WO2023045989A1 - Progressive multifocal ophthalmic lens - Google Patents

Abstract

A progressive multifocal ophthalmic lens and a method for providing a lens to a subject. The addition power of the progressive multifocal ophthalmic lens is not associated with a progressive multifocal path, thereby providing a greater degree of freedom of optometry and fitting to a doctor, and further providing the subject with the ophthalmic lens that more satisfies the characteristics and requirements thereof.

Description

A kind of progressive multifocal ophthalmic lens technical field

The present disclosure relates to the technical field of ophthalmic lenses, and more specifically, to a high-dimensional progressive multifocal ophthalmic lens.

Background technique

Myopia is a common vision problem. Traditional glasses are a standard tool for myopia correction. However, in terms of myopia control, wearing ordinary glasses can increase myopia rapidly every year. It has been proposed that the progression of myopic refractive error can be controlled by positioning the focal point in front of the retina, that is, through lens design so that the curved surface formed by the imaging point - the Petzval plane - is tangent to the retina in the macular area and lies in the paracentral area of the retina. Inner side, forming peripheral myopic defocus.

In the process of myopia prevention and control, in order to achieve peripheral myopia defocus, multi-focal lenses need to be used. Some multi-focal designs in the prior art adopt ring-shaped refractive multi-focal technology or diffractive multi-focal technology. Such a technical solution will cause sudden changes in optical power or surface morphology of the lens, causing scattering or diffraction in the sudden change area. However, scattering may cause diffuse light to irradiate the macular area, resulting in halos, spots, and reduced contrast sensitivity. Diffraction multi-focus usually only uses the first few levels of diffracted light, and part of the light energy cannot be transmitted to the retina, causing energy loss. The decrease in utilization, performance is also a decrease in contrast sensitivity. The continuous multi-focus design can avoid these problems.

In the prior art, the progressive multifocal lens usually uses a standard conic curve to describe the shape of the curved surface, and uses the e value to control it. But in this way, the addition power and the gradient multi-focus path are coupled together. For example, when the two ends of the focal power curve are determined, such as 0mm=-0.25D, 2.75mm=-3D, there is only one way of gradual multi-focus, or in other words, the addition power and the gradual multi-focus path are coupled together.

When controlling myopia, doctors may need to adjust the intensity of myopia defocus and imaging quality according to the progress speed of the patient. The degree of freedom provided by the coupled addition power and the gradual multi-focus path is small, which cannot fully meet the needs of doctors.

Contents of the invention

The present invention provides a progressive addition ophthalmic lens comprising in its optic zone a progressive addition zone having an optical center and a radius r _B , wherein, in the optic zone, the distance The optical power P(r) at the optical center r mm is:

Wherein, A is the additional optical power, L is the gradient coefficient, P _C is the optical center optical power, and wherein

When the sign in front of A is positive, P _C = prescription optical power P ₀ ;

When the sign in front of A is negative, P _C =P ₀ +A.

In some embodiments, A is selected from +0.25D to +10.00D.

In some embodiments, L is selected from 0.1-10.

In some embodiments, when r>r _B , P(r)=P(r _B ).

In some embodiments, the optical center does not coincide with the geometric center of the lens.

In some embodiments, the optical center is located 0.1-1 mm nasally from the geometric center.

In some embodiments, the gradient multi-focal area includes 2 or more fan-shaped divisions sharing a central vertex, wherein each fan-shaped division has the same A value and _PC value, and wherein at least one fan-shaped division has a different L value.

In some embodiments, the progressive multi-focus area includes 4 sector-shaped partitions.

In some embodiments, the lens is provided with a structure for increasing the rotational stability of the lens.

In some embodiments, the lens is a contact lens, scleral lens, spectacle lens, intraocular lens, or corneal inlay.

In some embodiments, the lenses are used to prevent and/or slow the progression of myopia.

The present invention thus also provides a method for providing an ophthalmic lens to a subject, preferably a subject who is myopic or belongs to a myopia-prone population. The ophthalmic lens includes in its optic zone a progressive addition zone having an optical center and a radius r _B , the method comprising:

(1) Select the value of the added optical power A and the gradient coefficient L for at least one eye of the subject;

(2) Determining the power curve of the ophthalmic lens for the at least one eye according to formula (I):

Wherein P(r) is the optical power at r mm from the optical center, A is the additional optical power, L is the gradient coefficient, P _C is the optical power of the optical center, and wherein

When the sign in front of A is positive, P _C = prescription optical power P ₀ ;

When the sign in front of A is negative, P _C =P ₀ +A.

