Accommodating intraocular lenses with toric surface

Abstract

To provide toric accommodating intraocular lenses.SOLUTION: In one embodiment, a toric accommodating intraocular lens comprises an anterior element and a posterior element. The anterior element can comprise an anterior optical surface. The posterior element can comprise a posterior optical surface. A fluid-filled optic fluid chamber can be defined between the anterior element and the posterior element. The toric accommodating intraocular lens is used to correct corneal astigmatism, spherical aberration, or a combination thereof.SELECTED DRAWING: Figure 2A

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Application No. 62 / 911,020, filed October 4, 2019, the contents of which are incorporated herein by reference.

[0002] The present disclosure relates generally to the field of intraocular lenses, and more specifically to accommodating intraocular lenses having a toric lens surface. [Background technology]

[0003] Cataracts are a condition in which the normally clear lens in a patient's eye becomes clouded. Cataracts can occur due to causes such as aging, genetics, trauma, inflammation, metabolic abnormalities, or radiation exposure. Age-related cataracts are the most common type of cataract. To treat cataracts, surgeons remove the patient's lens matrix from the lens capsule and replace it with an intraocular lens (IOL). Traditional IOLs provide one or more selected focal lengths to allow the patient to obtain distance vision. However, patients fitted with traditional IOLs often require glasses or corrective eyewear for certain activities after cataract surgery because the patient's eye is no longer able to focus on objects (or change optical power) to maintain a sharp image of the object or to focus on objects at different distances.

[0004] Newer IOLs, such as accommodating IOLs, allow the eye to regain some focusing ability. Accommodating IOLs (AIOLs) use intraocular power to change some part of the optical system to focus on distant or near objects. This is considered dynamic defocus and low order aberrations. Examples of AIOLs are discussed in the following U.S. Patent Application Publication Nos. 2018 / 0256315, 2018 / 0153682, and 2017 / 0049561, the contents of which are incorporated herein by reference, as well as the following U.S. patents: U.S. Pat. No. 10,299,913, U.S. Pat. No. 10,195,020, and U.S. Pat. No. 8,968,396.

[0005] In addition to low-order astigmatism, high-order astigmatism also causes visual disturbances and is commonly corrected with artificial lenses. These astigmatisms can include cylindrical astigmatism and spherical aberration. Cylindrical astigmatism generally occurs naturally in the cornea, and many patients with a history of cataracts have some degree of astigmatism. While toric IOLs have been used to correct astigmatism during cataract surgery, such toric IOLs suffer from the same drawbacks as conventional IOLs, since conventional IOLs cannot accommodate vision.

[0006] Furthermore, a difficulty faced by all toric lens manufacturers is that since the lens has different powers at different meridians, it is extremely important to maintain the cylindrical axis orientation of the lens after implantation. This difficulty becomes even more difficult when attempting to correct astigmatism at the same time as accommodation, or when attempting to correct spherical aberration at the same time as accommodation.

[0007] Therefore, a solution is needed that addresses the above-mentioned shortcomings and disadvantages of conventional and toric IOLs. Such a solution should not be overly complicated and should be cost-effective to manufacture. Summary of the Invention

[0008] Accommodating intraocular lenses for correcting corneal astigmatism and corneal astigmatism and spherical aberration are disclosed. In an embodiment, a toric accommodating intraocular lens is disclosed having an optic with an anterior element and a posterior element. The anterior element may have an anterior optical surface. The posterior element may have a posterior optical surface. An optical fluid chamber filled with fluid may be defined between the anterior element and the posterior element. At least one of the anterior optical surface and the posterior optical surface may be configured such that the radius of curvature of at least one of the anterior optical surface and the posterior optical surface is different along different optical surface meridians.

[0009] In some embodiments, the radius of curvature of the posterior optical surface may vary periodically around the circumference of the posterior optical surface, hi certain embodiments, the radius of curvature varies periodically (e.g., sinusoidally) around the circumference of the posterior optical surface.

[0010] The rear element may further comprise a rear inner surface. The rear inner surface may be a surface of the rear element facing the optical fluid chamber. The rear inner surface may be rotationally symmetric or approximately rotationally symmetric. The rear inner surface may be rotationally symmetric if the radius of curvature of the rear inner surface is the same or approximately the same along all surface meridians.

[0011] The posterior element may further have a posterior element thickness measured from the posterior optical surface to the posterior inner surface. The posterior element thickness may vary periodically around the posterior element such that the posterior element thickness is different along different optical surface meridians. The posterior element thickness may vary sinusoidally around the posterior element.

[0012] In some embodiments, the radius of curvature of the anterior optical surface may vary periodically around the circumference of the anterior optical surface. The radius of curvature of the anterior optical surface may vary periodically around the circumference of the anterior optical surface when the radius of curvature along one optical surface meridian is different from the radius of curvature along another optical surface meridian of the anterior optical surface. In certain embodiments, the radius of curvature varies periodically (e.g., sinusoidally) around the circumference of the anterior optical surface.

