WO2000030566A1

WO2000030566A1 - Posterior chamber intraocular implant device, and packaging therefor

Info

Publication number: WO2000030566A1
Application number: PCT/US1999/026013
Authority: WO
Inventors: Thomas J. Chambers
Original assignee: Staar Surgical Company, Inc.
Priority date: 1998-11-20
Filing date: 1999-11-19
Publication date: 2000-06-02
Also published as: AU1712900A

Abstract

This invention is a posterior chamber intraocular implant device for an eye, the device comprising a posterior chamber intraocular lens, a separate posterior chamber intraocular ring (10) configured to cooperate with the posterior chamber intraocular lens, and prevent rotation of the posterior chamber intraocular lens after being implanted into an eye.

Description

Title of the Invention

POSTERIOR CHAMBER INTRAOCULAR IMPLANT DEVICE, AND

PACKAGING THEREFOR

Field of the Invention

The present invention is directed to a posterior chamber intraocular implant for

placement in the posterior chamber of an eye of a human or animal. Specifically, the

posterior chamber implant device according to the present invention can be a posterior chamber intraocular lens, posterior chamber intraocular ring, and/or the combination of

a posterior chamber intraocular lens and ring.

A preferred embodiment of the posterior chamber intraocular implant device

according to the present invention is a posterior chamber intraocular lens and a

separate posterior chamber intraocular ring, which are preferably configured to

cooperate together when implanted to provide one or more features such as preventing

rotation of the posterior chamber intraocular lens within an eye. Alternatively, the

posterior chamber implant device according to the present invention can include a

posterior chamber intraocular lens connected to or provided with a posterior chamber intraocular ring. The present invention is also directed to packaging the posterior chamber

intraocular implant device.

Background of the Invention

The current state of the art for cataract surgery involves removal of the natural crystalline lens of the eye through a small incision using a phacoemulsification

apparatus. The phacoemulsification apparatus typically includes a hollow phacoemulsification needle driven by an ultrasonic hand piece. The

phacoemulsification needle is surrounded with a resilient coaxial sleeve made of

silicone rubber to define a liquid passageway between the outer surface of the

phacoemulsification needle and the inner surface of the resilient sleeve.

The phacoemulsification apparatus includes a liquid supply such as a bag or

bottle containing a suitable solution (e.g., balance salt solution, b.s.s.) for use during

the operation. The bottle or bag are located during the surgery above the patient's eye

to provide gravity feeding of the liquid through an infusion line to the hand piece. The phacoemulsification needle and sleeve are inserted through the small incision during

the surgery, and infusion liquid reaching the hand piece via the infusion line is directed

through the liquid passageway defined between the phacoemulsification needle and

resilient sleeve and exits and end opening of the resilient sleeve into the eye. The phacoemulsification apparatus includes a vacuum supply such as a peristaltic pump, which is connected to the hand piece by an aspiration line. The hand piece is configured to fluidly connect the aspiration line to a liquid passageway through

the lumen of the hollow phacoemulsification needle. The liquid entering the eye via the

infusion line and circulated within the eye is withdrawn through the lumen of the

hollow phacoemulsification needle during operation to remove particles of the natural crystalline lens being disintegrated by the phacoemulsification needle when contacting or nearly contacting the natural crystalline lens.

Once the natural crystalline lens is completely removed, a deformable

intraocular lens (IOL) is injected through the small incision into the eye with a lens

injecting device or placed through the small incision with a set of forceps gripping the deformed intraocular lens. The lens is manipulated and positioned within the capsular

bag, and then centered.

The phacoemulsification step and/or intraocular lens insertion step may be

traumatic to the capsular bag resulting in deformation of the shape and size of the

capsular bag, and or damage (e.g., stress damage, tears, broken posterior wall, damage

to zonules, etc.) causing potential complications. Further, once an intraocular lens has been implanted into the eye, the posterior wall of the capsular bag sometimes becomes

cloud due to epithelial cells original located only on the inner anterior surface of the capsular bag growing or migrating to the inner posterior surface of the capsular bag

causing capsular fibrosis.

There has been some efforts made in the United States with respect to intraocular lens and/or ring implants by Langerman. Langerman discloses methods and

device for treating various complications involving cataract surgery involving the

capsular bag. U.S. Patent No. 5,366,501 to Langerman, U.S. Patent No. Re. 34,998

to Langerman, U.S. Patent No. 5,593,436 to Langerman, and U.S. Patent No. 5,628,795 to Langerman are cited, and fully incorporated herein by reference.

Summary of the Invention

A first object of the present invention is to provide an improved posterior chamber implant device.

A second object of the present invention is to provide an improved posterior

chamber intraocular lens and intraocular ring.

A third object of the present invention is to provide a posterior chamber

intraocular lens and posterior chamber intraocular ring configured to prevent rotation

of the posterior chamber intraocular lens within an eye once implanted. A fourth object of the present invention is to provide a posterior chamber

intraocular ring configured to cooperate with a posterior chamber intraocular lens

implanted in an eye.

A fifth object of the present invention is to provide a posterior chamber

intraocular ring configured to shape and size of the eyes, in particular the sulcus and

capsular bag.

A sixth object of the present invention is to provide a posterior chamber intraocular lens and posterior chamber intraocular ring configured to reduce or

eliminate capsular fibrosis.

A seventh object of the present invention is to provide a posterior chamber intraocular ring configured to have an oblong-shaped configuration when implanted in

an eye.

An eighth object of the present invention is to provide a posterior chamber

intraocular lens and posterior chamber intraocular ring configured to reduce or

eliminate capsular fibrosis. A ninth object of the present invention is to provide a posterior chamber intraocular lens and posterior chamber intraocular ring configured to reduce opacification of the capsular bag.

