This invention relates to light adjustable lenses, and more specifically to light adjustable lenses with a modulable absorption.
The techniques and tools of cataract surgery are experiencing continuous, impressive progress. Subsequent generations of phacoemulsification platforms and newly invented surgical lasers keep increasing the precision of the placement of intraocular lenses (IOLs) and keep reducing the unwanted medical outcomes.
However, even if the IOLs are selected with careful planning and implanted with precision surgical equipment into the capsular bag, the post-implantation healing and scarring of the ophthalmic tissue often shifts or tilts the IOL away from its planned and optimal location in the capsular bag of the eye. This settling process can take a few weeks. This shift and tilt have the potential to worsen the optical performance of the IOL and thus the overall medical outcome of the cataract surgery.
Recently, an intraocular light adjustable lens (LAL) technology has been invented and developed to address this problem. Just like regular IOLs, LALs can shift and tilt during the few weeks long settlement process after implantation into the capsular bag. However, the shift or tilt of the LAL can be compensated by adjusting the optical properties of the implanted LAL. This adjustment can be achieved by illuminating the LAL with an ultraviolet (UV) light beam with a carefully selected spatial profile.
To prevent the UV portion of sunlight from modifying the optical properties of the LAL in the weeks between the implantation and the light adjustment procedure, the patients are asked to comply with the instruction of wearing UV blocking glasses. However, even a limited break in the compliance, such as the patient forgetting to put on the UV blocking sunglasses while going for a walk on a sunny day, can lead to uncontrolled and undesirable modifications of the optical properties of the LAL. U.S. Pat. Nos. 8,604,098 and 8,933,143, both entitled: “On-demand photoinitiated polymerization”, both to Boydston et al. proposed introducing a “masking compound” to address this issue. As described below, however, these designs did not solve the challenge of unintended lens modifications caused by patient non-compliance. Therefore, there is still an unmet medical need for improvements in the Light Adjustable Lens technology that reduces and possibly eliminates the need for a strict patient compliance with the wearing of the UV blocking glasses.
The above-described needs are addressed by embodiments of a modulable absorption light adjustable lens (MALAL), comprising: a light adjustable lens that is capable of changing its optical properties upon an adjusting irradiation, including a photo-modifiable material; and a modulable absorption front protection layer, including a modulable absorption compound whose absorption properties can be modulated with a modulating stimulus.
Other embodiments include a method of adjusting an optical property of a modulable absorption light adjustable lens, the method comprising: reducing an absorption of a modulable absorption compound of a modulable absorption front protection layer of the MALAL by a modulating stimulus, the MALAL having been previously implanted into an eye; and changing an optical property of a light adjustable lens of the MALAL by applying an adjusting irradiation.
This document describes embodiments of light adjustable intraocular lenses that provide improvements regarding the above described medical needs. The description starts by reviewing the Light Adjustable Lens technology in some detail.
Given the sensitivity of the optical properties of the LAL 10 to UV light, in the weeks between the implantation and the adjustment, the patients are instructed to wear UV blocking spectacles to prevent the UV portion of the solar radiation from accidentally modifying the optical properties of the LAL 10. However, even a limited slip-up in the compliance, such as the patient forgetting to put on the UV blocking spectacles when going outdoors, can cause substantial changes in the optical properties of the LAL 10.
To place the description of the MALAL 100 in context, first the Light Adjustable Lens LAL 110 will be described by itself in some detail in
In the LAL 110 of the MALAL 100, the photo-modifiable material 111 can further include photopolymerizable monomers or macromers 113, capable of photo-induced polymerization. These photopolymerizable monomers/macromers 113 can further include photopolymerizable endgroups 114. In addition, the photo-modifiable material 111 can include a photoinitiator 115 that can be cither separate from the photopolymerizable monomers/macromers 113, or can be a functional group at the end of the photopolymerizable monomers/macromers 113.
The modulating stimulus, such as the aforementioned UV illumination, can activate the photoinitiator 115, which, in turn, can induce the photopolymerization of the photopolymerizable monomers/macromers 113, typically via their photopolymerizable endgroups 114. This photopolymerization process adjusts an optical property of the LAL 110, and thereby an optical property of the MALAL 100, as described below.
The LAL 110 of the MALAL 100 can further include a dispersed ultraviolet (UV) absorber 116. This UV absorber 116 can play different roles. One of them is to make sure essentially all incident UV illumination is safely absorbed inside the LAL 110, thereby providing retinal safety for the eye. Further, the UV absorber 116 can also play a role in controlling and shaping the spatially varying depth profiles of the MALAL 100.
Up to now embodiments of the MALAL 100 were described that were adjustable by a UV illumination as the adjusting irradiation. In other embodiments, the adjusting irradiation can involve other parts of the electromagnetic spectrum, such as specific portions of the UV spectrum, or infrared portions. Also, the adjusting irradiation can be an incoherent, or a coherent, laser-like, illumination, that can be applied simultaneously to large areas of the LAL 110, or sequentially, in a scanning manner.
