This application is a continuation of application Ser. The present invention is directed intraocular lenses IOLs that define an optical power that is adjustable following implantation.
More particularly, the IOL is adapted for use in cataract patients that
Fluid vision accommodating iol powervision tv live an adjustment in the optical power of the lens post-implantation. Cataracts are a major cause of blindness in the world and the most prevalent ocular disease.
Visual disability from cataracts accounts for more than 8 physician office visits per year. When the disability from cataracts affects or alters an individual's activities of daily living, surgical lens removal with intraocular lens implantation is the preferred method of treating the functional limitations.
In the United States, about 2. A cataract is any opacity of a patient's lens, whether it is a localized opacity or a diffuse general loss of transparency. To be clinically significant, however, the cataract must cause a significant reduction in visual acuity or a functional impairment.
A cataract occurs as a result of aging or secondary to hereditary factors, trauma, inflammation, metabolic or nutritional disorders, or radiation. Age-related cataract conditions are Fluid vision accommodating iol powervision tv live most common. In treating a cataract, the surgeon removes material from the lens capsule and replaces it with an intraocular lens IOL implant. The typical IOL provides a selected focal length that
Fluid vision accommodating iol powervision tv live the patient to have fairly good distance vision.
Since the lens can no longer accommodate, the patient typically need glasses for reading. The surgeon selects the power of the IOL based on analysis of refractive characteristics of the patient's eye prior to the surgery. In a significant number or cases, after the patient's eye has healed from the cataract surgery, there is a refractive error that could not be predicted. There remain substantial difficulties in calculating the proper power of an IOL for any particular patient.
To solve any unpredicted refractive errors following IOL implantation, the ophthalmologist can perform a repeat surgery to replace the IOL—or the patient can live with the refractive error that may require prescription eyeglasses for both near and distant vision. What is needed is an IOL that carries means for adjusting its power post-implantation, as well as for treating astigmatisms. The present invention provides an intraocular lens that comprises first and second surface portions that are assembled to provide an interior space or chamber within the interior of the lens for allowing fluid flows therein to alter at least one surface portion of the lens to thereby alter optical parameters of the
Fluid vision accommodating iol powervision tv live. In an exemplary embodiment, the first and second surface portions extend to the lens body periphery wherein a first portion of the interior chamber extends within the central optic lens element.
A peripheral portion of the interior chamber extends about the lens periphery. The invention further provides a microporous or nanoporous body that is intermediate the central and peripheral regions of the interior chamber portions. In one embodiment, the
Fluid vision accommodating iol powervision tv live or nanoporous body is capable of cooperating with an external Rf or light source to expose a charge to a charge-carrying fluid within the interior chamber. By this means, fluid flows are induced to alter the Fluid vision accommodating iol powervision tv live parameters of the lens.
In another preferred embodiment, the coincident surfaces of the first and second lens portions that bound the interior chamber are configured with projecting shape structures that cooperate with one another and fluid movement to i amplify the dynamic range of surface curvature modification and further Fluid vision accommodating iol powervision tv live to insure that the first and second lens portions are mechanically coupled to allow controlled shape change.
In another preferred embodiment, the lens body is fabricated of first and second structural portions of first and second polymer types.
The first structural portion and first polymer type can
Fluid vision accommodating iol powervision tv live the substantial part of the optic element, and is a stable, flexible polymer as is known in the art. The second polymer is dimensionally-sensitive to light energy and is thus formed into a second structure that can be controllably changed in shape to move fluids within the interior of the lens or to otherwise directly, or indirectly, deform the first structural portion to alter the optical
Fluid vision accommodating iol powervision tv live of the IOL.
In order to better understand the invention and to see how it may be carried out in practice, some preferred embodiments are next described, by way of non-limiting examples only, with reference to the accompanying drawings, in which:.
Deformation and shape adjustment of the surface element Fluid vision accommodating iol powervision tv live preferred embodiments is caused Fluid vision accommodating iol powervision tv live fluid flows with an interior space of the lens to displace the surface element, when coupled with energy or stimulus from an external source see FIG.
In an exemplary embodiment, the IOL body is coupled to a portion that comprises radially-extending struts or haptics indicated at a and b in FIG. Typically, the haptics a and b have radial-outward ends that define arcuate terminal portions. The haptics a and b have a particular length so that the terminal portions create a slight engagement pressure when in contact with the equatorial region of the capsular sac after being implanted.
