Surgical implant delivery with dual mode drive

Abstract

An apparatus (100) for ophthalmic surgery. Some embodiments may include a housing (110), a bore through the housing, and a push rod (115) disposed at least partially within the bore. The push rod may be operable to move within the bore between three rod positions. A plunger key may be coupled to the housing and operable to move between three key positions. In a first key position, the plunger key may prevent the push rod from moving from the first rod position. In a second key position, the plunger key may allow the push rod to be rotated and advanced to a third rod position. In a third key position, the plunger key may allow the push rod to slide within the bore from the second rod position to the third rod position.

Description

[Technical field]

[0001] The present invention as recited in the accompanying claims relates generally to ophthalmic surgery. More particularly, but not by way of limitation, the claimed subject matter relates to systems, devices and methods for inserting an implant into the eye. [Background technology]

[0002] The human eye can be affected by a variety of diseases that can cause anything from mild vision loss to complete blindness. Contact lenses or glasses can compensate for some pathologies, while others may require ophthalmic surgery. In some instances, an implant may be advantageous or desirable. For example, an intraocular lens may replace the clouded natural crystalline lens to improve vision.

[0003] While the benefits of intraocular lenses and other implants are known, improvements in delivery systems, components, and processes continue to improve outcomes and benefit patients. Summary of the Invention [Means for solving the problem]

[0004]

[0005] Novel and useful systems, apparatus, and methods for ophthalmic surgery are set forth in the appended claims. Exemplary embodiments are provided to enable one of ordinary skill in the art to make and use the claimed subject matter.

[0005] Some embodiments may provide an apparatus for ophthalmic surgery that incorporates two delivery modes into one preloaded delivery system, for example, the apparatus may provide a choice between one-handed pushing and two-handed pushing and twisting, allowing the surgeon to select the delivery mode based on preference or situation.

[0006] In a more specific example, the device may have a plunger key with multiple positions. In a first position, the plunger key may lock the plunger in place, which may be advantageous for shipping and storage, for example. In a second position, the plunger may be released to slide axially to a rest position. From the rest position, the plunger key may remain in the second position for twist delivery or move to a third position. In the third position, the plunger may be released to be pushed from the rest position for delivery. In some examples, the plunger key may be coupled to the housing such that rotation is substantially constrained or prevented while moving axially between the multiple positions.

[0007] More generally, some embodiments of an apparatus for ophthalmic surgery may include a housing, a bore through the housing, and a push rod disposed at least partially within the bore. The push rod may be operable to move within the bore from a first rod position to a second rod position and a third rod position. The apparatus may further include a plunger key, which may be coupled to the housing and operable to move between a first key position, a second key position, and a third key position. In some examples, the plunger key may move axially between a plurality of positions and may be prevented from rotating as it moves between the plurality of positions. In the first key position, the plunger key may lock the push rod, thereby preventing the push rod from moving from the first rod position. In the second key position, the plunger key may allow the push rod to slide within the bore from the first rod position to the second rod position. In the second key position, the plunger key may also allow the push rod to rotate to the third rod position. In the third position, the plunger key may allow the push rod to slide within the bore from the second rod position to the third rod position.

[0008] In more specific embodiments, a portion of the push rod may include threads and the plunger key may include one or more thread tracks configured to mate with the threads of the push rod, such that when the plunger key is in the second key position, the push rod may rotate to advance from the second rod position to the third rod position. In some embodiments, the push rod may further include a slide track and the plunger key may be configured to slidingly engage with the slide track when the plunger key is in the second key position and the push rod is between the first rod position and the second rod position. The push rod may additionally or alternatively include a keyway configured to receive a portion of the plunger key at the first rod position and the first key position, such that the push rod may be held in the first rod position by a portion of the plunger key disposed in the keyway.

[0009] In a more specific example, the plunger key may include a shank, a tip coupled to one end of the shank, and one or more snap-fit ​​means coupled to the shank. The snap-fit ​​means may be configured to engage with the key mount at each of the first key position, the second key position, and the third key position. The key mount may include a catch configured to engage with the plunger key at each of the first key position, the second key position, and the third key position.