A tenth object of the present invention is to provide a posterior chamber intraocular lens and posterior chamber intraocular ring configured to cooperate together once implanted.

An eleventh object of the present invention is to provide a posterior chamber intraocular lens connected to an posterior chamber intraocular ring.

A twelfth object of the present invention is to provide a plate-type posterior chamber intraocular lens connected to a posterior chamber intraocular tension ring.

A thirteenth object of the present invention is to provide a separate posterior chamber intraocular lens and separate posterior chamber intraocular ring configured to connect together when implanted in an eye.

A fourteenth object of the present invention is to provide packing for containing both an intraocular lens and an intraocular ring. The present invention is directed to a posterior chamber intraocular ring configured to be inserted into the eye. The posterior chamber intraocular ring

according to the present invention is particularly suitable for use as a capsular tension

ring to be inserted into the capsular bag prior to, during, or after a step of removing

the natural crystalline lens of the eye during cataract surgery, or for use as a sulcus tension ring to be inserted into the sulcus prior to, during, or after a step of implanting a phakic intraocular lens over the natural crystalline lens.

The insertion of a capsular tension ring prior to removal of the natural

crystalline lens may facilitate stabilization of the capsular bag in preparation of the lens

removal step. More specifically, the capsular tension ring may provide a more uniform distribution of forces (e.g., elimination of point forces) to the connecting zonules reducing the amount of trauma and/or actual damage to the zonules during the lens

removal step. Further, the capsular tension ring may also reduce the risk of

compromising the posterior wall of the capsular bag during phacoemulsification.

The capsular tension ring can be inserted into the eye prior to the step of

removing the natural crystalline lens. Specifically, a capsular tension ring injecting

apparatus according to the present invention can be used to insert and implant the

capsular tension ring according to the present invention while the natural crystalline

lens is still intact prior to the lens removal step. The capsular tension ring can be inserted during or after the step of removing the natural crystalline lens. Specifically, the capsular tension ring can be inserted 1) after a portion of the anterior wall of the capsular bag (e.g., by capsularhexis) has been removed, 2) when a portion of the natural crystalline lens is removed, or 3) after the entire lens has been explanted.

The capsular tension ring can be implanted by making a small incision through the wall of the eye ball proximate to the capsular bag and inserting one of the capsular tension ring through the small incision. The capsular tension ring is further insert by an injecting apparatus or manually by instrumentation (e.g., gripping forceps), and threaded around the natural crystalline lens and inside the capsular bag. This implantation procedure can be implemented prior to, during, or after the lens removal step.

Alternatively, after the removal of the anterior wall of the capsular, the capsular tension ring can be inserted into the capsular bag by making a small incision in the eye anterior of the capsular bag (i.e., anterior or posterior chamber) and then manipulating the capsular tension ring through the anterior opening in the capsular bag for placement therein.

The posterior chamber intraocular ring according to the present invention is preferably configured to prevent rotation of the posterior chamber intraocular lens relative thereto. Specifically, the posterior chamber intraocular ring can be round when inserted (i.e., closed) into the eye, but may include additional structure to contact, interfere, engage, or connect in some manner with the intraocular lens

disposed within the eye. Alternatively, the posterior chamber intraocular ring can be

oblong-shaped (e.g., oval, rectangular, etc.) so that the posterior chamber intraocular

lens cannot freely rotate within the eye. Preferably, the oblong-shaped posterior chamber intraocular ring according to the present invention prevents any significant rotation of the posterior chamber intraocular lens relative to the oblong-shaped posterior chamber intraocular ring, and most preferably prevents any relative rotation

there between. Further, the oblong-shaped posterior chamber intraocular ring

according to the present invention like the circular embodiment can include additional

structure to contact, interfere, engage or connect in some manner with the intraocular

lens.

The posterior chamber intraocular ring according to the present invention is

particularly suitable for use with posterior chamber intraocular lenses which require a

specific set orientation in the eye be maintained after surgery. For example, it would

be particularly desirable to provide a toric aphakic or phakic intraocular lens. The

posterior chamber intraocular ring according to the present invention can be

specifically oriented into the eye upon implantation, and then a suitable toric lens can

be implanted so as to cooperate with the intraocular lens. In this manner, the

intraocular ring prevents the rotation of the toric intraocular lens. In embodiments of the posterior chamber intraocular ring according to the

present invention configured to connect with the intraocular lens, the connection can be reversible (e.g., interference fit, frictional engagement) or can be permanent (e.g., adhesive bonding, heat welding, ultrasonic welding, molding, heat staking). In

embodiments of the posterior chamber intraocular ring in which the connection is

permanent with the posterior chamber intraocular lens, the combined structure can be

one-piece, multi-piece and/or composite. For example, the entire ring/lens is one structure formed by molding a uniform composition (e.g., silicone, acrylic, polyamide)

or machined (e.g., polymethyl methacrylate (PMMA), polysulfone, nylon, stainless steel, titanium). Alternatively, the ring/lens can be made of a silicone based

composition lens portion and a polyamide ring molded into edge portions of the lens portion.

The posterior chamber intraocular rings according to the present invention can

have various cross-sectional shapes (e.g., circular, oval, rectangular, square, triangular,

C-shaped, polyhedron, star shaped) and dimensions (e.g., aspect ratio defined by the

thickness of the capsular tension ring cross-section divided by the width). The

posterior chamber intraocular rings can have uniform cross-sectional shapes and

dimensions. Alternatively, continuous and discontinuous portions of the posterior

chamber intraocular rings can have different cross-sectional shapes and/or dimensions.

