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WO1999003427A1 - Systeme de lentille intraoculaire - Google Patents

Systeme de lentille intraoculaire Download PDF

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Publication number
WO1999003427A1
WO1999003427A1 PCT/IL1998/000337 IL9800337W WO9903427A1 WO 1999003427 A1 WO1999003427 A1 WO 1999003427A1 IL 9800337 W IL9800337 W IL 9800337W WO 9903427 A1 WO9903427 A1 WO 9903427A1
Authority
WO
WIPO (PCT)
Prior art keywords
intraocular lens
optic
lens assembly
edge
assembly according
Prior art date
Application number
PCT/IL1998/000337
Other languages
English (en)
Inventor
Henry M. Israel
Original Assignee
Israel Henry M
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Israel Henry M filed Critical Israel Henry M
Priority to AU83549/98A priority Critical patent/AU8354998A/en
Publication of WO1999003427A1 publication Critical patent/WO1999003427A1/fr

Links

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
    • A61F2/1624—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 having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside
    • A61F2/1629—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 having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside for changing longitudinal position, i.e. along the visual axis when implanted
    • 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
    • A61F2/1694—Capsular bag spreaders therefor
    • 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
    • A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics
    • A61F2002/1683—Intraocular lenses having supporting structure for lens, e.g. haptics having filiform haptics
    • A61F2002/1686—Securing a filiform haptic to a lens body

