Patent Application
20160331521
The present invention relates generally to implantable intraocular lenses for vision correction.
The crystalline lens of the human eye refracts and focuses light onto the retina. Normally the lens is clear, but it can become opaque (i.e., when developing a cataract) due to aging, trauma, inflammation, metabolic or nutritional disorders, or radiation. While some lens opacities are small and require no treatment, others may be large enough to block significant fractions of light and obstruct vision.
Conventionally, cataract treatments involve surgically removing the opaque lens matrix from the lens capsule using, for example, phacoemulsification and/or a femtosecond laser through a small incision in the periphery of the patient's cornea. An artificial intraocular lens (IOL) can then be implanted in the lens capsular bag (or “capsule bag”)—the sack-like structure remaining within the eye following extracapsular cataract extraction; the lens “capsule” is the thin clear membrane that surrounds the natural crystalline lens—to replace the natural lens. Generally, IOLs are made of a foldable material, such as silicone or uncrosslinked acrylics, to minimize the incision size and required stitches and, as a result, the patient's recovery time. The most commonly used IOLs are single-element lenses (or monofocal IOLs) that provide a single focal distance; the selected focal length typically affords fairly good distance vision. However, because the focal distance is not adjustable following implantation of the IOL, patients implanted with monofocal IOLs can no longer focus on objects at to close distance (e.g., less than 60 cm); this results in poor visual acuity at close distances. To negate this disadvantage, multifocal IOLs provide dual foci at both near and far distances. However, due to the optical design of such lenses, patients implanted with multifocal IOLs often suffer from a loss of vision sharpness (e.g., blurred vision, halos, glare, and decreased contrast sensitivity). In addition, patients may experience visual disturbances, such as halos or glare, because of the simultaneous focus at two distances.
Recently, accommodating intraocular lenses (AIOLs) have been developed to provide adjustable focal distances (or “accommodations”), relying on the natural focusing ability of the eye. The term “accommodation” generally refers to the process by which the eye changes optical power to maintain focus at different distances, e.g., as an object recedes or approaches. When the circular ciliary muscle relaxes, the fibrous zonules that connect the muscle to the lens pull on the lens, flattening it to focus on a far object. When accommodating to a near object, the ciliary muscles contract and the lens zonules slacken, allowing the lens to assume a thicker and more convex form.
AIOLs respond to this ocular behavior in as manner analogous to that of the natural lens. Conventional AIOLs include, for example, a single optic that translates its position along the visual axis of the eye, dual optics that change the distance between two lenses, and curvature-changing lenses that change their curvatures to adjust the focus power. These designs, however, tend to be too complex to be practical to construct and/or have achieved limited success (e.g., providing a focusing power of only 1-2 diopters). One reason for the lack of success is the fact that the AIOL may not respond mechanically the way the natural lens does, or the patient may have an ocular anatomy that requires a non-uniform response by the lens.
Consequently, there is still a need for AIOLs that provide a high degree of accommodation and provide appropriate focusing power, optically respond correctly to the natural focusing mechanism of the patient's eye, and which can be easily manufactured and implanted in human eyes. In addition, such AIOLs should respond appropriately to the eye's natural accommodation mechanism, thereby allowing the patient to experience a range of focal distances with minimal complications.
In various embodiments, the invention relates to an AIOL that corrects vision and is optically responsive to the natural focusing mechanism of the patient's eye. The AIOL may include one or more components internal to its “lens” (typically a fluid-fillable reservoir having an exterior flexible membrane) as well as one or more components external to the lens.
In certain embodiments, an internal component includes, consists essentially of, or consists of a spanning member extending across the lens and that affects the way the device responds to accommodative action and/or to filling, or overfilling, of the lens with an optical fluid. Although internal component(s) may be located in the optical portion of the lens—i.e., a central chamber portion that effects vision correction following implantation—it or they may be configured to avoid interfering with the patient's vision. A spanning member may act to restrain lens expansion, in the manner of a rope, or may resist lens contraction in the manner of a strut.
In various other embodiments, an internal component includes, consists essentially of, or consists of an optically shaped rigid component. The rigid component comes into contact with the fluid-filled lens as the eye focuses, causing the fluid-filled lens to change shape. (As used herein, the terms “fluid-filled” and “fluid-fillable” are interchangeable and refer to a lens comprising or consisting essentially of an optically transparent and typically flexible membrane that defines a reservoir fillable by fluid; the fluid and membrane at least partially dictate the optical power of the lens. The lens is not necessarily filled with fluid prior to implantation in a patient's eye.) Physically the rigid component may be mounted to the lens through a series of flexible coupling members, which allow it to move in the anterior-posterior direction.
The rigid member may have optical focusing ability such as a lens, or it may have no optical power, as in the case that it is a uniform thickness optically clear spherical (or other shape—e.g. asphetical, toric, multifocal, planar) shell. In all cases, the rigid member is free to disengage from the lens in the axial direction, or to engage and alter the anterior (or posterior) surface of the lens. This movement is actuated either by directly applying pressure to the rigid member or by applying a force to the flexible members.
In various embodiments, the rigid component is located, either anterior to the anterior surface of the lens (or posterior to the posterior lens surface). The rigid component typically has a surface curvature that differs from curvature of the fluid-filled lens. As it comes into contact with the anterior surface of the fluid-filled lens, it causes the fluid-filled lens to conform to its curvature. Therefore, actuation of the rigid component causes an optical power change in the fluid-filled lens itself due to a curvature change of the anterior surface of the fluid-filled lens.
In some embodiments, the rigid member is a spherical-shaped portion with a radius of curvature larger than the liquid filled intraocular lens. When the fluid-filled lens contacts the rigid member, it assumes its shape and overall fluid-filled lens power is decreased due to a decrease in optical power from the anterior surface of the lens. When the rigid member is not in contact with the lens, the anterior surface of the fluid-filled lens takes its nominal shape and optical power is higher, corresponding to the accommodated state.
This contact occurs during the actuation of the rigid member. Initially, the central portion of the rigid member contacts the anterior surface of the fluid-filled lens. Then as it further actuates, it contacts a larger portion of the lens. Finally it contacts the whole anterior surface of the lens. During this process, the optical properties of the fluid-filled lens are altered initially with a change in only the central portion of the lens, extending radially, and finally throughout the whole optical portion of the lens.
In this manner, the lens may be considered as going from one optical state, S1, to a second optical state S2, with a continuous transition state mechanically spreading through the lens as the rigid component interacts with the lens. The transition state is characterized by a portion of the light focused in optical state S1 and a portion of the light focused in optical state S2. As the transition occurs the percentage of light in the S1 state decreases while the percentage in the S2 state increases.
