Adjustable intraocular lens

Abstract

An accommodative intraocular lens comprises: an optic portion including a visual fluid cavity; and a tactile portion fixed to and extending circumferentially from the optic portion, the tactile portion including a tactile fluid cavity in fluid communication with the visual fluid cavity; wherein the tactile portion is configured to engage with a capsular bag and deform in response to reshaping of the capsular bag due to movement of the ciliary muscle so that fluid moves between the tactile fluid cavity and the visual fluid cavity, thereby changing a visual parameter of the accommodative intraocular lens; wherein the tactile portion comprises a radial inner portion adjacent to the optic portion and a radial outer portion arranged radially further away from the optic portion; wherein the tactile fluid cavity is formed between a radial outer wall of the cavity and a radial inner wall of the cavity; and wherein the radial inner wall of the cavity is not as curved as the radial outer wall of the cavity.

Description

[0001] This application is a divisional application of the invention patent application with the application date of November 8, 2012, the international application number: PCT / US2012 / 064166, the national application number: 201280064328.9, and the name “Adjustable artificial lens and method of use”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims the benefit of U.S. Provisional Application No. 61 / 557,237, filed November 8, 2011, which is hereby incorporated by reference.

[0004] Incorporated by Reference

[0005] All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference. Background Art

[0006] The lens is a transparent biconvex structure in the eye that, together with the cornea, helps refract light to focus on the retina. The lens performs the function of changing the focal length of the eye by changing its shape, allowing it to focus on objects at various distances. Adjustment of the lens is known as accommodation. The lens capsule is a smooth, transparent membrane that completely surrounds the lens. The lens capsule is elastic and is made of collagen. The lens is flexible and its curvature is controlled by the ciliary muscles via the zonules, which connect the ciliary muscles to the equatorial region of the capsule. At shorter focal lengths, the ciliary muscles contract, the zonules relax, and the lens thickens, producing a rounder shape and therefore a high refractive power. Changing the focal length for objects at longer distances requires the ciliary muscles to relax, which increases the tension of the zonules, flattens the lens and therefore increases the focal length.

[0007] For a variety of reasons, the lens may be removed and replaced with an artificial lens, often called an intraocular lens. Some intraocular lenses are used to replace cataractous lenses, where stains develop in the lens of the eye, blocking the passage of light. Intraocular lenses are characterized as either non-accommodative or accommodative. Accommodative intraocular lenses are designed to function similarly to the original lens and are adapted to change the refractive power to provide near and distance vision.

[0008] The original lens is typically removed through a procedure called extracapsular extraction. This procedure involves performing a capsulotomy, making a circular incision in the front of the capsule, and then removing the lens material. A replacement artificial lens is then placed into the capsule through the opening created by the circular incision.

[0009] As described in detail in U.S. Application No. 12 / 685,531, filed January 11, 2010, to which this application claims priority, the size of the capsular bag varies from patient to patient, no well-established technique exists to measure the size of the capsular bag, and post-implantation changes may occur in the eye or in an accommodating intraocular lens. After implantation of an intraocular lens in an eye, it would be desirable for the base state or base power (also referred to herein as the "set point") of the accommodating intraocular lens to be more predictable and also to accommodate in response to movement of the ciliary muscle. Summary of the invention

[0010] One aspect of the present invention provides an adjustable intraocular lens, comprising: an optical portion including a visual fluid cavity; and a tactile portion fixed to the optical portion and extending peripherally from the optical portion, the tactile portion including a tactile fluid cavity in fluid communication with the visual fluid cavity through a plurality of fluid grooves, wherein the tactile portion is adapted to engage with the capsular bag and deform in response to reshaping of the capsule due to movement of the ciliary muscle so that fluid moves between the tactile fluid cavity and the visual fluid cavity, thereby changing the visual parameters of the adjustable intraocular lens.

[0011] In some embodiments, the haptic is secured to the optic at a position extending less than 180 degrees around the periphery of the optic. The haptic is securable to the optic at a position extending less than 90 degrees around the periphery of the optic. The haptic is securable to the optic at a position extending about 45 degrees or less around the periphery of the optic.

[0012] In some embodiments, the optic portion includes a buttress portion having a plurality of grooves formed therein.The haptic portion can include a buttress opening in fluid communication with the haptic fluid cavity, wherein the buttress opening is sized and configured to receive the buttress portion therein.

[0013] One aspect of the present invention provides an adjustable intraocular lens, comprising: a visual portion, comprising a visual fluid cavity; and a peripheral non-visual portion, having a peripheral fluid cavity in fluid communication with the visual fluid cavity, wherein the peripheral non-visual portion is adapted to engage with the capsular bag and deform in response to reshaping of the capsule due to movement of the ciliary muscle so that the fluid moves between the peripheral fluid cavity and the visual fluid cavity, thereby changing the visual parameters of the adjustable intraocular lens, wherein, in a cross-section of the peripheral non-visual portion in a plane extending in the anterior-posterior direction, the radially inner body portion of the peripheral portion has a thickness of approximately half the width of the peripheral portion.

