Apparatus for securing ocular tissue.

This invention is generally directed to surgical devices and more specifically to an apparatus and method for securing and modifying ocular tissue.

Background of the Invention

Frequently, it is desirable or necessary to secure a patient's eye in place during eye surgery. For example, it is possible to restore the power of accommodation in a presbyopic eye by implanting a scleral prosthesis into the sclera of the patient's eye. Also, it is possible to treat glaucoma, ocular hypertension, elevated infraocular pressure and other eye disorders by implanting a scleral prosthesis into the scleral of the patient's eye. During these types of procedures, an incision can be made in the sclera of the eye and spread below the surface of the sclera to form a scleral "tunnel." A scleral prosthesis can be placed inside the tunnel. Before performing the surgical procedure to implant scleral prostheses or another surgical procedure of the eye, the patient's eye needs to be fixed so that the patient's eye does not move during the procedure^ι χ surgical.

Figures 16A and 16B illustrate a conventional eye fixation tool. This eye fixation tool is placed on the surface of the patient's eye and is physically sutured with the sclera of the patient's eye. This eye fixation tool includes several notches where the surgical tool can be placed.

Figures 17A-17B illustrate a second conventional eye fixation tool, which has a handle, a solid ring and two rotating arms. The solid ring is rotatably coupled with the handle. The two rotating arms are coupled or mounted on the solid ring at a common rotating point. As shown in Figure 17A, the two swivel arms are in the open position, and the solid ring can be placed in a desired location in the patient's eye. As shown in Figure 17B, the two rotating arms can then be closed, which drives the spikes or other extensions in the arms into the patient's eye tissue. After that, the handle can be turned to the sides so that the surgeon or the tool has free access to the patient's eye through the rings. In other embodiments, the handle and the solid ring can be omitted and the two swivel arms can be used (the arms can be opened and closed to fix and release the patient's eye tissue). Also, in other embodiments, the two rotating arms may lack spikes or extensions, and the arms may be used to drive the spikes or extensions in the solid ring into the patient's eye tissue.

Brief Description of the Invention

This invention provides an apparatus and a method for securing eye tissue.

In a first embodiment, an apparatus includes a first ring and a second ring, wherein at least one of the rings includes means for fixing the eye tissue of the eye. The fixing means are arranged to hold the eye tissue of the eye and to release the eye tissue from the eye, based on the rotation of at least one of the rings.

In particular embodiments, the fixation means are arranged to hold the eye tissue in an eye area associated with the eye blade.

In other particular embodiments, the apparatus also includes a housing where the first and second rings are housed and a retaining ring inside the housing, configured to retain the first and second rings in the housing. The housing may also include a dome configured to protect a central portion of the eye.

In other particular embodiments, the apparatus also includes a base configured to be placed in the eye tissue of the eye and to retain the first and second rings. The apparatus may also include a dome configured to protect a central portion of the eye.

In other particular embodiments, the first and second rings may include tabs that extend outside the dome and the base. The tabs can be configured to rotate at least one of the first and second rings.

In additional particular embodiments, the apparatus includes one or more mechanisms to align a surgical tool with a position in the eye. For example, the dome may include one or more holes configured to receive one or more projections of the surgical tool so as to align the surgical tool with a position in the eye. As another example, the base may include one or more notches, where each notch is configured to receive a projection of the surgical tool so as to align the surgical tool with a position in the eye. In addition, the base may include one or more portions that are configured to lie in the eye. The one or more portions may include one or more edges configured to allow the base of the surgical tool to be aligned against one of the edges when the projection of the surgical tool is inserted into one of the notches.

In a second embodiment, a system includes an eye fixation device having a first ring and a second ring. At least one of the rings includes means for fixing the eye tissue of the eye, wherein the means for fixing are arranged to hold the eye tissue of the eye and to release the eye tissue from the eye, based on the rotation of at least One of the rings The system also includes a surgical tool that can be mounted on the eye fixation device.

In particular embodiments, the surgical tool includes a surgical blade configured to form the scleral tunnel in the eye's eye tissue.

In a third embodiment, one method includes placing the ocular fixation device in the patient's eye. The eye fixation device includes a first ring and a second ring, wherein at least one of the rings includes means for fixing the eye tissue of the patient's eye. The method also includes rotating at least one of the first and second rings so that the fixing means hold the eye tissue of the patient's eye.

In particular embodiments, the method also includes rotating at least one of the first and second rings so that the fixation means release the ocular tissue from the patient's eye.

In a fourth embodiment, an apparatus includes a first ring having a plurality of first teeth and a second ring having a plurality of second teeth. The first and second teeth are arranged to hold the eye tissue of the eye and to release the eye tissue from the eye based on the rotation of at least one of the rings.

In a fifth embodiment, an apparatus includes one or more rings that have means for fixing eye tissue of the eye. The fixing means are arranged to hold the eye tissue of the eye and to release the eye tissue from the eye based on the movement of at least one of one or more rings.

In a sixth embodiment, an apparatus includes a ring configured to be placed in the eye, wherein the ring includes a plurality of portions to rest against the surface of the eye. The ring also includes a plurality of portions that form a plurality of notches' S; 'configured to receive sutures to join the ring with the eye.

In a seventh embodiment, an apparatus includes a base configured to be pressed against the eye tissue of the eye. The apparatus also includes fixing means coupled with the base and configured to be secured against the eye's eye tissue. The apparatus also includes a handle configured to move the fixing means.

In an eighth embodiment, an apparatus includes a central portion configured to be placed on at least the cornea of ​​the eye. The apparatus also includes means for fixing the eye tissue of the eye, where the means for fixing are located in the central portion. In addition, the apparatus includes a tool holder coupled with the central portion and configured to receive a surgical tool.

Other technical characteristics may be apparent to persons skilled in the art, from the following Figures, descriptions and claims.

Brief Description of the Drawings

For a better understanding of this invention, reference is now made to the following description, taken together with the accompanying drawings, in which:

Figures 1A to 1F illustrate a first exemplary eye fixation device in accordance with this invention.

Figures 2A through 2C illustrate a second exemplary eye fixation device in accordance with this invention.

Figures 3A through 3C illustrate a third exemplary eye fixation device in accordance with this invention.

Figures 4A through 41 illustrate an exemplary use of an ocular fixation device during the creation of the scleral tunnel to receive the scleral prosthesis in accordance with this invention.

