INTRAOCULAR LENS INSERTION INSTRUMENT

Abstract: An insertion instrument provides improved features for insertion of a lens into the eye through a small incision. A tubular member (22) has a lumen (21) and a split nozzle (25) end portion for spreading after insertion. Ridges (33) on the lumen wall prevent rotation of the lens, and stabilizer components (45, 48, 50) extend from a plunger end portion to maintain the lens compressed and to prevent lens rotation in moving through the lumen.

Description: Description INTRAOCULAR LENS INSERTION INSTRUMENT Technical Field The present invention addresses problems related to the insertion of an intraocular lens through a small incision in the human eye. Reference is made to Applicant's related International Application No. PCT/US 9/20661 wherein are illustrated and described certain relevant features and components, which application is incorporated herein by reference. In recent years, foldable intraocular lenses have largely replaced hard, rigid lenses, the foldable lens being insertable through an incision of approximately one-half the size of an incision required for rigid lenses. A small incision enables more rapid recovery, less discomfort for a patient, and avoids many of the possible adverse complications of cataract surgery. Further, the procedure requires less time because suturing is not required. The problems addressed include undesirable rotation of a folded, compressed lens during passage through a lumen or tubular passage, the maintaining of the correct orientation of a lens relative to an insertion instrument, sudden expansion of unfolding of a compressed lens as it exits the insertion instrument into the eye, and difficulty in insertion of a tip of an insertion instrument into a small incision in the eye of a patient. Although various folding forceps have been provided for folding flexible lenses, it has generally been preferred by surgeons to utilize insertion devices whereby a lens enters the eye through a tube. Folding forceps devices generally comprise two components in addition to a lens, thus requiring two hands for their utilization. The improvements according to the invention include a plunger with stabilizing components thereon to exert forces on a folded lens to maintain the lens in folded configuration and to prevent rotation of the lens relative to a lumen wall. One or more slits in the nozzle end portion enable the spreading of the end portion by passage therethrough of the folded lens after insertion in the eye of a patient, thus to provide ease of admission of the folded lens into the eye of a patient. Ridges extend longitudinally of the lumen wall to aid in prevention of rotation of a folded lens relative to the lumen wall, these including ridges extending along opposite edges of at least one slit in the nozzle end portion of the insertion instrument to aid in the prevention of rotation of a folded lens relative to the lumen wall . Brief Description of Drawings Figure 1 is an exploded perspective view of an insertion instrument of the present invention showing its receptacle actuator, tubular portion and nozzle; Figures 2 and 3 are sectional views of the instrument of Figure 1 , showing a lens optic and haptics in folded configuration in the lumen with the nozzle tip inserted through an incision in the eye of a patient; Figure 4 is an enlarged fragmentary view of the nozzle portion, showing the nozzle tip portion inserted via an incision in the eye of the patient, and the lens expanding within the eye; Figure 5 is a perspective view of a plunger and stabilizer components thereon, according to the present invention; Figure 6 is a perspective cutaway view of the plunger and stabilizers thereof in relation to a folded lens optic and haptics in the lumen of the instrument of Figures 2 and 3; Figure 7 is an enlarged partial sectional view, taken at line 7-7 in Figure 6; Figures 8, 9 and 10 are sectional views taken at lines 8-8, 9-9, and 10-10 in Figure 1, showing a folded lens in different configurations in the plunger at successive positions in moving through the lumen; and Figures 11A and 11B are sectional views showing the interrelationship among the ram, lumen and lens in the folding of the lens into folded configuration in a pre-insertion position in the lumen-tube . Best Mode For Carrying Out the Invention Referring to the drawings, there is shown an improved insertion instrument 10 for inserting an intraocular lens into a patient's eye via a small incision. The instrument generally includes a lens insertion assembly 12 and an insertion actuator 14. The lens insertion instrument is adapted to receive a foldable intraocular lens 16 in an unfolded configuration. As utilized herein for purposes of description, the terms "horizontal", "vertical", "upward" and "downward" are defined in relation to preferred orientation normally employed by a surgeon in using the instrument in the insertion of an intraocular lens into the eye of a patient. In this context, "horizontal" is a longitudinal direction of the instrument and plunger as indicated in Figures 1 and 5, and "vertical" is the direction perpendicular to such horizontal orientation. However, the insertion instrument may be utilized in other orientations. The lens insertion assembly 10 includes a receptacle 18 and an elongate tubular portion 20 which has an interior passage or lumen 21, a nozzle 22, and a tip 24 for insertion into the eye, the nozzle having a longitudinal slit 25, as shown. The nozzle and tubular portion may typically be fabricated of polycarbonate, polyethylene, polystyrene, or other plastic with adequate flexibility. The lumen or bore 21 extends axially through tubular portion 20, and has a longitudinal central axis. The receptacle 18 is preferably formed integrally with the tubular portion and has a lens storage chamber 26 extending laterally of the bore through an opening (not shown) in the wall of the bore . The foldable lens 16 is formed of appropriate flexible optical lens material, and has a central optic 28 and generally flat plate haptics 30 joined