[0014] In some embodiments, the radially inner body portion has a thickness at least twice as great as a thickness of a radially outer body portion of the peripheral portion.The radially inner body portion can have a thickness at least three times as great as a thickness of a radially outer body portion of the peripheral portion.

[0015] In some embodiments, in the cross-section, the fluid cavity structure is substantially D-shaped.

[0016] One aspect of the present invention provides an adjustable intraocular lens, comprising: a visual portion, comprising a visual fluid cavity; and a peripheral non-visual portion, having a peripheral fluid cavity connected to the visual fluid cavity fluid, wherein the peripheral non-visual portion is suitable for engaging with a capsular bag and deforming in response to the reshaping of the capsule due to the movement of the ciliary muscle so that the fluid moves between the peripheral fluid cavity and the visual fluid cavity, thereby changing the visual parameters of the adjustable intraocular lens, wherein, in the area of ​​the peripheral non-visual portion suitable for engaging with the capsular bag, the peripheral portion has a first cross-section and a second cross-section, the first cross-section is in a plane extending in the front-to-back direction, and the outer surface of the tactile portion in the plane has a first structure, and the second cross-section is in a plane extending in the front-to-back direction, and the outer surface of the tactile portion in the plane has a second structure different from the first structure.

[0017] In some embodiments, the first cross-section has an outer surface that has a generally elliptical configuration.

[0018] In some embodiments, the first cross-section has an outer surface that has a generally D-shaped structure.

[0019] In some embodiments, the first cross-section has an outer surface in which the radially inner portion is more linear than the radially outer portion.

[0020] In some embodiments, in the first cross section, the peripheral fluid cavity has a first fluid cavity structure, and in the second cross section, the peripheral fluid cavity has a second fluid cavity structure that is substantially the same as the first fluid cavity structure. The first fluid cavity structure and the second fluid cavity structure have a radial inner surface that is more linear than a radial outer surface. The first fluid cavity structure and the second fluid cavity structure can be substantially D-shaped.

[0021] In some embodiments, in the first cross-section, the peripheral portion has a radially inner body portion having a thickness greater than the thickness of the radially outer portion. In the first cross-section, the peripheral portion can have a radially inner body portion having a thickness at least twice that of the radially outer portion.

[0022] One aspect of the present invention provides an adjustable intraocular lens, comprising: a visual portion, which includes a visual fluid cavity; and a peripheral non-visual portion, which has a peripheral fluid cavity connected to the visual fluid cavity fluid, wherein the peripheral non-visual portion is suitable for engaging with the capsular bag and deforming in response to the reshaping of the capsule due to the movement of the ciliary muscle to allow the fluid to move between the peripheral fluid cavity and the visual fluid cavity, thereby changing the visual parameters of the adjustable intraocular lens, wherein, in a cross-section of the peripheral non-visual portion that is within a plane extending in the anterior-posterior direction, the peripheral fluid cavity is roughly arranged as a whole in the radially outer part of the peripheral portion. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] Figure 1A and Figure 1B An example accommodating intraocular lens is shown;

[0024] Figure 1C Show Figure 1A and Figure 1B Cross-sectional view of an accommodative intraocular lens;

[0025] Figure 1D is a top view of an example posterior member of an accommodating intraocular lens;

[0026] Figure 1E is a cross-sectional assembly diagram of an example visual portion of an accommodating intraocular lens;

[0027] Figure 1F and Figure 1G showing an example haptic;

[0028] Figure 1H shows an example connection between the optic and the haptics;

[0029] Figure 2A-2C showing an example haptic;

[0030] Figure 2D-2F Show Figure 2A A cross-sectional view of the tactile part;

[0031] Figure 2G Show Figure 2A-2C an opening in a first end of the haptic;

[0032] Figure 3 Example diameters of accommodative intraocular lenses are shown;

[0033] Figure 4 showing an example haptic;

[0034] Figure 5A and Figure 5B illustrating deformation of an example haptic in response to an example force;

[0035] Figure 6 showing example fluid openings in an example haptic;

[0036] Figure 7 showing example fluid openings in an example haptic;

[0037] Figure 8 showing a cross-sectional view of an example accommodating intraocular lens;

[0038] Fig. 9 A cross-sectional view of an example accommodating intraocular lens having relatively short haptics is shown. DETAILED DESCRIPTION

[0039] The present invention generally relates to accommodative intraocular lenses. In some embodiments, the accommodative intraocular lenses described herein are adapted to be located within a pre-existing capsular bag from which the pre-existing lens was removed. In these embodiments, the peripheral non-optic portion (i.e., the portion that is not particularly adapted to focus light on the retina) is adapted to respond to the reshaping of the capsular bag due to relaxation and contraction of the ciliary muscle. The response is a deformation of the peripheral portion that causes fluid to move between the peripheral portion and the optic portion to change the visual parameters (e.g., power) of the intraocular lens.

