Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
  • A61F2/1648—Multipart lenses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
  • A61F2/1624—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside
  • A61F2/1627—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside for changing index of refraction, e.g. by external means or by tilting

Definitions

• a fluid modulated lens is a compound lens formed from two lenses enclosing a central compartment therebetween.
• FIGURE 1 illustrates the structure of a typical fluid modulated lens.
• the typical fluid modulated lens has four refractive surfaces A, B, C, and D.
• the two internal surfaces B and C form the boundary of the central compartment F.
• the overall power of the lens depends on the refractive index of the refractive medium present in the center compartment F and on the power of the refractive surfaces B and C.
• the power of the lens will depend on whether the central reservoir is filled with gas or liquid. More particularly, considering that the refractive index of transparent material used to make lenses, i.e., glass, plastic acrylic, hydrogel, silicon, etc.
• the central compartment of the fluid modulated lens is filled with a gas (FIGURE 1). Assuming the powers of the refractive surfaces A, B, C, and D are +5, +5, +5, and +5 diopters, respectively, then the overall power of the lens is 20 diopters.
• cataract surgery the human crystalline lens is removed and is replaced with an artificial lens.
• this artificial lens has a fixed power and that power cannot be changed after it is implanted inside the eye.
• the power of the intraocular lens should be decreased as the child grows to obtain/maintain sharp vision, otherwise the development of the visual area in the brain may cease or be retarded.
• the power of the intraocular lens should be decreased at least once, preferably twice. Heretofore, this requires difficult surgery to replace the intraocular lens with a new one having a lower power.
• the principle of fluid modulated lenses is used to provide variable focus intraocular lenses, so that the power of the lens can be changed after the lens has been implanted in the eye.
• the invention may be used to particular advantage in pediatric cataract surgery.
• the implanted intraocular lens is comprised of two or more lenses having at least one compartment defined therebetween.
• the power of the variable focus intraocular lens is changed by changing the fluid in the chamber of the intraocular lens, for example by perforating a wall of the intraocular lens so that fluid disposed within the eye flows into the intraocular lens cavity.
• the wall is perforated using a laser and, therefore, there is no need for surgery.
• variable focus intraocular lens can be used in adults to change the astigmatic element after the cataract wound heals. More specifically, conventionally the ophthalmologist can calculate the spherical power of the intraocular lens needed for the cataract patient, but the astigmatism depends on the healing of the cataract wound. Wound healing is variable from one person to another so the astigmatism varies, and most cataract patients need glasses to correct this astigmatic element.
• Variable focus intraocular lenses provided in accordance with the invention can be used in adults to change the astigmatic element after the cataract wound heals. This may be done using a laser with no surgical intervention and postoperative glasses may not be needed.
• FIGURE 1 is a schematic illustration of a typical fluid modulated lens
• FIGURE 2 illustrates the lens of FIGURE 1 with a liquid in the central compartment
• FIGURE 3 schematically shows a variable focus intraocular lens embodying the invention
• FIGURE 4 illustrates the variable focus intraocular lens of FIGURE 3 with a liquid disposed in the central compartment;
• FIGURE 5 schematically shows the optics of another variable focus intraocular lens provided in accordance with the invention.
• FIGURE 6 schematically shows the same variable focus intraocular lens as FIGURE 5 with one central compartment filled with fluid
• FIGURE 7 shows the same variable focus intraocular lens as
• FIGURE 6 with the second central compartment filled with fluid
• FIGURE 8 is an anterior view of an intraocular lens provided in accordance with the invention.
• FIGURE 9 is a schematic elevational view of a first intraocular lens assembly corresponding to the configuration of FIGURE 8;
• FIGURE 10 is a schematic elevational view of an alternate intraocular lens assembly corresponding to the configuration of FIGURE 8;
• FIGURE11 is a schematic cross-sectional view showing the intraocular lens of FIGURES 8-9 mounted within the eye;
• FIGURE 12 is a view similar to FIGURE 11 wherein the intraocular lens cavity has been filled with eye fluid;
• FIGURE 13 is a schematic cross-sectional view showing an alternate intraocular lens in accordance with the invention, disposed within the eye
• FIGURE 14 is a schematic cross-sectional view showing another alternate intraocular lens in accordance with the invention, disposed within the eye;
