Abstract
A fastening device for fixing an intraocular lens having protruding support elements in the eye of a patient comprises at least one tip suitable for penetrating the human ciliary body and preferably suitable for penetrating the human sclera and is connected or connectable to a protruding support element.
Claims
1. A fastening device for fixing an intraocular lens having protruding support elements in an eye of a patient, which fastening device comprises at least one tip suitable for penetrating the human ciliary body and suitable for penetrating the human sclera and is connected or connectable to one of said protruding support elements.
2. The fastening device according to claim 1, characterized in that the fastening device has a connecting structure for connecting said at least one tip to one of said protruding support elements of the intraocular lens, the connecting structure being configured as a hinge-like openable clamping region.
3. The fastening device according to claim 2, characterized in that the connecting structure is made from a different material than the at least one tip.
4. The fastening device according to claim 1, characterized in that the at least one tip comprises at least one barbed hook.
5. The fastening device according to claim 1, characterized in that the fastening device has two tips which are connected to one another via a common cavity extending within the two tips.
6. The fastening device according to claim 2, characterized in that the fastening device comprises, adjacent to the connecting structure, at an end of the fastening device opposite the at least one tip, a holding region for engagement by surgical tweezers.
7. The fastening device according to claim 6, characterized in that the holding region is made of a different material than the connecting structure and/or the at least one tip.
8. A kit of parts comprising the intraocular lens having protruding support elements and at least one fastening device according to claim 1, which can be connected to one of the protruding support elements.
9. A surgical tool for manipulating the fastening device according to claim 1, comprising a shaft and a coupling for the at least one tip.
10. The fastening device according to claim 2, characterized in that the at least one tip comprises at least one barbed hook.
11. The fastening device according to claim 2, characterized in that the fastening device has two tips which are connected to one another via a common cavity extending within the two tips.
12. The fastening device according to claim 5, wherein the two tips are connected to a connecting structure for connecting said two tips, via the common cavity, to one of said protruding support elements.
Description
[0018] The invention is explained in more detail below with reference to an exemplary embodiment shown in the drawing. In the drawings
[0019] FIG. 1a-1c show schematic representations of a fastening device according to the invention,
[0020] FIG. 2 shows a schematic representation of the interaction of a fastening device according to the invention with an intraocular lens having protruding support elements,
[0021] FIG. 3a-3c show a schematic representation of the use of a fastening device according to the invention on the eye,
[0022] FIG. 4a shows a schematic representation of a preferred variant of a fastening device according to the invention,
[0023] FIG. 4b shows an illustration of the application of the fastening device according to FIG. 4 on the eye,
[0024] FIG. 5 shows an illustration of a lens configuration with a fastening device according to the present invention and
[0025] FIGS. 6a to 6l show an illustration of an operation sequence using the surgical tool according to the invention together with the fastening device according to the invention.
[0026] In FIG. 1a, a fastening device according to the invention is generally designated by the reference number 1. The fastening device 1 has a tip 2 which is suitable for penetrating the human ciliary body or the human sclera. In connection with the present invention, penetration means that the tip 2 can penetrate through the ciliary body or the sclera. The fastening device 1 has a connecting structure 3 with which the fastening device 1 can be connected with so-called haptics, i.e. with the protruding support elements of an artificial intraocular lens. For this purpose, the connecting structure 3 according to a preferred embodiment has a clamping region 3′. The fastening device 1 according to the invention also has a holding region 10 at which the fastening device 1 can be gripped, for example, by tweezers, and manipulated accordingly during surgery. Reference numeral 15 denotes an axis marking which is intended to help in particular to position toric IOLs appropriately and to determine a tilting of the IOL due to any incorrect manipulation during the surgical treatment and to correct it immediately.
[0027] In the side view of the fastening device 1 according to the invention according to FIG. 1b, it can be seen that the connecting structure 3 has a passage 11 for a protruding support structure 4, which forms the clamping region 3′. In FIG. 1c it can be seen that the clamping region 3′ can be opened by a clamping cover 13, so that the protruding support structure can be inserted into the passage 11 and fixed in the direction of the arrow 14 by closing the clamping cover 13.
