The present disclosure relates generally to the field of ophthalmics, more particularly to ophthalmic devices, including intraocular lenses (IOLs) such as accommodating intraocular lenses.
A healthy young human eye can focus an object in far or near distance, as required. The capability of the eye to change back and forth from near vision to far vision is called accommodation. Accommodation occurs when the ciliary muscle contracts to thereby release the resting zonular tension on the equatorial region of the capsular bag. The release of zonular tension allows the inherent elasticity of the lens to alter to a more globular or spherical shape, with increased surface curvatures of both the anterior and posterior lenticular surfaces.
The human lens can be afflicted with one or more disorders that degrade its functioning in the vision system. A common lens disorder is a cataract which is the opacification of the normally clear, natural crystalline lens matrix. The opacification can result from the aging process but can also be caused by heredity or diabetes. In a cataract procedure, the patient's opaque crystalline lens is replaced with a clear lens implant or IOL.
In conventional extracapsular cataract surgery, the crystalline lens matrix is removed leaving intact the thin walls of the anterior and posterior capsules together with zonular ligament connections to the ciliary body and ciliary muscles. The crystalline lens core is removed by phacoemulsification through a curvilinear capsularhexis i.e., the removal of an anterior portion of the capsular sac.
After a healing period of a few days to weeks, the capsular sac effectively shrink-wraps around the IOL due to the capsularhexis, the collapse of the walls of the sac and subsequent fibrosis. Cataract surgery as practiced today causes the irretrievable loss of most of the eye's natural structures that provide accommodation. The crystalline lens matrix is completely lost and the integrity of the capsular sac is reduced by the capsularhexis. The “shrink-wrap” of the capsular sac around the IOL can damage the zonule complex, and thereafter the ciliary muscles may atrophy. Thus, conventional IOL's, even those that profess to be accommodative, may be unable to provide sufficient axial lens spatial displacement along the optical axis or lens shape change to provide an adequate amount of accommodation for near vision.
It is known to implant a combination of lenses to address refraction errors in the existing lens in the case of phakic IOLs or improve the refractive results of standard IOL after cataract surgery in the case of pseudophakic patients. These “piggyback” IOLs can be placed anterior to the previously implanted IOL or natural lens to improve the refractive results of cataract surgery in the case of pseudophakes or to change the refractive status of the eye in the case of phakic eyes, usually to correct high myopia. Generally, these lenses are implanted in the sulcus and are non-accommodating.
In some implementations, disclosed is an accommodating intraocular lens device for treatment of an eye. The lens device includes a stabilization haptic configured to be positioned within a region of an eye. The lens device includes a lens body having a sealed chamber containing a fixed volume of optical fluid. The lens body includes a shape changing membrane configured to outwardly bow in a region surrounding the optical axis of the eye; a shape deformation membrane configured to undergo displacement relative to the first shape changing membrane; and a static element. An inner surface of the shape changing membrane, an inner surface of the shape deformation membrane and an inner surface of the static element collectively form the sealed chamber. The lens device also includes a force translation arm having a first end configured to contact an outer surface of the shape deformation membrane of the lens body and a second end configured to engage a ciliary structure of the eye. The force translation arm is configured to move relative to the lens body upon movement of the ciliary structure.
The shape deformation membrane can be configured to undergo inward displacement towards the optical axis of the eye relative to the shape changing membrane during accommodation. Inward movement of the force translation arm can cause inward movement of at least one or more regions of the shape deformation membrane towards the optical axis of the eye causing a deformation of the sealed chamber. Inward movement of the shape deformation membrane can cause the optical fluid in the sealed chamber to press against the inner surface of the shape changing membrane and causes outward bowing of the shape changing membrane. The lens device can further include an internal support located within the sealed chamber. The internal support can mechanically isolate optical components of the lens from distortion during movement of the force translation arm. The internal support can include a plurality of internal supports spaced apart from one another within the sealed chamber. The internal support can include a tapered geometry to avoid contact during inward movement of the shape deformation membrane.
The stabilization haptic can be bonded to the lens body. The stabilization haptic can be molded as part of the lens body. The lens device can further include an exterior support. The internal support can be coupled to a perimeter region of the shape changing membrane. The internal support can form a partition within the sealed chamber dividing the sealed chamber into a deformable region and a central region. The deformable region can be located outside an optic zone. The deformable region can be located inside an optic zone. Inward movement of the force translation arm can cause inward movement of the shape deformation membrane and a deformation of the deformable region. Inward movement of the shape deformation membrane can compress the sealed chamber. The optical fluid in the sealed chamber can be non-compressible and can press against the inner surface of the shape changing membrane and cause outward bowing of the shape changing membrane. The internal support can be further coupled to a region of the static element. The internal support can include a channel extending through the internal support providing fluid communication between the deformable region and the central region of the sealed chamber.
The lens device can further include an exterior support. The exterior support can be rigid and can be configured to prevent distortion caused by movement of the force translation arms relative to the lens body. The stabilization haptic can be bonded to an external surface of the exterior support. The stabilization haptic can be molded as part of the exterior support. The first end of the force translation arm can extend through a channel in a peripheral wall of the exterior support such that the first end is positioned against the shape deformation membrane. The exterior support can include a central annular region and opposed side regions. The lens body can include a central portion and opposed, deformable portions. The central portion can align with the central annular region of the exterior support and the deformable portions of the lens body extend within the opposed side regions of the exterior support. An outer surface of the shape deformation membrane can be exposed through the central annular region. An outer surface of the static element can be exposed through the central annular region. A first of the force translation arms can extend through a first opening in a first sidewall of the exterior support into a first channel. A second of the force translation arms can extend through a second opening in a second sidewall of the exterior support into a second channel. The first channel and the second channel can be on opposite sides of the central annular region. The force translation arms can be configured to move back and forth within the first and second channels.
The shape deformation membrane can have a first surface coupled to the shape changing membrane and a second surface coupled to the static element and a sidewall extending between the first surface and the second surface. The sidewall of the shape deformation membrane can be aligned with and bonded to an inner surface of the central region of the exterior support such that the lens body is fixedly positioned relative to the exterior support. The central portion can surround the optical axis and deformable portions are located outside the central portion. An outer surface of the shape changing membrane near the central portion can be aligned with and bonded to an inner surface of the central annular region of the exterior support. The deformable portions can be freely movable within the exterior support. The deformable portions can be configured to undergo inward, collapsible movement or displacement relative to the central portion during accommodation. The first ends of the force translation arms cam be configured to be positioned against the deformable portions. Upon contraction, the ciliary structure can press against the second ends causing the first ends of the force translation arms to press upon the deformable portions and cause inward, collapsible movement of the deformable portions towards the central portion. Inward, collapsible movement of the deformable portions towards the central portion can cause the region of the shape changing membrane to outwardly bow. Inward, collapsible movement of the deformable portions towards the central portion can cause the optical fluid in the sealed chamber to press against the inner surface of the shape changing membrane causing the outward bowing of the shape changing membrane.
The central portion of the lens body can be generally circular and the deformable portions of the lens body have a shape selected from the group consisting of bellowed, pleated, trapezoidal, cylindrical, elliptical, conical, spherical, and hemi-spherical. The deformable portions of the lens body can move relative to the central portion of the lens body in response to a force applied by the ciliary structure onto the force translation arms. The deformable portions can move a distance between about 50 um and about 500 um. The distance the deformable portions move can cause at least a change in power of the lens body by at least 3 diopters. The force applied can be between about 0.1 gf to about 5 gf. The stabilization haptic can be configured to maintain alignment of the optics and resist movement of the device following implantation in the eye. The stabilization haptic can further include a biting element to improve fixation of the haptic within the eye. The biting element can include a grooved edge and/or a hole. The stabilization haptic can be open-loop, closed-loop, plate-style, plate loop, monobloc-plate style, j-loop, c-loop, modified J-loop, multi-piece, single-piece, angulated, planar, or offset haptics. The stabilization haptic can be coaxial or coplanar with the force translation arms. The stabilization haptic can be positioned on a different plane than the force translation arms. The stabilization haptic can be flexible, foldable or formed of a shape memory material. The stabilization haptic can be positioned within a ciliary sulcus or the capsular bag of the eye.
