Patent Publication Number: US-8968398-B2

Title: Pre-loaded IOL insertion system

Description:
RELATED APPLICATIONS 
     This application is a divisional application of and claims priority to U.S. application Ser. No. 13/623,953 filed on Sep. 21, 2012, which is a divisional application of and claims priority to U.S. application Ser. No. 12/144,512 filed on Jun. 23, 2008, now U.S. Pat. No. 8,273,122, both of which are hereby incorporated by reference in their entirety. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates to devices, systems, and methods for delivering an intraocular lens into an eye. More particularly, the invention relates to devices, systems, and methods in which the intraocular lens is loaded into the front end of the device. 
     BACKGROUND OF THE INVENTION 
     It is estimated that 73% of Americans between the ages of 65 to 74 get cataracts. A cataract is a clouding of the eye&#39;s lens that impairs a person&#39;s vision and, if left untreated, causes blindness. As a result, each year approximately 1.4 million people in the United States alone undergo cataract surgery, whereby the clouded natural crystalline lens is removed and replaced with an intraocular lens (IOL) implant. 
     Surgeons implant IOLs not only as a replacement for the natural crystalline lens but also to alter the optical properties of (provide vision correction to) an eye in which the natural lens remains. IOLs often include an optically clear disk-like optic of about 6 mm in diameter, and preferably at least one flexible fixation member or haptic which extends radially outward from the optic and becomes affixed in the eye to secure the lens in position. 
     The optics may be constructed of rigid biocompatible materials such as polymethyl methacrylate (PMMA) or deformable materials such as silicone polymeric materials, acrylic polymeric materials, hydrogel polymeric materials, and the like. The deformable materials allow the IOL to be rolled or folded for insertion through an injector or insertion cartridge and an incision into the eye. Once within the chamber of the eye, the IOL is expulsed from the injector and returns to its original shape. 
     Injectors or inserters for delivering IOLs into the eye typically employ a handpiece and a removable cartridge that receives the IOL and has a hollow insertion tube or cannula through which the folded IOL is passed using a push rod. Some inserters do without the cartridge. The inserter may be wholly or partly reusable, in which case the inserter or handpiece is usually made of some type of metal alloy that can be sterilized. Alternatively, disposable inserters made of less expensive materials, such as plastics, remain in a sterile package until ready for use. In all cases, the IOL is stored separately and transferred to a load chamber in the inserter or cartridge just prior to delivery. One particularly useful arrangement wherein the cartridge folds over an IOL is disclosed in U.S. Pat. No. 4,681,102 to Bartell. A cartridge opens to receive an IOL in a load chamber, and then folds closed and fits into an injector. A syringe-like plunger in the injector pushes the IOL from the load chamber through a tapered tube into the eye. The IOL unfolds as it emerges from the tip of the tapered tube. Another such insertion system is disclosed in Makker et al., U.S. Pat. No. 5,942,277. 
     One problem encountered with existing inserters is difficulty in loading the IOL into the inserter or cartridge. The IOL is typically manually moved from a sterile environment to an inserter or associated cartridge using forceps or tweezers. Manual transfer of the IOL presents difficulties in maintaining both sterility of the IOL and the correct orientation of the IOL, especially the haptics, within the cartridge or inserter. A wide variety of performance and outcomes results even with highly skilled personnel, and those having less training are more likely to perform poorly. Improper orientation of the IOL can result in inadequate surgeon control and even damage to the IOL during delivery into the eye. 
     These problems may be mitigated by preloading the IOL at the manufacturer into a cartridge or container that is designed to be included directly in the inserter. The cartridge or container may be attached to the inserter either at the manufacturer or by the user just prior to surgery. The IOL is stored directly in the inserter in an unstressed state in a sterile package in order to prevent deformation of the optic element. A transfer process is not generally necessary for loading the IOL into the inserter. One example of storing an IOL in an inserter component is seen in U.S. Pat. No. 7,156,854, filed May 28, 2003. In the &#39;854 patent, a nozzle portion  12  along with a removable stop  26  retains the IOL therein during storage and has internal ramps that assist in folding the IOL optic during an implant procedure. Also, U.S. Patent Publication No. 2008-0058830, filed Jul. 17, 2007, discloses a number of configurations for pre-loading IOLs for transfer to an insertion apparatus, and is expressly incorporated herein. 
