Patent Abstract:
A method for insertion of an intraocular lens into the eye of a patient, the method including removably attaching loop extensions to loops of an intraocular lens prior to insertion of the intraocular lens into the eye of a patient, initially inserting into the eye of the patient the loop extensions, pulling on the loop extensions through sclerectomies formed in the sclera of the eye of the patient, inserting the intraocular lens into the eye of the patient, positioning the intraocular lens in a desired position in the eye of the patient by pulling on the loop extensions through the sclerectomies, and fixing the loops to the sclera of the eye of the patient at the sclerectomies and detaching the loop extensions from the loops.

Full Description:
FIELD OF THE INVENTION 
     The present invention relates generally to intraocular lenses and methods and apparatus for insertion thereof into the eye of a patient. 
     BACKGROUND OF THE INVENTION 
     Pseudophakic patients for whom the original ocular capsular bag is not intact, for example as a result of cataract surgery or lens exchange, require novel methods and apparatus for the implantation and fixation of an intraocular lens within the patient&#39;s eye. 
     SUMMARY OF THE INVENTION 
     The present invention seeks to provide methods and apparatus for the implantation and fixation of an intraocular lens within the patient&#39;s eye. 
     There is thus provided in accordance with a preferred embodiment of the present invention an apparatus for preparation of an intraocular lens assembly prior to insertion thereof into the eye of a patient, the apparatus including a pair of elongate stretchable loop extension assemblies each including an elongate stretchable loop extension element, whose thickness varies as a function of an extent to which it is stretched, and a connector through which the elongate stretchable loop extension element is threaded. 
     Preferably, the connector includes a longitudinal cylindrical bore formed therewithin, the elongate stretchable loop extension element being threaded through the longitudinal cylindrical bore. Preferably, the connector includes a cylindrical portion and a funnel shaped portion. 
     In accordance with an alternative embodiment of the present invention, the elongate stretchable loop extension element includes a pair of connector motion-limiting elements integrally formed thereon for retaining the connector therebetween in a partially pretensioned configuration, a section of the elongate stretchable loop extension element being stretchably threaded within the connector, thereby retaining the connector motion-limiting elements in tight engagement with the connector. 
     Preferably, when the elongate stretchable loop extension element is in an unstretched configuration, a diameter of the elongate stretchable loop extension element is generally equal to a diameter of the longitudinal cylindrical bore of the connector, thereby tightly engaging the elongate stretchable loop extension element with an inner surface of the longitudinal cylindrical bore of the connector, and thereby tightly retaining the connector in a fixed position on the elongate stretchable loop extension element. 
     Preferably, when the elongate stretchable loop extension element is in a stretched configuration, a diameter of the elongate stretchable loop extension element is narrower than a diameter of the longitudinal cylindrical bore, thereby releasing the elongate stretchable loop extension element from an inner surface of the longitudinal cylindrical bore of the connector, and allowing for insertion of at least one additional element into the longitudinal cylindrical bore of the connector. 
     Preferably, the elongate stretchable loop extension element includes a pair of connector motion-limiting elements integrally formed thereon for retaining the connector therebetween when the elongate stretchable loop extension element is in the stretched configuration. 
     Preferably, after inserting at least one additional element into the longitudinal cylindrical bore of the connector when the elongate stretchable loop extension element is in the stretched configuration and then allowing the elongate stretchable loop extension element to return to an unstretched fastened configuration, a diameter of the elongate stretchable loop extension element is generally equal to a diameter of the longitudinal cylindrical bore of the connector, thereby tightly engaging the elongate stretchable loop extension element and the at least one additional element with an inner surface of the cylindrical bore of the longitudinal cylindrical bore of the connector, and thereby fastening the at least one additional element to the elongate stretchable loop extension element. 
