Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
  • A61F2/1616—Pseudo-accommodative, e.g. multifocal or enabling monovision
  • A61F2/1618—Multifocal lenses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
  • A61F2/1616—Pseudo-accommodative, e.g. multifocal or enabling monovision
  • A61F2/1621—Pseudo-accommodative, e.g. multifocal or enabling monovision enabling correction for monovision
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
  • A61F2/1648—Multipart lenses
• • G—PHYSICS
  • G02—OPTICS
  • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
  • G02C7/00—Optical parts
  • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
• • G—PHYSICS
  • G02—OPTICS
  • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
  • G02C7/00—Optical parts
  • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
  • G02C7/022—Ophthalmic lenses having special refractive features achieved by special materials or material structures
• • G—PHYSICS
  • G02—OPTICS
  • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
  • G02C7/00—Optical parts
  • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
  • G02C7/06—Lenses; Lens systems ; Methods of designing lenses bifocal; multifocal ; progressive

Definitions

• the present invention relates to an assembly consisting of a pair of multifocal ocular implants.
• the choice of the implant can be made according to the lifestyle of the patient and his expectations. We generally favor distance vision (for example in a driving situation) and near vision (for example in a reading situation of a book). But with the ever-increasing use of computers, tablets and smartphones, we also seek to privilege the intermediate vision (illustrated in particular by a situation in which we consult a screen).
• An implant with multifocal optical surfaces can be characterized by its TFMTF curve (Anglo-Saxon acronym for “Modulation Transfer Function Through Focus” which can be translated as “modulation transfer function depending on the distance of vision ").
• optical simulation software such as the Zemax software (registered trademark) of the company of the same name for intraocular implants placed in a medium eye model.
• TFMTF curve is established for a given spatial frequency.
• TFMTFs at 25 cycles / mm coarser objects
• 100cycles / mm fuse objects
• a TFMTF curve at 50cycles / mm (for example) of a given optical profile depends on the pupil of the optical system and the wavelength of the light used.
• TFMTF can be interesting for pupils from 2 to 6 mm in diameter.
• TFMTF greater than or equal to 0.15 is considered to provide a satisfactory close vision to the wearer, whereas a value of TFMTF greater than or equal to 0.30 is considered to provide the wearer with a satisfactory distance vision.
• the near vision "VP” is typically + 3D (in addition corneal plane), but can be between + 2D and + 4D.
• the intermediate vision "VI” is typically + 1.5D (in addition corneal plane) but can be between +1 D and + 2D.
• TFMTF curves of an implant placed in an eye can give information on the optical quality of the implant, the physical quantity that reflects the good vision of the wearer is its visual acuity.
• Visual acuity depends on the TFMTF of the implant, but also other parameters such as the contrast sensitivity of the wearer. In binocular vision, visual acuity also depends on the neuronal treatment of the patient who combines information from both eyes.
• the AV curve has a shape that follows that of the TFMTF curve, but with a wider envelope.
• visual acuity of nearly 8/10 on one eye and 8/10 on the other eye can give a binocular visual acuity of 10/10).
• FIG. 1 This is illustrated in the appended FIG. 1, in which are represented in solid lines the superimposed TFMTF curves of two identical + 3D addition implants, for a pupil 3 mm in diameter and at a wavelength of 546 nm ( on the abscissa: addition expressed in Dioptres / on the ordinate TFMTF at 50 cycles / mm), whereas the estimation of the TFMTF curve in binocular vision is shown in broken lines.
• the limit of this practice is that the gap between the two peaks peaks VI (intermediate vision) and VP (near vision) must be limited to be well tolerated by the wearer. This difference is usually 0.5D or 0.75D (for additions around 2.5D), because the overlap area between the two curves in near vision is low.
• the present invention aims at overcoming these difficulties, by proposing multifocal implants which, when worn together, make it possible to only to the wearer to have a good vision from a distance, but also to benefit from a continuous depth of field in binocular vision between the intermediate vision and the near vision.
• the present invention relates to an assembly consisting of a pair of multifocal ocular implants, characterized in that:
• each implant of this pair has a TFMTF curve ("Modulation Transfer Function Through Focus"), for a pupil of diameter less than or equal to 4 mm, preferably less than or equal to 3 mm, which has a peak corresponding to the distant vision of the wearer, as well as an asymmetric peak which spreads between the intermediate vision and the near vision, ie without discontinuity between the intermediate vision and near vision;
• TFMTF curve Modulation Transfer Function Through Focus
• the value of TFMTF is greater in intermediate vision than that of near vision
• the value of TFMTF is greater in near vision than that of the intermediate vision
• the ascending flank of the asymmetrical peak of the first implant has, in absolute value, an average slope greater than that of its descending blank
• the ascending flank of the asymmetric peak of the second implant has, in absolute value, a mean slope less than that of his flank descending.
• average slope is meant, throughout the present description and claims, the slope of the dummy line which passes through the highest point and the lowest point of the corresponding blank.
• the principle of the present invention is to combine in two eyes of a presbyopic patient (whether emmetropic or ametropic) two ocular implants (implants of crystalline sac, anterior chamber or intra-corneal sac) with multifocal optical surfaces ( refractive or preferentially diffractive) giving different modulation transfer function curves as a function of viewing distance (TFMTF) called "complementary".
