Negative dysphotopsia (ND) is characterized by subjective reports and complaints from patients having an intraocular lens (IOL) implanted, where the complaints describe the presence of a dark shadow in the far periphery. A number of patient factors, including small photopic pupil, high angle kappa and hyperopia, have been identified as increasing the risk of ND. The presence of ND is likely caused by absence of light in the retinal interval between light passing through and refracted by the IOL (e.g., at lower angles of incidence) and rays missing the IOL (e.g., at higher angles of incidence). While the light passing the IOL at the lower angles of incidence is refracted, changing its direction to a lower angle, the light at the higher angles miss the IOL and continue straight without deviation, thereby creating an angular interval on the retina that is not illuminated. The problem is partially alleviated at larger pupil sizes, since optical errors create larger deviations of rays at the pupil edge which partially hits the obscured part of the peripheral retina. On the other hand, for smaller pupils the pinhole effect exacerbates the ND effect. For the natural crystalline lens, ND is not a problem, since no light will miss the lens as it is larger and closer to the pupil.
An example computer-implemented method for evaluating negative dysphotopsia (ND) is described herein. The method can include constructing a non-sequential (NSC) ray-tracing model of an eye with an ophthalmic lens, and modelling a light source and a detector, where the detector is configured to mimic a retina of the eye. The method can also include for each of a plurality of pupil sizes, computing irradiance data using the light source, the NSC ray-tracing model, and the detector. The method can further include evaluating ND by analyzing the respective irradiance data for each of the pupil sizes.
In some implementations, the step of analyzing the respective irradiance data for each of the pupil sizes can include determining a retinal illumination gap between light refracted by the ophthalmic lens and light refracted only by a cornea of the eye.
Alternatively or additionally, the respective irradiance data in the temporal visual field can be analyzed.
Alternatively or additionally, the irradiance data can be at least one of an irradiance map or a cross-sectional irradiance profile. For example, in some implementations, the irradiance data can be a cross-sectional irradiance profile, and the method can further include deriving at least one of ND angular location, ND angular width, local contrast, or local area of reciprocal irradiance using the cross-sectional irradiance profile.
Alternatively or additionally, the method can further include constructing a sequential ray-tracing model of the eye using biometrical patient data.
Alternatively or additionally, the ophthalmic lens can be modeled as a three-dimensional (3D) object. Optionally, the method can include generating a 3D model of the ophthalmic lens. Optionally, the method can include adjusting the position or orientation of the 3D object within the eye.
Alternatively or additionally, the light source can be a wide angle high divergence light source.
Alternatively or additionally, the detector can be a spherical or aspherical detector. Optionally, in some implementations, the detector can be defined by an aspheric equation or a toric aspheric equation.
Alternatively or additionally, the method can optionally further include constructing a respective NSC ray-tracing model of the eye with each of a plurality of ophthalmic lenses, where each of the ophthalmic lenses is configured for a different degree of edge scattering, and for each of the pupil sizes, computing irradiance data using the light source, the respective NSC ray-tracing models, and the detector. The method can optionally further include selecting an ophthalmic lens design that reduces ND from the plurality of ophthalmic lenses.
Alternatively or additionally, the method can optionally further include constructing a respective NSC ray-tracing model of the eye with each of a plurality of ophthalmic lenses, where each of the ophthalmic lenses has a different edge thickness, and for each of the pupil sizes, computing irradiance data using the light source, the respective NSC ray-tracing models, and the detector. The method can optionally further include selecting an ophthalmic lens design that reduces ND from the plurality of ophthalmic lenses.
Alternatively or additionally, the ophthalmic lens can be an intraocular lens (IOL).
Another example computer-implemented method for reducing the detectability of negative dysphotopsia (ND) is described herein. The method can include constructing a respective NSC ray-tracing model of the eye with an ophthalmic lens for each of a plurality of different ophthalmic lens edge designs, and modelling a light source and a detector, where the detector is configured to mimic a retina of the eye. The method can also include, for each of a plurality of pupil sizes, computing irradiance data using the light source, the respective NSC ray-tracing models, and the detector, evaluating ND by analyzing the respective irradiance data for each of the pupil sizes, and selecting one of the different ophthalmic lens edge designs to reduce ND.