The lens body can include a deformable portion that is located outside the optic zone. The deformable portion can be a region of the shape deformation membrane. The lens body can include a deformable portion that is located inside the optic zone. The deformable portion can be a region of the shape deformation membrane. The shape deformation membrane can be annular. Outward bowing of the shape changing membrane can be manually adjustable after implantation of the device in the eye. The static element can be a static lens having an optical power. The static lens can be positioned posteriorly relative to the eye and the shape changing member can be positioned anteriorly relative to the eye. The shape changing membrane can have a constant thickness. The region of the shape changing membrane can be a reduced thickness region prone to give way upon increased internal pressure within the sealed chamber or upon application of pressure by the optical fluid against the inner surface of the shape changing membrane. The optical fluid can include a non-compressible liquid or gel of high clarity and transmission in the visible spectrum. The optical fluid can be silicone oil or fluorosilicone oil.
The force translation arms can have a length configured to extend between the shape deformation membrane of the lens body and the ciliary structure. The length can be adjustable prior to insertion of the device in the eye or after insertion of the device in the eye. The adjustment can be mechanical. The force translation arms can include two portions coupled together. The two portions can be coupled together by a hinge, piston, crimp, threads, or cam mechanism. The two portions can be coupled together by a chemical material. The ciliary structure can include at least one of ciliary muscle, ciliary body, ciliary process, and zonules.
More details of the devices, systems and methods are set forth in the accompanying drawings and the description below. Other features and advantages will be apparent from the description and drawings.
These and other aspects will now be described in detail with reference to the following drawings. Generally speaking the figures are not to scale in absolute terms or comparatively but are intended to be illustrative. Also, relative placement of features and elements may be modified for the purpose of illustrative clarity.
It should be appreciated that the drawings herein are exemplary only and are not meant to be to scale.
The present disclosure relates generally to the field of ophthalmics, more particularly to ophthalmic devices, including intraocular lenses (IOLs) such as accommodating intraocular lenses (AIOLs). The devices described herein can be switched back and forth repeatedly between accommodation to disaccommodation, just as in a young accommodative natural eye. The devices described herein can provide focusing power in both the distance and accommodative ranges by mechanically and functionally interacting with eye tissues typically used by a natural lens such as the ciliary body, ciliary processes, and the zonules, to effect accommodation and disaccommodation. The forces generated by these tissues are functionally translated to the devices described herein causing a power change to more effectively accommodate. The devices described herein are configured to be adjusted for size and fit prior to, during, as well as at any time after implantation. The devices described herein can be implanted in the eye to replace a diseased, natural lens. It should be appreciated, however, the devices can also be implanted as a supplement of a natural lens (phakic patient) or an intraocular lens previously implanted within a patient's capsular bag (pseudophakic patient).
With reference to
In a cataract procedure, the patient's opaque crystalline lens is replaced with a clear lens implant or IOL 30. In conventional extracapsular cataract surgery as depicted in
It is known to implant a combination of lenses to address refraction errors in the existing lens in the case of phakic IOLs or improve the refractive results of standard IOL after cataract surgery in the case of pseudophakic patients. These “piggyback” IOLs can be placed anterior to the previously implanted IOL or natural lens to improve the refractive results of cataract surgery in the case of pseudophakes or to change the refractive status of the eye in the case of phakic eyes, usually to correct high myopia. Generally, these lenses are implanted in the ciliary sulcus and are non-accommodating. As best shown in
Accommodating IOLs are beneficial also for patients not suffering from cataracts, but who wish to reduce their dependency on glasses and contacts to correct their myopia, hyperopia and presbyopia. Intraocular lenses used to correct large errors in myopic, hyperopic, and astigmatic eye are called “phakic intraocular lenses” and are implanted without removing the crystalline lens. In some cases, aphakic IOLs (not phakic IOLs) are implanted via lens extraction and replacement surgery even if no cataract exists. During this surgery, the crystalline lens is extracted and an IOL replaces it in a process that is very similar to cataract surgery. Refractive lens exchange, like cataract surgery, involves lens replacement, requires making a small incision in the eye for lens insertion, use of local anesthesia and lasts approximately 30 minutes. The accommodating IOLs described herein can be used in patients for refractive lens exchange.
Described herein are accommodating IOLs (“AIOLs”) that can achieve the desired optical power change, for example in the range of 3 diopter (D) to about 5 D, independent of the capsular bag. The devices described herein can include one or more force translation arms configured to be positioned in the eye to harness movements of one or more ciliary structures and translate the movements into functional forces to drive shape change of the lens body for accommodation and disaccommodation. The devices described herein can further include one or more stabilization haptics that can be separate from the force translation arms and positioned, for example, within the ciliary sulcus. The devices described herein obviate known issues that tend to occur due to capsular fibrosis described above. It should be appreciated that the devices described herein can be configured to harness movements of one or combinations of ciliary structures including, but not limited to, the ciliary muscle, the ciliary body, ciliary process, and zonules. For the sake of brevity, ciliary structure is used throughout to refer to the one or more ciliary structures for which movements can be harnessed by the force translation arms to effect accommodation of the lens body as will be described in more detail herein.
The devices described herein can be implanted in the eye to replace a diseased, natural lens. In some implementations, the devices described herein can be implanted as aphakic IOLs via refractive lens exchange procedures. The intraocular lenses described herein can also be implanted as a supplement of a natural lens (phakic patient) or an intraocular lens previously implanted within a patient's capsular bag (pseudophakic patient). The lenses described herein can be used in combination with intraocular lenses described in U.S. Patent Publication Nos. 2009/0234449, 2009/0292355 and 2012/0253459, which are each incorporated by reference herein in their entirety. As such, the lenses described herein can be used independently or as so-called “piggyback” lenses. Piggyback lenses can be used to correct residual refractive errors in phakic or pseudophakic eyes. The primary IOL used to replace the natural lens is generally thicker and usually has a power that can be in the range of ±10 D to ±25 D. The thicker, larger power lenses generally do not accommodate. In contrast, the supplemental lens need not possess a full range of diopters (D). The supplemental lens can be relatively thin compared to the primary IOL and can undergo more accommodation. Shape change and movement of the thinner lens is generally more easily accomplished relative to a thick primary lens. The AIOLs described herein can be used independently and need not be used in combination as piggyback lenses with the natural lens or an implanted IOL. The AIOLs described herein can be configured to be positioned in the sulcus 16 and/or the capsular bag 22.
The devices and systems described herein can incorporate any of a variety of features described herein and that elements or features of one implementation of a device and system described herein can be incorporated alternatively or in combination with elements or features of another implementation of a device and system described herein as well as the various implants and features described in U.S. Patent Publication Nos. 2009/0234449, 2009/0292355 and 2012/0253459, which are each incorporated by reference herein in their entirety. For the sake of brevity, explicit descriptions of each of those combinations may be omitted although the various combinations are to be considered herein. Additionally, the devices and systems described herein can be positioned in the eye and need not be implanted specifically as shown in the figures or as described herein. The various devices can be implanted, positioned and adjusted etc. according to a variety of different methods and using a variety of different devices and systems. The various devices can be adjusted before, during as well as any time after implantation. Provided are some representative descriptions of how the various devices may be implanted and positioned, however, for the sake of brevity explicit descriptions of each method with respect to each implant or system may be omitted.