[0040] The peripheral portion of the accommodative intraocular lens described herein is adjusted so that at least a portion of the peripheral portion is less responsive or less sensitive to certain types of capsular forces compared to other types of capsular forces. Less responsive or less sensitive as used herein generally means that the visual ability of the accommodative intraocular lens changes less in response to certain types of forces, and the peripheral portion is less sensitive to these types of forces compared to other types of forces. In general, the peripheral portion is adapted to respond less to forces in the anterior-posterior direction compared to radial forces. In some instances, the forces in the anterior-posterior direction are capsular forces that are not associated with the ciliary muscle, such as forces caused by a size mismatch between the capsular bag and the intraocular lens, or forces caused by a healing response of the capsular bag. The radial forces described herein are capsule reshaping forces and capsular forces caused by contraction and relaxation of the ciliary muscle, which cause the adjustment of the accommodative intraocular lens. Therefore, compared to the forces in the anterior-posterior direction, the accommodative intraocular lens of this article is considered to be more sensitive to radial forces, and therefore, compared to the forces in the anterior-posterior direction, the visual ability of the accommodative intraocular lens will change more in response to radial forces.

[0041] One advantage of the peripheral portion described herein is that it reshapes the capsule by substantially "supporting" the capsule from opening in a predictable manner, while still maintaining the radial sensitivity of the peripheral portion to radial forces to allow the accommodative lens to be accommodative. Because the peripheral portion is adapted to reshape the capsule in a more predictable manner in at least one direction, variations in the basic state of the accommodative intraocular lens due to one or more anatomical differences in capsule size, inaccurate capsule measurements, or changes in the capsule after implantation can be reduced. In some embodiments, the peripheral portion is adapted to reshape the capsule in a more predictable manner because it becomes stiffer in at least one direction. For example, in some embodiments, the peripheral portion is stiffer in the anterior-posterior direction than in the radial direction. In some embodiments, the peripheral portion is adapted to support the opening of the capsule in the anterior-posterior direction.

[0042] As used herein, "anteroposterior" or its derivatives are not limited to directions that are completely parallel to the visual axis, but should be understood as directions that are typically referred to as the anterior-posterior direction. For example and without limitation, the "anteroposterior" direction includes a direction or axis that is at a 10 degree angle to the visual axis of an accommodating intraocular lens. The "radial" forces described herein should not be considered to be in the anterior-posterior direction.

[0043] Figure 1A 1 is a top view showing an accommodating intraocular lens 10, which includes an optic portion 12 and a peripheral portion, which in this embodiment includes a first haptic and a second haptic 14 coupled to and extending circumferentially from the optic portion 12. The optic portion 12 is adapted to refract light entering the eye onto the retina. The haptic 14 is configured to engage the capsular bag and is adapted to deform in response to the ciliary muscle associated with capsular bag reshaping. Figure 1B is a perspective view of intraocular lens 10 showing optic 12 and haptics 14 coupled to optic 12 .

[0044] The tactile portions are in fluid communication with the optic portion. Each tactile portion has a fluid cavity that is in fluid communication with the optic cavity in the optic portion. The tactile portions are formed of a deformable material and are adapted to engage with the capsular bag and deform in response to the ciliary muscle associated with capsular bag reshaping. When the tactile portions are deformed, the volume of the tactile fluid cavity changes, causing the fluid disposed in the tactile fluid cavity and the optic fluid cavity to either move from the tactile fluid cavity into the optic fluid cavity or from the optic fluid cavity into the tactile fluid cavity. When the volume of the tactile fluid cavity decreases, the fluid moves into the optic fluid cavity. When the volume of the tactile fluid cavity increases, the fluid moves from the optic fluid cavity into the tactile fluid cavity. The flow of fluid flowing in and out of the optic fluid cavity changes the structure of the optic portion and the capabilities of the intraocular lens.

[0045] Figure 1C is along Figure 1AThe optic portion 12 includes a deformable front member 18 mounted on a deformable rear member 20. Each haptic 14 includes a fluid chamber 22 that is in fluid communication with a visual fluid chamber 24 in the optic portion 12. Figure 1C In the cross-sectional view of FIG, only the haptic portion 14 on the left side of the figure is shown to be connected to the visual portion 12 (although somewhat unclear). The haptic fluid cavity 22 on the left side of the figure is shown to be in fluid communication with the visual fluid cavity 24 via two holes 26, and the two holes 26 are formed in the rear member 20. Figure 1C The center right haptic 14 is in fluid communication with the optic cavity 24 via two other apertures (not shown) also formed in the posterior member at approximately 180 degree angles to the apertures shown.

[0046] Figure 1D 3 is a top view of the rear member 20 (the front member 18 and the tactile portion 14 are not shown). The rear member 20 includes an arch portion 29 in which a groove 32 is formed. The groove 32 provides fluid communication between the visual portion 12 and the tactile portion 14. The hole 26 is arranged at one end of the groove 32. Therefore, the visual fluid cavity 24 is connected to the single tactile portion fluid via two fluid grooves. The construction and size of the arch portion 29 are suitable for being arranged in an opening formed in the tactile portion 14, which defines one end of the tactile fluid cavity, as described below. Each arch portion 29 includes two grooves formed therein. The first groove in the first arch is aligned with the first groove in the second arch. The second groove in the first arch is aligned with the second groove in the second arch.