Figures 5A through 5C illustrate a fourth exemplary eye fixation device and an exemplary use of the eye fixation device in accordance with this invention.

Figures 6A through 6C illustrate a fifth eye fixation device and an exemplary use of the eye fixation device in accordance with this invention.

Figure 7 illustrates an exemplary positioning tool for use with the eye fixation device in accordance with this invention.

Figure 8 illustrates a sixth exemplary eye fixation device in accordance with this invention.

Figures 9A through 9C illustrate a seventh exemplary eye fixation device and an exemplary use of the eye fixation device in accordance with this invention.

Figures 10A through 10D illustrate an eighth eye fixation device in accordance with this invention.

Figures 11A and 11B illustrate a ninth exemplary eye fixation device in accordance with this invention.

Figures 12A and 12B illustrate an tenth exemplary eye fixation device in accordance with this invention.

'δ *

Figures 13A to 13D illustrate an eleventh exemplary eye fixation device in accordance with this invention.

Figures 14A through 14C illustrate an twelfth exemplary eye fixation device in accordance with this invention.

Figure 15 illustrates an exemplary method for ocular fixation in accordance with this invention; Y

Figures 16A and 16B illustrate conventional eye fixation tools.

Figures 17A and 17B illustrate a third conventional eye fixation tool.

Detailed description of the invention

Figures 1A to 1F illustrate a first exemplary eye fixation device 100 in accordance with this invention. The modality of the eye fixation device 100 shown in Figures 1A to 1F is illustrative only. Other embodiments of the eye fixation device 100 may be used, without departing from the scope of this invention.

As shown in Figures 1A and 1B, the eye fixation device 100 includes a body portion 102, a retaining ring 104 and two fixing rings 106-108. In this example, the body portion 102 includes a base 110 and a dome 112. The base 110, in this embodiment, is generally circular and is used to accommodate the retaining ring 104 and the fixing rings 106-108. Dome 112 represents a protective cover that can be used to protect the central portion * χ 'of the patient's eye. The body portion 102 may be formed of any suitable material, such as one or more transparent or opaque materials. The body portion 102 can be formed with the use of any technique, such as injection molding.

The fixing rings 106-108 can be inserted into the body portion 102 and the retaining ring 104 can be coupled with the body portion 102, which secures the fixing rings 106-108 within the body portion 102. The retaining ring 104 may be formed of any suitable material. The retaining ring 104 can be formed with any technique, such as injection molding.

The retaining ring 104 may be coupled or secured with the body portion 102 in any appropriate manner. For example, as shown in Figure 1C, the retaining ring 104 may include stops 114, and the body portion 102 may include corresponding receptacles 116. In this embodiment, the retaining ring 104 can be pushed into the body portion 102 until the stops 114 engage with the receptacles 116, which secures the retaining ring 104 in place.

As shown in Figure 1C, the retaining ring 104 may also have an inclined or tapered inner edge 118. This facilitates the placement of the eye fixation tool 100 in the patient's eye. For example, the edge 118 of the retention ring 104 may be inclined so that it is essentially parallel to the portion of the patient's sclera, where the retention ring 104 rests.

The 106-108 fixing rings are used to secure the device * s¡ ^J * -s * “*

100 ocular fixation in the patient's eye, so they help fix and prevent the movement of the patient's eye. As shown in Figures 1D and 1E, the fixing rings 106-108 can also include teeth 120. In this example, the fixing rings 106-108, including the teeth 120, are essentially flat (although angled teeth can be used) . Also, the teeth 120 in the different rings 106-108 fasteners are angled to each other. At least one of the fixing rings 106-108 may rotate with respect to the other fixing ring. In this way, the areas between the teeth 120 of the fixing rings 106-108 can be increased or decreased. This allows the teeth 120 to hold the eye tissue when the teeth 120 are pushed closer. This also allows the teeth 120 to release the eye tissue when the teeth 120 are pushed to separate. In some embodiments, the fixator rings 106-108 may be sized for teeth 120 to engage or secure over the eye tissue of the patient's eye (beyond the cornea and other areas in the central portion of the patient's eye). Fixing rings 106108 may be formed of any suitable material, such as metal. The 106-108 fixing rings can also be formed with any technique, such as photo-etching.

As shown in Figures 1D through 1F, the fixing rings 106-108 include windows 122, and the body portion 102 includes corresponding windows 124. In some embodiments, a surgeon can insert a tool through one of the windows 124 and use the tool to cause one or more of the 106-108 fixing rings to move. For example, the surgeon can insert a * s¡^J * -s * “* tool through one of the windows 124 and pull or push one of the fixing rings 106-108, which causes the openings between the teeth 120 of the fixing rings 106-108 to open or close . In another example, the surgeon can insert a tool through one of the windows 124 and push both fixing rings 106-108, which causes the openings between the teeth 120 of the fixing rings 106-108 to close. In other embodiments, part or all of the body portion 102 can be designed to rotate, which causes the fixing ring 106 to rotate with respect to the fixing ring 108. This may, for example, allow the eye fixation device 100 to be placed in the patient's eye and then rotate to fix the eye fixation device 100 over the patient's eye. Any other technique can be used to cause the teeth 120 of the fixing rings 106-108 to move relative to each other.

Figures 2A through 2C illustrate a second exemplary eye fixation device 200 in accordance with this invention. The embodiment of the eye fixation device 200 shown in Figures 2A to 2C is illustrative only. Other embodiments of the eye fixation device 200 may be used, without departing from the scope of this invention.

The eye fixation device 200 of Figures 2A to 2C operates in a manner similar to that of the eye fixation device 100 of Figures 1A to 1F. As shown in Figure 2A, the eye fixation device 200 includes a base 202, a dome 204 and fixing rings 206-208. The cross sections show structural details * s¡^J * -s * "* additional eye fixation device 200, as shown in Figures 2B and 2C. As shown here, the base 202 is coupled or secured with the dome 204 (or vice versa), which helps retain the 206-208 fixing rings that are located between the base 202 and the dome 204. In this example, the section The transverse base 202 includes a generally flat portion where the 206-208 fixing rings lie. The cross section of the base 202 also includes a projection along its outer edge, which engages or helps secure the dome 204. The base 202 may also have a shape that facilitates its placement in the patient's eye, such as when the flat portion of the base 202 is inclined to approximately coincide with the curvature of the sclera of the eye. The base 202 may be formed of any appropriate material. The base 202 can also be formed with the use of any appropriate technique, such as injection molding.