to opposite edges of the optic in a generally common plane transverse to the optic axis. Other types of foldable lenses may be utilized. The lens storage chamber 26 receives the lens in its unfolded configuration. A ram 32 serves as lens transfer and folding means, and cooperates with the chamber and receptacle 18 to define the lens storage space. The ram is operable by the user to move the unfolded lens from this storage position into the lumen or bore 21 (Fig. 11A) via the opening in the bore wall, and to fold the lens into a compact folded configuration with the lens in a pre-insertion position in the bore or lumen (Fig. 11B). The ram and receptacle have mating interfitting male and female configurations of slots 34 and ram wing portions 36. Referring to Figures 11A and 11B, the inner end of the ram has an arcuate end face 38 across which extends a transverse ridge 33 which is aligned with the longitudinal axis of the bore or lumen 21. The inner curvature 38 of the ram is curved like the inner surface of the bore or lumen (Fig. 11B). The end surface or face 38 of the ram is flush with the inner wall surface of the lumen and faces the opposing wall surface of the bore. A plunger 40 (Fig. 5) constitutes a lens insertion device for moving the folded lens 28, 30 (Fig. 6) through the lumen and the nozzle tip 24 to urge the lens through the tip and into the eye of the patient. The lens is wrapped about the end portion of the plunger as it moves through the lumen, as indicated in Fig. 6. A reduced, flat portion 44 of the plunger has extending therefrom a generally vertical stabilizer 46 and a horizontal stabilizer having oppositely extending wing portions 48, 50, as shown. A generally vertical reinforcing rib 56 extends from the vertical stabilizer 46 to provide rigidity. The end portion 54 of the plunger is recessed and concave, thus to better engage the end portion of a folded lens for accurately urging of the lens through the lumen. Manual operation of insertion actuator 14, which is preferably a rack and pinion arrangement, as shown, causes the end of plunger 40 to engage the lens in its pre-insertion position, and to urge the lens along the lumen toward nozzle 22 and tip 24, and thence into the eye of the patient. A longitudinal ridge 58 is defined on the lumen wall (Fig. 8) and is aligned with ridge 33 on the inner ram surface to prevent rotation of the lens relative to the lumen wall. Ridges 60, 62 are defined at opposite edges of slit wall. These ridges retain the lens against rotation relative to the lumen wall during movement along the lumen. In moving through the lumen and nozzle, the folded lens has the successive configurations indicated in Figures 8, 9 and 10, the lens being gradually opened to the configuration of Figure 10. In passing through the nozzle and the outlet or tip 24, the slitted end portions of the nozzle and tip are spread open, the spreading being limited by the sides of the incision in the eye. Thus there has been shown and described an intraocular lens insertion instrument which fulfills all the objects and advantages sought therefor. Many changes, modifications, variations and other uses and applications of the subject invention will, however, become apparent to those skilled in the art after considering this specification together with the accompanying drawings and claims. All such changes, modifications, variations and other uses and applications which do not depart from the spirit and scope of the invention are deemed to be covered by the invention which is limited only by the claims which follow.

Claims: Cl aims 1. An insertion instrument for delivery of an intraocular lens into a human eye through a small incision, said apparatus including: an elongate generally tubular member having a longitudinal axis and defining a lumen, said tubular member having a tapered nozzle portion defining an outlet end opening for release of the lens into the eye, and having a lens insertion opening spaced from said outlet end opening, a plunger for urging the lens through the lumen and outwardly therefrom into the eye, a lens receptacle defining a lens chamber communicating with said lens insertion opening in said tubular member, said lens receptacle having oppositely laterally extending slot portions, a ram slidable in said lens chamber and having laterally oppositely extending wing portions slidable in said lens receptacle slot portions, and said ram having an end portion contoured to cooperate with an inner lumen wall to fold the lens into a folded pre-insertion configuration. 10 2. An insertion apparatus according to Claim 1, wherein : at least one slit is defined in the tapered nozzle portion to facilitate the spreading of the nozzle portion upon movement therethrough of the lens. 3. An insertion apparatus according to Claim 1 , and further including: a ridge extending longitudinally on the lumen wall from said lens insertion opening in the direction of said nozzle portion for prevention of rotation of the folded lens relative to the lumen wall. 4. An insertion apparatus according to Claim 1, and further including: a lens receptacle spaced from said nozzle portion and defining a slit in communication with said lumen insertion opening, a ram slidable in said receptacle slot and having an inward portion contoured to cooperate with the lumen wall to fold the lens into a folded configuration in a pre-insertion position. 5. An insertion apparatus according to Claim 1, and further including: a ridge on said inward portion of the ram and positioned and adapted to retain the folded lens against rotation relative to said inner lumen wall . 6. An insertion apparatus according to Claim 5, wherein said ridge on the ram inward portion is aligned with said ridge extending longitudinally on the lumen wall. 7. An insertion apparatus according to Claim 1, wherein: the plunger has a forward portion recessed and configurated to engage the end portion of a folded lens haptic to accurately urge the lens through the lumen. 