[0010] Additionally or alternatively, some embodiments of the device may further include a nozzle, an implant bay coupled to the nozzle, an implant disposed in the implant bay, and a plunger coupled to a push rod within the bore, the push rod may be configured to advance the plunger during movement of the push rod to a third rod position to advance the implant through the nozzle.

[0011] In another exemplary embodiment, an apparatus for ophthalmic surgery may include a housing, a key mount coupled to the housing, a bore through the housing, a plunger disposed within the bore, a push rod coupled to the plunger, and a plunger key. The key mount may include a key track and a catch, and the push rod may include a keyway, a slide track, and a thread. The plunger key may include a shank disposed within the key track, a tip coupled to one end of the shank, a snap-fit ​​means coupled to the shank, and a protrusion coupled to the snap-fit ​​means. The tip may have one or more thread tracks. The push rod may be operable to move within the bore from a first rod position to a second rod position and a third rod position. The shank may be operable to move the tip from the first key position to the second key position and a third key position. The protrusion may be configured to engage the catch at each of the first key position, the second key position, and the third key position. At the first key position, the tip may be disposed within the keyway. In the second key position, the tip can be configured to engage the slide track between the first and second rod positions. In the second key position, the thread track can be configured to engage the threads between the second and third rod positions.

[0012] In yet another example, the device may include a nozzle, an implant bay coupled to the nozzle, an implant disposed in the implant bay, a housing, and a bore through the housing. The actuator may include a plunger disposed in the bore and a push rod at least partially disposed in the bore. The push rod may be operable to move the plunger within the bore from a first plunger position to a second plunger position and a third plunger position. The plunger key may be coupled to the housing and operable to move between a first key position, a second key position, and a third key position. In the first key position, the plunger key may prevent the push rod from moving the plunger from the first plunger position. In the second key position, the plunger key may allow the push rod to slide the plunger within the bore from the first plunger position to the second plunger position and rotate to move the plunger to the third plunger position to advance the implant from the implant bay within the nozzle. In the third key position, the plunger key can enable the push rod to slide the plunger within the bore from the second plunger position to the third plunger position to advance the implant from the implant bay and into the nozzle.

[0013] Features, elements, and aspects described with respect to some embodiments may be omitted, combined, or replaced with alternative features. Further features, objects, advantages, and preferred modes of making and using the claimed subject matter are described in more detail below with reference to the accompanying drawings of illustrative embodiments.

[0014] The accompanying drawings illustrate certain objects, advantages, and preferred modes of making and using certain embodiments of the claimed subject matter, and in the various instances, like reference numerals represent like parts. [Brief description of the drawings]

[0015] [Figure 1]1 is an auxiliary projection view of an exemplary apparatus for delivering an implant into an eye. [Diagram 2] FIG. 2 is an exploded view of the device of FIG. 1. [Diagram 3] FIG. 3 is a top view of the push rod shown in the example of FIG. 2. [Figure 4] FIG. 3 is a rear view of the plunger key shown in the example of FIG. 2. [Diagram 5] FIG. 5 is a side view of the plunger key of FIG. 4. [Figure 6] FIG. 5 is a bottom view of the plunger key of FIG. 4. [Figure 7A-7C] FIG. 2 is a rear cross-sectional view of the device of FIG. 1. [Figure 8A-8E] 2A-2C are cross-sectional side views of the device of FIG. 1 in different states; [Figure 9] 13A-13C are auxiliary projection views of another exemplary device for delivering an implant into the eye. [Figure 10] FIG. 10 is a partial top view of the device of FIG. [Figure 11] FIG. 10 is a partial top cross-sectional view of the device of FIG. [Figure 12] FIG. 10 is a cross-sectional view of the device of FIG. [Figures 13A-13C] 13A-13C are detailed views of a portion of the device of FIG. 12 in different states. [Figure 14A-14B] 10 is a schematic diagram illustrating an exemplary use of the device of FIGS. 1-9 for delivering an implant into the eye. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0016] The following description of exemplary embodiments provides information to enable one of ordinary skill in the art to make and use the subject matter recited in the appended claims, but may omit certain details that are already well known in the art. Thus, the following detailed description is to be considered illustrative rather than limiting.

