EP4149390A1 - Lentille oculaire artificielle - Google Patents

Lentille oculaire artificielle

Info

Publication number
EP4149390A1
EP4149390A1 EP21725096.8A EP21725096A EP4149390A1 EP 4149390 A1 EP4149390 A1 EP 4149390A1 EP 21725096 A EP21725096 A EP 21725096A EP 4149390 A1 EP4149390 A1 EP 4149390A1
Authority
EP
European Patent Office
Prior art keywords
lens
eye
cavity
eye lens
lens element
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP21725096.8A
Other languages
German (de)
English (en)
Inventor
Benjamin SCHREIBER
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Carl Zeiss Meditec AG
Original Assignee
Carl Zeiss Meditec AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Carl Zeiss Meditec AG filed Critical Carl Zeiss Meditec AG
Publication of EP4149390A1 publication Critical patent/EP4149390A1/fr
Pending legal-status Critical Current

Links

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
    • A61F2/1648—Multipart lenses
    • A61F2/1651—Multipart lenses comprising a telescope
    • 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
    • A61F2/15—Implant having one or more holes, e.g. for nutrient transport, for facilitating handling
    • 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
    • A61F2/1637—Correcting aberrations caused by inhomogeneities; correcting intrinsic aberrations, e.g. of the cornea, of the surface of the natural lens, aspheric, cylindrical, toric lenses
    • A61F2/1645—Toric 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
    • A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics
    • 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
    • A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2240/001—Designing or manufacturing processes
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having an inflatable pocket filled with fluid, e.g. liquid or gas