[0013] The anterior element may further comprise an anterior inner surface. The anterior inner surface may be a surface of the anterior element facing the optical fluid chamber. In some embodiments, at least a portion of the anterior inner surface and the rear inner surface may act as a chamber wall of the optical fluid chamber. The anterior inner surface may be rotationally symmetric or approximately rotationally symmetric. The anterior inner surface may be rotationally symmetric when the radius of curvature of the anterior inner surface is the same or approximately the same along all surface meridians.

[0014] The anterior element may have an anterior element thickness measured from the anterior optical surface to the anterior inner surface. The anterior element thickness may vary periodically around the anterior element such that the anterior element thickness is different along different optical surface meridians. The anterior element thickness may vary sinusoidally around the anterior element.

[0015] At least one of the anterior and posterior optical surfaces may comprise a flat meridian and a steep meridian oriented generally perpendicular to the flat meridian, the radius of curvature being smallest along the steep meridian and the radius of curvature being largest along the flat meridian.

[0016] The refractive power of an outer optical surface (posterior or anterior surface) of a toric accommodating intraocular lens may be greatest along a steep meridian of the outer optical surface, and the refractive power of the outer optical surface may be least along a flat meridian of the same outer optical surface. The steep meridian and flat meridian may be the principal meridians of the lens. The flat meridian may also be referred to as the cylindrical axis or simply the "axis" of the toric lens.

[0017] For example, the radius of curvature of the posterior optical surface may be smallest along a steep meridian of the posterior optical surface. The radius of curvature of the posterior optical surface may be largest along a flat meridian of the same posterior optical surface. Furthermore, the posterior element thickness may be largest (or thickest) along a flat meridian. The posterior element thickness may be smallest (or thinnest) along a steep meridian.

[0018] Also, for example, the radius of curvature of the anterior optical surface may be smallest along a steep meridian of the anterior optical surface. The radius of curvature of the anterior optical surface may be largest along a flat meridian of the same anterior optical surface. Furthermore, the anterior element thickness may be largest (or thickest) along a flat meridian. The anterior element thickness may be smallest (or thinnest) along a steep meridian.

[0019] The optic may have a base power or a base spherical power. The base power of the optic may change based on fluid pressure inside the fluid-filled optical fluid chamber. The base power of the optic may decrease or increase as fluid enters or leaves the optical fluid chamber. The shape of the optic may change in response to fluid entering or leaving the optical fluid chamber. In certain embodiments, the shape of a front element of the optic may change in response to fluid entering or leaving the optical fluid chamber. In other embodiments, the shape of a rear element of the optic may change in response to fluid entering or leaving the optical fluid chamber. In further embodiments, the shape of both the front and rear elements of the optic may change in response to fluid entering or leaving the optical fluid chamber.

[0020] The base power of the optic may change in response to deformation by the transforming optic (e.g., an anterior element, a posterior element, or a combination thereof). When the toric accommodating intraocular lens is implanted in a patient, the transforming optic deforms in response to physiological muscle movements of the patient (e.g., ciliary muscle movement).

[0021] In some embodiments, the toric accommodating intraocular lens may include one or more haptics connected to and extending from the optic. Each of the one or more haptics may include a haptic fluid chamber within the haptic. As fluid flows from the haptic fluid chamber into the optical fluid chamber, the base power of the optic may increase. As fluid flows or is withdrawn from the optical fluid chamber into the haptic fluid chamber, the base power of the optic may decrease.

[0022] The optical fluid chamber may be in fluid communication or fluidly connected to the haptic fluid chamber. The optical fluid chamber may be in fluid communication with the haptic fluid chamber through a pair of fluid channels. The fluid channels may be conduits or passageways that fluidly connect the optical fluid chamber to the haptic fluid chamber. The pair of fluid channels may be spaced apart from one another. For example, the pair of fluid channels may be spaced apart by about 0.1 mm to about 1.0 mm.

[0023] In some embodiments, the pair of fluid channels may be defined and extend through a portion of the optic. More specifically, the pair of fluid channels may be defined and extend through the posterior element.

[0024] The one or more haptics may be connected to the optic portion at a haptic-optical interface. The one or more haptics may be connected to the optic portion at a reinforcement portion along the optic portion. The reinforcement portion may be part of the haptic-optical interface. The pair of fluid channels may be defined or formed within the reinforcement portion.

[0025] In some embodiments, the toric accommodating intraocular lens may include two haptics connected to and extending from the optic. The first haptic may include a first haptic fluid chamber within the first haptic. The second haptic may include a second haptic fluid chamber within the second haptic. The first haptic may be connected to the optic at a first haptic-optical interface, and the second haptic may be connected to the optic at a second haptic-optical interface.

