WO2013086644A1

WO2013086644A1 - Surgical capsule tensioning ring for ophthalmology

Info

Publication number: WO2013086644A1
Application number: PCT/CH2012/000265
Authority: WO
Inventors: Markus KLEGER
Original assignee: Kleger Markus
Priority date: 2011-12-12
Filing date: 2012-12-03
Publication date: 2013-06-20
Also published as: CH705878A2

Abstract

The invention relates to a surgical capsule tensioning ring for ophthalmology, consisting at least partially of a shape memory material or of a shape memory alloy having a starting form and an end form that corresponds to the finished capsule tensioning ring. In the starting form, i.e. before implantation, the capsule tensioning ring is collapsed to an approximately compact body (8). In a preferred embodiment, said body can be a disc (13) or a ball that is positioned spirally around a notional centre (14). As a result, the body (8) is able to open uniformly circularly (15) and without risk of damaging the capsule sac. The resulting capsule tensioning ring positions itself automatically at the equator of the capsule sac, whereby repositioning is largely unnecessary. A single small incision of, for example, 1.8 mm is therefore sufficient for implanting the capsule tensioning ring or for introducing the body (8) into the capsule sac.

Description

Surgical capsular tension ring for ophthalmology

The present invention relates to a surgical capsular tension ring for ophthalmology. Second, it refers to a surgical instrument with the capsular tension ring to be implanted.

The human eyeball comprises an inner space of the eye enclosed by an outer skin. The outer skin is multi-layered, it is formed by the cornea, the sclera and the dermis. The interior of the eye is subdivided into an anterior chamber of the eye, a posterior chamber of the eye and a vitreous cavity in which the vitreous body is arranged. Between the anterior chamber of the eye and the vitreous the eye lens is arranged. The vitreous body is surrounded by the retina, which is connected to the brain via the optic nerve. The cornea forms the front transparent region of the outer skin and, together with the transparent liquid in the eye chamber, which consists predominantly of water, the lens and the glass body, an optical imaging system. The lens is in a capsule bag.

For example, in cataracts or cataracts, it is known in ophthalmology to open the capsular bag, to aspirate the clouded interior and then to implant an artificial lens. During the procedure or even postoperatively, undesirable shrinkage of the capsular bag may occur. Another reason for the collapse of the capsular bag may be damage to the zonula. To counter this is a capsular tension ring in the capsular bag used. The prerequisite is of course that the capsular bag is at least partially intact. The capsular tension ring counteracts the shrinkage or collapse of the capsular bag and spreads this approximately circular.

Known capsular tension rings consist of an arcuate, slightly elastic element. So they form an open ring, or a partial ring, and there are also suggestions to connect the free ends of the capsular tension rings together in the capsular bag. Consider, however, the small dimensions of the operative area as well as the capsular tension ring and its ends. Usually, the capsular tension rings are made of polymethyl methacrylate. They are inserted with tweezers and / or lengthways into the capsular bag by means of a suitably dimensioned hypodermic syringe and positioned there. There is a risk that the fairly fragile capsular bag or the zonula will be additionally injured. Furthermore, there is a certain problem that the arcuate Kapselspannring inside the round capsular bag exert an asymmetric clamping force and can distort this. Even if its ends are connected together.

Based on these findings, the invention has the object to provide a surgical capsular tension ring for ophthalmology, by which the aforementioned problems and complications can be avoided. In particular, the capsular tension ring should be handled safely during the procedure and then tension the capsular bag without damage. In addition, a surgical instrument for implanting this capsular tension ring to be proposed.

The inventive capsular tension ring corresponds to the characterizing features of claim 1. The belonging to the capsular tension ring surgical instrument is apparent from the patent claim 8. Further embodiments of the inventive concept can be seen from the dependent claims.

Hereinafter, preferred embodiments of the invention will be described with reference to the drawings.

Fig. 1 shows a schematic view of the interest here

Part of the eyeball;

Fig. 2 shows an implanted capsular tension ring;

FIGS. 3-5 show the capsular tension ring with a surgical instrument used for implanting the same;

Fig. 6 shows a capsular tension ring before implantation.

