WO2016062503A2 - Combined eye implant - Google Patents

Abstract

The invention relates to a combined eye implant (1) for implantation into a capsular bag (6) of the human or animal eye, in particular in the course of a cataract operation, the implant comprising: a substantially annular sensor implant (11), which surrounds a central cut-out section (3) and which has a pressure sensor (7) for measuring the intraocular pressure and microelectronics (8) for converting signals of the pressure sensor (7) into digital data and for transmitting this data to an external read-device via an antenna (9); and a lens implant (12), which, when implanted, at least partially covers the central cut-out section (3) of the sensor implant (11). In order to avoid mutual functional interference between the lens implant (12) and the sensor implant (11), according to the invention, the eye implant is improved by the provision of one or more retaining elements (13, 14) which secure the relative position of the sensor implant (11) to the lens implant (12) in an axial direction (2), allowing at least a minor relative displacement of the sensor implant (11) in relation to the lens implant (12) in a radial direction running orthogonally to the axial direction (2).

Description

 Combined eye implant

The present invention relates to a combined ocular implant intended for fixation in a capsular bag of the human or animal eye, in particular in the course of a cataract operation, having a substantially annular sensor implant enclosing a central recess and having a pressure sensor for measuring intraocular pressure. a microelectronics for the conversion of

Having signals of the pressure sensor in digital data and for transmitting these data via an antenna to an external reader, and with a lens implant, which at least partially covers the central recess of the sensor implant in the implanted state.

Such an eye implant is known from DE 10 2012 200 574 A1. In the known eye implant, the lens implant and the sensor implant are connected to one another such that both implants can be implanted together in the capsular bag of an eye. The connection is made by threads, by a hinge or flexible material. Through these connections, the lens implant is fixed relative to the sensor implant. After implantation, the two implants lie on top of each other and are immovably connected with each other. A problem in the implantation of said implants in the

 Capsular bag of the eye is that it comes in the postoperative period to a shrinkage of the capsular bag, which can be up to 20% of the capsular bag circumference. Common intraocular lenses therefore have a much smaller circumference and a smaller thickness than the natural lens, which in the course of cataract surgery from the

 Lens capsule is removed. As the shrinkage progresses, the lens capsule more or less clings to the lens implant,

in particular, if the implant is designed as usual. Also one in the course of the cataract surgery, a circular opening of the anterior capsular bag membrane with a defined diameter (Kapsulorhexis) attaches to the edge of the correspondingly dimensioned optic

Intraocular lens form conclusively. In contrast to the usually symmetrically designed lens implants, the known

Sensor implants often unbalanced. A substantially annular one is used for combination with said lens implant

Sensor implant with a central recess through which the lens of the lens implant can "see through"

annular body of the sensor implant usually the turns of an electric coil are housed, which serves as an antenna for data transmission between the sensor implant and an external reader. The sensor implant becomes asymmetrical in that in one area of the circular ring an electronic module has to be accommodated, which can not be reduced arbitrarily. This area therefore projects slightly into the central recess. Now, if such an asymmetrical sensor implant is introduced into the capsular bag of the eye, it may be due to the

Shrinkage effects occur in that the here also existing intraocular lens is moved out of the optical center (decentering) or tilted out of the right angle with respect to the optical axis.

In the further course, the dimension of the capsular bag stabilizes and it usually forms a so-called Nachstar and others

Fibrotisierungen. These tissue growths can be within the capsule bag, which is already compactly filled by the shrinkage

be space-demanding, whereby mechanical stress on the

Sensor implant, in particular the pressure sensor can be generated. As a result, incorrect measurements of intraocular pressure can occur. The object of the invention is to improve a combined eye implant of the type mentioned, so that the sensor implant does not deteriorate the function of the lens implant even under the influence of a shrinking capsular bag, especially the intraocular lens not decentered or tilted, and the lens implant

Measurement accuracy of the sensor implant not impaired.

The invention solves this problem in that the combined

Eye implant has one or more spacers, the relative position of the sensor implant to the lens implant in the axial direction with respect to a substantially in the direction of the eye

determine aligned axis and allow at least a slight relative displacement of the sensor implant relative to the lens implant in a direction orthogonal to the axial direction radial direction. The holding elements prevent an approximately directly applied to the sensor implant intraocular lens of the lens implant due to

Deformations of the sensor implant by it exerted

tilted mechanical stress or that shifts its optical axis relative to the optical axis of the eye, because the holding elements according to the invention are designed so that a corresponding relative movement of the sensor implant is not transmitted to the lens implant.

A first advantageous embodiment of the invention provides that the sensor implant is provided on its outside facing the lens implant with an axially projecting collar at least partially enclosing the central recess or with axially projecting nubs as spacers, wherein the nubs around the central

Recess are arranged around so that the lens implant rests against the collar or nubs. A convex outer contour of the intraocular lens of the lens implant is used for stable storage of the Lens impantate exploited on Sensorimplanat. It can also haptics commercial intraocular lenses for storage of the

Lens implant can be used. The collar or the nubs are arranged in the region of the radially inner edge of the sensor implant, which encloses the central recess, and thus not in a pressure- or stress-sensitive region of the sensor implant, whereby measured value distortions are avoided. The named

Embodiment is particularly well suited for commercial

Intraocular lenses. If it is not important to use commercially available intraocular lenses as a lens implant, the above-described collar or nubs can in principle also on the lens implant instead of on

Sensor implant to be formed.

