RU2777928C2 - Intraocular lenses and stabilization of peripheral part - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: intraocular lens filled with fluid contains: an optical part containing an optical fluid chamber; and a peripheral part containing at least one peripheral fluid chamber in communication via fluid with the optical fluid chamber, in which the outer periphery of the optical part has a peripheral surface, in which a radially inner part of the peripheral part of the intraocular lens has an inner surface. In this case, the peripheral surface is in close proximity to the inner surface, and the peripheral surface does not extend directly from the inner surface. At the same time, the peripheral surface and the inner surface are designed so that the peripheral part and the optical part are stabilized relatively to each other in at least one of proximal and distal directions, where the peripheral surface is in close proximity to the inner surface. In another option of an intraocular lens filled with fluid, the peripheral surface is complementary in shape to at least part of the radially inner part of the peripheral part of the intraocular lens.

EFFECT: use of this group of inventions will expand the arsenal of technical means, namely intraocular lenses.

20 cl, 26 dwg

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Provisional Application No. 62/580210 filed Nov. 1, 2017, which is incorporated herein by reference.

[0002] This application incorporates, by reference to the PCT, Publication No. WO 2017/079733 A1, published May 11, 2017.

INCLUSION BY LINK

[0003] All publications and patent applications mentioned in this specification are incorporated herein by reference to the same extent as if each individual publication or patent application were specifically and individually referred to as being incorporated by reference.

BACKGROUND OF THE INVENTION

[0004] Intraocular lenses may include one or more peripheral parts that are located radially outside of the optical part. During a surgical implantation procedure, at least a portion of the intraocular lens (IOL) may be twitched by out-of-plane forces in an anterior-posterior direction, which may make it difficult to achieve planar alignment of the intraocular lens during at least part of the surgical procedure.

SUMMARY OF THE INVENTION

[0005] One aspect of the present invention is an intraocular lens ("IOL") in which the outer periphery of the optic portion has a peripheral surface, and the radially inner portion of the peripheral non-optical portion of the IOL has an inner surface, where this peripheral surface is in close proximity to this inner surface. surface, and where this peripheral surface does not extend directly (is not connected and integral) from this internal surface, and where this peripheral surface and this internal surface are arranged so that the peripheral part and the optical part are stabilized relative to each other in at least at least one and possibly both of the proximal and distal directions, where the given peripheral surface is in close proximity to the given inner surface.

[0006] The optical peripheral surface may contain a recess, and at least part of the inner surface may be located in this recess.

[0007] The optical peripheral surface and the inner surface of the peripheral portion may be in close proximity at a location that is separated from and around the optical periphery from a location where the peripheral extends from (e.g., associated with or integral with) the optical portion.

BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Figures 1A and 1B depict an exemplary accommodating intraocular lens.

[0009] Figure 1C is a sectional view of the accommodating intraocular lens in Figures 1A and 1B.

[0010] Figure 1D is a plan view of an exemplary rear element of an accommodating intraocular lens.

[0011] Figure 1E is a sectional view of an assembly of an exemplary optical portion of an accommodating intraocular lens.

[0012] Figures 1F and 1G depict an exemplary haptics.

[0013] Figure 1H depicts an exemplary connection between an optic and a haptics.

[0014] Figures 2A, 2B and 2C depict an exemplary haptics.

[0015] Figures 2D, 2E, and 2F are sectional views of the haptics of Figure 2A.

[0016] Figure 2G shows the opening at the first end of the haptics of Figures 2A-2C

[0017] Figure 3 depicts approximate diameters of an accommodating intraocular lens.

[0018] Figure 4 depicts an exemplary haptics.

[0019] Figures 5A and 5B depict the deformation of an exemplary haptics in response to exemplary forces.

[0020] Figure 6 depicts a flow hole in an exemplary haptic.

[0021] Figure 7 depicts a flow hole in an exemplary haptic.

[0022] Figure 8 is a sectional view of an exemplary accommodating intraocular lens.

[0023] Figure 9 depicts a sectional view of an exemplary accommodating intraocular lens with relatively short haptics.

[0024] Figure 10 is a sectional view of an exemplary accommodating intraocular lens with optics centered at the periphery.

[0025] Figure 11 is an exemplary haptics.

[0026] Figure 12 shows an exemplary optical portion.

[0027] Figure 13 shows a portion of an exemplary haptics.

[0028] Figure 14 shows an exemplary IOL.

[0029] Figure 15 shows an exemplary IOL

[0030] Figure 16 shows an exemplary IOL.

[0031] Figure 17 shows a top view of an exemplary IOL.

[0032] Figure 18 shows an exemplary optical portion.

[0033] Figure 19 shows a sectional view of an exemplary IOL.

[0034] Figure 20 is a sectional view of an exemplary optic that includes a peripheral surface.

[0035] Figure 21 is a sectional view of an exemplary accommodating intraocular lens (AIOL) that includes an optic with a peripheral surface and a peripheral portion with at least one radially inner surface.

[0036] Figure 22 is an enlarged sectional view of an exemplary optical peripheral surface and an exemplary peripheral inner surface.

[0037] Figure 23 depicts an exemplary peripheral surface optic.

[0038] Figure 24 depicts an exemplary peripheral surface optic.

[0039] Figure 25 depicts an exemplary peripheral surface optic.

[0040] Figure 26 depicts an exemplary peripheral surface optic.

DETAILED DESCRIPTION

[0041] This invention generally relates to intraocular lenses. In some embodiments, the intraocular lenses described herein are suitable for placement within a natural capsular bag in which the native lens has been removed. In these embodiments, the peripheral non-optical portion (ie, the portion not adapted to focus light on the retina) is adapted to respond to remodeling of the capsular bag due to relaxation and contraction of the ciliary muscles. This response is a deformation of the peripheral part, which causes the fluid to move between the peripheral part and the optical part, changing the optical parameter (eg, optical power) of the intraocular lens.

[0042] Figure 1A is a plan view showing an accommodating intraocular lens 10 that includes an optic 12 and a peripheral portion, which in this embodiment includes first and second haptics 14 associated with the optic 12 and extending peripherally from her. The optical part 12 is adapted to refract the light that enters the eye onto the retina. The haptics 14 are organized to adhere to the capsular bag and are capable of deforming in response to changes in the shape of the capsular bag associated with the ciliary musculature. Figure 1B is a perspective view of the intraocular lens 10 showing the optic 12 and haptics 14 attached to the optic 12.

[0043] The haptics are in fluid communication with the optics. Each haptic has a fluid chamber that is in fluid communication with an optical chamber in the optical portion. Haptics are formed from a deformable material and are able to adhere to the capsular bag and deform in response to a change in the shape of the capsular bag associated with the ciliary muscles. When haptics deform, the volume of the haptic fluid chamber changes causing the fluid located in the haptic fluid chambers and the optic fluid chamber to move into the optic fluid chamber from the haptic fluid chambers or into the haptic fluid chambers from the optic fluid chamber. As the volume of the haptic fluid chambers decreases, fluid moves into the optical fluid chamber. As the volume of the haptic fluid chambers increases, fluid moves into the haptic fluid chambers from the optical fluid chamber. The flow of fluid or fluid into and out of the optical fluid chamber changes the configuration of the optical portion and the power of the intraocular lens.

[0044] Figure 1C is a sectional side view along section A-A shown in Figure 1A. The optics 12 includes a deformable front member 18 attached to a deformable back member 20. Each haptic 14 includes a fluid chamber 22 that is in fluid communication with the fluid optic chamber 24 in the optic 12. Only the connection between the haptics 14 on the left side of the figure and the optical part 12 are shown (albeit hidden) in sectional view in figure 1C. The fluid chamber of the haptic 22 on the left side of the figure is shown in fluid communication with the optical fluid box 24 via two holes 26 that are formed in the back member 20. The haptic 14 on the right side of Figure 1C is in fluid communication with the optical fluid box 24 by means of two additional holes also formed in the rear member (not shown) substantially 180 degrees from the holes shown.

[0045] Figure 1D is a plan view of the rear member 20 (the front member 18 and haptics 14 are not shown). Rear member 20 includes support portions 29 in which channels 32 are formed. Channels 32 provide fluid communication between optic 12 and haptics 14. Holes 26 are located at one end of channels 32. Therefore, fluid optic 24 is in communication. through a single haptic fluid via two flow channels. The support portions 29 are arranged to be positioned within holes formed in the haptics 14 which define one end of the haptics' fluid chamber, as described below. Each of the support portions 29 includes two channels formed therein. The first channel in the first support is aligned with the first channel in the second support. The second channel in the first support is aligned with the second channel in the second support.

