NL2025405A - Accommodating intraocular lens with elastically contracting haptics - Google Patents

Accommodating intraocular lens with elastically contracting haptics Download PDF

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Publication number
NL2025405A
NL2025405A NL2025405A NL2025405A NL2025405A NL 2025405 A NL2025405 A NL 2025405A NL 2025405 A NL2025405 A NL 2025405A NL 2025405 A NL2025405 A NL 2025405A NL 2025405 A NL2025405 A NL 2025405A
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lens
eye
optical
lens construction
combination
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NL2025405A
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NL2025405B1 (en
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Christiaan Rombach Michiel
Pieter Van Lawick Willem
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Akkolens Int B V
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1613Intraocular 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
    • A61F2/1624Intraocular 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
    • A61F2/1632Intraocular 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 radial position, i.e. perpendicularly to the visual axis when implanted
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1613Intraocular 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
    • A61F2/1648Multipart lenses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1602Corrective lenses for use in addition to the natural lenses of the eyes or for pseudo-phakic eyes
    • A61F2/161Posterior chamber lenses for use in addition to the natural lenses of the eyes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2/1613Intraocular 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
    • A61F2/1637Correcting aberrations caused by inhomogeneities; correcting intrinsic aberrations, e.g. of the cornea, of the surface of the natural lens, aspheric, cylindrical, toric lenses
    • A61F2/164Aspheric lenses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2002/1681Intraocular lenses having supporting structure for lens, e.g. haptics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/14Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16Intraocular lenses
    • A61F2002/1681Intraocular lenses having supporting structure for lens, e.g. haptics
    • A61F2002/1682Intraocular lenses having supporting structure for lens, e.g. haptics having mechanical force transfer mechanism to the lens, e.g. for accommodating lenses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0008Rounded shapes, e.g. with rounded corners elliptical or oval
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0013Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped

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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

The invention concerns an accommodating intraocular lens construction with comprising a variable optical lens fitted into driving means, for example, elastic haptics, 5 which haptics transfer movement of a driving component in the eye, for example, the capsular bag or the ciliary mass of the eye, to the optical element. When the driving component is active, meaning: contracted, the driving means are inactive, for example, elastically relaxed, with the lens providing relatively high optical power. When the driving component is inactive, meaning: expanded, the driving means are active, for 10 example, elastically stretched, with the lens providing a relatively low optical power.

Description

ACCOMMODATING INTRAOCULAR LENS WITH ELASTICALLY CONTRACTING
HAPTICS Summary The invention concerns an accommodating intraocular lens construction with comprising a variable optical lens fitted into driving means, for example, elastic haptics, which haptics transfer movement of a driving component in the eye, for example, the capsular bag or the ciliary mass of the eye, to the optical element. When the driving component is active, meaning: contracted, the driving means are inactive, for example, elastically relaxed, with the lens providing relatively high optical power. When the driving component is inactive, meaning: expanded, the driving means are active, for example, elastically stretched, with the lens providing a relatively low optical power.
Text This document, the present document, discloses an accommodating intraocular lens construction, ‘construction’ or ‘lens construction’, implanted in the human eye to replace the natural lens of the eye and to restore refraction of the aphakic eye and restore accommodation. Firstly, such construction has an optical axis with the construction comprising at least two optical elements of which at least one element translates, moves, by rotation and/or by shift in a plane largely perpendicular to the optical. The optical surfaces provide variation of at least one optical aberration of the lens with a degree of variation which is dependent on the degree of translation of the at least one of the optical elements. The invention also provides an intraocular accommodating lens comprising at least one haptic combination as disclosed above. which can be an elastic element which lens varies optical power by a change in radius with the degree of change depending on the degree of force exerted onto the haptics by the driving means as disclosed in, for example, US2011153015 and US7753953 and US2011282442. The accommodating intraocular lens can further comprise a combination of at least two lenses including at least one lens providing variable optical power to correct accommodation of the eye which variable lens comprises at least on optical element which lens can be combined with a separate lens of fixed optical power to correct the refraction of the eye.
Alternatively, the lens can comprise a combination of multiple optical elements, for example, two elements, of at least one of which is movable relative to the other in a direction perpendicular to the optical axis, wherein the optical elements have such a form as to result in a lens with different optical power at different relative positions of the optical elements with the degree of movement of the optical element depending on the degree of force exerted onto the haptics by the driving means.
