NL2015616A - Accommodating intraocular lens with irrigation channels. - Google Patents

Abstract

This document discloses channels in at least one optical element of a two optical element accommodating intraocular lens implanted in the sulcus of the eye. At least one element is fitted with at least one channel to allow fluids to flow freely in the eye. A 5 single channel in the centre of the anterior element, in the pupil of the eye, can allow liquid exchange between the anterior chamber of the eye and the inter-lenticular space of the intraocular lens, and, subsequently, through the inter-lenticular space, to the posterior chamber of the eye. Such channels prevent pseudo-phakic pupillary blockage.

Description

Accommodating intraocular lens with irrigation channels

This document discloses an intraocular lens of variable optical power, an accommodating intraocular lens, implanted in the sulcus of the eye. The lens comprises at least two optical elements of which at least one element is shiftable in a direction perpendicular to the optical axis. Each of the optical elements has at least one free-form optical surface, in addition to any other optical surfaces, with the free-form surface with such a shape that the combination of at least two free-form surfaces provides different focusing powers at a different position of at least one of the optical elements relative to the other optical element. Such intraocular lenses are disclosed in, for example, and not restricted to, with basic designs in US2009062912 and W02005084587, and the same concept, with various adaptations in, for example, US2014074233, WO2014058316, EP2765952, NL2012257278, US2010131955, US2010106245, NL1029548 and related documents. Ample examples of configurations and illustrations of such lenses can be found in said documents. At least one of the optical elements comprises at least one irrigation channel, also: channel, in the transverse direction, meaning: from the anterior side of said element to the posterior side which channel is adapted to allow fluids in the eye to move from a side of said optical element to the other side. For example, a single channel in the centre of the anterior element, in the pupil of the eye, allows liquid exchange between the anterior chamber of the eye and the inter-lenticular space of the intraocular lens, and, subsequently, to the posterior chamber of the eye. Such exchange can be blocked in absence of said channels which can cause increasing intraocular pressure. So, sulcus based intraocular lenses can cause pseudo-phakic pupillary blockage.

Channels in intraocular lenses have been disclosed in prior-art, for example in US2007244560, which discloses, as summarized in the abstract of said document: “The invention provides a medical device and method to reduce the occurrence of pseudophakic pupillary block following implantation of an intraocular lens. The device includes an intraocular lens configured with channels traversing through the surfaces of the lens optic. The invention includes special edge angulations and locations in the optic zone that eliminate optical distortion from channels. The channels perform as valves configured to allow flow of a patient's aqueous humor from one surface of the lens through to the other surface of the lens, thereby preventing fluid pressure from building up in a patient's eye which document describes slit-like channels infixed power intraocular lenses.'1'’ US2007244560 discloses (1) channels with special edge angulations, which angulations our invention does not has, but more important (2) US2007244560 is restricted to a single piece intraocular lens, one optical element, a “piggy-back”lens, so this invention allows fluid exchange between the anterior chamber and the posterior chamber in front of the natural lens, while the present invention concerns a lens with two optical elements, and at least one round channel, which allows free fluid exchange between the anterior chamber and the inter-lenticular space, and, (3) the channels of US2007244560 are slit-shaped channels between an anterior and a posterior opening, likely to create a valve function. The channels disclosed in the present document can be, simple, round holes, also: tubes, which tubes can be oriented at any angle versus any axis.

However, the channels can also have any shape which shape can be oriented at any angle versus any axis.

Also, US20050149184 discloses, as summarized in the abstract of said document “a phakic intraocular lens (PIOL) suitable for implantation between the iris and the natural lens in an eye. The PIOL allows for fluid circulation between its posterior and the anterior of said natural lens after implantation. The PIOL comprises a central optic part, a peripheral haptic part, and at least one penetrating channel. The channel!s) has an anterior orifice and a posterior orifice. The channel is arranged at the border of or outside, the central optic part” The lens described in this present document is an accommodating IOL with two optical elements, replaces the fixed optical power of natural lens in addition to said accommodative power, with a proposed channel which allows for fluid circulation between the anterior chamber of the eye and the inter-lenticular space and, with, in the preferred embodiment, a central single channel at the approximate position of the optical axis in the anterior optical element.

