Embodiments of the present disclosure relate to vision treatment techniques and in particular, to ophthalmic lenses such as, for example, contact lenses, corneal inlays or onlays, or intraocular lenses (IOLs) including, for example, phakic IOLs and piggyback IOLs (i.e. IOLs implanted in an eye already having an IOL).
Presbyopia is a condition that affects the accommodation properties of the eye. As objects move closer to a young, properly functioning eye, the effects of ciliary muscle contraction and zonular relaxation allow the lens of the eye to change shape, and thus increase its optical power and ability to focus at near distances. This accommodation can allow the eye to focus and refocus between near and far objects.
Presbyopia normally develops as a person ages and is associated with a natural progressive loss of accommodation. The presbyopic eye often loses the ability to rapidly and easily refocus on objects at varying distances. The effects of presbyopia usually become noticeable after the age of 45 years. By the age of 65 years, the crystalline lens has often lost almost all elastic properties and has only a limited ability to change shape.
Along with reductions in accommodation of the eye, age may also induce clouding of the lens due to the formation of a cataract. A cataract may form in the hard central nucleus of the lens, in the softer peripheral cortical portion of the lens, or at the back of the lens. Cataracts can be treated by the replacement of the cloudy natural lens with an artificial lens. An artificial lens replaces the natural lens in the eye, with the artificial lens often being referred to as an intraocular lens or “IOL.”
Monofocal IOLs are intended to provide vision correction at one distance only, usually the far focus. At the very least, since a monofocal IOL provides vision treatment at only one distance and since the typical correction is for far distance, spectacles are usually needed for good vision at near distances and sometimes for good vision at intermediate distances. The term “near vision” generally corresponds to vision provided when objects are at a distance from the subject eye at equal; or less than 1.5 feet. The term “distant vision” generally corresponds to vision provided when objects are at a distance of at least ab out 5-6 feet or greater. The term “intermediate vision” corresponds to vision provided when objects are at a distance of about 1.5 feet to about 5-6 feet from the subject eye. Such characterizations of near, intermediate, and far vision correspond to those addressed in Morlock R, Wirth R J, Tally S R, Garufis C, Heichel C W D, Patient-Reported Spectacle Independence Questionnaire (PRSIQ): Development and Validation. Am J Ophthalmology 2017; 178:101-114.
There have been various attempts to address limitations associated with monofocal IOLs. For example, multifocal IOLs have been proposed that deliver, in principle, two foci, one near and one far, optionally with some degree of intermediate focus. Such multifocal, or bifocal, IOLs are intended to provide good vision at two distances, and include both refractive and diffractive multifocal IOLs. In some instances, a multifocal IOL intended to correct vision at two distances may provide a near (add) power of about 3.0 or 4.0 diopters.
Multifocal IOLs may, for example, rely on a diffractive optical surface to direct portions of the light energy toward differing focal distances, thereby allowing the patient to clearly see both near and far objects. Multifocal ophthalmic lenses (including contact lenses or the like) have also been proposed for treatment of presbyopia without removal of the natural crystalline lens. Diffractive optical surfaces, either monofocal or multifocal, may also be configured to provide reduced chromatic aberration.
Multifocal IOLs may also rely on a refractive optical surface to direct portions of light energy toward differing focal distances, thereby allowing the patient to clearly see both near and far objects. Such refractive optical surfaces may include multiple regions having differing optical powers, to direct the light energy towards the different focal distances as desired. Such refractive optics, however, may result in reduced distant vision quality.
It would be desirable to provide improved refractive IOL systems and methods that confer enhanced image quality at a variety of different focal distances, including for distant vision, as well as for an extended depth of focus optic or a full range optic. Embodiments of the present disclosure provide solutions that address the problems described above, and hence provide answers to at least some of these outstanding needs.
Embodiments herein described include ophthalmic lenses with an optic disposed about an optical axis having a refractive profile including a region having an add power and a first distance region and a second distance region extending outward from the first distance region which is vertex matched with the first distance region. The region having the add power may be a near region. The first distance region may be a central region of the optic that the optical axis extends through. The second distance region may have a lesser power than the first distance region in an amount of between −0.1 diopter and −0.5 diopter, inclusive. The add power may be between 1 diopter and 5 diopter, inclusive.
