Non-sliding and non-sutured contact lens system for ophthalmic procedures
11039746 · 2021-06-22
Assignee
Inventors
- JEFFREY D. BENNER (SALISBURY, MD, US)
- STEVEN M. COHEN (SAINT PETERSBURG, FL, US)
- CHRISTOPHER FORREST LUMPKIN (EVERGREEN, CO, US)
Cpc classification
A61F9/009
HUMAN NECESSITIES
A61B3/117
HUMAN NECESSITIES
A61F2009/0052
HUMAN NECESSITIES
International classification
A61B3/00
HUMAN NECESSITIES
A61F9/00
HUMAN NECESSITIES
A61B17/02
HUMAN NECESSITIES
Abstract
A contact lens assembly for non-sliding, non-sutured, hands-free ophthalmic procedures utilizes a magnetically actuated anchoring mechanism operatively coupled between the contact lens assembly and a modified eye speculum applied to eyelids during ophthalmic procedure. The anchoring mechanism is configured with magnetically cooperating anchoring members, one coupled to the contact lens assembly, and another secured to a wire loop member of the modified eye speculum. After the eye speculum is applied to the eyelids to displace and stabilize the eyelids and secure the anchoring member in place, and the contact lens assembly is placed on the cornea of the eye and centered, he magnetically cooperating anchoring members are brought in contact, and thus secure the contact lens assembly at the surgical site.
Claims
1. A contact lens system for ophthalmic procedures, comprising: a contact lens assembly having a contact lens adapted for contacting an eye of a patient, and a contact lens holder secured to said contact lens; an eye speculum configured with a threaded member extending in axial direction for radially displacing a pair of speculum arm members, each speculum arm member being equipped with a wire loop member secured at a distal end thereof, said wire loop member being applied to the eyelids of a patient during an ophthalmic procedure to displace and stabilize the eyelids; and, a magnetically actuated anchoring mechanism operatively coupled between said eye speculum and said contact lens assembly, said anchoring mechanism including first and second magnetically cooperating anchoring members and a wire member secured, at one end thereof, to said contact lens holder, said first anchoring member being secured to at least one of said wire loop members of said eye speculum at a predetermined position thereat, and said second anchoring member being operatively coupled to said contact lens assembly and attached to said wire member in a displaceable relationship therewith along said wire member, whereby, during the ophthalmic procedure, said first and second anchoring members are disposed in a magnetic engagement one with another, resulting in an anchoring and stabilizing of said contact lens assembly at a desired position relative to the eye of the patient.
2. The contact lens system as recited in claim 1, where said anchoring mechanism is configured for retaining said contact lens at a selected procedure site during said ophthalmic procedure.
3. The contact lens system as recited in claim 1, further including a rotational mechanism operatively coupled between said wire member and said contact lens assembly, wherein said wire member defines a longitudinal axis along a length thereof, and said rotational mechanism supports rotational displacement of said contact lens assembly relative to the longitudinal axis of said wire member.
4. The contact lens system as recited in claim 1, wherein said contact lens is coupled to said contact lens holder in a co-axial rotationally displaceable relation therewith about the longitudinal axis of said contact lens holder.
5. The contact lens system as recited in claim 1, where said contact lens holder is fixedly secured to said contact lens at a periphery of said contact lens.
6. The contact lens system as recited in claim 5, where said contact lens holder is formed of a cylindrical tubing for receiving said contact lens.
7. The contact lens system as recited in claim 6, where said contact lens holder is adhered to said contact lens at at least a portion of said contact lens periphery.
8. The contact lens system as recited in claim 1, where said pair of wire loop members extending at said respective speculum arm members are displaced each from the other for maintaining said patient's eyelid in a stable displaced position, and wherein said first anchoring member is stably displaced at a predetermined position relative to said eyelid during the ophthalmic procedure.
9. The contact lens system as recited in claim 1, wherein each of said first and second anchoring members are fabricated from magnetically attractable materials selected from a group consisting of a magnetic material, metal material, and a combination thereof.
10. The contact lens system as recited in claim 9, wherein one of said first and second anchoring members is fabricated from a metal alloy, and wherein another of said first and second anchoring members is fabricated from a ferrous material.
11. The contact lens system as recited in claim 1, wherein said contact lens is configured with a bottom surface configured for contact with the eye, an upper surface, and side walls extending circumferentially between an edge of said bottom eye contact surface and an edge of said upper surface; and wherein said contact lens holder is an annularly contoured contact lens holder configured with: an annularly shaped bottom surface having inner and outer concentrically spaced apart edges; an annularly shaped upper surface having inner and outer concentrically spaced apart edges, outer walls extending circumferentially along and between said outer edges of said annularly shaped bottom and upper surfaces, respectively, of said annularly contoured contact lens holder, and internal walls extending circumferentially along and between said inner edges of said annularly shaped bottom and upper surfaces, respectively, of said annularly contoured contact lens holder and defining a holder opening therebetween, said holder opening being shaped and dimensioned in correspondence to said bottom surface of said contact lens.
