CA2274260A1 - Scleral prosthesis for treatment of presbyopia and other eye disorders - Google Patents

Scleral prosthesis for treatment of presbyopia and other eye disorders Download PDF

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Publication number
CA2274260A1
CA2274260A1 CA002274260A CA2274260A CA2274260A1 CA 2274260 A1 CA2274260 A1 CA 2274260A1 CA 002274260 A CA002274260 A CA 002274260A CA 2274260 A CA2274260 A CA 2274260A CA 2274260 A1 CA2274260 A1 CA 2274260A1
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CA
Canada
Prior art keywords
prosthesis
eye
sclera
anterior
posterior
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002274260A
Other languages
French (fr)
Other versions
CA2274260C (en
Inventor
Ronald A. Schachar
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Refocus Ocular Inc
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Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
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Application filed by Individual filed Critical Individual
Publication of CA2274260A1 publication Critical patent/CA2274260A1/en
Application granted granted Critical
Publication of CA2274260C publication Critical patent/CA2274260C/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00781—Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/147—Implants to be inserted in the stroma for refractive correction, e.g. ring-like implants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/0008—Introducing ophthalmic products into the ocular cavity or retaining products therein
    • A61F9/0017—Introducing ophthalmic products into the ocular cavity or retaining products therein implantable in, or in contact with, the eye, e.g. ocular inserts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00802—Methods or devices for eye surgery using laser for photoablation
    • A61F9/0081—Transplantation
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
    • Y10S623/902—Method of implanting
    • Y10S623/905—Eye

Abstract

Presbyopia is treated by implanting within a plurality of elongated pockets formed in the tissue of the sclera of the eye transverse to a meridian of the eye, a prosthesis having an elongated base member having an inward surface adapted to be placed against the inward wall of the pocket and having a ridge on the inward surface of the base extending along at least a major portion of the major dimension of the base. The combined effect of the implanted prosthesis is to exert a radially outward traction on the sclera in the region overlying the ciliary body which expands the sclera in the affected region together with the underlying ciliary body. The expansion of the ciliary body restores the effective working distance of the ciliary muscle in the presbyopic eye and thereby increases the amplitude of accommodation. Hyperopia, primary open angle glaucoma and/or ocular hypertension can be treated by increasing the effective working distance of the ciliary muscle according to the invention.

Claims (35)