Definitions

  • the present invention relates generally to intraocular lens assemblies for implantation into the human eye and more particularly to intraocular lens assemblies which provide accommodation in response to the contraction and relaxation of the ciliary muscles of the eye.
  • the present invention seeks to provide an improved intraocular lens assembly.
  • an intraocular lens assembly for implantation in a human eye, the eye including a ciliary muscle and zonules controlled by the ciliary muscle, the assembly including: an optic having anterior and posterior surfaces; at least two articulated linkage arms, each being attached to the optic at a first position on the arm thereof and cooperating with the ciliary muscle or the zonules at a second position on the arm, the optic being integrally formed as a single piece together with the at least two articulated linkage arms.
  • the intraocular lens assembly also comprises a ring attached to the at least two articulated linkage arms and integrally formed therewith as a single piece.
  • an intraocular lens assembly incorporates an optic for implantation within the lens capsule of the eye, the optic being held in place by at least two substantially rigid linkage arms, or haptics, which are attached at their inner ends to the edge or face of the optic.
  • the outer ends of the linkage arms are coupled with the movement of the zonules and the ciliary muscle.
  • the optic, linkage arms and connecting parts are made of biologically inert plastic or other biologically inert materials.
  • the linkage arms are connected to pivot joints at one or both the inner and outer ends thereof, which permit the arms to rotate about the pivot axes in response to radial expansion or contraction of the equatorial diameter of the capsule.
  • the arms hold the optic in a position which focuses distant images onto the retina.
  • the equatorial diameter of the lens capsule changes, exerting force on the outer ends of the linkage arms and thereby causing them to rotate about their pivots and shift the optic forward, away from the retina, so as to focus near images onto the retina.
  • the linkage arms move in the opposite direction, returning the optic to its previous position of distant focus.
  • the equatorial diameter of the lens capsule is determined at any time by the balance of outward radial force exerted by the zonular fibers and inward force due to the natural elasticity of the lens capsule.
  • the portions of the lens capsule remaining after surgery, particularly the posterior wall of the lens capsule provide, in some embodiments of the invention, a force which (axially) biases the optic toward the front of the eye. Further embodiments of the invention provide other elements for exerting forces which may affect the balance of forces acting on the optic and change its axial position.
  • the outer ends of the linkage arms are held in contact with or attached to an expanding ring, which is itself in contact with the edges of the lens capsule adjacent to the zonules.
  • the expanding ring serves both to hold the capsule open (i.e., to prevent its axial collapse) and to couple the linkage arms to the motion of the zonules.
  • This expanding ring may also exert an additional outward radial force on the equatorial edge of the capsule or may be segmented so that it serves only to position the linkage arms and to hold the lens capsule open.
  • FIG. 1 For example, such tensile members may take the form of a tensioned ring attached along the periphery of the lens capsule. This type of tensile member effectively reinforces the inherent tension of the edge of the lens capsule itself. Such tensioned members are especially useful when the posterior wall of the lens capsule is also removed.
  • the ciliary muscle or zonules produce a contrary force in the outward axial direction. Outward radial motion of the zonules or ciliary muscle will stretch the springs, increasing the forward axial force and causing the optic to move forward in the capsule. When the zonules or ciliary muscle subsequently return radially inward, the linkage arms will force the optic back to its previous position.
  • the lens capsule itself performs a similar function, in a somewhat different manner.
  • the elasticity of the capsule especially when the capsule is held open by the expanding ring, exerts an inward force on the edge of the lens capsule, where it is attached to the zonules.
  • the posterior wall of the lens capsule performs an additional function in many embodiments of the invention, in that in these embodiments the optic is in contact with the posterior wall of the lens capsule. Under this condition, the posterior wall acts on the optic to provide a restoring force for the optic when the diameter of the lens capsule increases. In this way it is not necessary to attach the outer edge of the haptics to the expanding ring to provide movement of the optic when the diameter of the lens capsule is increased.
  • the optic is positioned initially, for distant vision, in contact with the posterior wall of the capsule of the eye.
  • Two or more linkage arms are coupled flexibly to the optic so as to permit the linkage arms to pivot at the coupling during motion of the linkage arm, while still transmitting full axial motion from the arm to the optic.
  • the outer ends of the linkage arms are likewise preferably flexibly attached to an expanding ring, which holds them in place at the edge of the capsule adjacent to the zonules.
  • an alternative preferred embodiment of the invention is similar to the embodiment described above, but is designed to operate in accordance with Helmholtz's theory.
  • the optic is coupled to the expanding ring by two or more linkage mechanisms, each of which comprises an inner arm and an outer arm.
  • the inner arm is preferably rigidly connected at its inner end to the optic, and by a pivot at its outer end to the inner end of the outer arm.
  • the outer arm is connected at its outer end to the expanding ring.
  • This contraction causes the outer arms to rotate about their pivots in such a way that the angle between the inner and outer arms at the pivot connecting them decreases.
  • the inner and outer arms are so arranged that this rotation and decrease in pivot angle will cause the optic to move axially forward, thus providing for near images to be focused onto the retina.
  • flexible, resilient linkage arms may be radially pre-loaded, for example by the pressure of the posterior wall of the lens capsule on the optic, so as to hold the intra-optic assembly in place without their connection to an expanding ring.
  • the outer ends of the linkage arms may be fastened directly or indirectly to the zonules, ciliary muscle or radial edge of the lens capsule by suturing or gluing. It may be appreciated that the various types of mechanical linkages described here in relation to the various preferred embodiments of the invention may be used alternatively in conjunction with an expanding ring or with other methods, described herein, of coupling the linkage arms to the motion of the zonules or ciliary muscle.