The described embodiment can be improved even further by providing the sensor implant, on its outside facing the lens implant, with axially projecting projections which protrude as an anti-rotation into an aperture of the lens implant or project into a region next to the lens implant

Rotations of the lens implant about a substantially in

Viewing direction of the eye to block aligned axis. These

Embodiment is also suitable for commercial lens implants, which have side haptics in addition to the actual intraocular lens. If such a lens implant after the

Implantation in the capsular bag of the eye rotates about the axis pointing in the direction of the eye, a haptic of the lens implant could reach into the region of the pressure sensor of the sensor implant and distort the measured values obtained. In the described improved embodiment, such rotation is advantageously prevented.

In addition, the improved embodiment is suitable for the Use of non-spherical intraocular lenses, for example those lenses which have a cylindrical surface for the correction of astigmatism.

The described improved embodiment can only prevent relative rotation between the lens implant and the sensor implant, but not twisting of the sensor implant in the

Capsular bag of the eye. In order to prevent twisting of the sensor implant, this can be provided at its radially outer edge region with radially outwardly projecting teeth or the like. The teeth cling firmly in the tissue of the capsular bag, so that a

Rotation of the sensor implant is reliably prevented.

Another preferred embodiment of the eye implant according to the invention provides that the lens implant is arranged within the central recess of the sensor implant, wherein between the radially outer peripheral portion of the lens implant and the radially inner edge region of the sensor implant some play for small relative movements of the sensor implant over the

Sensor implant remains, and that the lens implant is provided at its radially outer peripheral portion with spacers which are configured as radially outwardly projecting projections which project beyond the radially inner edge region of the sensor implant and bear against the axial outer side in the axial direction. These

Embodiment requires a specially designed lens implant, but is suitable for use with commercially available sensor implants which need not be modified for combination with the particular lens implant.

In a further development of the latter embodiment is

provided that the radially inner edge region of the sensor implant has a non-rotational Symmetrical cross-section, in particular a straight edge portion, with a part-circular

Edge portion forms a closed ring, and that the radially outer peripheral portion of the lens implant has a cross section of the sensor implant following cross-section, in particular with a straight peripheral portion which merges into a partially circular peripheral portion, so that the lens implant relative to the sensor implant with respect to a substantially

Viewing direction of the eye-aligned axis is not or only slightly rotatable. From the rotation, the same advantages as in the embodiment described above with

Rotation. Should problems occur in the latter embodiment with a rotation of the sensor implant within the capsular bag, the radially outer edge region of the sensor implant can additionally be provided with radially outwardly projecting teeth, which engage in the tissue of the capsular bag and prevent the undesired rotation.

In a further development of the embodiment described last, it is recommended that the sensor implant at its radially outer

Edge region is provided with two radially protruding bulges, which are substantially symmetrical to a perpendicular to the straight

Edge portion and extending through the center axis of symmetry of the sensor implant and enclose each other in the circumferential direction an angle of about 90 °, and that the optical axis of the lens implant about halfway between the intersections of the axis of symmetry with the straight and the part-circular

Edge portion is arranged. The projecting bulges of the sensor implant cause it to be placed slightly offset in the capsular bag, so that the optical axis of the eye no longer passes through the center of the circle, which passes through the radially outer Edge region of the sensor implant is defined. This has the consequence that the optical axis of the eye no longer coincides with an optical axis of the intraocular lens, as it passes through the center of a circle from the radially outer peripheral portion of the

Intraocular lens is determined. The optical axis of the intraocular lens is therefore in the direction of the radially projecting bulges of the

Move the sensor implant by moving on the said axis of symmetry again as close as possible to the optical axis of the eye.

In a further advantageous embodiment of the invention, it is proposed that the radially inner edge region of the sensor implant is provided with at least two diametrically opposite or more spacers in the form of latching supports, which protrude from the inner edge region in the axial direction of the sensor implant and in each case a slot for latching Lens implant having at least two slots parallel to each other in the plane of the lens implant, and that the lens implant at its radially outer peripheral portion with at least two in

opposite directions radially projecting locking tongues is provided for locking into the slots of the sensor implant. By this embodiment, the intraocular lens is fixed in the space between the iris and the capsular bag, ideally without having contact with the surrounding ciliary body or iris tissue. The detents can be made of a different material than the sensor implant itself, for example, the sensor implant could be made to the outside of silicone rubber, while the detents consist of PMMA or a similar biocompatible polymer. In this embodiment, the lens implant is not only fixed at an axial distance on the sensor implant, but also secured against rotation. The latching suspensions according to the invention are within a range of

Sensor implant formed by which on its radially outer edge exerted mechanical stress of the capsular bag essentially unaffected.

In a variant of the last-described embodiment, the latching tongues of the lens implant may be provided with axially protruding and radially inwardly projecting claws which engage the latching supports of the

Grasp the sensor implant radially from the outside and engage radially inwards in the slots of the latching mountings or engage around radially from the inside and engage radially outwards into the slots.