     Despite some advances in this area, there remains a need for devices, systems, and methods that facilitate the placement of IOLs into an inserter or cartridge to reduce the problems associated with manual IOL manipulation. 
     SUMMARY OF THE INVENTION 
     The present invention relates to devices, systems, and methods for delivering an intraocular lens into the eye of a subject or patient that addresses at least some of the problems discussed above. 
     In accordance with one aspect of the invention, a system for delivering an intraocular lens (IOL) into the eye of a subject comprises an IOL having an optic, a leading haptic, and a trailing haptic. An IOL insertion system has a handpiece defining therein a holding station for receiving the IOL, the holding station including internal features that contact the leading and trailing haptics. An actuator displaces the IOL from the holding station in a distal direction along an axis, wherein one of the internal features of the holding station folds the leading haptic across the optic as the IOL is displaced in the distal direction. Also, a delivery tube has a proximal end open to the holding station along the axis to receive the IOL displaced by the actuator. The delivery tube defines a load chamber into which the IOL first enters, and the load chamber has dimensions that prevent unfolding of haptics. 
     Preferably, the holding station further includes an opening to the exterior thereof and passing over the trailing haptic of the IOL. The holding station may have a base and a cover that are hingedly connected and which may be unfolded for receiving an IOL therein. Also, the hinged base and cover may define a cavity that is sized to receive and retain the delivery tube such that the open proximal end thereof registers with an open distal end of the holding station, wherein the delivery tube and IOL are captured upon closure of the hinged base and cover. In a preferred embodiment, the actuator comprises a rod that translates linearly through the holding station and a substantial portion of the delivery tube. Furthermore, one of the internal features that contacts the trailing haptic may be a deflector rail that projects into the load chamber of the delivery tube. 
     The present invention also defines a method of packaging and delivering an IOL having an optic and leading and trailing haptics to a patient&#39;s eye. The method includes pre-loading an IOL in an insertion system, in that the IOL is packaged with the insertion system. The insertion system has a handpiece defining therein an IOL holding station for receiving the IOL, and an actuator adapted to displace the IOL from the holding station in a distal direction. The insertion system further includes a delivery tube adjacent the IOL holding station having an open proximal end for receiving the IOL displaced by the actuator. The method involves inserting a tool through an opening in the JUL holding station and manually repositioning a trailing haptic of the IOL over the IOL optic. The actuator displaces the IOL in the distal direction, and the IOL holding station has internal features that reposition the leading haptic of the IOL over the IOL optic and maintain the trailing haptic positioned over the IOL optic as the IOL is displaced. Finally, the delivery tube has an internal load chamber shaped to receive the IOL from the holding station and maintain the leading and trailing haptics positioned over the IOL optic. In the aforementioned method, the opening is desirably sized to receive a cannula of a viscoelastic applicator. A retaining pin may extend from the holding station into contact with the IOL to prevent movement of the JUL during repositioning of the trailing haptic of the IOL over the IOL optic. The internal feature that maintains the trailing haptic positioned over the IOL optic may be a deflector rail that projects into the load chamber of the delivery tube. The actuator preferably includes a detent feature that signifies to a user when the actuator has displaced the IOL into the load chamber, and the method includes displacing the IOL into the load chamber until the detent signifies its position, pausing, and then displacing the IOL farther through the delivery tube into a patient&#39;s eye. 