1. An ocular scleral prosthesis comprising a base member having an elongated planform with a major dimension, a minor dimension, an inner major surface and an outer major surface, said outer major surface being generally smooth and adapted to contact ocular tissue within a pocket surgically formed within scleral tissue of an eye, and a ridge member on said inner major surface of said base member, extending along at least a substantial fraction of said major dimension of said base.
2. The prosthesis of Claim 1 wherein said anterior rim is anteriorly concave and said posterior rim is posteriorly convex.
3. The prosthesis of Claim 1 wherein said outer major surface of said base is planar.
4. The prosthesis of Claim 1 wherein said outer major surface of said base is outwardly convex along said major dimension.
5. The prosthesis of Claim 1 wherein said planform is generally rectangular.
6. The prosthesis of Claim 1 wherein said planform has semicircular ends.
7. The prosthesis of Claim 1 wherein said planform is elliptical.
8. The prosthesis of Claim 1 wherein said ridge extends along substantially the entire major dimension of said base.
9. The prosthesis of Claim 1 wherein said ridge extends along a portion of said major dimension of said base member.
10. The prosthesis of Claim 1 wherein said ridge has a maximum height above said base located intermediate between said anterior edge and said posterior edge.
11. The prosthesis of Claim 10 wherein said maximum height of said ridge is located less than halfway from said anterior edge to said posterior edge.
12. The prosthesis of Claim 1 wherein said maximum height of said ridge is located about 12% of the distance from said anterior edge to said posterior edge.
13. The prosthesis of Claim 1 wherein said maximum height of said ridge is located at said anterior edge.
14. The prosthesis of Claim 1 wherein said major dimension is about 5 millimeters.
15. The prosthesis of Claim 1 wherein said minor dimension is about 2 millimeters.
16. The prosthesis of Claim 1 wherein said prosthesis is made of a physiologically acceptable metal.
17. The prosthesis of Claim 1 wherein said prosthesis is made of metal selected from the group consisting of titanium, platinum, gold, tantalum, stainless steel, and physiologically acceptable alloys.
18. The prosthesis of Claim 1 wherein said prosthesis is made of a ceramic material.
19. The prosthesis of Claim 18 wherein said ceramic is selected from the group consisting of porcelain, alumina, silica, silicon carbide, and high-strength glasses.
20. The prosthesis of Claim 1 wherein said prosthesis is made of a synthetic resin.
21. The prosthesis of Claim 20 wherein said synthetic resin is selected from the group consisting of poly(methyl methacrylate), polyethylene, polypropylene, poly(tetrafluoroethylene), polycarbonate, and silicone resins.
22. The prosthesis of Claim 1 wherein said prosthesis is made of a reinforced composite material.
23. The prosthesis of Claim 22 wherein said reinforced composite material is a glass-fiber-reinforced synthetic resin.
24. The prosthesis of Claim 22 wherein said reinforced composite material is a carbon-fiber-reinforced material.
25. The prosthesis of Claim 22 wherein said reinforced composite material is carbon-fiber-reinforced carbon.
26. The prosthesis of Claim 1 wherein said prosthesis is made of flexible material and is provided with an internal cavity filled with a fluid or a gel.
27. The prosthesis of Claim 26 wherein said fluid is water or a physiological saline solution.
28. The prosthesis of Claim 26 wherein said gel is a silicone material, or collagen, or gelatin.
29. The prosthesis of Claim 26 wherein said fluid is a physiologically acceptable oil.
30. The prosthesis of Claim 29 wherein said fluid is a silicone oil.
31. The prosthesis of Claim 1 wherein said prosthesis is provided with at least one hole for the passage of a suture.
32. A method for treating presbyopia comprising forming a plurality of elongated pockets, each having a lengthwise dimension, in a sclera of said eye, said lengthwise dimension being oriented generally transversely to a meridian of said eye, said eye having a sclera forming a generally globular outer layer of said eye, a transparent cornea forming an anterior surface of said eye, a limbus formed by the junction of said cornea with said sclera, a generally circular ciliary body located inwardly of said sclera posterior to said limbus, and a crystalline lens located centrally within said ciliary body and having an equator, said equator of said lens defining a plane intersecting said sclera in a generally circular intersection posterior to said limbus, said pockets having an anterior margin and a posterior margin, said anterior margin being located a distance of from about 0.5 millimeters to about 4.5 millimeters posterior to said limbus; and positioning in each of said pockets a prosthesis according to Claim 1, with said anterior edge of said prosthesis oriented toward the anterior portion of said eye and said inner major surface with said ridge oriented inwardly.
33. A method for treating hyperopia comprising forming a plurality of elongated pockets, each having a lengthwise dimension, in a sclera of said eye, said lengthwise dimension being oriented generally transversely to a meridian of said eye, said eye having a sclera forming a generally globular outer layer of said eye, a transparent cornea forming an anterior surface of said eye, a limbus formed by the junction of said cornea with said sclera, a generally circular ciliary body located inwardly of said sclera posterior to said limbus, and a crystalline lens located centrally within said ciliary body and having an equator, said equator of said lens defining a plane intersecting said sclera in a generally circular. intersection posterior to said limbus, said pockets having an anterior margin and a posterior margin, said anterior margin being located a distance of from about 0.5 millimeters to about 4.5 millimeters posterior to said limbus; and positioning in each of said pockets a prosthesis according to Claim 1, with said anterior edge of said prosthesis oriented toward the anterior portion of said eye and said inner major surface with said ridge oriented inwardly.
34. A method for treating primary open angle glaucoma comprising forming a plurality of elongated pockets, each having a lengthwise dimension, in a sclera of said eye, said lengthwise dimension being oriented generally transversely to a meridian of said eye, said eye having a sclera forming a generally globular outer layer of said eye, a transparent cornea forming an anterior surface of said eye, a limbus formed by the junction of said cornea with said sclera, a generally circular ciliary body located inwardly of said sclera posterior to said limbus, and a crystalline lens located centrally within said ciliary body and having an equator, said equator of said lens defining a plane intersecting said sclera in a generally circular intersection posterior to said limbus, said pockets having an anterior margin and a posterior margin, said anterior margin being located a distance of from about 0.5 millimeters to about 4.5 millimeters posterior to said limbus; and positioning in each of said pockets a prosthesis according to Claim 1, with said anterior edge of said prosthesis oriented toward the anterior portion of said eye and said inner major surface with said ridge oriented inwardly.
35. A method for treating ocular hypertension comprising:
forming a plurality of elongated pockets, each having a lengthwise dimension, in a sclera of said eye, said lengthwise dimension being oriented generally transversely to a meridian of said eye, said eye having a sclera forming a generally globular outer layer of said eye, a transparent cornea forming an anterior surface of said eye, a limbus formed by the junction of said cornea with said sclera, a generally circular ciliary body located inwardly of said sclera posterior to said limbus, and a crystalline lens located centrally within said ciliary body and having an equator, said equator of said lens defining a plane intersecting said sclera in a generally circular intersection posterior to said limbus, said pockets having an anterior margin and a posterior margin, said anterior margin being located a distance of from about 0.5 millimeters to about 4.5 millimeters posterior to said limbus; and positioning in each of said pockets a prosthesis according to Claim 1, with said anterior edge of said prosthesis oriented toward the anterior portion of said eye and said inner major surface with said ridge oriented inwardly.
CA2274260A 1997-10-08 1998-05-21 Scleral prosthesis for treatment of presbyopia and other eye disorders Expired - Lifetime CA2274260C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US08/946,975 US6007578A (en) 1997-10-08 1997-10-08 Scleral prosthesis for treatment of presbyopia and other eye disorders
US08/946,975 1997-10-08
PCT/US1998/010582 WO1999017691A1 (en) 1997-10-08 1998-05-21 Scleral prosthesis for treatment of presbyopia and other eye disorders

Publications (2)

Publication Number Publication Date
CA2274260A1 true CA2274260A1 (en) 1999-04-15
CA2274260C CA2274260C (en) 2010-02-16

Family

ID=25485282

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2274260A Expired - Lifetime CA2274260C (en) 1997-10-08 1998-05-21 Scleral prosthesis for treatment of presbyopia and other eye disorders

Country Status (20)

Country Link
US (5) US6007578A (en)
EP (1) EP1021146B1 (en)
JP (1) JP3828583B2 (en)
KR (1) KR100525498B1 (en)
CN (1) CN1267202A (en)
AR (1) AR013679A1 (en)
AT (1) ATE293417T1 (en)
AU (1) AU7693798A (en)
BR (1) BR9806304A (en)
CA (1) CA2274260C (en)
DE (1) DE69829866T2 (en)
EA (1) EA002476B1 (en)
ES (1) ES2242283T3 (en)
HU (1) HUP0003806A3 (en)
ID (1) ID21957A (en)
IL (1) IL130295A (en)
NO (1) NO318462B1 (en)
NZ (2) NZ336063A (en)
WO (1) WO1999017691A1 (en)
ZA (2) ZA984634B (en)

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