8. An insertion apparatus for delivery of an intraocular lens into a human eye through a small incision, said apparatus including: an elongate generally tubular member having a longitudinal axis and defining a lumen, said tubular member having a tapered nozzle portion defining an outlet end opening for release of the lens into the eye, means for insertion into the lumen of said lens via an insertion opening in the tubular 12 member with said lens in a folded condition, plunger means for urging the lens through the lumen and outwardly therefrom into the eye, and at least one stabilizer extending outwardly from a forward end portion of the plunger to exert force on the folded lens to maintain the lens in predetermined orientation and in folded configuration during movement of the lens through the lumen. 9. A lens insertion apparatus according to Claim 8, wherein: the stabilizer element is an optic stabilizer extending upwardly and forwardly of the forward end portion of the plunger to engage the folded optic of the lens to urge it downwardly and forwardly toward the nozzle portion. 10. A lens insertion apparatus according to Claim 9, wherein the stabilizer element slidably engages the lumen wall. 11. A lens insertion apparatus according to Claim 8, wherein: said stabilizer is a plate stabilizer extending laterally outwardly from the forward 13 end portion of the plunger to overlay and exert pressure on a folded lens haptic for maintaining a haptic in folded configuration and correctly oriented during movement through the lumen. 12. A lens insertion apparatus according to Claim 8, wherein : two plate stabilizers extend oppositely from said plunger end portion to act on a lens haptic to maintain it in folded configuration and correctly oriented during movement through the lumen . 13. An insertion apparatus for delivery of an intraocular lens into a human eye through a small incision, said apparatus including: an elongate generally tubular member having a longitudinal axis and defining a lumen, said tubular member having a tapered nozzle portion defining an outlet end opening for release of the lens into the eye, means for insertion into the lumen of said lens via an insertion opening in the tubular member with said lens in a folded condition, plunger means for urging the lens through the lumen and outwardly therefrom into the eye, said tapered nozzle portion having defined 14 therein at least one longitudinal slit extending to said outlet opening for resilient spreading of the tapered nozzle portion upon movement therethrough of the lens, an optic stabilizer extending forwardly and upwardly of the forward end portion of the plunger to engage the folded optic of the lens to urge it downwardly and forwardly, and at least one plate stabilizer extending 10 laterally outwardly from the forward end portion of the plunger to overlay and exert pressure on a lens haptic to aid in maintaining the haptic in folded configuration and properly oriented during movement through the lumen. ^5 14, An insertion apparatus according to Claim 13, wherein : the plunger has a forward end face recessed and configurated to engage the trailing end portion of a folded lens haptic for accurate 0 engagement to urge the lens through the lumen from its pre-insertion position through the lumen and outwardly into the eye of a patient. 15. An insertion apparatus according to Claim 13, and further including: a ridge extending longitudinally on the lumen wall from the lens insertion opening and toward said nozzle portion to prevent rotation of the folded lens relative to the lumen wall during movement through the lumen. 16. An insertion instrument according to Claim 1, and further including: ridges defined on the lumen wall and extending along opposite edges of the at least one slit to retain the lens against rotation relative to the lumen wall during movement through the nozzle. 17. An insertion instrument according to Claim 3, and further including: ridges defined on the lumen wall and extending along opposite edges of the at least one slit to retain the lens against rotation relative to the lumen wall during movement through the nozzle. 18. An insertion instrument according to Claim 5, and further including: ridges defined on the lumen wall and extending along opposite edges of the at least one slit to retain the lens against rotation relative to the lumen wall during movement 16 through the nozzle. 19. An insertion instrument according to Claim 13, and further including: ridges defined on the lumen wall and extending along opposite edges of the at least one slit to retain the lens against rotation relative to the lumen wall during movement through the nozzle. 20. An insertion instrument according to Claim 15, and further including: ridges defined on the lumen wall and extending along opposite edges of the at least one slit to retain the lens against rotation relative to the lumen wall during movement through the nozzle. 21. An insertion apparatus according to Claim 8, wherein : said ram comprises a ram member slidably mounted for movement through said insertion opening, and said ram has an end portion contoured to cooperate with an inner wall of said lumen to fold the lens into a folded pre-insertion configuration . 22. An insertion apparatus according to Claim 13, and further including: a ridge extending longitudinally on the lumen wall from said lens insertion opening in the direction of said nozzle portion for prevention of rotation of the folded lens relative to said lumen defined by the tubular member . 23. An insertion apparatus according to Claim 11, and further including: a lens receptacle defining a lens chamber communicating with said lens insertion opening in said tubular member, and said ram means is slidable in said lens chamber. 24. An insertion apparatus according to Claim 23, wherein : said ram has an end portion contoured to cooperate with an inner lumen wall to fold the lens into a folded pre-insertion configuration.

Inventors: CUMMING J STUART, CUMMING, J., STUART
Applicants: CUMMING J STUART, CUMMING, J., STUART
Application year: 1999
Main classification: A61F9
IPC codes: A61F2, A61F9