Accommodating Intraocular Lenses were developed in the early 1900's and have been sold in Europe for the last ten years and later in the U.S. They function by means of forward movement of the optic upon constriction of the ciliary muscle which increases the pressure in the posterior part of the eye with a simultaneous decrease in pressure in the front part of the eye pressure. The reverse pressure changes take place upon relaxation of the ciliary muscle, which results in the backwards movement of the lens for distance vision. The forward movement of the lens optic enables the patient implanted with the lens to automatically change their vision from distance to see at intermediate and near.
The currently marketed accommodating plate haptic intraocular lenses provide excellent distance and intermediate vision but sometimes require weak, +1.00, reading glasses for prolonged reading, for seeing small print, or reading in dim lighting conditions. The embodiments relating to the present invention presented herein are designed to substantially reduce the need for any reading glasses
It is important for intraocular lenses to have a consistent location along the axis of the eye to provide good uncorrected distance vision and to center in the middle of the vertical meridian of the eye. Without excellent uncorrected distance vision there is no point in implanting an accommodating lens whose function is to enable patients to be without glasses. With the advent of the new premium lenses, not only are the above requirements important but also the vision is likely to be better if the lens after implantation and centration, is without any tilt which can reduce the quality of vision particularly if the lens optic has a toric component or is a multifocal.
The word “haptic” has been used to describe an attachment to intraocular lenses. The original intraocular lens consisted of a single optic. These single optic lenses, without any attachments, were first implanted in London by Harold Ridley in 1949. These lenses frequently de-centered and it was discovered that there was a need to center and fixate the lens optic in the vertical meridian of the eye.
The first attachments to the optic were called “haptics”. They consisted of multiple flexible loops of various designs, J loops, C loops, closed loops and flexible radial arms.
Later, these loops which became commonly referred to as “haptics” were replaced in some lens designs with plates, called “plate haptics”. It is necessary to fixate and center the plate haptics within the capsular bag and so loops or fingers are extended from the distal lateral ends of the plate haptics. These can be of the same material as the plate or integrally molded into the plate lens design during manufacturing, and can be made of polymide, prolene PMMA or titanium.
When the accommodating lens plate haptic is fibrosed into the capsular bag of an eye after cataract surgery, sometimes several weeks or months following the surgery, a complication can occur. The lens can deform to a “Z” dislocated shape. This occurs when there is little sandwiching of the distal tip of the plate haptics between the remaining anterior and the posterior walls of the capsular bag.
The current accommodating lenses utilize an oblong lens body design having plate haptics connected to the lens optics by a single transverse hinge across the plate haptic. This promotes accommodation by allowing the optic to move forwards and backwards relative to the outer, or distal, ends of the plates. Such accommodating lenses are found in U.S. Pat. No. 5,476,514 and U.S. Pat. No. 5,496,366, both to Cumming, the disclosures of which are herein incorporated by reference. However, these designs do not permit adequate movement of the optic to a change in vitreous cavity pressure to allow many patients to read comfortably at near without glasses.
In order to increase the movement of the optic to respond to the increase in vitreous cavity pressure that occurs during constriction of the ciliary muscle, the transverse hinge may be weakened by elongating the hinge base or reducing the width of the hinge. However, elongating the hinge base would destabilize the lens optic, and making the hinge narrower would make it prone to tilting.
An accommodating intraocular lens design according to an embodiment of the present invention is described that overcomes the deficiencies of present designs noted above.
A flat, longitudinal accommodating intraocular lens is provided, having distinct separate plate haptics that are rigid longitudinally, but flexible transversely, and that extend to partially surround the optic. The flat plate haptics may have a groove or hinge across the width of its proximal ends adjacent to the optic. This hinge may be weakened by having at least two separate spaced apart narrow hinges on each edge of the plate haptics, thereby, reducing the overall width of the hinge. This plural strap design stabilizes the lens optic while reducing the resistance of the optic to a change in vitreous cavity pressure, thereby, allowing more movement of the optic along the axis of the eye. Further stabilization is achieved by making the haptics as wide, or wider, than the optic and extending the lateral proximal ends of the plate haptics to partially surround the optic. The plate haptics may be made rigid longitudinally by incorporating into the length of the haptics a rigid frame structure.
Thus, an accommodating lens according to the present invention may stabilize the solid, single, flexible lens optic, prevent tilt, provide more movement of the optic for better near vision and center and fixate the lens in the capsular bag with the finger-like flexible loops at the distal ends of the plates. This accommodating lens improves near vision by reducing the resistance to pressure changes on the optic with contraction and relaxation of the ciliary muscle and by further increasing the vitreous cavity pressure by means of the lateral plate haptic extensions, which with accommodation and constriction of the ciliary muscle are forced posteriorly such that their proximal ends to then lie posterior to the optic.