[0046] There are examples of advantages to having two channels in each support as opposed to one channel. The dual channel design, rather than a single channel, helps maintain dimensional stability during assembly, which can be important when assembling flexible and thin components. In addition, experiments have shown that some single-channel designs may not provide adequate optical quality over the entire accommodation range. In particular, lens astigmatism can occur in some single-channel designs, especially when accommodating an intraocular lens. It has been found that the dual channel support designs described herein can help reduce astigmatism or the likelihood of astigmatism, especially when the lens is accommodating. Astigmatism is reduced in these embodiments because the rigidity of the support is increased by the rib portion between the two channels. The extra rigidity results in less deflection due to pressure changes in the channels. Less deflection due to pressure changes in the channels results in less astigmatism. In some embodiments, the channels have a diameter of from about 0.4 mm to about 0.6 mm. In some embodiments, the channels are 0.5 mm in diameter. In some embodiments, the distance between the holes is from about 0.1 to about 1.0 mm.

[0047] Figure 1E is a sectional side view of the assembly along the line A-A of the optical portion 12, which includes the front element 18 and the rear element 20 (haptics not shown for clarity). By including flow channels 32 in the rear member 20, the rear member 20 must have sufficient structure through which channels 32 can be formed. The support portions 29 provide such structures in which channels 32 can be formed. than the front element 18, in the front-to-back direction. In an alternative embodiment, channels may be formed in front member 18 rather than rear member 20. The front member will include support portions 29 or other similar structures to provide a structure in which channels may be formed. In these alternative embodiments, the rear element may be formed similarly to the front element 18.

[0048] As shown in figure 1E, the rear element 20 is attached to the front element 18 on the peripheral surface 28, which extends along the periphery of the rear element 20 and is a flat surface. The elements 18 and 20 can be bonded together using known biocompatible adhesives. The front element 18 and the back element 20 can also be formed from the same material to eliminate the need to fasten the two elements together. In some embodiments, the diameter of the area where the front element 18 and the back element 20 are attached to each other is from about 5.4 mm to about 6 mm in diameter.

[0049] In some embodiments, the front element 18 is thicker (measured front-to-back) along the optical axis ("OA" in Figure 1C) than at the periphery. In some embodiments, the implementation of the thickness continuously increases from the periphery to the thickest part along the optical axis.

[0050] In some embodiments, the thickness of the rear element 20 decreases from the position along the optical axis to the edge of the central region "CR", indicated in figure 1C. The thickness again increases radially from the central region CR towards the periphery, as can be seen in figure 1C. In some specific embodiments, the central region CR is approximately 3.75 mm in diameter. Holes are formed in the bevelled surface 30.

[0051] In some embodiments, the thickness of the rear element 20 along the optical axis is from about 0.45 mm to about 0.55 mm, and the thickness of the rear element 20 at the periphery is from about 1.0 mm to about 1.3 mm.

[0052] In some embodiments, the thickness of the rear element 20 along the optical axis is from 0.5 mm, and the thickness of the rear element 20 at the periphery is approximately 1.14 mm.

[0053] In some embodiments, the thickness of the front element 18 along the optical axis is from about 0.45 mm to about 0.55 mm, and in some embodiments, from about 0.50 mm to about 0.52 mm. In some embodiments, the thickness of the front member 18 at the periphery is from about 0.15 mm to about 0.4 mm, and in some embodiments, from about 0.19 mm to about 0.38 mm.

[0054] In one particular embodiment, the thickness of the front element 18 along the optical axis is approximately 0.52 mm, and the thickness of the periphery of the front element 18 is approximately 0.38 mm, and the thickness of the rear element 20 along the optical axis is approximately 0.5 mm, and the thickness of the periphery of the rear member 20 is approximately 1.14 mm.

[0055] In one particular embodiment, the thickness of the front element 18 along the optical axis is approximately 0.5 mm, and the thickness of the periphery of the front element 18 is approximately 0.3 mm, and the thickness of the rear element 20 along the optical axis is approximately 0.5 mm, and the thickness of the periphery of the rear member 20 is approximately 1.14 mm.

[0056] In one particular embodiment, the thickness of the front element 18 along the optical axis is approximately 0.51 mm, and the thickness of the periphery of the front element 18 is approximately 0.24 mm, and the thickness of the rear element 20 along the optical axis is approximately 0.5 mm, and the thickness of the periphery of the rear member 20 is approximately 1.14 mm.

[0057] In one particular embodiment, the thickness of the front element 18 along the optical axis is approximately 0.52 mm, and the thickness of the periphery of the front element 18 is approximately 0.19 mm, and the thickness of the rear element 20 along the optical axis is approximately 0.5 mm, and the thickness of the periphery of the rear member 20 is approximately 1.14 mm.

[0058] The optical part is adapted to maintain the optical quality while accommodating. This ensures that when the accommodating IOL transitions between disaccommodated and accommodated configurations, the optical portion maintains optical quality. A number of factors contribute to this advantageous feature of an accommodating IOL. These factors include the peripheral region where the front element 18 is attached to the rear element, the shape profile of the front element 18 and the rear element 20 within the central region CR of the optic (see Figure 1C), and the thickness profiles of the front element 18 and the rear element 20. These contributing factors ensure that both the anterior and posterior elements flex in such a way as to maintain the shape necessary to maintain optical quality in the power range.

[0059] Figure 1F depicts one haptic 14 from the intraocular lens 10 (optical portion 12 and second haptic not shown for clarity). The haptic 14 includes a radially outer part 13 looking in the direction of the bands and a radially inner part 11 which faces the periphery of the optic (not shown). The haptic 14 includes a first end region 17 that is attached to the optical portion 12 and a second end region 19 that is closed. The haptic 14 also includes an opening 15 in the region of the first end 17 which provides fluid communication with the haptic. In this embodiment, opening 15 is sized and arranged to receive support portion 29 of optical portion 12.

[0060] Figure 1G is an enlarged view of opening 15 in haptic 14 which is adapted to receive support portion 29. Opening 15 has curved surfaces 33 and 35 that are shaped to conform to the curved surfaces of optical support 29. Surface 31 surrounds aperture 15 and provides a surface to which a corresponding optical surface can be attached.

[0061] Figure 1H is an enlarged top view of support portion 29 (half section) from rear member 20 located within opening 15 in haptic 14 (front optic not shown for clarity). Channels 32 are shown in half section. The haptic 14 includes a fluid chamber 22 defined by an inner surface 21. Fluid moves between the optical fluid chamber and the haptic fluid chamber 22 through channels 32 as the haptic 14 deforms.

[0062] Figure 2A is a plan view showing one haptics 14 shown in Figures 1A-1H. The optical part and the second haptics are not shown. Four sections A-D through the haptic are shown. Figure 2B is a side view of haptic 14 showing opening 15 and closed end 19. Figure 2C is a side view of haptic 14 showing the radially outer portion 13 and closed end 19.

[0063] Figure 2D is a sectional view along section A-A shown in Figure 2A. Of the four sections shown in Figure 2A, section A-A is the section closest to closed end 19. Radially inward 11 and radially outward 13 are shown. Flow channel 22 defined by surface 21 is also shown. In this section, the radially inner portion 40 is radially thicker (in the "T" direction) than the radially outer portion 42. The inner portion 40 provides front-to-back haptic fluid that more predictably changes the shape of the capsule in the front-to-back direction. The radially inner portion 40 has the largest thickness dimension 41, which is along the axis of symmetry in this section. The outer surface of the haptic 14 has a generally elliptical configuration in which the largest height dimension in the front-to-back ("A-P") direction is greater than the largest thickness dimension (measured in the "T" direction). The flow chamber 22 has a conventional D-shaped configuration in which the radially inner wall 43 is less curved (but not perfectly straight) than the radially outer wall 45. the thick part 40 is located near the optics.