[0026] In these embodiments, the optical fluid chamber can be in fluid communication with both the first haptic fluid chamber and the second haptic fluid chamber. The optical fluid chamber can be in fluid communication with the first haptic fluid chamber through the first pair of fluid channels. The optical fluid chamber can be in fluid communication with the second haptic fluid chamber through the second pair of fluid channels.

[0027] The first pair of fluid channels may be spaced apart from one another. The first pair of fluid channels may be spaced apart by about 0.1 mm to about 1.0 mm. The second pair of fluid channels may be spaced apart from one another. The second pair of fluid channels may be spaced apart by about 0.1 mm to about 1.0 mm.

[0028] The first pair of fluid channels and the second pair of fluid channels can be defined and extend through a portion of the optic. The first pair of fluid channels and the second pair of fluid channels can be defined and extend through the posterior element.

[0029] The optic may also include a first reinforcement portion and a second reinforcement portion at generally opposing locations on the optic or generally diametrically opposed locations. The pair of first fluid channels may be defined or formed in the first reinforcement portion. The pair of second fluid channels may be defined or formed in the second reinforcement portion.

[0030] The first pair of fluid channels may terminate at a first pair of apertures defined in the optic. The first pair of fluid channels may terminate at a first pair of apertures defined in the posterior element. The first pair of apertures may be spaced apart by about 0.1 mm to about 1.0 mm. The second pair of fluid channels may terminate at a second pair of apertures defined in the optic. The second pair of fluid channels may terminate at a second pair of apertures in the posterior element. The second pair of apertures may be spaced apart by about 0.1 mm to about 1.0 mm.

[0031] In some embodiments, the first pair of fluid channels and the second pair of fluid channels can be disposed in generally opposing positions on the optic. The first pair of fluid channels can be disposed generally diametrically opposed from the second pair of fluid channels.

[0032] In these embodiments, the first pair of apertures and the second pair of apertures may be disposed at generally opposing locations in the optic. The first pair of apertures may be disposed at generally diametrically opposed locations from the second pair of apertures.

[0033] As previously discussed, the base power or base sphere of the optic may change based on the fluid pressure inside the fluid-filled optical fluid chamber. The toric accommodating intraocular lens may also have a cylinder power.

[0034] The cylinder power of a toric accommodating intraocular lens may be the refractive power along the steep meridian of the toric accommodating intraocular lens, which is often expressed as the difference in refractive power (e.g., +1.0D or +3.0D) caused by the steep curvature of the toric lens along the steep meridian.

[0035] In some embodiments, the toric accommodating intraocular lens may have a cylinder power between about +0.75D and about +6.00D. For example, the toric accommodating intraocular lens may have a cylinder power of about +0.75D, +1.50D, +2.25D, +3.00D, +3.75D, +4.50D, +5.25D, or +6.00D. In some embodiments, the toric accommodating intraocular lens may have a cylinder power of about +0.75D (referred to as low cylinder). In other embodiments, the toric accommodating intraocular lens may have a cylinder power of about +6.0D (referred to as high cylinder).

[0036] One technical problem faced by applicants is how to introduce a cylindrical or toric surface into an accommodating intraocular lens such that the cylindrical power of the accommodating intraocular lens remains generally unchanged or stable when a change in base power occurs upon accommodation or disaccommodation of the lens (e.g., a change in base power between about ±1.0 and about 10.0).

[0037] One solution discovered by the applicant is to vary the radius of curvature of the outer optical surface (e.g., the posterior or anterior optical surface) while maintaining rotational symmetry on the opposite inner surface of the outer optical surface (e.g., the posterior or anterior inner surface). Another solution according to the present disclosure is to orient the flat meridian of the outer optical surface at an oblique angle to the midline that generally bisects the optic. Varying the orientation of the flat meridian is discussed in more detail in a subsequent section.

[0038] By designing a toric accommodating intraocular lens in this manner, the cylinder power of the optic can be maintained substantially constant or stable while the base power of the optic changes in response to changes in the fluid pressure of the fluid-filled optical fluid chamber. For example, the relative refractive power between the steep and flat meridians can be maintained substantially constant or stable as the base power of the optic changes upon accommodation or disaccommodation.

[0039] A toric accommodating intraocular lens may also have a cylindrical axis orientation. The cylindrical axis orientation may refer to the direction or position of a meridian of the lens. For example, the cylindrical axis orientation may refer to the direction or position of a flat meridian (i.e., cylindrical axis), a steep meridian, or a combination thereof, relative to other elements of the lens. The cylindrical axis orientation may also refer to the direction or position of one meridian of the lens relative to another meridian.

[0040] Another technical problem faced by applicants is how to keep the cylindrical axis orientation of a toric accommodative intraocular lens generally constant or fixed through changes in base power as the lens is accommodated or disaccommodated. A toric intraocular lens that has a cylindrical axis orientation that changes significantly when implanted in the eye would, at best, be of no benefit (or would not correct astigmatism) and, at worst, adversely affect the patient's vision (e.g., by inducing astigmatism on other meridians).

