Ophthalmic lenses may be utilized to correct optical aberrations of an individual's eye. For example, glasses and contact lenses may be utilized to correct for spherical aberration or astigmatism present in an individual's eye.
Ophthalmic lenses in the form of intraocular lenses may also be utilized to correct optical aberrations of an individual's eye. Intraocular lenses are typically implanted within the capsular bag of an individual's eye and often replace the natural lens present within an individual's eye. The natural lens may have become clouded due to cataracts or may need to be replaced due to other maladies of the individual's eye.
The intraocular lens preferably improves the vision of the individual's eye such that additional ophthalmic lenses in the form of glasses or contact lenses may not be needed. However, certain side effects may result from the implantation of the ophthalmic lens. One such side effect that may impact vision is negative dysphotopsia. Negative dysphotopsia may have high prevalence immediately after cataract surgery and may reduce over months and years. Improved methods of determining and reducing negative dysphotopsia is thus desired.
Apparatuses, systems, and methods disclosed herein may be directed to reducing negative dysphotopsia in an individual's eye. Such apparatuses, systems, and methods may include determining an angle kappa of an individual's eye. Such apparatuses, systems, and methods may further include tilt adjustable intraocular lenses.
Embodiments of the present disclosure include a method including selecting an intraocular lens providing angle kappa correction in an individual's eye, the intraocular lens being selected based on a determination of negative dysphotopsia in the individual's eye based on one or more measurements of angle kappa.
Embodiments of the present disclosure include a method including providing a tilt adjustment of an optical axis of an optic of an intraocular lens with respect to a platform of the intraocular lens, the tilt adjustment being provided based on a determination of negative dysphotopsia in an individual's eye based on one or more measurements of angle kappa.
Embodiments of the present disclosure include a method including determining an angle kappa of an individual's eye. The method may include producing a determination, based on the angle kappa of the individual's eye, of negative dysphotopsia in the individual's eye based on implantation of an intraocular lens in the individual's eye.
Embodiments of the present disclosure include an intraocular lens including an optic having an optical axis whose orientation can be modified respect to the mechanical axis of the platform. The intraocular lens may include a platform coupled to the optic and configured to support the optic. A tilt of the optical axis may be adjustable with respect to the platform.
Embodiments of the present disclosure include an intraocular lens including an optic having an optical axis whose orientation can be modified respect to the mechanical axis of the platform. The intraocular lens may include a platform coupled to the optic and configured to support the optic. The optical axis is tilted with respect to the platform to provide angle kappa correction in an individual's eye.
Embodiments of the present disclosure include a method including implanting an intraocular lens in an individual's eye. The intraocular lens may include an optic having an optical axis, and a platform coupled to the optic and configured to support the optic. A tilt of the optical axis is adjustable with respect to the platform.
Embodiments of the present disclosure include a method including implanting an intraocular lens in an individual's eye. The intraocular lens may include an optic having an optical axis, and a platform coupled to the optic and configured to support the optic. The optical axis is tilted with respect to the platform to provide angle kappa correction in the individual's eye.
Features and advantages of the systems, apparatuses, and methods as disclosed herein will become appreciated as the same become better understood with reference to the specification, claims, and appended drawings wherein:
The eye 10 includes a cornea 20 and an iris 22 disposed between the cornea 20 and the natural lens 12. The iris 22 provides a variable pupil 24 that dilates under lower lighting conditions (scotoptic vision) and contracts under brighter lighting conditions (photopic vision).
The eye 10 includes a retina 26 that receives light in the form of an image. The retina 26 includes the fovea 28, which is a small depression in the retina 26 at which visual acuity is the highest.
The eye 10 has a pupillary axis 30, which is a line perpendicular to the cornea 20 that intersects the center of the pupil 24. The eye 10 also has a visual axis 32, which is a line joining the fixation point of the eye 10 to the nodal point of the eye 10. An angle 34 between the pupillary axis 30 and the visual axis 32 is referred to as “angle kappa.”