In addition, the region having the add power may be positioned between the first distance region and the second distance region and may also be adjacent both the first distance region and the second distance region. The first distance region and the second distance region may both extend outward from the region having the add power. The region having the add power may be a central region of the optic that the optical axis extends through.
The difference in power between the first distance region and the second distance region in any of the embodiments may be less than the add power. And, the second distance region may gradually decrease in power outward from the region having the add power. It is also envisioned that the region having the add power may have at least two different add powers.
The ophthalmic lens of any embodiment herein may also have a second region having an add power extending outward from the second distance region. Such a lens may have a third distance region extending outward from the second region having the add power, the third distance region being vertex matched with the second distance region and with the first distance region. In addition, the second distance region may gradually decrease in power towards the third distance region and the third distance region may gradually decrease in power outward from the second region having the add power.
It is envisioned that any embodiment herein may function as an extended depth of focus optic or a multifocal optic.
Embodiments herein described include a method comprising fabricating an optic for an ophthalmic lens, the optic being disposed about an optical axis and having a refractive profile including a region having an add power and a first distance region and a second distance region extending outward from the first distance region and being vertex matched with the first distance region.
The method may further comprise receiving an ophthalmic lens prescription, and fabricating the optic based on the ophthalmic lens prescription with the refractive profile based on the ophthalmic lens prescription. A vertex shift of the second distance region caused by the region having the add power may then be determined, and then based on the determined vertex shift, the first distance region and the second distance region may be vertex matched. This method of fabrication may be used to fabricate any lens disclosed herein.
Embodiments herein described include a system for fabricating an ophthalmic lens, the system including a processor configured to determine a refractive profile of an optic, the refractive profile including a region having an add power and a first distance region and a second distance region extending outward from the first distance region and being vertex matched with the first distance region. The system may include a manufacturing assembly that fabricates the optic based on the refractive profile.
The system may further comprise of an input for receiving an ophthalmic lens prescription, wherein the processor is configured to determine the refractive profile of the optic based on the ophthalmic lens prescription. The processor may also be configured to determine a vertex shift of the second distance region caused by the region having the add power, and may be configured to determine the refractive profile such that the first distance region and the second distance region are vertex matched based on the determined vertex shift. This system for fabricating may be used to fabricate any lens disclosed herein.
Each major face of lens 11, including the anterior (front) surface and posterior (back) surface, generally has a refractive profile, e.g. biconvex, plano-convex, plano-concave, meniscus, etc. The two surfaces together, in relation to the properties of the surrounding aqueous humor, cornea, and other optical components of the overall optical system, define the effects of the lens 11 on the imaging performance by eye E. Conventional, monofocal IOLs have a refractive power based on the refractive index of the material from which the lens is made, and also on the curvature or shape of the front and rear surfaces or faces of the lens. One or more support elements may be configured to secure the lens 11 to a patient's eye.
Multifocal lenses may optionally also make special use of the refractive properties of the lens. Such lenses generally include different powers in different regions of the lens so as to mitigate the effects of presbyopia. As shown in
The refractive profile 18 may be configured to correct ocular aberrations of the eye E, including ocular spherical aberrations, among others. The refractive profile 18 may be multifocal, including a bifocal design as shown in
As shown in
The distance regions 28a-d have an add power of zero diopters (or no add power). The near regions 30a-c, however, each have an add power. The add power can comprise a variety of powers, including between 4 diopters and 1 diopter, inclusive (e.g., 4 diopter, 3 diopter, 2 diopter, 1.5 diopter, etc.), among other greater or lower powers. The near regions 30a-c may have a higher curvature and a generally higher overall power suitable for viewing at near distances. In an embodiment in which the optic is multifocal and has a greater number of focuses than two, then certain of the near regions 30a-c may have a different add power than each other to provide one or more additional focuses. As such, the add power used in different regions of the optic may be different.