Turning now to
For example, and without limiting this disclosure to any particular theory or mode of operation, the ciliary muscle 18 is an annular structure or sphincter. In natural circumstances, when the eye is viewing an object at a far distance, the ciliary muscle 18 within the ciliary body relaxes and the inside diameter of the ciliary muscle 18 gets larger. The ciliary processes pull on the zonules 20, which in turn pull on the lens capsule 22 around its equator. This causes a natural lens to flatten or to become less convex, which is called disaccommodation. During accommodation, the ciliary muscle 18 contracts and the inside diameter of the ciliary muscle 18 gets smaller. The ciliary processes release the tension on the zonules 20 such that a natural lens will spring back into its natural, more convex shape and the eye can focus at near distances. As will be described in more detail below, the devices described herein are configured to harness that inward/anterior movement of the ciliary muscle 18 (or one or more ciliary structures) with the force translation arms 115. As will be described in more detail herein, the contact portion 135 of the force translation arms 115 can be implanted such that they are either in resting contact or readily in contact upon contraction of the ciliary muscle 18 with at least one of the ciliary structures (i.e. zonules, ciliary processes, and/or ciliary body). Contraction of the ciliary muscle and inward/anterior movement of one or more of the ciliary structures towards the optical axis applies a force against the contact portions 135 of the force translation arms 115. The force translation arms 115 transfer the force to the lens body 105 by sliding inward through channels 132 toward central annular region 125. Contact portions 137 of the force translation arms 115 are configured to abut the deformable portions 107 of the lens body 105 causing shape change in the central portion 103 of the lens body 105 into a more spherical or convex shape thereby increasing the power of the lens suitable for near vision focus.
The exterior support 110 can be formed of a biocompatible plastic, including but not limited to silicone, polydimethylsiloxane (PDMS), polyurethane, PMMA, PVDF, polyamide, polypropylene, polycarbonate, PEEK, etc. and combinations thereof. The exterior support 110 can be configured to prevent distortion caused by movement of the force translation arms 115 through the channels 132. In some implementations, the exterior support 110 can be rigid. In other implementations, the exterior support 110 can be foldable such that the device can be implanted in the eye through a smaller incision than the non-foldable, rigid version.
The exterior support 110 can be bonded or coupled to one or more stabilization haptics 120. In some implementations, the stabilization haptics 120 can be coupled to the exterior support 110 via an element 121 encircling at least a portion of the central annular region 125 of the exterior support 110 (best shown in
Now with respect to
An outer surface of the sidewall 143 of the shape deformation membrane 140 can be aligned with and bonded to an inner surface of the central region 125 of the exterior support 110 such that the lens body 105 is fixedly positioned within the central region 125. It should be appreciated that the orientation of the lens body 105 within the device 100 and within the eye can vary such that the shape changing membrane 145 can be positioned anteriorly and the static element 150, such as a static lens, positioned posteriorly relative to the eye anatomy. Similarly, the shape changing membrane 145 can be positioned posteriorly and the static element 150 positioned anteriorly relative to the eye anatomy. Further, it should be appreciated that the shape changing membrane 145 and/or the static element 150 can create a sealed chamber 155 within the device 100 by coupling directly to the exterior support 110 rather than the surfaces 141, 142 of the shape deformation membrane 140. Further, the lens can include an anterior support coupled to and defining the diameter of the shape changing membrane 145.
The shape changing membrane 145 can be a flexible optic formed of an optically clear, low modulus elastomer such as silicone. The shape changing membrane 145 can have a constant thickness such that it is a planar element (see
In some implementations, the reduced thickness portions of the shape changing membrane 145 can be found near region 170 of the shape changing membrane 145 surrounding, within, or parallel to the optical axis A. The reduced thickness region 170 can be configured to give way due to increased pressure applied by the optical fluid within the sealed chamber 155 on an internal surface of the shape changing membrane 145 causing an outward bowing of the outer face (e.g., anterior face). Region 172 of the shape changing membrane 145 can have a thickness greater than region 170 and can be more resistant to reshaping under such internal pressure applied by the optical fluid in the sealed chamber 155. The regions 172 of the shape changing membrane 145 can continue to provide distance vision correction even when the region 170 is reshaped for near vision. Region 170 of the shape changing membrane 145 can be formed of a material that is relatively more susceptible to outward bowing than the material of region 172. Region 170 can be injection molded in combination with the regions 172 to provide a relatively seamless and uninterrupted outer face. The material of the regions 172 can be generally consistent, though the region 170 can have different stiffness or elasticity that causes it to bow outward farther than the surrounding region. The shape changing membrane 145 can be configured to have varied multifocal capabilities to provide the wearer of the AIOLs described herein with enhanced vision over a wider range of distances, for example, as described in U.S. Publication No. 2009/0234449, which is incorporated by reference herein in its entirety.
Again with respect to
Still with respect to
As mentioned above, the sealed chamber 155 of the lens body 105 can be filed with clear, biocompatible optical fluid. The optical fluid can be a non-compressible liquid or gel that is clear and transparent in the visible spectrum, for example, silicone fluids and gels, functionalized silicone fluids and gels (for example, halogen, i.e., fluorinated silicones, aromatic, i.e., phenyl functionalized silicones, etc.), hydrocarbon and functionalized hydrocarbons, such as long chain hydrocarbons, halogenated hydrocarbons, such as fluorinated and partially fluorinated hydrocarbons, aqueous systems, both fluids and gels, whose refractive index (RI) has been increased by the additions of water-soluble or water swellable polymers, bio-polymer swellable additives such as cellulose, as well as organic or inorganic additives that form nanostructures to increase refractive index. In some implementations, the optical fluid within the sealed chamber 155 has a refractive index higher than 1.37. In other implementations, the optical fluid within the sealed chamber 155 has a refractive index between 1.37-1.57. In other implementations, the optical fluid within the sealed chamber 155 has a refractive index between 1.37-1.60.
The optical fluid within the sealed chamber 155 can cause flexure of the shape changing membrane 145 upon movements of the deformable portions 182 of the shape deformation membrane 140 (and thus, the deformable portions 107 of the lens body 105). Inward movement of the deformable portions 182 can result in the non-compressible optical fluid contained within the fixed-volume sealed chamber 155 of the lens body to press against the surfaces of the sealed chamber 155 including the inner surface of the shape changing membrane 145 and the inner surface of the sidewall 143 of the shape deformation membrane 140. Because the shape changing membrane 145 has a region near the region 170 configured to bow outward upon application of a force, the pressure of the optical fluid against the inner wall of the shape changing membrane 145 results in outward bowing and reshaping of the outer surface of the shape changing membrane 145 upon inward movement of deformable portions 107. The accommodative portion of the optic zone becomes more convex increasing the power of the AIOL 100.
It should be appreciated that this shape change of the shape changing membrane 145 occurs without actual flow of optical fluid from one chamber to another chamber. Rather, a force being applied on the shape deformation membrane 140 to deform the sealed chamber 155 in a first region can cause a reactive deformation of the sealed chamber 155 in at least a second region as the optical fluid inside the sealed chamber 155 changes shape along with the changing shape of the sealed chamber 155. The sealed chamber 155 has a fixed volume, a constant pressure and is deformable. The optical fluid has a fixed volume, is non-compressible, and changes shape depending on the shape of the sealed chamber 155. Inward deformation of one or more portions of the chamber 155 (e.g. the deformable portions 107) can cause a reactive outward deformation of another portion of the chamber 155 (e.g. region 170 of the shape changing membrane 145) due to the non-compressible optical fluid inside the sealed chamber 155. The optical fluid therefore does not actually flow between separate chambers of the AIOL, but rather changes shape alone with the changing shape of the sealed chamber causing the accommodative portion of the optic zone of the shape changing membrane 145 to bow outward increasing the power of the AIOL 100.
The shape deformation membrane 140, shape change membrane 145, and static element 150 together can form a lens body 105 having any of a variety of shapes. The central portion 103 of the lens body 105 can be generally circular and the deformable portions 107 can have any of a variety of shapes including bellowed, pleated, trapezoidal, cylindrical, elliptical, conical, spherical, hemi-spherical and the like (see for example,
The shape deformation membrane 140 can be formed of an optically clear, low modulus elastomer such as silicone, urethane, or flexible inelastic film such as polyethylene. The central portion 180 of the shape deformation membrane 140 can be made of an elastic material. The deformable portions 182 of the shape deformation membrane 140 can be formed of elastic or inelastic materials.