Angle kappa 34 is typically in the nasal direction of an eye 10, as the fovea 28 is typically in the temporal direction of the eye 10. Notably, the magnitude of angle kappa 34 may vary for different individuals' eyes based on the particular physiology of the individual's eye. An average magnitude of angle kappa 34 is about five degrees, with a standard deviation of about 2.5 degrees. However, greater variation may be observed for different individuals. For example, an angle kappa 34 may be about 7.5 degrees or greater (e.g., about ten degrees or greater). An angle kappa 34 may be between about 2.5 degrees and about zero degrees in certain individuals, and may be about zero degrees in certain individuals. The amount of angle kappa may vary greatly in different individuals. The orientation of the angle kappa 34 may vary in different individuals as well.
The intraocular lens 36 may include an optic 38 and a platform including haptics 40 extending outward from the optic 38. The intraocular lens 36, and the optic 38, may include an anterior surface 42, and a posterior surface 44 facing opposite the anterior surface 42. One or more of the surfaces 42, 44 of the optic 38 may be configured to form an image on the retina 26 of the eye 10. The optic 38 may be configured to improve the vision of the eye such that other ophthalmic lenses (e.g., contact lenses, glasses) may not be needed. One or more of the surfaces 42, 44, for example, may be a refractive surface, a diffractive surface, or a combination of refractive or diffractive surfaces to form the image on the retina 26. In one embodiment, the intraocular lens 36, and the optic 38, may be multifocal, to provide a plurality of focuses. For example, a far focus corresponding to distance vision, and a near focus corresponding to near vision may result. In other embodiments, one or more intermediate focuses between the far focus and the near focus may result. In one embodiment, the intraocular lens 36 may be configured as an extended depth of focus lens, with an extended depth of focus between a far focus and a near focus.
The haptics 40 may be configured to center the optic 38 within the capsular bag 14. The haptics 40 may have a variety of configurations as desired.
The implantation of the intraocular lens 36 may produce negative dysphotopsia in the individual's eye. The negative dysphotopsia may be based on the implantation of the intraocular lens 36 in the individual's eye. According to embodiments herein, it is believed that an indicator of negative dysphotopsia based on the implantation of the intraocular lens 36 in the individual's eye may be the tilt of the optic 38 of the intraocular lens 36 with respect to the visual axis 32. The tilt of the optic 38 of the intraocular lens 36 with respect to the visual axis 32 may be caused by factors.
Such factors may include the angle kappa 34 (the angle between the pupillary axis 30 and the visual axis 32) and the tilt of the optic 38 of the intraocular lens 36 with respect to the pupillary axis 30 (the angle 46 between the pupillary axis 30 and the optical axis 48 of the optic 38).
As such, according to embodiments disclosed herein, the angle kappa 34 may be determined for an individual's eye. The angle kappa 34 of the individual's eye in embodiments may be determined by being measured pre-operatively, prior to the intraocular lens 36 being implanted into the patient's eye. The angle kappa 34 may be determined via a variety of methods. Such methods may include utilizing one or more of Purkinje images or a distance between a center of Placido rings and a center of the cornea 20 of the individual's eye. In embodiments, a method utilizing ultrasound biomicroscopy and corneal topography may be utilized. The methods utilized may involve measurements of the biometry of an individual's eye. A variety of other methods may be utilized as desired. The angle kappa 34 may be determined based on these measurements.
A determination of the likelihood of having negative dysphotopsia after cataract surgery may be produced in the individual's eye. In embodiments, the determination may be produced based on the angle kappa 34 of the individual's eye, and may include a determination of the risk of negative dysphotopsia in the individual's eye based on implantation of an intraocular lens in the individual's eye.
A variety of methods may be utilized to produce the determination of the likelihood of having negative dysphotopsia after cataract surgery in the individual's eye. In embodiments, the determined angle kappa 34 may be compared to a threshold value of angle kappa 34. It may be determined whether the angle kappa 34 meets such a threshold (by equaling or being higher than the threshold) to produce the determination of negative dysphotopsia. For example, if the determined angle kappa 34 is equal to or higher than a threshold value of five degrees, then a determination may be made that negative dysphotopsia in the individual's eye may occur. Other thresholds may be utilized. It is envisioned that the threshold value may be equal to or greater than two, three or four degrees. It is also envisioned that the threshold value may be equal to or greater than six, seven, eight, nine or even 10 degrees.
