NL2022753B1 - Accommodating intraocular lens combination comprising a variable lens and a variable sulcal insert - Google Patents

Abstract

The invention relates to an intraocular lens combination to be implanted at the sulcal plane of the eye with the combination comprising at least one variable lens of variable power and at least one variable sulcal implant adapted to provide a separation, a barrier, between any component of the lens and the iris of the eye.

Description

Accommodating intraocular lens combination comprising a variable lens and a variable sulcal insert The invention relates to an intraocular lens combination to be implanted at the sulcal plane of the eye with the combination comprising at least one variable lens of variable power and at least one variable sulcal implant adapted to provide a separation, a barrier, between any component of the lens and the iris of the eye. Restoring vision of an aphakic eye, meaning: an eye with no lens, the eye becoming aphakic following removal of the natural lens of the eye, which is a common surgical procedure generally due to a cataract of the lens. The eye is thereafter implanted with a plastic lens which artificial restores sharp vision at, generally, only one plane, generally focused only ‘at far’, by a ‘monofocal lens’, or, alternatively, restores sharp vision at multiple distances simultaneously, generally at two or three distances, by implantation of ‘multifocal lens. However, the ‘golden grail’ in ophthalmology is restoration of ‘true accommodation’ by an implanted artificial lens, meaning: an artificial lens providing the eye with sharp vision all distances, a sharp vision graduating seamlessly from far to ‘reading’ distances, as does the natural lens in an healthy young eye.

This document, the present document, discloses an accommodating intraocular lens combination, henceforth: ‘combination’, with the combination comprising at least one variable optical lens, also: ‘lens’ and at least one an sulcal insert, also: ‘insert’ which insert can be a sulcal disc, also: ‘disc’, or, alternatively, a sulcal ring, also: ‘ring’, with the combination to be positioned at the sulcal plane, behind the iris, with the combination adapted to replace the natural lens of the eye to restore refraction and accommodation of the eye. The optics of the lens provide firstly accommodation, meaning: providing variable defocus aberration to provide sharp vision over a range of distances aberrations of the eye, but the lens can also, additionally, provide correction of at least one additional other order variable aberration, for example, spherical variable aberration, if such correction is required. The lens included in the combination comprises at least two optical elements fitted, each, with at least one free-form, meaning: not rotational symmetrical, optical surface with at least one element adapted to translate in a direction largely perpendicular to the optical axis with the free-form surfaces providing a variable power of at least one optical aberration, generally the 2™ order defocus aberration, with the degree of variable power depending on the degree of translation.

The translation of at least one of the optical elements is generally a shift, meaning: a sliding translation perpendicular to the optical axis, or, alternatively, a rotation in a plane perpendicular to the optical axis, or, alternatively, a wedging of the optical elements, or, alternatively, any other translation, or alternatively, any combination of any movements movement in a plane largely perpendicular to the optical axis.

Such accommodating intraocular lenses are now well known, for example by prior art,

including, but not restricted to these documents: US2015342728, US2014336757, NL2012133, WO2014058315, US2012323321 and US2012310341. The combination comprises at least one translation haptic, meaning: a mechanical component of the lens adapted to provide translation of at least one optical element by transfer of movement of at least one component of the eye to at least one of the optical elements, or, alternatively, the combination construction comprises at least one haptic adapted to provide a combination of positioning and translation.

The at least one haptic is coupled to a natural component of the eye which component is generally, but not restricted hereto, the ciliary mass, the capsular bag or the capsular zonulae of the eye,

or, alternatively, at least one haptic can be connected to any artificial intraocular mechanical driver, for example a MEMS.

The combination also comprises an insert, which insert can comprise a central hole, to be positioned at the sulcal plane of the eye, with the insert adapted to provide a separation, a barrier, between any component of the lens, for example the anchors, meaning: the haptics, and the posterior surface of the iris of the eye.

Such insert protects the iris from contact with any moving components of the lens and thus prevent release of pigment from the iris.

The insert can be manufactured of any material, can be manufactured of the same material as the lens, can be manufactured of opaque material, or, alternatively, can be manufactured of transparent material.

Additionally, the insert can also comprises any components adapted to provide directional guidance for translation of at least one of the elements of the lens.

The insert can be circular, meaning: round, of any diameter, and can be fitted with a central hole of any diameter, preferably at least a diameter which corresponds to the maximum diameter of the iris, which is around 6mm, as not to interfere with the optics of the eye.

Alternatively, the insert can be of any shape, for example an oval insert which shape more corresponds to the natural shape of the sulcus, which oval shape can be manufactured accordingly for a specific eye, meaning: a customized ring design.

Also, the desired shape of the hole can be determined before surgery customized, for example, an oval hole with the insert to be implanted at a specific angle, to be determined before surgery, with the shape of the hole adapted to provide correction of fixed undesired aberrations of the eye, for example coma.