As mentioned, the patients are instructed to wear UV blocking glasses through steps
Returning to
When such a MALAL 100 is used in the LAL technology of
Some embodiments of the MALAL 100 can provide more than protection from accidental non-compliance. Some MALALs 100 can be fabricated to provide strong enough protection such that wearing UV blocking glasses is not even necessary between the implantation and the lock-in of the MALAL 100. This benefit of the MALAL 100 is a great relief for the patients and doctors, alike as it increases the patient comfort, as well as essentially eliminates the risks and undesirable outcomes of inadvertent non-compliance. In these MALALs 100, a modulable absorption compound 300 is chosen that has a sufficiently high UV absorption, and the modulable absorption front protection layer 120 is chosen with a sufficiently large thickness so that these factors in combination provide sufficient protection of the photo-modifiable material 111 of the LAL 110 from the solar UV irradiation during the weeks between the implantation in
Once the MALAL 100 settled in the capsular bag, the time comes to adjust the optical properties of the LAL 110 of the MALAL 100, as previously outlined in
As shown in
While until now embodiments of the MALAL 100 were described to be adjustable by a UV illumination being the modulating stimulus 310, in other embodiments the modulating stimulus 310 can take other forms, including an electromagnetic illumination, a laser irradiation, an infrared irradiation, an ultra-violet illumination, a magnetic stimulus, an electric field, a chemical stimulus, a heat transfer, an energy transfer, an ultrasound-mediated stimulus, a mechanical stimulus, a thermal stimulus, or a thermal relaxation.
Finally,
The physical extent of the modulable absorption front protection layer 120 can be characterized by a thickness that is less than 50%, 25%, 5%, or 2% of a thickness of the light adjustable lens LAL 110, in relative terms. In absolute terms, the thickness of the modulable absorption front protection layer 120 can be in the range of 1-200 microns, in some cases in the range of 1-100 microns, in yet others in the range of 10-50 microns.
Before proceeding, we return to U.S. Pat. Nos. 8,604,098 and 8,933,143, both entitled: “On-demand photoinitiated polymerization”, both to Boydston et al. These patents proposed introducing a “masking compound” into light adjustable lenses to reduce the risk of unintended polymerization until the time of the light adjustment, at which time a photoisomerization was triggered to allow the adjustment of the lens. However, the solution offered by these patents did not solve the problem, as the masking compound was broadly distributed throughout the volume of the light adjustable lens. Because the masking compound was dispersed throughout the volume of the lens, the frontal region of the light adjustable lens did not get sufficient protection and was prone to undesirable zone formation and thus to uncontrolled and undesirable changes of its optical properties.
Embodiments of the MALAL 100 deliver where this previous proposition failed, by concentrating the protective modulable absorption compound 300 in the front protection layer 120, formed and positioned frontally relative to the LAL 110, instead of dispersing the compound 300 throughout the volume of the LAL 110. This is the structural improvement that enables the MALALs 100 to provide full protection from UV rays for even the most frontal region of the LAL 110, because only this frontal positioning of the protective modulable absorption compound 300 prevents the accidental zone formation and the uncontrolled optical changes from the implantation, through the adjustment, until the lock-in of the MALAL 100.
As already described in relation to
Once the UV beam as the adjusting irradiation 210 has been applied with the spatial profile needed to eventually induce the adjustment of the optical properties of the LAL 110, as related to
Applying the low-to-high modulating stimulus 310-lth with (1) a dedicated light source, may be helpful for some embodiments, but in some others, it is not necessary. At least the following other agents can bring the cis conformation 300-l back to the trans conformation 300-h. (2) Thermodynamic relaxation, since the trans conformation has lower energy than the cis conformation, and therefore thermodynamic relaxation efficiently restores the azobenzene into its initial trans conformation. (3) Sunlight, or ambient light by itself can act as an efficient accelerant, to drive azobenzene into a driven steady state with high concentration of the trans conformation, as described next in detail.
In general, the full description of photoisomerization can be thought of as a dynamic balance of a trans-to-cis and a cis-to-trans reaction:
Here the reaction rates can be defined by the spectral integrals as follows:
Here φt and φc are the quantum yields of absorption, defined as photo-induced transition/absorbed photon, and are thus dimensionless. The wavelength dependence of these quantum yields in the relevant wavelength interval is minimal and will be disregarded. Is(λ) is the spectral irradiance of the incident radiation, in units of [power/(area*wavelength)], such as [mW/(cm2*nm)]. The trans-to-cis absorption, related to the π-π* transition, is induced by absorbing photons in the λt1-λt2 range, while the cis-to-trans absorption, related to the n-π* transition, is induced by absorbing photons in the λc1-λc2 range—these two wavelength intervals will be also referred to as absorption bands and constitute the boundaries of the integrals. εt(λ) and εc(λ) are the molar absorptivity values in the trans and cis states, respectively, in units of [volume/(mol*length)], such as [liter/(mol*cm)]; and cc and ct are the concentrations of the modulable absorption compound 300 in its low-absorption cis and high-absorption trans conformations, in the usual units of [mol/liter]. The molar absorptivities can be also thought of as absorption cross sections. Eqs. (2a)-(2b) yield the reaction rates R/R. in units of [(1/sec)*(reactions/cm3)], which are related to the inverse time constants kt/kc via the concentrations c/cc. Rtherm is the rate at which the cis state thermally decays into the trans state. Rtherm can be estimated as ktherm*cc, where ktherm can be defined as the inverse of the 1/e time constant for thermal relaxation. In some typical compounds, ktherm−1 is typically in the range of 1-20 hours, in some cases as long as 1-5 days, but can also be 10-1,000 seconds. In the presence of a low-to-high modulating stimulus 310-lth, including even ambient light, the Rtherm term is typically 2 or 3 orders of magnitude smaller than the integral term, and will be disregarded for the current analysis. Further, the concentration of the trans conformation is given by ct, while the concentration of the cis conformation by cc. Naturally, ct+cc=c0, the total concentration of the modulable absorption compound 300, in this case, that of azobenzene that does not change with time. The speed of light is denoted by simply c, and Plank's constant by h. With these constants, the λ/hc=1/hν term divides the spectral irradiance Is(λ) with its energy hν, thereby converting the spectral irradiance from power density to photon number density.