• FIGURE 15 is a schematic cross-sectional view showing yet an alternate intraocular lens in accordance with the invention, disposed within the eye;
• FIGURE 16 is a schematic cross-sectional view showing a further alternate intraocular lens embodying the invention, disposed within the eye;
• FIGURE 17 is a schematic cross-sectional view showing yet a further alternate intraocular lens in accordance with the invention, disposed within the eye.
• FIGURE 18 is a schematic cross-sectional view showing another alternate intraocular lens embodying the invention, disposed within the eye.
• variable focus intraocular lenses provided in accordance with the presently preferred, exemplary embodiments of the invention are compound lens formed of two or more lenses attached together and enclosing one or more closed central spaces therebetween.
• the central space(s) contain sterile air, gas and/or are at a reduced pressure (vacuum).
• the power of the variable focus intraocular lens is to be changed, one or more of the central space(s) is opened so that the aqueous humor (regular fluid present inside the eye) enters the central lens compartment, and changes the power of the intraocular lens.
• a central compartment can be opened either with a laser or surgically, e.g., through a weakened thin place in the wall of the central compartment, by removing a plug, by opening a valve, or the like.
• a YAG laser produces a localized explosion inside the eye disrupting the structures around the explosion.
• the magnitude and site of the explosion are controlled to the nearest micron.
• the aiming beam is focused on a target portion of the wall of the central compartment of the lens and the laser is fired to make a hole in the wall of the central compartment. If the central compartment of the variable focus intraocular lens contains a vacuum, the eye fluid enters the central compartment and changes the power of the intraocular lens. If the central compartment of the lens contains air or gas that is not under vacuum, the fluid will never the less enter the central compartment and the air or gas will dissolve in the eye fluid (aqueous humour), so that the lens central compartment will ultimately be filled with liquid.
• Argon, Krypton and Diode lasers can also be used to change the power of the variable focus intraocular lens but they are only absorbed by colored objects. Therefore, consistent with the intended use of such lasers, certain target area(s) in the wall(s) of the central compartment(s) must be appropriately colored so that they can absorb the laser. When laser is directed to those tinted areas, the areas absorb the laser and melt so that a hole is formed.
• Diopteric power of a refractive surface (Difference in refractive indices of the surrounding media) ⁇ (Radius of curvature of the refractive surface in meters)
• Diopteric power of a refractive surface between eye fluid (aqueous humor) and intraocular lens
• FIGURE 3 schematically shows the optics of a variable focus intraocular lens 10 embodying the concept of the invention, having four refractive surfaces 12, 14, 16, 18 and a central compartment 20.
• the wall 22 of the peripheral part of the central compartment 20 is thinned so that it can be perforated surgically or by laser.
• the power of the refractive surfaces 12 and 18 will be fixed as, in use, they are always in contact with liquid inside the eye.
• the powers of the refractive surfaces 14 and 16 depend on the content of the central compartment 20. If the central compartment 20 contains air, as schematically shown in FIGURE 3, the power is maximized, and if it contains a liquid, as schematically shown in FIGURE 4 the power is decreased accordingly.
• variable focus intraocular lens is surrounded by the eye fluid 24 (aqueous), at the outset, the central compartment 20 is filled with air 26.
• the powers of the refractive surfaces 12, 14, 16, and 18 are 10, 5, 5, and 10 diopters respectively.
• a flow path is then opened, e.g. by forming a hole 28 in the lens wall 22, to fluidly connect the central compartment 20 to the eye fluid 24 (aqueous), so that the central compartment 20 is fills with liquid, shown schematically at 30.
• FIGURE 5 schematically shows the optics of a variable focus intraocular lens 32 having six refractive surfaces, 34, 36, 38, 40, 42, 44 and two central compartments 46, 48 which are normally filled with sterile air.
• Filling central compartment 46 with eye fluid (aqueous) decreases the numerical value of the refractive surfaces 36 and 38.
• Filling the central compartment 48 with eye fluid (aqueous) decreases the numerical value of the refractive surfaces 40 and 42.
• Exemplary powers for these refractive surfaces and the overall power of the lens are listed below.
• Total power of the intraocular lens 22 diopters.
• FIGURE 6 shows the same variable focus intraocular lens 32 shown in FIGURE 5, but a fluid passage 50 has been opened, i.e., a hole has been created, between the eye fluid 52 and the central compartment 46.
• the powers of the refractive surfaces and the overall power of the lens are listed below.
