Artificial intraocular lens system

An artificial intraocular lens system is provided with posterior and anterior tabs adapted to receive and hold a pin substantially perpendicularly therebetween. Said lens system allows for the insertion and affixing of the lens in the eye without the use of sutures and without requiring incisions in the iris to be made by the surgeon. Also disclosed is a tool for insertion of a lens system into the eye.

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
This invention relates to artificial intraocular lens systems employed in 
ophthalmology for the correction of aphakia; and more particularly this 
invention relates to the lens support system for positioning and affixing 
the lens in the eye after a natural lens extraction. The invention further 
relates to a mechanical tool employed in inserting the lens system into 
the eye. 
2. Description of the Prior Art 
Presently, there are three distinct methods employed in the art of 
correcting aphakia resulting from a cataract extraction. In accordance 
with one practice, the aphakic patient is fitted with a powerful spectacle 
lens, which lens provides the correction required to restore useful vision 
to the aphakic eye. The ophthalmic lenses designed to correct an aphakic 
condition are highly undesirable because they are extremely thick, heavy, 
and tend to distort the wearer's appearance. The patient suffers from 
cosmetic discomfort, restricted peripheral vision, distortion of 
peripheral images, poor binocular vision, scotoma, and reduced ability to 
clearly focus. 
According to the second practice, the patient is fitted with a contact 
lens. The contact lens overcomes many of the disadvantages associated with 
spectacles. However, because cataracts are usually a problem associated 
with the elderly who have lost much of their dexterity, such contact 
lenses are not desirable. 
The third practice developed in the late 1940's when Harold Ridly inserted 
the first artificial intraocular lens into a human eye. Believing that the 
artificial lens belongs "where nature intended the crystalline to be", he 
inserted the artificial lens in the posterior chamber of the eye. The 
posterior chamber is that area between the iris and the vitreous humor 
where the natural lens is located i.e., rearwardly the iris. 
In the early 1950's, and as a result of medical complications which often 
occurred after a postpupillary insertion, lenses were developed for 
insertion in the anterior chamber of the eye. The anterior chamber being 
that area normally occupied by aqueous humor and being between the iris 
and the cornea i.e., forwardly of the iris. 
Throughout the evolution of the art of correcting aphakia, the shape of the 
artificial intraocular lens has remained substantially unchanged. The art 
has primarily concentrated on developing and improving ways for affixing 
the lens within the interior of the eye. To date, there have developed 
several methods of lens fixation such as posterior chamber fixation, 
anterior chamber fixation, iris fixation, iridocapsular fixation, and 
capsular fixation. Typical fixation means are disclosed in U.S. Pat. Nos. 
3,922,728 of Krasnov, 3,913,148 of Potthast, 3,906,551 of Otter, 3,866,249 
of Flom, 3,711,870 of Deitrick, and 3,673,616 of Fedorov, et al. 
Typically, the artificial intraocular lenses of the prior art are biconvex, 
planoconvex or concavoconvex in shape and have a power in the range of 
about +8 to +25 diopters as measured in the aqueous. As compared with the 
natural lens of the human eye, the artificial lenses are relatively heavy. 
Artificial lenses of the prior art have a number of disadvantages. The 
typical iris clip lens rely on the constrictor muscles of the iris as the 
positioning means. The iris is therefore maintained in the state of 
tension, is prevented from assuming a normal shape and the clips obstruct 
full and normal constriction. Often the operating physician sutures the 
iris to clips or holes drilled into the lens so as to secure and properly 
position the lens. The suture materials normally employed are known to 
disintegrate and dissolve over a period of time. As the suture material 
disappears positive fixation of the lens can be lost. In place of sutures 
some lenses require flexible wires which are caused to penetrate through 
the iris and engage a loop or other engaging means. The surgical steps are 
difficult especially for a relatively inexperienced physician; and the 
positioning and placement of these flexible wires require that the 
physician make an incision in the iris. 