[0047] Compared with having one groove, having two grooves in each buttress has advantages. Designs with two grooves instead of one groove help maintain dimensional stability during assembly, which may be very important when assembling flexible and thinner components. In addition, it has been experimentally observed that some designs with one groove cannot provide sufficient visual quality over the entire range of adjustment. Specifically, lens astigmatism is observed in some designs with one groove, especially when the intraocular lens is adjusted. It is found that the two groove buttress designs described herein reduce astigmatism, especially when the lens is adjusted. Astigmatism in these embodiments is reduced due to the ribs between the two grooves increasing the hardness of the buttress. The additional hardness results in less deflection caused by pressure changes in the grooves. Less deflection caused by pressure changes in the grooves results in less astigmatism. In some embodiments, the groove diameter is between about 0.4mm and about 0.6mm. In some embodiments, the groove diameter is about 0.5mm. In some embodiments, the distance between the holes is about 0.1mm to about 1.0mm.

[0048] Figure 1E1 is a side assembly view of the visual portion 12 along section AA, which includes the front member 18 and the rear member 20 (the tactile portion is not shown for clarity). Since the fluid groove 32 is included in the rear member 20, the rear member 20 needs to have sufficient structure through which the groove 32 can be formed. The buttress portion 29 provides a structure in which the groove 32 can be formed. At its outermost peripheral portion, the rear member 20 is higher than the front member 18 in the front-to-back direction. In alternative embodiments, the groove can be formed in the front member 18 instead of the rear member 20. The front member will include the buttress portion 29 or other similar structure to provide a structure in which the groove can be formed. In these alternative embodiments, the rear member can be formed similarly to the front member 18.

[0049] like Figure 1E As shown, the rear member 20 is fixed to the front member 18 at the peripheral surface 28, and the peripheral surface 28 extends around the periphery of the rear member 20 and is a flat surface. Known biocompatible adhesives can be used to fix the members 18 and 20 together. It is also possible to use a material to form the front member 18 and the rear member 20 to eliminate the need to fix the two members together. In some embodiments, the diameter of the area where the front member 18 and the rear member 20 are fixed to each other is about 5.4mm to about 6mm.

[0050] In some embodiments, the thickness of the anterior member 18 (measured in the anterior-posterior direction) is along the visual axis ( Figure 1C In some embodiments, the thickness increases continuously from the periphery to the thickest portion along the visual axis.

[0051] In some embodiments, the thickness of the posterior member 20 increases from a position along the visual axis to Figure 1C The edges of the central area marked by "CR" decrease. Figure 1C As can be seen in FIG. 3 , the thickness increases again radially outwards toward the periphery in the central region CR. In some specific embodiments, the diameter of the central region CR is about 3.75 mm. A hole is formed in the inclined surface 30 .

[0052] In some embodiments, the thickness of the posterior member 20 along the visual axis is between about 0.45 mm and about 0.55 mm, and the thickness at the periphery of the posterior member 20 is between about 1.0 mm and about 1.3.

[0053] In some embodiments, the thickness of the posterior member 20 along the visual axis is about 0.5 mm, and the thickness at the periphery of the posterior member 20 is about 1.14 mm.

[0054] In some embodiments, the thickness of the front member 18 along the visual axis is between about 0.45 mm and about 0.55 mm, and in some embodiments, between about 0.50 mm and about 0.52 mm. In some embodiments, the thickness of the front member 18 at the periphery is between about 0.15 mm and about 0.4 mm, and in some embodiments, between about 0.19 mm and about 0.38 mm.

[0055] In one specific embodiment, the thickness of the anterior member 18 along the visual axis is about 0.52 mm and the thickness of the anterior member 18 periphery is about 0.38 mm, and the thickness of the posterior member 20 along the visual axis is about 0.5 mm and the thickness of the posterior member 20 periphery is about 1.14 mm.

[0056] In one specific embodiment, the thickness of the anterior member 18 along the visual axis is about 0.5 mm, and the thickness at the periphery of the anterior member 18 is about 0.3 mm, and the thickness of the posterior member 20 along the visual axis is about 0.5 mm, and the thickness at the periphery of the posterior member 20 is about 1.14 mm.

[0057] In one specific embodiment, the thickness of the anterior member 18 along the visual axis is about 0.51 mm, and the thickness at the periphery of the anterior member 18 is about 0.24 mm, and the thickness of the posterior member 20 along the visual axis is about 0.5 mm, and the thickness at the periphery of the posterior member 20 is about 1.14 mm.

[0058] In one specific embodiment, the thickness of the anterior member 18 along the visual axis is about 0.52 mm, and the thickness at the periphery of the anterior member 18 is about 0.19 mm, and the thickness of the posterior member 20 along the visual axis is about 0.5 mm, and the thickness at the periphery of the posterior member 20 is about 1.14 mm.