[0064] Figure 2E is a section B-B shown in Figure 2A. Section B-B is essentially the same as section A-A, and figure 2E shows the approximate dimensions for both sections. The radially inner portion 40 has the largest thickness along the centerline of approximately 0.75 mm (in the radial direction "T"). The radially outer portion 42 has a centerline thickness of approximately 0.24 mm. The flow chamber 22 is approximately 0.88 mm thick. The haptic 14 has a midline thickness of approximately 1.87 mm. The height of the haptics in the front-to-back direction is approximately 2.97 mm. The height of the flow chamber is approximately 2.60 mm. In this embodiment, the thickness of the radially inner portion 40 is approximately 3 times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is approximately 2 times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is from about 2 to about 3 thicknesses of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is from about 1 to about 2 times the thickness of the radially outer portion 42.

[0065] The flow chamber 22 is located in the radially outer portion of the haptic 14. Essentially, the entire radially inner region of the haptic 14 in this section is solid material. Since the flow chamber 22 is defined by surfaces 43 and 45 (see Figure 2D), the location and size of the flow chamber 22 depends on the thickness of the radially inner portion 40 and the radially outer portion 42.

[0066] Figure 2F is a C-C section shown in Figure 1A. In section CC, the radially inner portion 40 is not as thick as the radially inner portion 40 in sections A-A and B-B, although in the section CC, the radially inner portion 40 is slightly thicker than the radially outer portion 42. In this in a particular embodiment, the radially inward portion 40 is approximately 0.32 mm in a C-C section. The radially outer portion 42 has a thickness approximately the same as the radially outer thickness in section A-A and B-B, approximately 0.24 mm. The outer surface of the haptics 14 does not have the same configuration as the outer surface in sections A-A and B-B. In section C-C, the radially inner surface of the haptic 51 is more linear than in sections A-A and B-B, making the outer surface of the haptic in section C-C D-shaped. In section C-C, the flow chamber 22 has a D-shape, as in sections A-A and B-B. The haptic in section C-C has a flow chamber configuration that is substantially the same as the flow chamber configurations in sections A-A and B-B, but has a different outer surface configuration than that of the outer surface of the haptic 14 in sections A-A. and V-V.

[0067] The thinner, radially inner portion 40 in section CC also creates access paths 23, which are shown in Figure 1A. This space between the optic 12 and the haptics 14 allows the clinician to insert one or more desiccant and/or suction devices into the space 23 during a procedure and apply suction to remove the viscoelastic fluid that can be used when delivering the intraocular lens to the eye. Pathways 23 may also be anywhere along the length of the haptics, and there may be more than one path 23. This application incorporates by reference the contents of Figures 23 and 24 and their textual description from US Publication No. 2008/0306588, which includes a plurality of pathways in haptics.

[0068] Figure 2G shows a D-D sectional view of Figure 2A. The haptic 14 includes an opening 15 which is adapted to receive supports from the optical portion described herein. The height of opening 15 in this embodiment is approximately 0.92 mm. The width or thickness of the hole is approximately 2.12 mm.

[0069] Figure 3 depicts the relative diameters of an optical portion 12 (not shown) and a peripheral portion that includes two haptics 14 (only one haptic is shown). In this embodiment, the optic has a diameter of approximately 6.1 cm, while the entire accommodating intraocular lens, including the peripheral portion, has a diameter of approximately 9.95 cm. The dimensions provided are not intended to be strictly limiting.

[0070] Figure 4 is a top view of the haptic 14 showing that the haptic 14 is opposed to an angle of approximately 175 degrees around the optic (ie, essentially 180 degrees). The optical part is not shown for clarity. Therefore, each of the two haptics is opposite an angle of approximately 180 degrees around the optic. The first area 61 of the haptic 14 is shown to be at an approximate angle of approximately 118 degrees. This is the radially outermost part of the haptics 14, adapted to be attached to the capsular bag and able to most sensitively respond to changes in the capsular shape. Area 61 can be seen as the most adaptive (responsive) part of haptics 14.

[0071] The angle between cuts A-A and B-B, which are considered to be the boundaries of the more rigid, radially inner portion of the haptics, is approximately 40 degrees. The rigid, radially inner part of the haptic 14 is located directly near the periphery of the optic. The dimensions and angles provided are not intended to be strictly limiting.

[0072] Figures 5A and 5B depict a portion of an accommodating intraocular lens 10 located in the capsular bag ("CB") after the native lens removed from the CB. The front direction is on top and the back direction is on the bottom on each figure. Figure 5A shows an accommodating IOL in a lower power configuration, or disaccommodated with respect to a higher power configuration, or accommodating, as shown in Figure 5B.

[0073] The "CB" elastic capsular bag is attached to the "Z" bands, which are attached to the "CM" ciliary muscles. When the ciliary muscles relax, as shown in Figure 5A, the girdles are stretched. This stretching stretches the capsular bag outward in a radial direction due to radially outward "R" forces due to the generally equatorial junction between the capsular bag and the bands. Stretching of the bands causes an overall lengthening and thinning of the capsular bag. When the native lens is still present in the capsular bag, the native lens becomes flatter (front-to-back) and taller in the radial direction, giving the lens less power. Relaxation of the ciliary muscles, as shown in Figure 5A, provides distance vision. However, when the ciliary muscles contract, as happens when the eye tries to focus on nearby objects, the radially inward part of the muscles shifts radially inward, causing the girdles to weaken. This is shown in Figure 5B. Relaxation of the girdles allows the capsular bag to move to a normally more curved configuration, in which the anterior surface has more curvature than in the disaccommodated configuration, providing greater optical power and allowing the eye to focus on near objects. This is commonly referred to as "accommodation" and the lens is said to be in an "accommodated" configuration.

[0074] In section A-A (which is the same as section B-B) of haptics 14 depicted in Figures 5A and 5B, the radially inward portion 40 includes a thicker bulk material that provides haptics 14 with stiffness in the forward direction. back. When the forces of the capsular bag are applied to the haptic in a front-to-back direction, the interior 40 deforms in a more repeatable and predictable manner due to its stiffness, making the baseline of the lens more predictable. In addition, the haptics, due to its more rigid interior, deform the capsule in a repeatable front-to-back fashion. Also, since the haptic is less flexible along the length of the haptic, the ground state of the accommodating intraocular lens is more predictable, since bending along the length of the haptic is one way in which fluid can move into the optic (and thereby change lens power). An additional advantage realized with a stiffer interior is that the haptics are more rigid to other forces such as twisting and warping due to the extra volume in the interior.

[0075] The radially outer part 42 is the part of the haptics that is directly connected to the part of the capsular bag that is connected to the bands. The outer portion 42 of the haptics is adapted to respond to capsule shape change forces "R" which are applied generally radially as the bands relax and stretch. This allows the haptics to deform in response to ciliary muscle forces (ie capsular contraction and relaxation) so that fluid will flow between the haptic and optic in response to ciliary muscle relaxation and contraction. This is shown in Figure 5B. As the ciliary muscles contract (FIG. 5B), the peripheral region of the elastic capsular sac changes shape and applies radially inward forces "R" to the radially outer portion 42 of the haptics 14. The radially outer portion 42 is capable of deforming in response to this measurement of the capsule's shape. The deformation reduces the volume of the flow channel 22, which directs fluid from the haptic chamber 22 to the optical chamber 24. This increases the pressure of the fluid in the optical chamber 42. The increase in fluid pressure causes the flexible anterior member 18 and the flexible posterior member 20 to deform, increasing curvature and thus increasing the power of the intraocular lens.

[0076] The haptic is adapted to be stiffer in the front-to-back direction than in the radial direction. In this embodiment, the radially outer portion 42 of the haptics 14 is more flexible (ie, less rigid) in the radial direction than the more rigid inner portion 40 in the back and forth direction. Thus, the haptics are less able to deform the lens in response to forces in the front-to-back direction than to forces in the radial direction. It also causes less fluid to move from the haptics to the optic in response to fore-and-aft forces than it does to move into the optic in response to radial forces. The haptic will also deform in a more predictable and repeatable manner due to its stiffer, radially interior.

[0077] Thus, the peripheral part is more sensitive to changes in the shape of the capsular bag in the radial direction than to change in the shape of the capsular bag in the front-to-back direction. Haptics are adapted to deform more radially than in the forward-backward direction. Therefore, the present invention includes a peripheral portion that is less sensitive to capsular forces along the first axis, but more sensitive to forces along the second axis. In the example described above, the peripheral part is less sensitive along the front-to-back axis and more sensitive along the radial axis.

