Methods and compositions usable in cataract surgery

Abstract

The invention relates to a method of performing ocular surgery, after an anterior capsulotomy has been made, by forming a sealed expanded capsular bag. The method includes sealing the capsular bag with a viscoelastic material to provide a gas tight seal to prevent leakage into the anterior chamber of the eye during the surgical process; expanding the capsular bag by introducing a gas capable of exerting a pressure on the inner surface of the capsular bag wall; inspecting and/or treating the capsular bag with one or several devices and/or agents suitable for performing inspection and/or treatment. The inspection and/or treatment can comprise any of visual inspection; estimation of capsular bag volume; labeling any residual epithelial cells to detect the presence thereof; removing residual epithelial cells; implanting one or more intracapsular implants; injecting a lens forming material for molding a lens in situ; drying the lens capsule; alone or in any combination. Use of a viscoelastic compound for the preparation of a temporary intraocular seal capable of sealing the capsular bag is also provided.

1 - 35 . (canceled)  
   
   
       36 . Use of a viscoelastic aqueous composition of a polysaccharide with both dispersive and cohesive qualities for the preparation of a temporary intraocular seal capable of sealing a gas expanded capsular bag during a surgical process after lensectomy for a time sufficient to admit surgical procedures to be performed, including inspection of the capsular bag inside and/or various treatments of the capsular bag.  
   
   
       37 . Use according to  claim 36 , wherein said composition has a concentration within the range of 18-40 mg/ml sodium hyaluronate and the sodium hyaluronate having a molecular mass within the range of 2.5×106 to 10×106<M> r,M .  
   
   
       38 . Use according to  claim 36 , wherein the molecular mass of the sodium hyaluronate is within the range 2.5×106-6×106<M> r,M  and the concentration of the aqueous solution is within the range of 18-35 mg/ml.  
   
   
       39 . Use according to  claim 36 , wherein the molecular mass of the sodium hyaluronate is within the range 2.5×106-5×106<M> r,M  and the concentration of the aqueous solution is within the range of 20-28 mg/ml.  
   
   
       40 . Use according to  claim 36 , wherein the composition further comprises a compound acting as a scavenger.  
   
   
       41 . Use according to  claim 36 , wherein the surgical procedures include visual inspection; estimation of capsular bag volume; labeling any residual epithelial cells to detect the presence thereof; removing residual epithelial cells; implanting one or more intracapsular implants; injecting a lens forming material for molding a lens in situ, drying the lens capsule; alone or in any combination.  
   
   
       42 . Use of a viscoelastic aqueous composition of a polysaccharide with both dispersive and cohesive qualities for the preparation of a temporary intraocular mold useful for forming a lens implant from a fluid material injected into the capsular bag by exerting a sufficient controlled adjustable localized pressure on the anterior surface of an expanded capsular bag in order to obtain a shape controlled molding of the anterior surface of a final lens implant and thereby obtain a controlled refractive outcome of treated eye.  
   
   
       43 . Use according to  claim 42 , wherein said composition has a concentration within the range of 18-40 mg/ml sodium hyaluronate and the sodium hyaluronate having a molecular mass within the range of 2.5×106 to 10×106<M> r,M .  
   
   
       44 . Use according to  claim 42 , wherein the molecular mass of the sodium hyaluronate is within the range 2.5×106-6×106<M> r,M  and the concentration of the aqueous solution is within the range of 18-35 mg/ml.  
   
   
       45 . Use according to  claim 42 , wherein the molecular mass of the sodium hyaluronate is within the range 2.5×106-5×106<M> r,M  and the concentration of the aqueous solution is within the range of 20-28 mg/ml.  
   
   
       46 . A method of performing visual correction of an eye by forming an intraocular lens in the capsular bag from which the natural crystalline lens has been surgical excised including the steps of: 
 injecting a predetermined amount of a lens forming fluid into the capsular bag;    locally introducing said viscoelastic material in amount sufficient to affect the shape of the anterior surface of the capsular bag;    optionally controlling the visual outcome of the eye and if necessary locally reintroducing said viscoelastic material in manner so as to approach a desired visual outcome;    forming the final lens implant.    
   
   
       47 . The method as claimed in  claim 46 , wherein the lens forming fluid comprises a silicone material having a specific gravity that is greater than 1.0 and a refractive index of a natural lens that is polymerized from a plurality of siloxane monomers.  
   
   
       48 . The method of  claim 46  wherein the refractive index ranges between 1.383 and 1.695.  
   
   
       49 . The method of  claim 46  wherein at least one siloxane monomer has a specific gravity greater than 1.0.  
   
   
       50 . The method of  claim 46  wherein the silicone is a terpolymer having a specific gravity of about 1.1 and a refractive index of about 1.41.  
   
   
       51 . The method of  claim 46  wherein the silicone is a copolymer having a specific gravity of about 1.1 and a refractive index of about 1.41.  
   
   
       52 . Method according to  claim 46 , wherein said composition has a concentration within the range of 18-40 mg/ml sodium hyaluronate and the sodium hyaluronate having a molecular mass within the range of 2.5×10 6  to 10×106<M> r,M .  
   
   
       53 . Method according to  claim 52 , wherein the molecular mass of the sodium hyaluronate is within the range 2.5×106-6×106<M> r,M  and the concentration of the aqueous solution is within the range of 18-35 mg/ml.  
   
   
       54 . Use according to  claim 53 , wherein the molecular mass of the sodium hyaluronate is within the range 2.5×106-5×106<M> r,M  and the concentration of the aqueous solution is within the range of 20-28 mg/ml.