     There is also provided in accordance with another preferred embodiment of the present invention a method for insertion of an intraocular lens into the eye of a patient, the method including removably attaching loop extensions to loops of an intraocular lens prior to insertion of the intraocular lens into the eye of a patient, initially inserting into the eye of the patient the loop extensions, pulling on the loop extensions through sclerectomies formed in the sclera of the eye of the patient, inserting the intraocular lens into the eye of the patient, positioning the intraocular lens in a desired position in the eye of the patient by pulling on the loop extensions through the sclerectomies, and fixing the loops to the sclera of the eye of the patient at the sclerectomies and detaching the loop extensions from the loops. 
     Preferably, each loop extension of the loop extensions includes an elongate stretchable loop extension element formed of stretchable silicon, a thickness of the elongate stretchable loop extension element varying as a function of an extent to which the elongate stretchable loop extension element is stretched. 
     Preferably, each loop extension of the loop extensions also includes a corresponding connector having a longitudinal cylindrical bore formed therewithin, the elongate stretchable loop extension element of the loop extension being threaded through the longitudinal cylindrical bore. Preferably, each of the connectors includes a cylindrical portion and a funnel shaped portion. 
     In accordance with an alternative embodiment of the present invention, each of the elongate stretchable loop extension elements includes a pair of connector motion-limiting elements integrally formed thereon for retaining the corresponding connector therebetween in a partially pretensioned configuration, a section of the elongate stretchable loop extension element being stretchably threaded within the corresponding connector, thereby retaining the connector motion-limiting elements in tight engagement with the corresponding connector. 
     Preferably, removably attaching the loop extensions to the loops of the intraocular lens includes stretching and retaining the elongate stretchable loop extension element of each of the loop extensions from an unstretched unfastened configuration to a retained stretched configuration, while the elongate stretchable loop extension element is in the retained stretched configuration inserting an end of a corresponding one of the loops into the longitudinal cylindrical bore of the connector of the loop extension, and after inserting an end of a corresponding one of the loops into the longitudinal cylindrical bore of the connector of the loop extension, releasing the elongate stretchable loop extension element from the retained stretched configuration, thereby placing the elongate stretchable loop extension element in an unstretched fastened configuration. 
     Preferably, when the elongate stretchable loop extension element is in the unstretched unfastened configuration, a diameter of the elongate stretchable loop extension element is generally equal to a diameter of the longitudinal cylindrical bores of the corresponding connector, thereby tightly engaging the elongate stretchable loop extension element with an inner surface of the longitudinal cylindrical bore of the corresponding connector, and thereby tightly retaining the corresponding connector in a fixed position on the elongate stretchable loop extension element. 
     Preferably, when the elongate stretchable loop extension element is in the retained stretched configuration, a diameter of the elongate stretchable loop extension element is narrower than a diameter of the longitudinal cylindrical bore, thereby releasing the elongate stretchable loop extension element from an inner surface of the longitudinal cylindrical bore of the corresponding connector. Preferably, the elongate stretchable loop extension element includes a pair of connector motion-limiting elements integrally formed thereon for retaining the corresponding connector therebetween when the elongate stretchable loop extension element is in the retained stretched configuration. 
     Preferably, when the elongate stretchable loop extension element is in the unstretched fastened configuration, a diameter of the elongate stretchable loop extension element is generally equal to a diameter of the longitudinal cylindrical bore of the corresponding connector, thereby tightly engaging the elongate stretchable loop extension element and the loop with an inner surface of the cylindrical bore of the longitudinal cylindrical bore of the corresponding connector, and thereby fastening the loop to the elongate stretchable loop extension element. 
     Preferably, pulling on the loop extensions through the sclerectomies formed in the sclera of the eye of the patient includes pulling the elongate stretchable loop extension elements of the loop extensions, the corresponding connectors of the loop extensions and the corresponding loops of the intraocular lens from within the sclera through the sclerectomies. Preferably, once pulled through the sclerectomies, each connector of the connectors is operative to serve as a motion-limiting element which prevents a corresponding one of the loops, the connector and a corresponding one of the elongate stretchable loop extension elements from being retracted into the sclera. 