An issue that may arise with an optic configured similarly as the optic shown in
Thus, referring back to
The refractive profile reflected in
The refractive profile reflected in
A region 44 having an add power may extend outward from the distance region 42. The region 44 may be adjacent to the distance region 42. The region 44 may have a greater surface curvature than the distance region 42 to provide for the add power. The region 44 may comprise a near region, configured for near vision, or may comprise an intermediate region for intermediate vision. The region 44 may have an add power of four diopters as shown in
A distance region 46 may be provided that extends outward from the distance region 42 and extends outward from the region 44. The region 44 may be positioned between the distance region 42 and the distance region 46 and adjacent to the distance regions 42, 46. The distance region 46 may extend outward from the region 44 to an outer periphery of the optic or to another radial distance. The distance region 46 may extend for a radial distance of about 1.8 millimeters (to provide an optic extending to an outer periphery of 3 millimeters), although other radial distances may be provided as well as other sizes of optics. The refractive profile represented in
The distance region 46 may have its vertex shifted by the presence of region 44. To compensate, the distance region 46 may be configured to have a lesser power than the central distance region 42. The distance region 46 may be vertex matched with the distance region 42. The dashed line shown in
The distance region 46 may gradually decrease in power outward from the region 44. As shown in
At least two focuses may be provided with the embodiment shown in
The refractive profile reflected in
The refractive profile reflected in
A region 60 having two different add powers may extend outward from the distance region 68. The region 60 may be adjacent to the distance region 68. The region 60 may have two different surface curvatures, each having a greater surface curvature than the distance region 68 to provide for the add power. The portion 72 of the region 60 having a greater add power may comprise a near region, configured for near vision, and the portion 74 of the region 60 having an add power less than the portion 72 may comprise an intermediate region for intermediate vision. Other designations of near and intermediate focus may be provided for the portions 72, 74 of the region 60 as desired.
The region 60 may include a centermost portion 72 that has an add power of four diopters as shown in
The region 60 may include an adjacent outermost portion 74 that has a lesser add power than the centermost portion 72 and extends outward from the portion 72. The adjacent outermost portion 74 may have an add power of two diopters as shown in
In other embodiments, the add powers of the portions 72, 74 may be alternated such that the portion 72 has a lesser add power than the portion 74. In addition, the add powers of the portions 72, 74 may be varied.
A distance region 70 may be provided that extends outward from the distance region 68 and extends outward from the region 60. The region 60 may be positioned between the distance region 68 and the distance region 70 and adjacent to the distance regions 68, 70. The distance region 70 may extend outward from the region 60 to an outer periphery of the optic or to another radial distance. The distance region 70 may extend for a radial distance of about 1.8 millimeters (to provide an optic extending to an outer periphery of 3 millimeters), although other radial distances may be provided as well as other sizes of optics. The refractive profile represented in
The distance region 70 may have its vertex shifted by the presence of region 60. To compensate, the distance region 70 may be configured to have a lesser power than the central distance region 68. The distance region 70 may be vertex matched with the distance region 68. The dashed line shown in
The distance region 70 may gradually decrease in power outward from the region 60. As shown in
An extended depth of focus may be provided with the embodiment shown in
The refractive profile reflected in
The refractive profile reflected in
A region 88 having an add power may extend outward from the distance region 100. The region 88 may be adjacent to the distance region 100. The region 88 may have a greater surface curvature than the distance region 100 to provide for the add power. The region 88 may comprise a near region, configured for near vision, or may be configured as an intermediate region for intermediate vision. The region 88 may have an add power of four diopters as shown in
A distance region 92 may be provided that extends outward from the distance region 100 and extends outward from the region 88. The region 88 may be positioned between the distance region 100 and the distance region 92 and adjacent to the distance regions 100, 92. The distance region 92 may extend outward from the region 88 for a distance of about 0.3 millimeters for a distance from the optical axis 94 of about 1.2 millimeters, although other distances may be provided.
The distance region 92 may have its vertex shifted by the presence of region 88. To compensate, the distance region 92 may be configured to have a lesser power than the central distance region 100. The distance region 92 may be vertex matched with the distance region 100. The dashed line shown in
The distance region 92 may gradually decrease in power outward from the region 88. As shown in
A region 90 having an add power may extend outward from the distance regions 100, 92 and the region 88. The region 90 may be adjacent to the distance region 92. The region 90 may have a greater surface curvature than the distance region 92, to provide for the add power. The region 90 may comprise an intermediate region, configured for intermediate vision, or may be configured to have different add powers corresponding to different vision distances (such as near vision). The region 90 may have an add power of two diopters as shown in
The region 90 may have a lesser add power than the centermost region 88 having an add power, to provide for a different focal length than the centermost region 88. In other embodiments, the add powers of the regions 90, 88 may be alternated such that the region 88 has a lesser add power than the region 90. In addition, the add powers of the regions 88, 90 may be varied.