As shown in the two FIGS. 1 and 2, the capsular bag 1 is connected to the lens 2 through the zonula 3 with the eyeball 4. To stabilize the capsular bag 1, a capsular tension ring 5 can be implanted, which supports the circumference of the capsular bag 1 from the inside and thus also ensures that the lens 2 remains free. This may be an artificial lens, which is not the subject of the present invention. The capsular tension ring 5 may be an open ring with respect to its shape in the implanted state, as shown as an example in Fig. 2. Whose free ends 6 and 7 may be rounded and have a broadened or thickened cross-section in order to avoid injury of the capsular bag 1, in particular during implantation. It should be noted that the capsule bag size is different for each person. Thus, the exact size and shape of the capsular tension ring 5 ultimately depends on the particular patient, wherein also various capsule tension ring sizes can be used. Up to this point, the capsular tension ring 5 can be assumed to be technically known. According to the invention, the capsular tension ring 5 consists at least partially of a shape memory material, or of a shape memory alloy, wherein the capsular tension ring 5 after implantation and the shape conversion can have approximately the end shape of an open ring shown in FIG. However, the final form of a closed ring is expressly excluded. For implantation, however, a relatively compact output form is provided. In the most meaningful embodiment, moreover, the capsular tension ring 5 will perform a unique shape transformation. At least an uncontrolled return of the capsular tension ring 5 to the initial shape is undesirable. As a material, for example, alloys in question, the nickel-titanium, copper-zinc, copper-zinc-aluminum, copper-aluminum-nickel or iron-nickel-aluminum have. However, there are also corresponding plastics, for example polymers.

The shape transformation may be initiated or promoted by contact with body temperature and / or body fluid. But it is also possible to ensure the transformation of the form by means of a surgical instrument 9. This can, for example, thermally or stress induced, or electrically and / or magnetically act on the capsular tension ring 5 to bring it from the initial shape into the final shape. The introduction of a liquid is conceivable. For this purpose, the surgical instrument 9 and / or the cartridge 12 may have corresponding devices. Namely, at least one line which is connectable to an energy source and / or to a liquid source. In the case of using a liquid, the interior of the surgical instrument 9 and / or the cartridge 12 can serve as a conduit.

Of central importance is the implantation of the capsular tension ring 5. A first example is shown schematically in FIG. The capsular tension ring 5 is a relatively compact body 8 prior to implantation shaped, which is implanted by means of a surgical instrument 9 in the capsular bag 1. This instrument 9 may be syringe-like, wherein the compact initial shape of the body 8 of the capsular tension ring 5 in the direction of arrow 10 from the distal end 11 of the instrument 9 is slidable. According to FIG. 4, it is possible to form the distal end 11 of the surgical instrument 9 as a separate cartridge 12, that is, detachable from the instrument 9. The capsular tension ring 5 in this case can be kept in stock as a relatively compact body 8 accommodated in a disposable cartridge 12. The instrument 9 could also have a plurality of cartridges 12 or a cartridge 12 with a plurality of bodies 8. Theoretically, the cartridge 12 could also serve alone as a surgical instrument. It could be connectable with a handle and / or with a device, not shown here, for example a medical pump and / or a power supply. According to FIG. 5, the distal end 11 and / or the cartridge 12 can also have a shape deviating from the circular cross section and, for example, be oval.

The body 8, as the starting form of the capsular tension ring 5, is formed in a preferred embodiment as a disc 13 or as a ball. Also conceivable would be an egg-shaped body 8. Likewise, resulting from a combination between disc 13 and ball intermediate shape with rounded circumference. The terms disc 3, sphere or egg shape are to be understood so that the body 8 should have approximately such a shape. It goes without saying that the reduced to the body 8 capsular tension ring 5 will usually not take a perfect, geometric outer circumference and that even empty spaces can not be completely excluded.