In some embodiments, the selection in step (1) is based on: the subject's age, the ratio of the subject's near vision time to distance vision time, and the myopia progression of the at least one eye Velocity, retinal topography, residual accommodation, or any combination thereof.

In some embodiments, the method of the present invention further comprises dividing the progressive multifocal zone of the ophthalmic lens into 2 or more according to the retinal topography or refractive topography of the at least one eye of the subject. A plurality of fan-shaped partitions sharing a central vertex, wherein each fan-shaped partition has the same A value and _PC value, and at least one of the fan-shaped partitions has a different L value.

Description of drawings

Fig. 1 shows the optical power curve when the sign in front of A is positive and negative according to an embodiment of the present invention, where r _B =2.75mm, L=0.5, P ₀ =-3D, A=0.75D ;

Fig. 2 shows the optical power curves under different L values according to an embodiment of the present invention, wherein the sign in front of A is positive, r _B =2.75mm, P ₀ =-3D, A=0.75D;

Fig. 3 shows the optical power curves under different A values according to an embodiment of the present invention, wherein the sign in front of A is positive, r _B =2.75mm, P ₀ =-3D, L=0.5;

Figures 4A to 4C are the optical simulation software OpticStudio Zemax, when CD contact lenses with different A and L values are placed on the surface of the model eye Liou&Brenna, the different spherical power curves (Figure 4A) and field curvature (Figure 4A) are calculated. 4B) and MTF curves (Fig. 4C);

Figures 5A to 5C are the different spherical power curves (Figure 5A) and field curvature (Figure 5A) calculated by the optical simulation software OpticStudio Zemax when CN contact lenses with different A and L values are placed on the surface of the model eye Liou&Brenna 5B) and MTF curves (Fig. 5C).

Detailed ways

Exemplary embodiments of the present invention will be described below with reference to the accompanying drawings. Unless defined otherwise, all technical and/or scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs.

The invention provides a progressive multifocal ophthalmic lens. The ophthalmic lens can be a progressive multi-focal lens for preventing the occurrence of myopia and controlling the progression of myopia, or a progressive multi-focus lens for presbyopia and hyperopia. The lens includes in its optic zone a progressive addition zone having an optical center and a radius r _B , wherein, in the optic zone, the optical power P at a distance r mm from the optical center (r) is:

Wherein, A is the additional optical power, L is the gradient coefficient, P _C is the optical center optical power, and wherein

When the sign in front of A is positive, _PC = prescription power P ₀ ; that is, the power at the optical center of the lens is the prescription power. At this time, the lens is basically CD (center- for-distance) lenses (see the solid line in Figure 1).

When the sign in front of A is negative, P _C =P ₀ +A, the focal power of the optical center of the lens has additional refractive power, and at this time, the lens is basically a CN (center-for-near) lens (see dotted line in Figure 1).

The present invention decouples the addition power from the progressive multi-focal path, so that doctors can adjust the prescription of the lens according to the patient's condition (such as the degree of myopia, the degree of tolerance, the speed of myopia progression, etc.), and can also adjust the prescription according to the patient's retinal topography/refraction. Optical topography (some patients will have local deformation of the retina, such as patients with posterior staphyloma) to adjust the lens, giving doctors more freedom in fitting, thus providing subjects with ophthalmic lenses that better meet their characteristics and needs. lens.

In the method of the present invention, L describes the progressive multi-focus path, when the sign in front of A is positive, it is a concave curve when L>1, it is a convex curve when L<1, and it is a straight line when L=1 (Figure 2). L can be any value selected from 0.1 to 10, such as 0.1, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9 , 9.5, 10. The greater the difference between L and 1, the greater the change rate of the focal power in some areas (when L>1, it is the peripheral area; when L<1, it is the central area), that is, the local focal power curve will be more steep. Steeper power curves result in sudden, large changes in power, which can result in more scattered light, reducing image quality. Thus, preferably, L is any value selected from 0.5 to 2, such as 0.6, 0.7, 0.8, 0.9, 1, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9 or 2.

