Aspects and embodiments disclosed herein and claimed pertain to systems, methods, devices for refractive correction of human eyes including correction of astigmatism, high-order aberrations, and presbyopia.
Conventional refractive corrections for human eyes over the last century provide for spherocylindrical corrections that includes a focus error (myopia and hyperopia), and astigmatim (a cylinder error). It is well know that conventional spherocylinderical correction left a host of residual high-order aberrations such as spherical aberration and coma uncorrected, and these high-order aberrations degrade acuity and quality of vision.
Introduction of modern wavefront sensor for the eye, described in “Objective measurement of wave aberrations of the human eye with the use of a Hartmann—Shack wave-front sensor” in Journal of the Optical Society of America A Vol. 11, Issue 7, (1994) pp. 1949-1957 by J Liana, B Grimm, S Goelz, and J F Bille, made it possible to precisely measure eye's aberrations using commercial aberrometers in clinical practices.
Wavefront-guided LAS IK based on wavefront aberrometers was FDA approved in the US in 2004. Although wavefront-guided LASIK was reported to be more efficacious than conventional LAS IK based on manifest refraction of a spherocylinderical correction in “Improved contrast sensitivity and visual acuity after wavefront-guided laser in situ keratomileusis: In-depth statistical analysis,” in Journal of Cataract and Refractive Surgery Volume 32, Issue 2, February (2006), pp. 215-220 by K A Tuan and J Liang, there was lacking evidence showing that high-order aberrations in human eyes were effectively eliminated by wavefront-guided LASIK. Improved vision by wavefront-guided LASIK could be attributed to a better correction for the eye's astigmatism, that can be precisely measured by waveront aberometers and corrected by surgical lasers. Effectiveness of wavefront-guided LASIK in correcting high-order aberrations is limited for at least two reasons: 1) errors in wavefront registration between wave aberration measured by wavefront aberrometers and its corresponding ablation map generated by surgical lasers, 2) effectiveness of surgical lasers in generating precise wavefront corrections towards a biological optics of human eyes.
Coma and other high-order aberrations are not correctable by spectacle eyeglasses, contact lenses, or 10Ls because 1) precise registration of a wavefront map of an eye with a spectacle lens is impossible if the eye changes its view direction through the lens, 2) contact lenses can rotate their orientation on the cornea or move their position from time to time on the cornea, 3) wavefront registration with custom-manufactured 10Ls due to corneal aberrations is almost impossible.
Consequently, although many configurations and methods for vision correction are known in the art, these conventional methods and systems suffer from one or more disadvantages as outlined above. Aspects and embodiments disclosed and claimed herein provide solutions to these disadvantageous problems.
In some embodiments, we provide a system for designing wavefront-engineered corrections for human eyes beyond a conventional spherocylindrical correction, comprising: an input module for obtaining wave aberration measurements of an eye; a processor module for i) determining a spherocylindrical correction, wherein the spherocylindrical correction consists of a focus error SPH and/or astigmatism specified by CYL and AXIS, ii) determining a deficiency factor for the spherocylindrical correction, wherein the deficiency factor includes degraded best corrected acuity and/or degraded quality of vision due to uncorrectable astigmatism, coma, and other high-order aberrations in the eye, iii) determining at least a wavefront component covering the central pupil of an eye up to 4.5 mm in diameter, wherein the wavefront component induces additional spherical aberration into the corrected eye for mitigating residual refractive errors beyond the spherocylindrical correction; an output module for communicating the spherocylindrical correction as well as the designed wavefront component covering the central pupil of the eye for at least one optical design for the optimized vision correction beyond a spherocylindrical correction.