  • the linkage arms or haptics are constructed of either rigid or resilient material, and are coupled to the edge of the capsule adjacent to the zonules, preferably by an expanding ring.
  • a substantially rigid ring is connected by a pivot to each of the linkage arms at a point between the arm's outer end and its inner pivot connection to the optic.
  • the substantially rigid ring has a diameter smaller than the minimum equatorial diameter of the capsule, but larger than the optic and generally coaxial to it.
  • the pivots on the rigid ring serve as fulcrums, and the linkage arms act as levers, rotating about the fulcrums when the capsule's equatorial diameter changes.
  • the linkage arms may be constructed so that when the equatorial diameter of the capsule increases, said lever action will cause the optic to move forward.
  • An alternative embodiment of the invention in accordance with Helmholtz's theory, similarly includes rigid or resilient linkage arms, connected to a rigid ring with pivots acting as fulcrums for lever action of the arms, as in the preceding embodiment.
  • the linkage arms are constructed so that when the equatorial diameter of the capsule decreases, said lever action will cause the optic to move forward.
  • two optics are used, one of which is adjacent to the posterior wall of the lens capsule and the other is held parallel and anterior to it, with an intervening space between them.
  • the refractive power of the optics and the spacing between them is so designed that when the ciliary muscle is relaxed, distant objects are focused onto the retina.
  • Each optic is held in place by two or more linkage arms or haptics, which are shaped and positioned in such a way as to cause each of the arms of the anterior optic to come into contact with and cross a corresponding arm of the posterior optic, at a pivot point along or near the equatorial plane of the capsule.
  • an intraocular lens assembly for implantation in a human eye, said eye including a ciliary muscle and zonules controlled by the ciliary muscle, the assembly comprising: an optic having anterior and posterior surfaces depending from a common edge; at least two linkage arms, integrally formed as one piece with said optic, each linkage arm being attached to the optic at a first position on the arm thereof and cooperating with ciliary muscle or the zonules at a second position on the arm; and at least two pivots, one of which is rotatably attached to each respective linkage arm intermediate the first and second positions.
  • an intraocular lens assembly for implantation in a human eye, said eye including a ciliary muscle and zonules controlled by the ciliary muscle, the assembly comprising: an optic having anterior and posterior surfaces depending from a common edge; and at least two substantially rigid linkage arms integrally formed as one piece with said optic, each being attached to the optic at a first position on the arm thereof and cooperating with ciliary muscle or the zonules at a second position on the arm.
  • an intraocular lens assembly for implantation in a human eye, said eye including a ciliary muscle and zonules controlled by the ciliary muscle and at least a portion of a lens capsule including an edge thereof and at least a portion of a posterior wall thereof, the assembly comprising: an expanding ring associated with the edge which contacts the edge portion of the lens capsule and preferably the posterior wall and positions the posterior wall toward the back of the eye from center of the lens capsule; and an optic associated with the expanding ring and integrally formed therewith.
  • an intraocular lens assembly for implantation in a human eye, said eye including a ciliary muscle and zonules controlled by the ciliary muscle and at least a portion of a lens capsule including an edge thereof, the assembly comprising: an expanding ring associated with the edge portion of the lens capsule and which provides a resilient radial force on the edge; and an optic associated with the expanding ring and integrally formed therewith.
  • the expanding ring bears against the edge of the lens capsule and provides an outward radial force or is attached to the edge and provides an inward radial force.
  • an intraocular lens assembly for implantation in a human eye, said eye including a ciliary muscle and zonules controlled by the ciliary muscle and at least a portion of a lens capsule including an edge thereof and at least a portion of a posterior wall thereof, the assembly comprising: an expanding ring associated with the edge comprising alternating rigid and elastic portions; and an optic associated with the expanding ring and integrally formed therewith.
  • Fig. 1 shows a cross-sectional view of an eye having therein a lens capsule containing an intraocular lens assembly according to a preferred embodiment of the invention
  • Figs. 2A and 2B are front and sectional side views of a preferred embodiment of the intraocular lens assembly shown in Fig. 1, Fig. 2B being taken along lines 2B - 2B of Fig. 2 A; Figs. 3A and 3B are respective sectional elevations of a preferred embodiment of the invention showing relative displacement of an optic forming an integral part of the intraocular lens assembly;
  • Figs. 3C and 3D are respective sectional elevations of another preferred embodiment of the invention showing relative displacement of an optic forming an integral part of the intraocular lens assembly;
  • Fig. 4 shows a cross-sectional view of an eye having therein a lens capsule containing an intraocular lens assembly according to another preferred embodiment of the invention
  • Figs. 5A and 5B are front and partial side views of a preferred embodiment of the intraocular lens assembly shown in Fig. 4, Fig. 5B being taken along lines 5B - 5B of Fig. 5A;
  • Figs. 6A and 6B are respective sectional elevations of a preferred embodiment of the invention showing relative displacement of an optic forming an integral part of the intraocular lens assembly;
  • Figs. 6C and 6D are respective sectional elevations of another preferred embodiment of the invention showing relative displacement of an optic forming an integral part of the intraocular lens assembly;
  • Fig. 6E is a sectional elevation showing part of the apparatus of Figs. 6C and 6D and illustrating the angular and geometric relationship between various portions thereof.
  • FIG. 1 shows a cross-section of a human eye 10 having an adaptive intraocular lens system 12, in accordance with a preferred embodiment of the invention, installed in place of the original material in a lens capsule 16.
  • the cornea and other anterior portions of the eye are at the left of the figure, and the retina and posterior portions of the eye are to the right.
  • Intraocular lens system 12 comprises an optic 14 placed within lens capsule 16.
  • Lens capsule 16 from which the original lens material has been removed, includes an outer edge 18, which is left intact and, optionally, a posterior wall 19 at least a portion of which may be left intact. At least a portion of the original anterior wall of the capsule is generally removed during the operation for removal of the lens material leaving an opening 20, through which the lens system is installed.