     Preferably, detaching the loop extension from the loop includes stretching the elongate stretchable loop extension element of the loop extension from the unstretched fastened configuration to a stretched unfastened configuration, and releasing the loop from the connector. 
     Preferably, when elongate stretchable loop extension element is in the stretched unfastened configuration, a diameter of the elongate stretchable loop extension element is narrower than a diameter of the longitudinal cylindrical bore of the corresponding connector, thereby releasing the elongate stretchable loop extension element and the loop from an inner surface of the longitudinal cylindrical bore of the corresponding connector. 
     There is further provided in accordance with yet another preferred embodiment of the present invention, a method of preparation of an intraocular lens assembly prior to insertion thereof into the eye of a patient, the method including removably attaching loop extensions to loops of an intraocular lens. Preferably, removably attaching loop extensions to loops of an intraocular lens includes providing a pair of elongate stretchable loop extension assemblies each including an elongate stretchable loop extension element, whose thickness varies as a function of an extent to which it is stretched and a connector through which the elongate stretchable loop extension element is threaded, and removably inserting an end of each loop of the intraocular lens into a corresponding connector of one of the pair of elongate stretchable loop extension assemblies. 
     Preferably, the connector includes a longitudinal cylindrical bore formed therewithin, the elongate stretchable loop extension element being threaded through the longitudinal cylindrical bore. Preferably, the connector includes a cylindrical portion and a funnel shaped portion. 
     In accordance with an alternative embodiment of the present invention, the elongate stretchable loop extension element includes a pair of connector motion-limiting elements integrally formed thereon for retaining the connector therebetween in a partially pretensioned configuration, a section of the elongate stretchable loop extension element being stretchably threaded within the connector, thereby retaining the connector motion-limiting elements in tight engagement with the connector. 
     Preferably, removably inserting an end of each loop of the intraocular lens into a corresponding connector of one of the pair of elongate stretchable loop extension assemblies includes stretching and retaining the elongate stretchable loop extension element of each of the elongate stretchable loop extension assemblies from an unstretched unfastened configuration to a retained stretched configuration, while the elongate stretchable loop extension element is in the retained stretched configuration inserting an end of the loop into the longitudinal cylindrical bore of the corresponding connector of one of the pair of elongate stretchable loop extension assemblies, and after inserting an end of the loop into the longitudinal cylindrical bore of the corresponding connector of one of the pair of elongate stretchable loop extension assemblies, releasing the elongate stretchable loop extension element from the retained stretched configuration, thereby placing the elongate stretchable loop extension element in an unstretched fastened configuration. 
     Preferably, when the elongate stretchable loop extension element is in the unstretched unfastened configuration, a diameter of the elongate stretchable loop extension element is generally equal to a diameter of the longitudinal cylindrical bore of the connector, thereby tightly engaging the elongate stretchable loop extension element with an inner surface of the longitudinal cylindrical bore of the connector, and thereby tightly retaining the connector in a fixed position on the elongate stretchable loop extension element. 
     Preferably, when the elongate stretchable loop extension element is in the retained stretched configuration, a diameter of the elongate stretchable loop extension element is narrower than a diameter of the longitudinal cylindrical bore, thereby releasing the elongate stretchable loop extension element from an inner surface of the longitudinal cylindrical bore of the connector. Preferably, the elongate stretchable loop extension element includes a pair of connector motion-limiting elements integrally formed thereon for retaining the connector therebetween when the elongate stretchable loop extension element is in the retained stretched configuration. 