[0028] In the following figures, the same or equivalent parts are provided with the same reference numerals. FIG. 2 shows that two pieces of the fastening device 1 according to the invention are connected to the haptics 4, i.e. to the protruding support elements 4 of an artificial intraocular lens 5, the protruding support elements 4 being clamped in the fastening region 3.
[0029] In FIG. 3a it is shown how the artificial intraocular lens 5 with protruding support elements 4, on which the fastening device 1 according to the invention is fixed, is inserted or placed in front of the pupil 6 and in front of the iris 18. FIG. 3b shows a state in which the tip 2 of the fastening device 1 attached to one of the two protruding support elements 4 passes through the sclera 7. FIG. 3c shows the state after the artificial intraocular lens 5 has been fixed behind the pupil 6, the tip 2 of the fastening device 1 attached to the other of the two protruding support elements 4 also passing through the sclera 7. It should be understood that the tips 2 of the fastening devices 1 are firmly connected to the eye and that the artificial intraocular lens 5 is securely positioned behind the pupil 6 through the intermediary of the protruding support elements 4.
[0030] FIG. 4a shows a variant of the present invention in which the fastening device 1 has two tips 2 which are connected to one another via a common cavity 8 extending within the two tips 2. As can be seen in FIG. 4b, the cavity opening at the tips 2 can be used to pull a surgical thread 9 through the tips 2 passing through the sclera and to fix the fastening device 1 according to the invention in such a way as to secure the artificial intraocular lens 5.
[0031] In FIG. 5 it can be seen that the fastening device 1 according to the invention can be formed in one piece with the protruding support elements 4, i.e. the haptics 4, that is, the artificial intraocular lens 5 is already manufactured with the fastening device 1 according to the invention on the protruding support elements 4.
[0032] The individual steps of the surgical method made possible by the invention are shown in FIGS. 6a to 6l.
[0033] In a first step (FIG. 6a), two perforations 19 in a diametrically opposite arrangement, i.e. offset by 180°, are pierced into the sclera 7 at a distance of approximately two millimeters from the limbus (transition from the cornea to the sclera 7). Then (FIG. 6b) a first incision 20 is made in the cornea in the region of the transition to the sclera 7, via which the IOL can subsequently be introduced in front of the pupil 6 and the iris 18. The first incision 20 is approximately 3 millimeters long. Two second incisions with a size of approximately 0.6 millimeters are designated by 21, through which a fine manipulation instrument can later be introduced. Thereafter, the intraocular lens 5 with the haptics 4 or the protruding support elements 4 is introduced in front of the iris 18 (FIG. 6c), with a protruding support element 4 still protruding from the incision 20. A first fastening device 1 according to the invention is then attached to the protruding support element 4 (FIG. 6d), the IOL 5 with the haptics 4 rotated with the aid of a fine manipulator 22 introduced through the incision 20 (FIG. 6e), and the second protruding support element 4 is led out of the incision 20 (FIG. 6f) so that a second fastening device 1 according to the invention can be clamped to the protruding support element 4 (FIG. 6g), preferably at the same distance from the free end of the support element 4 as with the other fastening device. Then the manipulation instrument 22 is on the one hand introduced via the second incision 21 behind the pupil 6 and on the other hand an external surgical tool 17 is led through the scleral perforation 19 and the fastening device 1 according to the invention is connected to the external surgical tool 17 in the eye. The connection between the tip 2 and the surgical tool 17 is made by a coupling (not shown). The tip 2 of the fastening device 1 according to the invention is guided to the outside through the perforation 19 and then uncoupled from the external tool 17 (FIGS. 6h and 6i, 6j) and the same is carried out with the second fastening device 1. The two tips 2 guided through the sclera 7 are deformed by cautery and thereby fixed in a form-fitting manner. (FIGS. 6k and 6l).