  • intraocular lens system 12 also includes two or more linkage arms 22, also known as haptics, which are integrally formed as one piece with the optic 14 at one end of the arms and which preferably rest on or are pivotably attached to an expanding ring 24 at a second end thereof.
  • linkage arms 22 also known as haptics
  • arms 22 are pivotably attached for limited rotational motion at pivots 26, symmetrically placed on the outer edge of the optic 14, and at pivots 27 on expanding ring 24.
  • pivots 26 and 27 are defined by flexible sections of the integrally formed one-piece intraocular lens system.
  • zonular fibers 28 also known as zonules
  • edge 18 of lens capsule 16 The other end of the zonules is attached to the sclera 30 of the eye.
  • the zonular fibers are acted upon by ligaments or the like 32 which are controlled by ciliary muscle 34.
  • the portion of the eye comprising the ciliary muscle and the volume it encloses is also known as the ciliary body.
  • Optic 14 produces an image on the retina at the back of the eye 10 corresponding to a focal plane 36.
  • optic 14 is made capable of movement along optical axis 38.
  • accommodation is made consequent to changes in tension of the zonular fibers. This change in tension acts on optic 14 so as to alter the image distance from optic 14 to focal plane 36.
  • linkage arms 22 each include a central beam portion 40, which is relatively rigid, having formed onto opposite ends thereof pivots 26 and 27.
  • the present invention may employ the same material for optic 14 and for arms 22, including the beam portion 40 and the pivots 26 and 27, wherein the relative rigidity of each portion is determined by its thickness.
  • the intraocular lens system may be formed as one piece from plural materials or reinforced, so as to cause various portions thereof to have greater or lesser rigidity.
  • the pivots 26 and 27 may be made of flexible material, which allows twisting or rotation of the arms about the pivot in response to rotational force applied to the arms 22, but prevents substantial axial motion of the arms.
  • This flexible material may also be elastic, so that pivots 26 and 27 exert a biasing force on arms 22, which will tend to return optic 14 to its original position when the rotational force applied to the arms is removed.
  • Expanding ring 24 is constructed preferably so as to exert an outward radial force, which will cause the ring to conform to the edge 18 of lens capsule 16, and expand or contract in response to expansion or contraction of the capsule, respectively.
  • Ring 24 serves to couple the outer end of linkage arms 22 to edge 18, so that radial forces exerted by zonules 28 and ciliary muscle 34 can act upon said arms.
  • Ring 24 may further serve to open capsule 16, i.e. to separate the anterior and posterior portions of the lens capsule, in place of the natural lens that was surgically removed, so that the elasticity of the capsule may serve more advantageously to exert inward radial force on the lens assembly as described below.
  • expanding ring 24 may be eliminated, and linkage arms 22 may instead be rotatably coupled at their outer ends to anchors, which may be glued or sutured to capsule edge 18, zonules 28 or less preferably, ciliary muscle 34. More preferably, the expanding ring is not eliminated but is provided as a split ring so that it exerts no force of its own in the radial direction while preserving the lens capsule in an open condition.
  • the axial position of the optic depends on the balance of forces between the zonules (and the expanding ring, if present) which urge edge 19 of the lens capsule outward and the resilience of the lens capsule which urges the edge of the lens capsule inward.
  • the effect of the force of the posterior wall 19 of the lens capsule on the optic also tends to push edge 18 of the lens capsule, outward.
  • the urging of the optic by the posterior wall enables the expanding ring 24 and the outer end position on the linkage arms to be held in place without any attachment of the lens assembly to the lens capsule or to the zonules. This simplifies implantation considerably.
  • the ratio of axial to radial displacement is large enough to provide at least 5: 1 amplification of the radial motion, so as to provide substantially complete accommodation.
  • complete accommodation requires an axial movement of the optic 14 of approximately 1 mm while the maximum radial movement of the ciliary muscle 34 is approximately 200 micrometers.
  • other ratios may be employed as required.
  • a larger ratio will result in a range of accommodation which is larger than required for near/far vision.
  • the exact placement of the optic becomes less critical since the contraction of the ciliary muscle will be sufficient to provide full accommodation even if far vision is overcompensated when the ciliary muscle is relaxed.
  • FIGs. 3 A and 3B illustrate an intraocular lens system including an optic 54 and arms 62, each having a beam 64 and pivots 66 and 67.
  • Fig. 3A illustrates the intraocular lens system where a force is applied to arms 62 causing bending thereof about pivots 66 and 67 and rearward displacement of the optic 54.
  • Fig. 3B illustrates the intraocular lens system of Fig. 3 A in the absence of such force, where the arms 62 are generally unbent at pivots 66 and 67, thus placing the optic 54 forwardly of its position shown in Fig. 3 A.
  • Figs. 3C and 3D illustrate an intraocular lens system constructed and operative according to another embodiment of the invention and including an optic 74 and arms 82, each having a beam 84 and pivots 86 and 87. It is seen that Fig. 3C illustrates the intraocular lens system where a force is applied to arms 82 causing bending thereof about pivots 86 and 87 and forward displacement of the optic 74. Fig. 3D illustrates the intraocular lens system of Fig. 3C in the absence of such force, where the arms 82 are generally unbent at pivots 86 and 87, thus placing the optic 74 rearwardly of its position shown in Fig. 3C.
  • Figs. 4, 5 A, 5B and 6A - 6D illustrate an alternative embodiment of the present invention.
  • This embodiment is similar to the embodiment of Figs. 1 - 3D described hereinabove with the difference between the embodiments being that in the embodiment of Figs. 4 - 6D the beam is much longer than the beam in the embodiment of Figs. 1 - 3D
  • the pivots may or may not be shorter than the pivots in the embodiment of Figs. 1 - 3D. Due to the increased length of the beam in the embodiments of Figs. 4 - 6D, the pivots are located relative to the optic and to the ring at locations different from those in the embodiment of Figs. 1 - 3D.
  • Fig. 4 shows a cross-section of a human eye 110 having an adaptive intraocular lens system 112, in accordance with a preferred embodiment of the invention, installed in place of the original material in a lens capsule 116.
  • the cornea and other anterior portions of the eye are at the left of the figure, and the retina and posterior portions of the eye are to the right.