[0041] One solution discovered by applicants is to orient the planar meridian of the toric accommodating intraocular lens at an oblique angle relative to the midline that generally bisects the optic. By designing the toric accommodating intraocular lens in this manner, the cylindrical axis orientation of the optic can be maintained substantially unchanged while the base power of the optic changes in response to changes in fluid pressure within the fluid-filled optical fluid chamber. For example, the orientation or position of the planar meridian of the toric accommodating intraocular lens can be maintained substantially unchanged or fixed relative to the corneal astigmatism axis of the eye as the base power of the optic changes through accommodation or disaccommodation.

[0042] In some embodiments, the oblique angle may be an angle of clockwise rotation relative to the midline. For example, the oblique angle may be an angle of clockwise rotation between about 30 degrees and 60 degrees. More specifically, the flat meridian may be an angle of clockwise rotation between about 30 degrees and 60 degrees relative to the midline. In certain embodiments, the oblique angle may be an angle of clockwise rotation between about 45 degrees. More specifically, the flat meridian may be an angle of clockwise rotation between about 45 degrees relative to the midline.

[0043] In some embodiments, the midline may be a line or axis that generally bisects the optic portion or divides the optic portion in half. In these and other embodiments, the midline may generally bisect the haptic-optical interface or extend through a central portion of the haptic-optical interface. For example, the midline may generally bisect both the first haptic-optical interface and the second haptic-optical interface. The midline may also pass through or generally bisect the first reinforcement portion and the second reinforcement portion.

[0044] As previously discussed, the optics may comprise at least one pair of fluid channels that place the fluid-filled optical fluid chamber in fluid communication with the haptic fluid chamber. The midline may extend between the pair of fluid channels or may generally bisect a portion of the optics that separates the pair of fluid channels. In some embodiments, the midline may extend between the pair of apertures or may generally bisect a portion of the optics that separates the pair of apertures provided at the ends of the pair of fluid channels. For example, the optics may comprise a first pair of fluid channels and a second pair of fluid channels, and the midline may extend between or generally bisect a portion of the optics that separates the first pair of fluid channels and the second pair of fluid channels.

[0045] In some embodiments, the anterior element may have an anterior optical surface that is aspheric or may deform from a spherical configuration to an aspheric configuration in response to fluid entering the fluid-filled optical fluid chamber. In some embodiments, fluid may enter the fluid-filled optical fluid chamber from one or more haptic fluid chambers of haptics connected to the optic.

[0046] In other embodiments, the posterior element may have an aspheric posterior optical surface or may transform from a spherical configuration to an aspheric configuration in response to the inflow of fluid into the fluid-filled optical fluid chamber, the aspheric configuration being able to correct high order astigmatism, such as spherical aberration.

[0047] An additional technical problem faced by applicants is how to introduce cylindricity / toricity and asphericity into an accommodating intraocular lens. An accommodating intraocular lens that can correct both corneal astigmatism and spherical aberration may enable cataract patients who suffer from such high order astigmatism to have their astigmatism corrected with just a pair of accommodating intraocular lenses.

[0048] One solution discovered by applicants is to separate the outer optical surface that changes to an aspheric configuration from the outer optical surface that has a toric lens surface. For example, an accommodating intraocular lens can be configured such that the optical surface that is aspheric is on the lens element opposite the lens element that has the toric optical surface.

[0049] In some embodiments, the posterior element has different radii of curvature along different optical surface meridians of the posterior optical surface, and the anterior element may be aspheric.

[0050] In other embodiments, the anterior element may have different radii of curvature along different optical surface meridians of the anterior optical surface, and the posterior element may be aspheric.

[0051] As with cylinder power and cylinder axis orientation, the asphericity of the outer optical surface may be maintained or stable through certain or all base power changes upon accommodation or disaccommodation.

[0052] In some embodiments, the outer optical surface (anterior optical surface or posterior optical surface) may be pressurized into an aspheric configuration as fluid enters a fluid-filled optical fluid chamber defined by the anterior and posterior elements. The outer optical surface may be pressurized such that a center or central portion of the optical element (anterior element or posterior element) bends or bulges outward beyond the outer periphery of the optical element, which is held down by an adhesive or bonding layer, into an aspheric configuration.

[0053] The adhesive or layer may adhere or join the front element to the rear element. The adhesive or layer may be generally annular.