     Preferably, when the elongate stretchable loop extension element is in the unstretched fastened configuration, a diameter of the elongate stretchable loop extension element is generally equal to a diameter of the longitudinal cylindrical bore of the connector, thereby tightly engaging the elongate stretchable loop extension element and the loop with an inner surface of the cylindrical bore of the longitudinal cylindrical bore of the connector, and thereby fastening the loop to the elongate stretchable loop extension element. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present invention will be understood and appreciated more fully from the following detailed description taken in conjunction with the drawings in which: 
         FIG. 1A  is a simplified pictorial illustration of an apparatus for preparation of an intraocular lens assembly, constructed in accordance with a preferred embodiment of the present invention; 
         FIG. 1B  is a simplified sectional view of a connector which is part of the apparatus of  FIG. 1A , the sectional view being taken along lines B-B of  FIG. 1A ; 
         FIG. 1C  is a simplified pictorial illustration of an apparatus for preparation of an intraocular lens assembly, constructed in accordance with an alternative embodiment of the present invention; 
         FIG. 1D  is a simplified sectional view of a connector which is part of the apparatus of  FIG. 1C , the sectional view being taken along lines D-D of  FIG. 1C ; 
         FIG. 2A  is a simplified pictorial illustration of a first step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 2B  is a simplified sectional view of a connector which is part of the apparatus of  FIGS. 1A &amp; 1B , the sectional view being taken along lines B-B of  FIG. 2A ; 
         FIG. 3A  is a simplified pictorial illustration of a second step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 3B  is a simplified sectional view of a connector which is part of the apparatus of  FIG. 1 , the sectional view being taken along lines B-B of  FIG. 3A ; 
         FIG. 4  is a simplified pictorial illustration of a third step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 5A  is a simplified pictorial illustration of a fourth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 5B  is a simplified sectional view of a connector which is part of the apparatus of  FIG. 1 , the sectional view being taken along lines B-B of  FIG. 5A ; 
         FIG. 6  is a simplified pictorial illustration of a fifth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 7A  is a simplified pictorial illustration of a sixth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 7B  is a simplified sectional view of a connector which is part of the apparatus of  FIG. 1 , the sectional view being taken along lines B-B of  FIG. 7A ; 
         FIG. 8  is a simplified pictorial illustration of a seventh step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 9  is a simplified pictorial illustration of an eighth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 10  is a simplified pictorial illustration of a ninth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 11  is a simplified pictorial illustration of a tenth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 12  is a simplified pictorial illustration of an eleventh step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 13  is a simplified pictorial illustration of a twelfth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 14  is a simplified pictorial illustration of a thirteenth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 15  is a simplified pictorial illustration of a fourteenth step in the operation of the apparatus of  FIGS. 1A &amp; 1B ; 
         FIG. 16  is a simplified pictorial illustration of an example of an intraocular lens assembly prepared by employing the apparatus of  FIG. 1 ; 
         FIGS. 17A and 17B  are simplified pictorial illustrations of an eye of a patient prepared for insertion of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16 ; 
         FIG. 18  is a simplified pictorial illustration of a first step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient; 
         FIG. 19  is a simplified pictorial illustration of a second step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient; 
         FIG. 20  is a simplified pictorial illustration of a third step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient; 
         FIG. 21  is a simplified pictorial illustration of a fourth step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient; 
         FIGS. 22A and 22B  are simplified pictorial illustrations of a fifth step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient; 
         FIG. 23  is a simplified pictorial illustration of a sixth step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient; 
         FIG. 24  is a simplified pictorial illustration of a seventh step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient; and 
         FIG. 25  is a simplified pictorial illustration of an eighth step in the implanting of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
     Reference is now made to  FIG. 1A , which is a simplified pictorial illustration of an apparatus for preparation of an intraocular lens assembly, constructed in accordance with a preferred embodiment of the present invention, and to  FIG. 1B , which is a simplified sectional view of a connector which is part of the apparatus of  FIG. 1A , the sectional view being taken along lines B-B of  FIG. 1A . The novel apparatus and surgical procedure associated therewith and described hereinbelow, in which an intraocular lens is placed within the sulcus of a patient&#39;s eye and thereafter fixed to the sclera of the eye, is particularly suitable for pseudophakic patients for whom the capsular bag is not intact, for example as a result of cataract surgery or lens exchange. It is appreciated that this novel apparatus and surgical procedure is also suitable for any surgical procedure which involves implantation of intraocular devices such as, for example, an artificial iris or an intraocular telescopic lens. 