• the wearer of such implants is given a continuous depth of field in binocular vision between the vision intermediate and near vision, which results in a visual acuity greater than 5/10 on this whole area.
• the crossing of said asymmetrical peaks corresponds to a TFMTF value of at least 0.10;
• the crossing of said asymmetrical peaks corresponds to a value of TFMTF of at least 0.15;
• the peak of each asymmetric peak has a TFMTF value of at least 0.15;
• the respective values of TFMTF at the vertices of the peaks corresponding to the distance vision have a difference of less than 30%.
• FIG. 4 is a representation, on the same and only diagram, of the TFMTF curves of two implants constituting an assembly according to the invention, for a pupil 3 mm in diameter and at a wavelength of 546 nm (in abscissa : addition expressed in Dioptres / ordinate TFMTF at 50 cycles / mm);
• FIG. 5 is a view identical to the previous one on which the estimation of the TFMTF curve in binocular vision is additionally carried;
• FIG. 6 is a TFMTF curve in binocular vision of implants belonging to the prior art.
• the present invention follows from the fact that the advantage of having the combination of two so-called “complementary" TFMTFs is to make it possible to better merge the vision of the two eyes of the wearer of the implants, while allowing a larger gap between the two peaks of VI (intermediate vision) and VP (near vision) with the previous devices mentioned above which apply the "Mix and Match" principle.
• the respective TFMTF curves of each of the two implants are referenced A and B and correspond for example to the dominant eye, respectively the dominated eye of the wearer (or vice versa).
• each curve A and B has a peak
• the respective values of TFMTF at the peaks of peaks A / VL and B / VL have a difference of less than 20% and preferably less than 10%.
• the two curves A and B have an "asymmetric widened peak" A / PE, respectively B / PE (compared to a conventional multifocal) which spreads between the intermediate vision VI and the near vision VP.
• a / PE compared to a conventional multifocal
• the value of TFMTF is greater in intermediate vision VI than that of near vision VP.
• the value of TFMTF is higher in near vision VP than that of the intermediate vision VI.
• the ascending flank FA of the asymmetric peak A / PE of the first implant has, in absolute value, a mean slope greater than that of its falling flank FD, while the ascending flank FA of the asymmetric peak B / PE of the second implant presents , in absolute value, a lower average slope than that of its downward flank FD.
• the two curves A and B of TFMTF intersect at a threshold greater than or equal to 0.15.
• the carrier of the pair of implants of the assembly according to the invention has a TFMTF greater than 0.15 over a much wider range of distance or depth of field (EDOF), typically from 1 D to 2.5 D (which corresponds to a viewing distance of 40 cm to 1 m).
• EEOF distance or depth of field
• M & M Mat and Match systems of the state of the art offer respectively a clear vision of 40 cm to 66 cm -see 75 cm- respectively in M & M + 2.5D / + 3D and M & M + 2.25D / + 3D.
• the combination of two so-called “complementary" TFMTFs also brings a more interesting binocular vision than that of a trifocal implant having a peak in far vision VL, a peak in intermediate vision VI, and a peak in near vision VP , with cancellations of the TFMTF between each of these peaks, which results in a lack of continuous vision between the near vision VP and the intermediate vision VI.
• the PC depth of field of the binocular TFMTF allows a continuity between its near vision and intermediate without sharpness falling between them, as it appears on the dashed line curve of Figure 5.
• the wearer may be bothered by the halo created by the peak of the near vision VP.
• distance vision is associated with two halos corresponding to the peaks of near vision and intermediate vision.
• the height of these two peaks being lower, the effect of these halos is less troublesome for the wearer than with a conventional bifocal implant.
• the wearer better supports several weaker halos rather than a strong and well defined halo.
• the use of two "complementary" implants according to the invention makes it possible to create a continuous or diffuse halo which is less awkward in far vision conditions and particularly in night driving.
• these implants can be placed on the eyes of a patient through an injector. And when this implementation is performed in the crystalline sac, they are introduced in the folded position through a small slot provided for this purpose.
• the present description has been made in relation to intraocular implants, the present invention also applies to intra-corneal implants and "piggybacks", that is to say implants placed in front of the crystalline sac.

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• Health & Medical Sciences (AREA)
• Ophthalmology & Optometry (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Vascular Medicine (AREA)
• Veterinary Medicine (AREA)
• Cardiology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Transplantation (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Animal Behavior & Ethology (AREA)
• Life Sciences & Earth Sciences (AREA)
• Physics & Mathematics (AREA)
• General Physics & Mathematics (AREA)
• Optics & Photonics (AREA)
• Prostheses (AREA)
• Eyeglasses (AREA)
• Diffracting Gratings Or Hologram Optical Elements (AREA)

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• 2017
  • 2017-10-05 FR FR1759329A patent/FR3072020B1/fr active Active
• 2018
  • 2018-10-01 ES ES18774079T patent/ES2881187T3/es active Active
  • 2018-10-01 JP JP2020540674A patent/JP7090168B2/ja active Active
  • 2018-10-01 AU AU2018344837A patent/AU2018344837B2/en active Active
  • 2018-10-01 WO PCT/EP2018/076656 patent/WO2019068645A1/fr not_active Ceased
  • 2018-10-01 PL PL18774079T patent/PL3691571T3/pl unknown
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