     Another aspect of the invention is an IOL insertion system, comprising a handpiece, a delivery tube, and an actuator. The handpiece defines a holding station which comprises a base for receiving an IOL and a cover that fits over the base and structure for contacting the IOL. The cover is hinged to the base to enable the cover to be open for introduction of the IOL to the base, and folded closed to capture the IOL and/or the delivery tube. The holding station further includes an open distal end. The delivery tube has an open proximal end and a distal tapered end. An exterior of the delivery tube is sized and shaped to fit within a cavity defined by the hinged holding station cover and base such that closing the cover over the base also captures the delivery tube with the open proximal end thereof in registration with the open distal end of the holding station. The actuator is adapted to displace the IOL from the holding station in a distal direction into the open proximal end of the delivery tube. In one embodiment, the system consists at most of five separate parts: the delivery tube, the handpiece in one or two parts, the actuator; and an O-ring that fits in the handpiece and damps movement of the actuator. The holding station may include an internal deflector member that contact and folds the leading haptic across the optic as the IOL is displaced in the distal direction. Desirably, the delivery tube has a load chamber into which the IOL first enters, the load chamber having dimensions that prevent unfolding of leading haptic. Preferably, the holding station includes an internal deflector rail and an opening to the exterior thereof and passing over the trailing haptic of the IOL, wherein a tool may be inserted in the opening to fold the trailing haptic over the IOL optic into contact with the deflector rail. In one embodiment the deflector rail extends into the open proximal end of the delivery tube and maintains the trailing haptic folded over the IOL optic as the IOL is displaced in the distal direction into the delivery tube. 
     The present invention also provides a method of assembling an IOL insertion system, comprising providing a handpiece defining therein a holding station for receiving the IOL. The holding station has a base for receiving an IOL and a cover that fits over the base and including structure for contacting the IOL. The cover is hinged to the base to enable it to be folded open for introduction of the IOL to the base, and the holding station further includes an open distal end. A delivery tube is provided having an open proximal end and a distal tapered end. An exterior of the delivery tube is sized and shaped to fit within a cavity defined by the hinged holding station cover and base. The holding station cover is folded open, an IOL is placed in the holding station base, and the delivery tube is positioned in the cavity defined by the holding station. The holding station cover is then folded closed over the base to capture the IOL and the delivery tube between the cover and base with the open proximal end thereof in registration with the open distal end of the holding station. 
     The method may further include inserting a tool through an opening in the IOL holding station and manually repositioning a trailing haptic of the IOL over the IOL optic, wherein the opening is sized to receive a cannula of a viscoelastic applicator. The IOL may be displaced with a handpiece actuator through the holding station and delivery tube, the IOL holding station further including internal features that reposition the leading haptic of the IOL over the IOL optic as the IOL is displaced in the distal direction and maintain the trailing haptic positioned over the IOL optic. The method of assembly may be accomplished manually, or with the assistance of robotic or otherwise automated assembly equipment. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Embodiments of the present invention will be better understood from the following detailed description when read in conjunction with the accompanying drawings. Such embodiments, which are for illustrative purposes only, depict the novel and non-obvious aspects of the invention. The drawings include the following figures, with like numerals generally indicating like parts: 
         FIG. 1  is an assembled perspective view of an insertion system according to an embodiment of the invention; 
         FIG. 2  is an exploded perspective view of the insertion system of  FIG. 1 ; 
         FIG. 3  is an exploded perspective view of an alternative insertion system similar to that shown in  FIG. 2  but with a preferred final mold configuration; 
         FIGS. 4A-4C  are several perspective views of a cover for a lens holding station of the insertion system of the present invention; 
         FIG. 5  is an upper perspective view of the lens holding station of the insertion system of the present invention showing an intraocular lens (IOL) positioned within a base and with the holding station cover removed; 