     As shown in  FIGS. 1A &amp; 1B , the apparatus  100  includes a pair of elongate stretchable loop extension assemblies  102  and  104 , which include corresponding elongate stretchable loop extension elements  112  and  114 , preferably formed of silicon, and whose thickness varies as a function of an extent to which it is stretched. Elongate stretchable loop extension assemblies  102  and  104  also include corresponding connectors  122  and  124  through which corresponding elongate stretchable loop extension elements  112  and  114  are threaded. Connectors  122  and  124  preferably include corresponding cylindrical portions  132  and  134  and corresponding funnel shaped portions  142  and  144 . Cylindrical bores  152  and  154  are preferably formed within respective connectors  122  and  124  along corresponding axes  162  and  164 . 
     Reference is now made to  FIG. 1C , which is a simplified pictorial illustration of apparatus  100  constructed in accordance with an alternative embodiment of the present invention, and to  FIG. 1D , which is a simplified sectional view of connector  122  of apparatus  100  of  FIG. 1C , the sectional view being taken along lines D-D of  FIG. 1C . 
     As shown in the alternative embodiment of  FIGS. 1C &amp; 1D , connector motion-limiting elements  166  and  168  are formed on elongate stretchable loop extension element  112  for retaining connector  122  therebetween in a partially pretensioned configuration, wherein a section of elongate stretchable loop extension element  112  disposed within connector  122  is stretched, thereby retaining elements  166  and  168  in tight engagement with connector  122 . 
     Reference is now made to  FIGS. 2A, 3A, 4, 5A, 6, 7A, 8, 9, 10, 11, 12, 13, 14 and 15 , which are simplified pictorial illustrations of steps in the operation of apparatus  100 , and to  FIGS. 2B, 3B, 5B and 7B  which are simplified sectional views of connector  122 , the sectional view being taken along lines B-B of respective  FIGS. 2A, 3A, 5A and 7A . It is appreciated that although  FIGS. 2A-15  illustrate steps in the operation of apparatus  100  as illustrated in the embodiment of  FIGS. 1A &amp; 1B , the same steps may be executed in the operation of apparatus  100  as illustrated in the alternative embodiment of  FIGS. 1C &amp; 1D . 
     As shown in  FIG. 2A , in the first step in the operation of apparatus  100 , elongate stretchable loop extension element  112  of elongate stretchable loop extension assembly  102  is unwound from the apparatus  100  to an unstretched configuration. As clearly seen in the unwound configuration of  FIG. 2A , elongate stretchable loop extension element  112  has a loose end  170  and a retained end  172  retained on apparatus  100 . 
     It is a particular feature of this preferred embodiment of the present invention that in the unstretched configuration of  FIGS. 2A &amp; 2B , the diameter of elongate stretchable loop extension element  112  is generally equal to the diameter of cylindrical bore  152 , thereby tightly engaging elongate stretchable loop extension element  112  with an inner surface  174  of cylindrical bore  152 , and thereby tightly retaining connector  122  in a fixed position on elongate stretchable loop extension element  112 . 
     As further shown in  FIG. 3A , in the second step in the operation of apparatus  100 , elongate stretchable loop extension element  112  of elongate stretchable loop extension assembly  102  is stretched from the apparatus  100  to a stretched configuration by a user pulling on loose end  170 . 
     It is a another particular feature of this preferred embodiment of the present invention that in the stretched configuration of  FIGS. 3A &amp; 3B , the diameter of elongate stretchable loop extension element  112  is narrower than the diameter of cylindrical bore  152 , thereby releasing elongate stretchable loop extension element  112  from inner surface  174  of cylindrical bore  152 , and thereby allowing insertion of additional elements into connector  122 . A pair of connector motion-limiting elements  176  and  178  are formed on elongate stretchable loop extension element  112  for retaining connector  122  therebetween on elongate stretchable loop extension element  112 . 
