WO1983001567A1

WO1983001567A1 - Anterior chamber lens

Info

Publication number: WO1983001567A1
Application number: PCT/US1982/001531
Authority: WO
Inventors: Corporation Surgidev; Larry G. Leiske; Myron E. Lippman
Original assignee: Surgidev Corp
Priority date: 1981-10-28
Filing date: 1982-10-28
Publication date: 1983-05-11
Also published as: EP0091959A1; AU1016683A; DE3249156T1

Abstract

Anterior chamber lens (10) including a lens optic (12) and two flexible opposing loops (14) (16) secured into a side edge of the optic (12). Each loop (14) (16) is substantially U-shaped and each opposing arm (24) (26) (48) (50) of the loop (14) (16) includes a slight ramp (34) (42) (62) (64) providing a vault for the lens with respect to each base member (28) (52) of each loop (14) (16). The lens (10) and loop (14) (16) are constructed from a single monomer or monofilament material, polymethylmethacrylate (PMMA), providing for stability, low mass, and flexibility. The loops (14) (16) are flexible in three degrees of freedom, particularly end-to-end. The lens (10) can be utilized in both primary and secondary implantations with either intracapsular or extracapsular cataract extractions.

Description

^{•""" "" "~ ~'} ANTERIOR CHAMBER LEWS... -

1 CROSS REFERENCES TO CO-PENDING APPLICATIONS

None.

BACKGROUND OF THE INVENTION

1. Field of the Invention — The present inven- 5 tion relates to an opthalmology implant, and, more importantly, pertains to an anterior chamber lens for primary or secondary implantation.

2. Description of the Prior Art — Prior art anterior chamber lenses have suffered from numerous

10 deficiencies. Some prior art lenses were constructed from types of materials that caused significant implan material reactions in the eye. Other prior art lenses provided large amounts of material in construction of the implant. Also, the prior art lenses did not 15 always have smooth surfaces which resulted in post¬ operative reaction.

Most importantly, the prior art lenses failed to provide flexibility in the supporting structure, thereby leading to post-operative tenderness. ²⁰ Other types of prior art lenses are manufactured from two types of material where the lens optics are manufactured from a first type of material and the supporting structure which takes many geometrical variations are manufactured from a second type of 25 material. This type of lens has lead to post¬ operative reactions. In some instances, the materials have been found to disolve in the body after implant.

Some prior art lenses are manufactured by machin¬ ing, hot pressing, or pantographing yielding a less 30 than flexible lense. Also, the edges of the lens are not smooth.

Finally, some types of lenses are lathe cut from types of material which provide for uneven surfaces and edges causing post-operative reactions. 3 The present invention overcomes the disadvantages of the prior art by providing a smooth, flexible, one-material anterior chamber lens. SUMMARY OF THE INVENTION

The general purpose of the present invention is an anterior chamber lens for any type of cataract extraction, and is also excellent for secondary or exchange implantation. The lens is flexible and soft to the human touch.

According to one embodiment of the present inven¬ tion, there is provided an anterior chamber lens including an optic having a planar surface, a slightly rounded edge, and a convex surface, two opposing

U-shaped flexible loops of the same material as the lens optic and having a slightly greater length in each arm that at a base, the opposing arms of each loop substantially parallel and including a ramp of a slight angle, each end of each loop frictionally and mechanically engaged into each hole positioned into the side of the lens whereby the lens is utilized in both primary and secondary implantations with either intracapsular or extracapsular cataract extractions and the lens support is flexible in three dimensions and to the touch. The optic and loops of the lens are manufactured from polymethylmethacrylate (PMMA).

An additional significant aspect and feature is a substantially 84% less optic supporting area available for iris touch than some of the prior art anterior chamber lenses.

One significant aspect and feature of the anter¬ ior chamber lens of the present invention is a lens having smooth surfaces thus eliminating post-operative reaction.

