EP1024737A1 - Dispositif de lentilles pour chirurgie vitreo-retinienne - Google Patents

Dispositif de lentilles pour chirurgie vitreo-retinienne

Info

Publication number
EP1024737A1
EP1024737A1 EP98956139A EP98956139A EP1024737A1 EP 1024737 A1 EP1024737 A1 EP 1024737A1 EP 98956139 A EP98956139 A EP 98956139A EP 98956139 A EP98956139 A EP 98956139A EP 1024737 A1 EP1024737 A1 EP 1024737A1
Authority
EP
European Patent Office
Prior art keywords
flange
eye
contact lens
patient
arrangement according
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP98956139A
Other languages
German (de)
English (en)
Other versions
EP1024737A4 (fr
Inventor
Donald A. Volk
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Volk Optical Inc
Original Assignee
Volk Optical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Volk Optical Inc filed Critical Volk Optical Inc
Publication of EP1024737A1 publication Critical patent/EP1024737A1/fr
Publication of EP1024737A4 publication Critical patent/EP1024737A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/12—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
    • A61B3/125—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes with contact lenses

Definitions

  • the invention relates to a lens arrangement for observation and surgical treatment of the vitreous or retina of the eye, and more particularly for use in vitreoretinal surgery.
  • Direct ophthalmoscopy lenses which create a virtual image within the eye
  • indirect ophthalmoscopy lenses which create a real image outside of the eye are two lens types which have been used for fundus observation and as aids in the surgical treatment of the eye.
  • Known lenses of this type that are used in vitreoretinal surgery are maintained on the eye through the use of a handle that is held by an assistant during the surgery.
  • the suture down ring is comprised of metal or other bio-compatible material and has one or more extending fingers or leg portions around which sutures, which have been sewn into the sclera, are tied.
  • the lens which may be, for example, a plano-concave direct ophthalmoscopy lens or an indirect ophthalmoscopy lens system comprised of two or more elements, slips into the suture down ring and is thereby stabilized and centered over the cornea.
  • a sterile interface solution is used in conjunction with the lens to produce an optical interface of the lens with the eye.
  • the suture down ring has been successfully used, but because its use involves a suturing procedure it could be desirably avoided were there to be a suitable non-invasive alternative.
  • a lens arrangement for use in vitreoretinal surgery including a contact lens element having a posterior surface adapted to fit an average cornea for placement on a patient's eye, and an anterior surface, the contact lens element transmitting light emanating from the patient's eye for viewing a structure of the patient's eye; and a flange surrounding and holding a circumferential edge of the contact lens element and extending radially onto the scleral region of the patient's eye, the flange having a posterior surface with a shape allowing it to rest on the scleral portion of the eye for stabilizing a position of the contact lens element on the patient's cornea, the flange having one or more openings allowing access to an incision through which a surgical tool or instruments may be
  • the one or more openings comprise a plurality of spaced apart recesses each having an opening at the out peripheral edge of the flange and extending radially inwardly, the opening and inward radial extent of each recess allowing access to an incision through which a surgical tool or instruments may be inserted.
  • the stabilizing portions of the flange existing between the one or more openings or recesses may include vacuum suction ports or channels designed to conduct a partial or high vacuum to further enhance the stable positioning of the lens on the eye.
  • the contact lens element may comprise a direct ophthalmoscopy lens, for example, of the plano-concave, convex-concave or bi-concave type, or alternatively may be part of a multi-element indirect ophthalmoscopy lens.
  • the contact lens element and flange may comprise an integral, one piece unit made of the same material.
  • the flange may comprise a separate component made of the same or different material from the contact lens element. In the latter case the contact lens element may slidably fit within a central opening of the flange or may be releaseably connected by other suitable mechanisms, such as a screw connection, friction fit or a bayonet connection.
  • FIG. 1 is a sectional view of a lens arrangement according to one embodiment of the invention.
  • Fig. 2 is a plan view of the contact lens element and flange illustrated in Fig. 1.
  • Fig. 3 is a sectional view of a lens arrangement according to another embodiment of the invention.
  • Fig. 4 is a plan view of the flange shown Fig. 3.
  • Fig. 5 is a sectional view of a lens arrangement according to yet another embodiment of the invention.
  • Fig. 6 is a sectional view and partial block diagram of a lens arrangement according to a further embodiment of the invention.
  • Fig. 7 is a plan view of the flange shown in Fig. 6.
  • Fig. 8 is a plan view of another embodiment of the flange.
  • Lens arrangement 10 mounted on a cornea 12 of an eye 14.
  • Lens arrangement 10 includes a frusto-conically shaped frame 16 which coaxially fixes a contact lens element 18 relative to an imaging lens
  • Concave posterior surface 22 has a shape substantially corresponding to the shape of an average cornea and therefore may have an apical radius of approximately 7.0 to 8.5 mm, and preferably may be approximately 7.7 to 7.8 mm.
  • Posterior surface 22 may be spherical or aspherical and may be fitted on the cornea with the use of an interface solution 26 as is commonly known in the art. Referring additionally to Fig.
  • posterior surface 22 preferably has a cord diameter d of approximately 9-13 mm and is most preferably about 11.7 mm.
  • Anterior surface 24 may have an apical radius ranging from infinity for a planar surface to either a convex or concave radius of approximately 6.0 mm., and may be either spherical or aspherical.
  • Contact lens element 18 has a peripheral region 28 which is connected with a flange 30 around its circumference. Flange 30 extends radically onto the sclera 32 of eye 14.