[0017] Exemplary embodiments may also be described with respect to spatial relationships between various elements or with respect to spatial orientations of various elements as illustrated in the accompanying figures. Typically, such relationships or orientations are subject to a frame of reference that corresponds to or is relative to a patient in a position to receive an implant. However, as will be appreciated by those skilled in the art, this frame of reference is merely a means of explanation rather than a rigid prescription.

[0018] 1 is an auxiliary view of an example of a device 100 capable of delivering an implant into an eye. In some embodiments, device 100 may include two or more modules that may be configured to be coupled and detached as appropriate for storage, assembly, use, and disposal. As shown in FIG. 1, some embodiments of device 100 may include a nozzle 105, a housing 110 coupled to nozzle 105, and an actuator 115 coupled to housing 110.

[0019] The nozzle 105 generally includes a tip 120 adapted for insertion into the eye through an incision. The size of the tip 120 may be adjusted as needed to suit the surgical requirements and procedure. For example, small incisions are generally preferred to reduce or minimize healing time. In some instances, an incision of less than 2 millimeters may be preferred, and the width of the tip 120 of the nozzle 105 may be less than 2 millimeters in some embodiments.

[0020] The housing 110 is generally configured to receive at least a portion of the actuator 115. The housing 110 may further include an implant bay 125, which generally represents a wide variety of devices suitable for holding an implant prior to delivery into the eye. In some embodiments, the implant bay 125 may additionally or alternatively be configured to prepare the implant for delivery. For example, some embodiments of the implant bay 125 may be configured to be manipulated by a surgeon or other operator to prepare the implant to be delivered by subsequent actuation of the actuator 115. In some instances, the implant bay 125 may be configured to actively deform, stretch, unfold, or otherwise manipulate features of the implant before the implant is advanced into the nozzle 105. For example, the implant bay 125 may be configured to fold, unfold, or unfold one or more features of an intraocular lens, such as haptics.

[0021] The actuator 115 is generally configured to advance the implant from the implant bay 125 to the nozzle 105 and then from the nozzle 105 through the incision and into the eye.

[0022] In general, the components of the device 100 may be directly or indirectly coupled. For example, the nozzle 105 may be directly coupled to the implant bay 125 and indirectly coupled to the actuator 115 through the implant bay 125. The coupling may include fluidic, mechanical, thermal, electrical, or chemical coupling (e.g., chemical bonding), or possibly any combination of couplings. For example, the implant bay 125 may be mechanically coupled to the actuator 115 and mechanically and fluidly coupled to the nozzle 105. In some embodiments, the components may also be coupled by physical proximity, being incorporated into one structure, or being formed from the same piece of material.

[0023] Figure 2 is an exploded view of the device 100 of Figure 1, showing further details that may be relevant to some embodiments. For example, the implant bay 125 of Figure 2 includes a base 205 and a cap 210 that may be coupled to the base 205.

[0024] The implant 215 may be disposed between the fundus 205 and the cap 210. In the example of FIG. 2, the implant 215 is an intraocular lens having an optic 220. In some examples, the optic 220 may have a shape similar to that of the natural lens of the eye. Examples of suitable materials may include silicone, acrylic, and combinations of such suitable materials. The implant 215 may also include one or more functional members for positioning the optic 220 in the eye, such as an anterior haptic 225 and a posterior haptic 230. In the example of FIG. 2, the anterior haptic 225 and the posterior haptic 230 extend from opposite sides of the optic 220. In some examples, the implant 215 may be filled with fluid, such as a fluid-filled accommodative intraocular lens.

[0025] 2, some embodiments of the actuator 115 may include a push rod 235, a plunger 240 coupled to one end of the push rod 235, and a knob 245 coupled to an opposite end of the push rod 235. The plunger 240 further includes a protrusion 242.

[0026] The nozzle 105 of FIG. 2 includes a bay interface member 250 that is connectable to the base 205 .

[0027] 2 may include a plunger key 255. In some examples, the plunger key 255 may be coupled to a key mount 260 on the housing 110.

[0028] FIG. 2 also illustrates an implant stop 265 , a first finger flange 270 , and a second finger flange 275 , one or more of which may be associated with various embodiments of the device 100 .