[0054] In these and other embodiments, the optical element is The thickness at the center or central portion may be greater compared to the periphery. This thickness difference may contribute to the deformation of the anterior optical surface from a spherical configuration to an aspheric configuration when fluid enters the fluid-filled optical fluid chamber. For example, the thickness at the center or central portion of the anterior element may be greater than the thickness at the periphery of the anterior element. This thickness difference may contribute to the deformation of the anterior optical surface from a spherical configuration to an aspheric configuration when the internal fluid pressure of the optical fluid chamber increases. [Brief description of the drawings]

[0055] [Figure 1A] FIG. 1A is a plan view of an embodiment of a toric accommodating intraocular lens. [Figure 1B] FIG. 1B is a cross-sectional view of an embodiment of a toric accommodating intraocular lens. [Figure 1C] FIG. 1C is an exploded view of an embodiment of a toric accommodating intraocular lens. [Figure 2A] FIG. 2A is a plan view of the posterior element of an embodiment of a toric accommodating intraocular lens. [Figure 2B] FIG. 2B is a cross-sectional view of the rear element taken along line AA of FIG. 2A. [Figure 2C] FIG. 2C is a cross-sectional view of the rear element along line BB of FIG. 2A. [Figure 2D] FIG. 2D is a cross-sectional view of the rear element along CC in FIG. 2A. [Figure 3A] FIG. 3A is a plan view of the anterior element of an embodiment of a toric accommodating intraocular lens. [Figure 3B] FIG. 3B is a cross-sectional view of the front element along line AA of FIG. 3A. [Figure 3C] FIG. 3C is a cross-sectional view of the anterior element along line BB of FIG. 3A. [Figure 4] FIG. 4 is a diagram showing the orientation of the flat meridian relative to the midline of a toric accommodating intraocular lens. [Diagram 5] FIG. 5 is a graph showing the change in a particular power of a toric accommodating intraocular lens as a function of the internal fluid pressure in the optical fluid chamber of the lens. [Figure 6]FIG. 6 is a graph depicting the stability of the cylinder versus the amount of toric rotation as a function of the angle of the cylinder axis relative to the midline of the intraocular lens. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0056] 1A is a plan view of an embodiment of a toric accommodating intraocular lens (AIOL) 100 that corrects corneal astigmatism, spherical aberration, or a combination thereof. The toric AIOL 100 may include an optic 102 and a peripheral portion including one or more haptics 104, including, in this embodiment, a first haptic 104A and a second haptic 104B connected to the optic 102 and extending from the optic 102 to the periphery. The toric AIOL 100 is placed in the natural lens capsule after the natural crystalline lens has been removed.

[0057] When implanted within the natural lens capsule, the optic 102 may be adapted to refract light that enters the eye and reaches the retina. One or more haptics 104 may engage the lens capsule and are adapted to deform in response to ciliary muscle movement (e.g., muscle relaxation, muscle contraction, or a combination thereof) in conjunction with reshaping the lens capsule. Engagement of the haptics 104 with the lens capsule is discussed in more detail in a subsequent section.

[0058] Figure 1B is a cross-sectional view along line AA of Figure 1A of an embodiment of a toric AIOL 100. As shown in Figure 1B, the optic 102 may include an anterior element 106 and a posterior element 108. An optical fluid chamber 110 may be defined between the anterior element 106 and the posterior element 108, the optical fluid chamber 110 being filled with fluid.

[0059] The anterior element 106 may have a front optical surface 112 and a front inner surface 114 opposite the anterior optical surface 112. The posterior element 108 may have a posterior optical surface 116 and a posterior inner surface 118 opposite the posterior optical surface 116. Any of the anterior optical surface 112, the posterior optical surface 116, or a combination thereof may be considered and referred to as an outer optical surface. The anterior inner surface 114 and the posterior inner surface 118 may face the optical fluid chamber 110. At least a portion of the anterior inner surface 114 and at least a portion of the posterior inner surface 118 may serve as a chamber wall of the optical fluid chamber 110.

[0060] Each of the one or more haptics 104 may include a haptic fluid chamber 120 within the haptic 104. For example, a first haptic 104A may include a first haptic fluid chamber 120A within the first haptic 104A, and a second haptic 104B may include a second haptic fluid chamber 120B within the second haptic 104B. Haptic fluid chamber 120 (e.g., first haptic fluid chamber 120A, second haptic fluid chamber 120B, or any combination thereof) may be in fluid communication or fluid connection with optical fluid chamber 110.

[0061] The optical fluid chamber 110 may be in fluid communication with one or more haptic fluid chambers 120 through a pair of fluid channels 122 (see FIG. 1A ). The fluid channels 122 may be conduits or passageways that fluidly connect the optical fluid chamber 110 to the haptic fluid chamber 120. The pair of fluid channels 122 may be spaced apart from one another. For example, the pair of fluid channels 122 may be spaced apart by about 0.1 mm to about 1.0 mm. In some embodiments, each of the pair of fluid channels 122 may have a diameter between about 0.4 mm to about 0.6 mm.

[0062] In some embodiments, the pair of fluid channels 122 may be defined and extend through a portion of the optic 102. More specifically, the pair of fluid channels 122 may be defined and extend through the posterior element 108.

[0063] 1A shows that one or more haptics 104 may be connected to the optics 102 at a haptic-optical interface 124. For example, one or more haptics 104 may be connected to the optics 102 at a reinforcement portion 126 (see FIG. 1C ) along the optics 102. The reinforcement portion 126 may be part of the haptic-optical interface 124. The pair of fluid channels 122 may be defined or formed within the reinforcement portion 126.