A further advantageous embodiment of the invention provides that the radially inner edge region of the sensor implant is provided with at least two diametrically opposite or more latching slots and that the lens implant in its outer peripheral region at least two extending in opposite radial directions and the sensor implant axially projecting spacers in shape has elastic haptics, which engage with locking lugs in the locking slots of the sensor implant. In this embodiment, the elastic haptics of the lens implant may be under a slight tension when engaged in the detent slots of the sensor implant. This ensures a secure attachment. However, it must be ensured that the mechanical stress on the sensor implant is either absorbed or is sufficiently low

avoid stress-induced measurement errors.

In a further preferred embodiment of the invention it is proposed that the lens implant in the region between the lens and two or more haptics adjoining the lens is provided with two or more opposing spacers in the form of axially projecting retaining clips, wherein the

Retaining clips the radially inner edge region of the sensor implant U- clasp in a form. This embodiment is again suitable for commercially available sensor implants, in which no additional

Holding elements must be present. The retaining clips protrude through the capsulorhexis into the space between capsular bag and iris to receive and fix the subsequently implanted sensor implant. This has the advantage that the sensor implant does not come into contact with the iris or the ciliary body.

In a modification of the last-mentioned embodiment, the radially inner edge region of the sensor implant may be provided with recesses into which the retaining clips of the lens implant engage. This effectively prevents twisting of the lens implant relative to the sensor implant.

The invention also includes an injector device for the implantation of combined eye implants as described above. Known injector devices have an injector cartridge with a Injektullülle and a hinged loading chamber for inserting a conventional lens implant, which by folding the

Charging chamber is folded and held in an inner, through the loading chamber and the injection nozzle extending injection channel of the Injektorkartusche ready for injection. The known injector device has an operating part into which the injector cartridge can be inserted and which is a press-in device for the injection of viscoelastic into the

Injector cartridge to the lens implant through the

Injection channel of the injection nozzle through and out of an injection port at the end of the Injektullülle out into an incision of the eye into it. Such a known injection device is not particularly well suited for the implantation of a combined eye implant according to the invention, because its parts are not completely from the loading chamber can be recorded. The known injection device must therefore be improved to both parts of the combined

To inject eye implant.

According to the invention this can be achieved in that the

Injector cartridge a first loading chamber for receiving a

 Sensor implant and a second loading chamber for receiving a lens implant, so that the sensor implant and the

Lens implant can be implanted as part of an injection process. In this case, the partial implant closest to the injection nozzle is first injected from the one loading chamber into the eye and then, in the course of the same injection process, away from the injection nozzle

Partial implant from the other loading chamber. Depending on the requirements of the implantation or the wishes of the physician involved in the implantation, first the lens implant and then the sensor implant can be injected or vice versa. In the first case, the lens implant in the first loading chamber and the sensor implant in the second chamber of the injector cartridge to place. In the second case, the doctor places the sensor implant in the first loading chamber and the lens implant in the second loading chamber. In a preferred embodiment of the invention

Injector device, the injection nozzle on a return channel for the return of viscoelastic from the injection area, wherein an inlet end of the return channel is disposed immediately adjacent to the injection port at the end of the injection nozzle and an outlet end of the return channel in a remote from the injection port portion of the injection nozzle. The entry end of the return channel is inserted into the incision of the eye during implantation together with the injection port. During the injection viscoelastic is pressed through the incision of the eye and the implant parts of the combined Eye implant injected. So that it does not come to an undesirable and harmful pressure in the eye, the return channel is provided. This allows backflow of viscoelastic agent from the eye to the outside, which reduces the pressure of the viscoelastic in the eye.

Embodiments of the invention are explained below with reference to the drawings. The figures show in detail:

Figure 1: in a schematic perspective view a

 Sensor implant according to a first embodiment of the invention with collar;

Figure 2 is a plan view of the sensor implant of Figure 1 in

 Combination with a lens implant;

Figure 3 is a schematic perspective view of the

 Sensor implant with lens implant of Figure 2;

Figure 4 is a schematic perspective view of a

 sensor implant according to the invention in a comparison with Figure 1 modified variant with nubs;

Figure 5 is a schematic perspective view of a

 combined eye implant with lens implant and the sensor implant of Figure 4;

FIG. 6 shows a combined ocular implant similar to that of FIG. 5 with additional anti-rotation locks on the sensor implant;

Figure 7 is a schematic representation of a combined eye implant according to the invention in a second embodiment with lateral projections on the lens implant; a combined eye implant similar to that of Figure 7 with modifications to the optical axis; a schematic perspective view of a

Sensor implant in a third embodiment with latching supports; a schematic representation of the sensor implant of Figure 9 and its placement in the capsular bag of the eye; as in FIG. 10, but additionally with a lock

Lens implant; a modified lens implant for use with the third embodiment of the sensor implant according to Figures 9-1 1; a representation of the sensor implant according to Figure 10 connected to a lens implant according to Figure 12 to a combined eye implant according to the invention; a schematic perspective view of a sensor implant according to the invention in a fourth embodiment with locking slots; a schematic perspective view of a

A lens implant in a fourth embodiment with angled haptics; an inventive combined eye implant with sensor implant of Figure 14 and lens implant of Figure 15; Figure 17: a schematic perspective view of a

 Lens implant in a fifth embodiment of the invention with locking lugs;

FIG. 18: the lens implant of FIG. 17 inserted in the capsular bag of the eye, with the capsulorhexis reaching through

 Holding arms;

FIG. 19: as in FIG. 18, but additionally with implanted and

 engaged sensor implant;

FIG. 20 shows the lens implant according to FIG. 17 in the anterior capsule with capsulorhexis according to FIG. 18 in combination with FIG

Sensor implant of FIG. 14.