12. The contact lens system as recited in claim 11, wherein said contact lens is received in said holder opening of said annularly contoured contact lens holder and maintained with said bottom surface in contact with the tissues of the eye at the desired procedure site by said annularly contoured contact lens holder anchored at said desired procedure site by said magnetically actuated anchoring mechanism.
13. The contact lens system as recited in claim 11, wherein said outer walls of said annularly contoured contact lens holder are shaped with a cut-out portion extending a predetermined length along said outer walls for surgical tools access and visualization of said desired procedure site.
14. The contact lens system as recited in claim 11, wherein said annularly contoured contact lens holder is fabricated from a material selected from the group of: surgical steel, bio-compatible plastic, polyether ether ketone (PEEK), polymer, and combination thereof.
15. The contact lens system as recited in claim 1, wherein said contact lens is selected from the group of a corneal lens and a gonioprism contact lens.
16. A method of performing an ophthalmic procedure, comprising: configuring a contact lens assembly comprising: a contact lens adapted for contacting an eye of a patient, and a contact lens holder secured to said contact lens; configuring an eye speculum with a threaded member extending in axial direction for radially displacing a pair of speculum arm members, each terminating in a wire loop member at a distal end thereof, securing a first magnetically cooperative anchoring member at a predetermined position on at least one of said wire loop members; configuring a magnetically actuated anchoring mechanism operatively coupling said contact lens assembly and said respective wire loop member of the eye speculum, said anchoring mechanism including said first magnetically cooperative anchoring member, a wire member secured, at one end thereof, to said contact lens holder, and a second magnetically cooperative anchoring member operatively coupled to said contact lens assembly and attached to said wire member in a displaceable relationship therewith along said wire member; placing said contact lens assembly over a desired procedure site; applying said eye speculum to the eyelids to displace and stabilize the eyelids, thus securing said first magnetically cooperative anchoring member at a predetermined position at the eyelid; bringing said first and second magnetically cooperative anchoring members in contact one with another to thereby magnetically engage one with another and anchor said contact lens assembly at a desired position relative to the eye of the patient; performing said ophthalmic procedure; upon completion of said ophthalmic procedure, disengaging said first and second magnetically cooperative anchoring members, thus de-actuating said anchoring mechanism; removing said contact lens assembly from the operational side; and removing said eye speculum from the patient's eye.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
(18)
(19) As shown in
(20) As shown in
(21) The system 10 is a novel non-sliding corneal contact lens assembly equipped with the suture-free stabilization/anchoring system for vitreoretinal surgery which utilizes the microstructures 24 on the bottom 22 of the lens 12 or the microstructures 28 on the bottom 26 of the ring holder 18. Microstructure 24 may be in numerous shapes, including, for example, micro-pins 30, micro-grips, micro-barbs, micro-needles, or other textured microstructures on the bottom surface of the contact lens 12 or the contact lens holder 18.
(22) For the sake of simplicity and clarity of description, the microstructures 24 and 28 are described, as an example, in reference to the micro-pins 30, although other microstructures on the bottom 22 of the lens 12 or the bottom 26 of the holder 18 are contemplated in the scope of the present invention. After the contact lens 12 is placed on the cornea 32 of the eye 14 and centered, a surgeon applies downward pressure on the contact lens 12, which secures the lens 12 to the cornea 32. The micro-pins 30 extend through a tear film 34 on the surface of the cornea 32 and a viscous coupling agent (solution) used during the procedure when applied to the ocular surface of the eye.
(23) The coupling fluids applied on the surface of the tear film 34 during the procedure may be selected from a group of coupling fluids such as 2% methocel, thiol-tears gel, 1.4% sodium hyaluronate, 0.9% simple saline, and other contact solutions applicable to the purposes of the ophthalmic care using contact lens.
(24) The micro-pins 30 extend through the tear film 34 and the viscous solution film 36 on the surface of the cornea 32, and gently indent into the superficial cornea 32 without injuring it. A friction force is created between the lens' bottom surface and the coupling agent layer 36, as well as superficial corneal layer 32, by the micro-pins 30 indentation into the superficial cornea 32, so that the contact lens 12 or the contact lens holder 18 is temporarily anchored to the cornea 32 for the duration of the ophthalmic procedure. After the ophthalmic procedure has been completed, the contact lens 12 and/or the lens holder 18 is lifted from the eye 14.