Such optical arrangements for intraocular lenses are described in detail in, for example,
US2010324673, US2009228101, WO2007016533, US2007108643US20080738127, US2010094413 and WO2011065833. Note that, for further explanation of the present invention the variable lens comprising at least two optical elements, at least one of which is movable relative to the other in a direction perpendicular to the optical axis will be used as an example and that similar principles can be applied to lens constructions comprising, for example, one optical element which applies a change in radius to vary the optical power as referred to above, as in, for example, said documents US2011153015 and US7753953,
US2011282442 referred to above and in the document US20140228949A1. For accommodation, the defocus aberration is the preferred aberration to vary but in principle any aberration of any Zernike order can be a variable aberration or a combination of any number of aberrations of various order can be variably varied.
Such lenses are, at present, restricted to lenses with at least two cubic optical surfaces, meaning: Zernike third order surfaces, of which the basic, free-form, non-rotational symmetric, shapes are known from Alvarez US3305294, which provides the original concept for a variable lens, for laterally shifting optical elements, and Baker CA1252655, for derived Chinese fan-like rotational shifting optical elements.
More precisely, in mathematics, these are all various variations on the basic formula according to Louis Alvarez as in, for example, US3305294, which lenses comprise two monkey-saddle surfaces according to u(x, Y)=ACC 34x72) + BX Cxy+ Dx Fl ¥). Such lenses can also provide, by movement of at least one of the optical elements, a variable extension of accommodation, and/or variable focus, and/or variable spherical aberration.
Such movement can be achieved, but not restricted to, principles as disclosed in US2009062912 and WO2005084587, and the same concept, with various adaptations in, for example, US2014074233, W02014058316, EP2765952, NL2012257278, US2010131955, US2010106245, NL1029548 and references made therein and related documents, all which principles have now, been shown to function well in the human eye.
Such accommodating, translating, intraocular lens constructions are known from other documents, for example from NL2012133, NL201242, EP1871299, EP1932492, for designs of such constructions, and, for clinical results, Alio et al., in Am J Ophthamol 2016 Apr, 164: 37-48, but not restricted hereto and such constructions referred to above comprise the following optical surfaces and functions.
Prior art discloses (1) fixed refraction of the eye restored by at least one rotational symmetrical largely spherical fixed lens, and, (2) variable accommodation of the eye provided by free-form cubic surfaces, and, (3) undesired optical variable aberrations due to shift of the fixed lens versus the optical axis corrected by additional free-form surfaces with a lens and (1) fixed refraction of the eye restored by at least two rotational symmetrical largely spherical fixed lenses, and (2) variable accommodation of the eye provided by said spherical lenses, and, (3) undesired optical variable aberrations due to shift of the fixed lenses versus the optical axis corrected by free- form surfaces.
So, the construction comprises at least one optical combination of at least two sets of optical surfaces which optical sets include at least one set of two spherical optical surfaces with each optical element comprising at least one such spherical surface which set is adapted to provide variable defocus of which the degree of defocus is depending on the degree of mutual translation of the set of spherical optical surfaces, in combination with at least one set of two free-form optical surfaces with each optical element comprising at least one such free-form surface which set is adapted to provide variable correction of at least one optical aberration other than defocus of which the degree of correction is depending on the degree of mutual translation of the set of the free-form optical surfaces. The translation of at least one of the optical elements is a shift, meaning: sliding, of the element in a direction perpendicular to the optical axis, as set forth in, for example WO2005084587, or, alternatively, a partial rotation in a plane perpendicular to the optical axis, as set forth in CA1252655, or, alternatively, a wedging of the optical elements in a plane largely perpendicular to the optical axis, or, alternatively, any combination of any movements movement in a plane largely perpendicular to the optical axis.
The lens construction can comprise at least one anchoring haptic, meaning: a mechanical component adapted to provide positioning and anchoring of the optical elements in the anterior chamber or the posterior chamber of the eye. Such haptics are included in almost every intraocular lens which haptics can be for example plate haptics or C-loops for monofocal IOLs and multifocal IOLs, which are IOLs which do not require any movement in the eye. Examples of haptics which translate a component of the lens construction are the elastic loops as in WO2005084587.