         FIG. 6  is the same perspective as  FIG. 5  but with the holding station cover shown opaque; 
         FIG. 7  is the same perspective view as  FIGS. 5 and 6  with the holding station cover shown solid and illustrating manipulation of a trailing haptic of the IOL with a tool; 
         FIG. 8  is a view similar to that of  FIG. 6  but showing the position of the trailing haptic after having been folded over the optic of the IOL with the tool of  FIG. 7 ; and 
         FIGS. 9A-9D  are horizontal cross-sections, looking upward along line  9 - 9  of  FIG. 7 , of an IOL in phantom within the insertion system of the present invention showing several steps in folding haptics of the IOL and transferring the IOL to a delivery tube. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The present invention facilitates the process of delivering an intraocular lens (IOL) into a patient&#39;s eye using an inserter. The IOL is typically implanted using an injector that rolls, folds, or otherwise configures the lens for delivery through a small incision in the eye in a way that reduces trauma and expedites post-surgery healing. The IOL is stored and transferred to a funnel-shaped delivery tube just prior to delivery. The injector or injector/cartridge is generally used in a manner like a hypodermic needle, with the IOL being injected into the eye through a delivery tube. The injector, cartridge and/or delivery tube may be first partially filled with a liquid or gel lubricating agent, for example a viscoelastic material. These are commonly used techniques for delivering an IOL into a patient&#39;s eye, and the present invention will be described in the same context. However, it should be understood that certain principles of the present invention can apply to modified systems, such as those that do not use a syringe-style injector or a funnel-like delivery tube. 
     Moreover, the present invention provides a system in which an IOL is pre-loaded within an inserter component to eliminate the need to manually transfer the IOL from a separate package to an inserter or cartridge. The term pre-loaded means that the IOL is packaged with the insertion system, and not separately, which would require transfer of the IOL to the insertion system at the time of a surgical procedure. However, the present system may also be used with an IOL is package separately and combined with the inserter system after shipment and/or at the time of implant. Likewise, although various components may be molded together, these components can also be remotely separately and assembled. Also, the insertion systems described herein are especially suited for manipulating leading and trailing haptics of an IOL without the need for skill or training, but certain aspects of the present invention may be applicable to IOLs having haptics that do not require such manipulation. In general, the present invention should not be considered limited to particular IOL insertion configurations except as defined accordingly in the claims. 
       FIG. 1  illustrates an exemplary IOL insertion system  20  of the present invention comprising a syringe-style device having, generally, a handpiece  22 , a plunger  24 , and a delivery tube  26  on a distal end thereof. The system  20  is also shown exploded in  FIG. 2 , and the handpiece  22  and plunger  24  components are shown exploded in  FIG. 3  in a preferred mold configuration. 
     The IOL is shown in  FIG. 2  positioned between two halves of a holding station  30 . The TOL may comprise a central circular optic  32  having a leading haptic  34  and a trailing haptic  36  generally spirally extending therefrom. As mentioned above, the present invention is especially suited for manipulating this particular configuration of IOL, although certain aspects of the invention may be applicable to other IOLs. One exemplary IOL as illustrated is a one piece acrylic Tecnis® brand of aspheric IOL available from Advanced Medical Optics of Santa Ana, Calif. 
     With reference to  FIGS. 1 and 2 , the system  20  defines a longitudinal axis from the plunger  24  at a proximal end to the delivery tube  26  at a distal end. The plunger  24  includes a thumb cap  40 , a piston rod  42 , a narrower push rod  44  fixedly connected to and extending from the piston rod, and a distal tip  46 . In the illustrated embodiment, the distal tip  46  is forked to enable reliable capture of a proximal edge of the IOL optic  32 . The plunger  24  translates axially through an elongate passage defined within the inserter handpiece  22  and is configured to urge the IOL from a holding station  30  through the distal delivery tube  26 . In a general sense, the plunger  24  represents any actuator capable of displacing the TOL from the holding station  30  in a distal direction through a delivery tube or other such device. The plunger  24  therefore may be generally termed an actuator so as to encompass other prime movers that can perform the same function, such as a rotary actuators, threaded actuators, levers, etc. 