(25) Referring to
(26) As shown in
(27) Referring to
(28) As shown in
(29) The lens 12 has the upper surface 48 spaced from the bottom surface 22 by circumferentially extending walls 50. The walls 50 of the contact lens 12 may form a cylindrical surface, trapezoidal surface, or other contoured surface as needed for specific optical properties of the lens 12. The upper surface 48 of the lens 12 may be smaller than, larger than, or of the same size with the surface of the bottom 22 of the lens 12 (as dictated by the needed optical properties of the lens 12).
(30) The contact lens 12 may be manufactured from acrylic, glass, or other bio-compatible and optically viable materials used for the contact lens.
(31) A number of micro structured elements 24 are provided on the bottom 22 of the lens 12. The function of the microstructures 24 is to provide friction between the bottom 22 of the lens 12 and the cornea 32 in order to prevent sliding of the lens 12 from the desired surgical site, as well as to anchor the lens in place when the microstructures 24 (for example micro-pins 30) penetrate through the viscous solution film 36 and tear film 34 and anchored to the superficial surface of the cornea 32.
(32) A number of micro-pins 30 are shown on the bottom 22 of the lens 12 which constitutes an anchoring system 16. Although the number of micro-pins 30 shown in
(33) The micro-pins 30 may be manufactured from surgical steel, bio-compatible plastics or polymers, for example, PEEK (polyether ether ketone), or other bio-compatible materials.
(34) The micro-pins 30 may be manufactured integral with the bottom 22 of the contact lens 12 (for example, by 3-D printing), or may be attached to the bottom 22 of the lens 12 via numerous mechanisms, including, for example, but not limited to, drilling, pressing, threaded engagement, thermo-soldering, coupling with the help of bonding agents (glue, adhesive), various interlocking mechanisms, such as, for example, interlocking tab and groove locking mechanism, etc. The microstructures may also be formed by chemical etching, chemical vapor deposition, plasma machining, photolithography, and other applicable processes.
(35) For example, as shown in
(36) Also alternatively to the drilling or gluing the micro-pins 30 into the bottom 22 of the lens 12, the lens with the micro-pins (or other microstructures contemplated in the present invention for the purposes of stabilization, centralization, and prevention of the slipping of the lens from the desired surgical site) may be formed by a 3-D printer from a bio-compatible plastic, or like composition, for example, PEEK material.
(37) The preferred diameter of the micro-pins (in their cross-section) may be in the range of 0.0012 inch, and can protrude from the surface of the bottom 22 of the lens 12 approximately 0.0013 inch to extend through the tear film 34 and viscous solution film 36 into contact with the cornea 32. The micro-pins length from the bottom 22 to the exposed ends 60 thereof generally should not exceed 1 mm in order to prevent deep penetration into the cornea further than the corneal superficial layer.
(38) The cross section of the micro-pins can be tapered down at the exposed ends 60 of the micro-pins 30, or squared off.
(39) Although shown as the same shape and same length in
(40) Referring to
(41) The annularly shaped contact lens holder 18 has an annularly shaped bottom 26 (with concentrically spaced apart inner and outer peripheral edges) and an annularly shaped upper surface 62 (with concentrically spaced apart inner and outer peripheral edges). The circumferential outside walls 64 extend between the outer peripheral edges of the bottom surface 26 and the outer peripheral edges of the upper surface 62.
(42) Internal walls 65 extend between inner peripheral edges of the annularly shaped bottom surface 26 and upper surface 62, respectively, of the holder 18, and define a circularly shaped opening 66 therebetween.
(43) The macular contact lens 12 is equipped with a flange element 68 which is formed integrally therewith or attached to the outer surface 70 of the circumferentially extending walls 50 of the lens 12. The flange element 68 has a flange 72 extending from the outer surface 70 of the circumferential extending walls 50 of the lens 12.
(44) The bottom surface 22 of the lens 12 and the circumferentially shaped holder opening 66 of the lens holder 18 are shaped and dimensioned to correspond each to the other to permit the bottom 22 of the lens 12 to pass through the circumferentially shaped holder opening 66. The flange member 68 is positioned around the outer surface 70 of the circumferentially extending walls 50 of the lens 12 a distance from the bottom 22 of the lens 12 corresponding to the height of the walls 64 of the lens holder 18 between the bottom surface 26 and the upper surface 62 thereof. When the contact lens 12 is received in the holder opening 66 of the lens holder 18, the flange 72 of the flange member 68 is supported by the annularly shaped upper surface 62 of the lens holder 18, thus preventing the contact lens 12 from displacing its bottom surface 22 below the bottom surface 26 of the lens holder 18.
(45) During the procedure, the lens ring holder 18 is positioned over the cornea 32, and the lens 12 is received in the holder opening 66 of the lens holder 18. The surgeon gently pushes down the contact lens/holder assembly 10, so that the microstructures 28 on the bottom surface 26 of the lens holder 18 penetrate through the tear film 34 and viscous solution film 36 (as shown in
(46) The lens ring holder 18 may be formed from polyether ether ketone (PEEK) material, or any other compound which is bio-compatible and capable of holding the contact lens 12 in position.