Definitions

  • the present invention relates to an eye lens for implantation in an eye with a front lens element with a first optical region and a first positive refractive power, a rear lens element with a second optical region and a second positive refractive power, and with an intermediate element, the intermediate element having the front lens element outside the first optical region and with the rear lens element outside the second optical region is connected, so that the front lens element, the rear lens element and the intermediate element form a cavity.
  • the invention also relates to a method for producing such an eye lens.
  • the invention relates to a method for implanting such an eye lens.
  • IOL intraocular lenses
  • the use of artificial eye lenses or intraocular lenses (IOL) has become established for the treatment of cataracts.
  • the natural lens of the eye clouded by the cataract is removed and replaced with an intraocular lens.
  • the insertion of an artificial eye lens may also be necessary for other reasons.
  • Optical concepts have recently been implemented that enable presbyopia to be corrected and / or to correct astigmatism.
  • intraocular lenses are used that have one or more fixed focal lengths and thus enable one or more fixed focal positions in the implanted state. A change in the focus position as a function of forces within the eye, which can be caused, for example, by the ciliary muscle of the eye, is not desirable.
  • a majority of the intraocular lenses are implanted in the capsular bag of an eye.
  • the anterior capsular bag membrane is opened, the natural lens of the eye is crushed and removed, and the artificial lens is inserted into the remaining capsular bag.
  • the intraocular lens is inserted through a so-called access incision, which provides an opening through the cornea into the capsular bag.
  • the width of the access incision affects the subsequent wound healing as well as possible Implantation complications. Furthermore, the width has an influence on the stability of the eye. If this is severely impaired by the access incision, this can affect the refractive power of the optically effective surfaces of the eye (such as the cornea). This can mean that the refractive power of the implanted eye lens no longer leads to the desired vision of the eye.
  • the implantation can induce astigmatism. It is therefore important to keep the width of the access incision as small as possible.
  • Micro Incision Cataract Surgery MIMS
  • widths of less than 2mm are now required for access incisions.
  • the intraocular lenses used here are folded into the eye before implantation and inserted into the eye via a special injector.
  • materials for an optical lens material are presented by way of example, which is suitable for the optical part of an intraocular lens and at the same time is soft enough to fold the lens.
  • the object of the present invention is to describe an eye lens which allows the width of access incisions to be further reduced.
  • a first aspect of the invention relates to an eye lens for implantation in an eye with a front lens element which has a first optical region and a first positive refractive power, and with a rear lens element which has a second optical region and a second positive refractive power.
  • the front lens element faces the cornea of the eye and the rear lens element faces the retina.
  • the two optical areas of the respective lens elements are designed so that light can penetrate the lens element on the respective side of the optical area facing the cornea and leave the lens element on the respective side of the optical area facing the retina.
  • the mentioned sides are as optical surfaces designed and are also called optically effective surfaces.
  • the optical area of a lens element can therefore be penetrated by light in the implanted state of the eye lens and contributes to the imaging on the retina.
  • the lens elements can be designed bi-convex, plano-convex or as a meniscus lens.
  • the optical surfaces of the lens elements can be spherical or aspherical. They can also take the form of a free-form surface, ie they can be described, for example, using a polynomial or piece-wise using polynomials.
  • the optical surfaces can additionally have diffractive optical structures in order, for example, to provide more than one refractive power.
  • the eye lens also has an intermediate element. This is firmly connected to the front lens element outside the first optical region and to the rear lens element outside the second optical region.
  • the front and rear lens elements are not connected to one another in the implanted state in the first and second optical regions.
  • the front lens element, the rear lens element and the intermediate element thus form a cavity.
  • the anterior and posterior lens elements and the intermediate element are shaped in such a way that, in the implanted state, the distance between the anterior lens element and the posterior lens element is fixed; they then have a fixed distance from one another.
  • the elements mentioned have a stability or rigidity that cannot be deformed by typical forces within the eye, which can be caused, for example, by the ciliary muscle of the eye.
  • the forces can be transmitted to the intermediate element, for example, via a haptic element, via which the eye lens is held and positioned in the eye, or via other edges of the eye lens.
  • the distance between the front and rear lens elements changes in the implanted state by less than 20%, preferably less than 10%, particularly preferably less than 5%.
  • the front and rear lens elements have a fixed (positive) refractive power in the implanted state.
  • the lens elements and the Intermediate element consists for example of known and established materials from which non-accommodating intraocular lenses are typically made.
  • the fixed distance between the lens elements and their fixed refractive powers in the implanted state ensures that the total refractive power of the eye lens, which results from the refractive powers of the lens elements and their distance from one another, is already known before implantation (taking into account the refractive indices of the media, surrounding the lens elements).