Furthermore, the lens can be tapered, meaning: the posterior section of the lens is of a smaller diameter compared to the anterior section, such that the posterior section of the lens is fit in a capsulorhexis in the posterior section of the capsular bag of the eye with capsulorhexis applied during implantation surgery by any means or, alternatively, post surgery by YAG laser or by femtosecond laser. Figure 1: An insert with (1) in this example, an opaque insert/ring, with (2) an oval hole, to correct, for example a existing coma of the eye. Figure 2: an oblique view of the same ring as in Figure 1, with (2a) the ring, and (2b) guiding directional rings and, (2c) the oval hole. Figure 3: (3) the cornea of the eye, (3a) the anterior chamber of the eye, (4) the iris of the eye, (4a) the pigment layer of the eye, (4b) the ciliary mass of the eye with the contracting, accommodating, ciliary muscle filaments, (5) a ‘ring’, as in Fig.1, (6) the ciliary zonulae of the eye, (7) the anterior surface of the anterior element of the lens, (8) the free-form surfaces affecting accommodation, (9) the zonulae connecting the capsular bag to the ciliary mass, (10) the lens of fixed power which corrects the refraction of the aphakic eye, (11) the remnants of the exterior posterior capsular bag after posterior capsulorhexis, and (12) the anterior of the vitreous of the eye. So, in summary: This document, the present document, discloses an intraocular lens combination, also: ‘combination’, adapted to be implanted at the sulcal plane of the eye with the combination comprising at least one optical lens, also: ‘lens’, which has an optical axis, which lens comprises at least two optical elements fitted, each, with at least one free-form optical surface with at least one element adapted to translate in a direction largely perpendicular to the optical axis with the free-form surfaces adapted to provide a lens of variable optical power with the degree of variable power depending on the degree of relative translation of the optical elements with the combination also comprising a sulcal insert to be positioned in the sulcal plane of the eye with the insert adapted to provide a separation, a barrier, between any component of the lens and the iris of the eye, with the insert a continuous disc, or, alternatively, with the insert is ring, a ‘ring’ meaning: a disc comprising a central hole, with the insert manufactured of any material, which can be the same material as is the lens, or, alternatively, the insert is manufactured of any opaque material, or, alternatively, any transparent material, with the insert can also comprises at least one component adapted to provide directional guidance for translation of at least one of the elements of the lens, with the insert being a continuous disc of any diameter or shape, or, alternatively, with the insert comprising a central hole of any diameter and of any shape, a slim ‘donut’, with the insert comprising a hole of any size or shape with the dimensions of the hole can be determined prior to surgery such that the dimensions can be customized according to the requirements of the particular eye into which the insert is implanted, with the insert in combination with a lens lens tapered such that the posterior section of the lens is adapted to fit in, fit through, a capsulorhexis in the posterior section of the capsular bag of the eye.

Claims (12)

Conclusions 1. Intraocular lens combination, also: 'combination', adapted to be implanted at the sulcal plane of the eye wherein the combination comprises at least one optical lens, also: 'lens', which has an optical axis, and which lens is at least comprising at least two optical elements, each mating with at least one form-free optical surface having at least one element adapted to move in a direction substantially perpendicular to the optical axis, the form-free surfaces being adapted to provide a lens with variable optical power the degree of variable force depends on the degree of relative displacement of the optical elements, characterized in that the combination also includes a sulcal insert to be positioned in the suical plane of the eye with the insert adapted to form a partition or barrier between each component of the lens and the iris of the 00g. Combination according to claim 1, characterized in that the sulcal insert is adapted to be placed between the lens and the iris. Combination according to claim 1 or 2, characterized in that the sulcal insert is connected to the lens or the haptic parts of the lens. Combination according to claim 1, 2 or 3, characterized in that the insert is a continuous disk. Combination according to any one of claims 1-4, characterized in that the insert is a ring, meaning a disk comprising a central hole. Combination according to any one of claims 1-5, characterized in that the insert is made of the same material as the lens. Combination according to any one of claims 1-6, characterized in that the insert is made of an opaque material. Combination according to any one of claims 1-6, characterized in that the insert is made of a transparent material. Combination according to any one of claims 1-8, characterized in that the insert also comprises at least one component adapted to provide a directional guide for moving at least one of the elements of the lens. An insert which is part of a combination according to any one of claims 1-9, characterized in that the insert is a continuous disc. An insert forming part of a combination according to any one of claims 1-9, characterized in that the insert is a ring comprising a central hole. An insert according to claim 11, characterized in that the shape and dimensions of the hole are determined prior to surgery so that the dimensions are adapted according to the requirements of the particular eye in which the insert is implanted. The combination of claim 1, characterized in that the lens is tapered from front to back such that the back of the lens is adapted to fit in or through a capsulorhexis in the posterior section of the capsular bag of the eye .