The lens can have any combination of channels in any combination of optical elements to allow free exchange of fluids between any combination of chambers in the eye, for example, in the preferred embodiment, the lens can have an anterior optical element with at least one central channel to provide, to allow, exchange of fluids between the anterior chamber of the eye and the inter-lenticular chamber of the lens, meaning: the space between the anterior optical element and the posterior optical element, or, alternatively, one central channel in the anterior optical element and at least one central channel in the posterior optical element to allow to allow exchange of fluids between the anterior chamber of the eye and the posterior chamber of the eye, or, alternatively, the combination of channels can include any number of central and peripheral channels in the anterior and the posterior optical elements. Generally, but at least one, of the channels has a round shape, a tube-shape.

The combination of channels should provide sufficient correction of intraocular pressure, by allowing free flow of liquids. Clearly, the combined diameter, area, of such channels should be so small that optical interference is negligible. For example, a single channel with a diameter of ~100um in the central area of the lens has, due to light scattering, a <1% detrimental effect on the overall optical performance of the lens.

Note that the lenses described in US2009062912 and related documents listed above comprise free-form surface forming the inter-lenticular space. During accommodative movement these free-form surfaces can act as a pump. A central channel in the anterior element thus serves two purpose, (1) allowing free flow of eye liquids as set forth in the present documents, but also, (2) reduction of friction due to the pumping action of the free-form surfaces, and thus improved accommodative movements. A method for an intraocular lens of variable optical power comprising at least two optical elements with at least one of the optical elements comprises at least one channel from the anterior side of said element to the posterior side of said element which channel is adapted to provide exchange of fluids in the eye from one side of the optical element to the other side of the same element. Such method can include forming at least one channel using mechanical means (for example by lathing, or, milling, or, drilling), and/or laser-means (drilling or ablasion by laser light) and/or moulding means (for example, by adding an insert forming the channel to the mould) and/or high power micro-water jets, with the method forming a combination of irrigation channels adapted to provide stable intraocular pressure within non-pathological range.

Intraocular lenses as disclosed in, for example, and not restricted to, with basic designs in US2009062912 and W02005084587, and the same concept, with various adaptations in, for example, US2014074233, WO2014058316, EP2765952, NL2012257278, US2010131955, US2010106245, NL1029548 and related documents can have irrigation channels also fitted to other components of these constructions, the mechanics, such as connection structures which connect optics and haptics, the haptics, and the flanges on the haptics.

So, in summary, the present document discloses intraocular lens of variable optical power, an accommodating intraocular lens, implanted in the sulcus of the eye, with the lens comprising a combination of optics and mechanics, with the lens comprising at least one variable-focus lens that includes at least two optical elements of which at least one element is shiftable in a direction perpendicular to the optical axis with each of the optical elements having at least one free-form optical surface, in addition to any other optical surfaces, with the free-form surfaces with such a shape that the combination of at least two free-form surfaces provides different focusing powers at a different position of at least one of the optical elements relative to the other optical element, with at least one of the optical elements comprising at least one irrigation channel, also: channel, from the anterior side of said element to the posterior side of said element which channel is adapted to provide exchange of fluids in the eye from one side of the optical element to the other side of the same element.

The lens can comprises any combination of channels in any combination of optical elements which combination can be adapted to provide exchange of fluids between any combination of chambers in the eye. In the preferred embodiment the anterior optical element comprises at least one central channel adapted to provide exchange of fluids between the anterior chamber of the eye and the inter-lenticular chamber of the lens. In another embodiment the combination includes at least one central channel in the anterior optical element and at least one central channel in the posterior optical element. In other embodiments the combination includes any number of central and peripheral channels in the anterior and the posterior optical elements. At least one of the channels has a round shape. The combination of channels provides a correction of intraocular pressure within non-pathological range.

Method for said intraocular lens of variable optical power comprising at least two optical elements with at least one of the optical elements comprising at least one channel from the anterior side of said element to the posterior side of said element which channel is adapted to provide exchange of fluids in the eye from one side of the optical element to the other side of the same element with the method including forming at least one irrigation channel by use of mechanical means, and/or laser-means and/or moulding means and/or water jet means and the method including forming a combination of channels adapted to provide a stable intraocular pressure within non-pathological range.