[0059] The optic portion is adapted to maintain visual quality throughout the entire process of accommodation. This ensures that the optic portion maintains visual quality when the accommodating intraocular lens is switched between the non-accommodating configuration and the accommodating configuration. Many factors contribute to this beneficial feature of the accommodating intraocular lens of the present invention. These factors include the peripheral area where the anterior member 18 is attached to the posterior member 20, the shape profile of the anterior member 18 and the posterior member 20 within the central area CR of the optic portion (see Figure 1C ), and the thickness profiles of the front member 18 and the rear member 20. These contributing factors ensure that the front member and the rear member are curved in a manner to maintain the shape required to maintain visual quality throughout the range of visual ability.

[0060] Figure 1FOne haptic 14 of an intraocular lens 10 is shown (the optic 12 and second haptic are not shown for clarity). The haptic 14 includes a radially outer portion 13 adapted to face the direction of the zonules, and a radially inner portion 11 facing the periphery of the optic (not shown). The haptic 14 includes a first end region 17 fixed to the optic 12, and a second end region 19 that is closed. At the first end region 17, the haptic 14 also includes an opening 15 that provides fluid communication with the haptic. In this embodiment, the size and structure of the opening 15 are adapted to receive the buttress portion 29 of the optic 12 therein.

[0061] Figure 1G is a close up view of opening 15 in haptic 14 adapted to receive buttress portion 29 therein. Opening 15 has curved surfaces 33 and 35 shaped to mate with the curved surfaces on optic buttress 29. Surface 31 surrounds opening 15 and provides a surface to which a corresponding surface of the optic can be secured.

[0062] Figure 1H 1 is a top view of a buttress portion 29 (shown in phantom) from a posterior member 20 (the anterior member of the optic portion is not shown for clarity) disposed in an opening 15 of a haptic portion 14. A groove 32 is shown in phantom. The haptic portion 14 includes a fluid cavity 22 defined by an inner surface 21. When the haptic portion 14 is deformed, fluid moves between the optic fluid cavity and the tactile fluid cavity 22 through the groove 32.

[0063] Figure 2A yes Figure 1A-1H 1. A top view of one haptic 14 is shown in FIG. The optic and the second haptic are not shown. Four sections AD through the haptic are marked. Figure 2B A side view of haptic 14 is shown, showing opening 15 and closed end 19 . Figure 2C is a side view of the haptic 14 showing the radially outer portion 13 and the closed end 19 .

[0064] Figure 2D is along Figure 2A The cross-sectional view is taken along the section AA shown in FIG. Figure 2AOf the four cross-sections shown, cross-section AA is the cross-section closest to the closed end 19. The radially inner portion 11 and the radially outer portion 13 are marked. The fluid groove 22 defined by the surface 21 is also shown. In this cross-section, the radially inner portion 40 is radially thicker than the radially outer portion 42 (in the "T" direction). The inner portion 40 provides hardness of the haptic in the anterior-posterior direction to reshape the capsule more predictably in the anterior-posterior direction. The radially inner portion 40 has a maximum thickness dimension 41, which is along the axis of symmetry in this cross-section. The outer surface of the haptic 14 generally has an elliptical configuration, in which the maximum height dimension in the anterior-posterior direction ("AP") is greater than the maximum thickness dimension (measured in the "T" direction). The fluid cavity 22 has an overall D-shaped configuration, in which the radially inner wall 43 is not as curved as the radially outer wall 45 (but is not completely linear). The radially outer portion 42 engages with the capsule bag to which the zonules are attached, while the thicker radially inner portion 40 is arranged adjacent to the optic portion.

[0065] Figure 2E Graphics Figure 2A The cross section BB is shown. The cross section BB is substantially the same as the cross section AA, and Figure 2E Example dimensions for two cross sections are provided. The radially inner portion 40 has a maximum thickness along the midline (in the radial direction "T") of approximately 0.75 mm. The radially outer portion 42 has a thickness along the midline of approximately 0.24 mm. The fluid cavity 22 has a thickness of approximately 0.88 mm. The tactile portion 14 has a thickness along the midline of approximately 1.87 mm. The height of the tactile portion in the anterior-posterior dimension is approximately 2.97 mm. The height of the fluid cavity is approximately 2.60 mm. In this embodiment, the thickness of the radially inner portion 40 is approximately 3 times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is approximately 2 times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is approximately 2 times to approximately 3 times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is approximately 1 times to approximately 2 times the thickness of the radially outer portion 42.

[0066] Fluid cavity 22 is disposed in the radially outer portion of haptic 14. In this cross section, substantially the entire radially inner region of haptic 14 is bulk material. Since fluid cavity 22 is defined by surfaces 43 and 45 (see Figure 2D ), the position and size of the fluid cavity 22 depends on the thickness of the radial inner portion 40 and the radial outer portion 42.