[0078] An exemplary advantage of the peripheral portions described above is that they deform the capsular bag in a repeatable manner and still maintain a high degree of sensitivity to radial forces during accommodation. The peripheral parts described above are stiffer in the front-to-back direction than in the radial direction.

[0079] An additional example of front-to-back capsular forces are capsular forces on the periphery after an accommodating intraocular lens is placed in the capsular bag and after the capsular bag generally undergoes a healing response. The healing response typically causes contraction forces on the haptic in an anterior-posterior direction, shown in Figure 5A as forces "A". These and other forces to change the shape of the capsular bag after implantation, not associated with accommodation, are described in US application No. 12/685531, registered January 11, 2010, which is incorporated here by reference. For example, there is some patient-to-patient variation in the size of the capsular bag, which is also detailed in U.S. Application No. 12/685531 filed Jan. 11, 2010. When an IOL is placed inside the capsular bag, size differences between the capsule and the IOL can cause forces acting on one or more parts of the intraocular lens in the front-to-back direction.

[0080] In this example of forward-backward capsular healing forces, these forces may be able to deform a deformable haptic before accommodation occurs. This deformation changes the volume of the haptic flow chamber, causing fluid to flow between the optical flow chamber and the haptic flow chambers. This may, in some cases undesirably, shift the base power of the lens. For example, fluid may be forced into the optic as the capsule heals, increasing the power of the accommodating IOL and creating a permanent myopic shift for the accommodating IOL. Fluid can also be forced out of the optic into the haptics, reducing the power of the accommodating IOL.

[0081] As used herein, the term "radial" should not be limited to exactly perpendicular to the front-to-back plane, but includes planes that are 45 degrees from the front-to-back plane.

[0082] Exemplary fluids are described in US application No. 12/685531, registered January 11, 2010, and in US application No. 13/003474, registered February 23, 2011, both of which are incorporated here by reference. For example, the fluid may be a silicone oil that is refractive index matched and non-matched with the front and back element polymeric materials. When using a fluid that is matched in refractive index to the bulk material of the optic, the entire optic acts as a single lens whose curvature changes with increasing and decreasing fluid pressure in the optic.

[0083] In the embodiment of Figures 2A-2G above, a haptic is a deformable polymeric material that has a substantially uniform composition across sections A-A, B-B, and C-C. The stiffer, radially inner portion 40 is related to its thickness. In alternative embodiments, the implementation of the radially inner part has a different composition than the outer part, where the material of the radially inner part is more rigid than the material of the radially outer part. In these alternative embodiments, the thickness of the radially inner and outer portions may be the same.

[0084] Figure 6 depicts a haptic 50 that has the same haptic configuration as shown in Figure 2B. The radially outer part 54 is shown. The haptic has an axis "A" at half the height of the haptic, or in other words, the axis A passes through the midpoint of the height of the haptic in the front-to-back direction. The aperture 52, in which the optical support is located, is located on the rear side of axis A. In this embodiment, the optic is slightly closer to the rearmost part of the haptics than the most forward part of the haptics. That is, in this embodiment, the optics are not centered with the haptics in the front-to-back direction.

[0085] Figure 7 depicts an alternative haptic 60 (optics not shown) showing the radially outer portion 64. The haptic 60 includes axis "A" at half the thickness of the haptic, or in other words, axis A passes through the midpoint of the height of the haptic at forward-backward direction. Hole 62 is symmetrical about axis A and the axis through the middle of hole 62 is aligned with axis A. In addition, axis A is the axis of symmetry for haptics 60. Symmetry of haptics along axis A can improve the ability to form components at relatively low loads. Figure 8 shows an embodiment of an intraocular lens 70 in which an optic 72 is attached to two haptics 60, which are the haptics shown in Figure 7. The optic is farther forward than in an embodiment in which the opening is not in the middle of the haptic. In this embodiment, the optics 72 are centered with the haptics in a front-to-back direction. Sections A-A, B-B, and C-C of haptics 60 are the same as shown in the other embodiments shown above, but these haptics may also have any alternative configuration.

[0089] Figure 9 depicts an intraocular lens 80 including an optic 82 and two haptics 84. The optics are the same as the optics described here. Haptics 84 are not as tall in the front-to-back direction as haptics 60, haptics 50, or haptics 14. In exemplary embodiments, haptics 84 are about 2.0 mm to about 3.5 mm high, and in some embodiments they are about 2.8 mm. The IOL 80 can be considered as a "small" size accommodating IOL for patients with a capsular bag that is less than a certain threshold size. The rear surface of the rear element 86 is located a little further in the rear direction than the rearmost parts 90 of the haptics 84.

[0087] Figure 10 depicts an accommodating intraocular lens 98 that includes an optical body 100 and a peripheral non-optical body, which in this embodiment includes haptics 160 and 180. Optical body 100 may be in fluid communication with one or both haptics 160 and 180, and the movement of fluid between the optics and haptics in response to movement of the ciliary muscles can change the optical power of the intraocular lens. This general process of fluid-driven accommodation in response to haptic deformation can be found here. The optics 100 includes a front element 120 attached to a rear element 140 together defining an optical fluid chamber in communication with the haptic fluid chambers 170 and 190 in the haptics. The "height" of the components in this description is measured in front-to-back direction. Optics 100 has the largest height "H1" measured in the front-to-back direction along the optical axis. Haptics 160 and 180 have the largest height dimensions "H2" measured in front-to-back direction parallel to the optical axis. The optical body has a center line B measured perpendicular to the optical axis and passing through the middle H1. Haptics also have central lines B, measured perpendicular to the optical axis and passing through the middle of H2. In this embodiment, the center lines coincide and are the same center line B. In other words, the most anterior surface or point of the anterior element 120 is spaced from the most anterior point or surface of the haptics by the same distance as the most posterior surface or point of the posterior element 140 from the rearmost point or surface of the haptics. They may be considered to be essentially the same lines in some embodiments, even if they are not the same but are spatially close to each other (eg, a few millimeters apart). Optics centered with haptics are also shown in Figure 8.

[0088] In this embodiment, the position of the optics 100 relative to the haptics may provide some advantages. For example, during wrapping and/or insertion, centered (or substantially centered) optics measured in the front-to-back direction can prevent or reduce the likelihood of wrapping one or more haptics over front element 120 or back element 140, which can happen when the optical the body is not essentially centered with respect to the haptics. For example, an optic that is much closer to the back of the lens can increase the likelihood that a haptic (eg, the free end of the haptic) may wrap around the front surface of the optic during deformation, loading, or implantation.

[0089] An additional advantage of having the optic body 100 centered or substantially centered relative to the peripheral body is that the optic is easier to pass through the capsulorhexis when placed in the eye. When the optic is closer to the back of the lens, it may be more difficult to rotate it in the capsular bag.

[0090] An additional advantage is that, compared to optics that are further back, the glare from the intraocular lens is reduced. By moving the optic forward (it will be closer to the iris when implanted), less light can be reflected from the radially outer peripheral edge of the optic (i.e., the edge surface near the haptics), reducing the glare from the edge effect.

[0091] In some embodiments of the intraocular lens of Figure 10, the anterior element 120 may have a height of 0.2 mm to 0.35 mm, such as 0.25 mm to element 140 may have a height of 0.36 mm to 0.50 mm, such as 0.40 mm to 0.45 mm, such as approximately 0.43 mm.

[0092] Before implementation, for example during manufacture, the intraocular lens shown in figure 10 may be filled with fluid. In some embodiments, the intraocular lens has a base state (at zero fluid pressure in the optic; or no fluid within it) of less than 15D, such as 13D. Approximately 13D, as used herein, refers to baselines from about 10D to about 15D. With a base state of 13D, it is usually possible to change the fluid pressure in one direction - higher. When the baseline of the intraocular lens is higher, such as approximately 20D, it may be necessary to change the fluid pressure higher or lower depending on the desired vision correction and the intended use of the intraocular lens. By having a smaller base state, lens state changes become more predictable, as the base state only changes in one direction.

[0093] One aspect of this invention is an accommodative intraocular lens, optionally filled with fluid and driven by fluid, which has an aspherical optical surface after manufacture and before implantation. That is, the intraocular lens is made with an aspherical optical surface. The aspherical optical surface can prevent spherical aberration when the pupil is fully expanded. There may be problems in the manufacture of an intraocular lens, especially an accommodating, fluid driven, intraocular lens with aspherical optical surfaces.