In all cases of the invention, the optical add power A itself is positive. According to different application scenarios, the additional optical power A can be any value selected from +0.25D to +10.00D, preferably +0.50D to +9.00D, +0.75D to +8.00D, +1.00D to +7.00D , +1.25D to +6.00D, +1.50D to +5.00D, or +2.00D to +4.00D, such as +0.25D, +0.50D, +0.75D, +1.00D, +1.25D, +1.50D , +1.75D, +2.00D, +2.25D, +2.50D, +2.75D, +3.00D, +3.25D, +3.50D, +3.75D, +4.00D, +4.25D, +4.50D, + 4.75D, +5.00D, +5.25D, +5.50D, +5.75D, +6.00D, +6.25D, +6.50D, +6.75D, +7.00D, +7.25D, +7.50D, +7.75D , +8.00D, +8.25D, +8.50D, +8.75D, +9.00D, +9.25D, +9.50D, +9.75D, or +10.00D. The larger the value of A is, the larger the focal power variation range of the progressive multi-focal zone is (see FIG. 3 ).

In the case of preventing the occurrence of myopia and controlling the progression of myopia, the A value is preferably +1.00D to +5.00D, more preferably +2.00D to +4.00D.

Research on simulated eyes found that for different A and L combinations, different myopia control effects and visual quality can be produced.

的光焦度，加入相应的光学曲面对相应的隐形眼，进行模拟。 Specifically, as described by Liou et al. (Hwey-Lan Liou and Noel A. Brennan, "Anatomically accurate, finite model eye for optical modeling," J. Opt. Soc. Am. A 14, 1684-1695 (1997)) , build the Liou&Brennan model eye in Optic Studio Zemax, and follow the

The focal power of the corresponding contact eye is simulated by adding the corresponding optical surface.

The focal power changes under different combinations of A and L were obtained by calculation (Figure 4A and Figure 5A), where the abscissa represents the distance from the center of the lens, and the ordinate represents the spherical power. As shown in Figures 4A and 5A, the larger A is, the higher the addition power is; the larger L is, the smoother the power change is. Field curvature (Fig. 4B and Fig. 5B) and MTF curves (Fig. 4C and Fig. 5C) under different combinations of A and L were also obtained by calculation. Among them, the extent to which the curvature of field moves in the negative direction is the degree of myopia defocus. The low-frequency part of MTF reflects the transfer of object outlines; the intermediate frequency part reflects the transfer of optical object layers; the high-frequency part reflects the transfer of object details. The results shown in the figure are summarized in Table 1.

Table 1 Effects of A and L on myopia defocus and visual quality in different lens designs

It can be seen that A and L have different effects in central distance lenses and central near vision lenses. In the case of myopia prevention and control, doctors can choose different combinations of A and L according to the patient's myopia progression speed, adjustment lag and other factors, so as to provide stronger myopia control or better vision. Sensitivity to adjust lens formulation parameters.

In the area outside the progressive multi-focal area, ie when r>r _B , the optical power is preferably constant, ie P(r)=P(r _B ). In some embodiments, the entire optical zone of the lens is a progressive addition zone, that is, r _B is equal to the optical zone radius of the lens. r _B can be any value selected between 0.5 and 3.5 mm, such as 0.6, 0.7, 0.8, 0.9, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2 , 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4mm. Those skilled in the art may need to select the appropriate size of the progressive multi-focal area, but for the prevention and control of myopia, r _B is preferably in the range of 2.5 to 3.5 mm, so as to provide the desired myopia defocus effect in more areas on the retina.

In some embodiments of the present invention, the optical center of the progressive multi-focal area does not coincide with the geometric center of the lens, because the visual axis of the human eye does not coincide with the optical axis, and there is an included angle, namely the Kappa angle . Therefore, the doctor can select the optical center position of the lens according to the Kappa angle of the patient, for example, the optical center is 0.1-1 mm from the nasal side of the geometric center, such as 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9 mm, preferably 0.5mm.