[0029] FIG. 3 is a top view of the push rod 235 of FIG. 2 and shows further details that may be relevant to some embodiments. For example, as shown in FIG. 3, some embodiments of the push rod 235 may include a thread 305. Some embodiments may further include a slide track 310, a plunger mating means 315, or both. The plunger mating means 315 may be located at an end opposite the knob 245, as shown in the example of FIG. 3. The slide track 310 may be a groove, channel, or similar feature of the push rod 235. Some embodiments may also include a keyway 320. As shown in the example of FIG. 3, the keyway 320 may be located near one end of the push rod 235. In a more specific example, the keyway 320 may be located near one end of the slide track 310.

[0030] FIG. 4 is a rear view of the plunger key 255 of FIG. 2, showing further details that may be relevant to some embodiments. The plunger key 255 of FIG. 4 generally includes a shank 405, a tip 410 coupled to one end of the shank 405, and one or more snap-fit ​​means 415 coupled to the shank 405. In the example of FIG. 4, the plunger key 255 includes two snap-fit ​​means 415, each of which is indirectly coupled to the shank 405 through a crossbar 420. More specifically, each of the snap-fit ​​means 415 is coupled to a respective end of the crossbar 420 of FIG. 4. As shown in the example of FIG. 4, the shank 405 is coupled to a central portion of the crossbar 420, and each of the snap-fit ​​means 415 may extend from the crossbar 420 generally parallel to the shank 405. In a more specific example, each of the snap-fit ​​means 415 may be cantilevered from the crossbar 420. Some embodiments of the plunger key 255 may further include one or more protrusions 425. In the example of FIG. 4, the plunger key 255 includes two protrusions 425, each of which is coupled to one of the snap-fit ​​means 415.

[0031] FIG. 5 is a side view of the plunger key 255 of FIG. 4 showing further details that may be relevant to some embodiments. For example, as shown in FIG. 5, the tip 410 may include a thread track 505. The thread track 505 may be parallel in some instances. As also shown in FIG. 5, some embodiments of a protrusion 425 may extend from the snap-fit ​​means 415. In the example of FIG. 5, the protrusion 425 extends generally perpendicular to the shank 405 from the snap-fit ​​means 415.

[0032] Figure 6 is a bottom view of the plunger key 255 of Figure 4 showing further details that may be relevant to some embodiments. As shown in Figure 6, the thread track 505 may be disposed obliquely with respect to the shank 405. In general, the thread track 505 may form a helical portion.

[0033] 7A, 7B, and 7C are cross-sectional views of the device 100 of FIG. 1 taken along section line 7-7. More specifically, FIG. 7A shows the plunger key 255 of FIG. 4 in a first position, FIG. 7B shows it in a second position, and FIG. 7C shows it in a third position. As shown in FIGS. 7A, 7B, and C, the key mount 260 may include a catch 705 and a key track 710. The catch 705 may engage the protrusion 425 to hold the plunger key 255 in each of these positions. The snap-fit ​​means 415 may be pushed toward the shank 405 to disengage the protrusion 425 from the catch 705 in each position, thereby allowing the shank 405 to move within the key track 710. In the example of FIGS. 7A-7C, the shank 405 may slide axially within the key track 710, and the key track 710 may substantially limit or prevent rotation of the shank 405. The example of FIGS. 7A-7C also shows a plunger track 715 within the housing 110.

[0034] 8A-8E are cross-sectional views along section line 8-8, illustrating further details that may be relevant to some embodiments of device 100 in different states. Each of FIGS. 8A, 8B, and 8C generally illustrates an example of device 100 having housing 110 of FIG. 2 and bore 805 therethrough. A push rod 235 may be disposed at least partially within bore 805. For example, push rod 235 may have a first end 810 disposed within bore 805. A second end 815 may extend from bore 805, and a knob 245 may be coupled to second end 815. A plunger 240 may also be disposed within bore 805. Some embodiments of plunger 240 may have a tip 820 and a head 825. The head 825 may be coupled to push rod 235. In some examples, head 825 may be coupled to plunger interface 315, which allows push rod 325 to advance plunger 240. In some embodiments, plunger 240 may also be coupled to housing 110 to control rotational movement of plunger 240. For example, protrusion 242 may engage plunger track 715, thereby allowing push rod 235 to advance plunger 240 axially while preventing rotation of plunger 240 within bore 805. Plunger key 255 may be disposed in or otherwise coupled to key mount 260.