Further, the posterior chamber intraocular ring can have various surface finishes (e.g., smooth, roughened, circular ridges, transverse ridges, matrix of protrusions and/or

indentations, knurled, scratched, shot penned, ground, polished).

The posterior chamber intraocular ring is preferably deformable to allow

insertion of the posterior chamber intraocular ring through a small incision in the eye.

The posterior chamber intraocular ring can be inserted through the small incision with a posterior chamber intraocular ring injecting apparatus to be described herein, or can

be inserted through a small incision.

The capsular tension ring according to the present invention can be configured to promote or prevent fibrosis by surface texturing and/or coating with chemical agents or compositions. The capsular tension rings can be impregnated, coated, treated or

otherwise contain pharmaceuticals for immediate or time-released treatment of the eye.

The packaging system according to the present invention is configured for

storing a posterior chamber intraocular ring and posterior chamber intraocular lens

together. For example, the posterior chamber intraocular ring and posterior chamber

intraocular lens can be stored side-by-side, above-below, concentric (i.e., intraocular

lens disposed within capsular tension ring) within the packaging. The packaging

system is preferably sterilized and maintains the posterior chamber intraocular ring and

posterior chamber intraocular ring in a sterilized condition throughout shipping,

distribution and storage until actual use. In a preferred embodiment, the posterior chamber intraocular ring, posterior

chamber intraocular ring, or both are preloaded in a surgical instrument configured for

insertion and implantation of these implants into the eye. Preferably, the surgical

instrument includes a cartridge portion, which can be preloaded and then inserted into a cartridge receiver of the surgical instrument then readied for operation.

Brief Description of the Drawings

Figure 1 is side planar view of a first embodiment of a posterior chamber intraocular ring according to the present invention.

Figure 2 is side planar view of a second embodiment of a posterior chamber intraocular ring according to the present invention.

Figure 3 is side planar view of a third embodiment of a posterior camber intraocular ring according to the present invention.

Figure 4 is side planar view of a fourth embodiment of a posterior chamber

intraocular ring according to the present invention.

Figure 5 is side planar view of a fifth embodiment of a posterior chamber

intraocular tension ring according to the present invention. Figure 6 is side planar view of a sixth embodiment of a posterior chamber

intraocular ring according to the present invention.

Figure 7 is side planar diagrammatic view of a seventh embodiment of a

posterior chamber intraocular ring according to the present invention.

Figure 8 is side planar diagrammatic view of an eighth embodiment of a

posterior chamber intraocular ring according to the present invention.

Figure 9 is side planar diagrammatic view of a ninth embodiment of a posterior

chamber intraocular ring according to the present invention.

Figure 10 is side planar diagrammatic view of a tenth embodiment of a

posterior chamber intraocular ring according to the present invention.

Figure 11 is side planar diagrammatic view of an eleventh embodiment of a

posterior chamber intraocular ring according to the present invention.

Figure 12 is side planar diagrammatic view of a twelfth embodiment of a

posterior chamber intraocular ring according to the present invention. Figure 13 is side planar diagrammatic view of a thirteenth embodiment of a posterior chamber intraocular ring according to the present invention.

Figure 14 is side planar diagrammatic view of a fourteenth embodiment of a posterior chamber intraocular ring according to the present invention.

Figure 15 is side planar view of a capsular tension ring type of a capsular tension ring according to the present invention. The ring is shown in a compressed

state as if it were implanted in a capsular bag as shown in Figure 17.

Figure 16 is end view of the capsular tension ring according to the present invention shown in Figure 15.

Figure 17 is front view of the capsular bag of an eye implanted with a capsular

tension ring according to the present invention shown in Figure 15.

Figure 18 is a top planar view of a posterior chamber intraocular lens/ring

according to the present invention.

Figure 19 is an edge view of the posterior chamber intraocular lens/ring shown

in Fig. 18. Figure 20 is a top planar view of a posterior chamber intraocular lens/ring according to the present invention.

Figure 21 is an edge view of the posterior chamber intraocular lens/ring shown in Fig. 20.

Figure 22 is a transverse cross-section view of an embodiment of a posterior chamber intraocular ring according to the present invention.

Figure 23 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 24 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 25 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention. Figure 26 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 27 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 28 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 29 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 30 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 31 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 32 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention. Figure 33 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 34 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 35 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 36 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 37 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 38 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 39 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention. Figure 40 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 41 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 42 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention.

Figure 43 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 44 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 45 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 46 is a transverse cross-section view of a posterior chamber intraocular ring according to the present invention. Figure 47 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 48 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 49 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 50 is a transverse cross-section view of a posterior chamber intraocular

ring according to the present invention.

Figure 51 is a side elevational view of a portion of a posterior chamber

intraocular ring according to the present invention.

Figure 52 is a side elevational view of a portion of a posterior chamber

intraocular ring according to the present invention.

Figure 53 is a side elevational view of a portion of a posterior chamber

intraocular ring according to the present invention. Figure 54 is a side elevational view of a portion of a posterior chamber intraocular ring according to the present invention.

Figure 55 is a side elevational view of a portion of a posterior chamber

intraocular ring according to the present invention.

Figure 56 is a side elevational view of a portion of a posterior chamber intraocular ring according to the present invention.

Figure 57 is a side elevational view of a portion of a posterior chamber intraocular ring according to the present invention.

Figure 58 is a side elevational view of a portion of a posterior chamber

intraocular ring according to the present invention.

Figure 59 is a side elevational view of a portion of a posterior chamber

intraocular ring according to the present invention.