Dome 204 represents a protective cover that protects the central portion of the patient's eye. Dome 204 may be formed of any suitable material, such as one or more transparent or opaque materials. Dome 204 can be formed with the use of any appropriate technique, such as by injection molding.

The fixing rings 206-208 are located between the base 202 and the dome 204. In this example, the fixing rings 206-208 include teeth 210 for coupling or securing onto the eye tissue of the patient's eye. At least one of the fixing rings 206-208 may rotate with respect to the other fixing ring to open or close the areas between the teeth 210 of the fixing rings 206-208. This allows teeth 210 to mate with * -s * "* the eye tissue and release the eye tissue from the patient's eye. In some embodiments, the fixing rings 206-208 may be sized for teeth 210 to engage with the scleral tissue of the patient's eye. The fixing rings 206-208 can be formed of any suitable material, such as metal. Fixing rings 206-208 may be formed of any appropriate material, such as photo-etching.

In this example, the 206-208 fixing rings are not completely flat. Instead, each of the fixing rings 206-208 includes a main section that is relatively flat and a curved section along its inner edge. The curved section of the fixing ring 206 is generally located on and inside the curved section of the fixing ring 208. Also, the curved sections of the fixing rings 206-208 include, are coupled with, or carry the teeth 210 of the fixing rings 206208. In addition, the teeth 210 may be flat or at an angle to the flat portions of the fixing rings 206-208.

As shown here, each of the fixing rings 206-208 includes one or more windows 212. The windows 212 can be used to identify the amount of space between the teeth 210 of the fixing rings 206208. For example, when the windows 212 of the fixing rings 206208 are aligned or almost aligned, this may indicate that the areas between the teeth 210 of the fixing rings 206-208 are essentially closed (the teeth 210 are engaged or secured on the eye tissue of the patient's eye). Similarly, when the windows 212 of the fixing rings 206-208 are not aligned well, this may indicate that the areas between the teeth 210 of the fixing rings 206-208 are essentially open (the eye tissue of the patient's eye is not insured or has been released).

In the example illustrated, the dome 204 can cover the windows 212 of the fixing rings 206-208, which can prevent the use of external tools from moving the fixing rings 206-208. To facilitate the coupling and release of the eye tissue by the eye fixation device 200, one or both of the fixing rings 206-208 can be rotated, such as through the rotation of the dome 204 or the base 202. For example, the fixing ring 206 can be fixed with respect to the dome 204 and / or the fixing ring 208 can be fixed with respect to the base 202. The eye fixation device 200 can be placed in the patient's eye and the surgeon can rotate dome 204 of eye fixation device 200. This can cause one of the fixing rings 206-208 to rotate with respect to the other fixing ring, which opens and closes the areas between the teeth 210 of the fixing rings 206-208. This technique is illustrative only and another appropriate technique can be used to couple and release the eye tissue with the use of the eye fixation device 200. For example, the windows can be formed in dome 204, over windows 212 in fastener rings 206208, which allows the use of an external tool by the surgeon.

Figures 3A to 3C illustrate a third exemplary eye fixation device 300 in accordance with this invention. The embodiment of the eye fixation device 300 shown in Figures 3A to 3C is illustrative only. Other modalities of * «can be used^J * -s * "* eye fixation device 300, without departing from the scope of this invention.

As shown in Figure 3A, the eye fixation device 300 includes a dome 302 and fixing rings 304-306. Again, dome 302 protects the central portion of the patient's eye and can be formed of an appropriate material, and with any appropriate technique. In this example, dome 302 is transparent and includes a mark used to center dome 302 in the patient's eye, although other modalities can be used. Also, the fixing rings 304-306 include teeth 308 that have the shape and are positioned so that they are angled to each other. This allows the teeth 308 of the fixing rings 304-306 to engage or secure over the ocular tissue (such as the scleral tissue) of the patient's eye. As shown in Figures 3A and 3B, at least one of the fixing rings 304-306 can rotate with respect to the other to open and close the areas between the teeth 308.

In this example, the fixing rings 304-306 include windows 310, which provide an indication of whether (and the limit) the fixing rings 304-306 are fixed on the eye tissue. For example, when the fixing rings 304-306 open (do not mate with the eye tissue), the windows 310 in the fixing rings 304-306 can be at least partially aligned. When the fixing rings 304-306 are closed (fixed on the eye tissue), the windows 310 in the fixing rings 304-306 are not aligned, and the windows 310 in the fixing ring 306 may be hidden.

As shown in Figure 3C, the fixing device 300 * « ^J * -s * “* * can also include a housing 312. The housing 312 holds the fixing rings 304-306 and the dome 302 of the eye fixing device 300. Housing 312 may also allow the surgeon to rotate at least one of the 304-306 fixing rings. In this example, housing 312 includes windows 314 and connection points 316. The windows 314 in the housing 312 can be aligned with the windows 310 in the fixing ring 304. This allows the surgeon to determine to what extent the 304-306 fixing rings are opened or closed (since the housing 312 conceals or covers the fixing rings 304-306). Connection points 316 represent areas where the surgical tool can be coupled with housing 312 (described in more detail below), although connection points 316 can be omitted, if desired. Housing 312 can be formed of any appropriate material, and with any appropriate technique. Housing 312 may also have an appropriate form or arrangement.

In this example, the fixing rings 304-306 have more of a cylindrical shape (although it is not necessary that they have a truly cylindrical shape and may, for example, have inclined sides). That is, the major surface of each fixing ring 304-306 extends and rotates about a central axis through the center of that fixing ring 304-306.

Although Figures 1A through 3C illustrate three examples of eye fixation devices, several changes can be made in Figures 1A through 3C. For example, the relative sizes and dimensions of the characteristics of the eye fixation devices are only * s¡^J * -s * "* illustrative and may be altered in any appropriate manner. Also, several features shown and described with respect to one of the eye fixation devices can be used with other features of other eye fixation devices. As a particular example, the fixing rings 206-208 of the eye fixation device 200 can be used with the eye fixation device 100. As another particular example, the same or different housing 312 used with the eye fixation device 300, with the other eye fixation devices 100 and 200 can be used. In addition, the dome can be omitted from an ocular fixation device, such as when the ocular fixation device is used to secure the patient's eye during corneal surgery and other surgical procedure.