FIG. 21 is a perspective view of a conventional one

 Injector cartridge with unfolded loading chamber;

FIG. 22: the injector cartridge of FIG. 21 with the flap closed

 Loading chamber;

FIG. 23 is a perspective view of a conventional one

 Injector for lens implants with inserted injector cartridge;

FIG. 24 shows an injector cartridge according to the invention with two

 Loading chambers on average.

FIGS. 1 to 3 show a combined eye implant 1 according to the invention, which is composed of a lens implant 12 and a sensor implant 1 1. The lens implant 12 is a commercially available intraocular lens which has the actual lens 55 in its center and has two elastic haptics 19 projecting in opposite directions in the peripheral region. The elastic haptics 19 serve to support and center the lens 55 or the entire lens implant 12 in the capsular bag 6 (see, for example, FIGS. 10, 11, 18, 20) of the eye. The elastic haptics 19 are each provided with a slot-shaped opening 16, whereby the elasticity is ensured. The free ends of the elastic haptics 19 can thus be compressed in the capsular bag 6 of the eye radially inwardly onto the optical axis 5 of the lens 55. When the lens implant 12 is centered in the eye, the optical axis 5 of the lens 55 coincides with the viewing direction 4 of the eye (see FIG. 6). As best seen in Figures 1 and 4, this is

 Sensor implant 1 1 annular and surrounds a central recess 3. The central recess 3 is bounded by the radially inner edge region 10 of the sensor implant 1 1. The annular body of the

Sensor implant 1 1 is circular only over about three quarters of its circumference, while a quadrant is asymmetrical and deviates from the circular shape. In this asymmetrical quadrant, an electronics chip is housed, which includes a pressure sensor 7 and a microelectronics 8. Since the pressure sensor 7 comes to lie in the implanted state of the sensor implant 1 1 inside the eye, he can measure the intraocular pressure there. The measurement signals supplied by the pressure sensor 7 are converted into digital data within the microelectronics 8 and buffered. The microelectronics 8 is connected to a trained as a telemetry antenna 9, whose

Windings through the annular portion of the sensor implant 1 1 run.

The power supply of the microelectronics 8 is carried out electromagnetically by means of transformer RF coupling with an external reader as in an RFID. The data is transmitted on the same route, by modulation of the electrical load of the implant coil 9, controlled by the electronic module 8 of the sensor implant 1 1. But there are other types of energy supply in question, for example, energy harvesting from the eye movements, ultrasound or solar cells that convert into the rear chamber incident light into electrical energy. The data transmission can also be optically by LED or in another one instead of radio waves

Alternative electro-acoustic done. The telemetry coil may instead of being arranged as an annular planar coil directly around the electronic chip, which carries the pressure sensor 7 and the microelectronics 8, as in the present example.

The dimensions of the sensor implant 1 1 are in

Outer diameter about 9 to 12 mm and the diameter of the radially inner edge portion 10 is about 7 mm. The sensor implant 1 1 is designed to taper flat in its edge region and has a thickness between 0.1 mm and 0.5 mm. But they are also edgy

 Versions possible, which are circumferentially between 0.7 mm and 1 mm thick. The latter embodiment has the advantage that it can more effectively prevent the formation of after-star or similar cell growth. The size of the electronic chip, which comprises the pressure sensor 7 and the microelectronics 8, is approximately 2 mm × 6 mm. Due to these dimensions, the inner diameter of the sensor implant 1 1 must be made asymmetrical.

Thus, the pressure sensor implant 1 1 as commercially available

Intraocular lens designed lens implant 12 not decentered and tilted even with shrinkage of the capsular bag 6, must be taken by appropriate measures to ensure that the force distribution between the two implants 1 1, 12 is symmetrically centered with respect to the optical axis. In the first exemplary embodiments of the invention illustrated in FIGS. 1 to 6, therefore, the spacers according to the invention are arranged on an outer side 17 of the sensor implant 1 1 facing the lens implant 12, namely around the central recess 3 in the radially inner edge region 10.

In a first variant of the first embodiment is as

Spacer a collar 13 is provided, which extends over about 270 ° of the radially inner edge portion 10 and adjacent at its two ends to the electronic module with pressure sensor 7 and microelectronics 8.

In a second variant of the first exemplary embodiment, the circumferential collar 13 is replaced by a plurality of studs 14 distributed over the same radially inner edge region 10, in the present case by seven studs 14. Depending on the requirements, however, there may also be more or fewer studs 14. As best seen in Figures 3 and 5, the knobs 14 or the collar 13 hold the lens implant 12 in the axial direction 2 at a distance from the sensor implant 1 1 and provide a symmetrical with respect to the optical axis 5 force distribution between the sensor implant 1 1 and lens implant 12. Together, the sensor implant 1 1 forms with the lens implant 12 a

Combined eye implant according to the invention 1.

