This invention relates to accommodating intraocular lens assemblages in general and in-the-bag accommodating intraocular lens assemblages in particular.
Referring to
Contraction of the ciliary body 19 allows the lens 26 to thicken to its natural thickness T1 along the visual axis VA for greater positive optical power for near vision (see
Near vision is defined at a distance range of between about 33 cm to 40 cm and requires an additional positive optical power of between about 2.5 Diopter to 23 Diopter over best corrected distance vision. Healthy human eyes undergo pupillary miosis to about 2 mm pupil diameter for near vision from an about 3 mm to 6 mm pupil diameter for distance vision corresponding to ambient illumination conditions. Ciliary body relaxation in healthy human eyes is capable of application of a patient specific accommodative physiological force on a natural crystalline lens. Maximal accommodative physiological forces occur for distance vision with the ciliary muscles relaxed and the capsular bag circumferentially stretched by the zonuli connecting the ciliary body to the lens capsule. Maximal accommodative physiological forces are estimated to be in the 10 gram force range depending on a patient's age, eye size, and other factors. Minimal near zero gram force accommodative physiological forces occur for near vision with the zonuli being untaut.
Commonly owned PCT International Application No. PCT/IL2017/050566 entitled Hybrid Accommodating Intraocular Lens Assemblages published under PCT International Publication No. WO 2017/203517 A1 discloses hybrid accommodating intraocular lens (AIOL) assemblages having two discrete component parts in the form of a discrete base member for initial implantation in a vacated capsular bag and a discrete lens unit for subsequent implantation in the vacated capsular bag for anchoring thereonto. The WO 2017/203517 hybrid accommodating intraocular lens (AIOL) assemblages are intended to be manufactured from presently commercially available bio-compatible foldable plastic materials known in the IOL industry. The discrete base member has a base member axis and includes a flat circular base member centerpiece and an elevated circumferential retainer bounding a circumferential groove. The discrete lens unit has a lens optics axis intended to be co-axial with the base member axis on mounting the discrete lens unit on the discrete base member. The discrete lens unit includes a lens optics having two diametrical pairs of identical shape memory resiliently flexible lens haptics radially outwardly extending therefrom for anchoring in the circumferential groove.
WO 2017/203517
There is a need for discrete lens units with lens haptics manufactured from presently commercially available bio-compatible shape memory foldable plastic materials suitable for IOL haptics for use in WO 2017/203517 hybrid AIOL assemblages for restoring visual accommodation comparable to natural accommodation of a healthy young human adult eye in terms of accommodation range and response time.
The present invention is directed towards improved WO 2017/203517 hybrid AIOL assemblages including a discrete lens unit with segmented lens haptics designed for restoring vision accommodation comparable to natural accommodation of healthy young human adult eye in terms of accommodation range and response time. Discrete lens units can include an even or odd number of segmented lens haptics. Each segmented lens haptics includes two or more lens haptics segments between its lens haptics affixed end and its lens haptics free end to enable compliance within the range of a human eye's accommodative physiological force. Accordingly, a segmented lens haptics is designed to flex at a flexible lens haptics segment and not flex at in inflexible lens haptics segment on application of an accommodative physiological force in contradistinction to aforesaid WO 2017/203517 lens haptics intended flexing therealong from its lens haptics affixed end to its lens haptics free end. Such flexibility is afforded by a relatively deep radial groove in a posterior lens haptics surface for reducing the thickness of a part of a lens haptics so that it becomes flexible under a physiologically available force compared to an adjacent part which remains thick and hence inflexible under the same physiologically available force.