Figure 60 is a side elevational view of a portion of a posterior chamber

intraocular ring according to the present invention. Figure 61 is a perspective of a posterior chamber intraocular lens/ring

packaging device.

Detailed Description of Preferred Embodiments

Definitions:

Intraocular Ring - an intraocular ring configured for implantation into the eye. The intraocular ring can be configured for implantation in any portion of the eye, including by not limited to cornea, sclera, anterior chamber, posterior chamber, sulcus,

capsular bag, vitreous, etc. The intraocular rings can be configured to be tension or

non-tension type rings when implanted into the eye.

Posterior Chamber - particular chamber of the eye located between iris and

vitreous.

Posterior Chamber Intraocular Ring - an intraocular ring configured and

suitable for placement within the posterior chamber of the eye.

Intraocular Lens (IOL) - any of a variety of lenses configured for implantation

into the eye of a human or animal. Intraocular lens include anterior chamber lenses,

posterior chamber lenses, capsular posterior chamber lens, aphal ic lens, phakic lens (e.g., INTRAOCULAR CONTACT LENS manufactured by Staar Surgical Company

of Monrovia, California), intercorneal ring (icr), intraocular corneal ring, tonic intraocular lens, multi-focal intraocular lens, and tonic multi-focal intraocular lens.

The intraocular lens can be substantially rigid (e.g., PMMA) or deformable (e.g.,

silicone, acrylic, COLLAMER). Further the intraocular lens can be three (3) piece lens

(e.g., optic portion and two separate opposed haptics) or plate-type IOLs.

Posterior Chamber Intraocular Lens - an intraocular lens configured and

suitable for placement within the posterior chamber of the eye.

Aphakic Intraocular Lens - an intraocular lens configured for replacement of

the natural crystalline lens.

Phakic Intraocular Lens - an intraocular lens configured for providing an

additional lens to the eye, which optically cooperates with the natural crystalline lens.

The IMPLANT ABLE CONTACT LENS (ICL) manufactured by Staar Surgical

Company of Monrovia, California is an example of a phakic lens.

A plurality of preferred posterior chamber intraocular rings according to the

present invention are shown in Figures 1-14. These intraocular ring are particularly

suitable and configured (i.e., shaped, sized, biocompatible, surface finish, sterile, etc.) for placement in the posterior chamber of the eye. However, these intraocular rings

may be suitable for implantation in other portions of the eye.

The preferred posterior chamber intraocular rings have the following features:

I. Overall shape of posterior chamber intraocular ring shaped to engage

with posterior chamber intraocular lens to prevent rotation thereof.

The posterior chamber intraocular ring can prevent rotation of the

posterior chamber intraocular ring by at least one portion of the

posterior chamber intraocular ring contacting, interfering, capturing, blocking, or stopping at least one portion of the posterior chamber

intraocular lens. For example, in the embodiments shown in Figs. 1-6 the inner edges of the ring portions themselves engage with edges of the

different types of lens shown in ghost image in Figs. 1 and 2, since these

common lens designs (i.e., plate-type and three-piece type) are by

nature oblong-shaped. Also see lens capturing effect shown in Fig. 17.

II. The posterior chamber intraocular ring is provided with connection

portions to contact, interfere, block, stop, or connect with the posterior

chamber intraocular lens. For example, in Figs. 8 and 10 connection

portions are provided to edges to engage with edges of the posterior

chamber intraocular lens to prevent rotation. Further, the posterior chamber intraocular lens can be directly connected to the posterior

chamber intraocular lens prior to implantation (see Fig. 18), or the

posterior chamber intraocular lens and/or ring can be provided with attachable connection portions to allow connection after implantation

(see Fig. 19).

III. The features of both I and II are used in combination.

Preferred embodiments of the posterior chamber intraocular ring according to

the present invention have an overall shape with and aspect ratio greater or less than

one (1) (e.g., oblong-shaped, oval, elliptical, rectangular, C-shaped, etc.). The aspect

ratio being defined by the average height (H) divided by the average width (W) or the

ratio H/D. The preferred embodiments of the posterior chamber intraocular rings shown in Figs.1-6 have an aspect ratio greater than one (1). This configuration tends

to prevent the rotation of the posterior chamber ring from rotation relative to the eye

once implanted into the capsular bag and/or sulcus. Further, when a posterior chamber

intraocular lens is disposed within the posterior chamber intraocular ring, the edges of

the oblong-shaped lens geometrically engages with the posterior chamber intraocular

ring unlike a circular-shape ring which allows for free rotation.

The intraocular ring 10 shown in Figure 1 is a modified C-shaped ring having

four (4) less well defined corners achieved by providing an additional radius of curvature to the ring at the location of these four (4) corners. The intraocular ring 10 is provided with bent ends 12a and 12b configured to allow gripping by a surgical

forceps.

The intraocular ring 20 shown in Figure 2 is an oval-shaped ring having a

continuously changing radius of curvature and is provided with a pair of eyelets 22a

and 22b. The intraocular ring 30 shown in Figure 3 has the same oval-shaped ring configuration but is provided with bent ends 32a and 32b instead of eyelets.

The intraocular ring 40 shown in Figure 4 has the same shape ring

configuration as the intraocular ring 10 shown in Figure 1, but is provided with eyelets

42a and 42b instead of bent ends.

The intraocular ring 50 shown in Figure 5 is a C-shaped ring having bent ends

52a and 52b, and the intraocular ring 60 shown in Figure 6 has the same C-shaped ring

configuration, but is provided with eyelets 62a and 62b instead of bent ends.