     Turning now to  FIG. 4 , it is shown that in the third step in the operation of apparatus  100 , loose end  170  of elongate stretchable loop extension element  112  is further stretched through a fork-shaped retaining element  180  formed on apparatus  100  and is retained therein by an extension element retaining element  182  formed on elongate stretchable loop extension element  112 . 
     As further shown in  FIGS. 5A &amp; 5B , in a fourth step of the operation of apparatus  100 , an intraocular lens  200  having loops  202  and  204  is brought into close proximity to elongate stretchable loop extension element  112 , and loop  202  is inserted into bore  152  of connector  122  via funnel shaped portion  142 . It is appreciated that loops  202  and  204  may be oriented either clockwise or counterclockwise with respect to intraocular lens  200 . As described hereinabove, in the stretched configuration, the diameter of elongate stretchable loop extension element  112  is narrower than the diameter of cylindrical bore  152 , thereby allowing insertion of elements other than elongate stretchable loop extension element  112  into connector  122 . 
     Thereafter, in a fifth step of the operation of apparatus  100  shown in  FIG. 6 , extension element retaining element  182  is released from fork-shaped retaining element  180  of apparatus  100 , thereby releasing elongate stretchable loop extension element  112 . As further shown in  FIGS. 7A &amp; 7B , in a sixth step of the operation of apparatus  100 , release of elongate stretchable loop extension element  112  from fork-shaped retaining element  180  allows elongate stretchable loop extension element  112  to return to the unstretched configuration wherein the diameter of elongate stretchable loop extension element  112  is generally equal to the diameter of cylindrical bore  152 , thereby tightly engaging elongate stretchable loop extension element  112  and loop  202  with inner surface  174  of cylindrical bore  152 , and thereby fastening loop  202  to elongate stretchable loop extension element  112 . 
     Thereafter, as shown in  FIG. 8 , in a seventh step of the operation of apparatus  100 , the user of apparatus  100  preferably employs a pair of surgical scissors to sever elongate stretchable loop extension element  112  between retained end  172  and connector motion-limiting element  176 , thereby disconnecting elongate stretchable loop extension element  112  along with loop  202  connected thereto, from apparatus  100 . 
     Turning now to  FIG. 9 , it is shown that in an eighth step of the operation of apparatus  100 , elongate stretchable loop extension element  114  of elongate stretchable loop extension assembly  104  is unwound from the apparatus  100  to an unstretched configuration. As clearly seen in  FIG. 9 , in the unwound configuration, elongate stretchable loop extension element  114  has a loose end  210  and a retained end  212  retained on apparatus  100 . 
     As described hereinabove with reference to  FIGS. 2A and 2B , it is a particular feature of this preferred embodiment of the present invention that in the unstretched configuration of  FIG. 9 , the diameter of elongate stretchable loop extension element  114  is generally equal to the diameter of cylindrical bore  154  of connector  124 , thereby tightly engaging elongate stretchable loop extension element  114  with an inner surface  214  of cylindrical bore  154 , and thereby tightly retaining connector  124  in a fixed position on elongate stretchable loop extension element  114 . 
     Thereafter, in a ninth step of the operation of apparatus  100  shown in  FIG. 10 , elongate stretchable loop extension element  114  of elongate stretchable loop extension assembly  104  is stretched from the apparatus  100  to a stretched configuration by a user pulling on loose end  210 . 
     As described hereinabove with reference to  FIGS. 3A and 3B , it is a particular feature of this preferred embodiment of the present invention that in the stretched configuration of  FIG. 10 , the diameter of elongate stretchable loop extension element  114  is narrower than the diameter of cylindrical bore  154 , thereby releasing elongate stretchable loop extension element  114  from inner surface  214  of cylindrical bore  154 , and thereby allowing insertion of additional elements into connector  124 . A pair of connector motion-limiting elements  216  and  218  are formed on elongate stretchable loop extension element  114  for retaining connector  124  therebetween on elongate stretchable loop extension element  114 . 