Another significant aspect and feature of the anterior chamber intraocular lens of the present invention is a lens constructed and made entirely of polymethylmethacrylate, providing for flexibility with adequate strength and rigidity. The PMMA is pure material, a single low monomer material which has a long proven history of intraocular use. During manu¬ facturing, the material provides that internal stress forces in the loops can be eliminated, thereby eliminat ing warpage. .^"" s^!-5-<∑- *\

C..1PΪ A further significant aspect and feature of the anterior chamber intraocular lens of the present invention is a lens of PMMA material which is low mass. One of the most significant aspects and features of the present invention is the flexibility of the loops of the lens. The loops are flexible in all directions including side-to-side, end-to-end, up-and- down, and in three dimensions. The flexible loops are twistable as well as compressible. The loops show a finite ease of flexibility. The loops exhibit physiologic flex. As the eye blinks, the loops flex. If the eye is compressed, the loops flex. On examina¬ tion of the eye by a surgeon or examining physican, the loops exhibit flex. The flexibility of the loops is such that the lens is inserted by a surgeon in one motion through a limbal as there is no torguing about the axis of the lens. The loops provide three-dimen¬ sional flexibility about the lens optic. Having thus described the invention, it is a principal object hereof to provide an anterior cham¬ ber lens, the lens denoted in the medical profession as the "Leiske Physioflex Style 10 Anterior Chamber Intraocular Lens." It is a principal object hereof to provide an anterior chamber lens which is lightweight, flexible, and manufactured of one material. The optic and loops can be an integral member.

Objects of the present invention include an an- terior chamber lens which has no significant post¬ operative tenderness. There is also a need for only a single iridectomy because of the design; a single peripheral iridectomy inside the loop is adequate. The anterior chamber lens also provides for easier insertion in that proper technique provides for the insertion of both angles of the superior loop in one motion. There is also excellent dilability of the pupil in that there is no interference with pupil dilation thereby making retinal inspection and surgi¬ cal procedures easier. The lens is excellent for primary or secondary implantation, and provides for either an intracapsular or extracapsular cataract extraction.

An additional object of the present invention is a low-mass, low-weight lens made of one material, PMMA. The material provides a low mass in aqueous thereby reducing the possibility of reaction and inter- nal stress due to eye movement or sudden movement.

The material also provides extreme smoothness on all surfaces thereby eliminating chance of abrasion or irritation secondary to iris movement should contact occur. The PMMA provides a uniform material and longevity for least reaction. More importantly, though, the material provides for desirable flexibility but adequate rigidity assuring that there is no danger of endothelial touch. The lens is designed with adequate vault, providing for no significant contact with the iris.

Further objects of the present invention include an anterior chamber lens which provides implant con¬ siderations of importance to the surgeon as well as to the patient. Those considerations include greatly diminished post-operative globel tenderness, less hyphema associated with accidental or diagnosed trauma such as scleral depression, optic supporting surface area available for iris touch substantially 84% less than with prior art lenses, no acutely angled feet to pass through iridectomy and inadvertently engage ciliary body, less likelihood of Descemet's membrane stripping caused by catching acutely angled feet, greatly reduced possibility of segmental iris block, no large lens feet capable of occluding iridectomy or irridotomy, no torquing around axis of lens while inserting the superior loop, 6mm lens optic to insure complete optical covering of the pupil, the lens nearly precluding possibility of uveitis, glaucoma or hyphema because of design and method manufacture, a lens with shape which diminishes iris tucking or iri tearing, and a lens which is less likely to engage vitreous humor because of lack of acutely angled feet. Finally, the PMMA lens does not activate complement.

Additionally, the PMMA loops and optic provide a smoot edge eliminating any finishing problems which existed in the prior art. The monofilament loops provide smoothness and no finishing is required. BRIEF DESCRIPTION OF THE DRAWINGS

Other objects of the present invention and many of the attendant advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings, in which like reference numer¬ als designate like parts throughout the figures thereof and wherein:

FIG. 1 illustrates a top view of an anterior chamber lens., the present invention;

FIG. 2 illustrates a side view of the lens of FIG. 1;

FIG. 3 illustrates a section taken along line 3-3 of FIG. 1; and, FIG. 4 illustrates a side view of the lens im¬ planted in an eye.

DESCRIPTION OF PREFERRED EMBODIMENTS FIG. 1, which illustrates a top view of an anterior chamber lens 10, the present invention, shows the lens optic 12, a first U-shaped flexible loop 14 and a second U-shaped flexible loop 16 where both of th loops 14 and 16 are diametrically opposed to each other at opposite sides of the lens optic 12. The lens optic 12 includes a planar surface 18, a thin side edge of finite width 20, and a convex surface 22,

^•as also illustrated in FIG. 2. The lens optic 12 and the loops 14 and 16 are manufactured of a material known as polymethylmethacrylate (PMMA). The diameter of the lens optic 12 is a range of 4-7mm and can have varying dioptric powers substantially in the range of 9-30.

