The present invention relates generally to ophthalmic lenses, and more particularly, to intraocular lenses (IOLs) having optimal shape factors.
Intraocular lenses are routinely implanted in patients' eyes during cataract surgery to replace the clouded natural lens. The post-operative performance of such IOLs, however, can be degraded due to a variety of factors. For example, aberrations introduced as a result of misalignment of the implanted IOL relative to the cornea, and/or the inherent aberrations of the eye, can adversely affect the lens's optical performance.
Accordingly, there is a need for improved IOLs that can provide a more robust optical performance.
In one aspect, the present invention provides an ophthalmic lens (e.g., an intraocular lens) having an optic with an anterior surface and a posterior surface. The optic exhibits a shape factor in a range of about −0.5 to about 4. In a related aspect, the shape factor of the optic lies in a range of about 0 to about 2. The above shape factors give rise to a plurality of different lens shapes, such as, bi-convex, plano-convex, plano-concave and convex-concave.
In another aspect, the optic is formed of a biocompatible polymeric material. By way of example, the optic can be formed of a soft acrylic polymeric material. Other examples of suitable materials include, without limitation, hydrogel and silicone materials.
In another aspect, at least one surface of the optic can be characterized by an aspheric base profile (i.e., a base profile that exhibits deviations from sphericity). By way of example, the base profile can be characterized by a conic constant in a range of about −73 to about −27.
In a related aspect, the aspheric profile of the lens surface can be defined in accordance with the following relation:
wherein,
c denotes the curvature of the surface at its apex (at its intersection with the optical axis),
r denotes the radial distance from the optical axis, and
k denotes the conic constant,
wherein
c can be, e.g., in a range of about 0.0152 mm−1 to about 0.0659 mm−1,
r can be, e.g., in a range of about 0 to about 5, and
k can be, e.g., in a range of about −1162 to about −19 (e.g., in a range of about −73 to about −27).
In a related aspect, the optic of the above lens can have a shape factor in a range of about 0 to about 2.
In some embodiments in which one or more surfaces of the ophthalmic lens exhibit asphericity, the shape factor of the lens (e.g., an IOL) can be selected as a function of that asphericity so as to optimize the lens's optical performance. By way of example, in one aspect, the invention provides an ophthalmic lens having an optic with an anterior surface and a posterior surface, where at least one of the surfaces exhibits an ashperical profile characterized by a conic constant in a range of about −73 to about −27. The optic exhibits a shape factor in a range of about −0.5 to about 4.
In a related aspect, an ophthalmic lens having an optic with a shape factor in a range of about 0 to about 2 includes at least one aspherical surface characterized by a conic constant in a range of about −73 to about −27.
In other aspects, an intraocular lens adapted for implantation in an eye having a corneal radius equal to or less than about 7.1 mm is disclosed, which includes an optic having an anterior surface and a posterior surface. The optic exhibits a shape factor in a range of about −0.5 to about 4. In a related aspect, the optic exhibits a shape factor in a range of about +0.5 to about 4, or in a range of about 1 to about 3.
In another aspect, the invention provides an intraocular lens adapted for implantation in an eye having a corneal radius in a range of about 7.1 mm to about 8.6 mm, which includes an optic having an anterior surface and a posterior surface. The optic exhibits a shape factor in a range of about 0 to about 3. In a related aspect, the optic exhibits a shape factor in a range of about +0.5 to about 3, or in a range of about 1 to about 2.
In another aspect, an intraocular lens adapted for implantation in an eye having a corneal radius equal to or greater than about 8.6 is disclosed, which includes an optic having an anterior surface and a posterior surface. The optic exhibits a shape factor in a range of about 0.5 to about 2. In a related aspect, the optic exhibits a shape factor in a range of about 1 to about 2.
In another aspect, the invention provides an intraocular lens adapted for implantation in an eye having an axial length equal to or less than about 22 mm, which includes an optic having an anterior surface and a posterior surface. The optic can have a shape factor in a range of about 0 to about 2, or in a range of about 0.5 to about 2.
In other aspects, the invention discloses methods for selecting an ophthalmic lens for implantation in a patient's eye based on one or more ocular biometric parameters of the patient. For example, a method of correcting vision is disclosed that includes selecting an IOL, which comprises an optic exhibiting a shape factor in a range of about −0.5 to about 4 (or in a range of about +0.5 to about 4), for implantation in an eye having a corneal radius that is equal to or less than about 7.1 mm.
In another aspect, a method of correcting vision is disclosed that includes selecting an IOL, which comprises an optic exhibiting a shape factor in a range of about 0 to about 3 (or in a range of about 0.5 to about 3), for implantation in an eye having a corneal radius in a range of about 7.1 mm to about 8.6 mm.