     Turning now to  FIG. 11 , it is shown that in the tenth step in the operation of apparatus  100 , loose end  210  of elongate stretchable loop extension element  114  is further stretched through a fork-shaped retaining element  220  formed on apparatus  100  and is retained therein by an extension element retaining element  222  formed on elongate stretchable loop extension element  114 . 
     Thereafter, in an eleventh step of the operation of apparatus  100  shown in  FIG. 12 , intraocular lens  200  is brought into close proximity to elongate stretchable loop extension element  114 , and loop  204  is inserted into bore  154  of connector  124  via funnel shaped portion  144 . As described hereinabove, in the stretched configuration, the diameter of elongate stretchable loop extension element  114  is narrower than the diameter of cylindrical bore  154 , thereby allowing insertion of elements other than elongate stretchable loop extension element  114  into connector  124 . 
     Turning now to  FIG. 13 , it is shown that in a twelfth step of the operation of apparatus  100 , extension element retaining element  222  is released from fork-shaped retaining element  220  of apparatus  100 , thereby releasing elongate stretchable loop extension element  114 . As further shown in  FIG. 14 , in a thirteenth step of the operation of apparatus  100 , release of elongate stretchable loop extension element  114  from fork-shaped retaining element  220  allows elongate stretchable loop extension element  114  to return to the unstretched configuration wherein the diameter of elongate stretchable loop extension element  114  is generally equal to the diameter of cylindrical bore  154 , thereby tightly engaging elongate stretchable loop extension element  114  and loop  204  with inner surface  214  of cylindrical bore  154 , and thereby fastening loop  204  to elongate stretchable loop extension element  114 . 
     Thereafter, in a fourteenth step of the operation of apparatus  100  shown in  FIG. 15 , the user of apparatus  100  preferably employs a pair of surgical scissors to sever elongate stretchable loop extension element  114  between retained end  212  and connector motion-limiting element  216 , thereby disconnecting elongate stretchable loop extension element  114  along with loop  204  connected thereto, from apparatus  100 . 
     Reference is now made to  FIG. 16 , which is a simplified pictorial illustration of an example of an intraocular lens assembly prepared by employing the apparatus of  FIG. 1 . As shown in  FIG. 16 , loop  202  of intraocular lens  200  is fastened to unstretched elongate stretchable loop extension element  112  within connector  122  and loop  204  of intraocular lens  200  is fastened to unstretched elongate stretchable loop extension element  114  within connector  124 . 
     It is appreciated that in the orientation of  FIG. 16 , intraocular lens  200  along with loops  202  and  204  is in an inverted configuration relative to the configuration of  FIGS. 1A-15 . In the configuration of  FIG. 16 , loop  202  serves as a leading left-hand loop when implanting intraocular lens  200  into an eye of a patient, as will be described hereinbelow with reference to  FIGS. 18-25 . 
     Reference is now made to  FIGS. 17A and 17B , which are simplified pictorial illustrations of a human eye prepared for insertion of an intraocular lens by sclerectomy. As shown in  FIGS. 17A and 17B , in preparation for insertion of intraocular lens  200 , a pair of scleral flaps  252  and  254  are surgically formed on both sides of the sclera  256  of the eye, thereby forming corresponding recesses  262  and  264 . Sclerectomies  272  and  274  which communicate between corresponding recesses  262  and  264  and the interior of sclera  256  are also surgically formed. 
     As described hereinabove, the novel procedure described hereinbelow in which intraocular lens  200  will be placed within the sulcus and fixed to the sclera is particularly suitable for pseudophakic patients for whom the capsular bag is not intact, for example as a result of cataract surgery or lens exchange. 