The lens construction should comprise at least one translation haptic, meaning: a mechanical component adapted to provide, by coupling to translation of at least one optical element by transfer of movement of at least one component in the eye, a component preferably related to accommodation, to at least one of the optical elements. For example, the construction can comprises at least one haptic coupled to a natural component of the eye which component is the ciliary mass of the eye, as in WO2005084587, or, alternatively, at least one haptic is coupled to a natural component of the eye which component is the capsular bag of the eye, or, alternatively, at least one haptic is coupled to a natural component of the eye which component is the zonula network of the eye, or, to the iris, or, alternatively, at least one haptic is coupled to a natural component of the eye which component is the iris of the eye as in WO2007027091, or, alternatively, at least one haptic is adapted to translate at least one of the optical elements by liquid pressure generated in the posterior chamber of the eye, as in, for example, HK1066160, or, alternatively, an flexible optical element which changes shape by infusion of liquids from containers coupled to the optical element, as in for example US2011282443, or, alternatively, any combination of means of translation including but not restricted to the examples cited above. Also, at least one haptic of the present invention can be coupled to a MEMS, meaning: micro-electro-mechanical system, which MEMS is adapted to provide movement of at least one optical element. Such movement can adjust at least one of the elements to a fixed position, fixed endpoint, for example, a fixed resting position to adjust emmetropia of the eye, or, alternatively, set fixed positions for the range of accommodation, or, alternatively, provide leverage for accommodative power driven by ciliary muscle contractions or by external signals, for example signals from a smartphone. To illustrate this concept: the phone can have three buttons marked ‘far vision’, ‘intermediate vision’ and ‘reading’. The accommodation could also be driven by signals from brain waves of the wearer of the lens which sounds maybe farfetched, but which concept is well known to a man skilled in the art for other, non-ophthalmology applications. The power for such MEMS can be supplied by a electric power generator, being a combination of at least one micro-magnet and one micro-spool which generates electric current during accommodation of the eye, or, alternatively, a micro-
spool which generates current by external power sources such as a dedicated external magnetic wave generator, as in, for example, WO2017039672 or, alternatively, by power generated by mobile telephones or other electrical systems outside the eye, in the body or outside the body.
5 The lens construction can comprise at least one single circulating oblong flexible haptic which is adapted to change shape when the driving means are active such that the ratio of the length of the chief axis and the length of the transverse axis of said haptic decreases when the driving means are active with said ratio increasing when the driving means are inactive.
The lens construction can comprise at least one single circulating oblong flexible haptic, as in, for example, WO2014058316, which is adapted to change shape when the driving means are active such that the ratio of the length of the major axis and the length of the transverse axis of said haptic decreases when the driving means are inactive with said ratio increasing when the driving means are active.
The lens construction comprises at least one combination of connection points which combination comprises at least one optics connection point and at least one driving connection point, both connected to the haptic at the point where the chief axis of the haptic transverses the transverse axis with said combination adapted to provide translation of movement of driving means into movement of at least one optical element along the chief axis. Alternatively, the lens construction comprises at least one combination of connection points which combination comprises at least one optics connection point and at least one driving connection point, both connected to the haptic at the point where the chief axis of the haptic transverses the transverse axis with said combination adapted to provide translation of movement of driving means into movement of at least one optical element along the transverse axis.
The lens construction comprises at least one haptic adapted to urge the optical element back to a resting position, a position of increased optical power, when the driving means are inactive, or, alternatively, the lens construction can comprise at least one haptic adapted to urge the optical element back to a resting position, a position of decreased optical power, when the driving means are active.
The optical elements can also comprise at least one fixed power optical surface to correct for any fixed optical disorder of the eye, for example, correct for presbyopia,
also: reading far-sightedness, or, alternatively, correct for variable disorder is a variable disorder generated by the lens construction, or, alternatively, is adapted to provide correction of any combination of disorders of the eye, or, alternatively, the lens construction can comprise an additional fixed power optical element which provides fixed optical power and at least one optical element which element is a multifocal lens, providing at least two distinct foci, which lens is adapted to provide different optical powers at different relative positions in a plane perpendicular to the optical axis, or, alternatively, the lens construction can comprise a pinhole-component adapted to provide extended depth of field. So, the lens construction can be provide correction of any combination of variable and fixed disorders of the eye. The ciliary muscle of the eye pulls the, gel-like, natural lens of the eye flat to focus the eye at distance. The bag is an anatomical structure which can not push a lens, but the bag can pull any lens if properly coupled to the lens. Once the ciliary muscle relaxes, to focus the eye at closer distance, the natural lens regains its shape, the resting state, by the elasticity of the natural lens, as does the lens disclosed in the present document. Such fusion of bag and lens is, partly, known from prior art, US11562035 and US20040243233, but for only a different mechanical concept compared to the invention disclosed in the present document.