In Figure 6 can be seen projections 15 which serve as rotation for the lens implant 12. One of the projections 15 is guided through an opening 16 of the lens implant 12. The other projection 15 is placed in a region 18 of the outer side 17 of the sensor implant 1 1, on which the elastic haptics 19 of the lens implant 12 come to rest. The projections 15 prevent that

Lens implant 12 relative to the sensor implant 1 1 rotates, so that no haptic 19 could reach the area of the pressure sensor 7 and could falsify the measured values.

In the first embodiment of the invention described, a commercially available lens implant 12 was used as an example

Intraocular lens described with so-called plate haptics and shown in Figures 2, 3, 5, 6. The invention is not on

Intraocular lenses with plate-haptics limited and includes in particular other compatible intraocular lenses such. B. integral with four haptics, three-piece with C-haptics, one-piece with C-haptics and other known or compatible embodiments.

Furthermore, in the first and the subsequently described second exemplary embodiment of the invention, it must be ensured that the two partial implants 1 1, 12 and 21, 22 are not allowed to be completely form-fitting with one another in order to prevent the circulation of aqueous humor inside the

To allow capsular bag 6.

In the second embodiment of the invention shown in FIGS. 7 and 8, the lens implant 22 is within the central one

Recess 3 of the sensor implant 21 is arranged. Here, the radially outer peripheral portion 24 of the lens implant 22 is designed slightly smaller than the radially inner edge region 10 of the sensor implant 21, wherein between the sensor implant 21 and lens implant 22 a circumferential gap remains so that the lens implant 22 within the central recess 3 of the sensor implant 21 with can move some play relative to the sensor implant 21. In order to determine the relative position between the sensor implant 21 and the lens implant 22 in the axial direction, in particular in the direction of the optical axis 5 of the lens of the

To fix the lens implant 22, two projections 23 are provided, which from the radially outer peripheral portion 24 of the lens implant 22nd project radially outwards in diametrically opposite directions and over the radially inner edge region 10 of the

Sensor implant 21 protrude to abut on the axial outer side 17 in the axial direction (opposite to the arrow 4). Since the radially inner edge region 10 of the sensor implant 21 in cross section not

is rotationally symmetrical, but in the area where the microelectronics 8 and the pressure sensor 7 are housed, has a straight edge portion 28 which merges at its two ends in an approximately 270 ° of the inner edge portion 10 comprising, partially circular edge portion 29 and with this a closed Ring forms, that becomes

Lens implant 22 prevented from twisting with respect to the sensor implant 21. Since the outer peripheral region 24 of the lens implant 22 has a cross-section adapted to the above-mentioned cross-section of the sensor implant 21, in which a straight peripheral section 25 merges into a part-circular peripheral section 26 at both ends, the lens implant 22 can thus be opposite to the

Sensor implant 21 with respect to an aligned in the direction 4 of the eye axis or only slightly rotate.

In a second variant of the second exemplary embodiment according to FIG. 8, two radially projecting recesses 27 are formed on the radially outer edge region 30 of the sensor implant, which protrude from a center 50 of the straight edge section 28 and through the center 60 of the part-circular edge section 29 of FIG

Sensor implant 21 extending symmetry axis 20 are symmetrically arranged and enclose an angle 40 of about 90 °. The bulges 27 ensure that the sensor implant 21 in the

Capsular bag 6 of the eye is positioned shifted in the direction of the axis of symmetry 20. So that the optical axis of the lens implant 22 again coincides with the viewing direction 4 of the eye, the optical axis 5 on the axis of symmetry 20 on the side of the Bulges 27 may be arranged shifted towards the rear, wherein the

Dimensions of the bulges 27 are selected so that the viewing direction 4 of the eye coincides with the optical axis 5, when the optical axis 5 of the lens implant 22 halfway between the intersections 50, 60 of the axis of symmetry 20 with the straight 28 and the part-circular Edge portion 29 of

Sensor implant 21 is located.

In the first two shown in Figures 1 to 8

Embodiments of the invention, both the sensor implant 21, and the lens implant 22 are implanted within the capsular bag 6 of the eye. This is different in the embodiments described below three to five, in which only one

In the figures 9 to 13, a third embodiment of the invention is shown in which a sensor implant 31 has two latching holders 33, starting from the inner edge region 10 in axial direction 2 protrude from the sensor implant 31 and are each provided with a slot 34. The two slots 34 are arranged parallel to each other and in the plane of the lens implant 32.

The lens implant 32 has in a first variant of the third

Embodiment of the invention at its radially outer

Peripheral region 37 two locking tongues 35 projecting radially in opposite directions 38, 39, which engage in the slots 34 of the sensor implant 31 and thus fix the lens implant 32 to the sensor implant 31, forming a combined eye implant 1 according to the invention, which can be seen in FIG. The two protrude

Rasthalterungen 33 of the accommodated in the capsular bag 6 Sensor implant 31 through the capsulorhexis of the capsular bag 6 of the eye and the lens implant 32 is on the other side of the

Kapsulorhexis placed outside the capsular bag 6.