In other embodiments, we provide a wavefront-engineered ophthalmic lens, configured as an implantable lens or wearable lens, comprising: an optic having an anterior surface and a posterior surface; the optic refracting light in an optical section having a diameter up to 8 mm and configured into a plurality of optical sections, wherein: i) in an inner central optical section with a diameter of typical 3 mm or between 2.5 mm and 4.5 mm, the optic is configured to induce additional spherical aberration for treatment of uncorrected refractive errors including residual astigmatism, coma, and other high-order aberrations, presbyopia in the eye left by the spherocylindrical correction, wherein the induced spherical aberration includes a positive spherical aberration, a negative spherical aberration, spherical aberrations of opposite sign, ii) the optic has a baseline extending across the entire optical section for the correction of a spherocylindrical correction.
In yet other embodiments, we provide an intraocular lens, comprising: a lens having an anterior surface and a posterior surface; a diffractive profile disposed on one of the anterior surface and the posterior surface, the diffractive profile comprising a plurality of concentric zones configured to produce constructive interference in a plurality of diffractive orders within a range of vision; and an aspherical profile disposed on the anterior surface or the posterior surface without the diffractive profile in the central portion having a diameter up to 4.5 mm, wherein the aspherical profile induces spherical aberration into the eye's central pupil for treatment of uncorrected residual refractive errors in the eye left by the spherocylindrical correction and/or for extending depth of focus for images of the diffractive orders.
In still other embodiments, we provide an ophthalmic lens, comprising: an optic having an anterior surface and a posterior surface disposed about an optical axis; wherein at least one of the surfaces has a profile characterized by superposition of a base profile and two auxiliary profiles, and the auxiliary profiles are distributed over a plurality of concentric zones in the central portion of the lens, further wherein the baseline profile defines a monofocal lens if the auxiliary profiles are absent; the central concentric zones have a central circular zone with radius of r1 and a plurality of annular zones with outer radius of rn (r2 for the first annular zone and r3 for the second annular zone, and so on); the first auxiliary profiles are expressed by f1(r) cos[2π2/t1(r)] for the central circular zone, −f2(r) cos[2π(r−r1)2/t2(r)] for the first annular zone, f3(r) cos[2π(r−r2)2/t3(r)] for the next annular zone and so on, wherein fn(r), including f1(r), f2(r), f3(r), are slow changing functions for amplitude modulation while tn(r), including t1(r), t2(r), t3(r), are variables for frequency modulation; and the second auxiliary profile provides focus shift(s) in at least one of the concentric zones.
Inducing spherical aberration into an eye's central pupil to mitigate astigmatism and coma was disclosed in PCT/US2020/027548 by J Liang and L. Yu. To be effective in correcting eye's aberrations as well as effectively prescribing the related lenses must take into account not only the complexity of the eye's high-order aberrations but also any interaction between residual astigmatism and high-order aberrations in human eyes. Eye's aberrations are known to be different from eye to eye, and as many as 65 Zernike polynomials were used to describe eye's wave aberrations in “Aberrations and retinal image quality of the normal human eye” published in Journal of the Optical Society of America A Vol 14, Issue 11, pp. 2873-2883 (1997)) by J Liang and D. R. Williams.
It is not difficult to realize the following from
Based on eye's MTF, three classes of optical quality can be used for characterizing human eyes: 1) Class I optics with its MTF far above the population mean MTF for Eye#1, 2) Class II optics with its MTF about the population mean MTF for Eye#2, 3) Class III optics with its MTF far below the population mean MTF for Eye#3 and Eye#4.
It must be emphasized that the mean MTF of the normal population in the literature was derived with a perfect correction of astigmatism in the human eyes, which is rarely achieved in conventional spherocylndrical corrections with eyeglasses, contact lenses, and IDLs. If uncorrected astigmatism in eye is taken into account, mean MTF of normal human eyes under a spherocylinderical correction will be far below the curve in
Additionally, it is also clearly seen that MTF of eyes with monofocal IDLs is not only below the mean MTF of normal human eyes but also lower than MTFs of Eye#3 and Eye#4. Therefore, mitigation of residual aberrations for post-op IOL eyes is also an unmet medical need for improving acuity and quality of vision.