Such accommodating intraocular lens construction according can be fitted with at least one flange which is fitted to the posterior optical element, which flange is adapted to provide a connection of the construction to the anterior section of capsular bag in the eye. For example, the flange can be adapted to be positioned under or in the rim of the capsulorhexis in the capsular bag. Said flange can be of another material as the material of which the accommodating intraocular lens construction is made. For example, the construction can be made of any flexible acrylate material, while the flange can be made of, for example, sturdy PMMA material or a metal fixed to the construction, by, for example, a pin-in-hole connection, all which construction, including connection of optical elements can be achieved by re-polymerization, bonding, by, firstly, applying a solution of monomers to the bonding area of at least one of the elements followed by, secondly, polymerization of the solution by, for example, UV-light or heat. So, the accommodating intraocular lens is an optical addition to any optical element in the capsular bag, additional to, for example, the natural lens of the eye, or, alternatively, to any artificial lens implanted in the bag prior to implantation of the accommodating intraocular lens.
Such accommodating intraocular lens construction can also includes at least one additional optical surface fitted onto at least one optical surface, for example, a spherical optical surface adapted to provide correction of the refraction of the eye, or, alternatively, a toric optical surface adapted to provide correction of astigmatism of the eye, or, alternatively, any combination of additional surfaces adapted to provide correction of any combination of aberrations of the eye.
Such accommodating intraocular lens construction can be firmly coupled to any optical element in the capsular bag, for example, by a pin-in-hole system with the optical element in the capsular bag being any artificial lens implanted prior to implantation of the accommodating intraocular lens construction.
The lens construction can comprise at least one haptic adapted to urge the optical element back to a resting position, a position of decreased optical power, when the driving means are inactive, or, alternatively, the lens construction can comprise at least one haptic adapted to urge the optical element back to a resting position, a position of increased optical power, when the driving means are active.
The lens construction can comprise optical elements which also comprise at least one optical surface to correct for any variable optical disorder of the eye, for example, presbyopia, also: reading far-sightedness of the eye, or, alternatively, at least one variable disorder generated by other optical surfaces of the lens construction such as, but not limited to, coma, prisma, astigmatism or a combination of any number of variable disorders.
Also, the lens construction can comprise at least one optical surface to correct for any fixed optical disorder, or combination of disorders of the eye, for example astigmatism or refractive error or asphericity.
Figures
Fig. 1 shows a schematic representation of the accommodating lens construction when driving means, 1, for example, the rim of the capsulorhexis in the capsular bag, are relaxed, meaning: expanded, 2, which decreases the overlap, 3, of the optical elements, 4 (with the connection between the elements not illustrated in this schematic representation), which decreased overlap results in decreasing optical power of the lens.
The haptics, 5, are expanded and elastically tense.
Fig. 2 shows a schematic representation of the accommodating lens construction when driving means, 6, are active, meaning: contracted, 7, which increases the overlap, 8, of the optical elements, which increased overlap results in increasing optical power of the lens. The haptics, 9, are contracted and elastically relaxed. Fig. 3 shows a schematic representation of the accommodating lens construction in the capsular bag, 10, with in this example the haptics of the lens construction with a design, 11, which folds around the rim of the capsulorhexis in the bag and which haptic is coupled with the rim by, in this example, a double pin-in-hole connection, 13. The driving means, in this example the rim of the bag, are inactive resulting in an overlap of the optical elements and an optical effect as shown in Fig.1. Fig. 4. As in Fig.3, with in this figure a representation of the lens configuration when the driving means are active, contracted, resulting in an overlap of the optical elements and an optical effect as shown in Fig.2. Fig 5 shows a top view of a lens construction, in this example a construction with O- loops, closed circular haptics, in the bag with pin-in-hole components, 14, coupling the bag to the lens construction and with slits in the anterior section of the rim of the bag, 15, designed to relax the part of the bag which part does not affect the lens performance, with the rim of the capsulorhexis, 17. Fig. 6 shows a top view of the same lens construction as represented in Fig.5 with, in this example, the haptics fitted with a clamp, 16,which couples the haptics to the rim of the capsular bag.