In a steady-state, dynamic equilibrium the trans-to-cis and the cis-to-trans rates are equal
These results are approximate, as they capture the situation when the illumination spectral irradiance Is(λ) is incident on the modulable absorption compound 300, so they hold close to the surface, or for a thin modulable absorption front protection layer 120. For modulable absorption front protection layers 120 extended in the z, or depth direction, the spectral irradiance decays with increasing z depth as it propagates through the front protection layer 120. A more complete treatment captures the effect of this decay on the absorption in terms of a z-depth dependent spectral irradiance Is(1,z) and integrates the rates of the absorption processes along the z-depth. The results of such an in-depth analysis are often well approximated by the above formulae. The influence of the depth-dependence of the irradiance will be further analyzed below.
First, the case of the high-to-low modulating stimulus 310-htl will be considered. In a typical case, such a stimulus 310-htl can be applied by a powerful UV light source, such as a mercury lamp or a UV LED. Such sources often generate an illumination with a quite narrow band. This can be approximated by a Dirac delta which is taken to be centered at the standard wavelength
of mercury lamps, 365 nm, thereby simplifying the integrals into products, and yields the simple expression for the concentration ratio a of such a Light Delivery Device LDD:
For azobenzene, φt≈0.15 and φc≈0.5; and the ratio of the molar absorbances is about 0.1, yielding aLDD≈0.3. This means that applying a UV light source as the source of the high-to-low modulating stimulus 310-htl induces a dynamical equilibrium in which the concentration ct of the trans conformation is about one third of that of cc, the concentration of the cis conformation, so only approximately 25% of the modulable absorption compound 300 will remain in the trans conformation compared to the approximately 100% initial concentration. This about 4-fold reduction of the trans conformation concentration is sufficient to let a large portion of a subsequent adjusting irradiation 210 through the front protection layer 120 into the LAL 110 for a suitably chosen thickness of the front protection layers 120. One aspect of the above derivation worth articulating explicitly is that the application of the high-to-low modulating stimulus 310-htl does not switch all high-absorption isomers 300-h into low-absorption isomers 300-l in full, much rather a partial modulation and transformation is the result.
Next, the reverse process, the low-to-high modulating stimulus 310-lth is described in a particularly simple case, when no explicit light source is applied, but, rather, simply the ambient light is allowed to control the concentrations of the two conformations. For this case, the spectral irradiance Is(2) is that of the solar radiation in case of a direct exposure, i.e. the patient looks directly into the Sun. The concentration ratio a remains the same for indirect, diffuse exposure, when only the diffused sunlight reaches the eye, since Eq. (4) that governs the concentration ratio is controlled only by the ratio of the solar irradiances, and from this ratio the effect of diffusion cancels out.
The magnitude of the solar irradiance below 300 nm wavelength which reaches the IOL is negligible because the cornea efficiently absorbs UV light for shorter wavelengths, and the molar absorption above 500 nm, of azobenzes and related compounds under consideration, is likewise negligible. Therefore, the integrals in Eq. (4) are executed over the λ=300 nm-500 nm wavelength range with the solar spectral irradiance, yielding:
Eq. (7) yields for some azo compounds and others described below an a concentration ratio of about 3. For some other modulable absorption compounds 300, a is in the range of 5-10. These values translate to a trans conformation concentration of ct=75% for a=3, and ct=84-91% for a=5-10. Front protection layers 120 with the modulable absorption compound being in its high absorption conformation 300-h in concentrations in the 75-91% range, can provide robust UV protection for the underlying LAL 110.
For completeness, several different embodiments low-to-high modulating stimulus 310-lth can be employed for various MALALs 100. (1) As discussed here, the patient simply being exposed to ambient light can increase the concentration of the high-absorption isomer 300-h back to levels where it can serve as an efficient front protection layer 120. For front protection layers of thickness 10-100 μ, in some cases 20-50 μ, and overall molar concentrations of co in the 10-100 millimolar range, in some cases in the 20-30 millimolar range, the time for this concentration increase can be in the 1-10 seconds range. Such a switching time can be naturally accommodated in the ophthalmologist office after the adjusting step of
The above considerations indicate that modulable absorption compounds 300 that have a concentration ratio a <<1 for a narrow bandwidth UV modulating stimulus 310-htl, while at the same time have a concentration ratio a>>1for solar radiation, or an explicit low-to-high modulating stimulus 310-lth, are well-suited to provide two beneficial effects: (1) such modulable absorption compounds 300 are capable of protecting the MALAL 100 from uncontrolled optical adjustments caused by involuntary patient non-compliance from implantation to lock-in; (2) while at the same time they are capable of enabling the application of adjustment illuminations 210 by a conformation change, induced by a modulating stimulus 310.