[0094] In some embodiments, an accommodative intraocular lens is made with an aspherical anterior surface and/or an aspherical posterior surface. One example of a method in which a fluid-filled, accommodating intraocular lens can have an anterior or posterior optical surface made aspherical is to create an optical surface with a spherical configuration during manufacture prior to fluid filling, then create asphericity in the optical surface during the process. filling. For example, during manufacture, one or both of the front surface and the back surface may be fabricated with spherical outer optical surfaces. The front surface can then be attached to the back surface. One or more haptics can then be attached to the optic. In some embodiments, the optics are fabricated prior to filling having a base state (at zero fluid pressure in the optic; or no fluid within it) of less than 15D, such as 13D. Approximately 13D here refers to base conditions from about 10D to about 15D. When fluid is injected into an accommodating IOL (eg, through a septum), the fluid filling step can increase fluid pressure in the optic and cause the front surface or back surface of the optic to have an aspherical configuration. Thus, one aspect of the present invention is a method of manufacturing an accommodative intraocular lens, which includes providing an optic with a fluid-filled pre-insertion state that has an asphericity made on one or more optical surfaces, such as an anterior optical surface. This fabrication method may include fabricating an optic in which the optical surface is spherical prior to being filled with fluid.

[0095] It may be desirable to maintain good optical quality in at least one surface of the central portion of the optic when it is deformed by disaccommodation or accommodation. One aspect of the present invention is an optic that has a very controlled and somewhat stable amount of asphericity in the central region of the optic throughout the power range. This may be referred to here as "preferential asphericity" in the central region of the optics. Preferential asphericity includes lens surfaces with surface aberrations that are arranged to compensate for spherical aberrations in the optical system of the eye and help maintain optical quality. Preferential asphericity is maintained in all or essentially the entire range of optical powers during accommodation and disaccommodation. In some cases, the asphericity can be controlled so that the spherical aberration of the entire lens system can remain low (or zero) over the entire power range. The optical region outside the central region may have a larger, more uncontrolled amount of asphericity.

[0096] In some embodiments, the central region of the optic, or region of predominant asphericity, has a diameter of less than 6.5 mm, less than 6.0 mm, less than 5.5 mm, less than 5.0 mm, less than 4. 5 mm, less than 4.0 mm, less than 3.5 mm, or even less than 3.0 mm. In some embodiments, the central region of the optic has a diameter of 3.5 mm to 5.5 mm. In some embodiments, the central region of the predominantly aspheric optic has a diameter less than 90% of the diameter of the optical body, less than 85%, less than 80%, or less than 75%. The optical diameter can be from 4 mm to 8 mm, for example from 5 mm to 7 mm. In some embodiments, the central region is 4 mm to 5 mm and the optical diameter is 5 mm to 7 mm. In some embodiments, the central region is 4.25 mm to 4.75 mm and the optical diameter is 5.75 mm to 6.25 mm.

[0097] The configuration of the anterior element and the posterior element can influence the configurations that are expected when deforming in accommodation or disaccommodation. In some embodiments, one or both of the anterior element and the posterior element are shaped or configured such that the central region of the optic has an advantageous asphericity that is adjustable and beneficial to the entire ocular system. In this embodiment, the front element 120 and, to a lesser extent, the rear element 140 are arranged so that the front surface of the front element 120 and the rear surface of the rear element 140 maintain an adjustable preferential asphericity in the central region of the optic during accommodation. In this embodiment, one aspect of the configuration that contributes to the central region retaining predominantly asphericity is that the front element 120 and possibly the rear element 140 have a thickness (also referred to herein as "height") that is greater at the center (e.g., at the apex of the front element 120) than at the periphery of the front element 120. An additional aspect of the configuration that contributes to preferential asphericity is that the front element is flatter on the inner surface (rear surface) than on the outer surface (front surface). During accommodation, the central region of the front element 120 increases in the center (which increases the strength of the PVGL), but the optical body retains its predominant asphericity due, at least in part, to the relatively thicker central region of the front element. It may also be aspheric to accommodate in exemplary embodiments where the asphericity is made on the front element, as described below.

[0098] The thickness profiles of the front and rear elements can help ensure that the optics retain preferential asphericity under all forces, an example of which is the thickness of the front and rear elements.

[0099] Figure 11 depicts an example of a haptics that may be part of any of the accommodating intraocular lenses here or other suitable IOLs not described here. One or more haptics may be made as shown in Figure 11. The haptic in Figure 11 is labeled "160", but it is understood that the haptic in Figure 11 may be part of other IOLs than those shown in Figure 10. The haptic includes a surface 220, which is attached to the outer edge of the optical body. Surface 220 is the radially inner surface of the haptic and is organized with a slight curvature thereto (along the length of the haptic) that is substantially the same curvature as the outer edge of the optic so that the entire surface 220 interacts with the surface of the outer edge of the optic body. Surface 220 is configured with respect to the optics such that the surface extension does not pass through the optical axis of the optics. An adhesive may be used to attach surface 220 to the surface of the outer edge of the optical body. In this embodiment, the connection between a haptic and an optic body does not involve placing the haptic or optic within a channel, well, or hole in another, as may be the case for some haptic/optic connection designs, as in the embodiment shown in Figures 1A-9. Some examples of the benefits of this type of configuration are described below.

[0100] Figure 12 shows a perspective view of the optics 100 with haptics omitted for clarity. The haptic surface 220 (not shown) is attached to the front element 120 and the rear element 140 of the optical body 100. Most of the surface 220 interacts with the rear part 140, but part of the surface 220 interacts with the front element 120. This is because the outer edge of the optical body is, primarily from rear member 140. In other optic configurations, surface 220 may be attached more to the front member than to the rear member. Note also that the height H3 of surface 220 (see Figure 11) is essentially the same as the height of the outer edge of the optical body.

[0101] Surface 220 of haptics 160 has a first end region 230 (see Figure 11) that has a larger surface area configuration than second end region 250. End region 230 of surface 220 has a larger surface area than end region 250 of surface 220 and includes the at least partially bevelled surfaces B as shown in Figure 13. The width W1 of the end region 230 is greater than the width W2 of the end region 250. This configuration of the end region 230 can provide typical advantages. For example, as part of the process of loading an intraocular lens into a delivery device and/or into a patient's eye, one or both of the haptics 160 and 180 may "invert" relative to the optic. That is, one or both haptics can change configuration from the natural resting configuration shown in Figures 10-14 by moving the free end 170 of the haptics away from the optic body. The extent to which the free end (and most of the haptic) moves away from the optic during distortion can vary. In some loading methods, one or both of the haptics may be substantially distorted such that the haptics is oriented behind or in front of the optic. In some cases, the free end of the haptic (ie, the end of the haptic not directly connected to the optic) is "oriented" substantially 180 degrees from the position where it is in the resting configuration. Typically, the deflection of the haptic causes stresses at the bonding interface between the haptic and the optic. The binding boundary between optic and haptic must be able to withstand these forces so that the haptic does not separate from the optic. When the haptics are distorted, there may be more stress in the optic/haptic junction at the end of boundary 230 that is closer to the free end. The end region 230 is thus the location where the haptic/optical interface is most likely to be damaged. End region 230, with its larger surface area and beveled configuration, acts to distribute applied stresses (or haptic stresses always reorient with respect to the optic) and prevent the haptic from separating from the optic.

[0102] The configuration of surface 220 can be modified in many ways to provide the desired connection between haptics and optics. Connecting haptics and optics in this way (as opposed to having one component nested within the other) thus allows for many more interface configurations, allowing more design flexibility.

[0103] In the embodiment of the haptic in Figure 11, the flow hole 240 is centered along the midline of the haptic. The center line is defined in the same manner as described in Figure 10. The center line passes through the midpoint of the height of the haptic (measured front-to-back) in the side view of the haptic.

[0104] Other aspects of the haptic may be the same as described here, for example, a greater thickness of the radially inner wall along the portion of the haptic, and one or more haptics follow the curvature of the periphery of the optic from the bound end to the free end, and the most anterior aspect of the haptic extends farther forward, than the most forward aspect of the optics.