The capsulorhexis and various openings for any types of clamps or hooks on the lens construction can be provided by traditional manual surgery or modern laser surgery. The translation of the optical elements can be a shift, meaning: sliding, of at least one optical element in a direction perpendicular to the optical axis, or, alternatively, a rotation of at least one of the optical elements in a plane perpendicular to the optical axis, or, alternatively, a wedging of at least one of the optical elements in a plane largely perpendicular to the optical axis, or, alternatively, a translation along the optical axis, or, alternatively, any combination of any such movements.
The construction can comprise at least one anchoring haptic, meaning: a mechanical component adapted to provide positioning and anchoring of the optical elements in the anterior chamber or in the posterior chamber of the eye. The construction can comprise at least one translation haptic, meaning: a mechanical component adapted to provide translation of at least one optical element by transfer of movement of at least one component in the eye to at least one of the optical elements. The construction can comprise at least one haptic adapted to provide a combination of positioning and translation. Driving components can be the capsular bag of the eye, or, coupled to a natural component of the eye which component is the zonula network of the eye or the iris of the eye, or, liquid pressure generated in the posterior chamber of the eye, or, a MEMS, meaning: Micro-Electro-Mechanical System, which MEMS is adapted to provide movement of at least one optical element.
The construction can comprise at least one single circulating oblong flexible haptic which is adapted to change shape when the driving means are active such that the ratio of the length of the chief axis and the length of the transverse axis of said haptic increases when the driving means are active with said ratio decreasing when the driving means are inactive. Lenses disclosed in for example, NL2012133, NL201242 and EP1871299 provide an increased optical power when the driving component in the eye is active and the driving means is tense, meaning: the elastic haptic compressed, and a decreased optical power which power when the driving component is inactive and the driving means is relaxed, meaning: the elastic haptic relaxed. The present document discloses lens constructions which provide a increased optical power when the driving component in the eye is active and the driving means is relaxed, meaning: the elastic haptic relaxed, at rest, and a decreased optical power which power when the driving component is inactive and the driving means is tense, meaning, for example: the elastic haptic stretched, tense. So, the lens construction provides, when the driving component in the eye is active and the driving means is relaxed, an optical power which power exceeds the optical power provided by the lens construction when the driving component is inactive and the driving means is tense. The lens construction can comprises coupling means to provide a connection between the optical elements, or, alternatively, the lens construction can comprise any number of independent optical elements. The driving component in the eye can be the ciliary muscle of the eye, or, alternatively, the capsular system of the eye, or, alternatively, the iris of the eye, or, alternatively, any other natural component in the eye, or, alternatively, any artificial component, for example the driving component can be a MEMS component. The lens construction can comprise at least one optical element with the driving means which driving means is at least one elastic haptic which haptic can be a C-loop elastic haptic, or, alternatively, at least one O-loop elastic haptic. The elastic haptic can also be adapted to provide any desired coupling to any MEMS driving component.
As known from prior art, when the driving component is active the driving means are elastically tense, for example, compressed, the optical elements show increased overlap and the lens provides high, for example, defocus, optical power and, when the driving component is inactive, the driving means are elastically relaxed, the optical elements show less overlap and the lens provides a lower optical power. As per the present document, as per the novel invention, as per the preferred embodiment, when the driving component is active the driving means are elastically relaxed, for example, contracted, the optical elements show increased overlap and the lens provides high, for example, defocus, optical power and, when the driving component is inactive, the driving means are elastically stretched, the optical elements show less overlap and the lens provides a lower optical power.
Alternatively, in an alternative embodiment, in which the optical element are shifted by design, when the driving component is active the driving means are elastically relaxed, for example, contracted, the optical elements show decreased overlap and the lens provides high, for example, defocus, optical power and, when the driving component is inactive, the driving means are elastically stretched, the optical elements show more overlap and the lens provides a lower optical power.
The construction can be composed of at least two separate constructions, a mechanical construction which provides coupling to any driving component and translation of any movement of the driving component into a movement of at least one optical element of the optical construction which construction provides variable optical power of which the degree of optical power depends on the degree of mutual movement of the at least two optical elements.
In any of the embodiments disclosed in the present document at least one optical element can be an element integrated in the lens construction or, alternatively, can be an element comprised by any component of the eye, for example, an optical surface engraved by a laser on, for example, the cornea of the eye, or, alternatively, can be any additional intraocular optical implant, for example, an anterior chamber intraocular lens, or, alternatively, a contact lens.