In the illustrated in Figures 12 and 13 the second variant of the third embodiment of the present invention are the

Latches 35 of the lens implant 32 additionally provided with claws 36 which in the slots 34 of the latching holders 33 of the

Snap sensor implant 31 radially from outside to inside.

In a modification of the second variant, not shown, the claws 36 can also engage radially from the inside out into the slots 34. This measure makes the arrangement more stable in the case of a shrinkage of the capsular hexis and at the same time provides protection for the iris

protruding parts.

Notwithstanding the exemplary embodiments three to five described here and shown in FIGS. 9 to 20, it is of course also possible to use more than two latching holders 33, latching tongues 35,

Locking slots 43, haptics 45, 53 and retaining clips 54 are provided.

A fourth embodiment of the invention is shown in FIGS. 14 to 16. The sensor implant 41 is in its radially inner

Edge region 10 is provided with two diametrically opposed locking slots 43. The associated lens implant 42 has two extending from its outer peripheral portion 44 in opposite radial directions 48, 49 and after a bend axially protruding developed elastic haptics 45 which are provided with detents 46 which engage in the detent slots 43 of the sensor implant 41, wherein the FIG. 16 shows a combined eye implant 1. That's it Sensor implant 41 within the capsular bag 6 and the lens implant 42 arranged outside.

Figures 17 to 19 show a fifth embodiment of the present invention, in which the lens implant 52 has a centrally located lens 55 which is at opposite

 Peripheral areas in two straight haptics 53 passes, which are shown only very schematically in Figure 17. In the region between the lens 55 and the two haptics 53, a retaining clip 54 is arranged in each case, which is configured in the cross-sectional profile U-shaped. The lens implant 52 is in the capsular bag 6 with Kapsulorhexis so

arranged as shown in Figure 18. It can then with the arranged outside of the capsular bag 6 sensor implant 51 to a

Combined eye implant 1 according to the invention can be connected, as shown in Figure 19. In this case, the retaining clips 54 clamp the radially inner edge region 10 of the sensor implant 51 in a U-shape.

However, the retaining clips 54 of the lens implant 52 can also be combined with a sensor implant 41 with latching slots 43, which is designed according to FIG. 14, the retaining clips 54 locking into the latching slots 43, as shown in FIG. All described sensor implants and lens implants can be introduced in the folded state by means of a corresponding injector through a very small incision in the eye, usually the respective combined eye implant only within the capsular bag by connecting sensor implant with lens implant arises. FIGS. 21 to 23 show a commercially available injector device 61 for the implantation of commercially available lens implants 12 in the context of cataract surgery. The injection device 61 is made from an operating part 67, into which an injector cartridge 62 is inserted.

The injector cartridge 62 has an injection nozzle 63 and a

hinged loading chamber 64 for inserting a lens implant 12. After inserting the lens implant 12 in the loading chamber 64, this is closed by closing its two handle parts 65, wherein the lens implant 12 is folded so that it in an inner, through the loading chamber 64 and the injection nozzle 63 extending

Injection channel 66 finds place and is kept ready for injection. The injection nozzle 63 is provided at its free end with an injection port 70 through which the folded lens implant 12 can slide out of the injector cartridge 62.

The operating part 67 has a press-in device 68, 69 for the

Pressing viscoelastic into the Injektorkartusche 62 on. The Viskoelastkum serves on the one hand as a lubricant to reduce the friction between the implant parts 1 1, 12 and the inner wall of the injection channel 66 and inside the eye. On the other hand, it serves as a hydraulic fluid for moving the implant parts 1 1, 12 im

Injection channel 66. Here, hyaluronic acid or methylcellulose is used as the viscoelastic. For the generation of the hydraulic pressure, the operating part 67 has a cylinder 68, which is filled in the ready state with viscoelastic, and a piston 69 which in the

Cylinder 68 is arranged längsverschieblich and protrudes with an end portion 81 of the cylinder 68. The end portion 81 can be pressed in the direction of injection either by hand or by means of a not shown mechanical device, which may also be motorized, so that the piston 69 passes the viscoelastic together with the lens implant 12 through the injection nozzle 63 and finally ejected from the injection port 70 at the end of the injection nozzle 63 and conveyed into an incision of the eye.

Similarly, the injector device according to the invention, whose control panel essentially corresponds to the control panel 67 of the prior art, which is only slightly adapted in its dimensions to the inventively modified Injektorkartusche 72.

FIG. 24 shows an injector cartridge 72 according to the invention which, in contrast to the known injector cartridge 62, has two inlets

Injection direction 82 arranged one behind the other loading chambers 73, 74 has. A first loading chamber 73 is arranged directly next to the injection nozzle 78 and intended for receiving a sensor implant 1 1. A second loading chamber 74 is arranged next to the first loading chamber 73 on the side facing away from the injection nozzle 78 and for the

Recording a lens implant 12 determined. If it appears more appropriate for the intended implantation,

Of course, the lens implant 12 in the first loading chamber 73 and the sensor implant 1 1 are inserted into the second loading chamber 74.