Again with respect to
In some implementations, the force translation arms 115 can each include an outer, contact portion 135 and an inner, contact portion 137 that can have any of a variety of shapes (see for example
Contact portion 137 can be coupled to contact portion 135. In some implementations, the contact portion 137 can be an elongate element coupled to and extending out from an inner surface of contact portion 135 (see e.g.
The position of the force translation arms 115 relative to the one or more ciliary structures can vary. Further, the force translation arms 115 can have a fixed length or can be adjustable. The adjustment of the force translation arms 115 can be performed prior to, during, or any time after insertion in the eye. It should be appreciated that the various components and features described for the various force translation arms can be incorporated with one or more various components and features described with respect to the various devices herein. Any of the devices and systems described herein can incorporate any of a variety of features and components described herein. Components or features of one implementation of a device and system described herein can be incorporated alternatively or in combination with components or features of another implementation of a device and system described herein. For the sake of brevity, explicit descriptions of each of those combinations may be omitted although the various combinations are to be considered herein.
The first and second elongate elements 738, 739 can engage one another according to other various mechanical configurations. For example,
In another interrelated implementation as shown in
In another interrelated implementation as shown in
In another interrelated implementation as shown in
In another interrelated implementation as shown in
In an interrelated implementation as shown in
It should be appreciated that the force translation arms 115 need not move relative to the exterior support 110 and the lens body 105. For example, the force translation arms 115 can be configured to generate an electric current generated upon ciliary structure motion and contact. For example, the force translation arms 115 can incorporate a piezoelectric system that generates an electric charge in response to the mechanical stress applied by the ciliary structures. The current generated by the force translation arms 115 can be used to cause accommodation in the lens body 105. For example, an external surface of contact portion 135 can include a piezoelectric disk that generates a voltage and cause accommodation of the lens.
As mentioned herein the overall length of the force translation arms 115 can be adjusted and fine-tuned before, during or after implantation for individual patients, as described above, to achieve customized and optimized contact between the force translation arms 115 and the ciliary structures such that shape change is in turn optimized. It should be appreciated that the shape change achieved in the lens body 105 can also be adjusted and fine-tuned any time after implantation of the device 100. In some implementations and as shown in
In an interrelated implementation as shown in
In an interrelated implementation as shown in
Table 1 below illustrates the relationship between the displacement of the deformable portions 182 (displacement from each side) and the outward bowing (and thus, dioptric change or accommodation) of the shape changing membrane that would result. The lens diameter in mm is the region of the shape changing membrane that is configured to bow outwardly in response to the optical fluid pressing against it from within the sealed chamber. The optical fluid can be a silicone oil having a refractive index between 1.37-1.57. The compressible portion length is the length (arrow L) of the deformable portion 182 of the membrane 140 and the compressible portion height (arrow H) is the thickness of the sidewall 143 of the shape deformation membrane 140 (see
The lens height (h) can be calculated from Pythagoras equation: (r−h)2+a2 r2. Hence: h=r−√(r2−a2).
For example, if the refractive index of the optical fluid is 1.4 and the diameter of the lens is 3 mm, a 28 micron movement from each deformable portion 182 creates a sufficient amount of pressure applied by the optical fluid against the shape changing membrane to form a 1D lens and if the diameter of the lens is 3 mm, a 84 micron movement of each deformable portion 182 creates a sufficient amount of pressure applied by the optical fluid against the shape changing membrane to form a 3D lens.
The devices described herein can be actuated into an accommodated (or unaccommodated) shape in direct response to ciliary structure movements, for example movements of the ciliary body and/or ciliary muscle. This direct ciliary translation of accommodation of the devices described herein can involve movement of optical fluid within the sealed chamber. As described above, and as shown also in
The AIOL 200 can include a lens body 205, a support 210, force translation arms 215, and one or more stabilization haptics 220. The support 210 can include an internal and/or external support 210. In some implementations, the support 210 is an external support 210 having a central annular region with which a central portion of the lens body 205 is aligned. The support 210 can include channels 232 or slots through a peripheral sidewall that extend into the central annular region (best shown in
As with previous implementations, the support 210 can be formed of a rigid polymer, including but not limited to silicone, polyurethane, PMMA, PVDF, PDMS, polyamide, polypropylene, polycarbonate, etc, or combinations thereof. The support 210 can be configured to prevent distortion caused by movement of the force translation arms 215 through the channels 232. The support 210 can be an exterior support located outside the sealed capsule 255 as shown in
The lens body 205 can include a shape deformation membrane 240, a shape changing membrane 245 and a static element 250, which can include a static lens. The shape deformation membrane 240, the shape changing membrane 245 and the static element 250 in combination with the support 210 create a generally planar, sealed chamber 255 that is configured to contain optical fluid therein. The shape deformation membrane 240 can be a ring-shape membrane coupled to an inner surface of the similarly ring-shaped support 210. A region of the shape changing membrane 245 can be coupled to a first surface of the support 210 and a region of the static element 250 can be coupled to a second, opposite surface of the support 210. It should be appreciated that the orientation of the lens body 205 within the AIOL 200 and within the eye can vary such that the shape changing membrane 245 can be positioned anteriorly and the static element 250 positioned posteriorly relative to the eye anatomy. Similarly, the shape changing membrane 245 can be positioned posteriorly and the static element 250 positioned anteriorly relative to the eye anatomy.
The static element 250 is best shown in
Now with respect to
As mentioned above, the sealed chamber 255 of the lens body 205 can be filled with optical fluid that can be a clear, biocompatible optical fluid. The optical fluid can be a non-compressible liquid or gel that is clear and transparent in the visible spectrum, for example, silicone fluids and gels, functionalized silicone fluids and gels (for example, halogen, i.e., fluorinated silicones, aromatic, i.e., phenyl functionalized silicones, etc.), hydrocarbon and functionalized hydrocarbons, such as long chain hydrocarbons, halogenated hydrocarbons, such as fluorinated and partially fluorinated hydrocarbons, aqueous systems, both fluids and gels, whose refractive index (RI) has been increased by the additions of water-soluble or water swellable polymers, bio-polymer swellable additives such as cellulose, as well as organic or inorganic additives that form nanostructures to increase refractive index. In some implementations, the optical fluid within the sealed chamber 255 has a refractive index higher than 1.37. In other implementations, the optical fluid within the sealed chamber 255 has a refractive index between 1.37-1.57. In other implementations, the optical fluid within the sealed chamber 255 has a refractive index between 1.37-1.60.
The optical fluid within the sealed chamber 255 can cause flexure of the shape changing membrane 245 upon movements of the shape deformation membrane 240. Inward movement of the shape deformation membrane 240 can result in the non-compressible optical fluid contained within the fixed volume, sealed chamber 255 to press against the surfaces of the sealed chamber 255 including the inner surface of the shape changing membrane 245. Because the shape changing membrane 245 has a region near the central portion configured to bow outward upon application of a force, the pressure of the optical fluid against the inner wall of the shape changing membrane 245 results in outward bowing and reshaping of the outer surface of the shape changing membrane 245.
The AIOL 200 can include force translation arms 215 configured to extend through channels 232 in the support 210. As described above, a force translation arm 215 can extend through the channel 232 of one side and a second force translation arm 215 can extend through the channel 232 of the opposing side. It should be appreciated however that the devices described herein can include more than two force translation arms 215. For example, the devices described herein can include three, four or more force translation arms 215 arranged evenly around the device. In some implementations, the force translation arms 215 can be a rigid polymer such as silicone, polyurethane, PMMA, PVDF, PDMS, polyamide, polypropylene, polycarbonate, etc. or combinations thereof. For example, the force translation arms 215 can be an element of a first material reinforced with a second material, such as PMMA.