To maximize the effect of the driving component, for example the rim of the anterior capsular bag a novel surgical procedure can be applied. Such method for implantation of an accommodating intraocular lens construction comprising at least two optical elements of which at least one element is adapted to move in at least one plane largely perpendicular to the optical axis of the eye with the construction also comprising at least one driving means to provide translation of movement of at least one driving component in the eye into said movement of at least one of the optical elements with the lens construction providing, when the driving component in the eye is active and the driving means is relaxed, an optical power which power exceeds the optical power provided by the lens construction when the driving component is inactive and the driving means is stretched with the haptics of the lens construction coupled to the rim the capsular bag by any surgical procedure which relaxes the remaining rim of the capsular bag, for example, slits in the rim to relax the rim of the capsular bag.
The preferred method can include at least one surgical procedure which includes application of at least one slit in the anterior remaining rim of capsular bag not coupled to the lens construction, or, alternatively, which can be application of at least one slit in the posterior section of capsular bag not coupled to the lens construction, or, alternatively, the surgical procedure can include application of at least one slit in any at least one section of the capsular bag not coupled to the lens construction.
So, the present document discloses an accommodating intraocular lens construction with at least one optical element to provide variable optical power with the optical element fitted within at least one driving means adapted to provide translation of movement of at least one driving component in the eye, for example, movement of the capsular bag of the eye, or, alternatively, movement of the ciliary mass of the eye, such that the degree of optical power of the optical element depends on the degree of movement of the driving the degree of which movement, in turn, depends on the degree of movement of the driving component.
The lens construction is adapted to provide, when the driving component in the eye is active and the driving means is relaxed, an optical power which power exceeds the optical power provided by the lens construction when the driving component is inactive and the driving means is stretched.
The lens construction can comprises one elastic optical element adapted to provide variable optical power, for example, an optical element which, elastically, changes shape, for example, a lens which provides a variable optical power of which the degree of optical power depends on the degree of change in radius of the optical element.
Alternatively, the lens construction can comprise a combination of at least two optical elements which elements are moveable in any direction perpendicular to the optical axis with the combination of the optical elements provide a lens of variable optical power of which the degree of optical power depends on the degree of movement of at least one of the optical elements with the degree of movement depending on the degree of movement of the driving means, which degree, in turn, depends on the degree of movement of the driving component in the eye.
Such lens constructions can be designed to be implanted to be implanted in the capsular bag of the eye with, for example, the capsular bag being the driving component, or, alternatively, such lens constructions can be designed to be implanted at the sulcus plane of the eye, at a plane in front of the capsular bag, with, for example, the ciliary mass being the driving component of the lens construction.
The driving component can be the ciliary muscle of the eye, or, alternatively, can be the capsular bag of the eye.
Alternatively, the driving component can be the iris of the eye, or, alternatively, can be an intraocular artificial MEMS component.
The driving means can be elastically relaxed when the driving component in the eye is contracted and that the driving means is elastically stretched when the driving component is expanded which driving means can be at least one optical element, for example, an elastic haptic as in at least one C-loop elastic haptic, or, alternatively, at least one O-loop elastic haptic.
Furthermore, the lens construction can comprise at least one elastic haptic to provide coupling to said, at least one, any artificial MEMS driving component.
Also, the lens construction can comprise at least two separate constructions, a mechanical construction to provide coupling to any driving component and translation of any movement of the driving component into a movement of at least one optical element of the optical construction which optical construction is provides variable optical power of which the degree of optical power depends on the degree of movement of the driving component.
The lens construction can provide restoration of a combination of refraction and accommodation of the eye by combining at least one component, which can be an optical surface, providing fixed optical power with at least one component providing variable optical power by any example of a variable optical lens set forth above but not limited thereto.
Alternatively,
the lens construction can provide restoration of only accommodation of the eye, for example with the lens construction being an add-on accommodative unit to any other lens providing the restoration of refraction of the eye, for example, the natural lens of the eye or, for example, a standard monofocal intraocular lens.
The method for implantation of such an accommodating intraocular lens construction includes a surgical procedure includes any surgical procedure applied to any section of the capsular bag which section is not coupled to the lens construction which procedure can include application of at least one slit in the capsular bag not coupled to the lens construction which can be application of at least one slit in the anterior rim of capsular bag not coupled to the lens construction, or, alternatively, at least one slit in the posterior section of capsular bag not coupled to the lens construction, or, alternatively, multiple slits in any section the capsular bag not coupled to the lens construction.