With the injector cartridge 72 according to the invention can

Sensor implant 1 1 and the lens implant 12 are implanted in a single injection operation in quick succession. After inserting the sensor implant 1 1 in the first loading chamber 73, this is closed by squeezing their two handle parts 75, wherein the sensor implant 1 1 is folded to extend in a through the two loading chambers 73, 74 and the injection nozzle 78

Injection channel 77 to find room. The lens implant 12 is folded after insertion into the second loading chamber 74 by squeezing the two handle portions 75 of the second loading chamber 74, so that it is also in the injection channel 77, only at a different location than the sensor implant 1 1. Thereafter, the Injektorkartusche 72 is in the control panel 67 or slightly to the inventive

Injector cartridge 72 adapted keypad inserted. In the context of the implantation of a combined eye implant 1, the injection process is basically the same as in an implantation of a conventional lens implant 1 1 by means of the known

Injection device 67. The difference is that during the injection of viscoelastic into the injection channel 77 of the

Inventively modified injector cartridge 72 in quick succession first the sensor implant 1 1 and then the lens implant 12 or in reverse order through the injection nozzle 78 through the injection port 70 in the direction of injection 82 out and injected through the incision into the eye. One needs for the two partial implants 1 1 and 12 of the combined eye implant 1 with advantage no two injection procedures. As a result, the implantation is carried out in a shorter time with a lower risk of errors, which is more comfortable and safer for the patient.

Another improvement in terms of safety and the

Avoidance of unnecessary injuries during implantation is that the injection nozzle 78 has a return channel 71 for the return of viscoelastic agent from the injection area. An inlet end 79 of the return channel 71 is immediately adjacent to the injection port 70 at the end of the injection nozzle 78 and an outlet end 80 of the

Return passage 71 disposed in a remote from the injection port 70 portion of the injection nozzle 78.

As the inlet end 79 of the return channel 71 during implantation together with the injection port 70 in the incision of the eye is introduced, which can be expressed by the press-in device 68, 69 of the operating part 67 of the injection port 70

Viscoelastic agent from the eye through the return channel 71 again emerge and be discharged into the outer space, which reduces the pressure of Viskoelastkums in the eye. In this way, an increase of the pressure above a predetermined value by the return passage 71 is prevented.

LIST OF REFERENCE NUMBERS

1 combined eye implant

 2 axial direction

 3 central recess

 4 Viewing direction of the eye

 5 optical axis of the lens

 6 capsular bag

 7 pressure sensor

 8 microelectronics

 9 antenna / coil

 10 radially inner edge region

 1 1 sensor implant

 12 lens implant

 13 collar

 14 pimples

 15 projections

 16 breakthrough

 17 outside

 18 area

 19 elastic feel

 20 symmetry axis

 21 sensor implant

 22 lens implant

 23 projections

 24 peripheral area

 25 straight peripheral section

 26 part circular peripheral portion

 27 bulge

 28 straight edge section

 29 part-circular edge portion

30 edge area 31 sensor implant

32 lens implant

33 locking bracket

34 slot

35 latching tongue

 36 claw

 37 peripheral area

38 radial direction

39 radial direction 40 angle

 41 sensor implant

42 lens implant

43 locking slot

 44 peripheral region 45 angled haptics

46 latch

 48 radial direction

49 radial direction

50 point of intersection / middle 51 sensor implant

52 lens implant

53 straight feel

54 retaining clips

55 lens

60 intersection / middle

61 injection device

62 injector cartridge

63 injection nozzle

64 loading chamber 65 handle parts

 66 injection channel

67 control panel cylinder

 piston

 injection port

Return channel

Injector cartridge first loading chamber second loading chamber first handle parts second handle parts