OTHER RING CONFIGURATIONS

Other suitable ring shape configurations for the intraocular ring according to

the present invention is shown in Figures 7-14. The intraocular ring 70 shown in Figure 7 is provided with four (4) foot pad ring portions 72a, 72b, 72c and 72d. These foot pad ring portions tend to anchor the intraocular ring 70 in the capsular bag or sulcus and prevent rotation thereof once

implanted into the eye.

The intraocular ring 80 shown in Figure 8 is circular-shaped and provided with

plate portions 82a and 82b connected to the ring portion 84 and eyelets 86a and 86b. The plate portions 82a and 82b include flat edges 88a and 88b, which engage with the

long edges of a plate type of IOL when disposed within the intraocular ring 80.

The intraocular ring 90 shown in Figure 9 is provided with multiple corners or

edges 90 a-h and eyelets 92a and 92b. The corners or edges tend to anchor the intraocular lens 90 in the capsular bag or sulcus and prevent rotation thereof in the eye.

The intraocular ring 100 shown in Figure 10 is circular shaped and provided

with plate portions 102a and 102b connected to ring portion 104 and eyelets 106a and

106b. The edges 108a and 108b grip end edges of a plate-type intraocular lens when

disposed within the intraocular ring 100.

The intraocular ring 110 shown in Figure 11 includes straight ring portions

112a, 112b and 112c, curved ring portions 114a and 114b, and eyelets 116a and 116b.

The straight ring portions 112a, 112b and 112c engage and cooperate with the long edges of a plate-type IOL to prevent rotation when disposed within the intraocular ring

110.

The intraocular ring 120 shown in Figure 12 is rectangular in shape having

longer sides 122a, and 122b and 122c combined, and shorter sides 124a and 124b.

The sides 122b and 122c are provided with eyelets 126a and 126b.

The intraocular ring 130 shown in Figure 13 is a modified rectangular shape

having longer sides 132a, and 132b and 132c combined, and shorter sides 134a and

134b. The sides 132b and 132c are provided with eyelets 136a and 136b. The comers

138a, 138b, 138c and 138d are rounded.

The intraocular ring 140 shown in Figure 14 is a modified rectangular shape

having longer sides 142a, and 142b and 142c combined, and shorter sides 144a and

144b. The sides 142b and 142c are provided with eyelets 146a and 146b. The comers

148a, 148b, 148c and 148d are rounded foot pads.

The capsular tension ring 150 having eyelets 151a and 151b and shown in Figs.

15-17, is an example of a pesterer chamber intraocular ring according to the present

invention. The capsular tension ring 150 is shown in a compressed configuration in

Fig. 15, as if it were implanted in the eye as shown in Fig. 17. The oblong-shaped capsular tension ring is compressed with varying stress forces by the zonules of the capsular bag. The zonules deform according to an equal an opposite compressive

force applied by the capsular tension ring 150 constantly attempting to further open

when implanted in the eyes. Thus, the zonules are variably compressed and tend to prevent rotation of the capsular tension ring 105 relative to the capsular bag and eye.

The plate-type intraocular lens 152 including lens portion 154 and opposed

plate haptic portions 156, 156 is disposed or captured within the capsular tension ring

150. The intraocular lens 152 cannot substantially rotate within the eye due the edges

of comers engaging and contacting with inside surface portions of the capsular tension

ring 150.

A preferred posterior chamber intraocular lens implant according to the present

invention includes the combination of a posterior chamber intraocular lens connected

to or connectable to a posterior chamber intraocular lens.

In Figs. 18 and 19, the posterior chamber intraocular implant device 160

includes a posterior chamber intraocular lens 162 connected to a posterior chamber

intraocular ring 164. Specifically, the posterior chamber intraocular lens includes a

lens portion 162a and opposed plate haptic portions 162b, 162b directly connected to

the posterior chamber intraocular ring 164. The lens/ring combination can be one

piece (e.g., molded or machined polymer), or can have a multi-piece construction (e.g.,

molded with multiple components, assembled). Further, the posterior chamber intraocular lens 162 can be connected to the posterior chamber intraocular ring 164 by

adhesive, molding, stacking, heat stacking, welding, heat welding, ultrasonic welding, machining, mechanically, or by other suitable means.

The connection between the posterior chamber intraocular lens 162 and

posterior chamber intraocular ring 164 can be permanent, substantially permanent,

detachable, etc. For example, the lens/ring combination is permanent purposely to

prevent separate during implantation and/or throughout life of implant. Alternatively,

the lens can be made to be detachable (e.g., perforations, lines of weakness, soluble by body fluids) so that the lens can or will at some time detach from the ring. For

example, a surgeon may want to replace a lens in the case of a phakic IOL while leaving the ring intact. Further, for example, the lens detaches from the ring with time

due to a bodily fluid soluble connection(s) to allow the lens to move some extent

relative to the ring with time (e.g., to provide wear, accommodation, patient aging,

etc.)

In the embodiment shown in Figs. 18 and 19, the lens 162 and ring 164 are

located in the same plane A- A (see Fig. 19) when implanted in the eye.

Another embodiment of a lens/ring implant device 170 is shown in Figs. 20 and

21. In this embodiment, the posterior chamber intraocular lens 172 is connectable to the posterior chamber intraocular ring 174. Specifically, the posterior chamber intraocular lens 172 is provided with through holes 173, 173 configured to accommodate and connect with inwardly extending protrusions 174a and 174a

provided with gripping hooks 174b and 174b, respectively. The posterior chamber

intraocular lens 172 is connected by the posterior chamber intraocular ring 174 by

inserting one gripping hook 174b at a time into the respective through holes 173. The posterior chamber intraocular ring tends to tend stretch the lens under tension maintaining the gripping hooks 174 engaged within the through holes 173.

