CN101534748A - Intraocular lens system with multiple eyepieces - Google Patents

Abstract

An accommodating intraocular lens, having: anteriorly and posteriorly movable extended portions, such as T-shaped haptics, extending from a central optic to be implanted in a human eye; and a second optic spaced from the posterior optic. The first optic would be implanted in the capsular bag and the second optic could be located in the capsular bag, in the ciliary sulcus, or in the anterior chamber. The second optic can be spaced from and secured to the first optic, and the lens assembly implanted in the capsular bag.

Description

Intraocular lens system with multiple eyepieces

technical field

The present invention relates generally to intraocular lenses for implantation in a human eye formed by anterior capsulotomy to empty the lens matrix from within the natural lens of the eye. More specifically, the present invention relates to a novel accommodating intraocular lens having several improved features, including most importantly an increased depth of focus.

Background technique

The human eye has an anterior chamber between the cornea and iris, a posterior chamber behind the iris containing the lens, a vitreous chamber behind the lens containing vitreous humor, and a retina behind the vitreous chamber. The lens of the normal human eye has a lens capsule attached along its periphery by zonules to the ciliary muscle of the eye and contains the lens matrix. The lens capsule has optically clear elastic anterior and posterior membranous walls, commonly referred to by ophthalmologists as the anterior and posterior capsules, respectively. Between the iris and the ciliary muscle is a circular slit-like space called the ciliary sulcus.

Young eyes have a natural ability to adjust. Natural accommodation involves the brain relaxing and contracting the ciliary muscles that provide near and distance vision to the eye. This ciliary muscle action is automatic and shapes the natural lens into the proper optical configuration for focusing light rays entering the eye from the viewed object onto the retina.

The human eye suffers from a variety of conditions that degrade or completely eliminate the ability of the eye to function normally. One of the most common of these conditions involves the progressive clouding of the matrix of the natural lens, leading to the formation of so-called cataracts. The current common practice of treating cataract is to surgically remove the human lens of the cataract and implant an artificial lens in the eye to replace the natural lens. The prior art includes various intraocular lenses for this purpose.

Intraocular lenses vary widely in physical appearance and configuration. The present invention relates to an intraocular lens having a central optic zone or optic and haptics extending from the optic and engaging structures within the eye in such a way as to support the optic on the axis of the eye.

Intraocular lenses also vary in their ability to accommodate and fit in the eye. Accommodability refers to the ability of the IOL to accommodate, i.e., focus the eye for nearsightedness and farsightedness. Certain patents describe so-called accommodating intraocular lenses. Other patents describe non-accommodating intraocular lenses. Most non-accommodating lenses have a monofocal optic that only focuses the eye at a certain fixed distance and require glasses to zoom. Other non-accommodating lenses have multifocal optics that image near and distant objects on the retina of the eye. The brain selects the appropriate image and suppresses others, allowing the multifocal IOL to provide both nearsightedness and farsightedness without glasses. However, bifocal IOLs have the disadvantage that each of the bifocal images only accounts for about 40% of the available light, while the remaining 20% is lost in scattering.

The intraocular lens has four possible placements in the eye. That is (a) in the anterior chamber, (b) in the posterior chamber, (c) in the capsular bag, and (d) in the vitreous chamber. The intraocular lenses disclosed herein are primarily intended for placement in the capsular bag, but some are placed in the ciliary sulcus and/or in the anterior chamber.

Contents of the invention

The present invention provides an improved accommodating intraocular lens to be implanted in a human eye which remains intact in the eye after removal of the lens matrix from the natural capsule of the eye lens through an anterior capsule opening in the natural lens . The anterior opening is created by performing an anterior capsulotomy - preferably an anterior capsulotomy - on the natural lens and is surrounded by the anterior capsule rim, which is the anterior capsule of the natural lens the remnants of. An improved accommodating intraocular lens according to the present invention includes an extension and one or more central optics, the optic generally having an anterior side and a posterior side, the extensions spaced circumferentially around the edge of the optic and extend substantially radially from the edge of the optic. These extensions have inner ends joined to the optic and opposite outer ends movable back and forth relative to the optic. To this end, the extension is pivotally or flexibly hinged at its inner end to the optic or elastically bendable over its entire length. As used herein, the terms "flexible", "flexible", "flexible" and the like are used in a broad sense to cover flexibly articulated and resiliently bendable extensions. The terms "hinge", "articulated", "articulated" and the like are used in a broad sense to encompass pivotal joints and extensions of flexible joints.