Alternatively or additionally, the one of the different ophthalmic lens edge designs can reduce a retinal illumination gap between light refracted by the ophthalmic lens and light refracted only by a cornea of the eye. In some implementations, the one of the different ophthalmic lens edge designs can minimize the retinal illumination gap between light refracted by the ophthalmic lens and light refracted only by a cornea of the eye.
Alternatively or additionally, the method can further include optimizing the ophthalmic lens edge design for a given optics diameter and/or for a given ophthalmic lens material.
Alternatively or additionally, the different ophthalmic lens edge designs can be different Lambertian scattering coefficients.
Alternatively or additionally, the different ophthalmic lens edge designs can be different edge thicknesses.
An example method for manufacturing an ophthalmic lens is also described herein.
An example method for creating a physical eye model including an ophthalmic lens is also described herein.
An example method for indirectly quantifying edge frosting effect of an ophthalmic lens is also described herein. The method can include obtaining measurements using an off-axis modulation transfer function (MTF) bench, the physical eye model as describe herein, and an electronic light sensor. The method can further include quantifying edge frosting effect of the ophthalmic lens by inputting the measurements into a non-sequential (NSC) ray-tracing model of an eye with an ophthalmic lens.
It should be understood that the above-described subject matter may also be implemented as a computer-controlled apparatus, a computer process, a computing system, or an article of manufacture, such as a computer-readable storage medium.
Other systems, methods, features and/or advantages will be or may become apparent to one with skill in the art upon examination of the following drawings and detailed description. It is intended that all such additional systems, methods, features and/or advantages be included within this description and be protected by the accompanying claims.
The components in the drawings are not necessarily to scale relative to each other. Like reference numerals designate corresponding parts throughout the several views.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. Methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present disclosure. As used in the specification, and in the appended claims, the singular forms “a,” “an,” “the” include plural referents unless the context clearly dictates otherwise. The term “comprising” and variations thereof as used herein is used synonymously with the term “including” and variations thereof and are open, non-limiting terms. The terms “optional” or “optionally” used herein mean that the subsequently described feature, event or circumstance may or may not occur, and that the description includes instances where said feature, event or circumstance occurs and instances where it does not. Ranges may be expressed herein as from “about” one particular value, and/or to “about” another particular value. When such a range is expressed, an aspect includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another aspect. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint. While implementations are described for intraocular lenses, it will become evident to those skilled in the art that the implementations are not limited thereto, but are applicable for other ophthalmic lenses.
As used herein, the terms “light” or “visible light” mean electromagnetic radiation within the visible waveband, for example, electromagnetic radiation with a wavelength in a vacuum that is between 390 nanometers and 780 nanometers. As used herein, the term “optical power” of a lens or optic means the ability of the lens or optic to converge or diverge light to provide a focus (real or virtual) when disposed within a media having a refractive index of 1.336 (generally considered to be the refractive index of the aqueous and vitreous humors of the human eye), and is specified in reciprocal meters or Diopters (D). See ISO 11979-2. As used herein the terms “focus” or “focal length” of a lens or optic is the reciprocal of the optical power. As used herein the term “power” of a lens or optic means optical power. Except where noted otherwise, optical power (either absolute or add power) of an intraocular lens or associated optic is from a reference plane associated with the lens or optic (e.g., a principal plane of an optic).
As used herein, the term “near vision” means vision produced by an eye that allows a subject to focus on objects that are at a distance of 40 cm or closer to a subject, typically within a range of 25 cm to 33 cm from the subject, which corresponds to a distance at which a subject would generally place printed material for the purpose of reading. As used herein, the term “intermediate vision” means vision produced by an eye that allows a subject to focus on objects that are located between 40 cm and 2 meters from the subject. As used herein, the term “distant vision” means vision produced by an eye that allows a subject to focus on objects that are at a distance that is greater than 2 meters, typically at a distance of about 5 meters from the subject, or at a distance of about 6 meters from the subject, or greater.