(47) The height of the walls 64 of the lens holder 18 may be in the range of 1-2 mm, with the holder opening diameter ranging from 9 to 15 mm, for example, 11.5 mm.
(48) The microstructures 28, for example, micro-pins 30, are formed along the circumference of the annularly shaped bottom 26 of the lens holder 18 in any manner similar to that described in previous paragraphs for the anchoring system 16 on the bottom 22 of the contact lens 12.
(49) A number of the micro-pins 30 on the bottom 26 of the lens holder 18 may range from 2 to 25 depending on the friction needed between the lens holder 18 and the tissues of the eye.
(50) It has been experimentally concluded that the microstructures 24, 28 can extend from the bottom of the lens 12 or from the bottom of the lens holder 18 no more than 1 mm in order to prevent excessive penetration and possible trauma to the surface of the tissues of the eye under surgery.
(51) Referring to
(52) The lens holder ring 42 includes an upper annularly shaped surface 87 and a bottom surface 88 which extend each from the other by a predetermined distance 90 defined by circumferentially shaped outer walls 92 of the gonioprism lens holder ring 42. The outer walls 92 extend between the outer peripheral edges of the annularly shaped upper and bottom surfaces 87, 88, respectively.
(53) The lens holder ring 42 further has inner walls 93 which extend circumferentially between inner peripheral edges of the annularly shaped upper and bottom surfaces 87, 88, respectively.
(54) The inner walls 93 are contoured with a cylindrically shaped surface and define a holder opening 94 therebetween. The holder opening 94 in the lens holder ring 42 is shaped and dimensioned to correspond to the bottom surface 80 of the gonioprism contact lens 40.
(55) The circumferentially shaped outer walls 92 and inner walls 93 may be configured with an incision access cut-out 96 which may be a partial cut-out with a connecting element 98 extending along the edge of the upper surface 86 of the lens holder ring 42.
(56) Alternatively, as shown in
(57) In the arrangement shown in
(58) In the gonioprism assembly 38, shown in
(59) Referring to
(60) From Step 2, the operation follows to Step 3, where a surgeon gently presses down either the contact lens to provide that the exposed ends of the micro-pins penetrate through the tear film and the viscous solution film, and in contact with superficial layer of the cornea.
(61) In the procedure which uses the assembly of the contact lens and the lens ring holder, the contact lens is lowered into the opening of the lens ring holder. In both situations, the bottom of the contact lens comes into contact with the viscous solution film (when the solution is used for the procedure) or with the tear film.
(62) In the following Step 4, the surgeon performs the ophthalmic procedure such as vitreoretinal surgery or macular surgery. During the procedure, the subject contact lens assembly allows the surgeon to visualize the macular and other structures of the eye in high magnification. The contact lens assembly remains stabilized and centered on the cornea of the eye and is prevented from slipping from the desired surgical site.
(63) Upon completion of the surgery procedure in Step 4, the surgeon lifts the contact lens assembly from the eye, thus disengaging the microstructures from the tissues of the eye. The tissues of the eye are not traumatized by the micro-pins engagement therewith.
(64) Following Step 5, the subject assembly may be discarded (optionally) or sent for disinfection for use in other procedures.
(65) During the Step 4, the surgery is performed in a hands-free manner, when the surgeon (or the surgeon's assistant) does not have to manually locate and relocate the contact lens assembly. Non-sutured stabilization and centralization of the subject contact lens assembly and prevention from sliding from the desired surgical site is provided in the present method by the subject anchoring system formed at the bottom of the lens or at the bottom of the lens ring holder.
(66) Referring to
(67) Following Step 1, the surgeon places the lens holder ring of the gonioprism assembly on the site of the surgery, lowers the gonioprism contact lens into the holder opening of the lens holder ring, and in Step 3 gently presses the lens holder ring down into the eye so that the exposed ends of the micro-pins (or other microstructures contemplated in the scope of the present invention) penetrate through the tear film and the viscous solution film of the eye as shown in
(68) In Step 2, the cut-out is positioned over the site of the corneal or cataract incision.
(69) In the following Step 4, the surgery (such as, for example, micro-invasive glaucoma surgery) is performed. During the surgery, the surgeon uses the subject gonioprism assembly in a hands-free manner without the need of stabilization and centralization of the gonioprism assembly by sutures. The sliding of the gonioprism assembly from the site of the surgery is prevented by the friction force provided by the microstructure on the bottom of the lens holder ring.