Figures 4A through 4I illustrate an exemplary use of an ocular fixation device during the creation of the scleral tunnel to receive the scleral prosthesis in accordance with this invention. The exemplary use shown in Figures 4A through 4I is illustrative only. An eye fixation device may be used in another appropriate manner (including only fixing the patient's eye) without departing from the scope of the invention.

As shown in Figures 4A through 4I, a surgical tool 450 is used, together with the eye fixation device 400 to form incisions in the patient's eye. In this example, the eye fixation device 400 represents the eye fixation device 300, although another suitable eye fixation device can be used.

<img file="MX364494B_D0001.tif" />

In this example, surgical tool 450 includes a surgical blade 452 and a connecting portion 454. As shown in Figures 4A to 4C, the connection portion 454 of the surgical tool 450 can be coupled with the connection points 456 of a housing associated with the eye fixation device 400, which mounts the surgical tool 450 in the eye fixation device 400. After that, as shown in Figures 4B through 4E, the surgical tool 450 can be rotated into position, and the surgical blade 452 can be rotated in and out of the patient's sclera to form the scleral tunnel. This process can be repeated by mounting the surgical tool 450 at a different connection point 456. As a particular example, four scleral tunnels can be formed in the patient's eye with the use of this technique.

In some embodiments, surgical tool 450 is removed from the eye fixation device 400 after one or more scleral tunnels have been formed, but before one or more scleral prostheses are implanted in the tunnels. The eye fixation device 400 can also be removed from the patient's eye before or after implanting the scleral prosthesis in the scleral tunnels.

In other embodiments, the eye fixation device 400 and the surgical tool 450 can be used to facilitate implantation of a scleral prosthesis in the scleral tunnel. For example, as shown in Figures 4F to 41, the surgical tool 450 can be configured to deposit the scleral prosthesis into the scleral tunnel during the formation of the scleral tunnel. In this example, the * s¡ blade^J * -s * "* surgical 452 includes a central portion 460, a curved surgical blade 462, and two hub arms 464a-464b. The central portion 460 is connected to the surgical tool 450 and can rotate in multiple directions to move the cutting blade 462 in and out of the scleral tissue of the patient's eye. The arms 464a-464b of the hub are coupled with the central portion 460 of the cutting blade 462, which helps to move the rotation of the moving central portion 460 of the cutting blade 462.

A prosthesis 466 is coupled with the tail end of the cutting blade 462. The prosthesis 466 may represent any suitable prosthesis, such as the prosthesis described in the patent documents incorporated above. As shown in Figures 4F and 4G, the cutting blade 462 initially is rotated through the scleral tissue of the patient's eye with the use of the arm 464b of the hub. Eventually, the arm 464a of the hub is coupled with the tip of the cutting blade 462, and the hub arm 464b is disengaged from the cutting blade 462. As shown in Figures 4H and 41, the arm 464a of the hub then continue rotating the cutting blade 462 through the scleral tissue and out of the newly formed scleral tunnel. In this example, the prosthesis 466 is pulled into the scleral tunnel upwards by the surgical blade 452 and disengaged from the cutting blade 462. The prosthesis 466 can then rotate to place the prosthesis 466 well in the newly formed scleral tunnel.

The technique shown in Figures 4F through 41 is illustrative only. Any other technique can be used to implant the scleral prosthesis into the scleral tunnel, whether the implant 's; 'Whether or not it occurs with the eye fixation device or with the surgical tool mounted on an eye fixation device.

Although Figures 4A through 41 illustrate an exemplary use of an eye fixation device during the creation of a scleral tunnel to receive the scleral prosthesis, several changes can be made in Figures 4A through 41. For example, surgical tool 450 it can be coupled with or mounted on the eye fixation device 400 in any appropriate way. Also, the same or similar techniques can be used to form incisions in other portions of the patient's eye. In addition, another suitable surgical tool may be used together with the eye fixation device, or the surgical tool may not be used with the eye fixation device.

Figures 5A through 5C illustrate a fourth exemplary eye fixation device 500 and an exemplary use of the eye fixation device 500 in accordance with this invention. The modality of the eye fixation device 500 and its use shown in Figures 5A to 5C are only illustrative. Other embodiments of the eye fixation device 500 and the uses of the eye fixation device 500 may be used without departing from the scope of this invention.

As shown in Figure 5A, the eye fixation device 500 is similar to the eye fixation device 200 of Figures 2A through 2C. The eye fixation device 500 includes a base 502, a dome 504, and fixing rings 506-508. In this example, the base 502 is coupled or secured with the dome 504 (or vice versa) and the fixing rings 506-508 are secured between the base 502 and the dome 504.

's; '

In this exemplary embodiment, the fixing rings 506-508 include tabs 510-512, respectively. Tabs 510-512 extend outwardly from base 502 and dome 504. For example, as shown in Figure 4B, one or more gaps 514 may exist between base 502 and dome 504 and tabs 510-512 they can extend through one or more of the holes 514. The tabs 510-512 can be used to control the opening and closing of the teeth in the 506-508 fixing rings. For example, the tabs 510-512 can be separated to open the teeth in the fixing rings 506-508 and the tabs 510-512 can be pushed together to close the teeth in the fixing rings 506-508.

As shown here, the base 502 of the eye fixation device 500 includes portions 516 that project from the main body of the eye fixation device 500 and are arranged to generally lie in the patient's eye. Portions 516 include straight edges or guides 518 and base 502 also includes notches 520. Guides 518 and notches 520 are used to align a surgical tool 522 during a surgical procedure. For example, surgical tool 522 may include a projection 524, which can be inserted into each of the notches 520 of the eye fixation device 500. Also, the surgical tool 522 can be positioned so that its base is aligned with one of the straight guides 518 of the eye fixation device 500. The surgical tool 522 can then be used to form an incision in the patient's eye, such as a scleral tunnel to receive the scleral prosthesis. In this particular example, the eye fixation device 500 includes guides 518 and notches 520 in four locations, although other locations can be supported.

In this way, the eye fixation device 500 serves to ensure the position of the patient's eye during a surgical procedure. At the same time, the eye fixation device 500 facilitates the placement of the surgical tool 522 in appropriate locations in the patient's eye.