[0105] The rear member 140 has two flow channels 210 that are in fluid communication with the haptic flow chambers 170 and 190. The outer edge of the rear member 140 includes two openings that define the ends of the flow channels 210. The haptic/optic boundary (which may be an adhesive joint) surrounds the two flow holes in the rear member 140. In some alternatives, the optic has only one flow channel instead of two.

[0106] Figure 13 is another view of the haptics 160 showing the slight curvature of the surface of the optical boundary 220 and the flow hole 240 therein.

[0107] Figure 14 is a rear perspective view of the intraocular lens of Figure 10. Flow channels 210 can be seen in the rear element 140, two of which are associated with each haptic. The boundary between haptics and optics can also be seen. Figure 14 shows section A-A as shown in Figure 10.

[0108] Figure 15 shows an additional view of the intraocular lens of Figure 10, showing gaps 292 between the outer edge of the optic and the haptics, as well as the connection between the optic and the haptics.

[0109] In some embodiments where one or more haptics are bonded to the optical body at separate locations rather than 180 degrees around the optic, the curing step that cures the adhesive that attaches the haptic to the optical body may cause the material to shrink in place. where two components are glued together. This shrinkage in some places can cause distortions in the lens, such as astigmatism. It may be beneficial or necessary to prevent or mitigate these distortions. Figure 16 is an exploded perspective view of an alternative accommodating intraocular lens 300. Figure 17 is a top view of the IOL 300. Figure 18 is a perspective view of portion 301 of the IOL 300. Figure 19 is an A-A sectional view of Figure 17.

[0110] Figures 16-18 depict an exemplary boundary between an exemplary optical body 301 (see Figure 18) and haptics 310, which can help mitigate distortion due to shrinkage where the optical body and haptics are bonded. The boundary between the optical body 301 and the haptics 310 is offset radially outward from the optical body 301 and specifically from the optical surfaces compared to other embodiments, such as in Figures 10-15. By moving the boundary, and potential shrinkage site, away from the optical surfaces, the amount of distortion caused on the optical surfaces by the curing step can be reduced. Each bonding region 311 of the haptics 310 interacts with the optical ridge 303 such that the boundary between the haptics and the ridge 303 is offset radially outward from the optical surface of the optic. This type of interface can be used with non-accommodating and accommodating IOLs, but in this embodiment the lens is an accommodating IOL.

[0111] For example, an accommodating intraocular lens 300 may comprise an optic body 301 (see Figure 18) and haptics 310. In this embodiment, haptics 310 are manufactured separately from optics 310 and then attached to optics 310. Each haptics 310 includes a radially internal flat surface 312 (only one is indicated in Figure 16) that is attached to the radially peripheral surface 306 of optics 310. In this embodiment, surface 312 is the radially inner surface of the binding region 311 of haptics 310. For example, an adhesive can be used to attach surface 312 to the radially peripheral surface 306 of the optics 310. The way the haptics is attached to the optics can affect the optical properties of the optics 70, as discussed above. For example, the adhesive curing process may cause the optics 301 to shrink in two separate locations, possibly resulting in distortion and aberration, such as astigmatism, of the IOL.

[0112] In this embodiment, the intraocular lens includes two protrusions 303 extending radially outward from the peripheral surface 309 of the rear element 304 of the optics 301. The protrusions 303 can be conceived as protrusions from the usual curved periphery of the optic defined by the surface of the outer edge 309. Each haptics 310 can having a first part 311 attached to the protrusion 303 and a free second part 315 located separately from the first part 311, where the radially inner surface of each haptics follows the radially outer peripheral surface of the optic. The protrusion 303 may also be referred to herein as a "landing site" or "landing".

[0113] The protrusions 303 may be raised areas extending from 10 microns to 1 mm, possibly from 10 microns and 500 microns, radially outward from the peripheral surface 309 of the optics. The radially peripheral surface 306 of the projections 303 may be 10 microns to 1 mm, possibly 10 microns to 500 microns, further radially from the center of the optic than the peripheral surface 309 of the optic. For example, the protrusions 303 may be raised areas extending 100 microns to 200 microns radially outward from the peripheral surface 309 of the optic. The radially outer peripheral surface 305 of the projection 303 may be 100 microns to 200 microns farther radially from the center of the optic than the peripheral surface 309 of the optic. Values outside these ranges are also possible. The protrusions 303 can move the bonding surfaces or bonding surfaces away from the optic to prevent damage to the optic due to shrinkage when the adhesive between the optic and the haptics cures.

[0114] In some embodiments, the optic is circular in top view, and the radially outer peripheral edge 309 of the optic is typically circular. When the projections are described here as extending radially outward from the optical body, the projections may extend outward from the usual curve of the radially outer peripheral edge of the optic.

[0115] In some embodiments, the optics and protrusions 303 of the intraocular lens may be a single body. For example, projections 303 may be formed as part of an optic. In some other embodiments, the projections 303 may be attached to the optics, for example with adhesive.

[0116] In some embodiments, the optics 301 includes a rear element and a front element, optionally defining a flow chamber (fluid chamber) to each other, as in the embodiment above. For example, the protrusions 303 may be part of the rear element since the rear element is thicker at the periphery. The protrusions may also be part of the front element. In another example, the protrusions may be part of the rear element and the front element of the optics.

[0117] All of the outer surfaces 306 of the protrusions 303 and the inner surfaces 312 of the haptics 310 may be planar so that they interact in a butt joint. For example, the radially outer circumferential surface 306 of the projections 303 may comprise a flat surface, possibly completely flat. The radially inner surface 312 of the haptics 310 may also comprise a flat surface, possibly completely flat. In another example, the radially outer circumferential surface 306 of the protrusions 303 may comprise a curved surface, possibly completely curved. The radially inner surface 312 of the haptic 310 may also comprise a curved surface, possibly fully curved. The curvature of the radially outer peripheral surface 306 may be the same as the curvature of the peripheral surface 309 of the optical body and in some embodiments may be greater or less than the curvature of the peripheral surface 309 of the optical body.

[0118] Haptics 310 may include a peripheral fluid chamber as described herein. The protrusions 303 may include at least one flow channel 308 and optionally at least two channels in fluid communication with a peripheral fluid chamber in the haptics. The raised protrusions 303 can provide greater stability to the flow channel since there is more optical material at the locations of the protrusions.

[0119] Typically, the protrusion may be located on a non-accommodating (constant power) intraocular lens, which is also made by combining haptics and optics. For example, a constant power intraocular lens, where the intraocular lens is a fluid-free optical body with one power (e.g., PMMA material) and two haptics, may include a protrusion also extending radially outward from the peripheral surface of the optical body.

[0120] The embodiment in Figures 16-19 also depicts an alternative haptics configuration in section (see Figure 19 for section) that can be included in any suitable optic here, such as optic 100 shown in Figure 10. Height H (measured in forward-backward) haptic 310 may be 2 mm - 2.5 mm and may be 2.1 mm - 2.4 mm. This may be less than other haptic heights for other intraocular lenses, such as heights greater than 3mm. It may be advantageous, but not essential, to have haptic heights between 2 and 2.5 mm. There is some variability from patient to patient in the size of gas anatomy. There is variability in the size of the capsule, for example, or in the distance between the capsule and the back of the iris. With some haptics there may be some lapping between the haptic and the back of the iris. And even if there is, it may not cause any problems. Thus, it may be advantageous, only with an excess of caution, to have haptic heights that minimize the chance of such chafing.

[0121] The haptics 310 also include an inner wall portion 313 on the radially inner side of the flow chamber 316 that has a thickness "t _i " that is greater than the wall thickness "t _o " of the haptics on the radially outer side of the chamber 316. In some embodiments, implementation of "t _i " from four to nine times greater than "t _about . Radially inner wall part 313 may be referred to here as the "spacer". As shown in figure 16, the spacer runs along almost the entire length of the haptics, but is absent where there is a between the optic and the haptic.The radially inner wall of the fluid chamber 316, as shown, is flatter than the radially outer wall of the fluid chamber 316. Haptics 310 are examples of haptics that have a section in a plane passing through the optical axis of the optic portion in which the haptic fluid chamber is located in the radially outer portion of the haptic, and where the radially inner portion of the haptic is non-flowing. examples of haptics that, in cross section in a plane passing through the optical axis of the optical part and in a direction perpendicular to the optical axis of the optical part through the midpoint of the haptics, have a thickness of the radially inner wall of the flow chamber, which is from four to 10 thicknesses of the radially outer wall of the fluid chamber . Haptics 310 are examples of haptics that, in cross section in a plane passing through the optical axis of the optic, have an outer surface that is not symmetrical about any axis passing through the peripheral portion and parallel to the optical axis of the optic, where the haptic is in a direction perpendicular to the optical axis of the optic through the midpoint of the haptic, has a thickness of the radially inner wall of the flow chamber greater than the thickness of the radially outer wall of the fluid chamber. Haptics 310 are examples of haptics that, in cross section in a plane passing through the optical axis of the optical portion, have a height measured in the front-to-back direction, where the greatest height of the peripheral portion in the radially outer half of the peripheral portion is greater than the largest height of the peripheral portion in the radially inner half of the peripheral part.