A distance region 102 may be provided that extends outward from the distance regions 100, 92 and extends outward from the regions 88, 90. The region 90 may be positioned between the distance region 92 and the distance region 102 and adjacent to the distance regions 92, 102. The distance region 102 may extend outward from the region 90 for a distance of about 1.5 millimeters for a distance from the optical axis 94 of about 3 millimeters, although other distances may be provided.
The distance region 102 may have its vertex shifted by the presence of region 90. To compensate, the distance region 102 may be configured to have a lesser power than the central distance region 100 and the intermediate distance region 92. The distance region 102 may be vertex matched with both the central distance region 100 and the intermediate distance region 92. The dashed line shown in
The distance region 102 may gradually decrease in power outward from the region 90. As shown in
The refractive profile represented in
Although the embodiment of
An extended depth of focus may be provided with the embodiment shown in
The refractive profile reflected in
A region 116 having an add power may comprise a near region, configured for near vision, or may be configured as an intermediate region for intermediate vision. The region 116 may have an add power of four diopters as shown in
Referring to
The distance regions 118, 120, 122 may have their vertices shifted by the presence of region 116. To compensate, the distance regions 118, 120, 122 may be configured to have a lesser power than the central region 116. The distance regions 118, 120, 122 may be vertex matched with each other. The dashed line shown in
The distance region 120 may gradually decrease in power outward from the distance region 118, and the distance region 122 may gradually decrease in power outward from the distance region 120. The amount of gradual reduction may be varied as desired.
The refractive profile represented in
Although the embodiment of
An extended depth of focus may be provided with the embodiment shown in
An optic for an ophthalmic lens that includes a diffractive profile disclosed herein may be fabricated utilizing a variety of methods. A method may include determining optical aberrations of a patient's eye. Measurements of a patient's eye may be made in a clinical setting, such as by an optometrist, ophthalmologist, or other medical or optical professional. The measurements may be made via manifest refraction, autorefraction, tomography, or a combination of these methods or other measurement methods. The optical aberrations of the patient's eye may be determined.
A determination of the visual range of the patient may also be determined. For example, the ability of the patient to focus on near objects (presbyopia) may be measured and determined. An amount of add power for the ophthalmic lens may be determined, as well as whether the ophthalmic lens should be bifocal, trifocal, or a greater number of focuses or an extended depth of focus lens may be determined as well.
The measurements of the patient's eye may be placed in an ophthalmic lens prescription, which includes features of an optic that are intended to address the optical aberrations of the patient's eye, as well as features that address the visual range for the patient (e.g., an amount of add power and number of focuses to be provided by the optic).
The ophthalmic lens prescription may be utilized to fabricate an optic for the ophthalmic lens. The refractive profile of the optic may be determined based on the ophthalmic lens prescription, to correct for the optical aberrations of the patient's eye. The refractive profile may also be determined to provide for the desired add power for the optic, as well as whether the optic should be bifocal, trifocal, or have a greater number of focuses or comprise an extended depth of focus optic. The refractive profile may have a region having a single add power (as shown for example in
A determination may be made of the vertex shift of the distance regions caused by the regions having the add power. The determination may be made via simulation provided by a processor (such as processor 117 shown in
The determination of the refractive profile and the fabrication of the optic may be performed remotely from the optometrist, ophthalmologist, or other medical or optical professional that performed the measurements of a patient's eye, or may be performed in the same clinical facility of such an individual. If performed remotely, the fabricated optic may be delivered to an optometrist, ophthalmologist, or other medical or optical professional, for being provided to a patient. For an intraocular lens, the fabricated optic may be provided for implant into a patient's eye.
The fabricated optic may be a custom optic fabricated specifically for the patient's eye, or may be fabricated in a manufacturing assembly and then selected by an optometrist, ophthalmologist, or other medical or optical professional for supply to a patient, which may include implantation in the patient's eye.