The diameter of outermost portions of the haptics is typically about In the embodiment illustrated in FIGS. The lens further has a posterior lens portion b with its exterior surface defining a posterior curvature pc. The lens portions a and b define a central optic portion with axis that comprises transparent optic element of the IOL for focusing light on the retina.
In one embodiment, the lens defines a peripheral non-optic portion that is outward of the optic element, and the lens portions a and b typically are bonded together at or about bond line in this peripheral non-optic portion The lens thereby defines and interior space or chamber that further defines a first interior space or chamber portion A within the central optic portion The lens portions and b are fabricated of a transparent, flexible material, such as a silicone polymeric material, acrylic polymeric material, hydrogel polymeric material or the like, all of which known in
Fluid vision accommodating iol powervision tv live art of IOL fabrication and allow the lens to be rolled or folded Fluid vision accommodating iol powervision tv live introduction into the eye through a small incision.
As will be described below, the functionality
Fluid vision accommodating iol powervision tv live the lens depends on flexibility or deformability of at least one lens surface, which in the exemplary embodiment of FIGS. The lens body, or at least one surface portion thereof, also can be fabricated of a slightly stiffer biocompatible material if very thin in cross section, such as polymethyl methacrylate PMMA. Thus, it is possible that the anterior and posterior surfaces a and b that can be formed of different materials such as silicone and PMMA.
The lens optic, depending on the material, can be injection-molded, fabricated with casting techniques or turned by a lathe as is known in the art. As can be seen in FIGS. These markings are adapted in some embodiments to cooperate with a light source, photo-sensing system, scanner and eye-tracking system as is known in the art to direct and localize a light beam at a selected location or locations of the lens for energy delivery thereto.
In the embodiment of FIGS. It be appreciated that the posterior lens element may have any selected curvature and the combination of the anterior and posterior lens surfaced can define a lens shape that is plano-convex, convexo-concave, or plano-concave.
Also, either or both anterior and posterior lens elements can have multiple concentric powers as in known in Fluid vision accommodating iol powervision tv live art of multi-focal lens design. The haptics or strut members can be polypropylene or like polymeric materials, coupled to the periphery portion and thus extend outwardly
Fluid vision accommodating iol powervision tv live engage the perimeter wall of the capsular sac to maintain the lens in a desired position.
The haptics can be glued or welded to the periphery portion or molded along with a portion of the lens. While the configuration of the haptics of the lens shown in FIG.
The chamber further defines a first chamber portion or central space A wherein a change in fluid volume therein will flex and displace lens wall portion The lens further
Fluid vision accommodating iol powervision tv live a second peripheral chamber portion or space B in the peripheral portion of the lens.
Of particular interest, a microporous body portion indicated at lies intermediate the first and second chamber portions A and B. As will be described below, the invention describes means for causing fluid flow from the peripheral chamber portion to the central chamber portion, or vice versa, to alter the shape and optical parameters of the optic portion The terms fluid flow, migration, perfusion and diffusion through the microporous body portion are used interchangeably herein to describe any movement through the microporous portionwhich also may be described for Fluid vision accommodating iol powervision tv live as porous, microporous, fluid-permeable, fluid-diffusible or fluid-migratable.
As will be described in more detail below, a lens corresponding to the invention
Fluid vision accommodating iol powervision tv live have a plurality of cooperating central and peripheral chambers, in which case each pair of cooperating chambers would be have an intermediate microporous body portion More specifically, the cross-sectional dimension of the flow passageways in material for Fluid vision accommodating iol powervision tv live in the invention range from about 5 nanometers to about 25 microns.
More preferably, the cross-sectional dimensions of the flow passageways range from about nanometers to about 5 microns. The microporous material typically is a networked porous polymer wherein the maximum cross-section of a flow passageway therein corresponds to the dimensional ranges described above. The microporous material can be a porous polymer such as a biocompatible polysiloxane, polyurethane, PFTE, polyacrylate, polyamide, polyester, polyolefin, nylon or co-polymers thereof.
Many means are known in the art for creating microporous polymers and need not be described further herein. The microporous material also encompasses ordered or nanostructured assembled materials that have pores or channels therein that correspond to the dimensional ranges above.