SUMMARY OF THE INVENTION 
In accordance with the present invention there is provided an artificial 
intraocular lens system which is extremely simple to implant. The 
implantation does not require either suturing of the lens to the iris or 
incisions of the iris. The lens system upon implantation is positively 
fixed to the iris. The lens does not interfere with the normal 
constriction or the dilation of the iris. There are no small diameter 
metal wires which will place a strain upon the iris. The density of the 
lens can be made to approach the density of the liquid in which the lens 
is surrounded after implantation thereby reducing harmful affects 
associated with the movement of the lens due to inertial effects. 
The lens system of this invention comprises an optical zone and means for 
supporting the lens in the eye. The lens may be supported in the anterior 
chamber, posterior chamber or iris plane of the eye. The improvement of 
this lens over the prior art comprises at least one pair of anterior and 
posterior tabs which extend from the periphery or circumferential edge of 
the optical zone. The tabs are oppositely disposed and spaced apart a 
distance sufficient to receive a portion of the iris therebetween without 
substantially interfering with the constriction and dilation of the iris. 
The anterior tab includes an opening adapted to receive and allow the 
passage of a pin therethrough. The anterior tab and the posterior tab 
cooperate to hold the pin substantially perpendicular therebetween whereby 
the pin having penetrated through the iris obtains a lens positively fixed 
in the eye. 
Preferably one end of the pin is anchored into the lens so that during the 
surgical implantation, the pin cannot be lost. The support system further 
includes additional anterior and posterior haptics such as haptic rims, 
loops, rods and/or tabs as supporting means for the lens. 
The invention further includes a medical tool or device for insertion of 
the lens into the eye. The tool comprises generally first, second and 
third relatively movable members. The first and second members are adapted 
to grip the anterior tab portion of the lens system. The third member is 
adapted to engage a pivotable pin provided on said lens system to move 
said pin relative to said tab. 
Further features of the invention will become apparent from the following 
description read with reference to diagrammatic drawings wherein like 
numbers refer to like parts.

DESCRIPTION OF THE PREFERRED EMBODIMENTS 
Referring to the drawings, FIGS. 1 and 2 there is illustrated an 
intraocular lens system according to this invention. As shown, the system 
comprises an optical zone 1. Extending from a portion of the 
circumferential edge 2 of the optical zone 1 is anterior tab 3 provided 
with elongated hole 4 positioned inwardly from tab edge 5, a groove 6 is 
provided so as to run longitudinally of tab 3 and extends from slightly 
inwardly the optical zone 1 to hole 4. The groove can be cut completely 
through the tab so as to provide an elongated hole or it can be formed by 
carving out a portion of the tab material. Hereinafter the structure 6 
shall be referred to as a groove but should be understood to include a 
hole. Embedded into and pivotably secured into the anterior side of the 
lens system and slightly inwardly the circumferential edge of optical zone 
1 is pin 7 having generally straight portion 8, hook portion 9, bight 
portion 10 and end 10A. In one embodiment end 10A is ball shaped and is 
anchored in a socket shaped depression in edge 2, thereby providing a ball 
and socket joint. Posteriorly, the optical zone is loop 11 having 
extensions 12 and 12' securely embedded in optical zone 1. Loop 11 is 
provided with an extension forming a posterior tab 13 provided with hole 
or groove 14 inwardly from posterior tab edge 15. Anterior tab 3 and 
posterior tab 13 are oppositely disposed and spaced apart a distance 
sufficient to receive a portion of the iris of the eye therebetween 
without interfering with the dilation and constriction of said iris. 
Extending in generally the opposite direction from tab 3 is tab 16 thereby 
providing additional supportive means of the lens system on the eye. Loop 
extensions 12 and 12' are embedded at a sufficient distance from optical 
zone circumferential edge 2 such that the iris can dilate and constrict 
without interference. 