     The lower half of the holding station  30  comprises a base  50  that, in a preferred embodiment, forms a distal extension of a base portion  52  of the handpiece  22 . The upper half of the holding station  30  comprises a cover  54  that abuts a top portion  56  of the inserter handpiece  22 . In the illustrated embodiment, as seen in  FIG. 1 , the cover  54  and top portion  56  fit directly over the base  50  and base portion  52  to form the elongated handpiece  22 . The overall shape of handpiece  22  may be somewhat flattened in a plane parallel to the interface between the upper and lower components. For example, the handpiece  22  may be configured to have an external aspect ratio in a cross-sectional plane perpendicular to the longitudinal axis of at least 1.5, at least 2, or at least 2.5 over a predetermined length parallel to the longitudinal axis, the predetermined length being greater than 50 percent or greater than 75 percent of the total length of the handpiece  22 . As seen in  FIG. 2 , the IOL optic  32  is positioned approximately at a horizontal midplane of the inserter handpiece  22 , which plane also defines the orientation of handpiece. 
     The handpiece further includes a pair of proximal finger tabs  60   a ,  60   b , one on the base portion  52  and one on the top portion  56 . When an operator desires to depress the plunger  24 , he or she places the thumb of one hand on the thumb cap  40 , and index and middle fingers on respective finger tabs  60   a ,  60   b.  Squeezing the hand closed depresses the thumb cap  40 . The flattened orientation of the inserter handpiece  22  may be ergonomically designed to lessen the profile between the index and middle fingers and thus enhance comfort. The flattened nature of the handpiece  22  also provides torque leverage so that the operator can more easily rotate the handpiece about its longitudinal axis. 
     The exploded view of  FIG. 2  shows a central channel  70  in the handpiece base  52  for receiving the piston rod  42  and push rod  44 . A similar mating channel is also provided on the underside of the handpiece top portion  56 . A semi-circular groove  72  provided at the proximal end of the base  52  (and a similar mating groove on the underside of the top portion  56 ) receives an O-ring  74 . The piston rod  42  includes two circular grooves  76   a ,  76   b  spaced along its length that register with the O-ring  74 . Specifically, the piston rod  42  has an outer diameter slightly larger than the inner diameter of the O-ring  74 , while the grooves  76   a ,  76   b  each have an outer diameter that is the same or approximately the same as the inner diameter of the O-ring. As the piston rod  42  passes through the proximal end of the handpiece  42  it spreads apart the O-ring  74  resulting in a degree of friction between plunger  24  and the handpiece  22 , therefore damping of the movement of the piston rod  42  and/or the IOL. The O-ring  74  resiliently springs inward into each of the grooves  76   a ,  76   b  as they reach the proximal end of the handpiece. The grooves  76   a ,  76   b  and associated O-rings thus provide detents to movement of the plunger  24  through the handpiece  22 . 
     The system  20  is packaged with the plunger  24  retracted and the distal groove  76   a  in registry with the O-ring  74 . A technician or other user can prepare the system for an JUL insertion operation by applying the appropriate amount of a viscoelastic, manipulating the trailing haptic  36  as described below, and advancing the plunger  24  such that the proximal groove  76   b  registers with the O-ring  74 . This positive position indicator notifies the user that the system  20  is ready for the surgeon. The plunger  24  remains out of contact, or just touches, the IOL. 
       FIG. 2  is an exploded view of the components of the system  20  in the orientation in which they will be assembled. However, a preferred mold configuration results in a total of five (or possibly fewer) components for the entire system, not counting the IOL. The five components include the plunger  24 , the delivery tube  26 , the O-ring  74 , the handpiece top portion  56 , and the remainder of the handpiece including the holding station  30  and base portion  52 . It is possible that the handpiece top portion  56  could be formed along with the remainder of the handpiece, though the mold would be fairly complicated and expensive. Likewise, the delivery tube  26  could be incorporated into the handpiece  22 , but again for reasons of manufacturing economy they are separate. 