Although Figures 5A through 5C illustrate a fourth example of an eye fixation device 500 and an exemplary use of the eye fixation device 500, several changes can be made in Figures 5A through 5C. For example, the relative sizes and dimensions of the characteristics of the eye fixation device 500 are illustrative only and can be altered in a suitable manner. Also, the guiding mechanisms described above (straight guides 518 and notches 520) can be used with other ocular fixation devices and with other surgical tools.

Figures 6A through 6C illustrate a fifth exemplary eye fixation device 600 and an exemplary use of the eye fixation device 600 in accordance with this invention. The modality of the eye fixation device 600 and its use shown in Figures 6A to 6C are illustrative only. Other embodiments of the eye fixation device 600 and the uses of the eye fixation device 600 can be used without departing from the scope of this invention.

As shown in Figure 6A, the eye fixation device 600 *&gt; 'is similar to the eye fixation devices described above. The eye fixation device 600 includes a base 602, a dome 604 and fixing rings 606-608. In this example, the base 602 is coupled or secured with the dome 604 (or vice versa) and the fixing rings 606-608 are secured between the base 602 and the dome 604. In this particular example, the fixing ring 606 includes multiple sets of teeth (which may have different heights from the surface of the patient's eye) and these teeth correspond to multiple sets of teeth of the fixing ring 608. As with the eye fixation device 500, the fixing rings 606-608 also include tabs 610-612, respectively, which extend outside the base 602 and the dome 604 and which can be used to control the opening and closing of the teeth in the rings 606-608 fixers.

As shown here, the dome 604 of the eye fixation device 600 includes holes 614. The holes 614 in this example are used to align a surgical tool 616 with one or more locations of the patient's eye. The surgical tool 616 includes an alignment portion 618, which has two extensions 620a-620b that form a partial circle around the eye fixation device 600. Each of the extensions 620a-620b includes an end that can be inserted into one of the holes 614 of the eye fixation device 600. As shown in Figures 6B and 6C, the alignment portion 618 of the surgical tool 616 also includes a retainer 622, which can be pressed against the base 602 of the eye fixation device 600. Collectively, the ends of extensions 620a-620b and retainer 622 represent three points that can be used to ensure correct placement *&gt; 'of the surgical tool 616 in the patient's eye.

In this example, surgical tool 616 includes two 624 multi-barbed gripping pins. As shown in Figure 6B, the snaps 624 can be opened before the surgical tool 616 is pressed into the patient's eye. As shown in Figure 6C, when the surgical tool 616 is pressed on the patient's eye, the grip pins 624 rotate (either inward or outward). This helps secure the surgical tool 616 in place in the patient's eye. The two clasps can be an independent part or accessory of a piece or an accessory with multiple spikes at each end.

In this exemplary embodiment, the extensions 620a-620b of the surgical tool 616 form a partial circle around the eye fixation device 600. This allows the surgical tool 616 to be attached or mounted on the eye fixation device 600, while leaving a large portion of the dome 604 exposed. Among other things, this may allow the use of a positioning tool 626, which can be used to place the eye fixation device 600 in one or more positions in the patient's eye. Additional details regarding the exemplary placement tool are provided below.

Although Figures 6A through 6C illustrate a fifth exemplary eye fixation device 600 and an exemplary use of the eye fixation device 600, several changes can be made in Figures 6A through 6C. For example, the relative sizes and dimensions of the »-s *" * characteristics of the eye fixation device 600 are illustrative only and can be altered in an appropriate manner. Also, the guiding mechanisms described above (the holes 614 in the dome 604 and the alignment portion 618 of the surgical tool 616) can be used with another eye fixation device and another surgical tool.

Figure 7 illustrates an exemplary positioning tool 700 for use with an eye fixation device in accordance with this invention. The mode of the positioning tool 700 shown in Figure 7 is illustrative only. Other embodiments of the positioning tool 700 can be used without departing from the scope of this invention.

In this exemplary embodiment, the positioning tool 700 represents a syringe structure having a body 702, a plunger 704 inserted into the body 702, a spring 706 and a suction cup 708. The spring 706 drives the plunger 704 towards the closed position, which means that the spring 706 moves the plunger 704 towards the suction cup 708 at the end of the body 702 (although the spring 706 can also propel the plunger 704 towards the open position ). The end of the piston 704 can form an air tight seal within the body 702 and the suction cup 708 can form an air tight seal with the eye fixation device.

To place an ocular fixation device in the patient's eye, the surgeon checks the transparent protective dome (or through the inner edge of the ring when the dome is not attached) and centers the fixation device on the limbus or cornea, as with the use of appropriate marks on * * s¡ '* -s * “* the eye (including any mark that may be placed in the eye in advance by the surgeon or by any other personnel). Once centered, the surgeon or another person can use the specialized tool to close the tabs and fix the rings in place or the rings can be manually fixed in place to firmly attach the fixation device to the eye. The surgeon or another person may use another appropriate technique to fix the fixation device in a position centered on the eye. Once attached to the eye, the surgeon or doctor can turn a portion of the fixation device back under the eyelid of! patient, leaving enough space exposed in the front of the fixation device and the transparent dome to attach the positioning tool with the transparent dome. The placement tool can be attached to the dome quadrant that is closest to the quadrant in which the surgeon will create a tunnel. Before attempting to attach the positioning device, the plunger 704 can be depressed (moving towards the suction cup), such as by the surgeon or doctor, aided by the spring 706. The suction cup 708 can then be placed in the device eye fixation, such as in the dome, (if any) of the eye fixation device described above. The surgeon or doctor retracts the plunger 704 from the body 702 of the positioning device, which allows the plunger 704 to move away from the suction cup 708. The air-tight seal creates a vacuum within the body 702 of the positioning tool 700, which causes the suction cup 708 to mate with the eye fixation device. A separate fixing mechanism can fix the piston 704 in place to maintain 'δ * the vacuum during the creation of the tunnel. On the contrary, the spring 706 can be placed between the piston 704 and the suction cup 708 in the body of the positioning device 702, which eliminates the need for a separate fixing mechanism for the piston 704, since the spring 706 can maintain pressure independently to maintain vacuum. Once the positioning device is firmly coupled with the transparent dome of the eye fixation device, the positioning tool can be used to control and stabilize the eye (like a handle) while the surgical tool is coupled simultaneously with the fixing device for the creation of the scleral tunnel. Once the tunnel has been created with the use of the surgical device, the plunger 704 of the positioning device can be depressed. This releases the suction cup 708 of the ocular fixation device, which allows the fixation device to be placed under the eyelid in a different location, to expose a new quadrant of the transparent dome for re-coupling of the positioning device and then the re-coupling of the surgical device for the creation of the following tunnel.