  • the exact knowledge of the total refractive power of the eye lens enables a precise selection of the eye lens for the respective eye.
  • the intermediate element can also be shaped in such a way that the relative positions of the lens elements are fixed to one another in the implanted state. In this way, tilting or twisting of the lens elements with respect to one another can be prevented, which could otherwise also change the total refractive power or create image errors.
  • the presented eye lens according to the invention is therefore a non-accommodating artificial eye lens.
  • the cavity comprising the front lens element, rear lens element and intermediate element has an opening which enables liquid to flow into the cavity.
  • a border of the opening can comprise surfaces of the lens elements and / or of the intermediate element. The dimensions of the border can differ from the distance between the lens elements.
  • the opening allows the lens of the eye to be compressed before implantation, so that the cavity has only a small volume. After the implantation, liquid (eg aqueous humor) can flow into the cavity, so that only then does the eye lens take on its final shape and the distance between the lens elements is fixed. Due to the reduced volume of the cavity prior to implantation, the eye lens according to the invention can be introduced into the eye via an injector which requires a smaller width for the access incision than is possible according to the prior art.
  • the eye lens according to the invention thus advantageously makes it possible to reduce the risks of an IOL implantation for the patient and to maintain the stability of the eye and thus to avoid a mismatch of the refractive power due to the artificial eye lens.
  • the at least four optically effective surfaces of the eye lens according to the invention allow additional degrees of freedom in the optical design compared to an eye lens with only two optically effective surfaces. This makes it easier to correct image errors. If, for example, materials with different refractive indices are used for the front and rear lens elements, chromatic aberrations can also be corrected.
  • the front and rear lens elements are designed in such a way that the eye lens can be folded.
  • the two lens elements have a rigidity that is so great that no deformation can occur due to forces within the eye and, on the other hand, the eye lens can still be folded prior to implantation, for example by means of an injector.
  • the lens of the eye can be folded particularly well if the cavity has two openings that are opposite one another.
  • the two openings can, for example, have the same x-values or the same y-values.
  • the two openings form a type of slot in the intermediate element connecting the two lens elements. Folding the eye lens along the imaginary connection of the two openings enables a particularly compact shape of the eye lens for implantation.
  • the cavity can also have more than two openings, which are arranged, for example, rotationally symmetrical to a center of the cavity.
  • the cavity is typically filled with a liquid which has a lower refractive index than the refractive indices of the lens elements. While the refractive index of the lens elements can typically be around 1.4 to 1.5, the refractive index of aqueous humor, for example, is around 1.33. This fact makes it surprisingly possible to reduce the thickness of an artificial eye lens compared to an eye lens according to the prior art with the same refractive power.
  • the thickness of the eye lens is understood to mean its maximum extent along the z-axis. Typically, the maximum expansion occurs between the lens vertex of the surface of the anterior lens element facing the cornea and the surface of the posterior lens element facing the retina.
  • the cavity acts like a plane-parallel plate with a lower refractive index compared to the lens elements.
  • the focal point of light that falls parallel on the front lens element is closer to the apex of the surface of the rear lens element facing the retina than in the case of an eye lens without a cavity, but with the same surface curvature of the surfaces facing the cornea or the retina.
  • This effect therefore makes it possible, astonishingly, to achieve a higher refractive power for an eye lens of the same thickness (as for an eye lens according to the prior art).
  • an eye lens with the same refractive power can be realized, the surfaces of the anterior or posterior lens element facing the cornea or retina having a smaller curvature; as a result, the eye lens according to the invention can have a smaller thickness than an eye lens according to the prior art with the same refractive power.
  • the statements also apply to lens elements with positive refractive power that have no flat surfaces on the side facing the cavity.
  • the eye lens has a thickness of less than 3 mm, preferably less than 1.5 mm, particularly preferably less than 0.9 mm.
  • Such an eye lens therefore has a smaller thickness than is currently possible according to the prior art. This is particularly advantageous for lenses of the eye, which are to provide a high total refractive power.
  • a cavity of great thickness is particularly advantageous here.
  • a surface of the front and / or rear lens element facing the cavity has a coating that prevents the front lens element from sticking to the rear lens element. If an eye lens is compressed or folded for an injection into the eye, it can happen that the surfaces of the lens elements facing the cavity touch one another.
  • the coating ensures that the two surfaces separate from each other again after the implantation.
  • the coating can be, for example, heparin. In this way, the desired total refractive power of the eye lens can be ensured after the implantation. This is particularly advantageous for an eye lens that can be folded, since touching the surfaces mentioned is particularly likely here during an injection.
  • a surface of the front and / or rear lens element facing the cavity has a diaphragm.