Other features and advantages of the present invention will become apparent from the following more detailed description, taken in conjunction with the accompanying drawings, which illustrate, by way of example, the principles of the presently described apparatus and method of its use.
Illustrated in the accompanying drawing(s) is at least one of the best mode embodiments of the present invention In such drawing(s):
The above described drawing figures illustrate the described invention and method of use in at least one of its preferred, best mode embodiment, which is further defined in detail in the following description. Those having ordinary skill in the art may be able to make alterations and modifications to what is described herein without departing from its spirit and scope. Therefore, it should be understood that what is illustrated is set forth only for the purposes of example and should not be taken as a limitation on the scope of the present apparatus and its method of use.
As illustrated in
The lens optic is preferably constructed of a flexible optical material such as silicone, hydrogel, acrylic material, but may be made of any similar material. Additionally, the lens optic is preferably shaped so as to be biconvex, refractive, diffractive, plano-convex, Fresnell, spheric, aspheric, toric or multifocal.
In a preferred embodiment, at least two plate haptics 200 are longitudinally coupled to opposing ends of the lens optic 100. As illustrated in
Turning now to
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As illustrated in
The accommodating lens further comprises at least one connecting member 300, shown in
As illustrated in
As illustrated in
In another embodiment, the connecting member comprises the proximal end of the plate haptic body, the proximal end being substantially thinner than the remainder of the plate haptic body. Preferably, the connecting member is approximately 1 to 1.5 mm long and is thinner than the plate haptic body.
According to one embodiment, when the accommodating lens is implanted into the capsular bag of the eye, the plate haptics and its loops contact the periphery of the capsular bag and operate to support the optic within the eye and to substantially align and fix the lens into the capsular bag, thereby centering the lens optic along the optical axis of the eye. The flexible projections extend beyond the diameter of the capsular bag and the lateral distal plate extensions contact the periphery of the capsular bag, increasing the contact area of the lens within the bag to provide additional fixation and support to for the lens within the capsular bag. In some embodiments, the distal end of the plate haptic comprises a distal flange 240 that engages the capsular bag and further increases the contact area. The distal end of the plates may be either ticker or thinner than the proximal body of the plate haptic.
As illustrated in
The longitudinal length or circumference diameter of the accommodating lens is preferably between 10.0 to 12.0 mm.
The enablements described in detail above are considered novel over the prior art of record and are considered critical to the operation of at least one aspect of the invention and to the achievement of the above described objectives. The words used in this specification to describe the instant embodiments are to be understood not only in the sense of their commonly defined meanings, but to include by special definition in this specification: structure, material or acts beyond the scope of the commonly defined meanings. Thus if an element can be understood in the context of this specification as including more than one meaning, then its use must be understood as being generic to all possible meanings supported by the specification and by the word or words describing the element.
The definitions of the words or drawing elements described herein are meant to include not only the combination of elements which are literally set forth, but all equivalent structure, material or acts for performing substantially the same function in substantially the same way to obtain substantially the same result. In this sense it is therefore contemplated that an equivalent substitution of two or more elements may be made for any one of the elements described and its various embodiments or that a single element may be substituted for two or more elements in a claim.
Changes from the claimed subject matter as viewed by a person with ordinary skill in the art, now known or later devised, are expressly contemplated as being equivalents within the scope intended and its various embodiments. Therefore, obvious substitutions now or later known to one with ordinary skill in the art are defined to be within the scope of the defined elements. This disclosure is thus meant to be understood to include what is specifically illustrated and described above, what is conceptually equivalent, what can be obviously substituted, and also what incorporates the essential ideas.
The scope of this description is to be interpreted only in conjunction with the appended claims and it is made clear, here, that the named inventor believes that the claimed subject matter is what is intended to be patented.
This application is based on and claims the benefit of the filing of U.S. Provisional Patent Application No. 61/398,107 filed Jun. 21, 2010; U.S. Provisional Patent Application No. 61/398,098 filed Jun. 21, 2010; U.S. Provisional Patent Application No. 61/398,115, filed Jun. 21, 2010; and U.S. Provisional Patent Application No. 61/398,099, filed Jun. 21, 2010, the contents and disclosure of which are fully incorporated herein by reference.
Number | Date | Country | |
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61398107 | Jun 2010 | US | |
61398098 | Jun 2010 | US | |
61398115 | Jun 2010 | US | |
61398099 | Jun 2010 | US |