This type of positioning tool 700 represents only one example of the types of tools that can be used to position and control an eye fixation device. Any other mechanism can be used to place and control an eye fixation device. For example, the eye fixation device may include a handle, such as a sliding ring that can be used to position and control the eye fixation device and then can be turned to the side and `` If lying on the dome or base of the eye fixation device. Any other handle or other mechanism can be used to allow the ocular fixation device to be manipulated and placed.

Although Figure 7 illustrates an example of a positioning tool 700 for use with the eye fixation device, several changes can be made in Figure 7. For example, another appropriate device or technique can be used to position and control the device eye fixation in the patient's eye.

Figure 8 illustrates a sixth eye fixation device 800 in accordance with this invention. The embodiment of the eye fixation device 800 shown in Figure 8 is illustrative only. Other embodiments of the eye fixation device 800 can be used without departing from the scope of this invention.

In this example, the eye fixation device 800 includes a base 802, a fixation mechanism 804 and a handle 806. The base 802 can generally be pressed against the patient's eye, such as by pressing base 802 down on the cornea of ​​the patient. The fixation mechanism 804 can then be coupled with the patient's sclera, which fixes the tool 800 in place and provides free access to the patient's sclera. The fixation mechanism 804 can use any appropriate technique to be fixed on the patient's eye, such as spikes that can be forced into the patient's scleral tissue. The handle 806 can be used to raise and lower the locking mechanism 804 after the base 802 has been pressed on the patient's eye.

* χ '

Although Figure 8 illustrates a sixth eye fixation device 800, changes can be made in Figure 8. For example, any appropriate mechanism can be used to couple or otherwise associate the eye fixation device 800 in the patient's eye.

Figures 9A through 9C illustrate a seventh exemplary eye fixation device 900 and exemplary use of the eye fixation device 900 in accordance with this invention. The modality of the eye fixation device 900 and its use shown in Figures 9A to 9C are illustrative only. Other embodiments of the eye fixation device 900 and other uses of the eye fixation device 900 can be contemplated, without departing from the scope of this invention.

As shown in Figures 9A through 9C, the eye fixation device 900 includes a central portion 902, a support 904 having a tool connection 906, and spikes 908. In some embodiments, the central portion 902 of the device 900 of Eye fixation usually fits over the patient's cornea or in some other portion of the patient's eye. The central portion 902 of the eye fixation device 900 may be centered in the patient's eye. The support 904 can be removably coupled with the central portion 902 and the tool connection 906 allows a surgical tool 910 to be coupled with the support 904. Alternatively, the support 904 can be coupled with an axial bolt with the center of the device fixing and turn to the next quadrant.

The spikes 908 hold the central portion 902 of the eye fixation device 900 in place in the patient's eye. For example, the spikes

908 They can be extended outward as shown in Figure 9A before placement in the patient's eye. The spikes 908 can then be pushed or rotated so that the ends of the spikes 908 are engaged or secured in the patient's eye and can be held in the closed position, for example, by internal springs or wire mechanisms.

In particular embodiments, the support 904 can be coupled in an orientation with the central portion 902, the surgical tool 910 can be coupled with the support 904 and the scleral tunnel can be formed. This process can then be repeated, with the support 904 removed and coupled in a different orientation with the central portion 902 so that the surgical tool 910 can form a scleral tunnel at another location in the patient's eye. Alternatively, the support 904 can be coupled with an axial bolt with the center of the fixing device 902 and rotated to the next quadrant for the creation of the next tunnel.

Although Figures 9A through 9C illustrate a seventh exemplary eye fixation device 900 and an exemplary use of the eye fixation device 900, several changes can be made in Figures 9A through 9C. For example, the eye fixation device 900 may include other mechanisms for coupling with the patient's eye or with a surgical tool 910.

Figures 10A through 10D illustrate an eighth eye fixation device 1000 in accordance with this invention. The modality of the eye fixation device 1000 shown in Figures 10A through 10D is illustrative only. Other embodiments of the eye fixation device 1000 can be contemplated, without departing from the scope of this invention.

In this example, the eye fixation device 1000 includes an outer ring 1002, an inner ring 1004 and ring connections 1006. The outer and inner rings 1002-1004 generally represent circular shaped structures. As shown in Figure 10A, the outer ring 1002 is generally, in a different plane than the smaller inner ring 1004. Typically, the ring connections 1006 couple the outer and inner rings 1002-1004 together, which forms an integrated structure. The ring connections 1006 have a shape such that a portion of the patient's eye can be adjusted through the outer ring 1002 and approach or come into contact with the inner ring 1004.

As shown here, the eye fixation device 1000 also includes multiple spikes 1008, which are rotatably coupled with the outer ring 1002. As shown in Figure 10B, the spikes 1008 can be opened prior to the placement of the eye fixation device 1000 in the patient's eye. As shown in Figures 10C and 10D, once placed in the patient's eye, each of the spikes 1008 can be rotated so that the ends of the spikes 1008 engage or secure with the patient's eye. To release the eye fixation device 1000, the spikes 1008 can be rotated again to remove the ends of the spikes 1008 from the patient's eye. In some embodiments, the spikes can be held in place, such as by external springs or tension wire constructed within second rings or external rings with a * -s * "* constant tension to hold them in the closed and fixed position while they are coupled with the eye tissue.

Although Figures 10A through 10D illustrate an eighth exemplary eye fixation device 1000, several changes can be made in Figures 10A through 10D For example, rings 1002-1004 can have any appropriate dimension, and inner ring 1004 can have a suitable distance from the outer ring 1002. Other appropriate mechanisms can also be used to couple the rings 1002-1004 together and to couple or otherwise associate the eye fixation device 1000 with the patient's eye.

Figures 11A to 11B illustrate a ninth eye fixation device 1100 in accordance with this invention. The modality of the eye fixation device 1100 shown in Figures 11A to 11B is illustrative only. Other embodiments of the eye fixation device 1100 can be contemplated, without departing from the scope of this invention.