  • a diaphragm it is possible, for example, to influence the angular spectrum of the light falling on the retina. In this way, for example, the perceived depth of field can be adjusted.
  • the diaphragm can be designed in the shape of a circular ring.
  • a surface of the front and / or rear lens element facing the cavity has a diffractive optical structure.
  • a diffractive optical structure is an interface between to understand two media with different refractive indices (for example lens material of the lens element and aqueous humor), which are designed in such a way that light is diffracted when passing through the interface and structurally interferes.
  • the surface typically has edges and thus has a discontinuity in the slope of the interface at these edges.
  • the diffractive optical structure can be arranged rotationally symmetrically - preferably with respect to the optical axis of the eye lens.
  • the diffractive optical structure can furthermore be superimposed on a curved surface.
  • the structure can be “absent” from this curved surface or it can be placed on top of it.
  • the diffractive optical structure makes it possible, for example, to provide more than one refractive power.
  • the front and / or the rear lens element has exactly two optically effective surfaces.
  • the optically effective surfaces of the front lens element consist of the surface facing the cornea and the surface facing the cavity.
  • the optically effective surfaces of the rear lens element consist of the surface facing the retina and the surface facing the cavity.
  • the front and / or rear lens element has an optically effective surface which is shaped like a torus.
  • This can be a cylindrical, spherical-toric or aspherical-toric shaped surface.
  • an optically effective surface facing the cavity is toroidally shaped.
  • the surfaces of the lens elements which face the capsular bag can be shaped to be rotationally symmetrical. This corresponds more to the situation with a natural eye lens.
  • the production of a lens element with a rotationally symmetrical Shape on the side facing away from the cavity and a cylindrical surface on the side facing the cavity is easier than the production of a lens surface which has different curvatures in two axes.
  • the eye lens is molded in one piece. All parts of the eye lens are thus made from the same material from a single workpiece (lens blank); the lens of the eye is not composed of several parts. Manufacturing tolerances can be better controlled via a one-piece eye lens, since errors when assembling individual parts of the lens can be avoided.
  • the cavity is shaped in such a way that, after the eye lens has been implanted in the eye, a clear, hydrophilic gel can be received.
  • a clear, hydrophilic gel can be received.
  • This can be a hydrogel or a silicone hydrogel, for example.
  • Corresponding materials are established for applications on and in the eye.
  • the stability of the eye lens can be improved.
  • the connection of the intermediate element with the front and / or rear lens element can be made softer, since the fixed distance between the lens elements must first be ensured via the gel in the cavity. To this end, swelling of the gel (hydration) can be taken into account.
  • the distance between the lens elements can be controlled by a controlled swelling of the gel via a targeted emission of light onto the gel.
  • the gel is used to improve the stability, the eye lens itself can comprise less supporting structures and thus have a further reduced volume for the implantation.
  • the optical properties of the eye lens can be precisely adapted to the needs of the eye.
  • a gel is used which has a lower refractive index than the lens elements when the cavity has a concave surface - ie that the front and / or rear lens element has a bi-convex shape.
  • a gel is preferably used which has a higher refractive index than the lens elements when the The cavity has a convex surface - that is to say that the front and / or rear lens element has the shape of a meniscus lens with positive refractive power, the concave side facing the cavity.
  • the total refractive power of the eye lens can be increased without changing the thickness of the eye lens.
  • the thickness of the torus and the sign of the torus can be determined via the refractive index of the gel.
  • the gel allows a reduction in possible light scattering within the cavity or other possible side effects such as the appearance of bubbles.
  • a drug or other chemicals can be introduced into the eye via the gel, which, for example, are released in a targeted manner over a longer period of time.
  • the gel can be introduced into the cavity via an applicator via the access incision and the opening of the cavity.
  • the cavity can, for example, be shaped in such a way that the shape of the opening is adapted to the shape of an applicator tip (like a key and lock), so that the gel can be specifically dispensed into the cavity - and not onto it over - is ensured.
  • the cavity can have a further opening through which liquid such as aqueous humor already in the cavity can flow out. This further opening can be very small so that liquid can easily flow out while the passage of gel is inhibited.
  • a second aspect of the invention relates to a method for producing an eye lens, in particular an eye lens according to one of the aforementioned configurations.
  • the method for forming a cavity with an opening has a method step of selective laser etching (also called “selective laser etching”, SLE).
  • SLE selective laser etching
  • Ultrashort laser pulses are focused into the volume of the eye lens, so that the Focus point the pulse energy is absorbed in a multiphoton process.
  • the material of the eye lens is changed in such a way that it can be chemically etched there.
  • a coherent area can be modified in such a way that it can be extracted using a wet-chemical process.
  • the cavity and the opening can be carved out of a lens blank.
  • other parts of the eye lens such as the surfaces of the lens elements facing the retina or cornea or such as the haptic