A lens is surgically implanted into a patient's eye through an opening in the anterior capsule of the capsular bag and placed in a position in which the optic of the lens is aligned with the opening and the outer end of the lens extension is at the periphery of the capsular bag Or in the conjunctival sac (cul-de-sac), or in the ciliary sulcus or anterior chamber. The lens has a radial dimension from the outer end of each extension to the axis of the lens optic such that when the lens is implanted in the eye, the outer ends of the extensions engage the inner peripheral wall.

After surgical implantation of an accommodating intraocular lens into the capsular bag of the eye, activated ectodermal cells on the posterior side of the anterior capsular rim of the capsular bag allow the rim to fuse to the elasticity of the capsular bag through fibrosis Posterior capsule. This fibrosis occurs around the lens extensions in such a way that these extensions are effectively "shrink-wrapped" by the fibrous tissue in such a way that a radial pocket is formed in the fibrous tissue containing the extensions, and the extensions The outer end of the sac is located in the external conjunctival sac of the capsular bag. In this case, the lens is thus secured within the capsular bag with the optic of the lens aligned with the anterior capsule opening in the capsular bag. The anterior capsular rim shrinks during fibrosis, and this shrinkage, combined with the shrink-wrapping of the extensions, compresses the lens radially in such a way that the optics of the lens, relative to the outer ends of the extensions, lie along the rim of the eye. The axis moves backwards. The fibrous, leathery anterior capsule rim blocks forward movement of the optic and forces it backward during fibrosis. Thus, fibrosis-induced movement of the optic during treatment occurs after the distance vision position, with either or both of the optic and the inner end of the extension pressing back against the elastic posterior capsule of the capsular bag And stretch the posterior capsule backward.

The normal brain-sensed relaxation and contraction of the ciliary muscle after fibrosis is complete will thus cause the lens optics to make forward and backward accommodative movements relative to the retina between near and distance vision positions. During this accommodation movement of the optical system, the lens extensions undergo an endwise movement within their pockets in the capsular bag.

According to another important aspect of the present invention, the extensions of presently preferred lens embodiments may be generally T-shaped haptics, each of said haptics comprising a plate haptic and a pair of relatively elongated haptics located at the outer ends of the plate haptics. Elastic flexible fixing fingers. In their normal, unstressed state, the two fixation fingers at the outer end of each haptic plate extend laterally outward in the plane of the haptic plate from opposite edges of the respective haptic plate and generally parallel to the radial direction of the haptic plate. The outer end edges are flush to form the horizontal "arms" of the T-loop plate. The radially outer end edge of the haptic plate is curved circularly about the central axis of the lens optic so that its radius is approximately equal to the radius of the inner periphery of the capsular bag when the ciliary muscle of the eye is relaxed. During implantation of the lens into the capsular bag, the inner peripheral wall of the capsular bag deflects the fingers of the plate haptics generally radially inward from their normal, stress-free position toward an arcuate curved configuration in which The radially outer edges of the middle fingers and the curved outer end edges of the respective haptic plates are approximately equal to a common circular curvature that approximates the curvature of the inner peripheral wall of the capsular bag. The outer T-ends of the haptics then gently press against the peripheral wall of the capsular bag and become fixed within the periphery of the capsular bag during fibrosis, so that the implanted lens is precisely centered in the capsular bag and the lens optics Align with the anterior capsular opening in the capsular bag.

Certain lens embodiments described have plate haptics that are smaller in width than the diameter of the optic. These relatively narrow plate haptics can bend or pivot relatively easily to aid in the accommodative action of the lens and form the haptic pocket with the largest length between the plate haptic fingers and the optic in the fibrotic capsular bag, which allows the lens to optically The adjustment movement of the head is maximized. The haptics are able to slide radially in the capsular bag during ciliary muscle contraction to move the optics forward for accommodation.

In certain lens embodiments of the invention described, the lens optics and the extension are molded or otherwise made as a unitary, single-piece lens structure in which the interior of the extension The end is integrally joined to the optical system, and the extension is elastically bendable at every point along its entire length, or has a flexible hinge adjacent to its inner end of the optical system, where the extension can be positioned relative to the optical system. Back and forth hinged movement. In other lens embodiments described, the optic and extension are each formed separately and have mating hinges that engage each other to pivotally join the optic and extension. In certain of these described embodiments, the extensions are T-shaped haptics formed by molding or otherwise integrally forming the flexible haptic fingers with the haptic plate itself. In other inventive embodiments described, the extensions are T-shaped haptics with T-shaped reinforcing inserts or inserts that reinforce the haptic plates and provide the T-shape to the haptics. Still other embodiments described also have reinforcing inserts that reinforce the haptics, provide the T-shape for the haptics, and/or provide matching pivotal hinges for the haptics and optics to pivotally connect the haptics to the optical system.