In the embodiment shown in Fig. 21, the posterior chamber intraocular lens 172

is located in a different plane relative to the posterior chamber intraocular ring 174.

Specifically, the plane A- A is located in front of the plane B-B.

TRANSVERSE RING CROSS SECTIONS

The cross-sectional size and shape of the posterior chamber intraocular rings

can provide different ways of interacting with the interior periphery of the capsular

bag. The configuration can vary the extent of structurally strength of the capsular bag

(e.g., added stiffness, integrity, stability) and potentially control or event prevent

fibrosis and opacification of the posterior wall of the capsular bag. The use of shape

edges contacting with one or more surfaces of the inner surface of the capsular bag

may impede or even prevent the migration of epithelial cell original located on the

anterior surface of the capsular to the posterior surface of the capsular bag. For example, shape ring-shaped ridges on an outer periphery of the posterior chamber

intraocular ring may provide a physical or structural barrier against epithelial cell

migration.

The surface geometry of the posterior chamber intraocular ring may have

significant effect on the performance of the implant regarding increasing the integrity

and stability of structures in the posterior chamber of the eye (e.g., capsular bag and sulcus), complications after cataract surgery or phakic lens implantation, effect diseases of the eye (e.g., glycoma, opacification, retinal detachment, etc.), effect

circulation and fluid within the eye, effect immune responses in the eye, effect

reflection and diffusion of light in the eye, and effect other significant factors.

Further, the surface configuration may have significant effect on adhesion with

eye tissue to achieve different goals (e.g., reduced opacification, light refraction and

diffusion, tissue morphology, etc.). Further, the extent of adhesive will dictate whether

the implant is later removable, movable, adjustable, fixable, or permanency.

Figs. 22-50 are various embodiments of different ring cross-sections potentially

suitable for implantation.

The transverse cross-sectional shapes can be simple with large planar surfaces

and minimum number of medium sharp edges (i.e., forty-five (45) or greater degree angle). For example, in Figs. 22, 24, 26, 27, 28 and 29 round, triangular, square,

hexagon, rectangular and pentagon cross sections are shown.

Preferably, there exists a greater number edges, and including or in addition

one or more substantially sharp edges (e.g., less than forty-five degree angle). More

preferably, multiple sharp edges are provided at locations which engage the capsular

bag or sulcus for particular applications. In Fig. 23, a round cross section with one

sharp edge is shown. In Fig. 25, a round cross section with four (4) sharp edges is shown. In Fig. 30, three (3) sharp edges located in a triangular configuration is shown. In Fig. 31, a star-shaped cross section is shown.

Figs. 22-31 having substantially solid or closed cross sections. The

embodiments shown in Figs. 32-34 have non-solid or open cross sections allow various mechanical connections with an intraocular lens. Specifically, these configurations can

grip edge portions of the intraocular lens. Alternatively, the configurations can be

reversed in orientation so that the sharp edges again engage surfaces portions of the

capsular bag when implanted. These embodiments are all configured in general to have

sharp edges on one side and more or less smooth surfaces on the opposite side. Again,

the sharp edges can be oriented either inwardly or outwardly depending on a particular

application. In Figs. 43, 43, 44, 46 and 48 are all provided with numerous shape edges. In

some embodiments the sharp edges are only on one side (e.g., Figs. 42, 43, and 44)

and in other embodiments the sharp edges are on all sides (e.g., Figs. 46 and 48).

In Figs. 45 and 47, these embodiments include one or more barbed members to

facilitate anchoring in the tissue, lens or both. Thus, barbs can be provided one more

than one side. In Fig. 49, the embodiment is provided with two (2) sharp spikes again

to facilitate gripping of the capsular bag or sulcus and or lens.

In Fig. 50., the embodiment is provided with a resilient outer layer 200 (e.g.,

polymer) and a deformable wire 202 to allow the shape of the ring to be adjusted.

Alternatively, the wire 202 can be provided with a significantly weak metal (e.g., lead)

to allow plastic deformation during implanting and/or with time once implanted or a rigid member (e.g., spring steel, plastic (polysulfone) ring) to stiffen the ring against

deformation.

RING SURFACE CONFIGURATIONS

Various embodiments of surface configurations for the posterior chamber

intraocular rings according to the present invention is shown in Figs. 1-57. The surface finish in generally can be smooth, roughened, scratched, shot

penned, sanded, etched, sputtered, ground, heat treated, light (e.g., laser) treated, etc.

to provide various finishes.

In addition, the surface may be provided with significant surface features such as grooves, ribs, slots, cuts, voids, holes, protrusions. Thus, these define macro surface configurations or features and the surface finish defines micro surface

configurations or features.

In Fig. 51, the ring is provided with continuous peripheral transverse grooves

providing sharp edges. In Fig. 52, the surface is provided with a matrix of protrusions

and/or indentations. In Fig. 53, the ring is provided with spaced apart peripheral transverse grooves providing rounded edges. In Fig. 54, the grooves are each wider to

provide multiple spaced apart transverse ridges. This embodiment, alternatively, can

also be provided with longitudinal grooves to provide a matrix of finger-like

projections.

In Fig. 55, the surface is provided with minor transverse grooves. In Fig. 56.

The surface is provided with uniformly spaced and arranged protrusions and/or

indentations. In Fig. 57, the surface is provided with random fine protrusions and/or

indentations. The posterior chamber intraocular rings can also be provided with macro three- dimensional features and characteristic to provide additional applications.

In Fig. 58, the ring is provided in a spiral-shaped configuration (e.g., tight or

loose spring or SLINKY-like arrangement). In Fig. 59, the ring is multiple strand and fiber-like in configuration. In Fig. 60, the ring is tape-like with irregular fenestrations.