Essentially, it is a matter of reducing the capsular tension ring 5, on the one hand, to the most compact possible starting shape of a body 8, which with the least possible risk of injuring the capsular bag 1, implanted. On the other hand, however, it must be ensured that this body 8 can unfold easily and in a controlled manner to the final shape of the capsular tension ring 5 after implantation. In the previously proposed embodiments, this is most meaningful in that the capsular tension ring 5 is placed around at least one center 14. In the example of FIG. 6, this results in a disc 13 in the form of a spiral. In three-dimensional development of this idea, the body 8 would come to the spherical shape. Or at most to any of an intermediate form, so the curved disc 13 or the flattened ball. Not excluded is also an approximately oval disc 13 or the already mentioned egg shape. Other forms would also be conceivable.

It is important in any case that the body 8 can unfold unhindered to Kapselspannring 5. If the capsular tension ring 5, starting from the idea of Fig. 6, is placed in its initial shape around a center 14, nothing can entangle during deployment. With regard to the capsular bag 1, however, there are additional advantages that are of central importance. In order to move from the compact body 8 according to FIG. 6 to the open capsular tension ring 5 according to FIG. 2, this will move relatively uniformly from the center 14 in the direction of the arrow 15 to the outside. There is thus a circular widening and unfolding. This causes two things. First, the capsular tension ring 5 will not primarily advance with a free end 6 or 7 but with its circumference. Secondly, due to the circular unfolding, the capsular tension ring 5 will lay largely by itself in the equator of the capsular bag 1, as shown in FIG. 1. These two properties obviate and solve the problems of previous capsular tensioning rings in a simple but highly effective manner. Since no prestressed, after the entry into the capsular bag 1 uncontrolled aufschnellender capsular tension ring is used, reduced to a very considerable extent the risk of additionally injuring the capsular bag 1 during the procedure. Since the capsule tensioning ring 5 according to the invention unfolds in a targeted manner, it is not necessary to use the same Previous cable tensioning rings also largely repositioning with a surgical instrument, for example, with tweezers. Therefore, for implanting the capsular tension ring 5, or for inserting the body 8 into the capsular bag 1, a single, small incision of, for example, 1, 8 mm is sufficient.

Of course, it is within the scope of the invention according to claim 1, the capsular tension ring 5 differently than schematically shown and described form. This concerns both its exact initial and final form. Also, the surgical instrument according to claim 8 can be realized differently than outlined as long as the capsular tension ring 5, or its initial shape as a body 8, held therein or thereto and inserted into the capsular bag 1.

Claims

claims

Surgical capsular tension ring (5) for ophthalmology, characterized in that it consists at least partially of a shape memory material or of a shape memory alloy, with an initial shape and at least one end shape, this final shape corresponds to the finished capsular tension ring (5).

2. Surgical capsular tension ring according to claim 1, characterized in that it is folded in a given prior to a shape transformation in a final shape output form to an approximately compact body (8).

3. Surgical capsular tension ring according to claim 2, characterized in that it is placed in a given prior to a shape transformation in a final shape output form around at least one center (14).

4. Surgical capsular tension ring according to claim 2 or 3, characterized in that it is formed in a given before a shape transformation in a final shape starting shape as a disc (13), for example, an approximately circular disc.

5. A surgical capsular tension ring according to claim 2 or 3, characterized in that it is approximately formed in a given prior to a shape transformation in a final shape output form as a ball.

6. Surgical capsular tension ring according to claim 2 or 3, characterized in that it is formed egg-shaped in a given before a shape conversion into a final shape output form.

7. A surgical capsular tension ring according to any one of claims 3-6, characterized in that it is arranged spirally in a given before a shape conversion into a final shape output form.

8. Surgical instrument with the capsular tensioning ring to be implanted according to claim 1, characterized in that the capsular tension ring (5) consists at least partially of a shape memory material or of a shape memory alloy, with an initial shape in which it is folded into an approximately compact body (8) , wherein this body (8) is arranged in or on the surgical instrument (9).

9. Surgical instrument according to claim 8, characterized in that this is formed like a syringe and the body (8) from an open, distal end (11) is slidable.

10. A surgical instrument according to claim 8 or 9, characterized in that this either at least one cartridge (12) or consists of such a cartridge (12), in which the body (8) is arranged.

11. Surgical instrument according to one of claims 8 - 10, characterized in that this and / or arranged on this cartridge (12) has at least one device, for example at least one line which can be connected to an energy source and / or to a liquid source is.