  • the manufacturing method of the eye lens for shaping the cavity and the opening has the method step of removing a lens material.
  • a drill can be used for this purpose, for example.
  • the ablation can be carried out using a laser.
  • the removal is advantageously carried out perpendicular to the optical axis (z-axis).
  • the opening advantageously has the same (or a smaller) extension than the cavity in the z-direction.
  • This method for shaping the cavity is particularly well suited if the surfaces of the lens elements facing the cavity are planar or cylindrical.
  • a removal can then take place in the direction of the cylinder axis.
  • other parts of the eye lens can be manufactured before or afterwards using known and established methods.
  • the manufacturing method of the eye lens for forming the cavity and the opening has the method step of punching.
  • lens material is removed from the lens blank with the aid of a stamp.
  • other parts of the eye lens can be manufactured before or afterwards using known and established methods.
  • the manufacturing method of the eye lens for shaping the cavity and the opening has the method step of shaping by means of ion implantation.
  • Foreign atoms are introduced into the eye lens in a targeted manner.
  • the foreign atoms are Material properties of the eye lens at the location of the foreign atoms changed in such a way that the etchability changes.
  • lens material can be removed using a wet chemical process and thus the cavity can be formed.
  • other parts of the eye lens can be manufactured before or afterwards using known and established methods.
  • the manufacturing method of the eye lens for forming the cavity and the opening has the method step of casting.
  • the negative used for casting includes the cavity and the opening so that these can be shaped in the casting process.
  • the opening is preferably shaped similarly to the case of an erosive formation of the cavity and opening, so that it is easier to detach the lens of the eye from the negative.
  • Other parts of the eye lens can also be manufactured using the casting process; they can also subsequently be produced from the cast lens blank with cavity and opening using known and established processes.
  • One-piece eye lenses can also be manufactured with all of the processes mentioned.
  • the manufacturing method for forming the cavity and the opening additionally or alternatively has a method step of bracing.
  • a non-positive connection between the intermediate element and the front and / or rear lens element is closed by pressing against one another.
  • other parts of the eye lens can be manufactured before or afterwards using known and established methods.
  • a third aspect of the invention relates to a method for implanting an eye lens with a cavity which is designed to receive a clear, hydrophilic gel after the eye lens has been implanted in the eye.
  • the method comprises inserting the eye lens into the eye. Because of the refinements carried out for the eye lens, it can be compressed particularly well for insertion into the eye, so that only a small width is required for an access incision.
  • the method for implantation includes the step of introducing clear, hydrophilic gel into the cavity.
  • the gel can be introduced using an applicator, the tip of which is inserted into the eye via the access incision and moved to open the lens of the eye. If necessary, the applicator tip can be attached to a suitably shaped opening in the lens of the eye, so that the gel can be introduced into the cavity in a targeted manner.
  • 1a shows a perspective illustration of a first exemplary embodiment of an eye lens according to the invention
  • 1b shows a perspective illustration of a further exemplary embodiment of an eye lens
  • FIG. 2 shows schematic representations of a third exemplary embodiment of an eye lens in a top view and in two side views
  • 3a and 3b are schematic representations of the third exemplary embodiment in two different sectional planes
  • FIG. 4a to c show schematic representations of the focal length for an eye lens according to the prior art and for a fourth and a fifth exemplary embodiment
  • FIG. 5 shows schematic representations of a sixth exemplary embodiment of an eye lens in a plan view and in two side views
  • 6a to 6c show schematic representations for variants of the lens elements in a sectional plane and a plan view of details of the lens elements; 7a and 7b show schematic representations of a seventh exemplary embodiment with toric surfaces in two different sectional planes;
  • FIG. 8 shows schematic representations of an eighth exemplary embodiment with toroidal surfaces in a plan view and in two side views; 9 shows a schematic representation of the lens elements for a variant of the eye lens with a gel in the cavity.
  • FIG. 1a shows a perspective illustration of a first exemplary embodiment of an eye lens 1 according to the invention, which is designed for implantation in the capsular bag.
  • the eye lens comprises a front lens element 10 and a rear lens element 20, which is covered in this perspective illustration.
  • An intermediate element 30 is connected to both lens elements 10, 20.
  • a cavity located between the lens elements and an opening are not shown in this illustration.
  • the intermediate element 30 is connected to two opposing haptic elements 60; In this example, these are shaped as so-called panel haptics.
  • the eye lens 1 is held in the eye in the implanted state by means of the haptic elements 60.
  • the optically effective surfaces of the front lens element 10 (and the first optical zone, not shown) and of the rear lens element 20 (and the second optical zone, not shown) are responsible for the optical imaging properties of the eye lens 1.
  • An optical axis A is perpendicular to an imaginary plane which is located between the surface of the front lens element 10 facing the cornea - in the implanted state - and the surface of the rear lens element 20 facing the retina.