[0067] Figure 2F Graphics Figure 2A. In section CC, the radial inner portion 40 is not as thick as the radial inner portion 40 in sections AA and BB, but in section CC, the radial inner portion 40 is slightly thicker than the radial outer portion 42. In this particular embodiment, the radial inner portion 40 in section CC is about 0.32 mm. The thickness of the radial outer portion 42 is about the same as the radial outer thickness in sections AA and BB, about 0.24 mm. The outer surface of the tactile portion 14 does not have the same structure as the outer surface in sections AA and BB. In section CC, the radial inner and outer surfaces of the tactile portion 51 are more linear than in sections AA and BB, giving the outer surface of the tactile portion in section CC an overall D-shape. In section CC, the fluid cavity 22 has an overall D-shape, the same as in sections AA and BB. The fluid cavity structure of the tactile portion in section CC is substantially the same as the fluid cavity structure in sections AA and BB, but has an outer surface structure that is different from the outer surface structure of the tactile portion 14 in sections AA and BB.

[0068] The thinner radial inner portion 40 in section CC also produces Figure 1A 23. The spacing between the optic 12 and the haptic 14 allows the physician to insert one or more irrigation and / or suction devices into the gap 23 during surgery and to perform suction to remove the viscoelastic fluid used to deliver the intraocular lens into the eye. The path 23 may also be anywhere along the length of the haptic, and there may be more than one path 23. The contents of Figures 23 and 24 of U.S. Publication No. 2008 / 0306588 and the original description thereof are incorporated herein by reference, including multiple paths in the haptic.

[0069] Figure 2G Shown by Figure 2A A view taken in mid section DD. The haptic 14 includes an opening 15 therein adapted to receive an buttress from the optic as described herein. In this embodiment, the height of the opening 15 is approximately 0.92 mm. The width or thickness of the opening is approximately 2.12 mm.

[0070] Figure 3 The relative diameters of the optic 12 (not shown) and the peripheral portion are shown, the peripheral portion including two haptics 14 (only one haptic is shown). In this embodiment, the optic has a diameter of about 6.1 cm, while the entire accommodating intraocular lens including the peripheral portion has a diameter of about 9.95 cm. The dimensions provided are not strictly limited.

[0071] Figure 46 is a top view of haptic 14 showing haptic 14 subtending an angle of about 175 degrees (i.e., approximately 180 degrees) surrounding the optic. For clarity, the optic is not shown. Thus, the two haptics each subtend an angle of about 180 degrees around the optic. A first region 61 of haptic 14 is shown as subtending an example angle of about 118 degrees. This is the radially outermost portion of haptic 14, adapted to engage the capsular bag, and adapted to be most responsive to changes in the shape of the capsular bag. Region 61 may be used as the most responsive portion of haptic 14.

[0072] The angle between sections AA and BB is considered to be the boundary of the stiffer radially inner portion of the haptic, which angle is about 40 degrees. The stiffer radially inner portion of the haptic 14 is located directly adjacent to the periphery of the optic. The dimensions and angles provided are not strictly limited.

[0073] Figure 5A and Figure 5B The illustration shows a portion of an accommodating intraocular lens 10 located in a capsular bag ("CB") after the original lens has been removed from the CB. In each figure, the anterior direction is the top and the posterior direction is the bottom. Figure 5B High capacity or adjustable structure shown, Figure 5A A lower power accommodating intraocular lens, or non-accommodating configuration, is shown.

[0074] The elastic capsule "CB" is connected to the zonules "Z", which are connected to the ciliary muscles "CM". When the ciliary muscles relax, such as Figure 5A As shown, the zonules are stretched. This stretching is caused by a radially outward force "R" pulling the capsular bag in a generally radially outward direction due to the generally equatorial connection between the capsular bag and the zonules. The stretching of the zonules causes an overall elongation and thinning of the capsular bag. While the original lens remains in the capsular bag, it becomes flattened (in the anterior-posterior direction) and taller in the radial direction, which causes the lens to have a lower power. As shown in FIG. Figure 5A The relaxation of the ciliary muscle shown provides distance vision. However, when the ciliary muscle contracts as the eye attempts to focus on a near object, the radially inner portion of the muscle moves radially inward, causing the zonules to relax. This is caused by Figure 5B . Relaxation of the zonules allows the capsular bag to move toward a generally more curved configuration in which the anterior surface has a greater curvature than in a non-accommodative configuration, providing increased power and allowing the eye to focus on near objects. This configuration is generally referred to as "accommodative," and the lens has an "accommodative" configuration.

[0075] exist Figure 5A and Figure 5BIn section AA of the haptic 14 shown in (which is the same as section BB), the radially inner portion 40 includes a thicker bulk material that provides stiffness to the haptic 14 in the anterior-posterior direction. When capsular bag forces are applied to the haptic in the anterior-posterior direction, the inner portion 40 deforms in a more repeatable and predictable manner due to its stiffness, making the basic state of the lens more predictable. In addition, the haptic causes the capsule to deform in a repeatable manner in the anterior-posterior direction due to its stiffer inner portion. In addition, because the haptic has less flexibility along the length of the haptic, and bending along the length of the haptic is one way that fluid can move into the optic portion (and therefore change the ability of the lens), the basic state of the accommodative intraocular lens is more predictable. An additional advantage achieved by the stiffer inner portion is that the haptic is stiffer relative to other forces such as rotational forces and tilting forces due to the additional amount of inner portion.