Now we return to the issue of the spectral irradiance decaying with increasing z-depth. Remarkably, this decay only increases the utility of the MALALs 100, because it induces a “self-shielding effect”. In the informative embodiment of ambient solar irradiation acting as the low-to-high modulating stimulus 310-lth, as the solar irradiation propagates deeper and deeper into the front protection layer 120, the UV portion of the solar irradiation Is(2.,z) is absorbed faster than the visible portion. This is so because in the presence of a realistic amount of trans high-absorption isomer 300-h, such as the previously determined c>25%, the absorptivity is higher in the UV range than in the visible range. For specificity, in typical modulable absorption compounds 300 which contain both trans high-absorption isomers 300-h and cis low-absorption isomers 300-l, this translates to ε(λ=365 nm)>ε(λ=450 nm). Inspection of Eq.(7) for the concentration ratio asolar reveals that as the spectral irradiance Is(λ,z) decays faster in the UV range, asolar increases faster. In a simplified explanation, deeper in the front protection layer 120 there are less and less UV photons to transform the modulable absorption compound 300 from the trans high-absorption isomer 300-h to the cis low absorption isomer 300-l, while in relative terms more and more visible photons are driving the reverse process from the cis low-absorption isomer 300-l to the trans high-absorption isomer 300-h, thereby increasing asolar with increasing depth, further increasing the overall protective UV blocking functionality of the front protection layer 120.
One more aspect of the depth-dependence of the spectral irradiance is articulated next. The overall reduction of the spectral irradiance exiting the front protection layer 120 through its distal surface is controlled by the absorbance that is given by the product of ε, the molar absorptivity of the modifiable absorption compound 300, c, the molar concentration of the modifiable absorption compound 300, and D, the thickness of the front protection layer 120. In optical design terms, the absorbance is sometimes also referred to as optical density. Thus, different embodiments of the front protection layer 120 that contain different modulable absorption compounds 300 with different molar absorptivities in different molar concentrations and with different thicknesses, will deliver approximately the same protection, as long as the product of these three quantities is the same. The eventual choice of the modulable absorption compound 300, its concentration and its thickness can be driven by additional considerations, such as the desire to avoid an excessive yellowing of the visual experience for the patient.
Before proceeding, it is useful to summarize the potential benefits of MALALs 100 with the above front protection layer 120 relative to existing designs, some of which were already mentioned earlier.
(1) MALALs 100 with front protection layer 120 greatly reduce the risk of uncontrolled optical changes in the LAL 110 resulting from accidental non-compliance by the patients, such as forgetting to wear the UV blocking glasses.
(2) Further, in MALALs 100 a considerably lower concentration of the UV absorber 116 can be employed that is dispersed in the volume of the LAL 110. Such LALs 110 require a substantially lower dose for the lock-in irradiation 220. Any reduction of the dose of the UV lock-in irradiation of the MALAL technology further enhances the safety of the procedure.
(3) MALALs 100 with a more absorbing front protection layer 120 can even provide such an effective UV blocking that the patients may not even need to wear UV blocking glasses from the implantation through the adjustment up to the lock-in. This is greatly beneficial as such MALALs 100 essentially eliminate the risks caused by accidental patient non-compliance, as well as greatly improve patient comfort from implantation to lock-in.
(4) MALALs 100 with even more absorbing front protection layers 120 may not even need the lock-in step of
(5) Even more remarkably, in a fraction of patients the implanted MALAL 100 may not even shift or tilt. Such patients may report that after the implantation their vision remained high quality and did not deteriorate noticeably. For these patients, the doctor may even conclude that not even one follow-up visit is needed for adjusting the MALAL 100. For all those patients who would need a longer trip for the adjustment and/or lock-in procedures, possibly even involving an airplane flight, the likelihood of no need for any kind of follow-up visit can mean a further qualitative improvement in their overall experience, or “journey”.
(6) Finally, in a small subset of cases, unforeseen changes may occur in the eye long after the cataract surgery, caused by various other ophthalmic degradation, injuries or any kind of shocks. In such cases, the fact that the no lock-in MALAL 100 remains adjustable can be very beneficial, as such MALALs 100 can be adjusted in response to the unforeseen developments even years after the implantation.
There are many other embodiments of the modulable absorption compound 300 beyond azobenzene. The modulable absorption compound 300 can be an azo-aromatic compound, a diazene, an azo-pyrazole, a dienylethene, a fulgicide, an azulene, a spiropyran, an ethene-aromatic compound, a macromer of one of these compounds, a polymer of these compounds, a composition containing one of these compounds, a composition containing one of these compounds as side-chains, a composition containing one of these compounds as a backbone having a side-chain, a nanoparticulate bonded to one of these compounds; and one of these compounds dissolved in an ionic fluid. The modulable absorption compound 300 could also be a polymer incorporating any of the just listed compounds into the polymer host matrix 112 itself, so it doesn't have to be incorporated as a side chain. Some such compounds may include a polymer which bends in response to light. The description continues by overviewing an extensive list of embodiments of the modulable absorption compound 300.