This type of lens interacts with the natural accommodation mechanism. First, when the eye is focused at far distance, the ciliary muscles are relaxed and the zonules pull tension on the lens capsule. This tension is applied to the rigid component, causing it to come into contact with the full visual field of the fluid-filled lens. As the eye begins to accommodate, the ciliary muscles contract and move inward, releasing tension on the zonules. As this process occurs, the rigid component moves away from the lens, first releasing contact peripherally, and then centrally as it moves anteriorly. This creates a transition state, based on the periphery of the lens with a radius of curvature corresponding to the natural fluid-filled lens, and the central portion corresponding to the rigid member. When the eye muscles are completely focused on near vision, the lens capsule is relaxed, and the rigid component is no longer in contact with the fluid-filled lens. At this point, the power of the fluid-filled lens is dictated by its natural state.
In various embodiments, the fluid-filled lens portion of the IOL includes, consists essentially of, or consists of a thin membrane well that is filled through one or more valves. The valve(s) provide fluidic access allowing for both filling and evacuation of the fluid preoperatively, intraoperatively, or postoperatively. The lens portion may be spheric, aspheric, toric, or other non-spherical shape for improved aberration reduction. It may be constructed of a biocompatible material or polymer (parylene, silicone, silicone derivative such as a phenyl substituted silicone, acrylic, polysulfone, hydrogel, collagen, or other suitable material). In certain embodiments the shell includes, consists essentially of, or consists of multiple materials (e.g., layered fluorosilicone and silicone, parylene deposition into silicone, etc.). The filling fluid may be a biocompatible refractive material; examples of these include but are not limited to: an oil, silicone oil, fluorosilicone, phenyl substituted, silicone oil, perfluorocarbon, aqueous material such as a sugar water, vegetable oil, gel, hydregel, nanocomposite, or electrically active fluid.
The rigid component may be in the shape of a lens that has a minimal power effect on the system. In other embodiments, it may have a non-uniform radius of curvature or points of contact that touch down onto the lens membrane. In yet other embodiments the rigid component may initially come into contact away from the center of the lens. As an example, it may come into contact with the periphery of the lens and then move to the center of the lens.
The rigid member may have optical properties to correct user vision as well. One example would be to have this stiffer material correct for astigmatism by using a toric shape.
The rigid member may be made of a biocompatible material such as a polymer (parylene, silicone, silicone derivative such as a phenyl substituted silicones, acrylic, polysulfone, hydrogel, collagen, or other suitable material). In other embodiments, it may have shape memory properties or heat activated materials, which may cause shape changes once exposed to a heat source (i.e., laser or light-emitting diode) once implanted into the capsular bag. This shape change may be used to adjust base power, astigmatism or other user optical needs that may have been preexisting, caused during surgery, or post-surgery effects (i.e. base power drift), in the preferred embodiment this rigid component can be manipulated (folded, split, etc.) to fit through a small incision in order to reduce the incision size used for surgery. One example of a shape-memory material is a shape-memory alloy (e.g., nitinol) frame embedded in a silicone. Shape change of the shape-memory alloy causes a change the shape of the silicone.
Yet another group of embodiments of the present application relate to IOLs having external components that provide a high degree of accommodation. Two or more haptics, i.e., non-optical, generally peripheral structures that hold the lens in place within the capsular bag inside the eye and transmit force from the eye to the lens. For example, in accordance with various embodiments, the haptics are positioned on the lens such that the changes in the shape of the capsular bag may be directly translated into a shape change of the IOL, thereby enabling the introduction of a desired accommodation to the lens. In addition, embodiments of the invention include additional features on the haptics and/or on the lens such that the distortion of the lens shape alters the optical power of the IOL without degrading the optical qualify of the lens vision zone, e.g., the modulation transfer function (MTF) parameter.
IOLs in accordance with embodiments of the invention generally include or consist essentially of a soft, deformable shell that accommodates one or more filling fluids (i.e., liquids and/or gases) via one or more valves (e.g., patch valves). The valves are typically accessible from an external portion of the lens with a needle or other fluid line for filling. The valves may be self-sealing, e.g., as described in U.S. patent application Ser. No. 14/980,116, filed on Dec. 28, 2015, the entire disclosure of which is incorporated by reference herein.
In accordance with various embodiments of the invention, the IOL interacts with the surrounding lens capsule of the eye both to maintain its position therein and to change optical power (i.e., accommodate). In general, interaction with the anterior and posterior lens capsules causes the lens to be centered and stabilized inside the lens capsule. In addition, the lens capsule can transmit force from the ciliary muscles in the eye to the fluid-filled IOL. For distance vision, the zonules apply radial tension along the equator of the lens capsule. This causes tension of the lens capsule to be translated to the fluid-filled IOL, causing the anterior and posterior surfaces thereof to he flattened and the equator of the lens capsule to be expanded. In this state, the IOL has low optical power corresponding to distance vision. During subsequent accommodation, the ciliary muscles contract, releasing tension on the zonules, allowing the lens to relax against the lens capsule; the radius of curvature of the anterior and posterior surfaces of the liquid-filled IOL is reduced, optical power of the lens is increased, and near vision is provided.
In general, for interaction with the lens capsule, the lens needs to appropriately fill the capsule. In various embodiments, the size (e.g., diameter) of the IOL is over 40% of the lens capsule size, and in certain embodiments over 60% of lens capsule size. In various embodiments, the size of the IOL may be selected, at least in part, by selecting either or both of the size of the lens bag of the IOL and an amount of filling fluid within the IOL. In various embodiments, the IOL interacts with the anterior capsule surface, the posterior capsule surface, or both capsule surfaces during accommodation.
In certain types of liquid-filled IOLs, the lens preferentially expands along the anterior-posterior (A-P) diameter, with the equatorial portions of the lens expanding less. This may be advantageous, as the lens largely maintains its equatorial shape, which may also improve optical function of the lens. However, matching the lens equator diameter with that of the capsular bag may be more challenging. Thus, in various embodiments of the present invention, the accommodative power of the lens capsule may arise not only from expansion and contraction along the A-P diameter, but also along the equatorial diameter of the IOL. Force-transmitting haptics may be utilized to translate force from the capsule to the IOL (e.g., to the lateral surface thereof).
In accordance with embodiments of the invention, force-transmitting haptics not only retain the IOL within the capsule, but also effectively transmit the force from the equator of the lens capsule to the side of the lens. This translation causes local motion of the sidewall of the IOL. However, the center of the IOL typically does not translate in the x and y directions, i.e., orthogonal axes in the radial direction of the lens (axes orthogonal to the optical axis of the lens). In various embodiments, the proportion of the outer x-axis and y-axis of the lens remains relatively constant during the accommodation process, thus preserving the original optical shape of the lens during the accommodation process. For example, if the lens is spherical, it may remain substantially spherical throughout the accommodation.