In accordance with this invention pivotable should be understood to include 
bendable. The pin is constructed of a malleable material. Pin 7 should be 
of a sufficient length such that upon bending the pin inwardly, hook 
portion 9 passes through hole 4 and is received by hole 14 the tabs 3 and 
13 cooperating to hold hook portion 9 substantially perpendicular 
therebetween. Furthermore, in the preferred embodiment groove 6 receives 
straight pin portion 8 such that the straight pin portion is substantially 
flush with or slightly lower than the anterior surface 17 of tab 3. 
In operation, upon partially opening the cornea and removal of the natural 
lens, the lens system is placed in the eye with pin 7 in an open position. 
Loop 11 and posterior tab 13 is positioned posteriorly the iris and tab 3 
anteriorly the iris. 
Upon properly positioning the lens in the eye, pin 7 is bent inwardly to 
position b. In the process pin portion 9 punctures through the iris (not 
shown) and thereby positive affixes the lens system into the eye without 
the need of sutures and without the need of the operating physician 
manually cutting incisions into the iris. To facilitate the puncturing of 
the iris the pin can be chiseled or pointed at its free end as illustrated 
in FIGS. 2, 7 and 15. As discussed further on a tool facilitating 
insertion of the lens system is described. 
In an especially preferred embodiment of the invention the anterior surface 
17 of tab 3 is provided with a depression 18 in the form of a slot or hole 
(hereinafter referred to as slot) located inwardly from hole 4 and 
forwardly from the place of securing the pin to the lens. As understood 
hereinafter, the slot can be carved from a portion of the tab material or 
it can be formed by cutting through the tab to form a hole. In the event 
it is necessary to remove the lens system from the eye, hole or slot 18 
facilitates such removal for one simply places a surgical instrument into 
the slot and raises the pin into open position a. In order to facilitate 
such an operation, slot 18 should desirably extend slightly transverse and 
perpendicular to groove 6. 
The lens system of FIG. 3 illustrates a slightly different arrangement in 
order to obtain positive fixation of the lens system in the eye. The lens 
system of FIG. 3 is provided with a pair of anterior tabs 3 and 3' 
extending from a portion of the circumferential edge 2 to optical zone 1. 
The tabs illustrated herein are shown slightly offset from each other, 
however, they may be simply arranged to extend parallel to each other. 
Oppositely disposed from anterior tabs 3 and 3' and spaced apart therefrom 
are posterior tabs 13 and 13', (not shown), extending from loop 11. The 
lens further includes pins 7 and 7' arranged to pass through hole 4 and 4' 
so as to be received in posterior tabs (not illustrated). The lens system 
further should preferably contain groove 6 and 6' and slot 18 and 18'. 
FIGS. 4 and 5 illustrate another arrangement of the lens system in 
accordance with this invention. In accordance with this embodiment, the 
lens system is substantially reduced in weight. As illustrated, optical 
zone 1 is provided to be embedded in annular haptic rim 19 which is U 
shaped in cross-section so as to receive a portion of the iris thereabout. 
Haptic rim 19 is further provided with extensions in the form of anterior 
tab 3, posterior tab 13 and anterior tabs 20 and 20' and posterior tabs 21 
and 21'. Tabs 20 and 21' are oppositely disposed and spaced apart from 
tabs 21 and 21' so as to receive a portion of the iris therein whereby 
constriction and dilation of the iris is not substantially obstructed or 
interferred with by these haptic support means. As described above 
posterior tab 13 is oppositely disposed and spaced apart from tab 3 and 
provided with hole 14 for receiving the free end of hook portion 9 of pin 
7. Pin 7 is preferably secured and embedded in haptic rim 19 at a point 
slightly outwardly from the inner portion of said rim. 
In order to reduce the weight of the lens system, tabs 20 and 20' are 
provided with holes 22 and 22' of substantial size. 