As mentioned earlier, the azo-aromatic compound can be e.g. azobenzene that exhibits the following conformational change [1]:
In other embodiments of the modulable absorption compound 300, the azo-aromatic compound can be 4-methoxy azobenzene [2]:
The modulable absorption compound 300 can also be an indazole, allylated azobenzene with various spacer links, or another version of phenyl azopyrazoles, as shown [3]-[6]:
Finally, in some embodiments, the ethene-aromatic compound can be stilbene [8]:
For the many other embodiments of the MALAL 100, the high-to-low modulating stimulus 310-htl can include a high-to-low illumination with a light having a band centered at a wavelength in a range of 300-400 nm; and the low-to-high modulating stimulus 310-lth can include a low-to-high illumination with a light having a band centered at a wavelength in a range of 300-700 nm, including the solar spectrum. In other words, when referencing an illumination and its wavelength, this wavelength often means the illumination having a band with a center peak at the mentioned wavelength, the band also having a bandwidth around this center wavelength, since the source of the illumination in many cases is not a coherent laser, and thus the illumination has a finite bandwidth, or spectral spread. For the high-to-low modulating stimulus 310-htl the source can be a narrow band source with a width of the band can be in the 1-50 nm range, in other embodiments in the 1-10 nm range, such as a mercury lamp or a UV LED. For the low-to-high modulating stimulus 310-lth, the source can have a quite broad band, including even the regular solar spectrum that extends from about 300 nm beyond 2,500 nm.
As described earlier, for some modulable absorption compounds 300, the naturally occurring thermal relaxation may be already sufficient to play the role of the low-to-high modulating stimulus 310-lth by inducing the transition from the low-absorption chromophore 300-l to the high-absorption chromophore 300-h. For MALALs 100 that transition the low-absorption chromophore 300-l into the high-absorption chromophore 300-h with thermal relaxation, the description in terms of a light source with a band center peak and a band width is not a natural characterization.
In some embodiments of the MALAL 100, the terms “low absorption” and “high absorption” can be articulated quantitatively. In some MALALs 100, a ratio of an absorptivity of the high-absorption conformation 300-h relative to an absorptivity of the low-absorption conformation 300-l at a wavelength in a range of 300-400 nm can be greater than 2. As an example, for a 4-amino azobenzene-based modulable absorption compound 300, the ratio of absorptivities is about 5, if a reference wavelength of 350 nm is selected, as shown in
In many embodiments of the MALAL 100, the high-absorption conformation 300-h of the modulable absorption compound 300 has a lower energy than the low-absorption conformation 300-l. Therefore, in equilibrium and in ambient conditions, a ratio of a concentration of the high-absorption isomer 300-h relative to a concentration of the low-absorption isomer 300-l is greater than 2 in at least one of a solid phase, a dilute solution, and in a host matrix-bonded state. In low light conditions, the energies of these high-absorption isomer 300-h and low-absorption isomer 300-l control the density ratios of these isomers in ambient conditions according to the exponential activation factors of statistical mechanics.
In some MALALs 100, the modulable absorption compound 300 can have a chemical composition such that at least 25%, or 50% of the high-absorption conformation 300-h transitions into the low-absorption conformation 300-l under the high-to-low illumination 310-htl with a radiant exposure in the range of 1 mJ/cm2-1,000 mJ/cm2, integrated over a wavelength range of 300 nm-400 nm.
It is recalled here that the irradiance of an illumination is measured in units of mW/cm2, whereas the radiant exposure is measured in units of mJ/cm2. Broadly speaking, the radiant exposure can be related to the irradiance as: radiant exposure=irradiance*time. However, in some embodiments of the MALAL 100 this relationship can be more complex than a simple product. The amount of absorption modulation in the MALAL 100 for a modulating stimulus 310 that has twice the irradiance, but half the time may be different, in spite of the product of these two factors having remained the same. Such non-linear relations are sometimes referred to as a violation of reciprocity. This violation occurs, for example, in cases when the thermal relaxation rate Rthermal in Eq.(2b) is fast, and comparable to the other rates.
The analogous characterization can be applied for the reverse transformation as well. In some MALAL 100 embodiments, the modulable absorption compound 300 can have a chemical composition such that at least 50% of the low-absorption conformation 300-l transitions into the high-absorption conformation 300-h under the low-to-high modulating stimulus 310-lth with a radiant exposure in the range of 1 mJ/cm2-1,000 mJ/cm2 over a wavelength range of 300 nm-700 nm. In many embodiments, the source of the high-to-low modulating stimulus 310-htl and the source of the adjusting irradiation 210 can be chosen to be the same, shared source, for example a UV source. A typical example can be a mercury arc lamp, or a UV LED, having a spectral peak around 365 nm. In contrast, in most embodiments, the source of the low-to-high modulating stimulus 310-lth is typically operated at longer wavelengths with a much broader spectrum and is thus distinct from the shared source. As mentioned, for relevant classes of MALALs 100 the ambient light of a doctor's office by itself can be an effective source of the low-to-high modulating stimulus 310-lth, emitting in a spectrum that can be mostly concentrated in the visible range of 400-700 nm.
Another way to characterize the effect of the modulating stimulus 310 is in terms of the quantum yields φt and φc, for the trans-to-cis and the cis-to-trans transitions. In such cases, the modulable absorption compound 300 can have a chemical composition such that φt, the quantum yield of the transition from the high-absorption conformation 310-h into the low-absorption conformation 310-l is greater than 1%. For some MALALs 100, this φt quantum yield can be higher than 5%, in some higher than 10%. The higher the quantum yield, the lower radiant exposure is sufficient to transform the high-absorption conformation 310-h into the low-absorption conformation 310-l. Here the quantum yield is defined in the customary manner of quantum yield=number of induced transformations/number of absorbed photons.