  • FIG. 1b A perspective illustration of a further exemplary embodiment of an eye lens 1 is shown in FIG. 1b. It differs from the embodiment in FIG. 1 a in that the haptic elements 60 are shaped as so-called C-loops.
  • FIG. 2 shows a schematic representation of a third exemplary embodiment of an eye lens 1 according to the invention in a plan view (top right) and in two side views (left and bottom).
  • the z-direction corresponds to a view of the eye lens 1 along the optical axis.
  • the x and y directions are perpendicular to this and perpendicular to each other. It should be noted that these and the other figures are not true-to-scale representations.
  • the top view (top right) shows the eye lens 1 from the z-direction.
  • the front lens element 10 emerges from the plane of the drawing, while the rear lens element 20 lies behind the plane of the drawing.
  • the edge of the rear lens element 20 is therefore shown as a dashed line; the radius of the rear lens element 20 is smaller than that of the front lens element 10, the edge of which is shown with a solid line.
  • the intermediate element 30 has an even larger radius; the outer edge is marked with a thin, solid line.
  • the inner edge of the intermediate element 30 is located below the front lens element 10 and is marked as a dotted line.
  • the (approximately) rice-shaped portion forms the edge of the cavity 40 in the xy direction.
  • the shape of the intermediate element 30 ensures that it is connected to the lens elements 10, 20 outside the optical regions (not shown).
  • the opening 50 is marked in the xy plane by two dotted lines which extend as far as the outer edge of the lens elements 10, 20 and the intermediate element 30. If the eye lens 1 is compressed for an implantation, then after the implantation liquid can flow into the cavity 40 through the opening 50 in the (negative) y-direction.
  • the intermediate element 30 is connected on both sides in the x-direction to a haptic element 60, which in this exemplary embodiment is shaped as a plate haptic.
  • the side view of the eye lens 1 shown on the left side of FIG. 2 corresponds to a view in the x direction. Since the cavity 40 and the opening 50 are also located within the eye lens 1 in this view, they are shown by dotted lines.
  • the two surfaces of the lens elements 10, 20 facing the cavity 40 are designed here as plane surfaces.
  • a side view of the eye lens 1 from a y-direction is shown. In this view, the opening 50 is above the plane of the drawing; the opening 50 is therefore shown with a solid line.
  • FIGS. 3a and 3b show a section of the eye lens 1 in the yz plane for an x coordinate which is marked with S y in FIG. 2.
  • the opening 50 has an extension (thickness) in the z-direction which corresponds to the extension of the cavity 40 in the z-direction. This is the distance between the front lens element 10 and the rear lens element 20.
  • FIG. 3b shows a section of the eye lens 1 in the xz plane for a y coordinate which is marked with S x in FIG. 2.
  • the representations for the two sectional planes clarify the volume of the cavity 40.
  • This volume of the eye lens 1 can be compressed for an implantation, so that the eye lens 1 can be introduced via an access incision of a particularly narrow width.
  • FIG. 4a shows a schematic illustration of the focal length of an eye lens 99 according to the prior art in a sectional image in the yz plane.
  • a parallel incident light bundle 80 falls on a front side (facing the cornea) of the eye lens 99, is refracted there, shines through the eye lens 99 and exits again on a rear side (facing the retina). Because of the curvatures of the front and back, the light is bundled in a focal point 85.
  • the focal point has a focal length.
  • the z-positions of the vertices of the eye lens 99 and of the focal point 85 are marked with dotted lines.
  • FIG. 4b shows the course of an incident parallel light bundle 80 for an eye lens 1 according to the invention according to a fourth exemplary embodiment.
  • the surface 12 of the front lens element 10 facing the cornea and the surface 22 of the rear lens element 20 facing the retina have the same curvatures as the eye lens 99 according to the prior art from FIG. 4a.
  • the surfaces 14, 24 of the lens elements 10, 20 facing the cavity 40 are plane-parallel.
  • the lens elements 10, 20 have the same refractive index as the eye lens 99 according to the prior art.
  • the cavity 40 is filled with aqueous humor which has a lower refractive index than the lens elements 10, 20.
  • the cavity 40 acts like a plane-parallel plate with a lower refractive index compared to the lens elements 10, 20 the result for the eye lens 1 is a focal length which is shorter than for the eye lens 99 according to the prior art without cavity 40: the focal point 85 of light falling parallel to the front lens element 10 is closer to the apex of that facing the retina Surface 22 of the rear lens element 20 than in the case of the eye lens 99 without a cavity 40.
  • the eye lens 1 according to the fourth embodiment shown here can achieve a higher refractive power than an eye lens 99 according to the prior art with the same external dimensions (such as the vertex distance between the front and back or between the corresponding surfaces 12, 22 of the eye lens according to the invention 1).
  • This effect can be used to reduce the dimensions of the eye lens 1 in order to generate the same refractive power as an eye lens 99 without a cavity 40.
  • This is shown schematically in Fig. 4c.
  • the curvatures of the surfaces 12, 22 of the lens elements 10, 20 facing the cornea or retina are smaller.
  • the fifth exemplary embodiment not only the curvature of the surfaces 12, 22, but also the z-dimension of the cavity 40 could have been adapted in order to be able to generate the same focal length.
  • the extent of the opening 50 in the z-direction is smaller than the extent of the cavity 40 in the z-direction; However, this is irrelevant for the considerations relating to the refractive power and the reduction in the volume of the eye lens 1.
  • FIG. 5 schematic representations of a sixth exemplary embodiment of an eye lens 1 are shown.
  • the representations of the top view (top right) and the side views (left and bottom) correspond to those from FIG. 2.