     Reference is now made to  FIGS. 18, 19, 20, 21, 22A, 22B, 23, 24 and 25 , which are simplified pictorial illustrations of steps in the implantation of an intraocular lens which is part of the intraocular lens assembly of  FIG. 16  into an eye of a patient. 
     As shown in the first step of  FIG. 18 , loose ends  170  and  210  of corresponding stretchable loop extension elements  112  and  114  are inserted into the eye via a limbal cut  280  surgically formed between the cornea  282  and the sclera  256 , and are pulled through sclerectomies  272  and  274 , respectively, by intraocular foreceps. Intraocular lens  200  is then inserted through limbal cut  280  to the position shown in  FIG. 19 . 
     Thereafter, as shown in  FIG. 20 , loose ends  170  and  210  of corresponding stretchable loop extension elements  112  and  114  are further completely pulled through sclerectomies  272  and  274 , respectively, thereby pulling respective connectors  122  and  124  along with loops  202  and  204  from within sclera  256  through sclerectomies  272  and  274 , respectively. 
     It is a particular feature of the present invention that once pulled through sclerectomies  272  and  274 , connectors  122  and  124  are operative to serve as motion-limiting elements which prevent loops  202  and  204 , corresponding connectors  122  and  124  and corresponding stretchable loop extension elements  112  and  114  from being retracted into sclera  256 . 
     As further shown in  FIG. 21 , forceps  290  are employed at a point distal to connector motion-limiting element  176  and at a point distal to extension element retaining element  182  to stretch stretchable loop extension element  112  and to thereby release loop  202  from connector  122 . As described hereinabove, in the stretched configuration, the diameter of elongate stretchable loop extension element  112  is narrower than the diameter of cylindrical bore  152 , thereby releasing elongate stretchable loop extension element  112  from inner surface  174  of cylindrical bore  152  and thereby allowing for release of loop  202  from connector  122 . As further described hereinabove, once pulled through sclerectomy  274 , connector  124  is operative to serve as a motion-limiting element which prevents loop  204 , connector  124  and stretchable loop extension element  114  from being retracted into sclera  256  while releasing loop  202  from connector  122 . After releasing loop  202  from connector  122 , loop  202  is then fixated into a bore  296  formed in a side surface of recess  262 . 
     Similarly, as further shown in  FIG. 22A , forceps  290  are employed at a point distal to connector motion-limiting element  216  and at a point distal to extension element retaining element  222  to stretch stretchable loop extension element  114  and to thereby release loop  204  from connector  124 . As described hereinabove, in the stretched configuration, the diameter of elongate stretchable loop extension element  114  is narrower than the diameter of cylindrical bore  154 , thereby releasing elongate stretchable loop extension element  114  from inner surface  214  of cylindrical bore  154  and thereby allowing for release of loop  204  from connector  124  and fixation of loop  204  into a bore  298  formed in a side surface of recess  264 . Released elongate stretchable loop extension element  114  is shown in  FIG. 22B . 
     As shown in  FIG. 23 , loops  202  and  204  remain protruding through respective sclerectomies  272  and  274  and fixated into bores  296  and  298  formed in side surfaces of corresponding recesses  262  and  264 , as described hereinabove with regard to  FIGS. 21 and 22B . 
     Turning now to  FIG. 24 , it is shown that after loose ends of loops  202  and  204  are inserted into corresponding bores  296  and  298 , surgical glue is applied to a bottom surface of each of recesses  262  and  264 . Thereafter, as shown in  FIG. 25 , scleral flaps  252  and  254  are folded back into respective recesses  262  and  264 , thereby gluing flaps  252  and  254  into corresponding recesses  262  and  264  and thereby forming a smooth surface of sclera  256 . 
     It will be appreciated by persons skilled in the art that the present invention is not limited by what has been particularly shown and described hereinabove. Rather the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove as well as modifications thereof which would occur to persons skilled in the art upon reading the foregoing description and which are not in the prior art.

Technology Classification (CPC): 0