     The preferred mold configuration is seen in  FIG. 3 , with the holding station cover  54  connected by a pair of living hinges  80   a ,  80   b  to the base  50 . The base  50  includes a pair of bifurcated fingers  82   a ,  82   b  that meet a similar pair of bifurcated fingers  84   a ,  84   b  extending from the cover  54  at the living hinges  80   a ,  80   b.  The opposed pairs of aligned fingers  82 ,  84  are shaped so as to form slots therebetween when folded about the living hinges  80  and a central cavity  86  for receiving a delivery tube  26 , as best seen in the assembled view of  FIG. 1 . In this regard, the delivery tube  26  desirably comprises a rear-loading cartridge as shown, and as described in co-pending application Ser. No. 12/111,028, filed on Apr. 28, 2008, the contents of which are expressly incorporated herein. 
     As mentioned above, the present insertion system  20  advantageously enables pre-loading of an IOL so that manual handling is eliminated. As can be seen from the figures, assembly of the system may include placing an IOL in a shaped cavity in the holding station base  50  with the cover  54  folded open as shown in  FIG. 3  (and see  FIG. 5 ). Subsequently, a portion of, or the entire, delivery tube  26  is placed in the cavity  86  and the holding station cover  54  folded 180° about the hinges  80  over the top of the base  50 . A pair of resilient latches  88   a ,  88   b  in the cover  54  snap around a pair of mating recesses  90   a ,  90   b  in the base  50  to lock the two components together. An open distal end of the holding station  30  communicates directly with an open proximal end of the delivery tube  26 . The O-ring  74  is placed in the groove  72  and the handpiece top portion  56  snapped onto the base portion  52 . Because of the preferred material, polypropylene, mechanical snaps or similar expedients are used to couple the parts together, although adhesives or other means may be used with other materials. Insertion of the plunger  24  into the proximal end of the channel  70  completes the assembly. 
     The IOL holding station  30  defines internal features that contact the leading and trailing haptics  34 ,  36  of the IOL to manipulate them during an implant procedure so that they are expelled from the delivery tube  26  in a controlled fashion. A wide of internal features are contemplated for contacting and controlling placement of the haptics  34 ,  36 , and the following description of one embodiment should be considered exemplary only. 
       FIGS. 4A-4C  illustrate detailed features of the holding station cover  54 . After the IOL has been placed in the cavity in the base  50 , and the cover  54  closed over the top of the base, a pair of retaining pins  100 ,  102  may be configured to contact the IOL and maintain the IOL in a desired orientation during an implant procedure, and also help maintain it in the cavity in the base during storage and/or shipment. One of the retaining pins  100 ,  102  may be configured to contact a tip of one of the haptics  34 ,  36 , while another may contact the IOL optic  32 . More specifically, the first retaining pin  100  may be located closer to a proximal end  104  of the cover  54  contacts the tip of the trailing haptic  36 , and the second retaining pin  102  contacts an outer edge of the IOL optic  32  at a junction between the optic and the trailing haptic  36 . These pins  100 ,  102  prevent rotation of the IOL during manipulation of the trailing haptic  36 , as explained below. 
     The underside of the holding station cover  54  further includes internal features that contact and deform the leading and trailing haptics; namely, a leading haptic deflector member  110  and a trailing haptic deflector rail  112 . The deflector member  110  and deflector rail  112  act on the leading and trailing haptics  34 ,  36  as the IOL translates through the holding station  30 . The cover  54  further includes a central rib  114  that helps guide the distal tip  46  of the plunger  24  through the holding station  30 . 
     Prior to movement of the IOL, however, the trailing haptic  36  may be folded over the top of the IOL optic  32 , either manually or using an automated device. To accomplish that, the holding station cover  54  is provided with an opening, such as the slot  120  as seen in  FIG. 4C  located over the trailing haptic  36 , through which a tool may be inserted to manipulate the haptic, as will be explained below. 