In this example, the eye fixation device 1100 is formed from two rotating segments 1102. Each segment 1102 includes spikes 1104 that can fix segment 1102 with the patient's eye, as in the sclera of the eye. Each segment 1102 also includes connection points 1104, which represent areas where other components (such as a surgical tool) can be coupled with the eye fixation device 1100. In addition, the eye fixation device 1100 can provide reference markers that identify the place where the scleral tunnels must be formed in the patient's eye, such as the locations on or between the barbs 1104. In some embodiments, one of the segments 1102 can be coupled with the patient's eye and then in another segment 1102 it can be turned out and engaged in the patient's eye.

Although Figures 11A and 11B illustrate a ninth exemplary eye fixation device 11000, several changes can be made in Figures 11A. And 11B. For example, each segment 1102 may include any suitable number of barbs 1104.

Figures 12A and 12B illustrate a tenth eye fixation device 1200 in accordance with this invention. The mode of the eye fixation device 1200 shown in Figures 12A and 12B is illustrative only. Other embodiments of the eye fixation device 1200 may be contemplated, without departing from the scope of this invention.

In this example, the eye fixation device 1200 generally includes a ring 1202 with cross bars 1204. Ring 1202 generally has the size and shape to lie in the patient's eye, such as having an inclined inner edge that generally lies in the sclera of the patient's eye. The transverse bars 1204 generally have the measures and shape to allow a portion of the patient's eye to fit through the ring 1202 and approach or come into contact with the transverse bars 1204.

In this exemplary embodiment, torsion stitches 1206 are provided along the ring 1202. Torsion stitches 1206 represent screw-like structures that can be coupled with and released *&gt; 'from the eye tissue of the patient's eye. For example, by rotating the torsion picks 1206 in one direction you can couple the torsion picks 1206 with the eye tissue of the patient's eye. Turning the torsion pegs 1206 in the opposite direction can release the eye tissue. In this way, the ring 1202 can be coupled with the patient's eye through a simple rotation of the torsion picks 1206.

As shown here, the eye fixation device 1200 also includes connection points 1208. The connection points 1208 generally represent areas where, for example, a surgical tool can be mounted to form scleral incisions in the eye fixation device 1200. In this example, each of the connection points 1208 includes a raised area of ​​the ring 1202 adjacent to a notch in the ring 1202. However, another suitable mechanism can be used to mount or otherwise couple any suitable surgical tool with the eye fixation device 1200.

Although Figures 12A and 12B illustrate a tenth exemplary eye fixation device 1200, several changes can be made in Figures 12A and 12B. For example, the ring 1202 and the cross bars 1204 may have any suitable shape or dimension, and the cross bars 1204 can be attached at any appropriate height above the ring 1202. Also, another appropriate mechanism can be used to couple or otherwise associate the eye fixation device 1200 in the patient's eye.

Figures 13A through 13D illustrate an eleventh eye fixation device 1300 in accordance with this invention. The mode of the '' If eye fixation device 1300 shown in Figures 13A through 13D is illustrative only. Other embodiments of the eye fixation device 1300 can be contemplated, without departing from the scope of this invention.

In this example, the eye fixation device 1300 includes a ring 1302 having a lever 1304. The lever 1304 is used to control the movement of the retractable bolts 1306 that can be retracted inside and extended outside the ring 1302. For example, the Lever 1304 can be placed in an elevated position as shown in Figure 13A, to retract bolts 1306 within ring 1302. Ring 1302 can then be placed in the patient's eye and placed properly. After this, the lever 1304 can be lowered, as shown in Figure 13B, which causes the bolts 1306 to extend from the ring 1302 and be fixed on the patient's eye tissue. For example, bolts 1306 can penetrate the patient's eye blade at a depth of 200 microns. Another appropriate mechanism can be used to cause bolts 1306 to retract and extend under the control of lever 1304.

In this exemplary embodiment, the eye fixation device 1300 may also include vertical teeth 1308, which may or may not penetrate the surface of the patient's eye. When the vertical teeth 1308 do not penetrate the surface of the patient's eye, the vertical teeth 1308 grab the patient's eye and provide lateral fixation, which means that the vertical teeth 1308 can help prevent lateral movement of the eye fixation device 1300 in the patient's eye. In addition, as with the different prostheses described above, the eye fixation device 1300 may include one or more connection points 1310 and one or more windows 1312.

Although Figures 13A through 13D illustrate an eleventh exemplary eye fixation device 1300, several changes can be made in Figures 13A through 13D. For example, ring 1302, lever 1304, bolts 1306 and other elements may have another appropriate shape or dimension. Also, other mechanisms can be used to couple or otherwise associate the ocular fixation device 1300 with the patient's eye.

Figures 14A through 14C illustrate a twelfth eye fixation device 1400 in accordance with this invention. The modality of the eye fixation device 1400 shown in Figures 14A through 14C is illustrative only. Other embodiments of the eye fixation device 1400 can be contemplated, without departing from the scope of this invention.

In this example, the eye fixation device 1400 includes a ring 1402 having a lock 1404 at one end and a receptacle 1406 at its other end. Ring 1402 also includes a joint 1408, which allows two portions of ring 1402 to open and close with respect to each other. In this embodiment, portions of ring 1402 can be separated to open ring 1402. The ring 1402 can be placed in the patient's eye and the lock 1404 can be pushed into the receptacle 1406, which forms a complete ring. As shown in Figure 14B, the lower edge of ring 1402 includes tips 1410 that can penetrate the eye tissue of the patient's eye, which secures ring 1402 in place in the patient's eye.

As shown here, the eye fixation device 1400 also includes connection points 1412, which generally represent areas where, for example, a surgical tool can be mounted to form incisions in the eye fixation device 1400. Any type of connection point or other mechanisms can be used to mount or otherwise couple the surgical tool with the eye fixation device 1400.

The eye fixation device 1400 also includes one or more windows 1414. The windows 1414 allow the surgeon or doctor to see through the eye fixation device 1400, in order to determine the position of the eye fixation device 1400 with respect to certain characteristics of the patient's eye. For example, the windows 1414 may allow the surgeon to ensure that the eye fixation device 1400 is coupled with the area in or near the patient's eye blade. The windows 1414 may have the appropriate size, shape and distribution in the eye fixation device 1400.

Although Figures 14A through 14C illustrate a twelfth exemplary eye fixation device 1400, several changes can be made in Figures 14A through 14C. For example, ring 1402, lock 1404 and receptacle 1406 may have any other appropriate shape or dimension. Also, any other mechanism can be used to couple or otherwise associate the eye fixation device 1400 in the patient's eye.