(70) Upon completion of the surgery in Step 4, the surgeon lifts the lens holder ring form the eye, thus disengaging the exposed ends of the microstructures on the bottom surface of the lens holder ring from the eye's tissues.
(71) In Step 6, following the removal of the gonioprism assembly from the eye, the gonioprism assembly can be optionally discarded or sent for cleaning and treatment for possible use in other procedures.
(72) During an opthalmic procedure, it is important that that the contact lens be maintained in a stable, non-moveable positional location as the surgeon is operationally proceeding. In some cases the patient may tilt his/her head with a responsive tilting of the contact lens holder and the contact lens. This tilting causes unwanted gravitational assist forces to be applied to the contact lens and the contact lens holder which may, in some cases permit a displacement of the contact lens from the intended site.
(73) Referring now to
(74) The contact lens assembly of 100 includes a speculum of 104 seen in
(75) Speculum 104 includes threaded member 108 for threaded engagement with plate member 118 of speculum 104. Operationally, threaded member 108 may be rotationally displaced to displace threaded member 108 in a linear direction coincident with axis line 110. A lower section (as seen in
(76) Intermediate arms 124 are respectively pivotally connected at pivots 126 to speculum arm members 112. Speculum arm members 112 are pivotally coupled to plate member 118 on opposing horizontally displaced ends to permit radial displacement of speculum arm members 112 responsive to the rotation of threaded member 108.
(77) In this manner, rotation of threaded member 108 which is in threaded engagement with plate member 118 causes a linear displacement in axis direction 112 of bracket member 122. Displacement of bracket member 122 being pivoted to intermediate arm members 124 which are in themselves pivoted being radially displaceable.
(78) Loop members 114 are fixedly connected to respective speculum arm members 112 as shown. Loop members 114 are operationally used for bearing against the patient's eyelids to maintain the patient's eyelids displaced each from the other during the ophthalmic procedure. As speculum arm members 112 are radially displaced away from each other there is a respective displacement of loop members 114 away from each other. As previously described loop members 114 are adapted to contact opposing eye lids of a patient during the medical procedure and maintain the patient's eyelids in a relatively stable and spaced position.
(79) Loop members 114 are generally wire members composed of a biocompatible solid material which has some flexibility such as stainless steel or some like composition not important to the inventive concept as herein described with the exception that loop members 114 are capable of accepting the loads imposed thereon.
(80) Contact lens assembly 100 includes contact lens 128 which may in some cases be in the form of a geoprism lens as shown in
(81) Contact lens 128 may be of the type previously described in
(82) As described, contact lens holder 130 is fixedly secured to contact lens 28 throughout or at least a portion of the periphery of contact lens 130 as is seen in
(83) As more clearly seen in
(84) Stabilizing wire 132 passes through a pair of sleeve members 136 which are mounted to and on opposing sides of stabilizing wire 132 which is clearly seen in
(85) Each end of plate member 118 is formed with a recess 140 within which respective speculum arm members 112 are pivotally connected as previously described. Thus the ends of plate member 118 take the form of a C-shape which provides a space between the speculum arm members 112 and the body of plate member 118.
(86) Sleeve member appendages 138 extending from an end of each of sleeve members 136 are insertable within opening or recess 140 of plate member 118 as seen in
(87) In this manner there is formed a continuous stabilizing wire 132 contour extending from stabilizing wire first ends 134 to provide a continuous stabilizing wire 132 between stabilizing wire first ends 134 as is seen in both
(88) Stabilizing wire 132 includes a lower stabilizing wire section which passes between loop members 114 having inner loop sections 116 as is seen in assembly in
(89) Operationally, when threaded member 108 is rotated, respective intermediate arm members 124 radially displace speculum arm members 112. Stabilizing wire 132 is mounted within speculum arm members 112, as is seen in
(90) Stabilizing wire 132 is fabricated from a malleable material such as stainless steel, a plastic composition or some like material which can hold its shape in a stable mode, but can be bent or flexibly displaced.
(91) In this manner during an ophthalmic procedure, contact lens holder 130 and captured contact lens 128 are lowered onto the predetermined location desired in cooperation with the eye speculum 104. If adjustments are needed to the positioning of lens holder 130, the surgeon can simply apply pressure to a mid-section of stabilizing wire 132 to effect displacement of lens holder 130 and associated contact lens 128. The adjustment pressure on stabilizing wire can be accomplished by the surgeon applying displacement force to the stabilizing wire 132 through the use of forceps contacting and applying pressure to opposing sides of stabilizing wire 132.
(92) In this manner, when a patient during a medical procedure tilts his/her head, the contact lens holder 130 and responsively the contact lens 128 are maintained in a stabilized position which acts against any gravity assist forces which may be encountered during the ophthalmic procedure.