The lens 10 is provided with two PMMA loops 14 and 16. The first loop 14 is now described in detail with the second loop 16 being identical to loop 14. The loop 14 is a substantially U-shaped member having two opposing arms 24 and 26 connected by a base 28, with rounded corners 30 and 32. The loops are substantially 0.25mm in diameter in a range of 0.08-0.50m_r_ and are canted including a like ramp in each arm referenced in FIG. 2. The ramp of arm 26 is best illustrated in FIG. 2 where the ramp sec¬ tion 34 connected between a lower section 27 and an end section 36, sections 27 and 36 being in^* substan¬ tially the same parallel plane and connected by the ramp member 34. The end 36 mechanically and friction- ally engages into a hole 38 in the edge 20 of the lens 10. Likewise, the opposing arm 24 is provided with a ramp 42 between lower section 40 and an end 44 which engages into a hole 46 in the lens 10 in a like man¬ ner. The holes 38 and 46 are provided and drilled into the side 20 of the lens 10. Accordingly, arms 24 and 26 are identical as illustrated in FIG. 1 and referenced in FIG. 2. The loop 14 has a preferred circular geometrical cross-section of a cylinder, but any other geometrical cross-section could be utilized such as an ovoid or ribbon. Also, the base could be somewhat flattened or exhibit a flat portion while the arms are of a predetermined cross-section as discussed. The loops could also exhibit other types of geometrical members such as a "W", a "J" having one arm longer than the other, or any other predeter¬ mined geometrical cross-section. While a closed loop has been illustrated, the loop can be open. 7

Likewise, the loop 16 is provided with arms 48 and 50, and base member 52 where the arms 48 and 50 connect to the base member 52 by rounded corners 54 and 56. Each of the arms of the loop 16 includes a lower section 58 and 60, ramps 62 and 64, and ends 66 and 68 mechanically and frictionally engage into holes 70 and 72 as previously described. All ends are subsequently heat staked into the holes.

By way of example and for purposes of illustra- tion only and not to be construed as limiting of the present invention, the distance between the arms of each of the loops 14 and 16 is preferably in a range of 2-10mm. The distance between the arms 48 and 50 is likewise 2-10mm. The diameter of the lens 10 is referenced between the opposing rounded corners such as 32 and 54, and the lens is manufactured from 10.5mm to 14.0mm with -12.5mm being the most common implant size. Diametrical length of the lenses is manufac¬ tured in 0.5mm increments from 10.5 to 14.0mm, although the lenses can be manufactured to any incre¬ ment as determined by a surgeon.

FIG. 2 illustrates a side view of the lens of FIG. 1 where all numerals correspond to those elements previously set forth. Particular notation is made of the vaulted distance between the planar surface 18 of the lens 10 and the lower edge of the members 26 and 58 which is preferably in a range of 0.05-0.7mm, by way of example and for purposes of illustration only, and not to be construed as limiting of the present invention.

FIG. 3 illustrates a section taken along line 3-3 of FIG. 1 and shows the arms 24 and 60 into and through the side 20 of lens optic 12. All other numerals correspond to those elements previously described.

PREFERRED MODE OF OPERATION—SURGICAL TECHNIQUE The following is one insertion process for the lens 10 in an eye 74. For pupillary dilation prior to surgery, 1%

Cyclogyl and 10% Neό-Synephrine are utilized and frequently include 1/4% Isoptohyoscine for extra- capsular procedures to adequately maintain pupillary dilation during phacoemulsification.

The surgical procedure currently suggested and utilized includes a bridle suture through the superior rectus, and a fornix-based flap. If the horizontal corneal diameter from nine to three o'clock (measuring from the white of the li bus on one side to the white of the limbus on the other side) has not been pre¬ viously calculated, the diameter should now be measured or if previously measured, the diameter may now be re-checked. A partial penetrating incision is now made at the limbus with a No. 57 Beaver blade. The incision should be of sufficient size to allow an intracapsular extrac¬ tion with care taken with the incision site. If the incision site is too much on the corneal side of the limbus, corneal endothelium may strip easily during surgical maneuvers, or if the incision is too far on the scleral side of the limbus, problems are encoun¬ tered with the iris and bleeding is more likely if such occurs. Two 8-0 absorbable sutures are now pre-placed at ten and two o'clock. The anterior chamber is now entered with a superblade or bladebreaker, and the incision completed with right and left curved corneal scissors with the outer blade sliding under the pre- placed sutures to avoid cutting the sutures. An 8-0 silk suture can be placed through the corneal side of the incision at twelve o'clock to be used as a traction suture by a surgical assistant to lift the cornea at the time of delivery of the cataract. This suture is later removed.