PACKAGING

The prevent invention includes a packaging device for a posterior chamber intraocular lens and a separate posterior chamber intraocular ring.

In a preferred embodiment shown in Fig. 61, the packaging device 300 includes

a tray provided with a pair of indentations 302 and 304 for accommodating the

posterior chamber intraocular lens and separate posterior chamber intraocular ring are

provided side-by-side. In the embodiment shown, one indentation 302 is rectangular

shaped for accommodating the posterior chamber intraocular ring and one indentation

304 is circular shaped for accommodating the posterior chamber intraocular lens.

Alternatively, the packaging device can be configuration to stack the posterior

chamber intraocular ring over the posterior chamber intraocular lens, or vice versa. The intraocular lens and ring according to the present invention can optionally

include other features, including:

1) calibration markings on intraocular lens and intraocular ring for orientation the intraocular lens relative to the intraocular ring after implantation in the eye.

2) intraocular lens and intraocular ring configured to allow reorientation of

the intraocular lens relative to the intraocular ring after implantation in

the eye a period significantly after the surgical operation.

3) intraocular ring configured to remove cataract lens debris or other byproducts of phacoemulsification through at least a portion of the life of the intraocular ring. For example, an adhesive, hydrophilic/hydrophobic

coating on the intraocular ring to attract cataract lens debris.

4) intraocular ring configured to self-center the intraocular lens.

5) adjustable intraocular ring configured to be modified in shape and/or

size by instruments, light (e.g., laser), chemical, heat, or other agents or

factors. 6) intraocular ring made of a bio-absorbable material.

7) three-dimensional intraocular ring designs.

8) intraocular ring having rigid and flexible portions to accommodate

different shaped capsular bags and/or sulcus.

9) intraocular ring having composite structures for varying structural

strength, rigidity, flexibility, hardness/softness.

10) intraocular ring configured to deform or further deform with time. For example, a synthetic plastic material operating in its plastic mode to

change shape of eye or accommodation.

11) intraocular lens having different aspect ratios.

12) intraocular ring made of multiple portions interfitting together to form

the overall ring structure.

13) intraocular ring is a matrix for binding pharmaceuticals for treatment of

the eye.

14) intraocular ring is made of a chain of material.

Claims

I CLAIM:

1. A posterior chamber intraocular implant device for an eye, said device comprising:

a posterior chamber intraocular lens; and

a separate posterior chamber intraocular ring, said posterior chamber

intraocular ring configured to cooperate with said posterior chamber

intraocular lens and prevent rotation of said posterior chamber intraocular lens after being implanted into an eye.

2. A device according to Claim 1, wherein said posterior chamber intraocular ring

is configured to prevent rotation of said posterior chamber intraocular ring

relative to an eye after being implanted in an eye.

3. A device according to Claim 1, wherein said posterior chamber intraocular ring

is shaped to have an average aspect ratio greater or less than one (1) when

viewing a side of said posterior chamber intraocular ring.

4. A device according to Claim 3, wherein a shape of said posterior chamber

intraocular ring is one selected from the group consisting of oblong, oval,

ovoid, elliptical, C-shaped, and rectangular.

5. A device according to Claim 1, wherein said posterior chamber intraocular lens and said posterior chamber intraocular ring are configured so that said intraocular lens is disposed within said posterior chamber intraocular ring when said posterior chamber intraocular lens and said posterior chamber intraocular

ring are both implanted into an eye.

6. A device according to Claim 1, wherein said posterior chamber intraocular lens

and said posterior chamber intraocular ring are configured so that said

posterior chamber intraocular lens is surrounded by said posterior chamber

intraocular ring when said posterior chamber intraocular lens and said posterior

chamber intraocular ring are both implanted into an eye.

7. A device according to Claim 1, wherein said posterior chamber intraocular lens

and said posterior chamber intraocular ring are configured to be located in a

same plane when implanted into an eye.

8. A device according to Claim 5, wherein said posterior chamber intraocular lens

and said posterior chamber intraocular ring are configured to be located in a same plane when implanted into an eye.

9. A device according to Claim 1, wherein said posterior chamber intraocular lens

and said posterior chamber intraocular ring are configured to be located in

different planes when implanted into an eye.

10. A device according to Claim 5, wherein said posterior chamber intraocular lens

and said posterior chamber intraocular ring are configured to be located in

different planes when implanted into an eye.

11. A device according to Claim 1, wherein said posterior chamber intraocular lens is an aphakic posterior chamber intraocular lens.

12. A device according to Claim 1, wherein said posterior chamber intraocular lens

is a phakic posterior chamber intraocular lens.

13. A device according to Claim 1, wherein said posterior chamber intraocular lens is an toric posterior chamber intraocular lens.

14. A device according to Claim 1, wherein said posterior chamber intraocular lens

is a multi-focal intraocular lens.

15. A device according to Claim 1, wherein said posterior chamber intraocular lens

in a toric multi-focal intraocular lens.

16. A device according to Claim 1, wherein said posterior chamber intraocular ring

is configured to connect together with said posterior chamber intraocular lens

after being implanted into an eye.

17. A device according to Claim 1, wherein said posterior chamber intraocular lens

is a deformable posterior chamber intraocular lens.

18. A device according to Claim 1, wherein said posterior chamber intraocular ring

is a deformable posterior chamber intraocular ring.

19. A device according to Claim 17, wherein said posterior chamber intraocular

ring is a deformable posterior chamber intraocular lens.

20. A device according to Claim 1, wherein said posterior chamber intraocular ring

is treated with a chemical composition for treatment of an eye.