[0035] In the exemplary state of FIG. 8A, the implant 215 is disposed in the implant bay 125. In this state, the implant stop 265 may also be configured to block forward movement of the implant 215. FIG. 8A shows the device 100 with the plunger key 255 in the first key position of FIG. 7A. In this position, the tip 410 of the plunger key 255 is disposed in the keyway 320, which may block movement of the push rod 235. This state may be advantageous for transportation and storage of the device 100, for example.

[0036] The example of Figure 8B shows a second condition of the device 100 in which the implant stop 265 has been rotated from the first position of Figure 8A to a second position that does not block forward movement of the implant 215. In this condition, the implant 215 may be collapsed or otherwise manipulated to prepare it for advancement through the nozzle 105. The plunger key 255 has also been moved to a second key position, which substantially corresponds to the position shown in Figure 7B. In this second key position, the tip 410 of the plunger key 255 is disengaged from the keyway 320.

[0037] From the condition shown in FIG. 8B, the push rod 235 can be advanced axially within the bore 805 such that the tip 410 of the plunger key 255 engages the slide track 310 to substantially prevent rotation of the push rod 235.

[0038] In a third state of the device 100 shown in FIG. 8C, the implant 215 is collapsed and the push rod 235 and plunger 240 are advanced to a second position, thereby advancing the implant 215 from the implant bay 125 into the nozzle 105. In the example of FIG. 8C, the end of the slide track 310 is configured to synchronize with the second position of the push rod 235 and plunger 240. The end of the slide track 310 can also provide a hard stop for the push rod 235 in the second position. The push rod 235 in FIG. 8C is advanced until the tip 410 of the plunger key 255 engages the threads 305 of the push rod 235. For example, the thread track 505 can include or consist essentially of a helical portion adapted to mate with the threads 305. Significantly, the thread track 505 can be adapted to mate with threads having various configurations, thread angles, leads, and pitches, and numbers of starts. In this condition, the tip 410 substantially prevents further advancement of the push rod 235 under axial load.

[0039] 8C, the push rod 235 may be advanced by rotating the push rod 235. For example, the knob 245 may be turned to rotate the thread 305 relative to the thread track 505, which may convert the rotational motion of the push rod 235 into linear motion, thereby advancing the push rod 235.

[0040] In a fourth state of the device shown in Figure 8D, the push rod 235 is rotated to advance the push rod 235 axially from the position of Figure 8C. For example, the knob 245 may be turned to engage the threads 305 with the thread track 505 to control the advancement of the push rod 235, which in turn controls the advancement of the plunger 240. For example, the plunger interface 315 may be rotated within the head 825, while the plunger track 715 and protrusion 242 may block rotation of the plunger 240 as it twists the push rod 235 to advance the plunger 240 and implant 215 until the implant 215 is expelled from the nozzle 105.

[0041] FIG. 8E illustrates a fifth state of the device 100. The fifth state of FIG. 8E represents an alternative to the fourth state shown in FIG. 8D. More specifically, in the fifth state of FIG. 8E, the plunger key 255 has moved from the second key position shown in FIG. 8C to a third key position that substantially corresponds to the position shown in FIG. 7C. In this third key position, the thread track 505 is disengaged or otherwise disengaged from the threads 305, thereby allowing the push rod 235 to advance under axial load rather than rotational advancement as shown in the fourth state of FIG. 8D. In the example of FIG. 8E, the push rod 235 has advanced from the position of FIG. 8C, thereby advancing the plunger 240 and the implant 215. For example, the knob 245 may be pressed to control the advancement of the push rod 235, thereby controlling the advancement of the plunger 240 and the implant 215 until the implant 215 is expelled from the nozzle 105. In some embodiments, the second finger flange 275 can be rotated downward to facilitate advancing the push rod 235 using one hand.

[0042] FIG. 9 is an isometric view of another example of the device 100. The device 100 of FIG. 9 shares some features with the previous examples. For example, the device 100 of FIG. 9 can include a nozzle 105, a housing 110, and an actuator 115. Similar to FIG. 1, the housing 110 can be coupled to the nozzle 105, and the housing 110 is generally configured to receive at least a portion of the actuator 115. The housing 110 can further include an implant bay 125 and a finger loop 905. FIG. 9 also shows another example of a plunger key 255 and a key mount 260.