With the Figures: In this example an accommodating intraocular lens according to US2009062912, W02005084587, US2014074233, WO2014058316, EP2765952, NL2012257278, US2010131955, US2010106245, NL1029548 and related documents is used for illustration purposes.

Figure 1 shows a lens according to a first embodiment, comprising an anterior optical element 1, a posterior optical element 2, a connection component 3 which connects the optical elements 1, 2 with haptics, 4 , with undulating flanges. In this embodiment the haptics comprise a flange 5. In this preferred embodiment a single round irrigation channel 6 has been provided in the centre of the anterior optical element 1, which channel 6 connects the anterior chamber of the eye with the inter-lenticular chamberand which channel is unobstructed by the iris also under photopic pupil conditions.

Figure 2 illustrates a second embodiment, which is substantially identical to the first embodiment, but wherein also in the in the centre of the posterior element 2 an irrigation channel 7 has been provided, which channel 7 connects the postererior chamber with the inter-lenticular chamber, so that both channels 6, 7 together connect the anterior chamber of the eye with the posterior chamber of the eye, a connection also unobstructed by the iris under photopic pupil conditions.

Figure 3 illustrates a third embodiment substantially identical to the first embodiment, but wherein additionally two peripheral channels, 8 have been provided. In this embodiment the additional channels 8 lie on a line extending perpendicular to the line connecting the centres of the haptics. These channels are within the optical area of the optical element. These channels connect the anterior chamber of the eye with the inter-lenticular chamber, just as the central channels does.

Figure 4 illustrates a fourth embodiment substantially identical to the first embodiment wherein additional channels 9 in the connection components 3 have been provided and wherein additional channels 10 in the haptics 4 have been provided.

Figure 5 illustrates a fifth embodiment with the two optical elements, 11, 12, the undulating flanges of embodiment 1-4 replaced by a single central flange, 13, wherein the channels are four largely elongated channels, 14, two at each side of the embodiment, with the channels separated by a bar shaped separator, 15.

It will be clear that the additional channels 8, 9, 10, 14 as discussed in the preceding embodiments can also be provided without the central channel 6, and that the additional channels 8, 9, 10 can be provided as single channels or as multiple channels.

Finally it will be clear that the additional channels can also be provided in the posterior optical element, either in combination with channels in the anterior optical element or with a closed anterior optical element. The location of the additional channels in the posterior optical element can deviate from that of the channels in the anterior optical element.

Claims (9)

An intraocular lens of variable optical strength adapted to be implanted in the sulcus of the eye, the lens comprising at least two optical elements, at least one of which is slidable in a direction perpendicular to the optical axis, each of the optical elements has at least one optically free-form surface, the free-form surface having such a shape that the combination of at least two free-form surfaces at a different position of at least one of the optical elements relative to the other optical element provides different refractive powers, characterized in that at least one of the optical elements comprises at least one flushing channel extending from the front of said optical element to the rear of said optical element and exchange of fluids in the eye from the front of the optical element to the rear of said optical element. Lens according to claim 1, characterized in that each of the optical elements comprises at least one leaching channel. Lens according to claim 1 or 2, characterized in that at least one of the optical elements comprises several channels. Lens according to claim 1 or 2, characterized in that one channel in an optical element is arranged centrally in the optical element. A lens according to claim 3, characterized in that the anterior optical element comprises a central channel adapted to provide exchange of fluids between the anterior eye chamber and the interlenticular chamber of the lens. A lens according to claim 5, characterized in that the posterior optical element comprises a central channel adapted to provide exchange of fluids between the posterior eye chamber and the interlenticular chamber of the lens. A lens according to any one of the preceding claims, characterized in that the channels have a round cross-section. 8. A lens according to any one of the preceding claims, characterized in that the channels are adapted to provide correction of intraocular pressure within the non-pathological region. A method for producing a variable optical power intraocular lens comprising at least two optical elements, which method is characterized by providing the optical elements and forming at least one leaching channel by using one of the means which are selected from mechanical means, laser means, forming means or water-steel means.