• Total power of the intraocular lens 20.8 spherical diopter and 1.2 cylinder diopter axis 90.
• FIGURE 7 shows the same variable focus intraocular lens 32 shown in FIGURE 6, but a fluid passage 54 has been opened, i.e., a hole has been created, between the eye fluid 52 and the central compartment 48.
• the powers of the refractive surfaces and the overall power of the lens are listed below.
• Total power of the Intraocular lens 20.8 spherical diopters.
• the air filled intraocular lens of this embodiment is formed of two lenses 58, 60 attached together by a thin diaphragm 62 enclosing a small compartment 64 therebetween.
• Compartment 64 initially contains sterile air which may be under negative pressure (vacuum).
• Conventional haptics 66 are provided to keep the intraocular lens in place inside the eye.
• the diaphragm 62 may be attached to both lenses as shown in FIGURE 9, or it may be a projection 62' from one lens 58' that is attached to the other lens 60', as shown in FIGURE 10.
• the intraocular lens 56 is shown implanted inside the eye, with the central compartment 64 filled with sterile air.
• a flow passage is opened as at 67 so that fluid can flow from the interior of the eye into compartment 64.
• the flow passage may be a perforation that is generated surgically with a small needle or non-surgically with a laser, a pre-plugged passage that is opened with a laser or surgically, a valve that is opened, etc. Thereafter, the air is absorbed and the compartment 64 between the two lenses 58,60 becomes filled with eye fluid (aqueous humour).
• the perforation of the diaphragm is made easier by pigmenting it to increase its laser absorption or designing ultra thin parts in the diaphragm.
• FIGURE 13 shows another embodiment in which the variable focus intraocular lens 68 is formed with more than two lenses, in this example, two bicovex 70, 72 and one planoconvex 74.
• the lenses are attached together by a thin membrane 76 and define two air filled spaces 78 and 80.
• the lens 68 is kept in place with two haptics 82.
• FIGURE 14 shows another embodiment in which the variable focus intraocular lens 84 is formed of two lenses 86 (biconvex) and 88 (piano), attached together.
• the anterior lens 86 has a thin peripheral wall 90 that can be attacked by laser or opened surgically.
• a central space 92 is present between the two lenses 86, 88.
• haptics 94 attach the lens inside the eye.
• FIGURE 15 shows yet another embodiment in which the air filled intraocular lens 96 is formed of two lenses 98 (concavoconvex) and 100 (biconvex) attached together.
• the posterior lens 100 has a thin peripheral wall 102 which is either a projection from one of the lenses to the other or a diaphragm extending between the two lenses, that can be attacked by laser or opened surgically.
• a central space 104 is defined between the two lenses and is filled with fluid when a fluid flow path is opened between the interior of the eye and the cavity 104.
• FIGURE 16 shows yet another embodiment in which the variable focus intraocular lens 106 is formed of two lenses I08 (biconvex) and 110 (biconvex) attached together.
• a thin peripheral wall 11 1 is protruded, either as a projection from one of the lenses, as shown, or as a diaphragm extending between the two lenses, and can be attacked by laser or opened surgically.
• a central space 112 is present between the two lenses for being filled with fluid.
• FIGURE 17 shows variable focus intraocular lens 114 formed of three lenses 116, 118, 120, two bi-convex and one piano, defining two compartments 122 and 124.
• the periphery of lens 116 may be thinned so that attacking it by laser or surgically opens space 122, or the lens connecting wall 126 may be perforated to fill space 122.
• Space 124 is opened either by perforating a thin peripheral part of lens 118 or 120, or by suitably perforating the lens connecting wall 128 therebetween.
• FIGURE 18 shows another variable focus intraocular lens 130 formed of three lenses 132, 134, 136, two planoconvex and one biconvex defining two compartments 138, 140.
• the periphery of lens 132 is thinned so that attacking it by laser or surgically opens space 138.
• Space 140 is opened either by perforating the thin peripheral part of lens 136, perforating a thin peripheral part of lens 134, if lens 132 is perforated, or perforating the lens connecting wall 142.

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• Health & Medical Sciences (AREA)
• Ophthalmology & Optometry (AREA)
• Cardiology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Transplantation (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Prostheses (AREA)

Applications Claiming Priority (3)

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• 1999
  • 1999-07-23 WO PCT/US1999/016547 patent/WO2000004849A1/en not_active Application Discontinuation
  • 1999-07-23 EP EP99935819A patent/EP1100412A1/de not_active Withdrawn
  • 1999-07-23 CA CA002338493A patent/CA2338493A1/en not_active Abandoned
  • 1999-07-23 AU AU51215/99A patent/AU5121599A/en not_active Abandoned

Non-Patent Citations (1)

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