The force-transmitting haptics in accordance with embodiments of the invention may increase the accommodative amplitude of a fluid-filled IOL. During the accommodated state of the lens, not only does the lens round up, but the equatorial force-transmitting haptic applies a force to the lateral side of the lens, further increasing lens pressure and decreasing lens radius of curvature on the anterior and posterior sides. In the unaccommodated state, the lens capsule applies pressure to the anterior and posterior sides of the lens, flattening it and providing distance vision. In addition, the force-transmitting haptic decreases the force on the lateral side of the IOL, which further decreases pressure and reduces optic power. Further, various embodiments of the invention minimize or substantially eliminate deformation of various portions of the IOL that may result from force applied to the lens periphery by the haptics. For example, embodiments of the invention minimize deformation of the optical regions of the lens and the anterior and posterior peripheral surface portions of the lens.
The fluid-filled IOLs in accordance with embodiments of the invention differ from conventional solid IOLs. For example, the fluid-filled lens is softer and more flexible than a conventional solid lens, and thus IOLs in accordance with embodiments of the invention utilize different amounts of three transmitted from the capsular bag to introduce similar levels of accommodation. In addition, the optical zone of the fluid-filled lens (i.e., where vision correction takes place and through which the patient sees) may be more vulnerable to degradation of optical quality due to, e.g., wrinkling of the balloon-like lens. Haptics in accordance with embodiments of the invention desirably minimize or substantially eliminate such degradation. Finally, the haptics in accordance with embodiments of the invention have material properties compatible with manufacturing processes utilized to create fluid-filled IOLs.
In various embodiments of the invention, the haptics transmit force to the lens by rotating relative to the lens. Since the lens itself is typically centered in the lens capsule and fits conformally therewithin, the haptics may transmit to rotational force to the lens itself without causing lens rotation. Rotation of the haptics may result in a large deformation of the side of the lens, and may thereby result in an increase in pressure in the lens during accommodation. The rotational force may act on a greater portion of the side of the lens. The lens rotation may be limited by the curvature of the haptic or angle of the haptic relative to the lens equator surface, which thereby acts as a stop at a point of maximum desired accommodation.
In various embodiments of the invention, the shape change of the lens caused by the haptic results from an increase in pressure inside the lens. As the haptic moves with the surrounding lens capsule and ciliary muscle movement, it transmits a force to the lens, thereby increasing the pressure inside the lens and increasing the lens power.
In various embodiments of the invention, a less flexible (or even substantially rigid) annulus is present on (e.g., surrounding) the optical surface of the lens. The annulus acts as a boundary for the anterior and/or posterior surface of the lens when the surface is subjected to force from the haptics. The annulus may constrain the portion of the lens membrane within the annulus to deform uniformly in a spherical manner, regardless of the distribution pattern of haptics disposed around the lens, thereby minimizing or substantially preventing astigmatism of the central optical surface during haptic deformation.
In yet another embodiment, the components including those described above may be inserted at different times or successive steps to create a multiple component fluid-filled intraocular lens. These fluid-filled lenses can be implanted pre-filled, or filled through a valve after implantation. When implanted in a pre-filled state, the lenses often require a larger surgical incision to fit the large size of the lens. Larger surgical incisions are problematic and require longer healing times. In addition, these incisions may induce postoperative astigmatism, and therefore lower postoperative visual acuity. Therefore there is a need for a multiple component intraocular lens system that allows one or more components to he implanted sequentially through small surgical incisions.
The separate components may be mechanically coupled, or have a fluid coupling. In certain embodiments of the invention, one or more portions of the lens come into fluidic contact with another component or component's contents during inflation. The components have interlocking portions which engage during filling and an interface, such as a valve, between the two components is activated or opened during the inflation process. Activation may occur from increased pressure between the two components causing a cracking pressure, or by pushing one component into a valve cracking feature. In other embodiments the valve is cracked after inflation by using a remote energy source such as a laser (e.g. Nd:YAG laser, femtosecond laser, picosecond laser, thermal or other optical source).
By breaking down a complex lens into multiple smaller components, the lens may be implanted into the eye through small surgical incisions. In addition, portions of the lens may be removed and/or exchanged without altering other portions of the lens. This technique is also an advantage when piggybacking lenses inside the eye.
By using a modular component-based implant, it is possible to adjust certain portions of the system individually. As an example, the power of a lens may be adjusted without affecting the haptic portion. In other embodiments, the lens may be adjusted by adjusting the haptic portion of the lens. The haptic portion of the lens may be used to translate the lens portion relative to the eye for better centration, move the lens portion in an anterior or posterior direction, or tip/tilt the lens portion for improved optical resolution, it may also be used to rotate the lens, for example, rotating a toric lens for better angular alignment of the lens with the cornea.
A separate component of the lens may be used to restore or maintain the natural lens capsule configuration, to space the lens capsule from the lens component and to prevent local inflammatory or immune reaction from interfering with the lens component of the multiple component IOL. This includes preventing lens epithelial cells from clouding the lens component or interfering with lens actuation as in the case of an accommodating intraocular lens (AIOL).
In certain embodiments of the invention, one portion of the lens is implanted into the capsule to maintain shape. Before, after, or during implantation, the lens capsule may be modified for better postoperative outcomes. Modification may include using a fluid such as hypotoric aqueous solution (e.g. saline, water, dextrose) or cytotoxic solution (local chemotherapy such as methotrexate, etc. . . . ) to eliminate remnant cells in the lens capsule. Other types of modification include removing portions of the lens capsule, while the lens capsule is supported by this surrounding/haptic component of the IOL.
In an aspect, embodiments of the invention feature an intraocular lens implantable into the capsular bag of an eye. The intraocular lens includes or consists essentially of a flexible membrane defining an interior region for accepting a filling fluid and providing an optical correction to vision and, extending from an outer surface of the flexible membrane, a plurality of haptics for retentively engaging surrounding tissue and transmitting force from the capsular bag to the flexible membrane, thereby altering a shape of at least a portion of the flexible membrane and an optical power of the intraocular lens. The haptics do not coincide with (or overlap) an optical axis of the lens.