In some implementations, the force translation arms 215 can each include an outer, contact portion 235 and an inner, contact portion 237 that can have any of a variety of shapes as described herein. Contact portion 235 can be configured to abut, contact, engage, functionally couple or be in close association with one or more ciliary structures, including but not limited to the ciliary body, ciliary processes, ciliary muscle, the zonules, or a combination thereof to drive shape change of the optics during accommodation and disaccommodation. Contact portion 235 of each force translation arm 215 can remain external to the support 210 such that it can remain in contact with the ciliary structure during accommodation and disaccommodation. In some implementations, the contact portion 235 can have an outer surface having a curved contour that can match a curved contour of a region of the eye in which the contact portion 235 associates. In some implementations, the contact portion 235 can have indentations, grooves, teeth, combs or other surface features to improve, for example, contact and interdigitation with ciliary processes or zonular processes. The outer surface of the contact portion 235 can also have sharpened or beveled edges on an upper and/or lower edge.
Contact portion 237 can be coupled to contact portion 235. In some implementations, the contact portion 237 can be an elongate element coupled to and/or extending out from an inner surface of contact portion 235 (see e.g.
The AIOL 300 can include a lens body 305, a support 310, and force translation arms 315. The support 310 can include an internal and/or an external support 310. In some implementations, the AIOL 300 has only an internal support sufficient to support the lens without any additional exterior support. The lens body 305 can be positioned within and coupled to a central region of the support 310. An anterior surface of the lens body 305 can be exposed through an anterior opening of the support 310 and a posterior surface of the lens body 305 can be exposed through a posterior opening of the support 310. It should be appreciated that orientation of the components of the lens body 305 within the AIOL 300 and within the eye can vary and that use of the terms “anterior” and “posterior” are not intended to be limiting.
The support 310 can include channels 332 or slots in a sidewall through which the force translation arms 315 can extend. The force translation arms 315 can move freely back and forth within the channels 332 as the ciliary structures move to effect accommodative shape change of the lens body 305. For example, a first force translation arm 315 can extend through a first channel 332 on one side of the support 310 and a second force translation arm 315 can extend through a second channel 332 on an opposing side of the support 310. The force translation arms 315 can each include an outer, contact portion 335 configured to contact at least a portion of a ciliary structure and an inner, contact portion 337 configured to translated within channel 332 and make contact with the lens body 305. The contact portion 335 of each force translation arm 315 can remain external to the support 310 such that it can remain in contact with the ciliary structure during accommodation and disaccommodation.
The support 310 can be formed of a material configured to prevent distortion caused by movement of the force translation arms 315 as well as prevent inadvertent movements of the force translation arms 315 (e.g. perpendicular to the direction of the force translation arm 315 inward/outward movement). In some implementations, one or more stabilization haptics 320 can be bonded to the support 310. In other implementations, the one or more stabilization haptics 320 can be bonded to a portion of the lens body 305 and the support 310 be located within the sealed chamber of the lens body 305. In other implementations, the one or more stabilization haptics 320 can be molded as part of the lens body 305 or the exterior support 310. The stabilization haptics 320 can be static haptics configured to maintain alignment of the optics of the device and to resist movement (e.g. vertical movement) of the AIOL 300 once implanted and undergoing accommodative shape change as described in more detail above. In some implementations, the one or more haptic(s) 320 can be placed in the ciliary sulcus and/or the capsular bag.
The lens body 305 can include a shape deformation membrane 340, a shape changing membrane 345, and a static element 350 (or static lens) sealed together into a generally planar lens body 305 having a sealed chamber 355. The sealed chamber 355 is configured to contain optical fluid therein, for example a fluorosilicone oil or other optical fluid described herein. The shape deformation membrane 340 can be a ring-shaped silicone structure (e.g. PDMS) coupled on a first surface (e.g. anterior surface) to a perimeter of the shape changing membrane 345 or an anterior support defining a diameter of the shape changing membrane 345. The shape deformation membrane 340 can be coupled on an opposite surface (e.g. posterior surface) to a perimeter of the static element 350. It should be appreciated that the components of the lens body can be coupled in any of a variety of configurations between themselves as well as with the support 310. The outer wall of the shape deformation membrane 340 can have regions configured to engage with the force translation arms 315 such that as the force translation arms 315 move, the regions likewise move. Movement of the shape deformation membrane 340 changes the shape of the sealed chamber 355 causing accommodation and disaccommodation as will be described in more detail below. In some implementations, the shape deformation membrane 340 can have a first region on the outer wall that engages with a first force translation arm 315 and a second region on the outer wall that engages with a second force translation arm 315. Each of the first and second regions on the outer wall of the shape deformation membrane 340 can include a surface feature 341 configured to engage with a corresponding feature 338 on the force translation arm 315 (best shown in
The support 310 can be formed of a harder material (or materials) than the shape deformation membrane 340 to prevent inadvertent movements of the moving parts of the device. The AIOL 300 can alternatively or in additionally include one or more ribs or internal supports 312 located within the sealed chamber 355 of the lens body 305. The internal supports 312 can act to mechanically isolate the optical components of the lens from optical distortion during movement of the moving parts of the AIOL 300. In some implementations, the one or more internal supports 312 connect the anterior and posterior supports. In some implementations, a first surface of the internal support 312 can be coupled to a perimeter region of the shape changing membrane 345 (best shown in
During accommodation, inward/anterior movement of the ciliary structure can be harnessed by contact portions 335 of the force translation arms 315 causing the force translation arms 315 to move inward toward the optical axis A. Inward movement of the force translation arms 315 urges the shape deformation membrane 340 to undergo movement or deformation relative to the shape changing membrane 345, for example, towards the optical axis. Inward movement, collapse, compression or deformation of the deformable regions 307 of the shape deformation membrane 340 toward the optical axis causes the non-compressible optical fluid contained within the fixed volume, sealed chamber 355 to press against the surfaces of the sealed chamber 355 including the inner surface of the shape changing membrane 345. The shape changing membrane 345 can have a region surrounding the optical axis configured to bow outward or flex upon application of a force into a more spherical or convex shape in the optic zone thereby increasing the power of the lens for near vision focus without imposing stress or squeezing on the optic zone. The pressure of the optical fluid against the shape changing membrane 345 reshapes the outer surface. It should be appreciated that this shape change can occur without flow of fluid from one part of the lens body 305 to another. Rather, the compression of the fixed volume sealed chamber 355 (and deformable region 307) filled with non-compressible optical fluid drives the shape change of the membrane 345. The deformable region 307 and central region 303 of the sealed chamber 355 can both be within the optic zone such that deformation of the shape deformation membrane 340 (and the deformable region 307) occurs inside the optic zone. Alternatively, the deformable region 307 can be located outside the optic zone such that deformation of the shape deformation membrane 340 (and the deformable region 307) occurs outside the optic zone.
The internal support 312 can have a tapered geometry such that the supports 312 do not come into contact with moving parts of the lens such as the shape deformation membrane 340. For example as shown in 26C, the support 312 can have a wider dimension near where the support 312 couples with the shape changing membrane 345 and an outer wall that tapers away from the shape changing membrane 345 such that the support 312 has a narrower dimension near where the shape deformation membrane 340 deforms to the greatest degree during accommodation. In another example as shown in
The dimensions of the components of the devices described herein can vary. The devices can be configured to be implanted through an incision that is less than about 4 mm. In some implementations, the overall diameter of the device is approximately 8 mm, although this can vary. For example, a device having flexible or foldable stabilization haptics can have a first diameter during implantation that is smaller than the diameter it achieves after implantation following unfolding or expansion of the stabilization haptics. In some implementations, the exterior support can be made from a flexible material(s) such that the exterior support can bend during implantation of the device. In some implementations, the central, optic zone portion of the lens body can have a diameter that is about 2.5 mm, about 3.0 mm, about 3.5 mm, about 4.0 mm, about 4.5 mm, about 5.0 mm, about 5.5 mm, about 6.0 mm, about 6.5 mm, or greater diameter. In some implementations, the accommodating diameter, or the region of the central optic zone that undergoes a shape change, is greater than 3.0 mm.