In another preferred embodiment, the microporous material can be a micromachined microchannel material Fluid vision accommodating iol powervision tv live any suitably shaped channels therein. Such a typically rigid material can be insert-molded into lens. In one such material embodiment, the microchannel structure can be fabricated in silicon by NanoSciences Corporation, Hurley Farms Industrial Park, Bldg.
A suitably dimensioned microchannel structure can be fabricated in silicon with high-aspect ratio channel in the range of somewhat less that 1 micron to about 8 microns by NanoSciences Corp.
Further, the company's proprietary technology allows for deposition of conductive surfaces within, or at end surfaces of, the microchannels which is useful in some embodiments of the invention disclosed herein. To cooperate with such a charge, the fluid media M in the respective chambers Fluid vision accommodating iol powervision tv live A and B carries a charge so that it responds to an electrical energy field created at or about one or more electrodes to thereby cause fluid flow.
For example, a charge applied to an electrode surface can cause the charged fluid media M to migrate from the peripheral chamber portion B to the central chamber portion A see FIG. The fluid media M can be any flowable media with a charge attached, and in embodiment can be a saline solution.
In another embodiment, the fluid media M can be matching index fluid such as a silicone polymer. The electrodes surfaces can be any type of conductive material, and in one embodiment is a thin film layer gold, platinum, tantalum or the like.
The use of an electrical charge to cause flows in a microchannel or nanochannel is known in the art, and for example is described in the following materials which Fluid vision accommodating iol powervision tv live incorporated herein by this reference: Now turning to FIG. The coil is tuned with respect to
Fluid vision accommodating iol powervision tv live first selected frequency from a remote external radiofrequency source shown schematically in FIG.
Thus, electromagnetic energy indicated by waves or electromagnetic field emf in FIG. In one embodiment, the second haptic b carries another coil that is tuned to a second selected frequency, with the positive and negative electrodes reversed with respect to the first and second chambers to cause fluid media M to migrate from the central chamber A to the peripheral chamber B to reverse the curvature change in the optic portion.
It should be appreciated that the coils can be carried in any part of the lens of the Fluid vision accommodating iol powervision tv live just the haptics. The circuitry can also carry at least one capacitor for transient energy storage, to assist the physician in the operation of altering the power of the lens.
Another way of describing the deformable wall is that the anterior lens curvature ac and coincident surface A have non-concentric radii—and in some preferred embodiments the coincident surface A has a non-singular radius and consists of projecting portions thereby defining a plurality of radii.
By way of illustration, FIG. It can understood that addition of fluid media M to the central chamber portion A will tend to displace, flex, deform or stretch the thinner central wall portion to a greater extent than the radially outward region indicated at In one embodiment, referring to FIGS.
Fluid vision accommodating iol powervision tv live shape structures a and b are adapted to contact one another and move relative to one another very slightly to amplify or control the displacement of wall portion when fluid media M migrates into the space or chamber portion A.
It can be understood that the shaped structure of the coincident surfaces A and B can define a plurality of projecting portions in the form of annular elements, or alternatively a plurality of spaced apart surface relief elements.
The further advantage of the lens design of FIGS. The more Fluid vision accommodating iol powervision tv live connection between the lens portions that carry anterior and posterior surfaces allows for adjustment to known precise dimensions and therefore optical parameters.
In these embodiments, the lens system preferably uses an index-matching fluid. Such a would be useful for treating astigmatisms.
Each chamber portion a - n communicates through a microporous structure collectively with a peripheral chamber portion a - n so that the system operates as described previously. Preferably, the deformable
Fluid vision accommodating iol powervision tv live wall and the Fluid vision accommodating iol powervision tv live surfaces A and b carry interior surface relief structures Fluid vision accommodating iol powervision tv live described previously.
The fluid flow Fluid vision accommodating iol powervision tv live can be as described previously; however, FIGS. In this embodiment, the microporous structure is fabricated of a hydrogel material that is adapted to open and close its porosities based on a very slight change in temperature of the hydrogel. At the same time, the light beam is localized to overlap and impinge upon the targeted space, for example space awhich elevates the temperature of fluid media M therein and its expansion causes a portion of the fluid to migrate from the center to the peripheral chamber portion.
The light beam can be scanned to treat several chamber segments at once. The illustration of FIG.