WO2005115278A1

WO2005115278A1 - Adaptable intraocular lens

Info

Publication number: WO2005115278A1
Application number: PCT/EP2005/004846
Authority: WO
Inventors: Arthur Messner
Original assignee: Humanoptics Ag
Priority date: 2004-05-19
Filing date: 2005-05-04
Publication date: 2005-12-08
Also published as: DE102004025305A1

Abstract

The invention relates to an adaptable intraocular lens for implantation in the capsular sac of an eye, said lens comprising a lens element (2) with the following: an essentially circular border (5); an optical axis (3); an anterior direction (6) that runs parallel to the optical axis (3) and a posterior direction (9) that runs diametrically opposite to said anterior direction; a lens plane (4) that runs perpendicularly to the optical axis (3); an anterior external face (7) and a posterior external face (8) opposite the former; at least two haptic elements (10; 10a; 10b) that are fixed to the lens element (2) and are configured in one piece with the latter (2) for supporting the lens element (2) in relation to the capsular sac and at least one cell barrier (27, 30) for preventing cellular migration towards the optical axis (3). The cell barrier (27, 30) is located at least in the vicinity of each haptic element (10; 10a; 10b), projecting in the manner of a crest from the latter (10; 10a; 10b) in the posterior direction (9), thus forming an acute-angled crest line (28, 31).

Description

Accomodable intraocular lens

The invention relates to an accommodatable intraocular lens for implantation in the capsular bag of an eye, in particular a human eye.

Accomodable intraocular lenses have long been known, in particular from DE 101 39 027 AI. If the natural lens in the eye becomes cloudy, it is removed from the capsular bag, the latter being retained. An accommodatable lens is then implanted. The operation tries to remove the lens epithelial cells from the capsular bag as much as possible. This is not always possible. In these cases, after the operation, cell growth, so-called post-star, can occur, which leads to a decrease in transparency in the area of the optics of the intraocular lens.

The invention has for its object to provide an accommodatable intraocular lens in which postoperative cell migration within the capsular bag is largely avoided.

The object is solved by the features of claim 1. The essence of the invention consists in providing, at least in the area of each haptic, a posteriorly projecting, sharp-edged cell barrier which ensures that lens epithelial cells do not migrate in the direction of the optical axis.

Further advantageous embodiments of the invention result from the subclaims. Additional features and details of the invention result from the description of three exemplary embodiments with reference to the drawings. Show it:

1 shows a cross section of an intraocular lens according to the invention in accordance with a first exemplary embodiment,

2 shows an anterior view of the intraocular lens according to FIG. 1,

3 shows a cross section of an intraocular lens according to a second exemplary embodiment, and

Fig. 4 is a posterior view of an intraocular lens according to a third embodiment.

A first exemplary embodiment of the invention is described below with reference to FIGS. 1 and 2. An intraocular lens 1, which is formed in one piece overall, has central optics 2 which have the shape of an optical lens which is convex on both sides. The intraocular lens 1 is manufactured, for example, from a transparent acrylate by machining. The material is hard during processing. The intermediate product is then placed in an aqueous saline solution, whereby the acrylate absorbs water and becomes elastic. This material is called pHEMA, polyhydroxyethyl methacrylate. It is reversibly deformable. This means that after deformation, e.g. B. by squeezing the haptics, returns to the original state after the absence of external influence. Other materials can also be used. The optics 2 have an optical axis 3 in the middle and a perpendicular to the optical axis 3 and lens plane 4 running centrally through the optics 2. In the present case, the optics 2 are mirror-symmetrical with respect to the lens plane 4. However, it is also possible to provide optics in which this is not the case. The optics 2 has a substantially circular edge 5. The optics 2 has an anterior outer surface 7, which extends in an anterior direction 6 parallel to the optical axis 3, and a posterior outer surface 8 opposite the outer surface 7. The posterior outer surface 8 points in a posterior direction 9 diametrically opposite the anterior direction 6.