  • Intraocular lens system 112 comprises an optic 114 placed within lens capsule 116.
  • Lens capsule 116 from which the original lens material has been removed, includes an outer edge 118, which is left intact and, optionally, a posterior wall 119 at least a portion of which may be left intact. At least a portion of the original anterior wall of the capsule is generally removed during the operation for removal of the lens material leaving an opening 120, through which the lens system is installed.
  • intraocular lens system 112 also includes two or more linkage arms 122, also known as haptics, which are integrally formed as one piece with the optic 114 at one end of the arms and which preferably rest on or are pivotably attached to an expanding ring 124 at a second end thereof.
  • linkage arms 122 generally surround the optic 114 and are attached thereto at the sides of the optic.
  • arms 122 are pivotably attached for limited rotational motion at pivots 126, symmetrically placed on the outer edge of the optic 114, and at pivots 127 on expanding ring 124.
  • pivots 126 and 127 are defined by flexible sections of the integrally formed one-piece intraocular lens system.
  • zonular fibers 128, also known as zonules is attached to edge 118 of lens capsule 116.
  • the other end of the zonules is attached to the sclera 130 of the eye.
  • the zonular fibers are acted upon by ligaments or the like 132 which are controlled by ciliary muscle 134.
  • the portion of the eye comprising the ciliary muscle and the volume it encloses is also known as the ciliary body.
  • Optic 114 produces an image on the retina at the back of the eye 110 corresponding to a focal plane 136.
  • optic 114 is made capable of movement along optical axis 138.
  • accommodation is made consequent to changes in tension of the zonular fibers. This change in tension acts on optic 114 so as to alter the image distance from optic 1 14 to focal plane 136.
  • linkage arms 122 each include a central beam portion 140, which is relatively rigid, having formed onto opposite ends thereof pivots 126 and 127.
  • the present invention may employ the same material for optic 114 and for arms 122, including the beam portion 140 and the pivots 126 and 127, wherein the relative rigidity of each portion is determined by its thickness.
  • the intraocular lens system may be formed as one piece from plural materials or reinforced, so as to cause various portions thereof to have greater or lesser rigidity.
  • the pivots 126 and 127 may be made of flexible material, which allows twisting or rotation of the arms about the pivot in response to rotational force applied to the arms 122, but prevents substantial axial motion of the arms. This flexible material may also be elastic, so that pivots 126 and 127 exert a biasing force on arms 122, which will tend to return optic 114 to its original position when the rotational force applied to the arms is removed. Expanding ring 124 is constructed preferably so as to exert an outward radial force, which will cause the ring to conform to the edge 118 of lens capsule 116, and expand or contract in response to expansion or contraction of the capsule, respectively. Ring 124 serves to couple the outer end of linkage arms 122 to edge 118, so that radial forces exerted by zonules 128 and ciliary muscle 134 can act upon the arms.
  • Ring 124 may further serve to open capsule 116, i.e., to separate the anterior and posterior portions of the lens capsule, in place of the natural lens that was surgically removed, so that the elasticity of the capsule may serve more advantageously to exert inward radial force on the lens assembly as described below.
  • expanding ring 124 may be eliminated, and linkage arms 122 may instead be rotatably coupled at their outer ends to anchors, which may be glued or sutured to capsule edge 118, zonules 128 or less preferably, ciliary muscle 134. More preferably, the expanding ring is not eliminated but is provided as a split ring so that it exerts no force of its own in the radial direction while preserving the lens capsule in an open condition.
  • the axial position of the optic depends on the balance of forces between the zonules (and the expanding ring, if present) which urge edge 118 of the lens capsule outward and the resilience of the lens capsule which urges the edge of the lens capsule inward.
  • the effect of the force of the posterior wall 1 19 of the lens capsule on the optic also tends to push edge 118 of the lens capsule, outward.
  • the urging of the optic by the posterior wall enables the expanding ring 124 and the outer end position on the linkage arms to be held in place without any attachment of the lens assembly to the lens capsule or to the zonules. This simplifies implantation considerably.
  • Figs. 6A and 6B illustrate an intraocular lens system including an optic 154 and arms 162, each having a beam 164 and pivots 166 and 167.
  • Fig. 6 A illustrates the intraocular lens system where a force is applied to arms 162 causing bending thereof about pivots 166 and 167 and rearward displacement of the optic 154.
  • Fig. 6B illustrates the intraocular lens system of Fig. 6 A in the absence of such force, where the arms 162 are generally unbent at pivots 166 and 167, thus placing the optic 154 forwardly of its position shown in Fig. 6 A.
  • Figs. 6C and 6D illustrate an intraocular lens system constructed and operative according to another embodiment of the invention and including an optic 174 and arms 182, each having a beam 184 and pivots 186 and 187. It is seen that Fig. 6C illustrates the intraocular lens system where a force is applied to arms 182 causing bending thereof about pivots 186 and 187 and forward displacement of the optic 174. Fig. 6D illustrates the intraocular lens system of Fig. 6C in the absence of such force, where the arms 182 are generally unbent at pivots 186 and 187, thus placing the optic 174 rearwardly of its position shown in Fig. 6C.
  • Fig. 6E illustrates the principle of operation of the integrally formed once piece intraocular lens system of the present invention. It is seen that the pivots 186 and 187 are off-axis with respect to the axis of a force applied to the intraocular lens system along an axis 244, as illustrated by arrows 246. Thus application of the force along axis 244 as indicated by arrows 246, causes displacement of an optic 174 in a direction indicated by an arrow 250 directed in the off- axis direction.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un système de lentille intraoculaire (12) destiné à substituer le cristallin de l'oeil et inséré dans la capsule (16) du cristallin. Le système (12) comprend une optique (14) des bras (22) rattachés de manière pivotante par des pivots (26, 27), et une bague de dilatation (24). Les muscles cibraires (34) agissent par l'intermédiaire de fibres de zonules (28) pour faire pression sur la capsule (16) et déplacer l'optique (14) sur le système de lentille intraoculaire (12).
PCT/IL1998/000337 1997-07-16 1998-07-16 Systeme de lentille intraoculaire WO1999003427A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU83549/98A AU8354998A (en) 1997-07-16 1998-07-16 Intraocular lens assembly