Claims (20)

ConclusiesConclusions 1. Accomoderende intra-oculaire lensconstructie omvattende ten minste één optisch element dat is aangepast om een variabel optisch vermogen te verschaffen, waarbij het optisch element is vastgezet binnen tenminste één aandrijfmiddel dat is aangepast om een translatie van beweging te verschaffen van ten minste één aandrijfcomponent in het oog, zodanig dat de mate van optisch vermogen van het optisch element afhankelijk is van de mater van beweging van het aandrijfmiddel, met het kenmerk dat de lensconstructie is aangepast om een optisch vermogen te verschaffen wanneer de aandrijfcomponent in het oog actief is en het aandrijfmiddel ontspannen is, welk optisch vermogen groter is dan het optisch vermogen dat verschaft wordt door de lensconstructie wanneer de aandrijfcomponent inactief is en het aandrijfmiddel is opgerekt.An accommodation intraocular lens assembly comprising at least one optical element adapted to provide variable optical power, the optical element being fixed within at least one drive means adapted to provide translation of movement of at least one drive component in the eye, such that the degree of optical power of the optical element depends on the material of movement of the driving means, characterized in that the lens construction is adapted to provide optical power when the driving component is active in the eye and the driving means relaxed, which optical power is greater than the optical power provided by the lens structure when the drive component is inactive and the drive means is stretched. 2. Lensconstructie volgens conclusie 1, met het kenmerk dat de lensconstructie een elastisch optisch element omvat dat is aangepast om een variabel optisch vermogen te verschaffen.Lens construction according to claim 1, characterized in that the lens construction comprises an elastic optical element adapted to provide variable optical power. 3. Lensconstructie volgens conclusie 1, met het kenmerk dat de lens een combinatie van ten minste twee optische elementen omvat, welke beweegbaar zijn in enige richting loodrecht op de optische as, waarbij de combinatie is aangepast om een lens te verschaffen met een variabel optisch vermogen waarbij de grootte van het variabel optisch vermogen afhangt van de mate van beweging van ten minste één van de optische elementen, waarbij de mate van beweging afhangt van de mate van beweging van het aandrijfmiddel.Lens construction according to claim 1, characterized in that the lens comprises a combination of at least two optical elements, which are movable in any direction perpendicular to the optical axis, the combination being adapted to provide a lens with variable optical power wherein the magnitude of the variable optical power depends on the amount of movement of at least one of the optical elements, the amount of movement depending on the amount of movement of the driving means. 4. Lensconstructie volgens conclusie 1 en 2, of volgens conclusie 1 en 3, met het kenmerk dat de lensconstructie is aangepast om geïmplanteerd te worden in de kapselzak van het oog.Lens construction according to claims 1 and 2, or according to claims 1 and 3, characterized in that the lens construction is adapted to be implanted in the capsular bag of the eye. 5. Lensconstructie volgens conclusie 1 en 2, of volgens conclusie 1 en 3, met het kenmerk dat de lensconstructie is aangepast om geïmplanteerd te worden bij het sulcusvlak van het oog.Lens construction according to claims 1 and 2, or according to claims 1 and 3, characterized in that the lens construction is adapted to be implanted at the sulcus plane of the eye. 6. Lensconstructie volgens enige combinatie van de voorgaande conclusies, met het kenmerk dat het aandrijfmiddel is aangepast om elastisch ontspannen te worden wanneer de aandrijffcomponent in het oog wordt samengetrokken en het aandrijfmiddel is aangepast om elastisch te worden gestrekt wanneer de aandrijfcomponent wordt geëxpandeerd.Lens construction according to any combination of the preceding claims, characterized in that the drive means is adapted to be elastically relaxed when the drive component is contracted in the eye and the drive means is adapted to be elastically stretched when the drive component is expanded. 7. Lensconstructie volgens enige combinatie van conclusies 1-6, met het kenmerk dat de aandrijfcomponent de kringspier van het oog is.Lens construction according to any combination of claims 1-6, characterized in that the driving component is the sphincter of the eye. 8. Lensconstructie volgens enige combinatie van conclusies 1-6, met het kenmerk dat de aandrijfcomponent de kapselzak van het oog is.Lens construction according to any combination of claims 1-6, characterized in that the driving component is the capsular bag of the eye. 9. Lensconstructie volgens enige combinatie van conclusies 1-6, met het kenmerk dat de aandrijfcomponent een intra-oculaire kunstmatige MEMS component is.Lens construction according to any combination of claims 1-6, characterized in that the drive component is an intraocular artificial MEMS component. 