Arranged on the optics 2 in the region of its edge 5 are four identical haptics 10 which extend radially outward and are offset by 90 °. It is possible to provide a different number of haptics as long as they are evenly distributed over the circumference of the optics. Often only two haptics are used. The haptics 10 have an inner joint 11, which is designed in the form of a film hinge, via which the haptic 10 is articulated on the edge 5 of the optics 2. The joint 11 has a pivot axis 12 or pivot line which is arranged in the center of the joint 11 and which lies essentially in the lens plane 4. The haptics 10 can thus be pivoted in a plane that runs perpendicular to the lens plane 4. In the radial direction behind the joint 11, the haptic 10 has an arm 13, which is designed to be closed, plate-shaped. The lateral end faces 14, 15 of each haptic 10 run parallel to one another. In plan view, the arms 13 essentially have the shape of a rectangle, the radial outer region being curved in the shape of a circular arc. The outer surface 16 of the arm 13 pointing in the anterior direction 6 is flat. The outer surface 17 opposite the outer surface 16 and pointing in the posterior direction 9 is convex, so that the arm 13 increases in the radial direction up to the center. increasing thickness and decreasing in thickness from the center outwards. At the outer end of the arm 13 there is another outer hinge 18 designed as a film hinge. The pivot axis 19 or pivot line of this joint 18 runs essentially parallel to the pivot axis 12 of the same haptic 10. The haptic 10 has a so-called angulation in the posterior direction 9. This means that a plane defined by the two pivot axes 12 and 19 includes an angulation angle b with the lens plane 4, for which the following applies: 2 ° <b <25 ° and preferably b = 5 °. At the outer end of the haptic 10, a support web articulated on the outside of the joint 18 is provided. In the view according to FIG. 2, the supporting web 20 is curved in a circular arc around the optical axis 3. The end faces of the web 20 are aligned with the end faces 14 and 15. The support web 20 has a support surface 21 which is located in the radial direction and which, beginning at its posterior end 22 in the anterior direction 6, runs partly on a circular cylinder jacket and then is continuously curved inwards towards the optical axis 3 and is rounded. The support surface 21 is intended to lie against the inside of the capsular bag in its equatorial area. The section of the support surface 21 pointing in the anterior direction 6 is an arc section 23. The inner surface 24 of the support web 20 protruding from the outer surface 16 of the arm 13 in the direction 6 runs on a circular cylinder jacket section around the optical axis 3, ie in the section shown in Figure 1 parallel to the optical axis 3. The arc section 23 and the inner surface 24 meet along a rounded ridge line 25, which, as shown in Figure 2, also lies on a circular arc section around the optical axis 3. Which extend from the posterior outer surface 17 of the arm 13 from the joint 18 in the posterior direction 9 and in the radial direction to the outside. de flank surface 26 extends obliquely to the lens plane 4, in particular at an angle of approximately 45 °. The supporting surface 21 and the flank surface 26 delimit a cell barrier 27 projecting posteriorly. The cell barrier 27 has the shape of a sharp-edged pointed comb with a sharp-edged comb line 28 projecting in the posterior direction 9. The radius of curvature R of the cell barrier 27 in the region of the ridge line 28 is less than or equal to 25 μm, in particular less than or equal to 10 μm. The axial

Distance between the comb line 28 and the rounded comb line 25 is 2a, where a = 0.4 mm. Midway between ridge lines 25 and 28, i.e. H. At the axial distance a from the ridge line 28, an outer-center line 29 is defined on the support surface 21. This line 29 is seen in the posterior direction 9 behind the lens plane 4, i. H. 1 to the right of the lens plane 4. If the swivel axes 12 are not in the lens plane 4, the outer center line 29 must be offset in the posterior direction 9 from the swivel axis plane 37 formed from the swivel axes 12 and shown in FIG. 3 , This is particularly relevant if the optics 2 are offset to the rear relative to the pivot axes 12. In the cross section shown in FIG. 1, the cell barrier 27 has the shape of an acute triangle, the outer flank running in the radial direction parallel to the optical axis and the inner flank running obliquely in the radial direction.

The accommodation behavior of lens 1 is briefly described below. After applying the circular, centered capsulorhexis and removing the natural lens from the capsular bag in the human eye, the intraocular lens 1 is inserted into the capsular bag through a small slit in the cornea, so that the anterior direction 6 of the lens 1 in the eye forward and the Posterior direction 9 in the eye towards points towards the retina. The support webs 20 of the haptics 10 rest on the inside of the capsular bag in its equatorial area. The lens 1 is curved in the anterior direction 6 in the sense that the angulation angle b is> 0 ° and thus the outer pivot axes 9 lie behind the pivot axis plane 37, ie to the right in FIG. 1. This state corresponds to the distant vision state of the human eye. If a closer optic is to be focused by the viewer, the ciliary muscle contracts, with a radially inward force being exerted on the support webs 20. This results in a shift of the optics 2 in the anterior direction 6, ie the lens 1 is more strongly curved forward. The optics 2 remain essentially unchanged in the accommodation process, so that their optical properties remain unchanged.

During the operation to remove the natural lens, lens epithelial cells remain inside the capsular bag and should be removed as far as possible. If this is not successful, they can multiply postoperatively and spread from the equatorial area of the capsular bag in the direction of the optical axis. This can lead to a decrease in the transparency of the overall arrangement in the area of the optics 2. This cell migration is prevented by the cell barrier 27. Of central importance is the sharp-edged configuration of the crest line 28 of the cell barrier 27. This prevents lens epithelial cells, which are located in the region of the support surface 21, from spreading beyond the cell barrier 27 in the direction of the optical axis 3.