[0043] Figure 10 is a partial top view of the device 100 of Figure 9, showing further details that may be relevant to some embodiments. For example, the plunger key 255 of Figure 10 includes a cap 1005 through which one or more snap-fit ​​means 415 may be indirectly coupled to the shank 405. The cap 1005 may be disposed over other features of the plunger key 255 as well as over portions of the key mount 260. For example, in some instances, the cap 1005 may be disposed over the shank 405 and the key track 710.

[0044] FIG. 11 is a partial top cross-sectional view of the device 100 of FIG. 9 taken along line 11-11, illustrating further details that may be relevant to some embodiments. For example, FIG. 11 illustrates another example of a protrusion 425 and a catch 705. As shown, one or more protrusions 425 may be coupled to a snap-fitting means 415 of FIG. 11. The catch 705 of FIG. 11 may engage the protrusion 425 to resist or prevent rotation of the cap 1005. The snap-fitting means 415 is pushed toward the shank 405, disengaging the protrusion 425 from the catch 705, thereby allowing the cap 1005 to rotate until the catch 705 engages the protrusion 425 after one rotation.

[0045] FIG. 12 is a cross-sectional view of the device of FIG. 9 taken along line 12-12, illustrating further details that may be relevant to some embodiments. FIG. 12 generally illustrates the housing 110 and a bore 805 through the housing 110. The push rod 235 may be disposed at least partially within the bore 805. The plunger 240 may also be disposed within the bore 805. The head 825 of the plunger 240 may be coupled to the push rod 235. In some examples, the head 825 may be coupled to the plunger interface 315. In some embodiments, the plunger 240 may also be coupled to the housing 110 to control the rotational movement of the plunger 240. For example, the protrusion 242 may engage the plunger track 715, which allows the push rod 235 to advance the plunger 240 axially while simultaneously preventing the plunger 240 from rotating within the bore 805. The plunger key 255 may be coupled to the key mount 260. In the example of FIG. 12, an implant 215 is positioned in the implant bay 125 .

[0046] Figure 13A is a detailed view of a portion of the device 100 of Figure 12, showing further details that may be relevant to some embodiments. Figure 13A shows the device 100 with the plunger key 255 in a first state. In this state, the tip 410 of the plunger key 255 is disposed within the keyway 320 in a first position, thereby preventing movement of the push rod 235. This state may be advantageous for transporting and storing the device 100, for example.

[0047] FIG. 13B shows the plunger key 255 of FIG. 13 in a second state. For example, the snap-fit ​​means 415 (not shown in FIG. 13B) can be pushed towards the shank 405 to disengage the protrusion 425 (not shown in FIG. 13B) from the catch 705 (not shown in FIG. 13B), substantially as described with respect to FIG. 11. The cap 1005 of FIG. 13B is rotatable about the shank 405. The cap 1005 can also be coupled to the housing 110 to hold its axial position during rotation. For example, the cap 1005 can engage the housing 110 through a cylindrical clearance mating surface and a fitted protruding ring. The ring can hold the axial position of the cap 1005 during its rotation to drive the plunger key 255 from one position to another. Rotating the cap 1005 can disengage the tip 410 from the keyway 320. For example, the shank 405 may have external threads 1305 and the cap 1005 may have an internal thread track 1310 configured to engage the threads 1305. The key mount 260 may prevent the shank 405 from rotating, such that when the cap 1005 is rotated, the thread track 1310 slides through the threads 1305 to move the shank 405 relative to the push rod 235. For example, the tip 410 may be moved from the first position of FIG. 13A to the second position shown in FIG. 13B by rotating the cap 1005 one full rotation to re-engage the catch 705 with the protrusion 425.

[0048] Figure 13C illustrates the plunger key 255 of Figure 13A in a third state, for example, by rotating the cap 1005 another time, thereby further retracting the shank 405 within the cap 1005 from the second position of Figure 13B to the third position.

[0049] Thus, the plunger key 255 can be manipulated between first, second, and third positions the same as or similar to those described above with respect to Figures 7A, 7B, and 7C. Similarly, the push rod 235 can be manipulated to eject the implant substantially as described with respect to Figures 8A-8E.