The concept of the quantum yield can be used to further characterize the modulable absorption compound 300 as follows. The modulable absorption compound 300 can have a chemical composition such that φt, the quantum yield of the transition from the high-absorption isomer 300-h to the low-absorption isomer 300-l in response to the high-to-low modulating stimulus 310-htl can be in the 1-20% range, while φc, the quantum yield of the reverse transition from the low-absorption isomer 300-l to the high-absorption isomer 300-h in response to the low-to-high modulating stimulus 310-lth can be in the 10-70% range. In other embodiments, these two quantum yields can be in the ranges of φt=5-10%, and φc=40-60%, respectively.
In some embodiments, the modulable absorption compound 300 includes a photoisomerizable moiety linked to one or more polymerizable moieties. In some embodiments, the modulable absorption compound 300 is described by the Formula [9]:
(Z1)n1-Y-(Z2)n2 [9]
In some embodiments, in Formula [9], n1 and n2 are each 1, and Z1 and Z2 are each independently connected to Y via a linker of 1 to 20 atoms in length (e.g., 1 to 6 atoms in length). In some embodiments, n1 is 2 or 3, and each Z1 is attached to Y via a branched linker (e.g., an amino or an ammonium containing linker). In some embodiments, when n1 and/or n2 is 2 or 3, then each Z1 and/or Z2 is independently connected to Y via a linear linker that is not branched. In some embodiments Y is an azoarylene, a diarylethene, or a dithienylethene. In some embodiments, each Z1 and Z2 is independently selected from a vinyl, a vinylidene, a diene, an olefin, an allyl, an acrylate, an acrylamide and an acrylic acid.
In some embodiments, in Formula [9], the modulable absorption compound 300 has the structure Ar1—N═N—Ar2 or Ar1—C═C—Ar2, where Ar1 and Ar2 are independently selected from aromatic 6-membered rings that may be substituted or unsubstituted and may include one or more heteroatoms. In some embodiments, the modulable absorption compound 300 includes an azobenzene moiety (e.g., where Ar1 and Ar2 are phenyl). In some embodiments, the modulable absorption compound 300 is capable of photoisomerization from a trans isomer to a cis isomer, e.g., as exemplified for the Ar1—N═N—Ar2 compound below shown below. In some embodiments, the cis isomer of the modulable absorption compound 300 spontaneously isomerizes back to the trans isomer.
In some embodiments, the azobenzene moiety is a photoisomerizable chromophore having absorption maximum near that of a photoinitiator (such as any of the photoinitiators used and described herein). In some embodiments, the azobenzene moiety has an absorption maximum about 50 nm or less (e.g., about 40 nm or less, about 30 nm or less, about 20 nm or less, or about 10 nm or less) from the absorption maximum of the photoinitiator.
In some embodiments, the thermodynamically more stable trans-azobenzene (t-AB) moiety tends to absorb at lower wavelengths than the corresponding cis-azobenzene (c-AB) isomer. Upon irradiation, photoisomerization may be facile and quantitative. In some embodiments, thermal relaxation from the c-AB moiety to the t-AB isomer occurs within hours (e.g., within 12 hours or less, such as 6, 5, 4, 3, 2 or within 1 hour or less) at ambient temperature. Irradiation of the t-AB moiety near its absorption maximum causes isomerization to the cis isomer and a change in the absorption spectrum (e.g., a shift in the absorption maxima).
In some embodiments, the modulable absorption compound 300 further includes a polymerizable moiety, i.e., a functional group capable of polymerization in a prepolymer composition upon application of a suitable stimulus (e.g., activation of a photoinitiator). The polymerizable moiety may include a functional group such as an alkenyl, a vinyl, a vinylidene, a diene, an olefin, an allyl, an acrylate or a (meth)acrylic functional group. In some embodiments, the polymerizable moiety is an allyl or a vinyl group.
In some embodiments, where the modulable absorption compound 300 comprises a polymerizable moiety, the modulable absorption compound 300 may be chemically incorporated into another component of the compositions of interest. For example, the modulable absorption compound 300 can be incorporated into the backbone of a polymer that is present as a matrix material (see below). Also, for example, the modulable absorption compound 300 can be incorporated into the backbone or as a sidegroup of the prepolymer (see below). In this way, small molecule modulable absorption compound 300s can be chemically incorporated into polymeric components of the compositions of interest. In some embodiments and for some applications, incorporating modulable absorption compound 300s in this manner makes it less likely for the masking component to diffuse out of the compositions of interest.
In some embodiments, the modulable absorption compound 300 is described by the structure of Formula [10]:
In some embodiments, in Formula [10], each Z3 and Z4 is independently selected from a vinyl, a vinylidene, a diene, an olefin, an allyl, an acrylate, an acrylamide and an acrylic acid.
In some embodiments, in Formula [10], L3 and L4 are each independently a linker of 1 to 20 atoms in length, such as of 1 to 6 atoms in length. In some embodiments, the linker L3 and/or L4, when present, may include an amino group that connects to a polymerizable moiety or a crosslinking moiety. In some embodiments, a linker is present and includes a branched amino group (e.g., a trivalent amino or a tetravalent ammonium group) for connecting two or three polymerizable moieties and/or crosslinking moieties to the azobenzene. In some embodiments, L3 and/or L4 is a branched amino (—N═) group. In some embodiments, L3 and/or L4 is a branched ammonium (—N(+)═) group. In some embodiments, L3 includes a branched amino or ammonium group, n3 is 2 or 3, and Z3 is an allyl or a vinyl.