Referring now to
The natural lens 16 is enclosed within a capsular bag 20, which is a thin membrane attached to a ciliary muscle 22 via zonules 24. An iris 26, disposed between the cornea 14 and the natural lens 16, provides a variable pupil that dilates under lower lighting conditions (mesopic or scotopic vision) and constricts under brighter lighting conditions (photopic vision). The ciliary muscle 22, via the zonules 24, controls the shape and position of the natural lens 16, allowing the eye 10 to focus on both distant and near objects. It is generally understood that distant vision is provided when the ciliary muscle 22 is relaxed, wherein the zonules 24 pull the natural lens 16 so that the capsular bag 20 and lens 16 are generally flatter and provide a longer focal length (lower optical power). It is generally understood that near vision is provided when the ciliary muscle contracts, thereby relaxing the zonules 24 and allowing the capsular bag 20 and lens 16 to return to a more rounded state that produces a shorter focal length (higher optical power).
Referring now to
Referring now to
Optionally, in some implementations, a sequential ray-tracing model of the eye can be constructed with and validated against individualized biometrical patient data. Such individualized biometrical data can include, but is not limited to, pupil size, anterior chamber depth, distance iris—IOL, axial length, anterior corneal topography, IOL tilt and decentration, and post-operative refractive errors. One example sequential ray-tracing eye model is the Liou-Brennan human eye model. The Liou-Brennan human eye model is only provided as an example, and it should be understood that other sequential eye models such as the TECNIS Chromatic Eye model from JOHNSON & JOHNSON of New Brunswick, N.J. can be used. Then, using the same biometry, the NSC ray-tracing model of the eye with an ophthalmic lens can be constructed (e.g., step 202).
At step 204, a light source and a detector can be modelled. The light source 312 can be a wide angle high divergence mono or polychromatic light source. The light source 312 is shown in the NSC ray-tracing model of
At step 206, irradiance data can be computed. In other words, irradiance data can be simulated using the modelled light source and detector, as well as the NSC ray-tracing model (e.g., as shown by
At step 208, ND can be evaluated by analyzing the irradiance data. In some implementations, this can include analyzing the figures of merit described above, e.g., the quantitative information derived from a cross-sectional irradiance profile. In other implementations, this can include determining a retinal illumination gap between light refracted by the ophthalmic lens and light refracted only by a cornea of the eye. The analysis can be performed on the respective irradiance data for each of the pupil sizes. Due to the pinhole effect, smaller pupils are associated with a higher incidence of ND complaints. For example, when using a standard monofocal IOL,
The irradiance data computations described above are conducted using a rotationally symmetric eye model (e.g., the NSC ray-tracing model shown in
Thus, in some implementations, the irradiance data in the temporal visual field can be analyzed. In other words, the irradiance data in one or more of the nasal, inferior, and superior visual fields can be ignored if surrounding bone structures limit the extent in these quadrants such that ND may not be detected by the subject in these quadrants.
For the purpose of reducing positive dysphotopsia (PD), which is subjectively perceived spurious bright images in scotopic conditions, caused by IOL edge-reflected light, the edges of IOLs can be roughened to various extents during manufacturing, which promotes light scattering. Roughening depends on the manufacturer and fabrication method. To account for the IOL edge glare relative intensity, the edge frosting effect can be retro-fitted by a Lambertian scattering surface to measurements performed by means of an off-axis modulation transfer function (MTF) bench, a physical wide angle eye model fitted with an IOL (e.g., the physical eye model shown in
Referring now to
Optionally, the methods described herein can be used to evaluate a plurality of ophthalmic lens designs, where each design is configured with a different degree of edge scattering. Using the results of such evaluation, an ophthalmic lens design that reduces ND can be selected. For example, a respective NSC ray-tracing model of the eye with each of a plurality of ophthalmic lenses, where each of the ophthalmic lenses is configured for a different degree of edge scattering, can be constructed. Thereafter, irradiance data can be computed as described herein and using each of the respective NSC ray-tracing models. This data can be analyzed to evaluate ND, and an ophthalmic lens design that reduces ND can be selected. This disclosure contemplates that ophthalmic lenses having the selected design can then be manufactured.