As described above, the deformable regions of the lens body can move or collapse relative to the central region of the lens body upon application of a degree of force on the shape changing membrane. The force applied to achieve movement of the shape changing membrane of the lens body to effect accommodation can be as low as about 0.1 grams of force (go. In some implementations, the force applied can be between about 0.1 gf to about 5.0 gf or between about 0.5 gf to about 1.5 gf or between about 1.0 gf to about 1.5 gf. The movements of the deformable regions of the lens body relative to the central portion of the lens body in response to forces applied to achieve accommodation can be as small as about 50 um. The movements of the deformable regions of the lens body relative to the central portion of the lens body (or e.g. region 107 relative to central region 103 or the deformable portion 182 of the shape deformation membrane 140 relative to the central portion 180 of the shape deformation membrane 140) in response to forces applied can be between about 50 um to about 500 um, between about 50 um to about 150 um, or between about 100 um to about 150 um. These ranges of forces applied and that result in these ranges of movement can provide the devices described herein with an accommodating capability that is within a dynamic range of greater than 3 D. In some implementations, the power is between 4 D and 6 D for about 100-150 um movement. The devices described herein can have an accommodating range that is at least 3 D for about 100 um movement of the shape changing membrane and about a force of at least 0.1 gf applied to the shape changing membrane. In other implementations, the devices can have an accommodating range that is at least 3 D for about 50 um movement and at least about 1.0 gf.
Suitable materials or combinations of materials for the preparation of the various components of the devices disclosed herein are provided throughout. It should be appreciated that other suitable materials are considered. U.S. Patent Publication Nos. 2009/0234449, 2009/0292355 and 2012/0253459, which are each incorporated by reference herein in their entirety, provide further examples of other materials suitable for forming certain components for the devices described herein.
The various devices described herein can be implanted according to a variety of surgical methods known in the art. Depending upon the features and components of the device, they can be implanted using various techniques or using various implements. The devices described herein can be used alone or in combination with another intraocular lens or the patient's natural lens. As described herein the power of the lens body as well as the relative position of the force translation arms and/or stability haptics can be adjusted and/or fine-tuned prior to implantation, during implantation or any time after implantation. It should also be appreciated that the devices described herein can be inserted through a small incision, such as an incision that is no greater than 3.5 mm. The devices described herein can be implanted such that the device is positioned outside the lens capsule, for example anterior to the capsule and posterior to the iris. The devices described herein can be implanted such that the central portion of the lens body is aligned with the optical axis of the eye. The force translation arms can be positioned relative to the one or more ciliary structures such as the ciliary body or the ciliary muscle. The force translation arms can be positioned such that they abut with the ciliary structure (or very closely associated to the ciliary structure without abutting) without causing compression of the lens body including the deformable region of the lens body when the ciliary structure is in the resting, disaccommodated state (unaccommodated). However, the force translation arms can be positioned close enough to the ciliary structure such that upon contraction of the ciliary muscle the lens body undergoes accommodation and upon relaxation of the ciliary muscle the lens body undergoes disaccommodation and the materials of the lens body rapidly return to their resting state. The relative position and length of the force translation arms can be adjusted according to the various methods described above using one or more of the various features for adjustment described herein. The stabilization haptics can be positioned within the ciliary sulcus (or other region) to further stabilize the device within the eye. The resting power of the lens body can also undergo further adjustment and fine-tuning according to the various methods described herein and using one or more of the various features for power adjustment described herein.
While this specification contains many specifics, these should not be construed as limitations on the scope of what is claimed or of what may be claimed, but rather as descriptions of features specific to particular embodiments. Certain features that are described in this specification in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable sub-combination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a sub-combination or a variation of a sub-combination. Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. Only a few examples and implementations are disclosed. Variations, modifications and enhancements to the described examples and implementations and other implementations may be made based on what is disclosed.
In the descriptions above and in the claims, phrases such as “at least one of” or “one or more of” may occur followed by a conjunctive list of elements or features. The term “and/or” may also occur in a list of two or more elements or features. Unless otherwise implicitly or explicitly contradicted by the context in which it is used, such a phrase is intended to mean any of the listed elements or features individually or any of the recited elements or features in combination with any of the other recited elements or features. For example, the phrases “at least one of A and B;” “one or more of A and B;” and “A and/or B” are each intended to mean “A alone, B alone, or A and B together.” A similar interpretation is also intended for lists including three or more items. For example, the phrases “at least one of A, B, and C;” “one or more of A, B, and C;” and “A, B, and/or C” are each intended to mean “A alone, B alone, C alone, A and B together, A and C together, B and C together, or A and B and C together.”
Use of the term “based on,” above and in the claims is intended to mean, “based at least in part on,” such that an unrecited feature or element is also permissible.
This application is a continuation of U.S. patent application Ser. No. 16/372,090, filed Apr. 1, 2019, issued as U.S. Pat. No. 11,331,182, which is a continuation of U.S. patent application Ser. No. 15/300,116, filed Sep. 28, 2016, issued as U.S. Pat. No. 10,285,805 on May 14, 2019, which is a national-phase entry of Patent Cooperation Treaty Application No. PCT/US2015/022501, which has an international filing date of Mar. 25, 2015, and claims the benefit of priority to U.S. Provisional Application Ser. No. 61/972,183, filed Mar. 28, 2014 and U.S. Provisional Application Ser. No. 61/977,568, filed Apr. 9, 2014; the full disclosures of which are incorporated herein by reference in their entireties.