A preferred accommodating intraocular lens of the invention is now described. These preferred lenses comprise two integral optics separated from each other by a fixed space, generally T-shaped and flexibly articulated haptics, the rear of the optic providing most of the optical power of the optic. These optics cooperate with the forwardly biased structure of the lens to increase the degree of accommodation or diopter of accommodation.

Description of drawings

Figure 1 diagrammatically shows a pair of optics of a multi-ocular lens system arranged with respect to the cornea and retina.

Figure 2 shows an example of a dual optic lens with haptics extending from one optic.

FIG. 3 is a top view of the optic in FIG. 2 further showing T-haptics.

4 is a cross-sectional view showing an optic and a plurality of spacers attaching the two optics together.

Figure 5 is yet another view of the posterior lens.

Figure 6 is yet another view of the anterior lens having a larger diameter than the posterior lens.

Figures 7a-7b are side and top views showing optics and suitable spacers.

Figures 8 to 12 are diagrams showing different arrangements of lenses in the eye, Figure 8 shows a conventional layout in a capsular bag, Figure 9 shows two lenses in a capsular bag, and Figure 10 shows One lens in the capsular bag and one lens in the ciliary sulcus. Figure 11 shows the situation of one lens in the capsular bag and one lens in the anterior chamber. Figure 12 shows the two optical parts connected together Situation in pouch.

Figure 13 shows the lens system in vitro.

Figure 14 shows the lens system in vitro after optic fibrosis.

Figure 15 shows a human eye with an existing accommodating intraocular lens.

Detailed ways

Referring now to these drawings, and initially to FIG. 15 , there is shown a human eye 10 whose natural lens matrix has been removed from the natural lens capsule of the human eye through an anterior opening formed in the capsule by an anterior capsulotomy. In this case, the anterior capsulotomy is a serial circular capsulotomy or capsulorhexis. As previously mentioned, the matrix of the natural lens, which is usually optically clear, often becomes clouded and forms a cataract, which can be cured by removing the matrix and replacing it with an intraocular lens.

Continuous annular capsulotomy, or capsulorhexis, involves tearing the anterior capsule along a generally circular tear line, resulting in a relatively smooth-edged circular opening in the middle of the anterior capsule. The cataract is removed from the natural lens capsule through this opening. After this surgical procedure, the human eye comprises an optically clear anterior cornea 12, an opaque sclera 14, an iris 18, a capsular bag 20 behind the iris, and a colloidal vitreous humor-filled vitreous cavity 21 behind the capsular bag, wherein the sclera 14 Inside is the retina 16 of the human eye. The capsular bag 20 is the natural lens structure of the human eye which remains intact in the human eye after successive annular capsulorhexises are performed and the natural lens matrix is removed from the natural lens.

The capsular bag 20 includes an annular anterior capsular remnant or rim 22 and a resilient posterior capsule 24 joined along the periphery of the capsular bag to form an annular slit-shaped conjunctival sac 25 between the rim and posterior capsule. The capsular rim 22 is the remnant of the anterior capsule of the natural lens that remains after a capsulorhexis is performed on the natural lens. The rim peripherally surrounds a central, generally circular front opening 26 (capsulotomy) in the capsular bag through which the natural lens matrix was previously removed from the natural lens. Capsular bag 20 is secured at its periphery to ciliary muscle 28 of the eye by zonules 30 .

The natural accommodation of a normal human eye with a normal human lens involves the brain controlling the automatic contraction or compression and relaxation of the eye's ciliary muscles in response to seeing objects at different distances. The normal state of muscle relaxation of the ciliary muscle is what reconfigures the lens of the human eye for distance vision. Contraction of the ciliary muscle is what reconfigures the lens of the human eye for near vision. The change from distance vision to near vision as the brain responds is called accommodation.

Implanted within the capsular bag 20 of the human eye 10 is an accommodating intraocular lens 32, such as that shown in US Patent No. 7,048,760, which replaces and performs its accommodative function for the removed lens of the human eye. The accommodating intraocular lens can be used to replace a natural lens that is virtually completely damaged, such as one with cataracts, or to provide satisfactory vision at one distance without glasses and at another distance with only glasses The natural lens provides satisfactory vision without conditions. For example, the accommodating intraocular lens of the present invention, as described below, can be used to correct refractive error and restore accommodation to a person in their 40s who needs magnifying glasses or bifocals for near vision.