Optionally, the methods described herein can be used to evaluate a plurality of ophthalmic lens designs, where each design has a different edge thickness. Using the results of such evaluation, an ophthalmic lens design that reduces ND can be selected. For example, a respective NSC ray-tracing model of the eye with each of a plurality of ophthalmic lenses, where each of the ophthalmic lenses has a different edge thickness, can be constructed. Thereafter, irradiance data can be computed as described herein and using each of the respective NSC ray-tracing models. This data can be analyzed to evaluate ND, and an ophthalmic lens design that reduces ND can be selected. This disclosure contemplates that ophthalmic lenses having the selected design can then be manufactured.
In some implementations, the ophthalmic edge design can optionally be optimized for a given optics diameter. For example, as described herein, an objective of the evaluation is to reduce, and in some implementations, minimize the retinal illumination gap between light refracted by the ophthalmic lens and light refracted only by the cornea of the eye. Thus, for a given optics diameter, based on the angular location of ND and the irradiance drop associated with ND, the degree of edge scattering and/or the edge thickness can be increased to minimize the retinal illumination gap. Similarly, the ophthalmic edge design can optionally be optimized for a given ophthalmic lens material. In this case, for a given refractive index, based on the angular location of ND and the irradiance drop associated with ND, the degree of edge scattering and/or the edge thickness can be increased to minimize the retinal illumination gap. This disclosure contemplates that ophthalmic lenses having the optimal design can then be manufactured.
The methods described herein can be used to design an ophthalmic lens edge, where the edge design is defined by the Lambertian scattering coefficient. Using the methods described herein, an ophthalmic lens edge scatter that reduces ND can be selected for a given IOL platform. For example, the ophthalmic lens edge scatter can be adjusted to reduce the retinal illumination gap between light refracted by the ophthalmic lens and light refracted only by a cornea of the eye. An ophthalmic lens edge design (e.g., the Lambertian scattering coefficient) that reduces, and in some implementations minimizes, the retinal illumination gap can be selected. For example, in
Alternatively or additionally, the methods described herein can be used to design an ophthalmic lens edge, where the edge design is defined by the thickness. Using the methods described herein, an ophthalmic lens edge thickness that reduces ND can be selected for a given IOL platform. For example, the ophthalmic lens edge thickness can be adjusted to reduce the retinal illumination gap between light refracted by the ophthalmic lens and light refracted only by a cornea of the eye. An ophthalmic lens edge design (e.g., the edge thickness) that reduces, and in some implementations minimizes, the retinal illumination gap can be selected. For example, in
It should be understood that the methods described herein for designing and manufacturing ophthalmic lens would require minimal manufacturing process adjustments and/or have a negligible impact on insertability and mechanical stability post-implantation.
It should be appreciated that the logical operations described herein with respect to the various figures may be implemented (1) as a sequence of computer implemented acts or program modules (i.e., software) running on a computing device (e.g., the computing device described in
Referring to
In its most basic configuration, computing device 900 typically includes at least one processing unit 906 and system memory 904. Depending on the exact configuration and type of computing device, system memory 904 may be volatile (such as random access memory (RAM)), non-volatile (such as read-only memory (ROM), flash memory, etc.), or some combination of the two. This most basic configuration is illustrated in
Computing device 900 may have additional features/functionality. For example, computing device 900 may include additional storage such as removable storage 908 and non-removable storage 910 including, but not limited to, magnetic or optical disks or tapes. Computing device 900 may also contain network connection(s) 916 that allow the device to communicate with other devices. Computing device 900 may also have input device(s) 914 such as a keyboard, mouse, touch screen, etc. Output device(s) 912 such as a display, speakers, printer, etc. may also be included. The additional devices may be connected to the bus in order to facilitate communication of data among the components of the computing device 900. All these devices are well known in the art and need not be discussed at length here.