[0076] The radially outer portion 42 is the portion of the haptic that directly engages a portion of the capsular bag that is connected to the zonules. The haptic outer portion 42 is adapted to respond to the capsule reshaping force "R", which is a force applied generally in the radial direction when the zonules relax and are stretched. This allows the haptic to deform in response to ciliary muscle related forces (i.e., capsule contraction and relaxation) so that fluid flows between the haptic and the optic portion in response to the relaxation and contraction of the ciliary muscles. This is Figure 5B When the ciliary muscle contracts ( Figure 5B ), the peripheral area of ​​the elastic capsule reshapes and applies a radially inward force "R" to the radially outer portion 42 of the haptic portion 14. The radially outer portion 42 is adapted to deform in response to the reshaping of the capsule. The deformation reduces the volume of the fluid groove 22, which forces the fluid from the haptic cavity 22 into the optic cavity 24. This increases the fluid pressure in the optic cavity 42. The increase in fluid pressure causes the flexible anterior member 18 and the flexible posterior member 20 to deform, increase the curvature and thus increase the capacity of the intraocular lens.

[0077] The haptic is adapted to be harder in the anterior-posterior direction than in the radial direction. In this embodiment, the radial outer portion 42 of the haptic 14 is more flexible (i.e., less hardness) in the anterior-posterior direction than the radially harder inner portion 40. This is due to the relative thickness of the outer portion 42 and the inner portion 40. The haptic is therefore adapted to deform less in response to an anteroposterior force than in a radial force. This also causes less fluid to move from the haptic into the optic in response to an anteroposterior force than in response to a radial force. The haptic also deforms in a more predictable and repeatable manner due to its harder radial inner portion.

[0078] Thus, the peripheral portion is more sensitive to reshaping of the bladder in the radial direction than to reshaping of the bladder in the anterior-posterior direction. The haptic is adapted to deform to a greater extent in the radial direction than in the anterior-posterior direction. Thus, the present invention includes a peripheral portion that is less sensitive to bladder forces along a first axis and more sensitive to forces along a second axis. In the above example, the peripheral portion is less sensitive along the anterior-posterior axis and more sensitive along the radial axis.

[0079] An exemplary advantage of the peripheral portions described above is that they deform the bladder in a repeatable manner during adjustment and still maintain a high degree of sensitivity to radial forces. The peripheral portions described above are stiffer in the anterior-posterior direction than in the radial direction.

[0080] Another example of capsular forces in the anterior-posterior direction is the capsular forces on the peripheral portion of the accommodating intraocular lens after it is in the capsular bag and after the capsular bag as a whole undergoes a healing response. The healing response typically causes contractile forces on the haptics in the anterior-posterior direction, Figure 5A 11, 2010, which is hereby incorporated by reference. For example, the capsular bag size varies somewhat from patient to patient, as is also described in detail in U.S. Application No. 12 / 685,531, filed on January 11, 2010. When the intraocular lens is located within the capsular bag, the difference in size between the capsule and the intraocular lens can produce forces applied to one or more portions of the intraocular lens in the anterior-posterior direction.

[0081] In instances where the capsule healing force is in the anterior-posterior direction, the force can deform the deformable haptic portion before any accommodation occurs. This deformation changes the volume of the haptic fluid cavity, causing fluid to flow between the optic fluid cavity and the haptic fluid cavity. In some instances, these undesirably change the basic capabilities of the lens. For example, as the capsule heals, fluid can be forced into the optic portion, increasing the capacity of the accommodating intraocular lens and producing permanent myopic changes to the accommodating intraocular lens. Fluid can also be forced out of the optic portion and into the haptic portion, reducing the capacity of the accommodating intraocular lens.

[0082] As used herein, "radial" need not be precisely defined as being orthogonal to the anterior-posterior plane, but rather includes planes that are at a 45 degree angle to the anterior-posterior plane.

[0083] Exemplary fluids are described in U.S. Application Nos. 12 / 685,531, filed January 11, 2010, and 13 / 033,474, filed February 23, 2011, which are incorporated herein by reference. For example, the fluid may be silicone oil that may or may not be index matched to the polymeric material of the anterior and posterior members. When a fluid that is index matched to the bulk material of the optic portion is used, the entire optic portion acts as a single lens with its outer curvature changing as the pressure of the fluid in the optic portion increases and decreases.

[0084] In the above Figure 2A-2G In an embodiment of the present invention, the haptic is a deformable polymeric material having a substantially uniform composition in sections AA, BB, and CC. The harder radially inner body portion 40 is due to its thickness. In alternative embodiments, the radially inner body portion has a different composition than the outer body portion, wherein the radially inner body portion material is harder than the radially outer body portion material. In these alternative embodiments, the thickness of the radially inner and outer portions can be the same.