The lens design of the present invention also allows the progressive multifocal area to be divided into 2 or more (for example, 3, 4, 5, 6, 7, 8) fan-shaped partitions that share a central vertex, wherein each fan-shaped partition has the same The A value and _PC value of , and at least one of the fan-shaped partitions has a different L value. Existing literature shows that on both sides of the fovea, the shape of the nasal side and the temporal side of the human retina is not completely symmetrical. Therefore, axisymmetric contact lenses or frame glasses may produce different myopic defocus on the nasal and temporal sides of the retina, resulting in an asymmetric emmetropization process on both sides of the retina, which may result in partial axial growth. The method of the invention enables the doctor to adjust according to the fundus conditions of different subjects, so that the power curve of the lens is different in different regions. For example, the lens can be divided into four subregions: upper, lower, nasal side, and temporal side, and the gradual change path of each subregion can be different, that is, L is different. It is preferably divided into 2 to 4 partitions.

Doctors can change the gradient coefficients of each division according to the subject's retinal topography or refractive topography, and choose the combination of A and L according to the patient's myopia progression.

After the focal power curve is determined, conventional methods in the field are used, for example, calculating the sagittal heights of the front and rear surfaces of the lens from the focal power curve, and then handing it over to a CNC machine tool for processing to prepare the desired lens.

The progressive multifocal ophthalmic lens of the present invention is selected from contact lenses, scleral lenses, spectacle lenses, intraocular lenses or corneal inlays, and is provided with structures for increasing the rotational stability of the lens if necessary. Because in the case of an asymmetric optical zone of the lens, it must be effectively maintained at a specific orientation. Especially in the case of contact lenses, they tend to rotate on the eye due to the force the eyelid exerts on the contact lens during blinking and the movement of the eyelid and tear film. Maintaining the orientation of the contact lens on the eye is usually achieved by altering the mechanical properties of the contact lens. Known methods include: prismatic weighting (including eccentricity or inclination of the anterior contact lens surface relative to the posterior surface), thickening of the lower contact lens perimeter, forming depressions or protrusions on the contact lens surface, and truncating the contact lens edge, among others.

The present invention also provides a method for providing an ophthalmic lens to a subject, particularly a myopic patient or a myopic-prone population, said ophthalmic lens comprising a progressive multifocal zone in its optical zone, said progressive multifocal zone With optical center and radius r _B , the method includes:

(1) Select the value of the added optical power A and the gradient coefficient L for at least one eye of the subject;

(2) Determining the power curve of the ophthalmic lens for the at least one eye according to formula (I):

Wherein P(r) is the optical power at r mm from the optical center, A is the additional optical power, L is the gradient coefficient, P _C is the optical power of the optical center, and wherein

When the sign in front of A is positive, P _C = prescription optical power P ₀ ;

When the sign in front of A is negative, P _C =P ₀ +A.

Wherein the selection in step (1) is based on: the age of the subject, the ratio of the subject's near vision time and distance vision time, the myopia progression rate of the at least one eye, the retinal topography , residual accommodation, or any combination thereof.

As an example, for a myopic patient A, since he usually writes homework at a position of 33cm, then the initial A value can be selected as 100cm/33cm=3D (that is, A=1/visual distance), and the doctor/optometrist then here The value is adjusted according to factors such as patient tolerance and adjustment lag. For presbyopia patients, A=1/near vision-patient's remaining accommodation power, therefore, the add power A is determined by the patient's remaining accommodation power. The greater the remaining adjustment power, the smaller the number of additions required. For example, a presbyopic patient B usually uses a mobile phone at a position of 33cm and has a 1D adjustment power, so the initial A value can be selected as 100cm/33cm-1D=2D, and the doctor/optometrist then adjusts the value around this value according to the patient's tolerance. Adjust according to the degree of acceptance.

L can be determined according to the proportion of near vision and distance vision in the subject's daily life. For example, if L=2 is taken as the starting point, for the center vision design, the larger L is, the stronger the myopia control effect is, therefore, L is positively related to the near vision time/far vision time. When the near vision time is extended, L increases, providing strong control. You can first select L=2*near vision time/distance vision time, and then adjust it according to the patient's tolerance. For the central distance vision design, the smaller L is, the stronger the myopia control effect is, therefore, L is positively related to distance vision time/near vision time. When the near vision time is extended, L decreases, providing strong control. You can first select L=2*distance vision time/near vision time, and then adjust it according to the patient's tolerance.