       FIG. 5  shows the IOL in its position within the cavity in the base  50  of the holding station  30  (the holding station cover  54  as been removed to illustrate the internal placement).  FIG. 6  is the same view but showing a portion of the cover  54 , and specifically the location of the slot-shaped opening  120 . The opening  120  extends parallel to the longitudinal axis of the system  20  over the trailing haptic  36 , from a point proximal to the trailing haptic  36  to a point over the IOL optic  32 . As seen in  FIG. 5 , the base  50  may define a guide channel  121  opposite, parallel and co-extensive with the opening  120  in the cover  54 . 
     Now with reference to  FIG. 7 , a tool  122  having a narrow elongated portion  124  may be inserted through the opening  120  to move the trailing haptic  36 . In a preferred embodiment, the opening  120  is sized to receive a cannula of a viscoelastic applicator such as Healon® viscoelastic available from Advanced Medical Optics of Santa Ana, Calif. The viscoelastic applicator is commonly used during IOL insertions to lubricate the internal passages of the inserter and/or cartridge, and in this regard performs dual functions. In general, the opening  120  is sized to receive any hypotube-like applicator, such as the one illustrated. The tool  122  extends far enough such that tip of the elongated portion  124  fits within the guide channel  121  in the base  50 . The guide channel  121  terminates short of the position of the IOL optic  32 , and thus prevents contact between the tool and optic.  FIG. 8  shows the position of the trailing haptic  36  after having been folded over the IOL optic  32  by the tool  122 . This operation is extremely simple and does not require highly skilled personnel. 
       FIGS. 9A-9D  are horizontal cross-sections looking upward at an IOL in phantom within the insertion system  20 , showing several steps in folding the leading and trailing haptics  34 ,  36  of the IOL and transferring the IOL to the delivery tube  26 .  FIG. 9A  illustrates the storage position of the IOL against the holding station cover  54 . The precise positions of the retaining pins  100 ,  102  relative to the IOL are shown. Namely, the first retaining pin  100  contacts the tip of the trailing haptic  36 , and the second retaining pin  102  contacts the junction between the optic  32  and the trailing haptic  36 . The length of the retaining pins  100 ,  102  is such that they gently contact and press the IOL at these locations against the holding station base  50  (see  FIG. 5 ). In the storage position as shown, the pins  100 ,  102  help maintain the optic  32  and trailing haptic  36  in the illustrated position.  FIG. 9A  also shows the opening  120  and the tool  122  therein. 
     Now with reference to  FIG. 9B , the tool  122  is moved along the opening  120  so that a distal portion of the trailing haptic  36  touches or engages the deflector rail  112 . The tool  122  acts on the proximal side of the trailing haptic  36  to bend it relative to the optic  32  and fold it over the top of the optic (under the optic in the illustration). The retaining pin  102  helps prevent movement of the optic  32 , and especially prevented from popping upward. The opening  120  has a length such that the tool  122  causes the trailing haptic  36  to fold over the optic  32  and into contact with a curved portion of the deflector rail  112 . The deflector rail  112  curves to accommodate rotation of the tip of the trailing haptic  36  into this position. At this point, the tool  122  can be removed without rebound of the trailing haptic  36  because of its contact with the deflector rail  112 . The material of the IOL and haptics influences the rate of rebound, and acrylic IOLs, especially when cold, are relatively slow to spring back into their initial relaxed positions. However, even if the IOL is formed of a material with greater elastic rebound properties (e.g., silicone), the trailing haptic  36  remains constrained by the deflector rail  112 . 
     In the configuration shown in  FIG. 9B , the IOL is prepared for transfer from the holding station  30  to the delivery tube  26 . As explained previously, the open distal end of the holding station  30  communicates with the open proximal end of the delivery tube  26 . The trailing haptic  36  has been folded over the top of the IOL optic  32  by the tool  122 . At this point, it will be appreciated that there may be a number of small apertures through the walls of the holding station  30  to permit application of a viscoelastic into the holding station and delivery tube  26 . One such aperture  126  is shown in  FIG. 9C . 