In yet another aspect, a method of correcting vision is disclosed that includes selecting an IOL, which comprises an optic exhibiting a shape factor in a range of about 0.5 to about 2, for implantation in an eye having a corneal radius that is equal to or greater than about 8.6 mm.
In another aspect, a method of corrected vision is disclosed that includes selecting an IOL, which comprises an optic exhibiting a shape factor in a range of about 0 to about 2 (or in a range of about 0.5 to about 2), for implantation in an eye having an axial length equal to or less than about 22 mm.
In another aspect, a method of designing an ophthalmic lens is disclosed that includes defining an error function, which is indicative of variability in performance of a lens in a patient population, based on estimated variability in one or more biometric parameters associated with that population, and selecting a shape factor for the lens that reduces the error function relative to a reference value. In a related aspect, the error function can further include an estimated error in optical power correction provided by the lens and/or an estimated aberration error.
In a related aspect, the error function (RxError) can be defined in accordance with the following relation:
wherein,
ΔBiometric denotes variability due to biometric data errors,
ΔIOLPower denotes variability due to optical power correction errors, and
ΔAberration denotes variability due to aberration contributions.
In another aspect, the ΔBiometric can be defined in accordance with the following relation:
ΔBiometric=√{square root over (Δk2+ΔAL2+ΔACD2)}
wherein,
Δk denotes error in keratometric measurements,
ΔAL denotes error in axial length measurements, and
ΔACD denotes error in anterior chamber depth measurements.
In another aspect, the ΔAberration can be defined in accordance with the following relation:
ΔAberration=√{square root over (ΔAstig2+ΔSA2+ΔOther2)}
wherein,
ΔAstig represents variability due to astigmatic aberration,
ΔSA represents variability due to spherical aberration, and
ΔOther represents variability due to other aberrations.
In a further aspect, the ΔIOLPower can be defined in accordance with the following relation:
ΔIOLPower=√{square root over (ΔIOLStep2+ΔIOLTol2+ΔELP2)}
wherein,
Further understanding of the invention can be obtained by reference to the following detailed description, in conjunction with the associated drawings, which are discussed briefly below.
In this exemplary embodiment, the lens 10 has a shape factor in a range of about 0 to about 2. More generally, in many embodiments, the shape factor of the lens 10 can range from about −0.5 to about 4. As known in the art, the shape factor of the lens 10 can be defined in accordance with the following relation:
wherein C1 and C2 denote, respectively, the curvatures of the anterior and posterior surfaces.
The shape factor of the IOL 10 can affect the aberrations (e.g., spherical and/or astigmatic aberrations) that the lens can introduce as a result of its tilt and decentration, e.g., when implanted in the subject's eye or in a model eye. As discussed in more detail below, aberrations caused by a plurality of IOLs with different shape factors were theoretically studied as a function of tilt and decentration by utilizing a model eye. Those studies indicate that IOLs having a shape factor in a range of about 0 to about 2 introduce much reduced aberrations as a result of tilt and decentration.
More particularly, to study the effects of an IOL's shape factor on aberrations induced by its tilt and decentration, a hypothetical eye model having optical properties (e.g., corneal shape) similar to those of an average human eye was employed. The radii of optical surfaces and the separations between optical components were chosen to correspond to mean values of those parameters for the human population. The refractive indices of the optical components were chosen to provide selected refractive power and chromatic aberrations. Further, the anterior corneal surface of the model was selected to have an ashperical shape. An IOL under study replaced the natural lens in the model. Table 1 below lists the various design parameters of the model eye:
An optical design software marketed as Zemax® (version Mar. 4, 2003, Zemax Development Corporation, San Diego, Calif.) was utilized for the simulations of the optical properties of the model eye. A merit function was defined based on the root-mean-square (RMS) wavefront aberration, that is, the RMS wavefront deviation of an optical system from a plane wave. In general, the larger the RMS wavefront error, the poorer is the performance of the optical system. An optical system with an RMS wavefront error that is less than about 0.071 waves is typically considered as exhibiting a diffraction-limited optical performance.
The effects of misalignment (tilt and/or decentration) of an IOL on its optical performance for a number of different shape factors was simulated by placing the IOLs in the above model eye and utilizing the Zemax® software. For these simulations, the IOL was assumed to have spherical surfaces so as to investigate the effects of the shape factor alone (as opposed to that of the combined shape factor and asphericity). To simulate the scotopic viewing conditions for old patients, a 5 mm entrance pupil was chosen. The following misalignment conditions were considered: 1.5 mm IOL decentration and a 10-degree IOL tilt. These two conditions represent the extreme cases of IOL misalignments.