Number | Name | Date | Kind |
---|---|---|---|
4159546 | Shearing | Jul 1979 | A |
4373218 | Schachar | Feb 1983 | A |
4485498 | Gimbel | Dec 1984 | A |
4685921 | Peyman | Aug 1987 | A |
4731078 | Stoy et al. | Mar 1988 | A |
4734095 | Siepser | Mar 1988 | A |
4769035 | Kelman | Sep 1988 | A |
4782820 | Woods | Nov 1988 | A |
4787903 | Grendahl | Nov 1988 | A |
4816030 | Robinson | Mar 1989 | A |
4816031 | Pfoff | Mar 1989 | A |
4842601 | Smith | Jun 1989 | A |
4865601 | Caldwell et al. | Sep 1989 | A |
4888012 | Horn et al. | Dec 1989 | A |
4888016 | Langerman | Dec 1989 | A |
4892543 | Turley | Jan 1990 | A |
4932966 | Christie et al. | Jun 1990 | A |
4932968 | Caldwell et al. | Jun 1990 | A |
4957505 | McDonald | Sep 1990 | A |
5066301 | Wiley | Nov 1991 | A |
5171266 | Wiley et al. | Dec 1992 | A |
5171320 | Nishi | Dec 1992 | A |
RE34424 | Walman | Oct 1993 | E |
5275623 | Sarfarazi | Jan 1994 | A |
5288293 | O'Donnell, Jr. | Feb 1994 | A |
5443506 | Garabet | Aug 1995 | A |
5476512 | Sarfarazi | Dec 1995 | A |
5489302 | Skottun | Feb 1996 | A |
5607472 | Thompson | Mar 1997 | A |
5684637 | Floyd | Nov 1997 | A |
5766245 | Fedorov et al. | Jun 1998 | A |
5774273 | Bornhorst | Jun 1998 | A |
5800806 | Yamamoto | Sep 1998 | A |
5932205 | Wang et al. | Aug 1999 | A |
6013101 | Israel | Jan 2000 | A |
6027531 | Tassignon | Feb 2000 | A |
6045535 | Ben Nun | Apr 2000 | A |
6096078 | McDonald | Aug 2000 | A |
6117171 | Skottun | Sep 2000 | A |
6120538 | Rizzo, III et al. | Sep 2000 | A |
6143315 | Wang et al. | Nov 2000 | A |
6188526 | Sasaya et al. | Feb 2001 | B1 |
6228115 | Hoffmann et al. | May 2001 | B1 |
6261321 | Kellan | Jul 2001 | B1 |
6277146 | Peyman et al. | Aug 2001 | B1 |
6299641 | Woods | Oct 2001 | B1 |
6387126 | Cumming | May 2002 | B1 |
6443985 | Woods | Sep 2002 | B1 |
6450642 | Jethmalani et al. | Sep 2002 | B1 |
6493151 | Schachar | Dec 2002 | B2 |
6506212 | Zhou et al. | Jan 2003 | B2 |
6524340 | Israel | Feb 2003 | B2 |
6552860 | Alden | Apr 2003 | B1 |
6558420 | Green | May 2003 | B2 |
6592621 | Domino | Jul 2003 | B1 |
6599317 | Weinschenk, III et al. | Jul 2003 | B1 |
6645246 | Weinschenk, III et al. | Nov 2003 | B1 |
6730123 | Klopotek | May 2004 | B1 |
6733122 | Feurer et al. | May 2004 | B1 |
6749634 | Hanna | Jun 2004 | B2 |
6818017 | Shu | Nov 2004 | B1 |
6836374 | Esch et al. | Dec 2004 | B2 |
6849091 | Cumming | Feb 2005 | B1 |
6851804 | Jethmalani et al. | Feb 2005 | B2 |
6855164 | Glazier | Feb 2005 | B2 |
6860601 | Shadduck | Mar 2005 | B2 |
6930838 | Schachar | Aug 2005 | B2 |
6935743 | Shadduck | Aug 2005 | B2 |
6966049 | Lepejian et al. | Nov 2005 | B2 |
6966649 | Shadduck | Nov 2005 | B2 |
7008449 | Willis et al. | Mar 2006 | B2 |
7025783 | Brady et al. | Apr 2006 | B2 |
7060094 | Shahinpoor et al. | Jun 2006 | B2 |
7068439 | Esch et al. | Jun 2006 | B2 |
7097660 | Portney | Aug 2006 | B2 |
7118596 | Zadno-Azizi et al. | Oct 2006 | B2 |
7118597 | Miller et al. | Oct 2006 | B2 |
7122053 | Esch | Oct 2006 | B2 |
7217288 | Esch et al. | May 2007 | B2 |
7220279 | Nun | May 2007 | B2 |
7229476 | Azar | Jun 2007 | B2 |
7247168 | Esch et al. | Jul 2007 | B2 |
7256943 | Kobrin et al. | Aug 2007 | B1 |
7261737 | Esch et al. | Aug 2007 | B2 |
7278739 | Shadduck | Oct 2007 | B2 |
7293873 | Dai et al. | Nov 2007 | B2 |
7341599 | Peyman | Mar 2008 | B1 |
7369321 | Ren et al. | May 2008 | B1 |
7381221 | Lang et al. | Jun 2008 | B2 |
7384429 | Hanna | Jun 2008 | B2 |
7438723 | Esch | Oct 2008 | B2 |
7453646 | Lo | Nov 2008 | B2 |
7485144 | Esch | Feb 2009 | B2 |
7601169 | Phillips | Oct 2009 | B2 |
7615056 | Ayton et al. | Nov 2009 | B2 |
7637947 | Smith et al. | Dec 2009 | B2 |
7675686 | Lo et al. | Mar 2010 | B2 |
7713299 | Brady et al. | May 2010 | B2 |
7753953 | Yee | Jul 2010 | B1 |
7763069 | Brady et al. | Jul 2010 | B2 |
7776088 | Shadduck | Aug 2010 | B2 |
7806930 | Brown | Oct 2010 | B2 |
7854764 | Ben Nun | Dec 2010 | B2 |
7857850 | Mentak et al. | Dec 2010 | B2 |
7883540 | Niwa et al. | Feb 2011 | B2 |
7985253 | Cumming | Jul 2011 | B2 |
7988285 | Sandstedt et al. | Aug 2011 | B2 |
8018658 | Lo | Sep 2011 | B2 |
8034106 | Mentak et al. | Oct 2011 | B2 |
8038711 | Clarke | Oct 2011 | B2 |
8158712 | Your | Apr 2012 | B2 |
8314927 | Choi et al. | Nov 2012 | B2 |
8343216 | Brady et al. | Jan 2013 | B2 |
8377125 | Kellan | Feb 2013 | B2 |
8414646 | De Juan, Jr. et al. | Apr 2013 | B2 |
8500806 | Phillips | Aug 2013 | B1 |
8663235 | Tassignon | Mar 2014 | B2 |
8668734 | Hildebrand et al. | Mar 2014 | B2 |
8715346 | de Juan, Jr. et al. | May 2014 | B2 |
8851670 | Dai et al. | Oct 2014 | B2 |
8900298 | Anvar et al. | Dec 2014 | B2 |
8956408 | Smiley et al. | Feb 2015 | B2 |
8968396 | Matthews et al. | Mar 2015 | B2 |
8974526 | Bogaert | Mar 2015 | B2 |
9005282 | Chang et al. | Apr 2015 | B2 |
9044317 | Hildebrand et al. | Jun 2015 | B2 |
9107748 | de Juan, Jr. et al. | Aug 2015 | B2 |
9114005 | Simonov et al. | Aug 2015 | B2 |
9326846 | Devita Gerardi et al. | May 2016 | B2 |
9421089 | Zadno-Azizi | Aug 2016 | B2 |
9681981 | Stevens | Jun 2017 | B2 |
9782291 | Stevens | Oct 2017 | B2 |
9814568 | Ben Nun | Nov 2017 | B2 |
9872763 | Smiley et al. | Jan 2018 | B2 |
10166096 | Ben Nun | Jan 2019 | B2 |
10195018 | Salahieh et al. | Feb 2019 | B2 |
10258805 | Reed et al. | Apr 2019 | B2 |
10743983 | Wortz et al. | Aug 2020 | B2 |
10751167 | Paine | Aug 2020 | B2 |
11331182 | de Juan, Jr. et al. | May 2022 | B2 |
20010001836 | Cumming | May 2001 | A1 |
20020188351 | Laguette | Dec 2002 | A1 |
20030060878 | Shadduck | Mar 2003 | A1 |
20030149480 | Shadduck | Aug 2003 | A1 |
20030171809 | Phillips | Sep 2003 | A1 |
20030187501 | Okada | Oct 2003 | A1 |
20030187504 | Weinschenk et al. | Oct 2003 | A1 |
20040006387 | Kelman | Jan 2004 | A1 |
20040015140 | Shields | Jan 2004 | A1 |
20040034417 | Heyman | Feb 2004 | A1 |
20040039446 | McNicholas | Feb 2004 | A1 |
20040082993 | Woods | Apr 2004 | A1 |
20040082995 | Woods | Apr 2004 | A1 |