The intraocular lens 32 includes a unitary body that may be formed from a relatively hard material, a relatively soft flexible semi-rigid material, or a combination of hard and soft materials. Examples of relatively hard materials suitable for use in the lens body are methyl methacrylate, polysulfone, and other relatively hard biologically inert optical materials. Examples of relatively soft materials suitable for the lens body are silicones, hydrogels, thermolabile materials, and other flexible semi-rigid bioinert optical materials.

The lens system comprises two optics fused together, one in front of the other, as will be explained further below starting with FIG. 1 . T-shaped extensions or plate haptics 36 extend radially from opposite edges of the optic. These haptics include a haptic member or haptic plate 36 which itself has an inner end engaging one or the other optic and an opposite outer free end and lateral fixation fingers at the outer end. Plate haptics 36 may be tapered longitudinally so that their width narrows or widens toward the ends, or may be wider at its periphery and narrower adjacent the optic. Optical system 34 is capable of moving back and forth relative to haptics 36 . The preferred lens embodiment shown is constructed of a resilient, semi-rigid material and has flexible hinges 38 joining the inner ends of the plate haptics 36 to an optic. The haptics are relatively stiff and capable of bending back and forth about a hinge relative to the optic. These hinges are formed by grooves 38 that penetrate into the front or back side and extend across the inner end of the plate haptics 36 . Haptic 36 is capable of bending about hinge 38 in the anteroposterior direction of the optical system. The lens has a relatively flat, stress-free structure in which the haptics 36 and their hinges 38 are arranged in the same plane laterally to the optical axis of the optic 34 . The lens is deformed from this normal, unstressed configuration by the back and forth movement of the haptics about its hinge, and this deformation generates an elastic strain energy force in the hinge that forces the lens back to its normal, unstressed configuration. The outer end edges of the haptics are preferably circularly curved with equal radii about the optical axis of optic 34 . Once the ciliary muscle contracts, the increased pressure in the vitreous cavity also helps the optics move forward towards the iris. And this increased pressure can also deform one or both of the optics to further improve near vision.

Reference is now made to FIG. 1 , which also diagrammatically shows a human eye 10 , cornea 12 , retina 16 , and further includes an anterior optic 40 and a posterior optic 41 . Although not shown in FIG. 1 , posterior optic 41 generally includes haptics 36 such as shown in FIGS. 2 and 3 (and FIG. 13 ). D1 denotes the distance from the cornea 12 to the first optic 40 and D2 denotes the space between the two optics 40 and 41 . D2 typically ranges from 0 to 3.0 mm. One of the optics may have a toric surface.

The letter "r" designates the four possible radii of the two optics, which range from 4.9 mm to 6.0 mm. RI1 represents the refractive index of the water between the cornea 12 and the first optic 40, RI1 and RI2' represent the refractive indices of the optics 40 and 41, respectively, and RI1' represents the refraction of the water between the two optics R3 represents the refractive index of the vitreous between the posterior lens 41 and the retina 16. RI1 is generally 1.336, RI3 is generally 1.336, RI2 is generally 1.427, and D2 is between 1.0 and 2.0 mm, generally 1.4 mm. Various radii, refractive indices and distances between the optics can be adjusted to give the deepest depth of focus.

FIG. 2 shows a polyocular lens system in which the diameter of the anterior optic 40 is larger than the diameter of the posterior optic 41 . The lens has haptics 36 provided with hinges 38 adjacent optic 41 . FIG. 3 is a top view of rear optic 41 showing T-haptic 36 , hinge 38 adjacent optic, and fixation fingers 44 . Figure 4 shows how the two optics 40 and 41 are separated and sealed with a post 46, preferably with liquid silicone and heat. This design enables the anterior optic 40 to be attached to the posterior lens 41 . As can be seen in FIGS. 9-11, the anterior optic 40, like the lens 41, has haptics and fixation fingers.

Figures 5 to 7b show the posterior lens 41, the anterior optic 40 and the strut 48 whereby, as seen in Figures 5 and 7b, the anterior optic may be connected with a suitable aperture 50 or 50'. The two optics 40 and 41 can be attached before or after implantation. The anterior optic 40 is detachable so that the anterior optic can be altered after implantation to provide a power change or a toricity charge.