In other aspects, it has been discovered that certain biometric parameters of the eye (e.g., corneal radius and axial length) can be considered while selecting the shape factor of an IOL for implantation in the eye to provide enhanced performance of the lens. As discussed in more detail below, in some embodiments, optimal IOL shape factors are provided for different eye populations, e.g., average human eye (eyes with average values for certain biometric parameters), and other populations characterized by extreme values for those parameters.
The biometric parameters of the above eye model were varied to simulate the performance of a plurality of IOLs having different shape factors for different eyes. For an average human eye, a corneal radius (r) of 7.72 mm, a corneal asphericity (Q) of −0.26, an anterior chamber depth (ACD) of 4.9 mm, and an axial length (AL) of 24.4 mm were assumed. To investigate human eyes with extreme large or small biometric values, the anterior chamber depth was varied from 4.3 mm to 5.5 mm, the corneal asphericity was varied from −0.50 to 0, the corneal radius was varied from 7.10 mm to 8.60 mm, and the axial length was varied from 22.0 mm to 26.0 mm. These ranges are sufficiently broad to cover the values exhibited by the majority of the population. The optical performance of the IOLs was evaluated based on two criteria: calculated wave aberration and modulation transfer function (MTF). As known to those having ordinary skill in the art, the MTF provides a quantitative measure of image contrast exhibited by an optical system, e.g., a system formed of an IOL and the cornea. More specifically, the MTF of an imaging system can be defined as a ratio of a contrast associated with an image of an object formed by the optical system relative to a contrast associated with the object.
Table 2 below presents the simulation results of the optical performance of IOLs having shape factors in a range of about −2 to about 4 for an eye having an average anterior chamber depth (ACD) of 4.9 mm, a corneal radius of 7.72 mm, a corneal asphericity of −0.26, and an axial length (AL) of 24.4 mm, at a pupil size of 5 mm.
For graphical presentation of the information in Table 2,
Table 3 below presents the simulation results for the optical performance of a plurality of IOLs having shape factors in the above range of −2 to 4 at a pupil size of 5 mm for an eye having a small anterior chamber depth (ACD) of 4.3 mm, but the same corneal radius (7.72 mm) and asphericity (−0.26) as well as axial length (24.4 mm) as that employed in the previous simulation.
Table 4 below presents the simulation results for the optical performance of a plurality of IOLs having shape factors in the above range of −2 to 4 at a pupil size of 5 mm for an eye having a large anterior chamber depth (ACD) of 5.5 mm, a corneal radius of 7.72 mm, a corneal asphericity of −0.26 and an axial length of 24.4 mm. Further,
These simulations indicate that IOLs with shape factors in a range of about −0.5 to about 4, and particularly those having shape factors in a range of about 0 to about 2, provide enhanced optical performance. The simulations, however, show that anterior chamber depth does not significantly affect the performance of an IOL.
Although in the afore-mentioned simulations the spherical aberrations were considered, in the IOL is misaligned relative to the cornea, other aberrations (e.g., defocus, astigmatism and coma) can also be present. The simulations of these aberrations for average, small and large ACD confirm that the aberrations can be minimized by utilizing shape factors in a range about 0 to about 2.
The impact of corneal asphericity (Q) on optimal IOL shape factor was also investigated by utilizing the aforementioned eye model and calculating spherical aberration and MTF for Q-=0 (spherical), Q=−0.26 and Q=−0.50. The more negative the Q value, the flatter is the peripheral portion of the cornea. Q=−0.26 corresponds to the asphericity of the normal human cornea while Q=−0.50 corresponds to the asphericity of an extremely flat cornea. Table 5 below lists the results of these simulations, with
The spherical aberration exhibited by a spherical cornea (Q=0) is significantly larger than those exhibited by the aspherical corneas (Q=−0.26 and Q=−0.50), as expected. As a result, the MTFs associated with Q=0 are lower than those for Q=−0.26 and Q=−0.50. However, for each of the three cases, the above simulations indicate that an optimal IOL shape factor lies in a range of about −0.5 to about 4, and preferably in a range of about 0 to about 2.
In another set of simulations, the effect of corneal radius on optimal shape factor was investigated. Table 6 below presents the simulation results corresponding to spherical aberration as well as MTFs at 50 lp/mm and 100 lp/mm obtained for a plurality of IOLs having shape factors in a range of about −2 to about 8 by utilizing the afore-mentioned eye model and varying the corneal radius. More specifically, the ACD, Q and AL were fixed, respectively, at 4.9 mm, −0.26, and 24.4 mm while the corneal radius was varied.