  • the cavity 40 has two openings 50, 50 '.
  • the openings 50, 50 ′ are located on opposite sides of the cavity 40.
  • the openings 50, 50 allow liquid to flow into the cavity 40 in the positive x-direction for opening 50' and in the negative x-direction for opening 50.
  • the two side views show that the cavity 40 and the openings 50, 50 'have the same z-extension. If an eye lens 1 shaped in this way is folded along the axis F, which is drawn in as a line of dots and lines, the result is a particularly small volume of the eye lens 1 for an implantation.
  • the intermediate element 30 comprises the haptics. This configuration of the intermediate element 30 is possible regardless of the number of openings 50, 50 '; the intermediate element 30 can also be shaped in this way in the other exemplary embodiments shown. It should also be noted that the embodiment shown here is particularly suitable for shaping the cavity 40 and the openings 50, 50 ′ by means of an abrasive process, by punching or by casting the eye lens 1.
  • the two surfaces 14, 24 facing the cavity 40 have a planar shape. Variants for these surfaces 14, 24 are shown in FIGS. 6a to c. These are in each case on the left the front 10 and rear 20 lens elements are shown schematically in a section in the xz plane. On the right-hand side, a detail of the configurations is shown in a plan view in an xy plane. All variants shown here can be used in the various exemplary embodiments on the front 10 and / or rear 20 lens element.
  • FIG. 6a shows a rear lens element 20 on the left, which has a curvature on the surface 24 facing the cavity.
  • the rear lens element 20 is shaped here as a meniscus lens; it has a positive refractive power.
  • FIG. 6 a also shows a front lens element 10 which comprises a further lens 70.
  • the further lens 70 has a refractive index which is different from the rest of the front lens element 10 (or from the first optical region).
  • the front lens element 10 is thus designed like a kit member and has a positive refractive power. In this way, for example, chromatic aberrations can be corrected particularly well.
  • the further lens 70 is shown in plan view.
  • the thin, concentric lines represent contour lines.
  • a front lens element 10 is shown on the left, which includes a diaphragm 72.
  • the diaphragm 72 is designed in the shape of a circular ring, as shown on the right in the figure. Light is blocked in the area of the diaphragm 72. In the example shown, the perceived depth of field can be adjusted in this way.
  • the screen 72 is located on a curved surface 14 facing the cavity; this area could also be designed flat.
  • the rear lens element 20 is shaped here as a bi-convex lens.
  • the diffractive optical structure 74 is designed to be rotationally symmetrical, as is shown on the right in the figure.
  • the edges of the diffractive optical structure 74 are shown as rings in a plan view.
  • the diffractive optical structure 74 of the two lens elements 10, 20 is in each case superimposed on a curved surface 14, 24; they could also be superimposed on a plane surface. In this case, the structures are placed opposite the surface 14 or they are “missing” from the surface 24.
  • only either the front 10 or the rear 20 lens element has a diffractive optical structure 74.
  • the structures 74 shown allow more than one refractive power to be provided.
  • FIGS. 7a and b show schematic representations of a seventh exemplary embodiment in two different sectional planes.
  • the cutting planes correspond to those from FIGS. 3a and b.
  • the surface 14 of the front lens element 10 facing the cavity 40 has a spherical-toroidal shape: In the yz plane shown in FIG. 7b deviates from the curvature in the xz plane. An aspherical-toric shape is also possible.
  • the surface 24 of the rear lens element 20 facing the cavity 40 has a cylindrical shape: in the xz plane shown in FIG. 7b, the surface 24 has a spherical shape with a finite curvature, while that of the curvature shown in FIG. 7a in the yz-plane has an infinite radius of curvature.
  • Only one of the surfaces 14, 24 facing the cavity can also have a toric shape.
  • Each of the two shapes of the lens elements 10, 20 shown can also occur in one of the other discussed exemplary embodiments.
  • the surfaces 14, 24 of the lens elements 10, 20 facing the cavity 40 have a cylindrical shape.
  • said surfaces 14, 24 have no curvature, while they have a curvature in a representation of the xz-plane.
  • An eye lens 1 shaped in this way is suitable for correcting astigmatism.
  • the cavity 40 has two openings 50, 50 '.
  • these are not in the direction of the haptics oriented, but aligned perpendicular to it. In this way, the stability of the feel is not affected.
  • an eye lens 1 shaped in this way is folded along the axis F, which is drawn in as a line of dots and lines, the result is a particularly small volume of the eye lens 1 for an implantation.
  • the embodiment shown here is particularly suitable for shaping the cavity 40 and the openings 50, 50 ′ using an abrasive process such as drilling, or for punching or casting the eye lens 1.
  • FIG. 9 shows a schematic representation of the lens elements 10, 20 for a variant of the eye lens 1 with a clear, hydrophilic gel 90 in the cavity 40.
  • This gel 90 can be introduced into the cavity 40 after the eye lens 1 has been implanted.
  • the gel 90 is selected in such a way that it additionally stabilizes the eye lens 1 in the hydrated state.
  • the gel 90 has a higher refractive index than that of aqueous humor. This increases the total refractive power of the eye lens 1 compared to an eye lens of the same geometry without gel 90.
  • the gel 90 could also have a refractive index that is greater than that of the material of the lens elements 10, 20. In that case, the total refractive power would be even greater.
  • a description of a device based on method features applies analogously to the corresponding method with regard to these features, while method features correspondingly represent functional features of the device described.