[0122] In some embodiments, one or more aspects of the optical body have a refractive index that is from about 1.48 to 1.55, such as from 1.50 to 1.53. In some embodiments, the refractive index of one or more components is about 1.48, about 1.49, about 1.50, about 1.51, about 1.52, about 1.53, about 1.54, or about 1.55. There may be some mismatch in refractive index between any of the front element, fluid, and back element, but in some embodiments, there is an index match between at least two components and possibly all three. When all components of an optic have the same or substantially the same refractive indices, they are said to be index-matched. Any of the properties of intraocular lenses (eg, refractive index, fluid compositions, monomers) described in U.S. Provisional Application No. 62/173877 filed June 10, 2015 can be performed in any of the intraocular lenses developed here.

[0123] Examples of materials that can be used to make any of the IOLs, including the fluid in it, can be found in PCT/US2016/037055, incorporated herein by reference in its entirety.

[0124] Peripheral parts with any configuration described here can be attached to the optical part using the connecting concepts described here. For example, peripheral portions with the configurations or sections of the configurations shown in Figures 16 and 19 may be attached to the optical portion even if the optical portion does not include a protrusion, such as the optical protrusion 303 shown in Figure 16. For example, the haptics 310 shown in figures 16 and 19 may be attached to the optical part using the connecting concepts and geometries shown in figures 11-15. In such a scenario, the end of the haptic 310 to be attached to the optic typically has a curved inner surface, as shown in Figure 13, such that the curved inner surface of the haptic will abut against the curved outer surface of the optic.

[0125] An intraocular lens can be placed in the eye (possibly in a capsular bag) using known techniques. During a surgical implantation procedure, at least a portion of the IOL may receive out-of-plane forces in an anterior-posterior direction. To help resist these forces and facilitate the planar alignment of the intraocular lens during at least part of the surgical procedure, the IOL may include one or more additional elements that help stabilize the peripheral portion relative to the optic portion in a front-to-back direction.

[0126] In some embodiments, at least a portion of the optic may have a configuration or shape that is complementary to at least a portion of the peripheral portion. This may be an optical peripheral surface that is complementary to at least a portion of the inner surface of the peripheral portion.

[0127] In order to possibly facilitate the achievement of a planar positioning of the IOL during implantation (planar, in this context, with respect to a plane perpendicular to the optical axis of the optical part), the optical part can be adapted to increase the stability of the peripheral part in the axial direction to try to prevent, minimize and/ or reduce the axial movement of the peripheral part relative to the optical part.

[0128] Figure 20 is a sectional view of an optical portion of an exemplary intraocular lens 320 (possibly accommodating) that includes an optic 330. The peripheral portion is omitted for clarity. The optics 330 includes an anterior element 331 and a posterior element 332, and unless otherwise noted, the intraocular lens may (but need not) have the features seen in any of the embodiments in Figures 1A-19. The sectional view shown in Figure 20 is the same sectional view taken along the A-A section shown in Figure 17. One difference between the optics 330 and the optics in Figure 19 is that the optics 330 includes a peripheral surface 333 (in this embodiment, a recess) along at least a portion of its periphery. "Recess" as used in this context generally refers to the surface of an optical periphery that extends radially further inward than the other part of the optical periphery. In this example, peripheral surface 333 includes a region 335 that is radially further inward than optic region 334 and optic region 336. In this example, optic region 334 is anterior to recessed region 335 and optic region 336 is posterior to recessed region 335 Stability can be enhanced by raised regions on both sides of the recess, but it is possible that in some embodiments the optics do not include regions anterior and posterior to the recess that extend radially further outward than the recess, some examples of which are described below. For example, it may be desirable to prevent movement of the peripheral portion in only one direction (eg forward but not rear, or rear but not forward).

[0129] The optical peripheral surface may have a variety of configurations as long as it provides axial stability of the peripheral portion in at least one direction. The configuration of the peripheral surface may also depend on the configuration of the peripheral portion. In some embodiments, the peripheral surface may be generally U-shaped or generally C-shaped (as shown in Figure 20), comb-shaped, and so on. The peripheral surface configuration may include curved and/or flat surfaces. In some embodiments, the optical peripheral surface includes one or more raised ridges that extend radially further outward than the optical periphery region located radially inward relative to the at least one raised ridge.

[0130] It can be conceived that the peripheral surfaces described here capture at least a portion of the peripheral portion and reduce or minimize movement of at least a portion of the peripheral portion in at least a forward or rearward direction.

[0131] Figure 21 depicts the same A-A section of Figure 20, but includes a peripheral portion 340, which in this embodiment includes first and second haptics as in the embodiment in Figure 19. The haptics in Figure 21 may be the same or similar to the haptics in Figure 19. The haptics include a body 341 that includes a portion 343 that extends radially further inward than the optic portion. In this embodiment, the portion of haptic 343 extends radially further inward than optic region 334 and optic region 335, region 334 being anterior to the haptic where the haptic will extend radially further inward than region 334 and region 336 being posterior to the haptic where the haptic extend radially further inward than region 336. In this embodiment, the portion of the haptic that extends within the recess is the radially inner portion of the haptic.

[0132] Figure 22 is an enlarged view of only a portion of the intraocular lens, showing hypothetical dotted line and hatching, a radially inner haptics section 337 that extends radially inward further than the optics sections 334 and 336. It is this portion 337 that is believed to be located radially within the peripheral surface of the optic.

[0133] In the embodiment of Figure 21, only a portion of the haptics (measured along its height in the front-to-back direction) is within the recess of the optic. In this embodiment, the central haptic region is proximate and within the recess, and the haptic regions in front and behind the central haptic region are not considered to be located radially within the recess. In some embodiments, 75% or less (measured along height) of the peripheral portion is within the recess. In some embodiments, 50% or less of the peripheral portion is within the recess, and in some embodiments, 25% or less of the peripheral portion is within the recess.

[0134] In the embodiment of Figure 21, the part of the peripheral part that is inside the optical recess does not extend directly from the optic. This means that this part of the peripheral part is not connected or does not form one whole with the optics in this section. That is, the peripheral part that is inside the recess is separated from the place where the peripheral part extends from the optics (for example, associated with it or integral). This helps to make it clear that this recess, at least in this embodiment, is not at the junction between the peripheral part and the optic, but is separated from the junction. Section A-A in figure 17 (which is the same section as in figures 19-21) is an example of a position that is separated from the place where the peripheral parts extend directly from the optics.

[0135] In this embodiment, the part of the haptic that is radially within the recess is directly adjacent to the optic (but does not extend from the optic at that location) and in some cases may be engaged with the optic or very closely coupled with the optic. In some embodiments, the inner surface of the peripheral portion that is adjacent to the optic is 100 microns or less from the surface of the optic, and may be 50 microns or less from it.

[0136] In an alternative to that shown in Figure 21, the recess may be in the front element only (if the front element is thick), or it may be formed in both the front and rear elements.

[0137] In any of the accommodating intraocular lenses herein, the optics may not include separate anterior elements and thus the recess is not limited to part of the anterior element or the posterior element (or both), but rather is considered part of the optic as a whole regardless of the design of the optic. parts.

[0138] As stated above, the recess may have different configurations and need not be symmetrical about an axis perpendicular to the optical axis of the optic. The recess may serve its purpose as long as it provides some axial stability to at least a portion of the peripheral portion. Therefore, the configuration of the peripheral part can also influence the configuration of the periphery of the optics.