In some embodiments of present inventions, we disclose a wavefront method for treatment of eye's aberrations beyond a spherocylindrical correction. The method comprises the steps of: 1) measuring wave aberration of an eye, 2) determining a spherocylindrical correction from the measured wave aberration, 3) determining at least a wavefront component covering central pupil of an eye having a diameter about 3 mm (more than 2.5 mm and less than 4.6 mm). The wavefront component induces additional spherical aberration into the corrected eye for mitigating residual refractive errors beyond the determined spherocylindrical correction, which include but are not limited to coma and residual astigmatism.
With the aberrations in Eye#4 known from an wavefront aberrometer, we determined 1) a controlled amount of negative spherical aberration in wavefront design #1 and a controlled amount of positive spherical aberration in wavefront design #2 both within a 3.5 mm pupil, 2) a SPH offset from the determined spherocylindrical correction. It must be emphasized that the controlled amount of negative/positive positive spherical aberration in design #1/#2 as well as the SPH offset must be custom determined based on residual aberrations in the eye. The two wavefront designs are compared with the conventional sphero-cylidrical correction in
As shown in
It must be noticed that inducing additional spherical aberration into eye's central pupil does not lead to MTF reduction. Instead, eye's point-spread image is simply reshaped, leading to effective mitigation to uncorrectable aberrations in the eye.
The same wavefront optimization was applied to Eye#3 with results in
lens rotation because both spherical aberration and focus offset is rotationally symmetric, 2) tolerance of lens displacements as much as 0.75 mm according to our simulation, 3) tolerance in manufacturing errors in SPH/CYL.
In one embodiment, the method in the present invention for wavefront-engineered corrections by inducing spherical aberration into eye's central pupil further includes prescribing a contact lens, a surgical procedure such as a laser vision correction, or surgical implants of a phakic IOL.
In another embodiment, the induced spherical aberration into eye's central pupil includes: i) a positive spherical aberration, ii) a negative spherical aberration, iii) spherical aberrations of opposite sign in two concentric zones.
In some embodiments, we disclose a system for designing wavefront-engineered corrections of human eyes beyond a spherocylindrical correction. The system comprises 1) an input module for obtaining wave aberration of an eye, 2) a processor module for i) determining a spherocylindrical correction that consists of a focus error SPH and/or astigmatism specified by CYL and AXIS, ii) determining a deficiency factor for the spherocylindrical correction, and the deficiency factor includes degraded best corrected acuity and/or degraded quality of vision due to residual astigmatism, coma, and other high-order aberrations in the eye, iii) determining at least a wavefront component covering central pupil of an eye having a diameter of about 3.5 mm up to 4.5 mm, 3) an output module for communicating the spherocylindrical correction as well as the designed wavefront component covering central pupil of the eye for at least one optical design for the optimized vision correction beyond a spherocylindrical correction. The wavefront component induces additional spherical aberration into the corrected eye for mitigating residual refractive errors beyond the spherocylindrical correction.
In one embodiment, determining a deficiency factor for the spherocylindrical correction includes providing at least one simulated retinal image of an acuity chart under the spherocylindrical correction and estimating a best corrected acuity. For eyes with significant uncorrected aberrations, the estimated acuity would be worse than 20/20.
In another embodiment, determining a deficiency factor for the spherocylindrical correction includes i) calculating optical quality of an eye from the residual aberration under a spherocylindrical correction, ii) comparing the calculated optical quality of the eye with a defined metrics from normal human eyes and determining necessity of inducing additional spherical aberration into eye beyond the spherocylindrical correction. The residual aberration is the difference between the wave aberration of an eye and the spherocylindrical correction. The optical quality can be modulation transfer function (MTF) and the defined metrics from normal human eyes can be a mean MTF from a normal population.
In yet another embodiment, determining a deficiency factor for the spherocylindrical correction includes receiving a desired presbyopia power for a presbyopia correction beyond the spherocylindrical correction. The presbyopia power is positive and between +0.5D and +3.5D.