Posteriorly within the inner portion of haptic rim, there is provided 
groove 24. By slightly bending the rim, lens optical zone 1 in the shape 
of a convex lens is inserted into the groove 24 and locked in place upon 
snapping haptic rim back into normal position. As illustrated in FIGS. 4 
and 5, the U shaped annular haptic rim is in the form of a collar button 
having a hollow 25 in its center thereby providing a hole for the passage 
of light. 
Upon inserting the lens illustrated in FIGS. 4 and 5 into the eye, optical 
zone 1 would be situated in the posterior chamber of the eye. By placing 
groove 24 essentially within the apex of the U shaped rim the lens system 
can be arranged such that upon insertion optical zone 1 would be situated 
substantially within the iris plane of the eye. 
FIGS. 6 and 7 illustrate another lens system configuration. The 
circumferential edge 2 of optical zone 1 has extending therefrom an 
annular haptic rim 19 of U-shaped cross-section. Anterior tab 3 and 
posterior tab 13 extend from a portion of the haptic rim and are provided 
with holes 4 and 14 to receive and hold perpendicularly therebetween hook 
portion 9 of pin 7. The secured end of pin 7 is embedded in the optical 
zone slightly inwardly from the circumferential edge of said optical zone. 
Additional supportive means are provided by anterior tabs 20 and 20' and 
posterior tabs 21 and 21', (not shown). However, these tabs may be 
substituted with loops, rods, or other well-known means for support of 
intraocular lenses. 
The slot means 18 is shown here as a groove or hole crossing groove 9 
transverse as compared with the round shaped depression described in the 
previous figures. 
FIGS. 8 and 9 illustrate still another lens system combination comprising 
posterior tab 13 and anterior tab 3 for receiving a pin 7 perpendicularly 
therebetween. As illustrated, Anterior tab 3 includes locking means 26 so 
as to hold the pin securely upon the pin being inwardly pushed into 
position b. 
FIGS. 10, 11, 12 and 13 illustrate additional means of securing pin 7 
perpendicularly between the anterior and posterior tabs. In FIG. 10 there 
is illustrated a pin which is pivotally secured to a hinge pin 27 embedded 
in the haptic rim portion of the anterior tab 3. The hooked portion is 
further provided with shoulders which prevent forward or backward movement 
of said pin upon said pin being inwardly pivoted to a position b. 
FIG. 11 illustrates a threaded pin 28 which is received by threaded holes 
29 and 30 of anterior and posterior tabs 3 and 13. In operation the lens 
comprising optical zone 1 and haptic rims, rods and/or loops would be 
positioned in the eye and thereafter the operating physician would merely 
screw threaded pin 28 into threaded holes 29 and 30 thereby penetrating 
the iris located in the posterior and anterior haptic parts so as to 
positively fix the lens in the eye. 
FIG. 12 illustrates another form of pin and locking means. The straight pin 
7 is passed through holes 4 and 14 and positioned as in c. The portion of 
the pin extending outwardly beyond the anterior tab 3 is then bent down 
and secured into the groove 31 which is cut into anterior tab 3. 
FIG. 13 illustrates another form of pin 7 wherein the pin is provided with 
detents 32 and 32' thereby preventing removal of the pin which is secured 
and positively affixed through the iris. 
In another embodiment of the invention there is provided an intraocular 
lens which is essentially weightless relative to the median in which the 
lens is surrounded. In FIGS. 14 and 15, there is illustrated an 
intraocular lens system comprising an annular haptic rim of U-shaped 
cross-section further including tab extensions 3 and 13 including holes 4 
and 14 and pivotable pin 7 having straight portion 8 and hook portion 9 
connected by bight portion 10, groove 6 and slot 18 for facilitating easy 
removal of the pin should such a need arise. The optical zone 1 is 
contained within the annular haptic rim including a high plus lens 33 and 
spaced apart therefrom a plano lens 34. The space therebetween being 
airtight. The absence of material between the plano and plus lens further 
reduces the weight of this lens system. In addition to the space between 
the plano and plus lens one may further reduce the weight of this lens 
system by cutting holes in various portions of the haptic rim and other 
supporting means. 