Embodiments of the invention may include one or more of the following in any of a variety of combinations. One or more, or even all, of the haptics may be elongated and/or curved. One or more, or even all, of the haptics may be shaped as an S or a partial circle (e.g., half-circle). One or more, or even all, of the haptics may be circular. The plurality of haptics may include, consist essentially of, or consist of four or more haptics. The haptics may be distributed around the flexible membrane (e.g., around an equator of the flexible membrane) substantially symmetrically. The haptics may be asymmetrically distributed around the flexible membrane (e.g., around an equator of the flexible membrane). A spacing around the flexible membrane (e.g., around an equator of the flexible membrane) between each pair of the haptics may be approximately equal. The intraocular lens may include a ring disposed around a periphery of the flexible membrane (e.g., around an equator of the flexible membrane). The ring may define a plurality of apertures, each haptic extending through an aperture. The ring may prevent direct transmission of force from the capsular bag to the flexible membrane. The intraocular lens may include a reinforcing pattern disposed on an inner surface and/or the outer surface of the flexible membrane. The reinforcing pattern may be less flexible than the flexible membrane. The reinforcing pattern may be disposed outside an optical zone of the intraocular lens (i.e., disposed outside of the portion of the lens through which vision of the patient typically occurs). The thickness of all or a portion of the reinforcing pattern is greater than a thickness of the flexible membrane. The reinforcing pattern may have a polygonal shape with a plurality of vertices. One or more, or even all, of the haptics may each extend from the flexible membrane at one of the vertices. The reinforcing pattern may be outside the optical axis. The reinforcing pattern may include, consist essentially of, or consist of straight segments that curve under accommodation. The segments may curve away from the optical axis under accommodation. One or more, or even all, of the haptics may each include, consist essentially of, or consist of a hollow tube.
In another aspect, embodiments of the invention feature an intraocular lens implantable into the capsular bag of an eye. The intraocular lens includes or consists essentially of a flexible membrane defining an interior region for accepting a filling fluid and providing an optical correction to vision, and disposed on an outer surface of the flexible membrane, a plurality of haptics for transmitting force from the capsular bag to the flexible membrane, thereby altering a shape of at least a portion of the flexible membrane and an optical power of the intraocular lens. Each haptic is a solid curved segment extending along a portion of the outer surface of the flexible membrane away from an optical axis thereof. The haptics are spaced around the outer surface of the flexible membrane to define gaps therebetween in a relaxed state of the intraocular lens, a size of each gap decreasing in an accommodated state of the intraocular lens.
Embodiments of the invention may include one or more of the following in any of a variety of combinations. The haptics may surround the optical axis of the flexible membrane. The plurality of haptics may include, consist essentially of, or consist of four or more haptics. In the relaxed state of the intraocular lens, the sizes of the gaps may be substantially equal. The gaps may decrease to approximately zero (i.e., the haptics may contact each other) in an accommodated state of the intraocular lens. The haptics may be attached to the flexible membrane by an adhesive.
In yet another aspect, embodiments of the invention feature an intraocular lens implantable into the capsular bag of an eye. The intraocular lens includes or consists essentially of a flexible membrane defining an interior region for accepting a filling fluid and providing an optical correction to vision, an elastic ring surrounding and spaced apart from the flexible membrane, the elastic ring being configured to accept force from the capsular bag and configured to retentively engage surrounding tissue, and extending from the elastic ring to the flexible membrane, a plurality of haptics for transmitting force from the elastic ring to the flexible membrane, thereby altering a shape of at least a portion of the flexible membrane and an optical power of the intraocular lens.
Embodiments of the invention may include one or more of the following in any of a variety of combinations. One or more, or even all, of the haptics may each include, consist essentially of, or consist of a plurality of segments each having a first end connected to the elastic ring and a second end connected to the flexible membrane. One or more, or even all, of the segments may be linear. For one or more, or even, all, of the haptics, a spacing between the first ends of the segments may be larger than a spacing between the second ends of the segments. For one or more, or even all, of the haptics, the second ends of the segments may meet at a common point on the flexible membrane.
In another aspect, embodiments of the invention feature an intraocular lens that includes, consists essentially of, or consists of a membrane defining a central chamber for containing an optical fluid and a spanning member extending between opposed areas of an internal surface of the membrane. When the central chamber is filled, it provides vision correction when implanted in a patient's eye, the central chamber having an optical axis extending through a vision-correcting optical zone of the central chamber. The spanning member resists expansion and/or collapse of the central chamber.
Embodiments of the invention may include one or more of the following in any of a variety of combinations. The spanning member may be elastomeric so as to restrain expansion of the membrane but not collapse thereof. The spanning member may be stiff so as to restrict both collapse and expansion of the membrane. The spanning member may include, consist essentially of, or consist of a spiral spring. At least a portion of the spanning member may extend along an optical axis of the lens. At least a portion of the spanning member may be continuous and solid. At least a portion of the spanning member may be tubular. The lens may have an optical zone. At least a portion of the spanning member may have a diameter larger than a diameter of the optical zone of the lens. The membrane may be at least partially filled with a first optical fluid. The spanning member may be at least partially filled with a second optical fluid different. The first and second optical fluids may be different. The first and second optical fluids may be the same. The membrane may be at least partially filled with an optical fluid, and the spanning member may be permeable to the optical fluid. The spanning member may join the internal surface of the membrane at first and second opposed ends. Each of the ends may have at least one shaped terminal head member with a distal region attached to or integral with the interior surface of the membrane. At least one of the head members may have a terminal surface area sufficiently small relative to a surface area of the interior surface of the membrane to permit the membrane to bulge upon overfilling with an optical fluid. At least one of the head members may have a terminal surface area sufficiently large relative to a surface area of the interior surface of the membrane to resist bulging of the membrane upon overfilling with an optical fluid. At least one end of the spanning member may include, consist essentially of, or consist of a plurality of branches each terminating in a head member with a distal region attached to or integral with the interior surface of the membrane. At least one of the head members may have a substantially symmetric terminal surface. The terminal surface may be round. At least one of the head members may have a substantially asymmetric terminal surface. The terminal surface may include, consist essentially of, or consist of a plurality of radial projections. The exterior surface of the membrane overlying at least one of the head members may have a plurality of radial grooves. The spanning member may be colored. At least a portion of the spanning member may have a color different from a color of the flexible membrane.
In yet another aspect, embodiments of the invention feature a method of correcting a patient's vision. A fluid-fillable and/or fluid-filled deformable lens having an optical axis is installed within the patient's capsular bag following removal of the natural lens therefrom. A rigid member is installed along the optical axis within the patient's capsular bag. Actuation of the rigid member causes it to releasably contact a portion of a surface of the deformable lens and thereby alter an optical power of the deformable lens. The contacted surface has an area dependent on a degree of the actuation.