[0064] The optical fluid chamber 110 may be in fluid communication with a first haptic fluid chamber 120A through a first pair of fluid channels 122A. The optical fluid chamber 110 may be in fluid communication with a second haptic fluid chamber 120B through a second pair of fluid channels 122B.

[0065] The two fluid channels of the pair of first fluid channels 122A may be spaced apart from one another. The two fluid channels of the pair of first fluid channels 122A may be spaced apart from one another by about 0.1 mm to about 1.0 mm. The two fluid channels of the pair of second fluid channels 122B may be spaced apart from one another. The two fluid channels of the pair of second fluid channels 122B may be spaced apart from one another by about 0.1 mm to about 1.0 mm.

[0066] In some embodiments, the pair of first fluid channels 122A and the pair of second fluid channels 122B may be disposed generally opposite from the optic 102. The pair of first fluid channels 122A may be disposed generally diametrically opposite from the pair of second fluid channels 122B.

[0067] The pair of first fluid channels 122A and the pair of second fluid channels 122B may be defined or extend through a portion of the optic 102. The pair of first fluid channels 122A and the pair of second fluid channels 122B may be defined or extend through the posterior element 108.

[0068] The design with two fluid channels 122 rather than one channel allows for dimensional stability during manufacturing, which can be important when manufacturing flexible and thin components. Additionally, it has been observed through experimentation that the design with two fluid channels 122 provides better optical quality over the entire range of accommodation than certain one-channel designs. The increased stiffness of the two fluid channel design results in less deflection due to pressure changes in the fluid channels.

[0069] 1C, the optic 102 may include a first reinforcement portion 126A and a second reinforcement portion 126B at generally opposed or generally diametrically opposed locations of the optic 102. The pair of first fluid channels 122A may be defined or formed in the first reinforcement portion 126A. The pair of second fluid channels 122B may be defined or formed in the second reinforcement portion 126B.

[0070] A pair of fluid channels 122 (e.g., any of the first pair of fluid channels 122A or the second pair of fluid channels 122B) may have an internal opening 128 at one end of the pair of fluid channels 122 and a pair of external openings 130 at the other end of the fluid channels 122. The pair of internal openings 128 may be defined or formed in a portion of the rear element 108. As shown in Figures 1B and 1C, the internal openings 128 may be defined or formed in a raised inner surface 132 of the rear element 108. In some embodiments, the raised inner surface 132 may be an angled or chamfered surface.

[0071] The pair of external openings 130 may be defined or formed in a raised outer surface 134 of the posterior element 108. The raised outer surface 134 may be part of the reinforcement portion 126. The raised outer surface 134 may also be part of the haptic-optical interface 124.

[0072] For example, Figure 1C shows a pair of interior openings 128 located at one end of a pair of first fluid channels 122A and defined along a raised inner surface 132 of the rear element 108. Figure 1C also shows a pair of exterior openings 130 serving as ends of a pair of second fluid channels 122B and defined along a raised outer surface 134 of the rear element 108. The pair of exterior openings 130 of the pair of first fluid channels 122A and the pair of interior openings 128 of the pair of second fluid channels 122B are obscured in Figure 1C.

[0073] The two openings of the pair of internal openings 128 may be spaced apart from each other by about 0.1 mm to about 1.0 mm. The two openings of the pair of external openings 130 may be spaced apart from each other by about 0.1 mm to about 1.0 mm. The pair of internal openings 128 of the pair of first fluid channels 122A may be disposed generally diametrically opposed or opposite the internal openings 128 of the pair of second fluid channels 122B on the raised inner surface 132.

[0074] FIG. 1C also shows that each haptic 104 (e.g., any of the first haptic 104A or the second haptic 104B) may have an optical connection end 136 and a closed free end 138. A haptic fluid port 140 may be defined at the optical connection end 136 of the haptic 104. The haptic fluid port 140 may function as an opening for the haptic fluid chamber 120. When the haptic 104 is connected to the optical portion 102, fluid in the haptic fluid chamber 120 may flow out of the haptic fluid chamber 120 through the haptic fluid port 140 and into the optical fluid chamber 110 through the pair of fluid channels 122. Similarly, fluid in the optical fluid chamber 110 may flow out of the optical fluid chamber 110 through the pair of fluid channels 122 and into the haptic fluid chamber 120 through the haptic fluid port 140.

[0075] 1A and 1C, the haptics 104 may be connected to the optics 102 at the reinforcement portion 126. For example, a first haptic 104A may be connected or attached to the optics 102 at a first reinforcement portion 126A, and a second haptic 104B may be connected or attached to the optics 102 at a second reinforcement portion 126B.