FIGS. 16 and 17 illustrate another modification of maintaining the pin in 
position. In accordance with this embodiment the pin is inserted through 
holes 4; and 14 and the pin extension is bent over the edge of anterior 
tab 3 which is provided with a shoulder for receiving said bent portion of 
the pin. 
The materials of which the intraocular lens system of this invention can be 
formed are well known in the art, for example, the lens system including 
optical zone, haptic rims, tabs and loops can be made from any optically 
clear plastic material such as polymethylmethacrylate resin (Perspec CQ, 
Imperial Chemical Industries, Ltd., Great Britain). The pins are 
preferably made from an inert metal such as platinum or titanium or from a 
polymeric material such as isotatic polypropylene. 
Preferably, the optical zone is formed of an optically clear plastic 
polymeric material such as polymethylmethacrylate and the haptic parts 
including haptic rims loop and tabs can be made of polypropylene. 
Polymethylmethacrylate having a density of approximately 1.12 and 
polypropylene having a density of approximately 0.91 would provide a lens 
system having a density approaching that of the aqueous median in which 
the lens is surrounded in the eye and hence would the lens be essentially 
weightless within the eye. 
In operation, the tab extensions and particularly the positioning of the 
pins within the tabs should be such that the pin penetrates the iris 
beyond the sphincter and dilator muscles of the eye. 
Illustrated in FIGS. 18 and 19 is a tool 35 particularly adapted for use in 
the insertion of, for instance, assembly illustrated in FIG. 2. Tool 35 
includes first 36 and second 37 spring members. Member 36 includes a first 
portion 38, a second portion 39 and a third portion 40. The free end of 
third portion 40 includes a gripping portion 41 having a groove 42 (FIG. 
20) provided therein. Member 37 includes a first portion 43, a second 
portion 44 and a third portion 45. As with member 36, the free end of 
portion 45 is provided with gripping portion 46 having a groove 47 
provided therein. Member 37 also includes a stub pin 47a to limit the 
relative inward movement between members 36 and 37. As is evident from 
inspection of FIGS. 18 and 19 groove 42 and 47 are dramatically opposed 
for gripping a tab member, such as tab 3 (FIG. 1) therebetween. As is also 
evident from inspection of FIGS. 18 and 19, attached to third portions 40 
and 45 is a generally elongated, U-shaped actuator member 48, including 
leg portions 49 and 50 and cross member 51. Member 48 is made of spring 
material with, as illustrated in FIG. 19 cross member 51 biased away from 
gripping portions 41 and 46. 
As those skilled in the art will appreciate, member 48 may be replaced 
with, for instance, a single elongated member attached to one of third 
portions 40, 45 and having an L or T-shaped free end. 
In operation, tab 3 illustrated in, for example, FIG. 1 is held in grooves 
42 and 47 of gripping portions 41 and 46, as illustrated in FIGS. 20 and 
21. The spring tension of members 36 and 37 in conjunction with the 
configuration of gripping portions 41, 46 and the configuration of tab 3 
insure that tab 3 is securely held without any pressure applied to holding 
portions 38 and 43. With the cornea held back and the natural lens 
removed, the lens system is inserted in the eye so that tab pairs 3 and 13 
capture the iris therebetween. Any further support means are also properly 
positioned. With the lens system positioned, pressure is then applied to 
actuator member 48 which forces pin 7 through the iris and into opening 4 
provided in tab 13 to securely hold the lens system within the eye. 
It will be apparent to those skilled in the art that various modifications 
of the artificial intraocular lens described herein can be made without 
departing from the spirit and scope of the invention. For instance, the 
number of anterior and posterior tabs for positioning a pin perpendicular 
therein may be varied. Materials other than those described herein may be 
suitably employed for forming the artificial intraocular lens systems, the 
materials disclosed herein merely being illustrative. The dimensions of 
the artificial intraocular lenses may be changed as required by the 
operating physician and the patient to be fitted.