injection channel

injection nozzle

entry end

exit end

Claims

PATENT CLAIMS Combined eye implant designed for fixation in one Capsular bag (6) of the human or animal eye is determined, in particular in the course of a cataract operation, with a substantially annular sensor implant (1 1, 21, 31, 41, 51) enclosing a central recess (3), which has a pressure sensor (7) for measuring intraocular pressure, a Microelectronics (8) for converting signals from the Pressure sensor (7) into digital data and for transmitting this data via an antenna (9) to an external reading device, and with a lens implant (12, 22, 32, 42, 52), which in the implanted state has the central recess (3) of Sensor implant (1 1, 21, 31, 41, 51) at least partially covered, characterized in that the combined eye implant (1) has one or more spacers (13,14, 23, 33, 35, 36, 38, 43, 46, 54) which determine the relative position of the sensor implant (1 1, 21 , 31 , 41 , 51 ) to the lens implant (12, 22, 32, 42, 52) in the axial direction (2) with respect to an axis essentially aligned in the viewing direction (4) of the eye and an at least slight relative displacement of the Sensor implant (1 1 , 21 , 31 , 41 , 51 ) compared to that Lens implant (12, 22, 32, 42, 52) in an axial direction (2) Allow orthogonal radial direction. Combined eye implant according to claim 1, characterized in that the sensor implant (1 1) on its outside (13) facing the lens implant (12) with an axially projecting collar (13) which at least partially encloses the central recess (3) or with axially projecting Knobs (14) are provided as spacers around the central one Recess (3) are arranged around so that Lens implant (12) rests on the collar (13) or the knobs (14). 3. Combined eye implant according to claim 2, thereby characterized in that the sensor implant (1 1) is provided with axially projecting projections (15) on its outside (17) facing the lens implant (12), which are called Anti-twist device protrudes into an opening (16) in the lens implant (12) or in an area (18) next to it Raise the lens implant (12) to prevent rotation of the lens Lens implant (12) to block an axis essentially aligned in the viewing direction (4) of the eye or restrict. 4. Combined eye implant according to claim 1, thereby characterized in that the lens implant (22) is arranged within the central recess (3) of the sensor implant (21), with some play between the radially outer peripheral region (24) of the lens implant 22 and the radially inner edge region (10) of the sensor implant (21). for small relative movements of the lens implant (22) relative to the sensor implant (21), and that the lens implant (22) is provided on its radially outer peripheral region (24) with spacers which are designed as projections (23) projecting radially outwards, which protrude beyond the radially inner edge region (10) of the sensor implant (2)1 and rest against its axial outer side (17) in the axial direction. 5. Combined eye implant according to claim 4, thereby characterized in that the radially inner edge region (10) of the Sensor implant (21) is not rotationally symmetrical Cross-section, in particular a straight edge section (28), which forms a closed ring with a partially circular edge section (29), and that the radially outer Circumferential region (24) of the lens implant (22) has a cross section following the said cross section of the sensor implant (21), in particular a straight peripheral section (25) which merges into a partially circular peripheral section (26), so that the lens implant (22) for Sensor implant (21) cannot be rotated or can only be rotated insignificantly with respect to an axis directed essentially in the viewing direction (4) of the eye. 6. Combined eye implant according to claim 5, thereby characterized in that the sensor implant (21) has two radially projecting ones on its radially outer edge region (30). Bulges (27) are provided, which are essentially symmetrical to an axis of symmetry (20) which runs perpendicular to the straight edge section (28) and through its center (50). Sensor implant (21) are arranged and in relation to each other Circumferential direction includes an angle (40) of approximately 90°, and that the optical axis (5) of the lens implant (22) is approximately halfway between the intersection points (50, 60) of the Axis of symmetry (20) is arranged with the straight edge section (28) and the partially circular edge section (29). 7. Combined eye implant according to claim 1, thereby characterized in that the radially inner edge region (10) of the Sensor implant (31) with at least two diametrically opposite or multiple spacers in the form of locking brackets (33), which start from the inner edge region (10) in the axial direction (2) from the sensor implant (31) protrude and each have a slot (34) for snapping it into place Have lens implant (32), with at least two slots (34) essentially parallel to each other in the plane of the Lens implant (32), and that the lens implant (32) has on its radially outer circumferential region (37) with at least two locking tongues (35) projecting radially in opposite directions (38, 39) for snapping into the slots (34) of the Sensor implant (31) is provided. 8. Combined eye implant according to claim 7, thereby characterized in that the locking tongues (35) of the lens implant (32) are provided with axially projecting and radially inwardly projecting claws (36) which hold the locking brackets (33) of the Grip the sensor implant (31) radially from the outside and snap it radially inwards into the slots (34) of the locking brackets (33) or grip it radially from the inside and snap it radially outwards into the slots (34). 9. Combined eye implant according to claim 1, thereby characterized in that the radially inner edge region (10) of the sensor implant (41) with at least two diametrically opposite or multiple locking slots (43) and that the lens implant (42) in its outer Circumferential region (44) has at least two spacers in the form of angled elastic haptics (45) which run in opposite radial directions (48, 49) and also protrude axially from the lens implant (42), which are inserted into the with locking lugs (46). Engage the locking slots (43) of the sensor implant (41). 10. Combined eye implant according to claim 1, thereby characterized in that the lens implant (52) is in the area between the lens (55) and two or more straight haptics (53) adjoining the lens (55) is provided with two or more opposing spacers in the form of axially projecting retaining clips (54), the Holding clips (54) clasp the radially inner edge region (10) of the sensor implant (51) in a U-shape. Injector device for the implantation of a combined Eye implant (1) according to one of the preceding claims, wherein the injector device (61) has an injector cartridge (62, 72) with an injection nozzle (63, 78) and a hinged one Loading chamber (64, 73, 74) for inserting an eye implant (1), which is folded by closing the loading chamber (64, 73, 74) and in an inner, through the loading chamber (64, 73, 74) and the injection nozzle (63 , 78) running injection channel (66, 77) of the injector cartridge (62, 72) is kept ready for injection, the injector device (61) having a control part (67) into which the injector cartridge (62, 72) can be inserted and the one Press-in device (68, 69) for pressing viscoelastic into the injector cartridge (62, 72) in order to push the eye implant (1) through the injection channel (66, 77) of the injection nozzle (63, 78) and out of an injection opening (70). at the end of To transport the injection nozzle (63, 78) out into an incision in the eye, characterized in that the injector cartridge (72) has a first loading chamber (73) for receiving a Sensor implant (1 1) and a second loading chamber (74) for receiving a lens implant (12), so that the sensor implant (1 1) and the lens implant (12) can be implanted as part of an injection process. 12. Injector device according to claim 1 1, characterized in that the injection nozzle (78) has a return channel (71) for the return of viscoelastic from the injection area, an inlet end (79) of the return channel (71) immediately next to the injection opening (70) at the end of the injection nozzle (78) and an outlet end (80) of the return channel (71) is arranged in a region of the injection nozzle (78) remote from the injection opening (70).