(93)
(94) The subject gonioprism contact lens assembly 206 includes a gonioprism contact lens 208 to be removably attached to the eye 204 during an ophthalmic procedure by means of the subject magnetically actuated anchoring system (also referred to herein as the anchoring mechanism or anchoring. stabilizing mechanism) 210, which will be detailed in further paragraphs.
(95) The subject contact gonioprism lens assembly 206 for ophthalmic procedures further includes the gonioprism lens holder 212 which receives the lens 208 and holds the entire gonioprism contact lens assembly 206 in place during the ophthalmic procedure through the action of the anchoring system 210 provided in cooperation with the contact lens holder 212. The anchoring system 210 may be provided in a direct cooperation with the contact gonioprism lens 208 or, alternatively, in a direct coupling with the lens holder 212. As an example only, and not to limit the subject design to such particular configuration, the subject system will be further described with the focus mainly on the embodiment in which the subject anchoring system 210 can be coupled directly to the contact lens holder 212.
(96) The anchoring system 210 is configured with a pair of magnetically cooperating anchoring members (also referred to herein as units) 214 and 216, which may both be fabricated from a magnetic material, or alternatively, one of the anchoring units 214, 216 may be fabricated from a magnetic alloy, while another anchoring unit may be manufactured from a metallic material capable of magnetic attraction to the cooperating anchoring unit.
(97) The subject anchoring mechanism 210 further includes a wire member 218 which is attached at the end 220 thereof to the contact lens holder 212 through a rotational mechanism 222. The rotational mechanism 222 permits a bi-directional rotation of the lens holder 212 about the longitudinal axis 224 of the wire member 218 (shown by arrows A in
(98) Alternatively, the wire member 218 may be attached directly to the contact gonioprism lens 208. However, as an example only, but not to restrict the scope of the subject invention to this particular design, further description will focus on the design assuming the attachment of the wire member 218 directly to the lens holder 212.
(99) When the wire member 218 is held by a surgeon with the finger tips 215, for example, in proximity to the end 226 of the wire member 218 (as shown in
(100) An additional degree of freedom for adjustment of the subject contact lens assembly 206 positioning is beneficially provided by a displacement feature of the lens holder based anchoring member 216 along the wire member 218. The magnetically attractable lens holder based anchoring member 216, as shown in
(101) The mechanism ensuring the displacement of the anchoring unit (member) 216 along the wire member 218 may be configured either by machining of a through opening within the anchoring member 216 for the wire member 218 to pass through to permit the anchoring member 216 sliding along the wire member 218, or by providing a some sort of a rail structure for the anchoring member 216 displacement along the wire member 218, or, alternatively, by forming a threaded engagement between the anchoring member 216 and the wire member 218 which can be transformed into a linear displacement of the anchoring member 216 along the wire member 218. These and any other configurations permitting displacement of the anchoring member 216 along the wire member 218 are contemplated in the the subject system.
(102) As shown in
(103) The subject gonioprism contact lens assembly 206 cooperates with a speculum 230 shown in
(104) The subject speculum 230 may be fabricated based on any type of the eyelid speculum, for example, the type that is commonly known as a “Lieberman eyelid speculum”, although other speculums may be used in conjunction with the subject anchoring mechanism 210 in the subject system 200. For the purpose of clarity and ease of understanding, the “Lieberman” speculum will be used in further description as the basis for the subject speculum modification.
(105) The speculum 230 includes threaded member 232 for threaded engagement with a plate member 234 of the speculum 230. Operationally, the threaded member 232 may be rotationally displaced to displace the threaded member 232 in a linear direction coincident with the axis line 236.
(106) A lower section (as seen in
(107) The intermediate arms 240 are respectively pivotally connected at pivots 242 to the speculum arm members 244. The speculum arm members 244 are pivotally coupled to the plate member 234 at the opposing horizontally displaced ends 246 to permit radial displacement of the speculum arm members 244 responsive to the rotation of the threaded member 232.
(108) In this manner, rotation of the threaded member 232 (which is in a threaded engagement with the plate member 234) causes a linear displacement in the axis direction 236 of the bracket member 238. Displacement of the bracket member 238, being pivoted to the intermediate arm members 240, results in a radial displacement of the arm members 240.
(109) Wire loop members 248 are fixedly connected to respective speculum arm members 244 as shown in
(110) As the speculum arm members 244 are radially displaced away from each other, there is a respective displacement of the wire loop members 248 away from each other. The wire loop members 248 are adapted to contact opposing eye lids of a patient during the medical procedure and maintain the patient's eyelids in a relatively stable and spaced position, as shown in
(111) The wire loop members 248 are generally wire structures composed of a biocompatible solid material which has some flexibility such as stainless steel or some like composition not important to the inventive concept, as herein described, with the exception that the wire loop members 248 are capable of accepting the loads imposed thereon.