[0139] Figures 23-26 are sectional views of alternative examples of peripheral surface optics that include one or more dimples (these may have the same A-A section shown in Figure 17). The optics in Figures 23-26 show that optics other than those described herein may include one or more recesses, and that the particular design of the optic is not critical. The optics in figures 23-26 are depicted as monolithic structures to depict how a variety of optics can have the recess described here. Also, any of the optics here (including the optics in Figures 23-26) can be used with any of the peripherals here (including any haptics here). Figures 23-26 do not show the peripheral part for clarity.

[0140] Figure 23 depicts an optical portion 350 having first and second recesses 351 and 352, respectively, formed in the peripheral surface. In this embodiment, the recesses have at least one flat surface.

[0141] Figure 24 depicts optics 360 with peripheral surfaces that have dimples 361 and 362. Dimples 361 and 362 have flat surfaces and generally define a trough.

[0142] Figure 25 depicts an optic 370 that includes peripheral surfaces that include recesses 371 and 372. In this embodiment, the recesses are not symmetrical about an axis perpendicular to the optical axis of the optic. In this embodiment, the optic portion 373 will be anterior to the haptic inside the recess, but the optic has no portion rearward to the haptic within the recess. This can be applied if only the forward movement of the peripheral part is considered. Likewise, the orientation of the optic can be reversed so that part 373 is on the back of the haptics inside the recess.

[0143] Figure 26 includes an optic 380 that includes peripheral surfaces that include recesses 381 and 382 that extend along all or substantially all of the periphery of the optic (front-back direction).

[0144] The peripheral surface (eg, recess) may extend (in plan view as in Figure 17) around any part of the periphery of the optic or around the entire periphery of the optic. The peripheral surface may in fact also extend around the area where the peripheral is attached to the optics, but usually not.

[0145] In some embodiments, and with reference to Figure 17, the optic includes a peripheral surface (eg, recess) where at least a portion of the peripheral surface of the interior is directly adjacent to the optic. For example, with reference to Figure 17, a dimple may be present in the optic everywhere around the periphery except at the junction and in gap regions 292. In this embodiment, this is the case where haptics are directly adjacent to the optic, and whose position can be stabilized due to their close proximity. proximity to the optics (which may actually touch the optics). The indentation can, of course, extend further than just these areas. For example, an indentation may extend near gaps 292 even if an indentation in this area does not directly stabilize part of the haptics. For example, it may be easier to make the recesses longer than necessary.

[0146] In embodiments where the recess does not extend around the entire optic, there may be multiple recesses separated by a region of the optic that does not include the recess. There may be any number of individual recesses as desired.

[0147] There may be peripheral portions that are more annular than peripheral portions, and which may actually completely surround the optic. The depressions in these embodiments may extend around a significant portion of the optic.

[0148] In any of the embodiments herein, the peripheral portion may alternatively have any of the recesses herein in the radially inner surface, and the peripheral surface of the optic may be shaped (e.g., extending radially outward) at least a portion of which is complementary to the recess of the peripheral portion. All other aspects of the present invention may apply to these alternative embodiments.

[0149] Any of the recesses here may be created during the manufacture of one or more components of the intraocular lens, for example during machining or molding of one or more parts.

[0150] Any of the other methods of introducing at least one recess can be introduced in any of the other embodiments here.

[0151] In some embodiments, the surface is described here as a recess, but it is understood that the recess is only an exemplary peripheral surface (if part of an optic) and an exemplary, radially inner surface (if part of a peripheral portion), and is not intended to be limiting.

[0152] Embodiments in all figures 20-26 are examples of the outer periphery of the optical part, which has a peripheral surface that is at least partially complementary in shape, at least part of the radially inner part of the peripheral part of the VL, in which the optical surface directly adjacent to the radial interior, and in which the optical surface does not extend directly (is not attached and integral) from the radial interior, where they are immediately adjacent.

[0153] Embodiments in all figures 20-26 are examples of an intraocular lens in which the outer periphery of the optical portion has a peripheral surface, and the radially inner portion of the peripheral portion of the IOL has a radially inner surface, where the peripheral surface is directly adjacent to this inner surface, and where the peripheral surface does not extend directly (does not connect or form a single unit) from the inner surface, and where the peripheral surface and the inner surface are organized so that the peripheral part is stabilized in at least one direction, and possibly in both, from the proximal and distal directions relative to the optical part.

Claims (31)

1. A fluid-filled intraocular lens (IOL) comprising: an optical part containing an optical fluid chamber; and a peripheral part containing at least one peripheral fluid chamber in fluid communication with the optical fluid chamber, in which the outer periphery of the optical part has a peripheral surface, in which the radially inner part of the peripheral part of the intraocular lens has an inner surface, wherein said peripheral surface is in close proximity to said inner surface, and wherein said peripheral surface does not extend directly from said inner surface, and wherein said peripheral surface and said inner surface are made so that the peripheral part and the optical part are stabilized relative to each other in at least one of the proximal and distal directions, where the said peripheral surface is in close proximity to the said inner surface. 2. An intraocular lens according to claim 1, wherein the peripheral surface comprises a recess and wherein at least a portion of the inner surface is in said recess. 3. An intraocular lens according to claim 2, wherein the inner surface, which is located in said recess, is located axially between the most anterior location of the optic portion and the most posterior location of the optic portion. 4. The intraocular lens of claim 1, wherein said inner surface, in plan view of the intraocular lens, is spaced from and around the outer periphery of the optic portion from a location where the peripheral portion extends from the optic portion. 5. An intraocular lens according to claim 1, wherein said inner surface is located between the location where the peripheral part extends from the optical part and the free and closed distal end of the peripheral part. 6. The intraocular lens of claim. 1, in which the inner surface of the peripheral part physically interlocks with the optical part or is in close proximity to the optical part and is not physically attached directly to the optical part, where they are physically interlocked or located in close proximity. 7. The intraocular lens according to claim 2, wherein the midpoint of the peripheral part, measured in the front-to-back direction, is the part of the inner surface that is in the recess of the optical part. 8. An intraocular lens according to claim. 2, in which the specified recess is symmetrical about an axis perpendicular to the optical axis of the optical part. 9. An intraocular lens according to claim 2, in which the inner surface of the peripheral part, located in the recess, is symmetrical about an axis perpendicular to the optical axis of the optical part. 10. An intraocular lens as claimed in claim 2, wherein said recess is located axially in a front-to-back direction between an anteriormost location of the optic portion and a most posterior location of the optic portion. 11. The intraocular lens of claim 2, wherein the inner surface, which is in the recess, has a height in the front-to-back direction that is less than the largest dimension of the height of the peripheral part. 12. The intraocular lens of claim. 1, in which the peripheral part is attached to the optical part at one or more attachment points, and where the peripheral part extends around the outer periphery of the optical part. 13. The intraocular lens of claim. 1, in which the peripheral part contains at least the first haptic, the first haptic is attached to the optical part at the point of attachment, where the first haptic extends partially around the outer periphery of the optical part, where the free end of the first haptic is not attached directly to the optic part and where the radially inner part is the inner part of the first haptics. 14. The intraocular lens of claim 13, wherein the peripheral portion comprises a second haptic, wherein the second haptic is attached to the optic portion at a second attachment site, where the second haptic extends partially around the outer periphery of the optic portion, and where the second free end of the second haptic is not attached directly to optical part. 15. An intraocular lens according to claim 2, wherein said recess extends around the entire outer periphery of the optical portion. 16. The intraocular lens of claim 2, wherein said recess does not extend to where the peripheral portion extends from the optical portion. 17. The intraocular lens of claim. 2, wherein the optical portion includes separate recesses spaced around the outer periphery of the optical portion. 18. The intraocular lens of claim. 2, wherein said inner surface is located in the recess of the optical portion in the configuration of the resting state of the intraocular lens. 19. The intraocular lens of claim. 2, wherein said intraocular lens is configured such that the inside of the peripheral portion is in the recess of the optical portion after the intraocular lens is placed in the eye, and where the inner portion of the peripheral portion is not in the recess of the optical portion in the configuration resting state of the intraocular lens. 20. A fluid-filled intraocular lens, comprising: an optical part containing an optical fluid chamber; and a peripheral part containing at least one peripheral fluid chamber in fluid communication with the optical fluid chamber, in which the outer periphery of the optical part has a peripheral surface that is complementary in shape to at least part of the radially inner part of the peripheral part of the intraocular lens, where the specified peripheral surface is in close proximity with the radially internal part and where a given peripheral surface does not extend directly from the radially inward portion where they are in close proximity.

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