  • Flange 30 has a posterior surface 34 which has a different curvature from that of posterior surface 22 of contact lens element 18, and more specifically, posterior surface 34 of flange 30 has a curvature substantially corresponding to the curvature of an average sclera of an eye, for example, a 12 mm. radius. Consequently, the curvature of the posterior surface 34 of flange 30 is substantially flatter than the curvature of the posterior surface 22 of contact lens element 18, and as such the lens device tends to be stabilized and centered over the cornea of the eye.
  • Flange 30 has an anterior surface 35 that may have a slope or curvature that provides an adequate thickness of approximately 1.5 mm. to flange 30, thereby providing substantiality and strength to this component.
  • Posterior surface 34 of flange 30 has a outside cord diameter D which may range from approximately 15 mm to approximately 20 mm. and is preferably 16 to 17 mm in diameter.
  • Contact lens element 18 is fixed, for example, by a screw connection (not shown) to the smaller diameter end of frusto-conical frame 16.
  • Imaging lens 20 is fixed at the larger opening end of frusto-conical frame 16 between a shoulder 36 and an o-ring 38, or by other conventional fastening means.
  • Imaging lens 20 is coaxially fixed relative to contact lens element 18 and is preferably biconvex with a power which may be as high as 150 to 170 diopters.
  • Imaging lens 20 is spaced from and cooperates in a known manner with contact lens element 18 for capturing light rays exiting the eye through the cornea and passing through contact lens element 18. Imaging lens 20 focuses such light rays to create a real image of the retina and vitreous anterior to the cornea, and preferably anterior of imaging lens 20.
  • An indirect ophthalmoscopy lens system of this type which includes a contact lens element and one or more imaging lenses is known in the art and is described in detail, for example, in my prior U.S. Patent No. 5,046,836, which is incorporated herein by reference.
  • FIG. 2 is a plan view of contact lens element 18 and flange 30.
  • contact lens element 18 and flange 30 are made of the same optically transparent material and are integrally connected with one another in peripheral region 28 as a single unit.
  • flange 30 has four evenly spaced recesses 40 each of which has an opening at the outer periphery 42 of flange 30 and extend radially inwardly toward contact lens element 18.
  • the circumferential extent C of the opening of each recess 40 at the outer periphery 42 may be from about 4 to about 8 mm, and is preferably about 6.75 mm, and each recess 40 extends radially inwardly from an imaginary extension of the outer periphery 42, shown by a dotted line in Fig.
  • the recess or recesses are sized to accommodate known dimensions of current surgical tools which penetrate the sclera during vitreoretinal surgery.
  • Figures 3 and 4 illustrate an embodiment modified from that of Figures 1 and 2 wherein a flange 30' constitutes a separate component from that of contact lens element 18' which is fixed in frame 16' coaxially with imaging lens 20.
  • Flange 30' which is shown in plan view in Figure 4, may be made of metal or any other suitable material which is biocompatible with the eye.
  • contact lens element 18' presents a circumferential edge 19 which has a diameter the same or just slightly less than the inner diameter of flange 30' so that contact lens element 18' can be slidably received within flange 30' for stabilizing the indirect ophthalmoscopy lens system 10' relative to eye 14.
  • Recesses 40 in flange 30' are sized the same as described in connection with Figure 2.
  • Flange 30' thus operates in the same manner as flange 30 in Figure 2 to stabilize the lens system 10' relative to the eye.
  • Flange 30' may be designed to accommodate lens types presently used in vitreoretinal surgery, thus providing a means by which such existing lenses may be used advantageously without the need for a handle or suture down ring.
  • Figure 5 shows an embodiment of the invention wherein a flange 30" is integrally connected with a direct ophthalmoscopy lens 43.
  • Direct ophthalmoscopy lens 43 has a concave posterior surface 44 which has a shape adapted to fit an average cornea and a piano anterior surface 46.
  • Direct ophthalmoscopy lens 43 operates in a known manner for creating a virtual image of the patient's retina which can be viewed through a microscope by an observer.
  • flange 30 which is connected to direct ophthalmoscopy lens 43 in a peripheral region 48, has 4 recesses like those illustrated in Figure 2, spaced apart evenly around the circumference of the flange for accommodating surgical tools or instruments inserted into the eye during surgery.
  • figure 5 illustrates direct ophthalmoscopy lens 43 and flange 30" as constituting a single component made of the same optically transparent material, it is possible for flange 30" and direct
  • FIGS. 6 and 7 show a contact lens arrangement relating to an embodiment of the invention wherein a flange 30'" incorporates vacuum ports 52 communicating with the posterior surface 34' of the flange to further enhance the stable positioning of a slidably received direct ophthalmoscopy contact lens element 43' through vacuum suction to the sclera of a patient's eye 14.
  • a vacuum port may be located on one or more of the structural portions of the flange between the recesses 40, and may be designed as a channel at the posterior surface or hole passing through the body of the flange from posterior surface 34' to anterior surface 35'.
  • a small diameter flexible hose 56 such as surgical silicone hose, may be adapted to the vacuum ports 52 and connected to a vacuum source 58 such as a metered vacuum pump, squeeze bulb or syringe operated by the physician's assistant.
  • the flange surrounding the contact lens element may incorporate a bridge 49 to form fully enclosed openings 50 as shown in Figure 8.
  • bridge 49 may incorporate a vacuum channel extending partly or fully around the circumference of the lens for the same purpose as described in the embodiment of Figures 6 and 7.
  • the flange may have less than four recesses or openings.
  • the flange may have one recess, or alternatively three recesses or openings spaced apart at the 11 o'clock, 2 o'clock and 4 or 8 o'clock positions, which are incision positions that a surgeon may typically utilize for inserting surgical tools or instrumentation into the eye during a surgical procedure.
  • the size of the recesses or openings may vary from the dimensions mentioned above, particularly in the circumferential extent of the recess or opening.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Prostheses (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