The processor 117 may comprise a central processing unit (CPU) or other form of processor. In certain embodiments the processor 117 may comprise one or more processors. The processor 117 may include one or more processors that are distributed in certain embodiments, for example, the processor 117 may be positioned remote from other components of the system 121 or may be utilized in a cloud computing environment. The memory 125 may comprise a memory that is readable by the processor 117. The memory 125 may store instructions, or features of intraocular lenses, or other parameters that may be utilized by the processor 117 to perform the methods disclosed herein. The memory 125 may comprise a hard disk, read-only memory (ROM), random access memory (RAM) or other form of non-transient medium for storing data. The input 123 may comprise a port, terminal, physical input device, or other form of input. The port or terminal may comprise a physical port or terminal or an electronic port or terminal. The port may comprise a wired or wireless communication device in certain embodiments. The physical input device may comprise a keyboard, touchscreen, keypad, pointer device, or other form of physical input device. The input 123 may be configured to provide an input to the processor 117.
The system 121 may be utilized to perform the methods disclosed herein, such as the process of determining a refractive profile of the optic. The processor 117 may be configured to determine the refractive profile to correct for the optical aberrations of the patient's eye, and to provide for the desired add power for the optic, as well as provide an optic that may be bifocal, trifocal, or have a greater number of focuses, or an extended depth of focus lens. The refractive profile may have a region having a single add power (as shown for example in
The processor 117 may be configured to make a determination of the vertex shift of the distance regions caused by the regions having the add power. Upon the determination of the vertex shift being made, processor 117 may configure the refractive profile to vertex match the distance regions, as disclosed herein.
The processor 117 may provide the refractive profile to the manufacturing assembly 119, which may be configured to fabricate the optic for the ophthalmic lens based on the refractive profile. The manufacturing assembly 119 may comprise one or more apparatuses for forming the optic, and may comprise a high volume manufacturing assembly or a low volume manufacturing assembly. The manufacturing assembly 119 may be used for manufacture remote to a clinic in which measurements of the individual's eye or made, or local to such a clinic. The manufacturing assembly may include apparatuses such as lathe tools, or other lens formation devices to fabricate the optic.
In one embodiment, the processor 117 may be provided with an ophthalmic lens prescription for the individual's eye that may be provided as discussed herein. The processor 117 may receive the ophthalmic lens via the input 113. The system 121 may fabricate the optic for the ophthalmic lens based on the prescription.
The system 121 may be configured to fabricate any of the embodiments of ophthalmic lenses disclosed herein.
Beneficially, the refractive profiles disclosed herein may improve distant vision performance, without adversely affecting near and intermediate performance.
The refractive profiles disclosed herein may be provided on an anterior surface, a posterior surface, or a combination of such surfaces of the optic. The powers of the regions having the add power, and the position of such regions may be varied as desired. The lesser powers of the distance regions may be varied as desired. The optics produced may comprise multifocal, extended depth of focus, and full range optics. The features of the optics disclosed herein may be utilized by themselves, or in combination with diffractive profiles of the optics and/or with features providing for correction of chromatic aberrations (e.g., achromats, which may be diffractive).
An optic as disclosed herein may be biconvex, or possibly plano-convex, or convex-concave, or other refractive surface combinations.
Corrective optics may be provided by phakic IOLs, which can be used to treat patients while leaving the natural lens in place. Phakic IOLs may be angle supported, iris supported, or sulcus supported. The phakic IOL can be placed over the natural crystalline lens or piggy-backed over another IOL. It is also envisioned that the present disclosure may be applied to inlays, onlays, accommodating IOLs, pseudophakic IOLs, other forms of intraocular implants, spectacles, and even laser vision correction.
The ophthalmic lenses disclosed herein in the form of intraocular lenses are not limited to lenses for placement in the individual's capsular bag. For example, the intraocular lenses may comprise those positioned within the anterior chamber of the eye. In certain embodiments the intraocular lenses may comprise “piggy back” lenses or other forms of supplemental 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 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 priority to U.S. Provisional Patent Application No. 62/955,327, filed on Dec. 30, 2019, the entire contents of which are hereby incorporated by reference.
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