For myopia patients, when the myopia progression rate is greater than the average annual progression rate of patients of the same age, strong control is selected, or for young subjects (such as 8-12 years old), because their myopia progression rate is usually faster, Strong control can also be adopted; when the progression rate of myopia is approximately equal to the average annual progression rate of patients of the same age, moderate control is selected; when the progression rate of myopia is lower than the average annual progression rate of patients of the same age, weak control is selected. If the growth rate of myopia increases after wearing weak control lenses for a period of time, such as 1 month, then return to strong control lenses.

Examples of parameter selection for different control strengths are shown in Table 2. It should be understood that these are just examples, and the doctor will use various parameters in combination according to the experience of use and the actual situation of the patient, so as to achieve individualized treatment.

Table 2 Exemplary parameter selection

Those skilled in the art will appreciate that the invention described herein is susceptible to variations and modifications other than those specifically described. The present invention is not limited to the specific constructions described and shown herein, but includes all such changes and modifications that fall within its spirit and scope. Those skilled in the art can make any combination of any two or more of the features, structures or parts presented individually or jointly in this specification without departing from the spirit and scope of the present invention.

Claims (11)

A progressive addition ophthalmic lens comprising in its optic zone a progressive addition zone having an optical center and a radius r _B , wherein, in the optic zone, a distance from the optical center The optical power P(r) at r mm is:

Wherein, A is the additional optical power, L is the gradient coefficient, P _C is the optical center optical power, and wherein When the sign in front of A is positive, P _C = prescription optical power P ₀ ; When the sign in front of A is negative, P _C =P ₀ +A. The progressive multifocal ophthalmic lens according to claim 1, wherein A is selected from +0.25D to +10.00D; and/or L is selected from 0.1 to 10. The progressive multi-focus ophthalmic lens according to claim 1 or 2, characterized in that, when r>r _B , P(r)=P(r _B ). The progressive multifocal ophthalmic lens according to any one of claims 1 to 3, wherein the optical center does not coincide with the geometric center of the lens. The progressive multifocal ophthalmic lens according to claim 4, wherein the optical center is located 0.1-1 mm from the nasal side of the geometric center. The progressive multi-focal ophthalmic lens according to any one of the preceding claims, wherein the progressive multi-focal area comprises 2 or more, for example 4, fan-shaped partitions sharing a central apex, wherein each fan-shaped partition has The same A value and _PC value, and at least one of the fan-shaped partitions has a different L value. The progressive multifocal ophthalmic lens according to any one of the preceding claims, wherein the lens is provided with a structure for increasing the rotational stability of the lens. Progressive multifocal ophthalmic lens according to any one of the preceding claims, characterized in that said lens is a contact lens, a scleral lens, a spectacle lens, an intraocular lens or a corneal inlay. A method for providing an ophthalmic lens to a subject, particularly a myopic patient or a myopically predisposed population, the ophthalmic lens comprising a progressive multifocal zone in its optic zone, the progressive multifocal zone having an optical center and a radius r _B , the method comprises: (1) Select the value of the added optical power A and the gradient coefficient L for at least one eye of the subject; (2) Determining the power curve of the ophthalmic lens for the at least one eye according to formula (I):

Wherein P(r) is the optical power at r mm from the optical center, A is the additional optical power, L is the gradient coefficient, P _C is the optical power at the optical center, and wherein When the sign in front of A is positive, P _C = prescription optical power P ₀ ; When the sign in front of A is negative, P _C =P ₀ +A. The method according to claim 9, wherein the selection in step (1) is based on: the age of the subject, the ratio of the near vision time and distance time of the subject, the at least one The eye's rate of myopia progression, retinal topography, residual accommodation, or any combination thereof. The method according to claim 9 or 10, further comprising dividing the progressive multifocal zone of the ophthalmic lens into two or more according to the retinal topography or refractive topography of the at least one eye of the subject More fan-shaped partitions sharing a central vertex, wherein each fan-shaped partition has the same A value and _PC value, and at least one of the fan-shaped partitions has a different L value.

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