Un dispositif de lentilles destiné à être utilisé en chirurgie vitréo-rétinienne comprend un élément (18) lentilles de contact comportant une surface postérieure (12) dont la forme est adaptée pour s'ajuster sur une cornée moyenne afin d'être placée sur l'oeil d'un patient et une surface antérieure (24). L'élément lentilles de contact transmet la lumière émanant de l'oeil du patient pour voir une structure de ce même oeil. Un rebord (30) entoure et retient une région périphérique de l'élément lentilles de contact et s'étend radialement sur la région sclérale de l'oeil du patient. Le rebord comporte une surface postérieure dont la forme est adaptée à une courbure sclérale moyenne pour que le rebord repose sur la sclère et stabilise ainsi une position de la lentille de contact sur la cornée du patient. Le rebord comporte au moins une ouverture (50) qui permet d'accéder à une incision par laquelle on peut introduire dans l'oeil un outil ou un instrument chirurgical.
EP98956139A 1997-10-22 1998-10-22 Dispositif de lentilles pour chirurgie vitreo-retinienne Withdrawn EP1024737A4 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US95552597A 1997-10-22 1997-10-22
US955525 1997-10-22
PCT/US1998/022317 WO1999020171A1 (fr) 1997-10-22 1998-10-22 Dispositif de lentilles pour chirurgie vitreo-retinienne