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IL12132797A IL121327A (en) 1997-07-16 1997-07-16 Intraocular lens assembly
IL121327 1997-07-16

Publications (1)

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WO2001060286A1 (fr) 2000-02-16 2001-08-23 Humanoptics Ag Implant intraoculaire et dispositif de cristallin artificiel
EP1108402A3 (fr) * 1999-12-14 2003-08-27 Boehm, Hans-Georg, Dr. rer. nat. Lentille intraoculaire capable de s'accommoder
US6660035B1 (en) * 2000-08-02 2003-12-09 Advanced Medical Optics, Inc. Accommodating intraocular lens with suspension structure
US6761737B2 (en) 2001-01-25 2004-07-13 Visiogen, Inc. Translation member for intraocular lens system
EP1457170A1 (fr) * 2003-03-13 2004-09-15 GenioVis GmbH Lentille intraoculaire de chambre postérieure
WO2004053536A3 (fr) * 2002-12-10 2004-09-30 Charles David Kelman Lentille intraoculaire d'adaptation multifocale
US6932839B1 (en) * 2002-11-27 2005-08-23 William Kamerling Intraocular lens assembly and method
WO2005115278A1 (fr) * 2004-05-19 2005-12-08 Humanoptics Ag Lentille intraoculaire apte a l'accommodation
US7125422B2 (en) * 2002-10-25 2006-10-24 Quest Vision Technology, Inc. Accommodating intraocular lens implant
EP2101684A4 (fr) * 2007-01-05 2010-07-14 C & C Vision Int Ltd Implant intra-oculaire accommodatif "w"
US8182531B2 (en) 2006-12-22 2012-05-22 Amo Groningen B.V. Accommodating intraocular lenses and associated systems, frames, and methods
US8343216B2 (en) 2002-01-14 2013-01-01 Abbott Medical Optics Inc. Accommodating intraocular lens with outer support structure
US8425597B2 (en) 1999-04-30 2013-04-23 Abbott Medical Optics Inc. Accommodating intraocular lenses
US20140249625A1 (en) * 2002-02-02 2014-09-04 John H. Shadduck Accommodating intraocular lens
US9005283B2 (en) 2004-04-16 2015-04-14 Visiogen Inc. Intraocular lens
US9011532B2 (en) 2009-06-26 2015-04-21 Abbott Medical Optics Inc. Accommodating intraocular lenses
US9039760B2 (en) 2006-12-29 2015-05-26 Abbott Medical Optics Inc. Pre-stressed haptic for accommodating intraocular lens
US9271830B2 (en) 2002-12-05 2016-03-01 Abbott Medical Optics Inc. Accommodating intraocular lens and method of manufacture thereof
US9421089B2 (en) 2007-07-05 2016-08-23 Visiogen, Inc. Intraocular lens with post-implantation adjustment capabilities
US9603703B2 (en) 2009-08-03 2017-03-28 Abbott Medical Optics Inc. Intraocular lens and methods for providing accommodative vision
US9636213B2 (en) 2005-09-30 2017-05-02 Abbott Medical Optics Inc. Deformable intraocular lenses and lens systems
US9814570B2 (en) 1999-04-30 2017-11-14 Abbott Medical Optics Inc. Ophthalmic lens combinations
US9968441B2 (en) 2008-03-28 2018-05-15 Johnson & Johnson Surgical Vision, Inc. Intraocular lens having a haptic that includes a cap
US9987125B2 (en) 2012-05-02 2018-06-05 Johnson & Johnson Surgical Vision, Inc. Intraocular lens with shape changing capability to provide enhanced accomodation and visual acuity
US10646330B2 (en) 2012-12-26 2020-05-12 Rainbow Medical Ltd. Accommodative intraocular lens
US11484402B2 (en) 2011-11-08 2022-11-01 Alcon Inc. Accommodating intraocular lenses
US11707354B2 (en) 2017-09-11 2023-07-25 Amo Groningen B.V. Methods and apparatuses to increase intraocular lenses positional stability
US11751991B2 (en) 2002-12-12 2023-09-12 Alcon Inc. Accommodating intraocular lenses and methods of use