Embodiments of the invention may include one or more of the following in any of a variety of combinations. At least a portion of the rigid member may be substantially planar. At least a portion of the rigid member may have a thickness larger than a thickness of a membrane of the deformable lens. At least a portion of the rigid member may have optical power. At least a portion of the rigid member may have no optical power. At least a portion of the rigid member may be a segment of a sphere having as radius larger than a radius of the deformable lens. The rigid member may be actuated by far-distance focus of the patient's eye. The rigid member may be anchored to the capsular bag by one or more flexible coupling members. At least a portion of the rigid member may be polymeric. At least a portion of the rigid member may include, consist essentially of, or consist of a shape-memory material (e.g., a shape-memory alloy). At least a portion of the rigid member may have a shape. The portion of the deformable lens in contact with the rigid member may assume the shape of the rigid member. The rigid member may be deformable so that the portion of the deformable lens in contact with the rigid member only partially assumes the shape of the rigid member.
In another aspect, embodiments of the invention feature a combination that includes, consists essentially of, or consists of a focus-altering component and a fluid-fillable and/or fluid-filled deformable lens having an optical axis and sized to fit within a patient's capsular bag. The focus-altering component includes, consists essentially of, or consists of a rigid member having an interaction surface and, joined thereto, a plurality of flexible coupling members configured for anchoring the focus-altering component to the capsular bag so as to permit interaction within the capsular bag between the rigid member and the deformable lens.
Embodiments of the invention may include one or more of the following in any of a variety of combinations. At least a portion of the rigid member may be substantially planar. At least a portion of the rigid member may have a thickness larger than a thickness of a membrane of the deformable lens. At least a portion of the rigid member may have optical power. At least a portion of the rigid member may have no optical power. At least a portion of the rigid member may be a segment of a sphere having a radius larger than a radius of the deformable lens. The coupling members may be configured to permit the interaction in response to far-distance focus of the patient's eye. At least a portion of the rigid member may be polymeric. At least a portion of the rigid member may include, consist essentially of, or consist of a shape-memory material (e.g., a shape-memory alloy). At least to portion of the rigid member may have a shape. The portion of the deformable lens in contact with the rigid member may assume the shape of the rigid member. The rigid member may be deformable so that the portion of the deformable lens in contact with the rigid member only partially assumes the shape of the rigid member.
In yet another aspect, embodiments of the invention feature a combination that includes, consists essentially of, or consists of a retaining structure and a fillable intraocular lens which, when tilled with an optical fluid, has an optical power, an optical axis and a matable feature. The retaining structure includes, consists essentially of, or consists of (i) a central gap portion comprising a matable feature complementary to the matable feature of the lens, whereby mating of the matable features couples the lens to the retaining structure for retention of the lens within the central gap portion, and (ii) peripheral means for stabilizing the retaining structure within the capsular bag of a patient.
Embodiments of the invention may include one or more of the following in any of a variety of combinations. The retaining structure may have a ring configuration. The retaining structure may have as peripheral edge. The stabilizing means may include, consist essentially of, or consist of a plurality of haptics projecting from the peripheral edge of the retaining structure. The retaining structure may be tillable with a fluid. The retaining structure may be at least partially filled with a fluid. The fluid may be a liquid and/or a gas. One of the matable features may include, consist essentially of, or consist of a tab, and the other matable feature may include, consist essentially of, or consist of a recess. The matable features may be roughened or modified surfaces providing a mechanical interface when in contact. The matable features may be frictional surfaces providing a mechanical interface when in contact. The combination may include means for establishing fluid communication between the lens and the retaining structure. The means for establishing fluid communication may include, consist essentially of, or consist of valve portions on the lens and on the retaining structure. The lens may include a plurality of haptic members and may be coupled to the retaining structure via the haptic members. The lens may not be in contact with the retaining structure. The retaining structure may include, consist essentially of, or consist of a plurality of discrete fillable chambers. The retaining structure may include, consist essentially of, or consist of a secondary lens. The combination may include means facilitating alignment of the intraocular lens and the secondary lens.
These and other objects, along with advantages and features of the present invention herein disclosed, will become more apparent through reference to the following description, the accompanying drawings, and the claims. Furthermore, it is to be understood that the features of the various embodiments described herein are not mutually exclusive and may exist in various combinations and permutations. As used herein, the terms “about,” “substantially,” and “approximately” mean ±10% (e.g., by weight or by volume), and in some embodiments, ±5%. Reference throughout this specification to “one example,” “an example,” “one embodiment,” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the example is included in at least one example of the present technology. Thus, the occurrences of the phrases “in one example,” “in an example,” “one embodiment,” or “an embodiment” in various places throughout this specification are not necessarily all referring to the same example. Furthermore, the particular features, structures, routines, steps, or characteristics may be combined in any suitable manner in one or more examples of the technology. The headings provided herein are for convenience only and are not intended to limit or interpret the scope or meaning of the claimed technology.
In the drawings, like reference characters generally refer to the same parts throughout the different views. Also, the drawings are not necessarily to scale, with an emphasis instead generally being placed upon illustrating the principles of the invention. In the following description, various embodiments of the present invention are described with reference to the following drawings, in which;
FIGS, 15A-15C are schematic views of intraocular lenses with haptics surrounded by an elastic ring in accordance with embodiments of the invention.
A. Internal Components
In other embodiments, the spanning member 120 is a spring in tension with a predefined spring constant, k; as a result, the spanning member maintains a length dimension of L with an allowable expansion of ΔL, thereby limiting the amount of curvature change of the anterior and posterior membrane surfaces 106a, 106p. In this case, the spanning member may be an elastomeric polymer. i.e., a polymer exhibiting viscoelasticity and a low Young's modulus. Examples include polyurethanes and polybutadiene, and various other polymers. Alternatively, the spanning member 120 may be a spiral spring.
The spanning member 120 is preferably optically clear and/or slender enough to negate any effect on vision. Optical clarity may be obtained by index-matching the spanning member 120 to the fluid filling the lens 100 in order to reduce light scatter and improve optical properties. Alternatively or in addition, the spanning member 120 may be permeable to the filling fluid, with the filling fluid altering the refractive properties of the spanning member 120. For example, the spanning member may be a permeable polymer or shaped as a tube that is filled with an optical fluid (which may have the same or a different refractive index from that of the lens filling fluid). As depicted in
More generally, all or part of the spanning member 120 may be colored to facilitate visual detection thereof once the lens is implanted, signaling incorrect fill volume and/or the need for fill volume adjustment. The ends 125a, 125p of the spanning member 120 may be joined to the interior surface of the membrane 106 in any suitable manner, e.g., by an adhesive such as epoxy or by heat, or the spanning member 120 may instead be co-molded with the membrane so as to be an integral part of the lens structure. Although the spanning member 120 is shown as a solid structure, in some embodiments it is molded as a spiral spring from a polymer having a desired stiffness.