Chrymotrypsin is generally instilled under the iris to aid zonulysis after the formation of a peri¬ pheral iridectomy at twelve o'clock. The iridectomy does not need to be in the extreme periphery, and a round or oval shape is preferable. The cataract is delivered using a cryophake after the anterior chamber has been gently flushed with balanced salt solution to wash out the loose zonular material. If this has been a planned extracapsular extraction, a small central discission of the posterior capsule prior to air insertion and lens implant insertion is done thereby assuring excellent visibility for this pro- cedure. Miochol is now instilled in the anterior chamber to constrict the pupil prior to lens implant insertion. Prior to implant insertion, air should also be inserted in the anterior chamber to prevent contact of the endothelium with the implant. The eye is now ready for intraocular lens inser¬ tion. The size of the lens 10 to be inserted in a given eye is similar to other types of anterior chamber lenses; namely, one millimeter larger on the diagonal measurement of the implant than the horizontal diameter of the cornea at its widest point, measuring from the white of the limbus to the white on the opposite side. An 11.5mm limbal measurement would therefore corre¬ spond to a 12.5mm lens implant.

Ultrasonic axial length determinations and corneal kerato eter readings are used to determine implant spherical power. Dioptric implant power calculations are substantially and appear to be nearly the same as for other styles of anterior chamber lenses.

Following removal of the lens 10 from a sterile package, the lens 10 should be inspected under the microscope or surgical loop prior to wetting with balanced salt solution. The loops should be rectangu¬ lar and not skewed to the right or the left. One arm of the loop should not be longer than the other. The two loops should be gently grasped with two smooth pickups and slightly wiggled to show they are intact. The diagonal diameter can also be checked at this time with a millimeter ruler or Stahl measuring device. If there is any question, the implant should be flushed with balanced salt solution and reinspected, which will almost always show the implant to be intact. The lens body and loops should be clear. The most difficult part for the beginning implant surgeon is holding the lens. Almost any type of smooth pickup can be used with success. A small, angled, smooth pickup is favored. Lens holders for other anterior chamber lenses can also be used but those with serrated jaws should be avoided and appli¬ cation of too much pressure on the loop should also be avoided, as this will score the material, introducing roughness at that point and defeating one of the features of the lens. Also, extreme pressure could conceivably crack the loop although this is unlikely. The implant lens 10 is handled like any other fine optical device, not because it is fragile, which it is not, but to avoid damaging the optical and smooth qualities of the lens. This applies to all implants. Also, touching the lens with a gloved finger or laying the implant temporarily on a surface which may contain lint can cause traces of powder or lint to be picked up by the lens and carried into the eye, causing post¬ operative inflammation for which the lens implant or the manufacturer would be blamed. The implant should be flushed with balanced salt solution just prior to insertion.

Insertion of anterior chamber lenses is easier with a miotic pupil. If the pupil is not small follow- ing cataract extraction, Miochol is used to constrict it. An iridectomy can be performed before or after cataract extraction and lens implantation, generally using one iridectomy inside the superior loop.

Also, if the chamber is not deep, air in the anterior chamber will make insertion of the inferior loop easier and also protect the endothelium from touching the lens. If one has difficulty maintaining the anterior chamber during insertion, the A-C is temporarily overdistended with air and the excess removed if necessary just prior to the insertion of the superior loop.

The lens 10 is held with a smooth pickup in the middle of the superior loop and the lens 10 slid in horizontally with minimal separation of the incision, thereby maintaining the air in the anterior chamber and protecting the endothelium. A traction suture through the corneal side of the incision at twelve o'clock aids in this maneuver. Slight traction on this suture will slightly separate the lips of the incision and the lens can be slid in without losing chamber.

Once the inferior loop is past the inferior pupil¬ lary border, the grip on the superior loop with the smooth pickup can be released completely and the implant advanced into the anterior chamber by tapping the superior loop gently with the edge of the smooth pick¬ up. At this point, if there is too much air in the anterior chamber, the inferior loop will rest on the iris below the inferior angle ^"recess. Because of the lightness of the lens 10, removing excess air with a 30-gauge cannula at this point will cause the inferior loop and iris to rise. This should be done until the inferior loop is level with the inferior angle recess. This is an important procedural point, and following this procedure will insure that the inferior loop will not be inserted posteriorly to the angle recess when the superior loop is inserted.