In some embodiments, in Formula [10], L3 and L4, when present, may be attached to the azobenzene ring at any convenient positions. For example, L3 may be attached to the first phenyl ring at the 2, 3 or 4 position relative to the azo substituent. For example, L4 may be attached to the second phenyl ring at the 2′, 3′ or 4′ position relative to the azo substituent. All combinations of L3 and/or L4 positioning around the first and second phenyl rings, respectively, are envisaged. For example, L3 and L4 may be attached at the 2 and 2′ positions, respectively. For example, L3 and L4 may be attached at the 3 and 3′ positions, respectively. For example, L3 and L4 may be attached at the 4 and 4′ positions (i.e., para), respectively. Alternatively, L3 may be attached at the 4-position of the first phenyl ring, and L4 may be attached at the 2′ position of the second phenyl ring. Exemplary arrangements of L3 and L4 are shown in the compounds described below.
In some embodiments, the modulable absorption compound 300 is described by the structure of Formula [11]:
In some embodiments, the modulable absorption compound 300 is as described by except that one or both of the terminal allyl groups may be independently replaced with any convenient polymerizable moiety or crosslinking moiety, as described herein.
In some embodiments, in Formula [11], one or both of L3 and L4 are connected to the azobenzene via an electron withdrawing substituent, such as, a carbonyl, an ester, an amido, a sulfonyl or a sulfonamide. In some embodiments L3 and L4 are independently —(CH2)m1-Z4-(CH2)m2— where m1 and m2 are each independently 0 or an integer from 1 to 6, and Z4 is selected from a carbonyl (—C(═O)—), an ester (—C(═O)O—), an amido (e.g., —C(═O)NH—), a carbamate (e.g., —OC(═O)NH—), a sulfonyl (—SO2—), a sulfonamide (e.g., —SO2NH—), an ether (—O—), a thioether (—S—) or a urea group (e.g., —NHC(═NH)NH—). In some embodiments, m1 is 2 and m2 is 0. In some embodiments, Z4 is —O—.
In some embodiments, the modulable absorption compound 300 is described by one of the following Formulae [12]-[14]:
In some embodiments, the modulable absorption compound 300 is described by the structure of Formulae or [16]:
In some embodiments, in Formulae or [16], one or more of R1-R8 is -L5-O—CH2CH═CH2, where L5 is an optional linker group. In some embodiments, in Formulae or
[16], each L5 is a C1-C6 alkyl chain (e.g., a C2 alkyl). In some embodiments, in Formulae or
[16], each L5 is absent. In some embodiments, in Formulae or [16], R1-R8 are each hydrogen.
In some embodiments, the modulable absorption compound 300 is described by the structure of Formula [17]:
In some embodiments, in Formula [17], A is a N-linked heterocycle, such as but not limited to, morpholino, thiomorpholino piperidino, piperazino, homopiperazine, azepano, or pyrrolidino. In some embodiments, in Formula [17], A is a N-linked heterocycle (e.g., an Nmorpholino or a N-piperidinyl).
In some embodiments, the modulable absorption compound 300 is described by the structure of Formula [18]:
In some embodiments, in Formula [18], each L5 is independently a C1-C6 alkyl chain (e.g., a C2 alkyl).
In some embodiments, in Formula [18], at least one (e.g., two) of R16-R20 and R21 includes a polymerizable moiety (e.g., an allyl group) or a crosslinking moiety. In some embodiments, in Formula [18], at least one of R16-R20 and R21 includes an allyl or a vinyl group. In some embodiments, in Formula [18], R18 is —(CH2)m1-L6-(CH2)m2-Z6 where m1 and m2 are each independently 0 or an integer from 1 to 6, and L6 is selected from a carbonyl (—C(═O)—), an ester (—C(═O)O—), an amido (e.g., —C(═O)NH—), a carbamate (e.g., —OC(═O)NH—), a sulfonyl (—SO2—), a sulfonamide (e.g., —SO2NH—), an ether (—O—), a thioether (—S—) or a urea group (e.g., —NHC(═NH)NH—). In some embodiments, m1 is 2 and m2 is 0. In some embodiments, L6 is —O—.
In some embodiments, at least one of R16-R20 and R21 (e.g., R18, R19 or R20) is -L7-O—CH2CH═CH2, where L7 is an optional linker group, possibly a C1-C6 alkyl chain (e.g., a C2 alkyl).
In some embodiments, in Formula [18], Y is O. In some embodiments, in Formula [18], one or more of R16-R20 is nitro. In some embodiments, in Formula [18], R18 is nitro, and R16, R17, R19 and R20 are hydrogen.
In some embodiments, the modulable absorption compound 300 is selected from one of the following Formulae [19]-[25]:
To avoid unwanted photoinitiated polymerization or crosslinking induced by ambient sunlight during healing, the modulable absorption compound 300 is included in the front protection layer 120 to block such photoinitiation by absorbing the UV component of the incident light. The photoinitiator 115 and the modulable absorption compound 300 can be selected to have overlapping absorption spectra, so that the modulable absorption compound 300 is capable of absorbing sufficient ambient UV to prevent the activation of the photoinitiator 115. Upon application of the high-to-low modulating stimulus 310-htl, photoisomerization of the modulable absorption compound in its high-absorptivity isomer 300-h results in a shift in the absorption maximum of the modulable absorption compound 300 away from that of the photoinitiator 115, such that the absorption spectra overlap of the photoisomerized modulable absorption compound 300 and the photoinitiator 115 is substantially reduced at a wavelength suitable for activation of the photoionitiator 115.