The processing unit 906 may be configured to execute program code encoded in tangible, computer-readable media. Tangible, computer-readable media refers to any media that is capable of providing data that causes the computing device 900 (i.e., a machine) to operate in a particular fashion. Various computer-readable media may be utilized to provide instructions to the processing unit 906 for execution. Example tangible, computer-readable media may include, but is not limited to, volatile media, non-volatile media, removable media and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules or other data. System memory 904, removable storage 908, and non-removable storage 910 are all examples of tangible, computer storage media. Example tangible, computer-readable recording media include, but are not limited to, an integrated circuit (e.g., field-programmable gate array or application-specific IC), a hard disk, an optical disk, a magneto-optical disk, a floppy disk, a magnetic tape, a holographic storage medium, a solid-state device, RAM, ROM, electrically erasable program read-only memory (EEPROM), flash memory or other memory technology, CD-ROM, digital versatile disks (DVD) or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices.
In an example implementation, the processing unit 906 may execute program code stored in the system memory 904. For example, the bus may carry data to the system memory 904, from which the processing unit 906 receives and executes instructions. The data received by the system memory 904 may optionally be stored on the removable storage 908 or the non-removable storage 910 before or after execution by the processing unit 906.
It should be understood that the various techniques described herein may be implemented in connection with hardware or software or, where appropriate, with a combination thereof. Thus, the methods and apparatuses of the presently disclosed subject matter, or certain aspects or portions thereof, may take the form of program code (i.e., instructions) embodied in tangible media, such as floppy diskettes, CD-ROMs, hard drives, or any other machine-readable storage medium wherein, when the program code is loaded into and executed by a machine, such as a computing device, the machine becomes an apparatus for practicing the presently disclosed subject matter. In the case of program code execution on programmable computers, the computing device generally includes a processor, a storage medium readable by the processor (including volatile and non-volatile memory and/or storage elements), at least one input device, and at least one output device. One or more programs may implement or utilize the processes described in connection with the presently disclosed subject matter, e.g., through the use of an application programming interface (API), reusable controls, or the like. Such programs may be implemented in a high level procedural or object-oriented programming language to communicate with a computer system. However, the program(s) can be implemented in assembly or machine language, if desired. In any case, the language may be a compiled or interpreted language and it may be combined with hardware implementations.
This disclosure contemplates creating a physical eye model (e.g., a model that mimics the aphakic eye) including an ophthalmic lens. The physical eye model can be created based on the ophthalmic lens as evaluated according to any of the methods described herein. In some implementations, the ophthalmic lens is an IOL. This disclosure contemplates that the IOL can be any type of IOL. The physical eye model can further include a cornea, a pupil, a holder for the ophthalmic lens, a light source, and/or an electronic light sensor. An example physical eye model is described below with regard to
This disclosure contemplates indirectly measuring edge frosting effect of an ophthalmic lens. For example, it is possible to obtain measurements using an off-axis modulation transfer function (MTF) bench, the physical eye model described herein, and an electronic light sensor. These measurements can be input into an NSC ray-tracing model (e.g., NSC ray-tracing model shown in
In some implementations, a set-up including a physical wide angle eye model can be constructed as depicted in
The electronic light sensors can comprise charged-coupled devices (CCD), including both imaging CCDs and intensity CCDs. In other embodiments complementary metal-oxide-semiconductor (CMOS) detectors can be used. In yet other embodiments a wavefront sensor such as a Shack-Hartmann wavefront sensor could be used. Finally, in some embodiments interferometers, photomultiplier tube (PMT) sensors, or small and large angle microscope sensors can be used. The light sensor can detect light emitted by a light source (not shown in
Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing the claims.
This application claims priority to, and the benefit of, under 35 U.S.C. § 119(e) of U.S. Provisional Appl. No. 62/773,983, filed Nov. 30, 2018, which is incorporated by reference herein in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/EP2019/083179 | 11/29/2019 | WO | 00 |
Number | Date | Country | |
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62773983 | Nov 2018 | US |