The profiles of the ends 125a, 125p influence the mechanical response of the lens 100 not only to natural ocular accommodation but also to filling of the lens 100 via the valve 110. With reference to
To reduce or avoid the emergence of a bulge, the profile of the spanning-member ends can be altered, as shown in
A non-unitary end is illustrated in
Uniform and non-uniform end interfaces or attachment surfaces are illustrated in
As shown in
In this manner, this type of lens can act as a variable multifocal lens. In the two extremes (near and for viewing), the lens is a monofocal IOL, with 100% of the light projected for near or far viewing respectively. Intermediate viewing is associated with varying amount multifocality which gradually transitions in percentage from near viewing to far viewing.
FIGS. and 9B depict a fluid-filled lens 901, a rigid component 902 and coupling members 904 that space the fluid-filled lens 901 from the rigid component 902. Coupling members 902 nominally maintain the rigid component anterior to fluid-filled lens 901 and centered to the optical axis as shown in the top view. Coupling members 902 may be hinged as shown.
When the zonules go into tension, as seen as the arrow in the bottom view, the capsular bag 903 expands radially and with a decrease in anterior-posterior (A-P) thickness as shown in the figure. The A-P thickness decrease of the capsular bag 903 causes the bag to compress the posterior membrane of the fluid-filled lens 901 and brings the rigid component 902 into contact with anterior surface of fluid-filled lens 901. In some embodiments, the compressive force on the posterior side of the fluid-filled lens 901 causes the membrane to deform, causing the lens 901 to press on the posterior membrane and undergo an optical power change.
In various embodiments, the rigid component 902 is stiff enough to cause the fluid-filled lens membrane to conform to its shape. In other embodiments, the rigid component 902 has points that protrude out toward the fluid-filled lens 901. These protrusions make contact with critical fulcrum points on the fluid-filled lens 901 (not shown). These fulcrum points then deform the membrane of the fluid-filled lens. In another embodiment, the rigid component 902 has some flexibility to it so that as it contacts fluid-filled lens 901, the final state is an intermediate state between the curvature of the fluid-filled lens and that of the rigid component 902. In this embodiment, the lens acts both as a multifocal lens and an accommodating IOL. In addition, the contact edges between the fluid-filled lens 901 and the rigid component 902 may be less discontinuous, leading to smooth transition between far and near focal points.
In another embodiment of the invention, coupling features 904 interact with the equatorial region of the capsular bag 905. In this embodiment the coupling features 904 maintain contact between the fluid-filled lens 901 and the rigid component 902. The equatorial region of the capsular bag pushes radially on the coupling, members and moves the rigid member away from fluid-filled lens 901.
In certain embodiments, a structure around the fluid-filled lens 901 connects to the fluid-filled lens 901 and the coupling members 904. In other embodiments, the coupling members act as a spring and may be assisted by the expansion and contraction of the capsular bag equator 905. The coupling members may interact with the lens through a series of legs that extend to the lens periphery. In addition, these extensions that extend from the equator to the coupling member may be used to increase leverage or displacement and aid in the movement of the rigid component.
The rigid component may itself have a non-spherical shape, with the possibility for correction or induction of aberration into the lens. In certain configurations it has multifocality itself, thereby convening the lens into a lens with a multifocal surface when engaged. The rigid component itself may also be to lens (monofocal, toric, multifocal, aspheric, and other configurations known to those skilled in the art).
In other configurations, the rigid component deforms itself when engaging with the lens. Instead of two focal lengths, there is a smooth continuous change in curvature of the lens during engagement. In this manner, it may act as a smooth transition between near and far focus, with no multifocality. In this manner, the lens may be considered to have accommodation as well as a shift in multifocality. If the rigid component is flexible enough, the lens may act entirely or almost entirely as an accommodating intraocular lens, with a smooth monofocal transition between near and far viewing distance.
In some embodiments the rigid component may have features that help integrate itself into the capsular bag. In some embodiments small holes could be cut into the capsular bag where small protrusions from the rigid component would stick through. As the capsular bag fibrosis, it will integrate with the protrusions on the rigid component. Other embodiments include but are not limited to: hooks, clasps (around the capsulorhexis), or snap in features (such as a male and female piece with the capsular bag locked inbetween).
B. External Components
Embodiments of the present invention feature fluid-filled (e.g., liquid-filled) accommodating IOLs having one or more haptics for force translation from and retention within the eye capsular bag. In various embodiments, the haptics are attached to the fluid-fillable lens of the IOL during manufacture thereof. In various embodiments, the stiffness (and/or other mechanical properties) of the haptics are selected to enable effective force transmission between the fluid-filled lens and the capsular bag. For example, greater flexibility may result in less force transmission to the lens while less flexibility may result in greater force transmission to the lens. Haptics in accordance with embodiments of the invention may include, consist essentially of, or consist of elongated filaments or fibers having any of a variety of different shapes. The material of the haptic may be different from that of the lens bag of the IOL and attached thereto during the manufacturing process.
In various embodiments, the lens haptics include, consist essentially of, or consist of one or more biocompatible materials such as acrylic, polypropylene, polyvinylidene fluoride (e.g., KYNAR.), polyethersulfone, silicone, polyester, parylene, and/or a shape-memory alloy (e.g., an alloy of nickel and titanium such as nitinol). In various embodiments, the lens haptics may be composed of one or more non-biocompatible materials that are coated with one or more biocompatible materials. In various embodiments, the haptic includes, consists essentially of, or consists of a solid fiber or hollow tube of one or more materials that may be encapsulated by a coating of one or more different materials, e.g., to select a desired stiffness of the haptic. The thickness and/or composition of such coatings may be varied in different portions and/or along the length of the haptic in order to locally vary the flexibility of one or more portions of the haptic.
In various embodiments, IOLs each have only two haptics for force transmission from the capsular bag to the lens. For example, the two haptics may be oriented directly across from each other along a diameter (e.g., the equatorial diameter that is perpendicular to the optical axis) of the lens.
Haptics in accordance with embodiments of the invention may have any of a variety of shapes different from the half-circular shape shown in
In various embodiments, IOLs may each have three, four, five, or more haptics for force transmission; such embodiments may enable the transmitted flame to be more uniformly distributed around the periphery of the lens. For example,
As mentioned above, the balloon-like lenses of IOLs in accordance with embodiments of the invention are flexible and therefore more vulnerable to degradation of optical quality from, e.g., wrinkling of the lens surface, asymmetric bulging of the optical zone of the lens, etc. Thus, embodiments of the present invention advantageously prevent deformation of the fluid-filled lens of the IOL resulting from direct interaction between the lens and the capsular bag and constrain deformation of the lens to result only (or substantially only) via the haptics attached to the lens. For example,
The ring 1210 may include, consist essentially of, or consist of one or more biocompatible materials such as high-durometer silicone, parylene, acrylic, or collagen or a collagen derivative. As described above regarding haptic 1020, the ring 1210 may be composed of a non-biocompatible material coated with one or more biocompatible materials. According to the material selection of the ring, haptic, and lens, the components may be bonded using an adhesive, overmolded in portions, molded as anterior and posterior pieces, or molded in a unitary piece. In various embodiments featuring ring 1210, one or more of the haptics 1020 may include stops that limit the penetration depth of the haptic 1020 into the interior of ring 1210. In various embodiments, the ring 1210 includes, consists essentially of, or consists of silicone having a cross section of approximately 1 mm×2 mm the ring 1210 is therefore much less flexible than the lens 1010, which may have a thickness of, liar example approximately 20 μm to approximately 100 μm.