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US6685741B2 (en) * 1999-07-29 2004-02-03 Bausch & Lomb Incorporated Intraocular lenses
US6599317B1 (en) * 1999-09-17 2003-07-29 Advanced Medical Optics, Inc. Intraocular lens with a translational zone
US20030060878A1 (en) 2001-08-31 2003-03-27 Shadduck John H. Intraocular lens system and method for power adjustment
US6935743B2 (en) 2002-02-06 2005-08-30 John H. Shadduck Adaptive optic lens and method of making
US8328869B2 (en) 2002-12-12 2012-12-11 Powervision, Inc. Accommodating intraocular lenses and methods of use
US8361145B2 (en) 2002-12-12 2013-01-29 Powervision, Inc. Accommodating intraocular lens system having circumferential haptic support and method
US20050131535A1 (en) 2003-12-15 2005-06-16 Randall Woods Intraocular lens implant having posterior bendable optic
US9872763B2 (en) 2004-10-22 2018-01-23 Powervision, Inc. Accommodating intraocular lenses
US8668734B2 (en) 2010-07-09 2014-03-11 Powervision, Inc. Intraocular lens delivery devices and methods of use
US8968396B2 (en) 2007-07-23 2015-03-03 Powervision, Inc. Intraocular lens delivery systems and methods of use
JP5752415B2 (ja) 2007-07-23 2015-07-22 パワーヴィジョン・インコーポレーテッド 移植後のレンズの屈折力の修正
EP2671541B1 (fr) * 2007-07-23 2019-04-17 PowerVision, Inc. Accommodation de lentilles intraoculaires
CN101754728B (zh) 2007-07-23 2013-09-18 力景公司 晶状体递送系统
US9610155B2 (en) 2008-07-23 2017-04-04 Powervision, Inc. Intraocular lens loading systems and methods of use
US10299913B2 (en) 2009-01-09 2019-05-28 Powervision, Inc. Accommodating intraocular lenses and methods of use
JP2013520291A (ja) 2010-02-23 2013-06-06 パワーヴィジョン・インコーポレーテッド 遠近調節型眼内レンズのための液体
EP2939636A4 (fr) 2012-12-26 2016-08-31 Frontier Vision Co Ltd Dispositif d'extension de cristalloïde
EP3785668A1 (fr) 2013-03-15 2021-03-03 Alcon Inc. Dispositifs de stockage et de chargement de lentille intra-oculaire et procédés d'utilisation
US9968442B2 (en) 2013-12-13 2018-05-15 Mirai Eye Inc. Accommodating intraocular lens
CN107635511A (zh) 2015-06-10 2018-01-26 力景公司 人工晶状体材料和组分
EP3884905A1 (fr) 2015-11-06 2021-09-29 Alcon Inc. Lentilles intraoculaires d'accommodation
WO2021067574A1 (fr) 2019-10-04 2021-04-08 Alcon Inc. Lentilles intraoculaires ajustables et procédés d'ajustement post-opératoire de lentilles intraoculaires
WO2025006182A1 (fr) 2023-06-30 2025-01-02 Alcon Inc. Système et procédés de compensation d'inclinaison de lentille intraoculaire

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US4790847A (en) * 1987-05-26 1988-12-13 Woods Randall L Intraocular lens implant having eye focusing capabilities
US5476514A (en) * 1990-04-27 1995-12-19 Cumming; J. Stuart Accommodating intraocular lens