The iris at this point sometimes seems to stick to the under surface of the lens, and grasping the superior loop with two smooth pickups (one in each hand) and rocking the inferior loop back and forth several times like the pendulum of a clock will break the iris free and insure that the iris is not carried into the- angle recess or tucked. Because of the slight flexibility of the loops,

' the entire superior loop can be inserted in one motion. This also avoids dislocating a portion of the inferior loop. The scleral side of the incision is grasped with a toothed pickup and the superior loop in the middle with a smooth pickup. Pulling the sclera towards one's self, with one motion the surgeon pushes the entire loop slightly inferiorly and then posteriorly into the angle recess, always pulling the scleral side of the wound toward one's self rather than shoving the lens inferiorly too vigorously as this can cause an angle tear and recession just as with other anterior chamber style lenses. This is an important point.

At this stage with the anterior chamber adequately formed, the pupil should be central and round. If the pupil is oval superior-inferiorly, it may mean the implant is too large. If the pupil is irregular, it may point to an iris tuck which usually does not occur with the lens 10. The lens 10 can easily be repositione at this point. Irregular pupils may however be due to the use of dilating drops., paresis of the sphincter from stretching the iris in removing a cataract through a small pupil, or localized blood in the anterior cham¬ ber. The corneal side of the incision should be lifted slightly to inspect the superior loop to make sure the entire loop has been inserted past the scleral edge of the incision and is in the angle recess.

The implant should be snug but not too tight. Usin a 30-gauge cannula and nudging the superior loop side- ways, it should move easily but not be loose. This maneuver can also be used to position the lens centrally, with the great majority of implants used 12.5mm. in size. If a choice is to be made, the surgeon should lean toward a less snug fit than one too tight. Also, the limbal measurement does not always conform to the formula given for the size of the implant. Again, the transition zone at the limbus may be indistinct or wider than usual, and these variations should be taken into account and allowances made at the time of su ge-εy.. At this point, the peripheral iridectomy should be between the two vertical arms of the superior loop. The 8-0 absorbable sutures are now tied. The wound is further closed with crossing "X" type mattress sutures using 10-0 Nylon and additional 8-0 absorbable inter¬ rupted sutures. However, a closure should be done which is comfortable for the surgeon and results in a snug wound. A tighter closure will result in minus cylinder at 180°, which is much more desirable than minus cylinder at 90°, indicating a too-loose closure. In addition, minus cylinder at 180° tends to decrease with time, and the Nylon sutures may be cut to aid in this process. Minus cylinder at 90° tends to increase for a period of time following surgery, which is also undesirable. The depth of the sutures also appears to affect the changes in cylinder. Deeply placed sutures may allow no change in cylinder from that noted in the first several post-operative visits, while conversely, shallow suture placement will allow a gradual shift of astigmatic minus cylinder from 180° toward 90° for a period of time following surgery. Ideally, of course, no astigmatic cylinder at all is the goal. At present, it is preferable to conclude with about -2.00 diopters of cylinder at 180° at the conclusion of surgery.

Miochol is now used to deepen the anterior cham¬ ber and further constrict the pupil. The conjunctival flap is secured at the limbus with thermal cautery. A 1/2 cc. of Celestone may be placed subconjunctivally in the inferior cul-de-sac to reduce inflammatory reaction. Neosporin ophthalmic drops are generally flushed about the globe prior to the start of surgery, and again at the conclusion of surgery. A patch and shield are placed until the day following surgery. A shield only is worn at night during sleep for about three weeks. Post-operative medication consists of Maxitrol drops, one/two drops three times daily. Later, Steroid drops only may be used if post-operative inflammation persists. Older patients are generally discharged from the hospital on the second post-operative day, but dis¬ charge the day following surgery is not unusual. An operative procedure at a surgi-center with discharge home or to an extended care facility may also be gen¬ erally acceptable. No restriction is placed on general activities, but vigorous activity and heavy lifting should be avoided for a period of time following surgery. Extracapsular cases are done using either the

Kelman Phacoemulsification Unit or by simple expression and removal of the cortex by hand-operated irrigating and suction tips.

The lens is manufactured by known processes and can be a multiplicity of cylindrical loops or ribbons produced concurrently or assembled for the loops or like structures of predetermined geometrical configura¬ tions in lieu of the loops. Optic and loop structure can be manufactured from a single piece of material such as PMMA or the like.