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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)

Abstract

La présente invention concerne une lentille oculaire (1) comprenant un élément de lentille avant (10) et un élément de lentille arrière (20), qui présentent chacun une puissance optique positive et une région optique, et un élément intermédiaire (30), qui est relié aux éléments de lentille (10, 20) à l'extérieur des régions optiques de sorte que les éléments de lentille (10, 20) et l'élément intermédiaire (30) forment une cavité (40). Le problème abordé par la présente invention consiste à décrire une lentille oculaire (1) qui permet de réduire la largeur d'une incision d'accès nécessaire pour l'implantation. Le problème est résolu par une lentille oculaire (1) dans laquelle les éléments de lentille (10, 20) et l'élément intermédiaire (30) sont mis en forme, de sorte que sous l'état implanté, la distance entre l'élément de lentille avant (10) et l'élément de lentille arrière (20) est fixée et dans laquelle la cavité (40) présente une ouverture (50, 50') qui permet au liquide de s'écouler dans la cavité (40). Le problème est également résolu par un procédé de production d'une telle lentille oculaire (1) et par un procédé d'implantation.
EP21725096.8A 2020-05-13 2021-05-07 Lentille oculaire artificielle Pending EP4149390A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102020206037.1A DE102020206037A1 (de) 2020-05-13 2020-05-13 Künstliche Augenlinse
PCT/EP2021/062172 WO2021228717A1 (fr) 2020-05-13 2021-05-07 Lentille oculaire artificielle

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EP4149390A1 true EP4149390A1 (fr) 2023-03-22

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EP21725096.8A Pending EP4149390A1 (fr) 2020-05-13 2021-05-07 Lentille oculaire artificielle

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US (1) US20230149154A1 (fr)
EP (1) EP4149390A1 (fr)
CN (1) CN115515532A (fr)
DE (1) DE102020206037A1 (fr)
WO (1) WO2021228717A1 (fr)

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4932970A (en) 1988-05-17 1990-06-12 Allergan, Inc. Ophthalmic lens
DE19738345C1 (de) 1997-09-02 1999-05-06 Mdp Medical Device Polymers Gm Intraokularlinse
NL2002540C2 (en) 2009-02-17 2010-08-18 Oculentis B V Ophthalmic lens with optical sectors.
WO2013176979A1 (fr) 2012-05-25 2013-11-28 California Institute Of Technology Lentille intraoculaire composite à accommodation et procédés associés
DE102012016893A1 (de) * 2012-08-24 2014-05-15 Be Innovative Gmbh Intraokularlinse, insbesondere Kapselsackintraokularlinse

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CN115515532A (zh) 2022-12-23
WO2021228717A1 (fr) 2021-11-18
US20230149154A1 (en) 2023-05-18
DE102020206037A1 (de) 2021-11-18

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