[0085] Figure 6 The tactile part 50 is shown in the figure. Figure 2B The haptic structures shown are identical. The radially outer portion 54 is indicated. The haptic has an axis AA passing through half the height of the haptic. The opening 52 in which the optic buttress is arranged is on the rear side of the axis A. In this embodiment, the optic is located slightly closer to the rearmost portion of the haptic than to the frontmost portion of the haptic.

[0086] Figure 7 An alternative haptic 60 is shown (without the optic portion shown) wherein a radially outer portion 64 is indicated. The haptic 60 includes an axis AA passing through half of the thickness of the haptic. The opening 62 is symmetrical about the axis A. Furthermore, the axis AA is the axis of symmetry of the haptic 60. The symmetry of the haptic along the axis A can enhance the ability to mold components with relatively low stresses. Figure 8 An embodiment of an intraocular lens 70 is shown in which the optic 72 is coupled to two haptics 60, which are Figure 7 1. In this embodiment, the optic is located in a more forward direction, where the opening is not along the midline of the haptic. The cross sections AA, BB, and CC of the haptic 60 are the same as those shown in the other embodiments described above.

[0087] Fig. 9An intraocular lens 80 is shown that includes an optic 82 and two haptics 84. The optic is the same as the optic described herein. The haptics 84, measured in the anterior-posterior direction, are not as tall as haptics 60, haptics 50, or haptics 14. In an exemplary embodiment, the height of haptics 84 is between about 2.0 mm and about 3.5 mm, and in some embodiments, they are about 2.8 mm high. Intraocular lens 80 can be considered a "small" sized accommodative intraocular lens for patients with capsular bags below a certain threshold size. The posterior surface of posterior member 86 is arranged in a slightly more posterior direction than the rearmost portion 90 of haptics 84.

[0088] Features of the intraocular lenses described herein can be similarly applied to non-fluid-actuated accommodative intraocular lenses. For example, a non-accommodating intraocular lens can include a peripheral portion having a first harder region that provides an area of ​​the peripheral portion that is insensitive in a first direction. For example, in an intraocular lens having two lenses adapted to move away from each other to change the power of the lenses, the peripheral portions of the lenses can be adjusted so that a first type of capsule reshaping does not cause a change in the distance between the lenses and, therefore, keeps the power of the intraocular lens the same.

[0089] In addition, the accommodative intraocular lens of the present invention can also be adapted to be located outside of the original capsular bag. For example, after the original lens has been removed or when the original lens is still in the capsular bag, the accommodative intraocular lens can be adapted to be located in front of or in front of the capsular bag, wherein the peripheral portion of the lens is adapted to respond directly to the ciliary muscle rather than relying on reshaping of the capsule.

Claims

1. An adjustable intraocular lens, comprising: an optic portion, which includes an optic fluid cavity; as well as a haptic secured to and extending circumferentially from the optic, the haptic comprising a haptic fluid cavity in fluid communication with the optic fluid cavity; wherein the haptic is configured to engage the capsular bag and deform in response to reshaping of the capsular bag due to movement of the ciliary muscle to move fluid between the haptic fluid chamber and the optic fluid chamber to change a visual parameter of the accommodative intraocular lens; wherein the tactile portion includes a radially inner portion adjacent to the optic portion and a radially outer portion disposed radially further away from the optic portion, wherein the radially inner portion has a thickness that varies in the front-to-back direction and has a maximum thickness at a middle portion in the front-to-back direction, wherein the radially inner portion is thicker in the radial direction than the radially outer portion; wherein the tactile fluid cavity is formed between a radial outer wall of the cavity and a radial inner wall of the cavity; and Therein, the radial inner wall of the cavity is less curved than the radial outer wall of the cavity.

2. The accommodative intraocular lens according to claim 1, wherein: The cross-sectional profile of the tactile fluid cavity is generally D-shaped along a section of the tactile portion.

3. The accommodative intraocular lens according to claim 1, wherein: The radially outer wall of the cavity is part of the radially outer portion, and the radially inner wall of the cavity is part of the radially inner portion; and wherein, when the cross-section of the tactile portion is observed in a plane extending in the front-to-back direction, the radially inner wall of the cavity is not as curved as the radially outer wall of the cavity.

4. The accommodative intraocular lens according to claim 1, wherein: The haptic is configured to deform more in response to forces in a radial direction than in response to forces in a front-to-back direction.

5. The accommodative intraocular lens according to claim 4, wherein: The haptics are configured such that a greater volume of fluid moves between the haptic fluid cavity and the optic fluid cavity in response to forces acting on the haptics in a radial direction than in response to forces acting on the haptics in an anterior-posterior direction.

6. The accommodative intraocular lens according to claim 1, wherein: The radially inner portion is approximately three times thicker than the radially outer portion.

7. The accommodating intraocular lens according to claim 1, wherein: The radially inner portion is approximately twice as thick as the radially outer portion.

8. The accommodating intraocular lens according to claim 1, wherein: The haptic includes a fluid-enclosed distal end that is not directly attached to the optic.

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