     Subsequently, the plunger  24  ( FIG. 2 ) is depressed so that the distal tip  46  of the pushrod  44  enters the holding station  30  and contacts the proximal end of the IOL. As seen in  FIG. 9C , the distal tip  46  acts on the trailing haptic  36  as well as the edge of the optic  32 . The IOL is shown in a position after having been moved distally a short distance by the plunger  24 . The leading haptic deflector member  110  contacts the leading haptic  34  and causes it to deflect relative to the optic  32 . Ultimately, the leading haptic  34  will fold over the top of the optic in a similar manner as the trailing haptic  36 .  FIG. 9C  also shows a slight further bending of the trailing haptic  36  as it cams along the deflector rail  112 .  FIG. 4B  best shows the configuration of the deflector rail  112 , which includes a small step  113  against which the trailing haptic  36  slides. 
       FIG. 9D  shows the IOL having been transferred into a load chamber  130  of the delivery tube  26 . The size of the chamber  130  is desirably smaller than the diameter of the IOL optic  32 , and therefore acts on and causes the optic to curl upward into a “taco” shape. The transition of the optic  32  from its original planar configuration to a curled configuration prevents the haptics  34 ,  36  from elastically rebounding back to their original positions. In other words, the haptics  34 ,  36  are captured over the top of the IOL optic  32  by its curled configuration. 
     The system  20  is thus designed to transfer the pre-loaded IOL directly from the holding station  30  into the delivery tube  26 , and in the process fold the haptics  34 ,  36  over the optic  32  and maintain each of them in that desirable position. The deflector member  110  folds the leading haptic  34  over the optic  32 , and when the leading haptic passes the deflector member it is already substantially within the load chamber  130 . Because of the relatively slow elastic rebound property of the IOL materials, the leading haptic  34  does not spring forward again immediately, and the IOL continues a short distance further until the optic  32  begins curling, at which point the leading haptic  34  cannot spring forward. In a similar way, the deflector rail  112  extends beyond the distal end of the main body of the holding station cover  54  and into the load chamber  130 . The trailing haptic  36  remains constrained by the deflector rail  112  until the optic  32  is substantially within the load chamber  130 . The deflector rail  112  therefore maintains the trailing haptic  36  folded over the optic  32  until such time as the optic begins curling, after which the trailing haptic cannot spring back. 
       FIG. 9D  shows the IOL in its loaded configuration within the delivery tube  26 . This position corresponds to the location of the plunger  24  when the proximal groove  76   b  on the plunger rod  42  registers with the O-ring  74  (see  FIG. 2 ). In other words, the detent function of the proximal groove  76   b  signifies to a user that the IOL has been loaded within the delivery tube  26 . At this stage, the system  20  is fully prepared for use by a surgeon in the delicate operation of transferring the IOL from the delivery tube  26  into an eye of a patient. The tapered or funnel-like configuration of the delivery tube  26  can be seen in  FIG. 9D . The IOL eventually emerges from a distal tip  132 , which is most often angled. Because the haptics  34 ,  36  remain folded over the optic  32 , they are in predictable and controlled positions throughout this operation. After emerging from the distal tip  132 , the haptics  34 ,  36  gradually rebound into their original substantially spiral shapes, as seen in  FIG. 5 . 
     The above presents a description of the best mode contemplated of carrying out the present invention, and of the manner and process of making and using it, in such full, clear, concise, and exact terms as to enable any person skilled in the art to which it pertains to make and use this invention. This invention is, however, susceptible to modifications and alternate constructions from that described above which are fully equivalent. Consequently, it is not the intention to limit this invention to the particular embodiments disclosed. On the contrary, the intention is to cover modifications and alternate constructions coming within the spirit and scope of the invention as generally expressed by the following claims, which particularly point out and distinctly claim the subject matter of the invention.