For all the eye fixation devices described above, the different components or elements of the eye fixation device may have different shapes, sizes or dimensions. For example, some of the ocular fixation devices may have curved lower surfaces, which allows the ocular fixation devices usually to be found on the surface of the patient's eye. Also, various elements or features of the ocular fixation devices can be used with other ocular fixation devices. In addition, although they are often described as coupled or otherwise associated with the patient's eye in the sclera or limbus, ocular fixation devices can be coupled with or otherwise associated with the patient's eye in other locations. In addition, ocular fixation devices are often described as used to support a surgical procedure that involves the implantation of the scleral prosthesis within the scleral tunnels in the patient's eye. However, any appropriate surgical procedure can be carried out with the use of the eye fixation device.

In particular embodiments, any of the ocular fixation devices described above may have a size such that the teeth, prongs and other fixation means for associating the ocular fixation device with the eye are secured, come into contact, coupled or released. the tissue at or near the eye blade. This region of the eye may be suitable for this type of procedure as it heals quickly. However, each of the eye fixation devices may have an appropriate *&gt; 'shape or size.

The use of various mechanisms to secure or fix the ocular tissue, such as rings or other devices having teeth, spikes or pins, has been described. However, eye fixation devices may have any appropriate mechanism to secure or fix the eye tissue. In this document, the phrases "fixing means" and "fixing means" refer to any structure or portion thereof extending from, projected, part or otherwise associated with the eye fixation device and which it is pressed against, comes into contact or penetrates the surface of the patient's eye. These "fixing means" include one or more teeth, spikes, bolts, projections or other extensions or projections coupled, joined, extended from, integrated with, or otherwise associated with a ring or with another structure placed near the eye. "Fixing means" also include other mechanical structures such as one or more torsion picks or sutures. In some embodiments, the "fixing means", such as the teeth may be flat or at an angle to the structure with which the means are associated. In addition, in this document, an eye fixation device can be "associated with" the eye when the eye fixation device is secured or engaged with the eye.

Figure 15 illustrates an example of an exemplary method 1500 for ocular fixation in accordance with this invention. The method of method 1500 shown in Figure 15 is illustrative only. Other embodiments of method 1500 may be used without departing from the scope of this invention.

* yes ^J * -s * “*

An ocular fixation device is placed in the patient's eye at step 1502. This may include, for example, placing any of the ocular fixation devices described above in the patient's eye. The eye fixation device may include a dome so that the central portion of the patient's eye is covered and protected by the eye fixation device.

One or more fixing rings of the eye fixation device are rotated to secure the eye fixation device in the patient's eye in step 1504. This may include, for example, using an external tool to move one or more of the fixing rings of the eye fixation device. This may include rotating one or more portions of the eye fixation device to cause one or more of the fixing rings to rotate. This may also include turning one or more tabs coupled with one or more fixing rings to cause one or more fixing rings to rotate. Any other appropriate technique can be used to rotate one or more fixing rings of the eye fixation device.

An ocular surgical procedure occurs in step 1506. This may include, for example, forming one or more scleral tunnels in the sclera of the patient's eye. Optionally, one or more scleral prostheses or other implants are placed in the patient's eye at step 1507. This may include, for example, inserting a scleral prosthesis as the tunnels are formed (as shown in Figures 4F to the 4I above). This may also include inserting the scleral prosthesis into the tunnels manually or in another way after a surgical tool has been mounted on the ocular fixation device 'δ * and is used to form the scleral tunnels.

One or more fixing rings of the eye fixation device are rotated to release the eye fixation device from the patient's eye in step 1508. This may include, for example, using an external tool, one or more portions of the eye fixation device or tabs are coupled with the fixing rings to rotate one or more fixing rings. The ocular fixation device is removed from the patient's eye in step 1510. Optionally, one or more scleral prostheses or other implants are placed in the patient's eye at step 1511. This may include, for example, inserting the scleral prostheses into the tunnels manually or otherwise after the Eye fixation device has been removed from the patient's eye. One or both optional steps 1507 and 1511 show that the eye fixation device can be used in a variety of ways during a surgical procedure.

Although Figure 15 illustrates an example of a method 1500 for ocular fixation, several changes can be made in Figure 15. For example, any surgical procedure may involve the use of ocular fixation. Also the surgical procedure may, but not necessarily, involve the implantation of one or more scleral prostheses or other implants or elements within the patient's eye. In addition, while describing that rotating one or more locking rings secures or releases the patient's eye, other techniques (such as those associated with other modalities of the eye fixation devices described above) can be used.

It may be convenient to establish definitions of certain words or phrases used throughout this document. The terms "include" or "comprise" as well as their derivatives, mean inclusion without limitation. The term "o" is inclusive, which means and / or. The term "ring" refers to a structure that is generally circular or oval shaped.

Figures 16A and 16B illustrate a conventional eye fixation tool. This eye fixation tool is placed on the surface of the patient's eye and is physically sutured with the sclera of the patient's eye. This eye fixation tool includes several notches where the surgical tool can be placed.

Figures 17A and 17B illustrate a third conventional eye fixation tool, which has a handle, a solid ring and two swivel arms. The solid ring is rotatably coupled with the handle. The two rotating arms are coupled or mounted on the solid ring at a common rotating point. As shown in Figure 17A, the two swivel arms are in the open position, and the solid ring can be placed in a desired location in the patient's eye. As shown in Figure 17B, the two rotating arms can then be closed, which drives the spikes or other extensions in the arms into the patient's eye tissue. After that, the handle can be turned to the sides so that the surgeon or the tool has free access to the patient's eye through the rings. In other embodiments, the handle and the solid ring can be omitted and the two swivel arms can be used (the arms can be opened and closed to fix and release the patient's eye tissue). Also, in other embodiments, the two rotating arms may lack spikes or extensions, and the arms may be used to propel the spikes or extensions in the solid ring into the patient's eye tissue.

While this invention describes various modalities and methods, the associated alterations and changes of these modalities and method will be apparent to persons skilled in the art. For example, while showing how to provide manual rotation or movement of one or more rings or other structures in the eye fixation device, any appropriate technology, such as a mechanical or electrical mechanism, can be used to rotate or move one or more rings or other structures in the eye fixation device. Accordingly, the above description of the exemplary embodiments does not define or restrict this invention. Other changes, substitutions and alterations are possible without departing from the spirit and scope of this invention, as defined in the appended claims.