(112) In the subject system 200, the modified eye speculum 230 is equipped with the magnetically attractable anchoring member 214 (also referred to herein as the speculum-based anchoring unit) which is attached to one of the wire loop members 248.
(113) The subject contact lens assembly 206 is a novel non-sliding corneal contact lens assembly equipped with the suture-free stabilization/anchoring system 210 for vitreoretinal surgery which utilizes the magnetic attraction between the magnetically cooperating anchoring units (members) 214 and 216, where the unit 216 is a lens holder-based anchoring unit attached at the wire member 218 which is rotationally secured to the lens holder 212 (or to the gonioprism lens 208 itself), and where the speculum-based anchoring member 214 is secured to the wire loop member 248 of the eye speculum 230.
(114) In operation, as shown in
(115) Subsequently, as shown in
(116) For being magnetically cooperative, the first and second anchoring members 214, 216 are fabricated from magnetically attractable materials selected from a group consisting of a magnetic material/alloy, metal (or ferrous) material/alloy, and their combination, meaning that at least one of the anchoring members is made from a magnetic material, while another can be made from a magnetic material or a ferrous material. For example, when the anchoring member 216 secured to the contact lens holder 212 is fabricated from a magnetic alloy, the anchoring member 214 secured to the eye speculum 230 may be manufactured either as a magnet or as a ferrous plate.
(117) During positioning of the contact lens assembly 206 on the eye 204, the surgeon can beneficially adjust orientation and position of the contact lens holder 212 due to the rotational mechanism 222 formed between the wire member 218 and the contact lens holder 212. After the contact lens assembly 206 is placed on the cornea 262 of the eye 204 and centered, the surgeon, by bringing the anchoring units 214 and 216 in contact one with another, secures the contact lens 208 to the cornea 262, and can perform the ophthalmic procedure in a “hands-free” fashion, as shown in
(118) A viscous coupling agent (solution) 264 is used during the procedure when applied to the ocular surface of the eye, so the bottom of the lens 208 and the lens holder 212 may be in a direct contact with the solution applied on the surface of the eye for reducing sensitivity of the eye surface to the contact with the contact lens at the contact lens holder.
(119) The coupling fluids 264 applied on the surface of the tear film during the procedure may be selected from a group of coupling fluids such as 2% methocel, thiol-tears gel, 1.4% sodium hyaluronate, 0.9% simple saline, and other contact solutions applicable to the purposes of the ophthalmic care using contact lens.
(120) Although applicable to any contact lens and numerous ophthalmic procedures, as an example, the subject system 200 is described in the application for the surgical contact gonioprism assembly 206 for glaucoma surgery, where the gonioprism contact lens 208 is used to obtain adequate visualization of the critical angle of the peripheral cornea to perform the micro invasive glaucoma surgery (MIGS) which includes implanting the stent or cutting into the trabecular meshwork. Glaucoma surgeons are generally opposed to placing fixation sutures during the glaucoma procedure in order to avoid trauma to the cornea or sclera of the eye. For this reason, the subject suture-free system 200 of the current invention using the gonioprism contact lens 208 is highly desirable for use in ophthalmic procedures involving glaucoma surgical procedures.
(121) A bottom 280 of the contact lens 208 is an eye contacting surface which may be shaped as a circular arc or in another suitable curved configuration to conform with the curvature of the eye cornea 262.
(122) The gonioprism lens 208 has the upper surface 282 spaced from the bottom surface 280 by circumferentially extending side walls 284. The walls 284 of the contact lens 208 may form a cylindrical surface, trapezoidal surface, or other contoured surface as needed for specific optical properties of the lens 208. The upper surface 282 of the lens 208 may be smaller than, larger than, or of the same size with the surface of the bottom 280 of the lens 208 (as dictated by the needed optical properties of the lens 208).
(123) The contact lens 208 may be manufactured from acrylic, glass, or other bio-compatible and optically viable materials used for the contact lens.
(124) Referring to
(125) Alternatively, the wire member 218 may be attached by the end 220 thereof at another surface of the contact lens holder 212 (or the contact lens 208), such as, for example, the top surface 288 of the lens holder 212 or the upper surface 282 of the contact gonioprism lens 208.
(126) As shown in
(127) Internal walls 294 extend between the inner peripheral edges of the annularly shaped bottom surface 290 and the upper surface 288, respectively, of the contact lens holder 212, and define a circularly shaped holder opening 296 therebetween.
(128) The bottom surface 280 of the contact lens 208 and the circumferentially shaped holder opening 296 of the contact lens holder 212 are shaped and dimensioned to correspond each to the other to permit the bottom 280 of the lens 208 to pass through the circumferentially shaped holder opening 296.
