Surgery – Instruments – Corneal cutter or guide for corneal cutter
Patent
1996-08-06
1998-12-01
Buiz, Michael
Surgery
Instruments
Corneal cutter or guide for corneal cutter
606107, 128898, A61F 900
Patent
active
058431055
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
This invention is a surgical method and device for inserting a biocompatible material into an intrastromal passageway to permanently alter corneal curvature. The device and method allow for the placement of the material in the optimal position for maximal visual correction.
BACKGROUND OF THE INVENTION
Anomalies in the overall shape of the eye can cause visual disorders. Hyperopia ("farsightedness") occurs when the front-to-back distance in the eyeball is too small. In such a case, parallel rays originating greater than 20 feet from the eye focus behind the retina. In contrast, when the front-to-back distance of the eyeball is too large, myopia ("nearsightedness") occurs and the focus of parallel rays entering the eye occurs in from of the retina. Astigmatism is a condition which occurs when the parallel rays of light do not come to a single point within the eye, but rather have a variable focus due to the fact that the cornea is aspherical and refracts light in a different meridian at different distances. Some degree of astigmatism is normal, but where it is too high, it must often be corrected.
Hyperopia, myopia, and astigmatism are usually corrected by glasses or contact lenses. Surgical methods for the correction of such disorders are known. Such methods include radial keratotomy (see e.g., U.S. Pat. Nos. 4,815,463 and 4,688,570) and laser corneal ablation (see, e.g., U.S. Pat. No. 4,941,093).
Another method for correcting those disorders is through implantation of polymeric rings in the eye's corneal stroma to change the curvature of the cornea. Previous work involving the implantation of polymethylmethacrylate (PMMA) rings, allograft corneal tissue, and hydrogels is well documented. One of the devices involves a ring design that allows a split ring to be inserted into a channel dissected in the stromal layer of the cornea using a minimally invasive incision through which the channel for the implant is created and through which the implant is inserted.
U.S. Pat. No. 4,452,235 to Reynolds describes a method and apparatus for corneal curvature adjustment. The method involves inserting one end of a split end adjusting ring into the cornea of the eye and moving the ring in a circular path until its ends meet. The ends are thereafter adjusted relative to each other until the shape of the eye has assumed a desired curvature whereupon the ends are fixedly attached to maintain the desired curvature of the cornea.
PCT Application No. PCT/US93/03214 filed 7 Apr., 1993 describes a corneal vacuum centering guide and dissector for use in inserting an intrastromal corneal ring ("ICR"). The device is made of up of three major components: a vacuum centering guide, a barrel that fits within the inner bore of the centering guide and to which is attached the third major component, a circular dissecting ring. The three components are further described below.
The vacuum centering guide has a support base that has a proximal end, a distal end and a center section. The center section has a wall with a generally cylindrical bore with a central axis. The central section extends between the proximal and distal ends of the support base. The cylindrical bore has a ratio of length to diameter of between about 0.25:1 and 15:1. An annular vacuum chamber located at the proximal end of the support base is adapted to create an annular vacuum space when placed against the eye.
The barrel and dissector blade assembly is used in connection with the vacuum centering guide in order to produce the circular interlamellar pathway within the corneal stroma. The barrel fits within the inner bore of the centering guide. The dissecting ring is attached to the barrel in such a way that when an eye surgeon twists the barrel, the ring moves through the interlamellar space in the stroma producing the desired channel or pathway.
A drawback to prior methods to produce an intrastromal channel has been the inability to control the depth of the pathway since the dissector blade tended to create a nonplanar channel. A new method f
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Mathis Mark L.
Proudfoot Robert A.
Scholl John A.
Silvestrini Thomas A.
Buiz Michael
Truong Kevin
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