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1. WO1999030645 - CORNEAL IMPLANT METHODS AND PLIABLE IMPLANT THEREFORE

Publication Number WO/1999/030645
Publication Date 24.06.1999
International Application No. PCT/US1998/027100
International Filing Date 18.12.1998
Chapter 2 Demand Filed 19.07.1999
IPC
A61F 2/14 2006.1
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
FFILTERS 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
2Filters 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
02Prostheses implantable into the body
14Eye parts, e.g. lenses, corneal implants; Artificial eyes
A61F 9/013 2006.1
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
FFILTERS 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
9Methods 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
007Methods or devices for eye surgery
013for compensation of ocular refraction
CPC
A61F 2/147
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
FFILTERS 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
2Filters 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
02Prostheses implantable into the body
14Eye parts, e.g. lenses, corneal implants; ; Implanting instruments specially adapted therefor; Artificial eyes
147Implants to be inserted in the stroma for refractive correction, e.g. ring-like implants
A61F 2/148
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
FFILTERS 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
2Filters 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
02Prostheses implantable into the body
14Eye parts, e.g. lenses, corneal implants; ; Implanting instruments specially adapted therefor; Artificial eyes
148Implantation instruments specially adapted therefor
A61F 9/013
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
FFILTERS 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
9Methods 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
007Methods or devices for eye surgery
013Instruments; for compensation of ocular refraction
A61F 9/0133
AHUMAN NECESSITIES
61MEDICAL OR VETERINARY SCIENCE; HYGIENE
FFILTERS 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
9Methods 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
007Methods or devices for eye surgery
013Instruments; for compensation of ocular refraction
0133Knives or scalpels specially adapted therefor
Applicants
  • KERAVISION, INC. [US]/[US] (AllExceptUS)
  • SILVESTRINI, Thomas, A. [US]/[US] (UsOnly)
Inventors
  • SILVESTRINI, Thomas, A.
Agents
  • BECKING, Frank, P.
  • PRICE Nigel John King
Priority Data
08/993,94618.12.1997US
Publication Language English (en)
Filing Language English (EN)
Designated States
Title
(EN) CORNEAL IMPLANT METHODS AND PLIABLE IMPLANT THEREFORE
(FR) PROCEDES D'IMPLANT CORNEEN ET IMPLANT SOUPLE UTILISE A CETTE FIN
Abstract
(EN) This invention involves an improved surgical method and associated apparatus for correcting refractive defects of the vision, using an intracorneal implant. A small radial incision is made in the periphery of the cornea, near the limbus and a blunt spatula is used to separate the lamellae of the corneal stroma. A circular interlamellar pathway through the stroma is formed using either a single 360 degree blunt, arc-shaped dissector tool or a pair of clockwise and counterclockwise 180-200 degree dissector tools. The circular pathway created defines the margin or outer boundary of an intracorneal channel that will be formed. The intracorneal channel is then expanded radially inward in a controlled stepwise fashion to widen the channel or to create an intracorneal pocket. This is done by introducing a dissector tool with a side leg into the incision and moving the dissector tool in an arc-shaped path to widen the intracorneal channel. A single 360 degree dissector tool or a pair of clockwise and counterclockwise 180-200 degree dissector tools can be used. Dissector tools with progressively longer side legs are used to expand the channel until the desired width is achieved or until a complete intracorneal pocket is created. An intracorneal implant, which may be a split ring, segmented ring or continuous ring intracorneal implant or an intracorneal lens implant, is inserted into the channel or pocket and the incision is closed. The intracorneal implant is positioned remotely from the incision so that less stress is exerted on the incision during healing. The surgical apparatus, including the blunt, arc-shaped dissector tools and the side-leg dissector tools can be designed to be operated manually or with a vacuum centering guide which allows careful and precise control over the intracorneal channel created.
(FR) La présente invention concerne un procédé chirurgical amélioré et un appareil associé permettant de corriger les défauts de réfraction de la vue grâce à un implant cornéen. On effectue une petite incision radiale à la périphérie de la cornée, près du limbe, et on utilise une spatule arrondie pour séparer les lamelles du stroma cornéen. On forme un passage interlamellaire circulaire à travers le stroma à l'aide d'un seul outil dissecteur arqué arrondi de 360 degrés ou à l'aide de deux outils dissecteurs de 180-200 degrés formés dans le sens des aiguilles d'une montre ou dans le sens contraire. Le passage circulaire ainsi créé définit la marge ou la frontière extérieure du canal intracornéen qui sera formé. On agrandit ensuite radialement vers l'intérieur, de façon graduelle et contrôlée, le canal cornéen afin de l'élargir ou de créer une poche intracornéenne. A cette fin, on introduit dans l'incision un outil dissecteur muni d'un bras latéral et on déplace celui-ci selon une trajectoire arquée afin d'élargir le canal cornéen. On peut pour ce faire utiliser un seul outil dissecteur arqué arrondi de 360 degrés ou deux outils dissecteurs de 180-200 degrés formés dans le sens des aiguilles d'une montre ou dans le sens contraire. On utilise des outils dissecteurs dotés de bras latéraux progressivement plus longs afin d'étendre le canal jusqu'à ce que l'on obtienne la largeur désirée ou jusqu'à ce que soit créée une poche intracornéenne complète. On insère alors dans le canal ou dans la poche un implant intracornéen, anneau fendu, anneau segmenté, anneau continu ou cristallin artificiel, et l'on referme l'incision. L'implant intracornéen est placé loin de l'incision de manière à réduire les contraintes qui s'exercent sur celle-ci pendant la cicatrisation. L'appareil chirurgical, y compris les outils dissecteurs arqués arrondis et les outils dissecteurs à bras latéral, peut être conçu pour être manoeuvré manuellement ou avec un guide de centrage à dépression qui permet de régler avec soin et précision le canal intracornéen formé.
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