(129) Prior to the procedure, the contact lens holder 212 is positioned over the cornea 262, and the contact lens 208 is received in the holder opening 296 of the contact lens holder 212. The surgeon lowers the contact lens assembly 206 into contact with the tear film and viscous solution film 264 and brings the anchoring units 214, 216 in contact one with another (as shown in
(130) During positioning of the contact lens holder assembly 206 on the eye 204, the surgeon can rotate the lens holder 212 relative to the wire member 218, as well as rotate the lens 208 inside the holder opening 296 in the contact lens holder 212, to adjust the position of the lens/lens holder relative to the patient's eye. When the anchoring units 214 and 216 are magnetically engaged one with another, stabilization and centralization of the contact lens assembly 206 in place is attained, and any deviation of the assembly 206 from the desired position during the ophthalmic procedure is prevented.
(131) The lens holder 212 may be formed from polyether ether ketone (PEEK) material, or any other compound which is bio-compatible and capable of holding the contact lens 208 in position.
(132) The height of the walls 286 of the lens holder 212 may be, for example, in the range of 1-2 mm, with the lens holder opening diameter ranging from 9 to 15 mm, for example, 11.5 mm.
(133) As shown in
(134) The ophthalmic procedure supported by the use of the subject non-sliding, non-sutured hands-free contact lens anchoring assembly is performed in the following sequence of operational steps:
(135) The method begins in Step 1, wherein, as shown in
(136) In Step 2, the modified eye speculum 230, shown in
(137) Subsequently, as shown in
(138) For being magnetically cooperative, the anchoring members 214, 216 are fabricated from magnetically attractable materials, such as magnetic materials/alloys, metal (or ferrous) materials/alloys, and their combination, meaning that at least one of the anchoring members (214 or 216) is made from a magnetic material, while another can be made from a magnetic material or a ferrous material to serve as a coupling member (plate). For example, when the anchoring member 216 secured to the contact lens holder 212 is fabricated from a magnetic alloy, the anchoring member 214 secured to the eye speculum 230 may be manufactured either as a magnet or as a ferrous coupling plate. Reciprocally, when the anchoring member 214 is formed from a magnetic alloy, the anchoring member 216 may be formed as a metallic (ferrous) coupling member.
(139) In Step 4, subsequent to Step 3, the subject contact lens assembly 206 equipped with the subject anchoring system 210 is positioned in alignment the desired surgery site. During Step 4, shown in
(140) Once the desired position and orientation of the contact lens assembly 206 is found in Step 4, as shown in
(141) The surgery is performed in a hands-free manner, when the surgeon (or the surgeon's assistant) does not have to manually locate and relocate the subject contact lens assembly. Non-sutured stabilization and centralization of the subject contact lens assembly and prevention from sliding from the desired surgical site is provided by the subject anchoring system supported by magnetic attraction between the anchoring members 214 and 216 secured, respectively, to the lens holder 212 and the eye speculum 230.
(142) Upon completion of the surgery procedure, the surgeon disengages anchoring member 214 and 216, and removes the contact lens assembly 206 from the eye 204. The tissues of the eye are not traumatized in any way by the subject anchoring mechanism.
(143) Subsequent to the surgery, the subject assembly 206 may be discarded (optionally) or sent for disinfection for use in other procedures.
(144) The contact lens holder 212 may be secured to the contact lens 208 through an adhesive bonding or some other like technique. Contact lens holder 212 is fixed to the contact lens 208 at least partially along a periphery of the contact lens 208. In this manner, the contact lens holder 212 is fixedly attached to the contact lens 208. The function of the contact lens holder 212 is to provide support and stabilization of the contact lens 208 when the contact lens 208 is positioned over a medical procedure site of a patient's eye.
(145) The contact lens holder 212 is fixedly secured to the contact lens 208 throughout or at least a portion of the periphery of the contact lens 208. The contact lens holder 212 may be formed of a polygonal or circular cross-sectional contour tubing for matingly interfacing with the contact lens 208. The contact lens holder 212 is formed by a substantially cylindrical tubing which receives the contact lens 208. However, the particular contour of the contact lens holder 212 is not important to the inventive concept as herein described with the exception that it is adhered to at least a portion of the contact lens 208 in order to securely hold the contact lens 208 within the contact lens holder 212. The contact lens holder 212 may be composed of a solid composition which is bio-compatible, such as stainless steel or some like composition which is substantially rigid.
(146) Although this invention has been described in connection with specific forms and embodiments thereof, it will be appreciated that various modifications other than those discussed above may be resorted to without departing from the spirit or scope of the invention as defined in the appended claims. For example, functionally equivalent elements may be substituted for those specifically shown and described, certain features may be used independently of other features, and in certain cases, particular locations of the elements may be reversed or interposed, all without departing from the spirit or scope of the invention as defined in the appended claims.