These simulations indicate that for a very steep cornea (e.g., a corneal radius of 7.1 mm), the IOL's shape factor has a relatively small impact on the spherical aberration and the MTF. For example, in such a case, for shape factors in a wide range of about −1 to about 8, good optical performance is observed, though shape factors in a range of about 0.5 to about 4 are preferred. However, for a cornea having a large radius, e.g., a radius larger than about 8.6 mm, an optimal range of about 0 to about 2 (e.g., about 0.5 to about 2) for the IOL's shape factor is observed. The peak of the IOL's optical performance as a function of the shape factor also shifts as the corneal radius varies from a small value to a large one. For example, the simulations indicate a peak performance at a shape factor of about 3 for a cornea with a radius of about 7.1 mm and at a shape factor of about 1 for a cornea with a radius of about 8.6 mm.
Similar to corneal radius, it was discovered that an optimal shape factor for an IOL can vary as a function of the eye's axial length. By way of example, Table 7 below presents the results of simulations for optical performance of a plurality of IOLs having shape factors in a range of −2 to 8 for a plurality of different axial lengths (ALs). The model eye utilized for these simulations was characterized by an ACD=4.9 mm, a corneal radius (r)=7.72 mm, and a corneal asphericity (Q)=−0.26. The graphical representation of these simulations are provided in
The above simulations indicate that while for a long axial length (e.g., an axial length of about 26 mm), IOLs having shape factors over a wide range (e.g., in a range of about −1 to about 8) provide substantially similar performance, for a short axial length (e.g., an axial length of about 22 mm), an optimal IOL shape factor lies in a range of about 0 to about 2 (preferably in a range of about 0.5 to about 2). Further, the peak of optical performance exhibits a shift as a function of axial length variation.
In some embodiments, an anterior or a posterior surface of the IOL includes an aspherical base profile selected to compensate for the corneal spherical aberration. Alternatively, both anterior and posterior surfaces can be aspherical so as to collectively provide a selected degree of compensation for the corneal spherical aberration. By way of example,
wherein,
c denotes the curvature of the surface at its apex (at its intersection with the optical axis),
r denotes the radial distance from the optical axis, and
k denotes the conic constant.
In some embodiments, the conic constant k can range from about −1162 to about −19 (e.g., from about −73 to about −27) and the shape factor of the lens can range from about −0.5 to about 4, and more preferably, from about 0 to about 2. To show the efficacy of such aspherical IOLs in reducing the corneal spherical aberrations, two aspherical IOLs were theoretically designed. The IOLs were assumed to be formed of an acrylic polymer commonly known as Acrysof. One of the IOLs was selected to have a shape factor of zero (X=0) while the other was chosen to have a shape factor of 1 (X=1). The edge thickness for each IOL was fixed at 0.21 mm. For the IOL with X=0, the anterior and posterior radii were set, respectively, at 22.934 mm and −22.934 mm, the central thickness was set at 0.577 mm and the anterior surface asphericity (i.e., the conic constant) was selected to be −43.656. For the IOL with X=1, the posterior surface was selected to be flat while the radius of the anterior surface was set at 11.785 mm. The central thickness of this lens was 0.577 mm and the anterior surface was assumed to have an asphericity characterized by a conic constant of −3.594.
The simulations of the optical performances of these two IOL designs in the aforementioned eye model show a reduction of the total RMS wavefront errors to about 0.000841 waves in case of the IOL having a shape factor that approaches zero and to about 0.000046 in case of the IOL having a shape factor of unity.
Another factor that can affect the optical performance of an IOL is its effective position. The effective lens position (e.g., defined here as the location of the principal plane relative to the posterior surface) can vary as a function of the lens's shape. The location of the second principal plane (PP2) relative to the apex of the posterior surface can be defined by the following relation:
wherein n1 and n2 denote, respectively, the refractive indices of the IOL and the surrounding medium, F1 represents the optical power of the anterior surface and F2 represents the optical power of the lens, and d is the lens's central thickness. The haptics plane (the anchor plane for the implanted IOL) located at the central-line of the lens edge can have a distance from the apex of the posterior surface specified as:
wherein ET denotes the lens's edge thickness and Sag2 denotes the sag height of the posterior surface at the lens's edge. Utilizing the above Equations (3) and (4), the location of the second principal point relative to the haptics plane can be defined as follows:
wherein ΔPP2 denotes an offset shift of the principal plane, and the other parameters are defined above.