The threshold value may be determined in a variety of manners. For example, data from patients that have already had intraocular lenses implanted in their eyes may be utilized. Such data may include parameters of the angles of the intraocular lenses and the angle kappas, and whether negative dysphotopsia is experienced by such individuals. As an example, an average tilt of the optic 38 of the intraocular lens 36 with respect to the pupillary axis 30 (the angle 46 between the pupillary axis 30 and the optical axis 48 of the optic 38) may be four degrees. Further, a minimum tilt of the optic 38 of the intraocular lens 36 with respect to the visual axis 32 in individuals experiencing negative dysphotopsia may be eight degrees. As such, a threshold value of angle kappa 34 may be set at five degrees, at which a measured value of angle kappa 34 at or greater than this threshold may result in negative dysphotopsia in the individual's eye based on implantation of the intraocular lens in the individual's eye.
The determination of negative dysphotopsia in the individual's eye accordingly may be based on one or more measurements of angle kappa, which may include a measurement of angle kappa of the individual's eye, and may include measurements of angle kappa of other individuals. Other forms of biometry may be utilized to produce the determination of negative dysphotopsia in the individual's eye. Such forms of biometry may be those used to perform a power calculation for the intraocular lens.
The determination of the likelihood of having negative dysphotopsia after cataract surgery in the individual's eye may be produced in a variety of forms. In embodiments, the determination may comprise a probability of negative dysphotopsia occurring. The probability may be a probability of negative dysphotopsia in the individual's eye based on one or more measurements of angle kappa, and may be based on implantation of the intraocular lens in the individual's eye. For example, upon the angle kappa 34 being determined, a likelihood of negative dysphotopsia may be produced. A clinician accordingly may use such a probability to determine whether there is a high likelihood of negative dysphotopsia occurring following implantation of the intraocular lens. The clinician accordingly may determine whether to proceed with implantation of the intraocular lens based on the likelihood of negative dysphotopsia occurring.
In embodiments, the determination may comprise a binary result of negative dysphotopsia occurring in the individual's eye (e.g., a yes or no determination based on the measured angle kappa 34).
In embodiments, the clinician may determine a type of intraocular lens that may be implanted in the patient's eye based on the likelihood of negative dysphotopsia occurring (e.g., a risk estimation of negative dysphotopsia). A clinician may select an intraocular lens that may be designed to address the presence of negative dysphotopsia, for example a tilt adjustable intraocular lens or a lens having an optical axis that is tilted, or other form of lens as disclosed herein.
A clinician may select an intraocular lens that may provide angle kappa correction in the individual's eye. The correction may be a whole or partial correction in embodiments. The intraocular lens may have an optic with an optical axis that is tilted with respect to a platform to provide the angle kappa correction in the individual's eye. Such an optic may comprise an optic as shown in
The determination of negative dysphotopsia in the individual's eye based on implantation of the intraocular lens in the individual's eye may be made in a variety of manners. For example, a processor 50 as shown in
In embodiments, a tilt adjustable intraocular lens may be selected and utilized. The tilt adjustable intraocular lens may be utilized to address the determination of negative dysphotopsia in the individual's eye. For example, if there is a high likelihood of negative dysphotopsia determined for an individual's eye, then a tilt adjustable intraocular lens may be selected for implantation in the individual's eye. Such a tilt adjustable intraocular lens may be configured to have the optic centered with respect to the visual axis 32 by adjusting the tilt of the optic, and may be centered with a relatively small variation in the angle from the visual axis.
Implantation of a tilt adjustable intraocular lens may include determining the visual axis 32 of the individual's eye. The tilt of the optical axis of the intraocular lens may then be adjusted to center the optic with respect to the visual axis 32. The adjustment may occur prior to implantation of the intraocular lens, or during or after implantation. Further, the determination of the visual axis 32 of the individual's eye may occur prior to, during, or after implantation of the intraocular lens. The clinician may iteratively determine the visual axis 32 and adjust the tilt of the optical axis to center the optic with respect to the visual axis 32.