20040111153 | Woods et al. | Jun 2004 | A1 |
20040148023 | Shu | Jul 2004 | A1 |
20040162612 | Portney et al. | Aug 2004 | A1 |
20040169816 | Esch | Sep 2004 | A1 |
20040169820 | Dai et al. | Sep 2004 | A1 |
20040237971 | Radhakrishnan et al. | Dec 2004 | A1 |
20050021138 | Woods | Jan 2005 | A1 |
20050060032 | Magnante et al. | Mar 2005 | A1 |
20050065534 | Hohl | Mar 2005 | A1 |
20050107873 | Zhou | May 2005 | A1 |
20050113914 | Miller et al. | May 2005 | A1 |
20050125059 | Pinchuk et al. | Jun 2005 | A1 |
20050137703 | Chen | Jun 2005 | A1 |
20050251253 | Gross | Nov 2005 | A1 |
20050256571 | Azar | Nov 2005 | A1 |
20060047340 | Brown | Mar 2006 | A1 |
20060064162 | Klima | Mar 2006 | A1 |
20060100701 | Esch et al. | May 2006 | A1 |
20060238702 | Glick et al. | Oct 2006 | A1 |
20060259138 | Peyman | Nov 2006 | A1 |
20070010881 | Soye et al. | Jan 2007 | A1 |
20070054131 | Stewart | Mar 2007 | A1 |
20070078515 | Brady | Apr 2007 | A1 |
20070088433 | Esch et al. | Apr 2007 | A1 |
20070100444 | Brady et al. | May 2007 | A1 |
20070123982 | Yablonski et al. | May 2007 | A1 |
20070129798 | Chawdhary | Jun 2007 | A1 |
20070129800 | Cumming | Jun 2007 | A1 |
20070129801 | Cumming | Jun 2007 | A1 |
20080046075 | Esch et al. | Feb 2008 | A1 |
20080046076 | Rombach | Feb 2008 | A1 |
20080097459 | Kammerlander et al. | Apr 2008 | A1 |
20080103592 | Maloney | May 2008 | A1 |
20080106698 | Dai et al. | May 2008 | A1 |
20080119864 | Deinzer et al. | May 2008 | A1 |
20080125862 | Blake | May 2008 | A1 |
20080129962 | Dai et al. | Jun 2008 | A1 |
20080288066 | Cumming | Nov 2008 | A1 |
20090005865 | Smiley et al. | Jan 2009 | A1 |
20090012609 | Geraghty et al. | Jan 2009 | A1 |
20090171458 | Kellan et al. | Jul 2009 | A1 |
20090234449 | De Juan, Jr. et al. | Sep 2009 | A1 |
20090292355 | Boyd et al. | Nov 2009 | A1 |
20100094415 | Bumbalough | Apr 2010 | A1 |
20100121444 | Ben Nun | May 2010 | A1 |
20100280609 | Simonov et al. | Nov 2010 | A1 |
20110054600 | Bumbalough | Mar 2011 | A1 |
20110071628 | Gross et al. | Mar 2011 | A1 |
20110112636 | Ben Nun | May 2011 | A1 |
20110118834 | Lo et al. | May 2011 | A1 |
20120078364 | Stenger | Mar 2012 | A1 |
20120168422 | Boyd et al. | Jul 2012 | A1 |
20120253459 | Reich et al. | Oct 2012 | A1 |
20130013061 | Coroneo | Jan 2013 | A1 |
20130041382 | Ben Nun | Feb 2013 | A1 |
20130110235 | Schwiegerling | May 2013 | A1 |
20130116781 | Ben Nun | May 2013 | A1 |
20130150960 | DeBoer et al. | Jun 2013 | A1 |
20130245754 | Blum et al. | Sep 2013 | A1 |
20140012240 | Ho et al. | Jan 2014 | A1 |
20140058507 | Reich et al. | Feb 2014 | A1 |
20140074074 | Dick et al. | Mar 2014 | A1 |
20140121768 | Simpson | May 2014 | A1 |
20140180403 | Silvestrini et al. | Jun 2014 | A1 |
20140228949 | Argento et al. | Aug 2014 | A1 |
20140277437 | Currie | Sep 2014 | A1 |
20150087743 | Anvar et al. | Mar 2015 | A1 |
20150150676 | Nun | Jun 2015 | A1 |
20150250584 | Blum et al. | Sep 2015 | A1 |
20150257874 | Hildebrand et al. | Sep 2015 | A1 |
20160008126 | Salahieh et al. | Jan 2016 | A1 |
20160030161 | Brady et al. | Feb 2016 | A1 |
20190038401 | Reich et al. | Feb 2019 | A1 |
20190183637 | Ben Nun | Jun 2019 | A1 |
20190223999 | Nun | Jul 2019 | A1 |
20200188088 | Reich et al. | Jun 2020 | A1 |
20210259826 | Ben Nun | Aug 2021 | A1 |
20210290372 | Ben Nun | Sep 2021 | A1 |
20210378815 | Salahieh et al. | Dec 2021 | A9 |
20220168464 | Clarke et al. | Jun 2022 | A1 |
20240050222 | Salahieh | Feb 2024 | A1 |
Number | Date | Country |
---|---|---|
2944010 | Oct 2015 | CA |
101137338 | Mar 2008 | CN |
101795642 | Aug 2010 | CN |
103025271 | Apr 2013 | CN |
103096837 | May 2013 | CN |
105392448 | Mar 2016 | CN |
0 162 573 | Nov 1985 | EP |
1 917 932 | May 2008 | EP |
1932492 | Jun 2008 | EP |
2005169131 | Jun 2005 | JP |
2005533611 | Nov 2005 | JP |
2008-532617 | Aug 2008 | JP |
2008183434 | Aug 2008 | JP |
2009532176 | Sep 2009 | JP |
2011500270 | Jan 2011 | JP |
2016525432 | Aug 2016 | JP |
WO-9303686 | Mar 1993 | WO |
WO-03000154 | Jan 2003 | WO |
WO-03017867 | Mar 2003 | WO |
WO-03017873 | Mar 2003 | WO |
WO-2004010905 | Feb 2004 | WO |
WO-2004037122 | May 2004 | WO |
WO-2004037127 | May 2004 | WO |
WO-2004053568 | Jun 2004 | WO |
WO-2004054471 | Jul 2004 | WO |
WO-2004107024 | Dec 2004 | WO |
WO-2005057272 | Jun 2005 | WO |
WO-2005082285 | Sep 2005 | WO |
WO-2007067867 | Jun 2007 | WO |
WO-2007113832 | Oct 2007 | WO |
WO-2007117476 | Oct 2007 | WO |
WO-2008031231 | Mar 2008 | WO |
WO-2009055099 | Apr 2009 | WO |
WO-2010010565 | Jan 2010 | WO |
WO-2012006186 | Jan 2012 | WO |
WO-2012023133 | Feb 2012 | WO |
WO-2012067994 | May 2012 | WO |
WO-2013016804 | Feb 2013 | WO |
WO-2015066502 | May 2015 | WO |
WO-2017096087 | Jun 2017 | WO |
Entry |
---|
U.S. Appl. No. 16/345,364, filed Apr. 26, 2019, US 2019-0269500. |
U.S. Appl. No. 17/166,680, filed Feb. 3, 2021, US 2021-0259826. |
U.S. Appl. No. 17/221,525, filed Apr. 2, 2021, US 2021-0290372. |
U.S. Appl. No. 17/364,202, filed Jun. 30, 2021, US 2022-0160495. |
U.S. Appl. No. 17/600,571, filed Sep. 30, 2021, US 2022-0168464. |
PCT/US21/37354, Jun. 15, 2021, WO 2021/257518. |
Gimbel, H.V., Debroff, B.M. (2004), “Intraocular lens optic capture.” J Cataract Refract Surg Jan. 2004;30(1):200-6. |
U.S. Appl. No. 17/575,155, filed Jan. 13, 2022, US 2022-0218467. |
U.S. Appl. No. 17/970,131, filed Oct. 20, 2022, US 2023-0129111. |
U.S. Appl. No. 17/979,675, filed Nov. 2, 2022, US 2023-0240835. |
U.S. Appl. No. 18/010,616, filed Dec. 15, 2022, US 2023-0383062. |
PCT/US2022/47293, Oct. 20, 2022, WO 2023/069630. |
PCT/US2023/60967, Jan. 20, 2023, WO 2023/141552. |
PCT/US2023/16450, Mar. 27, 2023, WO 2023/192202. |
Number | Date | Country | |
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20220323205 A1 | Oct 2022 | US |
Number | Date | Country | |
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61977568 | Apr 2014 | US | |
61972183 | Mar 2014 | US |
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Child | 16372090 | US |