[0076] More specifically, the haptic connection end 136 may be connected to a raised outer surface 134 of the posterior element 108. The raised outer surface 134 may also be referred to as a "landing" or a "haptic connection end landing." The raised outer surface 134 may extend radially from an outer periphery 142 of the optic 102. For example, the raised outer surface 134 may extend radially from an outer periphery 142 of the posterior element 108 of the optic 102. The raised outer surface 134 may extend radially from the outer periphery 142 between about 10 microns and 1.0 mm, or between about 10 microns and 500 microns.

[0077] The haptic connection end 136 may have a generally flat surface for bonding or otherwise connecting to the generally flat surface of the raised outer surface 134. When the haptic connection end 136 is connected to the raised outer surface 134, the haptic fluid port 140 may surround the exterior opening 130 of the fluid channel 122. The haptics 104 may be connected or bonded to the optics 102 using a biocompatible adhesive. In some embodiments, the adhesive may be the same adhesive used to connect or bond the anterior element 106 to the posterior element 108.

[0078] Each haptic 104 may also include a radially outer portion 144 that faces and contacts the inner surface of the patient's capsular bag when the toric AIOL 100 is implanted within the capsular bag. Each haptic 104 may also include a radially inner portion 146 that faces the outer circumferential surface 142 of the optic 102. Capsular bag engagement with the radially outer portions 144 of the haptics 104 is discussed in more detail in a subsequent section.

[0079] The optic 102 may have a base power or a base spherical power. The base power of the optic 102 may change based on the fluid pressure inside the fluid-filled optical fluid chamber 110. As fluid enters and leaves the optical fluid chamber 110, the base power of the optic 102 may decrease or increase.

[0080] As fluid flows from the haptic fluid chamber 120 into the optical fluid chamber 110, the base power of the optics 102 may increase. As fluid flows out or is drawn out of the optical fluid chamber 110 into the haptic fluid chamber 120, the base power of the optics 102 may decrease.

[0081] A portion of the optic 102 may be made of a deformable or pliable material. In some embodiments, a portion of the optic 102 may be made of a deformable or pliable polymeric material. For example, a portion of the anterior element 106, the posterior element 108, or a combination thereof, may be made of a deformable or pliable polymeric material. A portion of one or more haptics 104 (e.g., the first haptic 104A, the second haptic 104B, or a combination thereof) may be made of the same deformable or pliable material as the optic 102. In other embodiments, a portion of one or more of the haptics 104 may be made of a different material than the optic 102 .

[0082] In some embodiments, a portion of the optic 102 may be made of a cross-linked copolymer, including a copolymer mixture. The copolymer mixture may include alkyl acrylate or methacrylate, fluoroalkyl (meth)acrylate, and phenyl alkyl acrylate. As used herein, these types of acrylic cross-linked copolymers are generally considered to be copolymers of multiple acrylic acids, methacrylic acids, or combinations thereof, as should be understood by those skilled in the art, and the term "acrylate" as used herein may be understood to interchangeably mean acrylic acid, methacrylic acid, or combinations thereof, unless otherwise specified. The cross-linked copolymers used to fabricate the optic 102 may include or consist in part of alkyl acrylates in an amount of about 3% to 20% (wt%), fluoroalkyl acrylates in an amount of about 10% to 35% (wt%), and phenyl acrylates in an amount of about 50% to 80% (wt%). More specifically, in some embodiments, the cross-linked copolymer may comprise or consist in part of n-butyl acrylate in an amount of about 3% to 20% (wt%) (e.g., between about 12% and 16%), trifluoroethyl methacrylate in an amount of about 10% to 35% (wt%) (e.g., between about 17% and 21%), and phenylethyl acrylate in an amount of about 50% to 80% (wt%) (e.g., between about 64% and 67%). The final composition of the cross-linked copolymer used to fabricate the optic 102 may also include a cross-linking agent such as ethylene glycol dimethacrylate (EGDMA). For example, the final composition of the cross-linked copolymer may include a cross-linking agent (e.g., EGDMA) in an amount of about 1.0%. The final composition of the cross-linked copolymer used to fabricate the optic 102 may also include an initiator (e.g., Perkadox 16) and a UV absorber.

[0083] The haptic 104 may also include or be comprised in part of a cross-linked copolymer including a copolymer blend. The copolymer blend may include an alkyl acrylate, a fluoroalkyl acrylate, and a phenyl acrylate. For example, the cross-linked copolymer used to fabricate the haptic 104 may include or be comprised in part of an alkyl acrylate in an amount of about 10% to 25% (wt%), a fluoroalkyl acrylate in an amount of about 10% to 35% (wt%), and a phenyl acrylate in an amount of about 50% to 80% (wt%). More specifically, in some embodiments, the cross-linked copolymer may include or consist in part of n-butyl acrylate in an amount of about 10% to 25% (wt%) (e.g., between about 19% to about 23%), trifluoroethyl methacrylate in an amount of about 10% to 35% (wt%) (e.g., between about 14% to about 18%), and phenylethyl acrylate in an amount of about 50% to 80% (wt%) (e.g., between about 58% to about 62%). The final composition of the cross-linked copolymer used to fabricate the haptic 104 may include a cross-linking agent such as EGDMA. For example, the haptic 104 may include a cross-linking agent (e.g., EGDMA) in an amount of about 1.0%. The haptic 104 may also include a number of photoinitiators.