In one embodiment, communicating at least one optical design for the optimized wavefront correction further includes showing vision results from a plurality of design options so that the best correction can be selected manually.
In another embodiment, the optimized vision correction is applied to an ophthalmic lens having an optical section with a diameter up to 8 mm. The ophthalmic lens includes a contact lens, an implantable contact lens (ICL), an intraocular lens (IOL), a phakic IOL, and an accommodating IOL.
In yet another embodiment, the optimized vision correction is further applied to a laser vision correction.
In one embodiment, the input module is a wavefront sensor for an eye that provides measurements of eye's wave aberration, or it receives eye's wave aberration from another device such as a wavefront sensor for an eye.
In another embodiment, inducing additional spherical aberration into the corrected eye includes: i) a positive spherical aberration, ii) a negative spherical aberration, iii) spherical aberrations of opposite sign in two concentric zones.
In yet another embodiment, the output module includes i) a display device, ii) generating a file that can be transmitted to another display device.
In still another embodiment, the system for optimizing vision correction of an eye beyond a spherocylindrical correction further includes a phoropter module for updating the determined spherocylindrical correction.
Wavefront-engineered multifocal lenses is disclosed in US provisional patents (#62/920,859, #62/974,317, #62/995/872) for treatment of presbyopia in addition to a spherocylindrical correction.
We applied two designs of wavefront multifocal lenses (Wavefront Design #2A and Wavefront Design #2B) to eyes with Class 3 optics (Eye#3 and Eye#4).
It is seen in
In some embodiments we describe a wavefront-engineered ophthalmic lens that can be configured as an implantable lens or a wearable lens.
In one example in
In one embodiment, the wavefront-engineered ophthalmic lens is further configured to be a contact lens, an intraocular lens (IOL), a phakic IOL, or an implantable contact lens.
In still some embodiments of present inventions, we disclose a contact lens for vision tests of human eyes. The lens comprises of an optic having an anterior surface and a posterior surface and the optic refracts light in an optical section having a diameter up to 8 mm. In addition, optical section of the lens is configured into a plurality of optical sections: I) in an outer annular optical section the optic is a monofocal lens or a powerless plate, II) in an inner central optical section, located inside the outer annular optical section, with a diameter of typical 3 mm or between 2.5 mm and 4.5 mm, the optic is configured to induce additional spherical aberration into eye's central pupil in one of the following forms: i) a positive spherical aberration, ii) a negative spherical aberration, iii) spherical aberrations of opposite sign.
In one embodiment, the contact lens for vision tests of human eyes further includes a focus power and/or a cylinder power.
In another embodiment, the outer annular optical section of the contact lens for vision tests of human eyes has reduced light transparency, which can be tinted or printed.
In an embodiment, we disclose an intraocular lens that comprises: 1) a lens having an anterior surface and a posterior surface, 2) a diffractive profile is disposed on one of the anterior surface and the posterior surface, and the diffractive profile comprises a plurality of concentric zones configured to produce constructive interference in a plurality of diffractive orders within a range of vision, 3) an aspherical profile is disposed on the anterior surface or the posterior surface without the diffractive profile having a diameter up to 4.5 mm. The aspherical profile in the central portion of the lens induces spherical aberration into the eye's central pupil for treatments of potential residual refractive errors in the eye left by the spherocylindrical correction and/or for extending depth of focus for the images associated with the diffractive orders.
The potential uncorrected residual refractive errors include astigmatism, coma, and high-order aberrations while the induced spherical aberration by the aspherical profile is represented by one of the following forms: i) a positive spherical aberration, ii) a negative spherical aberration, iii) spherical aberrations of opposite sign.