[0050] 14A and 14B are schematic diagrams illustrating an exemplary use of the apparatus 100 to deliver an implant 215 to an eye 1400. As shown, for example, an incision 1405 may be made by a surgeon in the eye 1400. In some instances, the incision 1405 may be made through the sclera 1410 of the eye 1400. In other instances, the incision may be formed in the cornea 1415 of the eye 1400. The incision 1405 may be sized to allow a portion of the nozzle 105 to be inserted to deliver the implant 215 into the capsular bag 1420. For example, in some instances, the size of the incision 1405 may have a length of less than about 3000 micrometers (3 millimeters). In other examples, the length of the incision 1405 can be from about 1000 micrometers to about 1500 micrometers, from about 1500 micrometers to about 2000 micrometers, from about 2000 micrometers to about 2500 micrometers, or from about 2500 micrometers to about 3000 micrometers.

[0051] Once the incision 1405 is made, the nozzle 105 can be inserted through the incision 1405 such that the width of the tip 120 matches the length of the incision 1405, thereby allowing the nozzle 105 to extend into the interior portion 1425 of the eye 1400. The device 100 can then expel the implant 215 through the nozzle 105 and into the capsular bag 1420 of the eye 1400, substantially as described with respect to Figures 8A-8E or 13A-13C.

[0052] In some embodiments, the implant 215 may include an intraocular lens having a shape similar to that of the natural lens of the eye, which may be made of a variety of materials. Examples of suitable materials may include silicone, acrylic, and combinations of these suitable materials. In some examples, the implant 215 may include a fluid-filled intraocular lens, such as a fluid-filled accommodative intraocular lens. The implant 215 may also include an intraocular lens that includes one or more functional members, such as haptics, for positioning the intraocular lens within the eye. In the example of FIGS. 14A and 14B, the implant 215 illustrates an intraocular lens having an optic 220, an anterior haptic 225, and a posterior haptic 230.

[0053] The implant 215 may be delivered in a folded configuration that may return to a resting state in the capsule 1420 with the anterior haptics 225 and posterior haptics 230 at least partially curved around the optic 220, as shown in FIG. 14B. The capsule 1420 may hold the implant 215 therein in relationship to the eye 1400 such that the optic 220 refracts light directed toward the retina (not shown). The anterior haptics 225 and posterior haptics 230 may engage the capsule 1420 to secure the implant 215 therein. After delivering the implant 215 into the capsule 1420, the nozzle 105 may be removed from the eye 1400 through the incision 1405, allowing the eye 1400 to heal over time.

[0054] The systems, devices, and methods described herein may provide numerous advantages. Some embodiments may be particularly advantageous for intraocular lens delivery, providing multiple delivery modes in one device. For example, some embodiments of device 100 may allow for a choice between one-handed push delivery or two-handed push and twist delivery, allowing the surgeon to select the delivery mode based on preference or other criteria.

[0055] Although shown in a few exemplary embodiments, those skilled in the art will recognize that the systems, devices, and methods described herein may incorporate various modifications and improvements that are within the scope of the appended claims. Moreover, descriptions of various alternatives using terms such as "or" are not necessarily mutually exclusive unless the context clearly requires otherwise, and the indefinite articles (a, an) do not limit objects to the singular unless the context clearly requires otherwise. Components may also be combined or excluded in various configurations for purposes of sale, manufacture, assembly, or use. For example, in some configurations, the nozzle 105, the implant bay 125, and the actuator 115 may each be separated or combined with each other in various ways for purposes of manufacture or sale.

[0056] The claims may also include additional subject matter not specifically recited in detail. For example, certain features, elements, or aspects may be omitted from the claims if they are not necessary to distinguish the novel and inventive features from those already known to those skilled in the art. Features, elements, and aspects described with respect to some embodiments may also be omitted, combined, or replaced with alternative features serving the same, equivalent, or similar purpose without departing from the scope of the invention as defined by the appended claims.

Claims

1. 1. An apparatus for ophthalmic surgery, Housing and a hole through the housing; a push rod at least partially disposed within the bore and operable to move within the bore from a first rod position to a second rod position and a third rod position; a plunger key coupled to the housing and operable to move between a first key position, a second key position, and a third key position; The plunger key, in a first key position, prevents the push rod from moving from the first rod position, in a second key position, allows the push rod to slide through the hole from the first rod position to the second rod position and rotate from the second rod position to the third rod position, and in a third key position, allows the push rod to move through the hole from the second rod position to the third rod position.