10. Lensconstructie volgens enige combinatie van conclusies 1-6, met het kenmerk dat het ten minste ene optische element het aandrijfmiddel omvat welk aandrijfmiddel ten minste een elastisch haptische is.Lens construction according to any combination of claims 1-6, characterized in that the at least one optical element comprises the driving means, which driving means is at least one elastic haptic. 11. Lensconstructie volgens conclusie 10, met het kenmerk dat de elastisch haptische tenminste een elastisch haptische C-lus is.Lens construction according to claim 10, characterized in that the elastic haptic is at least one elastic haptic C-loop. 12. Lensconstructie volgens conclusie 10, met het kenmerk dat de elastisch haptische tenminste een elastisch haptische O-lus is.Lens construction according to claim 10, characterized in that the elastic haptic is at least one elastic haptic O-loop. 13. Lensconstructie volgens enige combinatie van de voorgaande conclusies, met het kenmerk dat de lensconstructie ten minste twee aparte constructies omvat, ten eerste een mechanische constructie die is aangepast om een koppeling te verschaffen met enige aandrijfcomponent en een translatie van enige beweging van de aandrijfcomponent naar een beweging van, ten tweede, ten minste één optisch element van de optische constructie welke is aangepast om een variabel optisch vermogen te verschaffen waarbij de grootte van het optisch vermogen afhangt van de mate van de mate van beweging van de aandrijfcomponent.Lens structure according to any combination of the preceding claims, characterized in that the lens structure comprises at least two separate structures, firstly a mechanical structure adapted to provide coupling with some drive component and a translation of some movement of the drive component to a movement of, second, at least one optical element of the optical construction which is adapted to provide a variable optical power, the magnitude of the optical power depending on the amount of motion of the driving component. 14. Lensconstructie volgens enige combinatie van conclusies 1-13, met het kenmerk dat de lensconstructie is aangepast om een combinatie van de refractie en de accommodatie van het oog te herstellen.Lens construction according to any combination of claims 1-13, characterized in that the lens construction is adapted to restore a combination of the refraction and accommodation of the eye. 15. Lensconstructie volgens enige combinatie van conclusies 1-13, met het kenmerk dat de lensconstructie is aangepast om slechts de accommodatie van het oog te herstellen.Lens construction according to any combination of claims 1-13, characterized in that the lens construction is adapted to restore only the accommodation of the eye. 16. Werkwijze voor het implanteren van een accomoderende intra-oculaire lensconstructie volgens conclusie 1, met het kenmerk dat de chirurgische procedure enige chirurgische procedure omvat die wordt toegepast op enige sectie van de kapselzak, en welke sectie niet met de lensconstructie is gekoppeld.A method of implanting an accommodating intraocular lens assembly according to claim 1, characterized in that the surgical procedure includes any surgical procedure applied to any section of the capsular bag, and which section is not coupled to the lens assembly. 17. Werkwijze volgens conclusie 16, met het kenmerk dat de chirurgische procedure het aanbrengen van ten minste één insnijding in de kapselzak omvat, welke niet met de lensconstructie is gekoppeld.A method according to claim 16, characterized in that the surgical procedure comprises making at least one incision in the capsular bag which is not coupled to the lens assembly. 18. Werkwijze volgens conclusie 17, met het kenmerk dat de chirurgische procedure het aanbrengen van ten minste één insnijding in de voorste rand van de kapselzak omvat, welke niet met de lensconstructie is gekoppeld.A method according to claim 17, characterized in that the surgical procedure comprises making at least one incision in the leading edge of the capsular bag which is not coupled to the lens structure. 19. Werkwijze volgens conclusie 17, met het kenmerk dat de chirurgische procedure het aanbrengen van ten minste één insnijding in de achterste sectie van de kapselzak omvat, welke niet met de lensconstructie is gekoppeld.A method according to claim 17, characterized in that the surgical procedure comprises making at least one incision in the posterior section of the capsular bag that is not coupled to the lens assembly. 20. Werkwijze volgens conclusie 17, met het kenmerk dat de chirurgische procedure het aanbrengen van ten minste één insnijding in enige sectie van de kapselzak omvat, welke niet met de lensconstructie is gekoppeld.A method according to claim 17, characterized in that the surgical procedure includes making at least one incision in any section of the capsular bag that is not coupled to the lens assembly.
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