement for the Cutler ball and 10 ring implant.

American Journal Ophthalmology, volume 31, #6, June 1948, p. XIV. Advertisement for the Cutler ball ring with mesh implant.

American Journal Ophthalmology, volume 32, A Universal Type Integrated Implant by N. L. Cutler.

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