Most importantly, a discrete lens unit is designed such that on application of a predetermined compression force, whereupon its posterior lens optics surface is intimately immerged in an anterior base member centerpiece surface, each flexible lens haptics segment of each and every segmented lens haptics is flexed to its maximal degree to close its groove such that a posterior lens haptics surface becomes a single continuous arcuate shape in a transverse cross section of a discrete lens unit co-directional with its discrete lens unit axis as opposed to a staggered arcuate shape without application of a compression force. By virtue of closing of the grooves along its posterior lens haptics surface, each segmented lens haptics becomes a rigid arched structure whereupon the discrete lens unit as a whole becomes a rigid structure which is no longer affected by an additional applied force which inherently occurs during capsular fibrosis and contraction, thereby avoiding tilting or dislocation of a discrete lens unit with consequential optical aberrations.
While maintaining accurate design symmetry for all its two or more segmented lens haptics, compliance of a discrete lens unit can be adjusted by fine tuning one or more design parameters of its segmented lens haptics as follows: First, creating a pivot point along a segmented lens haptics by forming one or more opposite pairs of cutouts between its lens haptics affixed end to its lens haptics free end such that a segmented lens haptics has a smaller arc length between a pair of cutouts compared to its arc length at its lens haptics affixed end and its arc length at its lens haptics free end in a top plan view of its anterior lens optics surface. And second, in the case that a segmented lens haptics includes two or more spaced apart flexible lens haptics segments, the flexible lens haptics segments can be made with different flexibilities such that one flexible lens haptics segment starts to flex before an adjacent flexible lens haptics segment at a lower force within the accommodative physiological force range.
Discrete lens units are preferably formed with a lens optics surround surrounding a lens optics such its two or more spaced apart shape memory resiliently flexible segmented lens haptics radially extend from the lens optics surround. Each segmented lens haptics preferably has a haptics manipulation aperture adjacent thereto in the lens optics surround thereby affording convenient access thereto for dialing purposes of a discrete lens unit to its correct position in an implanted eye.
In order to understand the invention and to see how it can be carried out in practice, preferred embodiments will now be described, by way of non-limiting examples only, with reference to the accompanying drawings in which similar parts are likewise numbered, and in which:
WO 2017/203517 Hybrid AIOL Assemblages
The discrete lens unit 40 includes a lens optics 41 and two diametric pairs of equispaced shape memory resiliently flexible lens haptics 42 radially outward extending from the lens optics 41. The lens unit 40 can be manufactured as a monolithic structure. Alternatively, the lens haptics 42 can be manufactured separately from the lens optics 41 and attached thereto using industry known attachment technologies. The lens optics 41 has a lens optics axis 43 for co-axial alignment with a human visual axis VA, an anterior lens optics surface 44, a posterior lens optics surface 46 and a lens optics edge 47. The posterior lens optics surface 46 includes a central circle 48 having an approximate 2.5 mm diameter around the lens optics axis 43 corresponding to near vision pupil size under normal reading illumination conditions and a surrounding annular multi-focal segment 49.
The lens haptics 42 has a lens haptics free end 51 with a lens haptics curved edge corresponding to a curvature of an anchoring interface of the discrete base member 60. Each lens haptics 52 preferably has a manipulation aperture 53 and an elongated anterior spacer pair 54 adjacent to the lens optics 41. The discrete lens unit 40 preferably has an optical axis marker 56 for assisting correct alignment with respect to a human visual axis VA on implantation.
The discrete base member 60 has a base member axis 61 and includes a flat circular base member centerpiece 62 and a base member surround 63. The base member 60 can be manufactured as a monolithic structure. Alternatively, the base member surround 63 can be manufactured separately from the base member centerpiece 62 and attached thereto using industry known attachment technologies. The base member centerpiece 62 has a flat circular anterior base member centerpiece surface 64 and a flat circular posterior base member centerpiece surface 66. The base member surround 63 is formed with an elevated circumferential retainer 67 for forming a circumferential groove 68 with the anterior base member centerpiece surface 64 for receiving the lens haptics free ends 51 for anchoring the discrete lens unit 40 on the discrete base member 60.