In embodiments, the clinician may provide a tilt adjustment of an optical axis of an optic of an intraocular lens with respect to a platform of the intraocular lens, with the tilt adjustment being provided based on the determination of negative dysphotopsia in the individual's eye based on one or more measurements of angle kappa. The tilt adjustment may be provided as a determination of whether to provide the tilt adjustment, based on the determination of negative dysphotopsia in the individual's eye based on one or more measurements of angle kappa. For example, if a low propensity of negative dysphotopsia is determined, then a clinician may determine that no tilt adjustment is needed. Conversely, if a high propensity of negative dysphotopsia is determined, then a clinician may determine that a tilt adjustment is needed.
In embodiments, the tilt adjustment may be provided as an amount of tilt adjustment based on the determination of negative dysphotopsia in the individual's eye based on one or more measurements of angle kappa. For example, the clinician may be able to determine how much of a tilt adjustment may be needed, based on the determination of negative dysphotopsia in the individual's eye based on one or more measurements of angle kappa. The clinician may determine the degree to which the tilt should be adjusted. Such an adjustment, in embodiments, may be performed post-implantation of the intraocular lens into the individual's eye. For example, a corrective procedure may be performed to provide an angle kappa correction after the individual's eye already has been implanted with the intraocular lens.
The tilt adjustment may provide an angle kappa correction in the individual's eye. The clinician may perform the tilt adjustment intraoperatively in embodiments. One or more of a mechanical adjustment or a laser ablation, as disclosed herein, may be utilized. For example, according to methods herein, a laser ablation may be performed to one or more surfaces of the optic 70 to provide an angle kappa correction. The amount of material to be ablated may be determined based on the desired angle kappa correction. The tilt of the optical axis may be set based on the measured angle kappa of the individual's eye (e.g., the tilt to center with the visual axis).
The amount of tilt may be scaled so that the clinician may control the tilt during implantation within a tilt correction range. The tilt correction range may be based on pre-existent analytical models. The analytical models, in embodiments, may be configured to collect pre and post-surgery biometry (such as intraocular lens tilt, angle kappa, etc.) and produce a prediction model. In embodiments, average values may be utilized.
As shown in
The optical axis 85 may be tilted to provide angle kappa correction in an individual's eye. As such, the tilt of the optical axis 85 may be set such that the optical axis 85 is centered with respect to the visual axis 32. In embodiments, the optical axis 85 may be set based on the measured angle kappa of the individual's eye (e.g., the tilt to center with the visual axis).
The optical axis 85, in embodiments, may be pre-set based on an angle kappa of one or more individual's eyes. For example, the angle kappa of many individuals may be known and the optical axis 85 may be pre-set based on an average angle kappa of these many individuals. As such, a clinician may select the intraocular lens 81 having an average value of angle kappa correction. In embodiments, the type of intraocular lens (including the angle of the optical axis) may be selected according to methods disclosed herein, including selection for providing an angle kappa correction in an individual's eye, with the intraocular lens being selected based on a determination of negative dysphotopsia in the individual's eye based on one or more measurements of angle kappa.
Centering the optic with respect to the visual axis 32 may beneficially reduce the prevalence of negative dysphotopsia in the individual's eye. The embodiments disclosed herein may be utilized with one or more of a monofocal optic, a multifocal optic, or an extended depth of focus optic. The optics may be refractive and/or diffractive. Tilt adjustable intraocular lenses may be applied to compensate for the negative impact of large angle kappa in image quality, particularly for multifocal intraocular lenses.
Features of embodiments may be modified, substituted, excluded, or combined as desired.
In addition, the methods herein are not limited to the methods specifically described, and may include methods of utilizing the systems and apparatuses disclosed herein.
In embodiments, a method may include implanting an intraocular lens in an individual's eye. In embodiments, the intraocular lens may include features as disclosed herein, including an optic having an optical axis, and a platform coupled to the optic and configured to support the optic, wherein a tilt of the optical axis is adjustable with respect to the platform.
A method may include determining a visual axis of the individual's eye. The method may include adjusting the tilt of the optical axis with respect to the platform to center the optic with respect to the visual axis of the individual's eye.
In embodiments, a screw coupling may couple the platform to the optic, and the method may further comprise adjusting the screw coupling to adjust the tilt of the optical axis with respect to the platform to center the optic with respect to the visual axis of the individual's eye.
In embodiments, a method may include laser ablating a portion of one or more of the optic or the platform to adjust the tilt of the optical axis with respect to the platform to center the optic with respect to the visual axis of the individual's eye.