The optical diameter of the lens 41 may be 4.0-6.5 mm, the end-to-end length of the haptics 36 is 10.0-12.5 mm, the tip-to-ring tip length of the ring 44 is 10.5-13.0 mm, the width of the hinge 38 is 1.0-5.0 mm, the base The depth is 0.05-1.0 mm. Typical materials are silicone, acrylic or any suitable optical material, as well as polyimide or other logs materials such as PMAA.

Referring now to FIGS. 8-12 , FIG. 8 is a schematic diagram similar to FIG. 13 showing the optic 34 of a standard intraocular lens in the capsular bag 20 . Figure 9 diagrammatically shows lenses with haptics 40 and 41 disposed in the capsular bag. Figure 10 diagrammatically shows the optic 41 in the capsular bag 20 and the anterior optic 40 in the ciliary sulcus.

Figure 11 shows diagrammatically two separate lenses 41 located in the capsular bag 20 and the lens 40 located in the anterior chamber. Figure 12 shows lens systems 40 and 41 integrally joined and disposed in a capsular bag. In each case, the posterior optic can be a standard accommodating intraocular lens.

Both lenses 40 and 41 may be stable accommodating intraocular lenses according to patent application Serial No. 11/461,290, Attorney Docket No. 13533.4069, filed July 31, 2006.

Figure 13 shows the lens system in vitro. The lens system can be designed with haptics attached to the anterior optic, resulting in an anterior arch when the lens system is focused for the distance in Figure 14, or with haptics attached to the posterior optic, resulting in an anterior arch when the lens system is at Creates a back arch in long distance positions. Figure 14 shows the in vitro lens after fibrosis.

While embodiments of the invention have been shown and described, various modifications may be made without departing from the scope of the invention, and all such modifications and equivalents are covered by the scope of the invention.

Claims (17)

1, a kind of accommodating intraocular lens comprises: the first flexible optical portion, and it has front side and rear side; And button loop, it comprises at least two parts of extending from described optic, described part has the inner of contiguous described optic and away from the outer end of described optic, described optic can move forward and backward with respect to the outer end of described button loop, and described part has the fixed component at the outer end place that is positioned at described part, and

Second optic, itself and described first optic are spaced apart and be attached to described first optic, and described second optic constitutes the part of optical system integratedly.

2, intraocular lens as claimed in claim 1, wherein, described part is the button loop plate.

3, intraocular lens as claimed in claim 1, wherein, each part comprises the button loop plate of at least one finger with the far-end that is positioned at this part.

4, intraocular lens as claimed in claim 1, wherein, described part is the elasticity bendable on its a part of length.

5, intraocular lens as claimed in claim 1, wherein, described first optic, described part and described fixed component are integrally formed.

6, intraocular lens as claimed in claim 1, wherein, described second optic and described fixed component are integrally formed.

7, intraocular lens as claimed in claim 1 further comprises at the inner of described part and described button loop being attached to hinge between the described optic on it.

8, intraocular lens as claimed in claim 1, wherein, described part comprises the zone of attenuation, thereby forms hinge.

9, intraocular lens as claimed in claim 8, wherein, flexible described hinge is formed by groove.

10, intraocular lens as claimed in claim 1, wherein, described part and described fixed component comprise T shape button loop.

11, intraocular lens as claimed in claim 1, wherein, described first optic is the back optic, described second optic is preceding optic.

12, intraocular lens as claimed in claim 1, wherein, described first optic is preceding optic, described second optic is the back optic.

13, intraocular lens as claimed in claim 10, wherein, described first optic and described second optic are with in the implanted capsule bag.

14, intraocular lens as claimed in claim 10, wherein, described first optic is with in the implanted capsule bag, and described second optic is positioned at ciliary groove.

15, intraocular lens as claimed in claim 10, wherein, described first optic is with in the implanted capsule bag, and described second optic is with among the implanted anterior chamber.

16, a kind of accommodating intraocular lens comprises: the first flexible optical portion, and it has front side and rear side; And button loop, it comprises at least two parts of extending from described optic, described part has the inner of contiguous described optic and away from the outer end of described optic, optical system can move forward and backward with respect to the outer end of described button loop, and described part has the fixed component at the outer end place that is positioned at described part, and

Second optic, itself and described first optic are spaced apart and be attached to described first optic.

17, intraocular lens as claimed in claim 15, wherein, described crystalline lens is used for implanting the capsule bag.

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