21. A device according to Claim 20, wherein said chemical for said chemical

treatment is in the form of one selected from the group consisting of coating a

surface of the intraocular lens, impregnating a material forming the intraocular lens, and configuring the intraocular lens to provide one or more reservoirs for

containing the chemical.

22. A device according to Claim 1, wherein said posterior chamber intraocular ring

is configured to have an overall shape with a varying radius of curvature when viewing a side of said intraocular ring.

23. A device according to Claim 1, wherein said posterior chamber ring is made of

a material including one selected from the group consisting of silicone polymer,

acrylic polymer, collagen-containing polymer, COLLAGEN, polyamide,

polyimide, nylon, polymethyl methacrylate, PLEXIGLAS, polysulfone, glass,

fiberglass, graphite, boron, ceramic, metal, stainless steel, titanium, and composite materials.

24. A device according to Claim 1, wherein said posterior chamber lens is made of

a material including one selected from the group consisting of polymer, silicone

polymer, acrylic polymer, collagen-containing polymer, COLLAGEN, and

copolymer.

25. A device according to Claim 23, wherein said posterior chamber lens is made of a material including one selected from the group consisting of polymer,

silicone polymer, acrylic polymer, collagen-containing polymer, COLLAGEN, and copolymer.

26. A posterior chamber intraocular implant device for an eye, said device

comprising:

a posterior chamber intraocular ring, said posterior chamber intraocular ring having a shape with an aspect ratio greater or less than one (1) when view a side of said posterior chamber intraocular ring.

27. A device according to Claim 26, wherein said posterior chamber intraocular

ring is configured to prevent rotation of said posterior chamber intraocular ring

relative to an eye after being implanted in an eye.

28. A device according to Claim 26, wherein a shape of said posterior chamber

intraocular ring is one selected from the group consisting of oblong, oval,

ovoid, elliptical, C-shaped, and rectangular.

29. A device according to Claim 26, wherein said posterior chamber intraocular

ring is configured so that an intraocular lens can be disposed within said posterior chamber intraocular ring when the posterior chamber intraocular lens and said posterior chamber intraocular ring are both implanted into an eye.

30. A device according to Claim 26, wherein said posterior chamber intraocular ring is configured so that a posterior chamber intraocular lens can be surrounded by said posterior chamber intraocular ring when the posterior

chamber intraocular lens and said posterior chamber intraocular ring are both

implanted into an eye.

31. A device according to Claim 26, wherein said posterior chamber intraocular

ring is configured to be located in a same plane as a posterior chamber

intraocular lens when implanted into an eye.

32. A device according to Claim 29, wherein said posterior chamber intraocular

ring is configured to be located in a same plane as a posterior chamber

intraocular lens when implanted into an eye.

33. A device according to Claim 26, wherein said posterior chamber intraocular

lens is located in a different plane relative to a posterior chamber intraocular lens when implanted into an eye.

34. A device according to Claim 29, wherein said posterior chamber intraocular ring is located in a different plane relative to a posterior chamber lens when

implanted into an eye.

35. A device according to Claim 26, wherein said posterior chamber intraocular ring is an intraocular capsular ring.

36. A device according to Claim 26, wherein said posterior chamber intraocular

lens is an intraocular sulcus ring.

37. A device according to Claim 26, wherein said posterior chamber intraocular

ring is configured to connect together with a posterior chamber intraocular lens after being implanted into an eye.

38. A device according to Claim 26, wherein said posterior chamber intraocular

ring is a deformable posterior chamber intraocular ring.

39. A device according to Claim 26, wherein said posterior chamber intraocular

ring is treated with a chemical composition for treatment of an eye.

40. A device according to Claim 39, wherein said chemical for said chemical

treatment is in the form of one selected from the group consisting of coating a surface of the intraocular lens, impregnating a material forming the intraocular

lens, and configuring the intraocular lens to provide one or more reservoirs for

containing the chemical.

41. A device according to Claim 26, wherein said posterior chamber intraocular

ring is configured to have an overall shape with a varying radius of curvature when viewing a side of said intraocular ring.

42. A posterior chamber intraocular lens and posterior chamber intraocular ring

packaging device, said device comprising:

a posterior chamber intraocular lens; and

a posterior chamber intraocular ring.

43. A device according to Claim 42, including a tray for accommodating said

posterior chamber intraocular lens and said posterior chamber intraocular ring.

44. A device according to Claim 43, wherein said tray is provided with one or

more indentations for accommodating said posterior chamber intraocular lens

and said posterior chamber intraocular ring.

45. A device according to Claim 44, wherein said tray is provided with two separate indentations configured for individually storing said posterior chamber intraocular lens and said posterior chamber intraocular ring.

46. A device according to Claim 44, wherein said tray is provided with one

indentation configured for accommodating both said posterior chamber

intraocular lens and said posterior chamber intraocular ring.

47. A device according to Claim 46, wherein said one indentation is configured to store said posterior chamber intraocular ring in a position above said posterior chamber intraocular lens.

48. A device according to Claim 44, wherein one said indentation is configured in

a shape of and to accommodate said posterior chamber intraocular lens and

another indentation is configured in a shape of and to accommodate said posterior chamber intraocular ring.

49. A device according to Claim 48, wherein said indentations are located side-by-

side.

50. A device according to Claim 48, wherein said indentation s are superimposed.

51. A device according to Claim 42, wherein said packaging device is sterilized.

52. A device according to Claim 42, wherein said packaging device is a cartridge.

53. A device according to Claim 52, wherein said cartridge is configured to be

disposed withing a cartridge receiver of an surgical implantation device.