A method may include adjusting the tilt of the optical axis prior to implantation of the intraocular lens in the individual's eye. A method may include adjusting the tilt of the optical axis during or after implantation of the intraocular lens in the individual's eye.
In embodiments, the visual axis of the individual's eye may be determined based on an angle kappa of the individual's eye.
A method may include measuring the angle kappa utilizing one or more of Purkinje images or a distance between a center of Placido rings and a center of a cornea of the individual's eye.
In embodiments, a method may include implanting an intraocular lens in an individual's eye. The intraocular lens may include an optic having an optical axis, and a platform coupled to the optic and configured to support the optic. The optical axis may be tilted with respect to the platform to provide angle kappa correction in the individual's eye.
In embodiments, the intraocular lens may be selected based on an angle kappa of the individual's eye. The optical axis may be tilted with respect to the orientation plane of the haptics for the intraocular lens.
In embodiments, a degree of the tilt of the optical axis is set based on an angle kappa of one or more individuals' eyes.
The method may include determining a visual axis of the individual's eye. A tilt of the optical axis with respect to the platform may center the optic with respect to the visual axis of the individual's eye. The visual axis of the individual's eye may be determined based on an angle kappa of the individual's eye. The method may include measuring the angle kappa utilizing one or more of Purkinje images or a distance between a center of Placido rings and a center of a cornea of the individual's eye.
According to embodiments herein, the processor 50 shown in the system of
In closing, it is to be understood that although aspects of the present specification are highlighted by referring to specific embodiments, one skilled in the art will readily appreciate that these disclosed embodiments are only illustrative of the principles of the subject matter disclosed herein. Therefore, it should be understood that the disclosed subject matter is in no way limited to a particular methodology, protocol, and/or reagent, etc., described herein. As such, various modifications or changes to or alternative configurations of the disclosed subject matter can be made in accordance with the teachings herein without departing from the spirit of the present specification. Lastly, the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to limit the scope of systems, apparatuses, and methods as disclosed herein, which is defined solely by the claims. Accordingly, the systems, apparatuses, and methods are not limited to that precisely as shown and described.
Certain embodiments of systems, apparatuses, and methods are described herein, including the best mode known to the inventors for carrying out the same. Of course, variations on these described embodiments will become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventor expects skilled artisans to employ such variations as appropriate, and the inventors intend for the systems, apparatuses, and methods to be practiced otherwise than specifically described herein. Accordingly, the systems, apparatuses, and methods include all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described embodiments in all possible variations thereof is encompassed by the systems, apparatuses, and methods unless otherwise indicated herein or otherwise clearly contradicted by context.
Groupings of alternative embodiments, elements, or steps of the systems, apparatuses, and methods are not to be construed as limitations. Each group member may be referred to and claimed individually or in any combination with other group members disclosed herein. It is anticipated that one or more members of a group may be included in, or deleted from, a group for reasons of convenience and/or patentability. When any such inclusion or deletion occurs, the specification is deemed to contain the group as modified thus fulfilling the written description of all Markush groups used in the appended claims.
The terms “a,” “an,” “the” and similar referents used in the context of describing the systems, apparatuses, and methods (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein is intended merely to better illuminate the systems, apparatuses, and methods and does not pose a limitation on the scope of the systems, apparatuses, and methods otherwise claimed. No language in the present specification should be construed as indicating any non-claimed element essential to the practice of the systems, apparatuses, and methods.
All patents, patent publications, and other publications referenced and identified in the present specification are individually and expressly incorporated herein by reference in their entirety for the purpose of describing and disclosing, for example, the compositions and methodologies described in such publications that might be used in connection with the systems, apparatuses, and methods. These publications are provided solely for their disclosure prior to the filing date of the present application. Nothing in this regard should be construed as an admission that the inventors are not entitled to antedate such disclosure by virtue of prior invention or for any other reason. All statements as to the date or representation as to the contents of these documents is based on the information available to the applicants and does not constitute any admission as to the correctness of the dates or contents of these documents.
This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 63/134,946, filed Jan. 7, 2021, which is incorporated herein by reference in its entirety.
Number | Date | Country | |
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63134946 | Jan 2021 | US |