In various embodiments of the present invention, the local elastic properties of the flexible lens of the IOL are altered via incorporation of a reinforcement pattern disposed on the lens surface or within the lens (e.g., at or near the lens equator), ideally outside the optical zone of the lens. Advantageously, the force transmission by the haptics to the lens may be focused at particular portions of the reinforcement pattern and transmitted to the lens through the reinforcement pattern, thereby minimizing or substantially eliminating undesired wrinkling or bulging of other portions of the lens. For example, the reinforcement pattern may have a polygonal shape (e.g., triangle, square, pentagon, hexagon, etc.), with each haptic of the IOL attached to the lens at a point corresponding to one of the vertices of the polygon. For example,
As mentioned above, in various embodiments of the invention the reinforcement pattern 1310 is less flexible than the membrane of the lens 1010. For example, the reinforcement pattern 1310 may include, consist essentially of, or consist of a less flexible material than the membrane, and/or may have a lamer thickness than that of the membrane. The reinforcement pattern 1310 may include, consist essentially of, or consist of, for example, a biocompatible material such as silicone, a silicone derivative such as a fluorosilicone, phenyl-silicone, or parylene. The reinforcement pattern 1310 may be fabricated on the lens 1010 membrane via, for example, local deposition (e.g., vapor deposition), molding, or a coating process such as spray- or dip-coating. In various embodiments, the reinforcement pattern 1310 is composed of a coating that is a dispersant with a volatile component and a non-volatile component. In such embodiments, the dispersant has a low viscosity to allow coating and/or shaping until the volatile component is evaporated from the base material (e.g., a polymer).
The haptics of the IOL need not be elongated fibers, the ends of which are affixed to the lens at a point. Rather, in accordance with embodiments of the present invention, haptics may include, consist essentially of, or consist of partial curved rings that each surrounds a portion of the periphery of the lens. In such embodiments, the IOL may feature two or more haptics that collectively contact and surround only a portion of the periphery of the lens—gaps between the partial-ring haptics allow the lens to change shape in response to the force transmitted to the lens by the haptics. The partial-ring haptics may be substantially rigid rather than flexible and thus not deform while transmitting force from the capsular bag to the lens of the IOL. (In other embodiments, the partial-ring haptics may be flexible but preferably less flexible than the membrane of the lens.) As an example,
Partial-ring haptics 1410 may include, consist essentially of, or consist of one or more biocompatible materials such as acrylic, polypropylene, polyvinylidene fluoride (e.g., KYNAR), polyethersulfone, silicone, polyester, parylene, shape-memory alloy (e.g., an alloy of nickel and titanium such as nitinol). In various embodiments, the haptics 1410 may be composed of one or more non-biocompatible materials that are coated with one or more biocompatible materials. The haptics 1410 may be pre-manufactured and attached to the lens 1010 via, e.g., an adhesive (e.g., silicone adhesive), or the haptics 1410 may be molded together with the lens 1010 during fabrication thereof. In various embodiments, the haptics 1410 may be deposited (e.g., vapor deposited) on the lens 1010 or spray- or dip-coated onto the lens 1010.
In various embodiments of the present invention, the haptics do not transmit force directly from the capsular bag to the lens of the IOL. Instead, a flexible, elastic ring may surround the periphery of the lens and be connected to the lens is two or more haptics. (As used herein, the term “ring” is used to connote a closed shape that is not necessarily circular; rather, a ring. may be, e.g., elliptical, polygonal, or irregular in shape.) In such embodiments, the force from the capsular bag first distorts the flexible ring, which in turn deforms and/or translates the haptics, resulting in deformation of the shape of the lens. In some embodiments, the haptics may extend partially or completely through apertures defined by the flexible ring, similar to the configuration described above for IOL 1200 (and, in such embodiments, the haptics and/or the ring may incorporate stops to retard or prevent further motion of the haptics after a pre-determined amount of force is transmitted thereby).
The ring 1510 may include, consist essentially of, or consist of one or more biocompatible materials such as acrylic, polypropylene, polyvinylidene fluoride (e.g., KYNAR), polyethersulfone, silicone, polyester, parylene, shape-memory alloy (e.g., an alloy of nickel and titanium such as nitinol). In various embodiments, the ring 1510 may be composed of one or more non-biocompatible materials that are coated with one or more biocompatible materials. The ring 1510 may be pre-manufactured and attached to the haptics 1020 via, e.g., an adhesive (e.g., silicone adhesive), or the ring 610 may be molded together with the haptics 1020 and/or the lens 1010 during fabrication thereof.
IOLs in accordance with embodiments of the invention may be implanted with minimal or no volume of fluid within the lens to decrease IOL size and this the incision size required to implant the IOL within a patient's eye. The lens may contain one or more valves accessible from an external portion of the lens with a needle or other fluid line for filling. Such valves may be self-sealing, e.g., as described in U.S. patent application Ser. No. 14/980,116, filed on Dec. 28, 2015, the entire disclosure of which is incorporated by reference herein.
C. Multiple-Component IOL
Refer to
Haptics 1604 may be free to move radially within the retaining structure 1606, but may have stops that limit total travel in one or more directions. This prevents the haptics from becoming disengaged from the retaining structure 1606 during implantation, from being too far internally to interact with fluid-filled lens 1602, or interfering with fluid-filled lens implantation into the retaining structure. In a similar manner, haptics 1604 may be constrained by the retaining structure 1606 so they do not rotate.
In other embodiments of the invention, haptics 1604 are mechanically constrained and fixed in retaining structure 1606 and provide no mechanical coupling to fluid-filled lens 1602. In such cases, fluid-filled lens 1602 interfaces with the retaining structure 1606 in order to maintain its position relative to the lens capsule. If haptics 1604 are omitted, retaining structure 1606 makes contact with the lens capsule on one or more suffices (e.g., anterior, posterior, peripheral) thereof.
In other embodiments, fluid-filled haptic component 1708 is separately filled after implantation, or pre-filled during implantation. In such circumstances, the features 1710, 1722 mechanically restrain and couple the fluid-filled lens component 1702 to the fluid-filled haptic component 1708.