A second exemplary embodiment of the invention is described below with reference to FIG. 3. Structurally identical parts are given the same reference numerals as in the first exemplary embodiment, to the description of which reference is hereby made. Structurally different, but functionally similar parts are given the same reference numerals followed by a. The main difference compared to the first embodiment is that in the area of the edge 5 of the optics 2 there is a second inner cell barrier 30 in the radial direction in front of the joint 11, which is also comb-shaped and a sharp-edged comb line protruding in the posterior direction 31 owns. The height of the cell barrier 30 with respect to the lens plane 4 is approximately the same as the distance of the highest point of the optics 2, ie its apex 32, from the lens plane 4. The cell barrier 30 has an inner flank 33 facing the optical axis 3, which starts from the optics 2 is initially continuously curved and then runs straight, ie parallel to the optical axis 3. The outer flank 34 rises steadily starting from the joint 11 at an angle to the lens plane 3. The specifications for the radius of curvature R in the area of the ridge line 31 are the same as those for the radius of curvature R in the area of the ridge line 28. The inner cell barrier 30 is designed in a ring shape, ie it surrounds the entire optics 2 in a ring shape and is not only in the area of the haptics 10 provided. In this respect, it represents a second migration protection that surrounds the entire optics 2.

A third exemplary embodiment of the invention is described below with reference to FIG. Identical parts are given the same reference numerals as in the first exemplary embodiment, to the description of which reference is hereby made. Structurally different, but functionally similar parts are given the same reference numerals with a b after them. The main difference compared to the first two exemplary embodiments is that the haptics 10b are not designed in the form of a closed plate, but rather an essentially right have angular recesses 35. The outer contour of the haptics 10b remains essentially the same as in the first exemplary embodiment, the haptics according to FIG. 4 having a greater width B than the haptics according to FIG. 2. The flat, plate-shaped arms in the first exemplary embodiment are reduced to two parallel arms Arm webs 36, which are connected at their outer ends by the support web 20b. As in the first exemplary embodiment, the support webs 20b have cell barriers 27. In addition, an inner cell barrier 30 is provided in accordance with the second exemplary embodiment. However, it is possible to provide only the inner cell barrier or only the outer cell barrier. An advantage of the recesses 35 is that the front and rear capsule sheets of the capsular bag can be glued together in each haptic 10b through the recesses 35, thereby ensuring additional fixation of the intraocular lens 1b.

It applies to all exemplary embodiments that in an intraocular lens according to the invention only the outer cell barrier 27, only the inner cell barrier 30 or both can be provided at the same time.

Claims

claims

1. Accomodable intraocular lens for implantation in the capsular bag of an eye a. with an optic (2), which has i. a substantially circular edge (5), ii. an optical axis (3), iii. an anterior direction (6) running parallel to the optical axis (3) and a diametrically opposite posterior direction (9), iv. a lens plane (4) running perpendicular to the optical axis (3), and v. an anterior outer surface (7) and an opposite posterior outer surface (8), b. with at least two haptics (10; 10a; 10b) attached to the optics (2) and formed in one piece with the optics (2) to support the optics (2) with respect to the capsular bag, and c. with at least one cell barrier (27, 30) to avoid cell migrations in the direction of the optical axis (3), the cell barrier (27, 30) i. is arranged at least in the area of each haptic (10; 10a; 10b), and ii. protrudes from the respective haptics (10; 10a; 10b) in the manner of a comb in the posterior direction (9), forming a sharp-edged comb line (28, 31).

2. Intraocular lens according to claim 1, characterized in that a second cell barrier (27) is provided at the outer end of each haptic (10; 10a; 10b) in the radial direction.

3. Intraocular lens according to claim 1 or 2, characterized in that each haptic (10; 10a; 10b) has an arm (13; 13b) which is articulated on the optics (2) via a first joint (11).

4. Intraocular lens according to claim 3, characterized in that each haptic (10; 10a; 10b) has a support element (20; 20b) connected to the outer end of the arm (13; 13b) for support in the equatorial region of the capsular bag, wherein the support element (20; 20b) is articulated on the arm (13; 13b) with a second joint (18).

5. intraocular lens according to claim 3 or 4, characterized in that in each case a first cell barrier (30) is arranged on the first joint (11).

6. intraocular lens according to claim 5, characterized in that the first cell barrier (30) is annular.

7. intraocular lens according to claim 6, characterized in that the ridge line (31) of the first cell barrier (30) in the posterior direction (9) with respect to the lens plane (4) has the same height as the optics (2) at its highest point (32 ).

8. Intraocular lens according to claim 4, characterized in that the support element (20; 20b) projects with respect to the second joint (18) in the anterior direction (6) up to an anterior edge (25).

9. intraocular lens according to claim 8, characterized in that the second cell barrier (27) has a second ridge line (28), the axial Distance from the anterior edge (25) is 2a and an outer-center line (29) is defined centrally between the second ridge line (28) and the anterior edge (25).

10. Intraocular lens according to claim 9, characterized in that the first joints (11) of the haptics (10; 10a; 10b) have associated pivot axes (12) which lie in a common pivot axis plane (37).

11. Intraocular lens according to claim 10, characterized in that the outer center line (29) is offset in the posterior direction (9) with respect to the swivel axis plane (37).