Cited By (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9814570B2 (en) 1999-04-30 2017-11-14 Abbott Medical Optics Inc. Ophthalmic lens combinations
US8425597B2 (en) 1999-04-30 2013-04-23 Abbott Medical Optics Inc. Accommodating intraocular lenses
EP1108402A3 (fr) * 1999-12-14 2003-08-27 Boehm, Hans-Georg, Dr. rer. nat. Lentille intraoculaire capable de s'accommoder
US6749634B2 (en) 2000-02-16 2004-06-15 Humanoptics Ag Intraocular implant and an artificial lens device
WO2001060286A1 (fr) 2000-02-16 2001-08-23 Humanoptics Ag Implant intraoculaire et dispositif de cristallin artificiel
US6660035B1 (en) * 2000-08-02 2003-12-09 Advanced Medical Optics, Inc. Accommodating intraocular lens with suspension structure
US7452362B2 (en) 2001-01-25 2008-11-18 Visiogen, Inc. Method of implanting an intraocular lens system
US6761737B2 (en) 2001-01-25 2004-07-13 Visiogen, Inc. Translation member for intraocular lens system
US6846326B2 (en) * 2001-01-25 2005-01-25 Visiogen, Inc. Connection geometry for intraocular lens system
US7452378B2 (en) 2001-01-25 2008-11-18 Visiogen, Inc. Distending portion for intraocular lens system
US9504560B2 (en) 2002-01-14 2016-11-29 Abbott Medical Optics Inc. Accommodating intraocular lens with outer support structure
US8343216B2 (en) 2002-01-14 2013-01-01 Abbott Medical Optics Inc. Accommodating intraocular lens with outer support structure
US20140249625A1 (en) * 2002-02-02 2014-09-04 John H. Shadduck Accommodating intraocular lens
US9456895B2 (en) * 2002-02-02 2016-10-04 Powervision, Inc. Accommodating intraocular lens
EP1558180A4 (fr) * 2002-10-25 2010-03-03 Quest Vision Technology Inc Lentille intraoculaire implantable a accommodation
US7125422B2 (en) * 2002-10-25 2006-10-24 Quest Vision Technology, Inc. Accommodating intraocular lens implant
US6932839B1 (en) * 2002-11-27 2005-08-23 William Kamerling Intraocular lens assembly and method
US10206773B2 (en) 2002-12-05 2019-02-19 Johnson & Johnson Surgical Vision, Inc. Accommodating intraocular lens and method of manufacture thereof
US9271830B2 (en) 2002-12-05 2016-03-01 Abbott Medical Optics Inc. Accommodating intraocular lens and method of manufacture thereof
WO2004053536A3 (fr) * 2002-12-10 2004-09-30 Charles David Kelman Lentille intraoculaire d'adaptation multifocale
US11751991B2 (en) 2002-12-12 2023-09-12 Alcon Inc. Accommodating intraocular lenses and methods of use
EP1457170A1 (fr) * 2003-03-13 2004-09-15 GenioVis GmbH Lentille intraoculaire de chambre postérieure
US9005283B2 (en) 2004-04-16 2015-04-14 Visiogen Inc. Intraocular lens
WO2005115278A1 (fr) * 2004-05-19 2005-12-08 Humanoptics Ag Lentille intraoculaire apte a l'accommodation
US9636213B2 (en) 2005-09-30 2017-05-02 Abbott Medical Optics Inc. Deformable intraocular lenses and lens systems
US8163015B2 (en) 2006-07-25 2012-04-24 C&C Vision International Limited “W” accommodating intraocular lens
US8496701B2 (en) 2006-12-22 2013-07-30 Amo Groningen B.V. Accommodating intraocular lenses and associated systems, frames, and methods
US8182531B2 (en) 2006-12-22 2012-05-22 Amo Groningen B.V. Accommodating intraocular lenses and associated systems, frames, and methods
US9039760B2 (en) 2006-12-29 2015-05-26 Abbott Medical Optics Inc. Pre-stressed haptic for accommodating intraocular lens
EP2101684A4 (fr) * 2007-01-05 2010-07-14 C & C Vision Int Ltd Implant intra-oculaire accommodatif "w"
US9421089B2 (en) 2007-07-05 2016-08-23 Visiogen, Inc. Intraocular lens with post-implantation adjustment capabilities
US9968441B2 (en) 2008-03-28 2018-05-15 Johnson & Johnson Surgical Vision, Inc. Intraocular lens having a haptic that includes a cap
US10052194B2 (en) 2009-06-26 2018-08-21 Johnson & Johnson Surgical Vision, Inc. Accommodating intraocular lenses
US9011532B2 (en) 2009-06-26 2015-04-21 Abbott Medical Optics Inc. Accommodating intraocular lenses
US9603703B2 (en) 2009-08-03 2017-03-28 Abbott Medical Optics Inc. Intraocular lens and methods for providing accommodative vision
US10105215B2 (en) 2009-08-03 2018-10-23 Johnson & Johnson Surgical Vision, Inc. Intraocular lens and methods for providing accommodative vision
US11484402B2 (en) 2011-11-08 2022-11-01 Alcon Inc. Accommodating intraocular lenses
US9987125B2 (en) 2012-05-02 2018-06-05 Johnson & Johnson Surgical Vision, Inc. Intraocular lens with shape changing capability to provide enhanced accomodation and visual acuity
US10646330B2 (en) 2012-12-26 2020-05-12 Rainbow Medical Ltd. Accommodative intraocular lens
US11278393B2 (en) 2012-12-26 2022-03-22 Rainbow Medical Ltd. Accommodative intraocular lens
US11707354B2 (en) 2017-09-11 2023-07-25 Amo Groningen B.V. Methods and apparatuses to increase intraocular lenses positional stability

Also Published As

Publication number Publication date
JPH1147168A (ja) 1999-02-23
IL121327A (en) 2003-12-10
IL121327A0 (en) 1998-01-04
AU8354998A (en) 1999-02-10

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