Publications (2)

Publication Number Publication Date
EP1024737A1 true EP1024737A1 (fr) 2000-08-09
EP1024737A4 EP1024737A4 (fr) 2004-03-03

Family

ID=25496936

Family Applications (1)

Application Number Title Priority Date Filing Date
EP98956139A Withdrawn EP1024737A4 (fr) 1997-10-22 1998-10-22 Dispositif de lentilles pour chirurgie vitreo-retinienne

Country Status (4)

Country Link
EP (1) EP1024737A4 (fr)
JP (1) JP3623739B2 (fr)
CA (1) CA2305892C (fr)
WO (1) WO1999020171A1 (fr)

Families Citing this family (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2155394B1 (es) * 1999-06-04 2001-12-16 Inst Barraquer Lente para cirugia vitreo-retiniana en oftalmologia.
JP3827229B2 (ja) * 2001-06-21 2006-09-27 Ｈｏｙａヘルスケア株式会社 硝子体手術用コンタクトレンズの保持装置および硝子体手術用コンタクトレンズの保持部並びに連結部
JP4791009B2 (ja) * 2004-06-25 2011-10-12 株式会社ニデック 硝子体手術用コンタクトレンズ保持リング
JP4877570B2 (ja) * 2005-07-04 2012-02-15 Ｈｏｙａ株式会社 硝子体手術用コンタクトレンズ保持リング
JP4931408B2 (ja) * 2005-12-02 2012-05-16 Ｈｏｙａ株式会社 眼科手術用コンタクトレンズ
JP4792292B2 (ja) * 2005-12-29 2011-10-12 伸吉 戸塚 角膜保護カバー
AU2011320709B2 (en) 2010-10-26 2015-12-17 Alcon Inc. Ophthalmoscopic surgical contact lens
MX2017001042A (es) * 2014-07-25 2017-05-04 Vision Ease Lp Lente delgado estabilizado.
CN109691974A (zh) * 2018-12-28 2019-04-30 中国科学院宁波工业技术研究院慈溪生物医学工程研究所 用于视网膜边缘成像的接触式透镜及成像系统
DE102021119298B4 (de) * 2021-07-26 2025-03-27 Carl Zeiss Meditec Ag Kontaktloses Visualisierungssystem für ein Operationsmikroskop für die Augenchirurgie
DE102021119297B4 (de) 2021-07-26 2025-03-27 Carl Zeiss Meditec Ag Kontaktloses Visualisierungssystem für ein Operationsmikroskop für die Augenchirurgie

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH645263A5 (en) * 1980-03-13 1984-09-28 Heinz A Oertli Microsurgical device having a lens for use in eye operations
US4558698A (en) * 1984-03-01 1985-12-17 Dell Lawrence W O Laser canaliculostomy eye-treatment
US5046836A (en) * 1989-10-27 1991-09-10 Volk Donald A Diagnostic indirect ophthmalmoscopy contact lens system
US5347326A (en) * 1992-10-05 1994-09-13 Volk Donald A Diagnostic or therapeutic contact lens
US5623323A (en) * 1994-10-26 1997-04-22 Ocular Instruments, Inc. Extra wide field ophthalmic lens

Also Published As

Publication number Publication date
JP3623739B2 (ja) 2005-02-23
CA2305892C (fr) 2006-04-04
CA2305892A1 (fr) 1999-04-29
JP2001520066A (ja) 2001-10-30
EP1024737A4 (fr) 2004-03-03
WO1999020171A1 (fr) 1999-04-29

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