WO 2017/203517 Hybrid AIOL assemblages with Segmented Lens Haptics
The discrete lens unit 80 has a discrete lens unit axis 81 and includes a central lens optics 82 and a lens optics surround 83 surrounding the lens optics 82. The lens optics 82 has an anterior lens optics surface 84 similar to the anterior lens optics surface 44 and a posterior lens optics surface 86 similar to the posterior lens optics surface 46. The lens optics 82 has an at least minimum diameter in accordance with prevailing ISO standard requirements. The lens optics surround 83 has an external diameter of between about 6 mm to 7 mm. The lens optics surround 83 has a flat anterior surface 83A and a flat posterior surface 83B both perpendicular to the discrete lens unit axis 81 and therefore with zero optical power. In the case that the lens optics 82 has a toric optical power, the lens optics surround 83 preferably includes an optical axis marker 87 for assisting angular alignment of the discrete lens unit 80 to the required angle with respect to a human visual axis VA during implantation.
The discrete lens unit 80 has a diametric pair of shape memory resiliently flexible segmented lens haptics 88 radially extending from the lens optics surround 83. The segmented lens haptics 88 are made from clinically approved, bio-compatible, implantable shape memory foldable material suitable for lens haptics. The segmented lens haptics 88 are preferably symmetrical and have identical compliance to an applied capsular force such that the entire discrete lens unit 80 reciprocates relative to the discrete base member 60 without tilting with consequential optic aberrations.
Each segmented lens haptics 88 has a monolithic structure in the sense it is manufactured as a single unitary piece from the same material along its entire length from a lens haptics affixed end 89 at the lens optics surround 83 to its lens haptics free end 91. Each segmented lens haptics 88 has an anterior lens haptics surface 92 in the direction of the anterior lens optics surface 84 and a posterior lens haptics surface 93 in the direction of the posterior lens optics surface 86. Each segmented lens haptics 88 includes an elongated anterior spacer pair 94 adjacent to the lens optics surround 83 for spacing an anterior capsule flange 27 from the discrete lens unit's anterior surface for enabling unhindered fluid flow in and out of a capsular bag. Each segmented lens haptics 88 includes a throughgoing haptics manipulation aperture 96 mostly in the lens optics surround 83 for dialing the discrete lens unit 80 around the discrete lens unit axis 81 for setting at a required position.
Each segmented lens haptics 88 has localized flexible segments formed by generally circumferential grooves 97 in the posterior lens haptics surface 93 with respect to the discrete lens unit axis 81. The grooves 97 are generally isosceles triangular shaped in a transverse cross section co-directional with the discrete lens unit axis 81. Each groove 97 includes an apex 98 towards the anterior lens haptics surface 92, a first opposing surface 99 towards the lens haptics affixed end 89 and a second opposing surface 101 towards the lens haptics free end 91 and facing the first opposing surface 99.
Each grooved section of a segmented lens haptics 88 constitutes a flexible lens haptics segment 102 within the range of a human eye's accommodative physiological force. Conversely, each non-grooved section of a segmented lens haptics 88 constitutes an inflexible lens haptics segment 103 within the range of a human eye's accommodative physiological force. A flexible lens haptics segment 102 has a thickness T3 at its apex 98 and an inflexible lens haptics segment 103 has a thickness T4 where T4 >T3.
In
Flexible lens haptics segments 102 can be designed such that some flexible lens haptics segments are more flexible to an accommodative physiological force than others. Such graded flexibility affords a controlled staggered compaction of a lens optics 82 towards a discrete base member 60 on application of an accommodative physiological force for distance vision. Conversely such graded flexibility affords a controlled staggered separation of a lens optics 82 from a discrete base member 60 on removal of an accommodative physiological force for near vision.
While the invention has been described with respect to a limited number of embodiments, it will be appreciated that many variations, modifications, and other applications of the invention can be made within the scope of the appended claims.
Number | Date | Country | Kind |
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1817955 | Nov 2018 | GB | national |
Filing Document | Filing Date | Country | Kind |
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PCT/GB2019/053118 | 11/4/2019 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
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WO2020/089657 | 5/7/2020 | WO | A |
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