Although shown as discrete elements, interface features 1702, 1722 may be as simple as a radial mechanical interface (e.g., a raised off-round tab and a complementary recess) between fluid-filled lens component 1702 and fluid-filled haptic component 1708 during filling, or may instead be a roughened surface or simple stiction between the two components. This mechanical interface may be enhanced through the use of surface modification (e.g., oxygen and/or nitrogen plasma treatment, parylene deposition into the surface, or adding other functional groups), surface roughness (e.g., etching the surface), or using localized hydrogen bonding, ionic bonding, or hydrophobic bonding between the surfaces. In other embodiments, surface linking is increased by using polymers that continue to cure after implantation. This includes silicone elastomers that have been partially cured, but continue to cure post-implantation.
One component comprises or consists of a wall 1838 and a valve 1834. The first component has an internal fluid compartment to the left of wall 1838. The second component comprises or consists of a wall 1836 and valve 1832. The internal fluid compartment of the second component is to the right of wall 1836. In
For example, a haptic component may comprise a haptic wall 1938 and a coupling portion 1934 with a protruding sharp penetrating member 1930. The sharp penetrating member 1930 is already in fluidic contact with the haptic component. When fluid-filled lens component is filled, a lens coupling member 1932 comes into contact with sharp penetrating membrane 1930. As inflation continues, sharp penetrating member 1930 penetrates fluid-filled lens coupling member 1932, leading to fluidic continuity between the haptic and the lens. The haptic component can then be filled along with the fluid-filled lens component.
Other coupling mechanisms are possible. One example uses two-piece valves that couple together and open after interlocking. A second example uses pressure between the lens component and haptic component to seal. A third example uses glue or adhesive that holds the two components together. In certain embodiments, the two pieces come into contact. Then at a later time an aperture is opened between the two membranes using an optical or thermal source, e.g., a Nd:YAG laser, femtosecond laser, picosecond laser, or other thermal or optical source.
Haptic component 2006 controls the environment around intraocular lens 2014. The environment may determine, for example, specific optical properties, chronic dopants, and pressure that collectively create a net optical outcome in conjunction with the optical properties of the lens component 2002. In addition, haptic component 2006 can be used to adjust the position of the intraocular lens component 2002.
Haptic component can be inflated to space the surrounding lens capsule away from intraocular lens component 2002. In certain embodiments, haptic component 2006 is inserted and inflated, stabilizing the lens capsule. After implantation of haptic component 2006, the lens capsule is modified for better postoperative outcomes. This modification may involve elimination of residual cells and/or lens matrix, or removal of portions of the lens capsule. Cytotoxic agents or agents to prevent chemotaxis of residual lens epithelial cells may be used to prevent cell migration and subsequent capsular opacification and/or fibrosis. Cytotoxic agents include fluids such as hypotoric aqueous solution (e.g., saline, water, dextrose, or mannitol) or cytotoxic solution (e.g., local chemotherapeutics such as methotrexate, etc.). Alternatively or in addition, surface modification (oxygen plasma, ammonia plasma, nitrogen plasma, parylene deposition, etc.) may be used to eliminate remnant cells in the lens capsule. These agents may be applied to the capsule as a lavage, or impregnated into the surface or filling fluid of the lens and/or haptic. Other types of modification include removing portions of the lens capsule while the lens capsule is supported by this surrounding/haptic component of the IOL. For example, after implantation of the haptic member, the posterior lens capsule may be mechanically removed, treated with laser (Nd:YAG, femtosecond laser, etc.), or thermally ablated. After treatment, intraocular lens component 2002 can be implanted into the lens capsule.
The intraocular lens may be positioned within the capsular bag by altering the fluid fill of the haptic component 2006. For example, if intraocular lens component 2002 is mechanically coupled to haptic component 2006, then by increasing the fill in different portions or compartments (not shown) of haptic component 2006, the lens can be repositioned, re-centered, tip/tilted, moved anteriorly or posteriorly. In addition, the lens can be rotated. Therefore, an intraocular lens component 2002 that is already mounted can be optimized either during or post-implantation for better refractive outcomes.
The fluid-filled portions of the multiple-component implantable IOL are constructed of a biocompatible materials such as a polymer (e.g., parylene, silicone, silicone derivative such as a phenyl-substituted silicone, acrylic, polysulfone, hydrogel, collagen, or other suitable material). In certain embodiments, the membrane portions comprise or consist essentially of multiple materials (e.g., layered fluorosilicone and silicone, parylene deposited into or onto silicone, etc.). When a portion of the fluid-filled component acts as a lens, a biocompatible refractive filling fluid may be used. Examples of these fluids include but are not limited to oils such as silicone oil, fluorosilicone, phenyl-substituted silicone oil, perfluorocarbon, an aqueous material such as a sugar water, vegetable oil, gel, hydrogel, nanocomposite, or electrically active fluid. Other fluids include saline, ringers solution, or other aqueous solutions. In certain embodiments the chambers are filled with an osmotically active solute. By placing the component into the eye, the chamber fills through diffusion of aqueous fluid into the chamber. In other embodiments, the walls of the fluid-filled chambers are semipermeable to air and gas, allowing trapped air bubbles or gas to diffuse out over a period of time.
Reference throughout this specification to “one example,” “an example,” “one embodiment,” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the example is included in at least one example of the present technology. Thus, the occurrences of the phrases “in one example,” “in an example,” “one embodiment,” or “an embodiment” in various places throughout this specification are not necessarily all referring to the same example. Furthermore, the particular features, structures, routines, steps, or characteristics may be combined in any suitable manner in one or more examples of the technology. The headings provided herein are for convenience only and are not intended to limit or interpret the scope or meaning of the claimed technology.
The terms and expressions employed herein are used as terms and expressions of description and not of limitation, and there is no intention, in the use of such terms and expressions, of excluding any equivalents of the features shown and described or portions thereof. In addition, having described certain embodiments of the invention, it will be apparent to those of ordinary skill in the art that other embodiments incorporating the concepts disclosed herein may be used without departing from the spirit and scope of the invention. Accordingly, the described embodiments are to be considered in all respects as only illustrative and not restrictive.
This application claims priority to, and the benefits of. U.S. Provisional Patent Application No. 62/159,620, filed on May 11, 2015, U.S. Provisional Patent Application No. 62/159,638, filed on May 11, 2015, U.S. Provisional Patent Application No. 62/159,661, filed on May 11, 2015, and U.S. Provisional Patent Application No. 62/161,302, filed on May 14, 2015, the entire disclosures of which are hereby incorporated by reference.
| Number | Date | Country | |
|---|---|---|---|
| 62159620 | May 2015 | US | |
| 62159661 | May 2015 | US | |
| 62161302 | May 2015 | US |