2. the push rod includes a screw thread; the plunger key includes one or more thread tracks configured to mate with the threads of the push rod, whereby when the plunger key is in the second key position, the push rod may rotate and advance from the second rod position to the third rod position; 10. The apparatus of claim 1.

3. the push rod further includes a slide track; the plunger key is configured to slidingly engage the slide track when the plunger key is in the second key position and the push rod is between the first rod position and the second rod position.

3. The apparatus of claim 2.

4. The apparatus of claim 2 , wherein the push rod further includes a slide track configured to stop the push rod at the second rod position.

5. The device of claim 1 , wherein the push rod further includes a keyway configured to receive a portion of the plunger key at the first rod position and the first key position.

6. The device of claim 1 , wherein the housing includes a key mount configured to hold the plunger key at each of the first key position, the second key position, and the third key position.

7. The plunger key is Shank and a tip connected to one end of the shank; one or more snap-fit ​​means connected to said shank; Including, the snap-fit ​​means is configured to engage the key mount at each of the first key position, the second key position, and the third key position; 7. The apparatus of claim 6.

8. The apparatus of claim 6 , wherein the key mount includes a catch configured to engage the plunger key at each of the first key position, the second key position, and the third key position.

9. The plunger key is Shank and one or more snap-fit ​​means connected to said shank; one or more protrusions connected to said snap-fit ​​means; Including, the protrusion is configured to engage the catch at each of the first key position, the second key position, and the third key position; 9. The apparatus of claim 8.

10. The plunger key is Shank and a cap disposed on the shank; one or more snap-fit ​​means connected to said cap; one or more protrusions connected to said snap-fit ​​means; Including, the protrusion is configured to engage the catch at each of the first key position, the second key position, and the third key position; 9. The apparatus of claim 8.

11. 11. The device of claim 10, wherein the cap is rotatable about the shank to move the plunger key between the first key position, the second key position, and the third key position.

12. the shank includes external threads; the cap includes an internal thread track configured to engage the external threads of the shank to move the plunger key; 12. The apparatus of claim 11.

13. Nozzle and an implant bay coupled to the nozzle; an implant disposed in the implant bay; a plunger coupled to the push rod within the bore; further comprising the push rod is configured to advance the plunger and advance the implant through the nozzle when the push rod moves to the third rod position.

10. The apparatus of claim 1.

14. 1. An apparatus for ophthalmic surgery, Housing and a key mount coupled to the housing, the key mount including a key track and a catch; a hole through the housing; a plunger disposed within the bore; a push rod coupled to the plunger and operable to move within the bore from a first rod position to a second rod position and to a third rod position; A keyway; Slide track and Threads and a push rod including: A plunger key, a shank disposed within the key track; a tip coupled to one end of the shank, the tip having one or more thread tracks; snap-fit ​​means connected to the shank; a protrusion connected to said snap-fit ​​means; a plunger key including: Including, the shank is operable to move the tip from a first key position to a second key position and a third key position, and the protrusion is configured to engage the catch at each of the first key position, the second key position, and the third key position; At the first key position, the tip is disposed within the keyway; In the second key position, the tip is configured to engage the slide track between the first rod position and the second rod position; The device wherein the thread track is configured to engage the threads in the second key position.

15. 1. A device for delivering an implant to an eye, comprising: A nozzle; an implant bay coupled to the nozzle; an implant positioned within the implant bay; Housing and a hole through the housing; An actuator, a plunger disposed within the bore; a push rod at least partially disposed within the bore and operable to move the plunger within the bore from a first plunger position to a second plunger position and to a third plunger position; an actuator including: a plunger key coupled to the housing and operable to move between a first key position, a second key position, and a third key position; Including, The plunger key, in the first key position, prevents the push rod from moving the plunger from the first plunger position, in the second key position, the push rod slides the plunger within the bore from the first plunger position to the second plunger position and rotates to move the plunger to the third plunger position to advance the implant from the implant bay through the nozzle, and in the third key position, the push rod slides the plunger within the bore from the second plunger position to the third plunger position to advance the implant from the implant bay through the nozzle.

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