In another embodiments, we disclose another ophthalmic lens, and it comprises: 1) an optic having an anterior surface and a posterior surface disposed about an optical axis, 2) at least one of the surfaces has a profile characterized by superposition of a base profile and two auxiliary profiles. The auxiliary profiles are distributed over a plurality of concentric zones in the central portion of the lens while the baseline profile, covering the entire lens, defines a monofocal lens if the auxiliary profiles are absent. The central concentric zones have a circular area with radius of r1 and a plurality of annular zones with outer radius of rn (r2 for the first annular zone and r3 for the second annular zone, and so on). The first auxiliary profiles can be expressed by f1(r) cos[2π2/t1(r)] for the central circular zone, −f2(r) cos[2π(r−r1)2/t2(r)] for the first annular zone, f3(r) cos[2π(r−r2) 2/t3(r)] for the next annular zone and so on. The functions fn(r), including f1(r), f2(r), f3(r), are slow changing for amplitude modulation while tn(r), including t1(r) t2(r) t3(r), are variables for frequency modulation. The second auxiliary profile provides focus shift(s) in at least one of the concentric zones.
Three advanced features are introduced to overcome limitations associate with modulated periodical lenses described by Xin Hong in U.S. Pat. No. 9,101,466 B2.
In one aspect, if fn(r) and Tn(r) form their own continues function like those in U.S. Pat. No. 9,101,466 B2, the second auxiliary profile can provide an independent focus control needed in the central circular zone. A controlled focus offset in the central circular zone is important for controlling the total depth of focus from the DISTANCE focus to the NEAR focus, which can be found with the wavefront bifocal, trifocal lenses in the PCT application #PCT/US2020/027548, titled “METHODS AND DEVICES FOR WAVEFRONT TREATMENTS OF ASTIGMATISM, COMA, PRESBYOPIA IN HUMAN EYES” by J. Liang and L. Yu. It is also evident that two different focus offsets are used for optimizing the lenses with two aspherical zones.
In another aspect, the discrete functions fn(r) and Tn(r) allow to control focus error, primary spherical aberration, and high-order spherical aberrations for each aspherical zone.
In one example, if both fn(r) and Tn(r) are constant, the first auxiliary
profile for the n-th zone can be expressed as
where r is the radial distance from the lens center, c and T are both constants. The Taylor expansion of Wn(r) is
where c, c1, c2, c3 are constants. Except for the constant term (c), the auxiliary profile induces primary spherical aberration r4 as well as high-order spherical aberrations (r8 ,r12 and etc). It is also noticed that the coefficient for spherical aberrations (c1, c2, c3) are related.
In another example, if fn(r) and Tn(r) in any section are controlled so that the first auxiliary profile for the n-th zone can be approximated by a Gaussian function
where r is the radial distance from the lens center, q and d are both constants. The Taylor expansion of Wn(r) is
Except for the constant term, the auxiliary profile induces a focus offset term (r2), a primary spherical aberration term r4 as well as high-order spherical aberration terms(r6 ,r8). It is also noticed that the coefficients for the focus offset (q1) and spherical aberrations (q2, q3, q4) are related.
In yet another aspect, individual functions fn(r), including f1(r), f2(r), f3(r), provides the freedom beyond a typical cosine function for the amplitude modulation in U.S. Pat. No. 9,101,466 B2. This allows controls of 1) total number of aspheric zones and 2) relative modulation strength between the zones.
In one embodiment, the second auxiliary profile provides a focus shift in central circular zone. In another embodiment, the ophthalmic lens is further configured to be a contact lens, an intraocular lens (IOL), a phakic IOL or an implantable contact lens.
This application claims priority to U.S. provisional applications S/Ns 63/102,887 filed on Jul. 9, 2020 entitled “Methods and systems for treatment of astigmatism, coma, and high-order aberrations in human eyes” and 63/204,483 filed on Oct. 6 2020, entitled “Methods and systems for treatment of astigmatism, coma, and high-order aberrations in human eyes,” the subject matters of which are incorporated herein by reference in their entirety to the fullest extent allowed by law.
Filing Document | Filing Date | Country | Kind |
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PCT/US21/40513 | 7/6/2021 | WO |
Number | Date | Country | |
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63204483 | Oct 2020 | US | |
63102887 | Jul 2020 | US |