Various modifications can be made to the present invention without departing from the apparent scope thereof. Other two- or multi-structure configurations are within the scope of the invention, especially two-loop configurations. Other geometrical configura¬ tions are within the scope and teachings of this patent, especially where the lens is composed of a second material while the loops are composed of PMMA.

The lens can take other geometrical configurations such as aspheric, convex-convex, or convex-concave, and the disclosure is not solely limited to the plano¬ convex configuration. The lens could be made of material .other than PMMA.

Finally, while the flexible loops are illustrated as closed loops, other loop structures are within the teachings and scope of the present invention. The two flexible loops can be a continuous single loop or can be more than two loops. Each of the loops can be a single monofilament strand of PMMA having one end attached to the optic and assuming a predetermined geometrical shape such as an open loop having one free end, a "W" configura- tion, a "J" configuration, an "S" configuration, or any other predetermined geometrical configuration in lieu of the closed loop U-shaped configuration as illustrated.

The loops, also disclosed as strands and ribbons, can be produced simultaneously with the lens of assembled individually to the lens.

While the loops have been illustrated in a closed configuration, the end of the loop could be open or in the alternative, the base of the loop could be open with the arms of the loops being either straight or in a preformed geometrical configuration.

It is important that whatever configuration the loops take, the loops can be provided with a ramp to vault the lens away from the iris as desired. Having just described the invention, what is claimed is:

Claims

CLAIMS 16

1. Anterior chamber lens comprising: a. lens including a flat, planar surface, finite thickness, and a rounded convex surface having a predetermined dioptric; and, b. plurality of flexible loops of a pre¬ determined geometrical shape, ends of said loops secured into said thickness of said lens, said lens and said loops composed of like material.

2. Anterior chamber lens comprising: a. lens including a substantially flat planar surface and a substantially opposing convex surface; and, b. two opposing flexible loops, said opposing loops being ramped, and ends of said loops positioned into opposing sides of said lens, whereby said ramp runs from substantially mid portion of said loops to said intersection of said loops with said lens thereby vaulting the lens away from the iris of the eye.

3. Lens of claim 2 wherein said lens and said loops are of the same material.

4. Lens of claim 2 wherein said material is poly¬ methylmethacrylate.

5. Lens of claim 2 wherein each of said loops is substantially U-shaped.

6. Lens of claim 5 wherein each of said loops has a cylindrical cross-section.

7. Lens of claim 6 wherein said diameter of said cross-section is in a range of 0.08-0.50mm.

8. Lens of claim 5 wherein each of said loops is flexible.

9. Lens of claim 5 wherein said optic is in a range of 4-7mm.

10. Lens of claim 5 wherein said U-shaped member comprises substantially parallel arms and a connecting base, distance between said arms in a range of 2-lOmm.

11. Lens of claim 5 wherein said diameter between opposing corners of said U-shaped loops is in a range of 10.5-14.0mm.

12. Lens of claim 2 wherein said loops are sub¬ stantially rectangular, with rounded corners.

13. Lens of claim 2 wherein said ramp provides a vault in a range of 0.05-0.7mm.

14. Lens of claim 2 wherein iris touch of said loops is minimal.

15. Anterior optic chamber lens comprising: a. lens including a substantially flat planar surface and a substantially opposing convex surface, said lens optic formed of polymethylmethacrylat (PMMA) ; b. two opposing ramped U-shaped loops, each of said loops formed of a smooth round cylindrical member and each of said loops substantially rectangu¬ lar with rounded corners, each of said loops made of PMMA, ends of said loops secured into opposing sides of said lens optic whereby said loops provide three dimensional flexibility in both primary and secondary implantations with either intracapsular or extra- capsular cataract extractions.

16. Anterior chamber intraocular lens, said lens comprising: a. lens including a substantially flat planar surface, an opposing substantially convex surface, and a finite thickness portion disposed between said planar and said convex surfaces, said lens being made of polymethylmethacrylate material, and having a dioptric power in the range of 9 to 30; and, b. two opposing ramped flexible U-shaped loops, said loops of polymethylmethacrylate, said ramps extending from a mid portion of each of said loops to said lens, each of said loops secured into holes into thickness portion of said lens, said holes substantially parallel to said planar surface of said U-shaped loop whereby said lens if flexible, lightweight and com¬ posed of one material.

17. Anterior chamber lens comprising: a. lens including an optic of polymethyl¬ methacrylate (PMMA); and, b. at least one monofilament flexible strand of PMMA of a predetermined geometrical shape, one end of each of said strands secured into said optic.