By way of example, the 2nd principal plane shift for the aforementioned IOL having a shape factor of zero (X=0) was calculated (by utilizing the above equations) across a power range of 0 to about 35 D as +/−0.03 mm, while the corresponding shift for the IOL having a shape factor of unity (X=1) was calculated as +/−0.15 mm.
To better appreciate the enhanced optical performance provided by the IOLs of the invention, some of the major factors contributing to the variability of post-operative refractive errors can be considered. These factors are generally classified into three categories: biometric data errors (ΔBiometric), IOL power errors (ΔIOLPower) and high-order aberration contributions (ΔAberration). An overall variability (Rx) can be calculated based on these factors by utilizing, e.g., the following relation:
The ΔBiometric can, in turn, be defined in accordance with the following relation:
ΔBiometric=√{square root over (Δk2+ΔAL2+ΔACD2)} Eq. (7)
wherein Δk denotes the error in keratometric measurement, ΔAL denotes the error in axial length measurement, and ΔACD denotes the error in the anterior chamber depth measurement. The ΔIOLPower can be defined in accordance with the following relation:
ΔIOLPower=√{square root over (ΔIOLStep2+ΔIOLTol2+ΔELP2)} Eq. (8)
wherein ΔIOLStep denotes the variability caused by the use of IOLs whose optical powers differ by finite steps for correcting patients' refractive errors that vary over a continuous range, ΔIOLTol denotes manufacturing power tolerance, and ΔELP denotes the variability in the shift of the IOL effective position across the power range. Further, ΔAberration can be defined in accordance with the following relation:
ΔAberration=√{square root over (ΔAstig2+ΔSA2+ΔOther2)} Eq. (9)
wherein ΔAstig, ΔSA, ΔOther denote, respectively, astigmatic, spherical and other higher order aberrations.
The optical performance of the aforementioned exemplary IOL designs having shape factors (X) of zero and unity were evaluated based on estimated Rx variability for three conditions: (1) uncorrected visual acuity (i.e., in the absence of corrective spectacles) with IOL power step of 0.5 D (UCVA), (2) uncorrected visual acuity with a refined IOL power step of 0.25 D (UCVA+) and (3) best corrected visual acuity (i.e., utilizing optimal corrective spectacles) (BCVA). The variability due to biometric measurements was estimated from information available in the literature. The focus of the analysis relates to estimating contributions of the spherical aberration, errors due to IOL misalignments, and the 2nd principal plane (PPL) shifts. For comparison purposes, a baseline value of 0.65 D was assumed for UCVA and UCVA+ and a baseline value of 0.33 D was assumed for BCVA, for eyes with spherical IOLs. Table 8 below lists absolute and percentage reductions in Rx relative to the baseline values for the two IOLs:
The information presented in Table 8 shows that reductions in Rx variability are achieved for both IOLs (X=0, and X=1), thus indicating improved optical performance of those lenses. For the IOL with a vanishing shape factor (X=0), the visual benefits are almost evenly distributed among UCVA, UCVA+ and BCVA while for the other IOL (X=1), the visual benefit associated with BCVA is more pronounced.
A variety of known manufacturing techniques can be employed to fabricate the lenses of the invention. The manufacturing tolerances can also affect the optical performance of an IOL. By way of example, such tolerances can correspond to variations of, e.g., surface radii, conic constant, surface decentration, surface tilt, and surface irregularity, with tolerances associated with surface asphericity (conic constant) generally playing a more important role that others in affecting optical performance. Simulations, however, indicate that the IOL's misalignments upon implantation in the eye are typically more significant factors in degrading optical performance than manufacturing tolerances (e.g., manufacturing errors can be nearly 10 times less than misalignment errors). By way of further illustration, the optical performance of the aforementioned aspherical lenses with X=0 and X=1, implanted in the aforementioned eye model, was theoretically investigated by employing Monte Carlo simulations. More specifically, 500 hypothetical lenses were generated under constraints of typical manufacturing tolerances and were randomly oriented relative to the cornea. For example, the tolerances associated with the surface radii, surface irregularities, and surface decentration and tilt were assumed to be, respectively, within +/−0.1 mm, 2 fringes, 0.05 mm and 0.5 degrees. The results of the Monte Carlo simulations are summarized in
Those having ordinary skill in the art will appreciate that various changes can be made to the above embodiments without departing from the scope of the invention.
The present application claims priority to U.S. Provisional Patent Application Ser. No. 60/668,520 entitled “Intraocular Lens,” filed on Apr. 5, 2005, which is herein incorporated by reference. A U.S. patent application entitled, “Intraocular Lens,” assigned to the assignee of the present application, and filed concurrently herewith, is herein also incorporated by reference.
Number | Date | Country | |
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60668520 | Apr 2005 | US |