In some embodiments, photoisomerization of the modulable absorption compound 300 occurs via a cis-trans isomerization, a cyclization reaction, or a ring-opening reaction. Convenient photoisomerizable compounds include compounds that are capable of blocking absorption by the photoinitiator 115 and that experience a significant shift in absorption maxima upon application of a suitable modifying stimulus 310. In some embodiments, the modulable absorption compound 300 undergoes a cyclization or ring-opening photoisomerization upon absorption of the modifying stimulus 310.
In some embodiments, the modulable absorption compound 300 includes a photoisomerizable moiety that is a stilbene (e.g., an azastilbene), an azobenzene moiety, an azoarylene, a fulgide, a spiropyran, a naphthopyran, a quinone, a spirooxazine, a nitrone, a triaryl methane (e.g., a triphenyl methane), a thioindigo, a diarylethene, a dithienylethene, or an overcrowded alkene. In some embodiments, the modulable absorption compound 300 includes an alkenyl (C═C) or an azo moiety (—N═N—) moiety that undergoes photoisomerization via a cis-trans transition. In some embodiments, the modulable absorption compound 300 includes a diarylethene that undergoes photoisomerization via an electrocyclic cyclization reaction. In some embodiments, the modulable absorption compound 300 includes a spiropyran that undergoes photoisomerization via a ring opening transition.
In some embodiments, the photoisomerizable moiety is selected from an azoarylene, a diarylethene, and a dithienylethene.
In some embodiments, photoisomerization of the modulable absorption compound 300 results in a second isomer that is thermally unstable, e.g., the second isomer will revert to the first isomer when the light source is removed. In such cases, photoisomerization is reversible.
In some MALALs 100, the modulable absorption front protection layer 120 can further include an additional non-modulable ultraviolet-absorbing compound having a chemical composition, absorptivity and thickness sufficient to prevent an adjustment of the optical properties of the light adjustable lens when exposed to a radiant exposure up to 10,000 mJ/cm2 integrated over a wavelength range of 300 nm-400 nm, at irradiances not exceeding 3mW/cm2. In some embodiments, the radiant exposure can be up to 50,000 mJ/cm2.
If the size of the accidental zone 20 is so small, then it is possible to perform additional measurements before the adjustment step of
The protective ability of the front protection layer 120 can be captured in yet another manner: in some embodiments of the MALAL 100, an absorption-modulation time Tam of the front protection layer 120 can be shorter than a zone-formation time Tar of the light adjustable lens 110: Tam<Tzf. In some representative cases, the absorption-modulation time (the time it takes for the modulable absorption compound 300 to transition from the low-absorptivity isomer 300-l to the high absorptivity isomer 300-h) can be in the 0.1 sec-10 sec range, in some others in the 0.1 sec-1 sec range, whereas the zone-formation time of the LAL 110 can be in the 5 sec-100 sec ranges, in some others in the 10 sec-50 sec range. Such front protection layers 120 can efficiently prevent a zone formation even in the very unlikely case of the modulable absorption compound 300 unintentionally getting transitioned from its high-absorption isomer 300-h to its low-absorption isomer 300-l: the front protection layer 120 can self-heal before the formation of a zone.
Finally,
In some embodiments of the method 400, the reducing 410 the absorption includes applying 415 a high-to-low modulating stimulus 310-htl as the modulating stimulus for transforming the modulable absorption compound 300 from a high-absorption conformation 300-h to a low-absorption conformation 300-l; and
the changing 420 of the optical property is followed by transforming 425 the modulable absorption compound 300 from the low-absorption conformation 300-l to the high-absorption conformation 300-h by applying a low-to-high modulating stimulus 310-lth as the modulating stimulus 310. In some cases, the high-to-low modulating stimulus 310-htl includes a high-to-low illumination with a light having a narrow band centered at a wavelength in a range of 300-400 nm; and the low-to-high modulating stimulus 310-lth includes one of a low-to-high illumination with a light having a broad band centered at a wavelength in a range of 300-700 nm, an ambient illumination, and a thermal relaxation.
While this document contains many specifics, details and numerical ranges, these should not be construed as limitations of the scope of the invention and of the claims, but, rather, as descriptions of features specific to particular embodiments of the invention. Certain features that are described in this document in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable sub-combination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to another sub-combination or a variation of a sub-combinations.
This patent application is a Continuation of U.S. application Ser. No. 17/583,329, filed on Jan. 25, 2022; as a Continuation of U.S. application Ser. No. 16/658,142, filed on Oct. 20, 2019, now issued as U.S. Pat. No. 11,266,495 on Mar. 8, 2022; entitled “Light Adjustable Intraocular Lens with a Modulable Absorption Front Protection Layer,” the contents of each are incorporated herein by reference in their entirety for all purposes.
Number | Date | Country | |
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Parent | 17583329 | Jan 2022 | US |
Child | 18666508 | US | |
Parent | 16658142 | Oct 2019 | US |
Child | 17583329 | US |