[0084] In some embodiments, the refractive index of the polymeric or composite material used to fabricate the optic 102 may be between about 1.48 and about 1.53. In certain embodiments, the refractive index of the polymeric or composite material used to fabricate the optic 102 may be between about 1.50 and about 1.53 (or about 1.5178).

[0085] The optic 102 may deform or flex in response to fluid entering or leaving the optical fluid chamber 110. The optic 102 may deform or flex as a result of the material composition (e.g., polymeric composition) of the optic 102 described above. The haptics 104 may also deform in response to interaction or engagement with a patient's lens capsule when the toric AIOL 100 is implanted in the patient's eye. The haptics 104 may deform as a result of the material composition (e.g., polymeric composition) of the haptics 104 described above.

[0086] In some embodiments, the front element 106 may deform or bend (e.g., change curvature) as fluid enters or leaves the optical fluid chamber 110. In other embodiments, the rear element 108 may deform or bend (e.g., change curvature) as fluid enters or leaves the optical fluid chamber 110. In further embodiments, both the front element 106 and the rear element 108 may deform or bend as fluid enters or leaves the optical fluid chamber 110.

[0087] In some embodiments, the fluid in the optical fluid chamber 110 and the haptic fluid chamber 120, or a combination thereof, may be oil. More specifically, in certain embodiments, the fluid in the optical fluid chamber 110, the haptic fluid chamber 120, or a combination thereof may be silicone oil or fluid. Fluid may flow between the optical fluid chamber 110 and the haptic fluid chamber 120 in response to bending or deformation of the haptics 104, the optics components 102 (e.g., the anterior element 106, the posterior element 108, or a combination thereof).

[0088] The fluid within the optical fluid chamber 110 and the haptic fluid chamber 120, or a combination thereof, may be a silicone oil or fluid that includes or consists in part of diphenylsiloxane. In other embodiments, the silicone oil or fluid may include or consist in part of a ratio of one unit of diphenylsiloxane to two units of dimethylsiloxane. More specifically, in some embodiments, the silicone oil or fluid may be diphenyltetramethylcyclotrisiloxane. In additional embodiments, the silicone oil or fluid may include or consist in part of a diphenylsiloxane and dimethylsiloxane copolymer.

[0089] The fluid (e.g., silicone oil) may be index matched to the polymeric or composite material used to fabricate the optic 102. When the fluid is index matched to the polymeric or composite material used to fabricate the optic 102, the entire optic 102 including the fluid behaves as a single lens. For example, the fluid may be selected to have a refractive index between about 1.48 and 1.53 (or between about 1.50 and 1.53, such as about 1.5178). In some embodiments, the fluid (e.g., silicone oil) may have a polydispersity index between about 1.2 and 1.3. In other embodiments, the fluid (e.g., silicone oil) may have a polydispersity index between about 1.3 and 1.5. In other embodiments, the fluid (e.g., silicone oil) may have a polydispersity index between about 1.1 and 1.2. Examples of other fluids are described in U.S. Patent Application Publication No. 2018 / 0153682, the contents of which are incorporated herein by reference.

[0090] The base power of the optic 102 may change in response to deformation by a deformation component of the deformation optic 102 (e.g., the anterior element 106, the posterior element 108, or a combination thereof). The optic 102 may deform in response to physiological muscle movements of the patient (e.g., ciliary muscle movement) when the toric AIOL 100 is implanted within the capsular bag of the patient's eye, and the toric AIOL 100 deforms in response to reshaping of the capsular bag in conjunction with the ciliary muscle.

[0091] The toric AIOL 100 may be implanted or introduced into the patient's capsule after the natural lens has been removed from the capsule. The patient's capsule is connected to the zonules fibers, which are connected to the patient's ciliary muscle. The capsule is elastic, and movement of the ciliary muscle causes the capsule to deform via the zonules fibers. For example, when the ciliary muscle relaxes, the zonules stretch. This stretching pulls the capsule generally radially outward with a radially outward force. This tension on the capsule stretches the capsule to make room within the capsule. If the patient's natural lens is present within the capsule, the natural lens will typically become flatter (in an anterior to posterior direction), reducing the lens power and providing distance vision. In this configuration, the patient's natural lens is in a disaccommodated state or is undergoing disaccommodation.

[0092] However, when the ciliary muscle contracts, as occurs when attempting to focus on a nearby object, the radially inner portion of the ciliary muscle moves radially inward and the zonules relax. Relaxation of the zonules causes the elastic lens capsule to contract, exerting a radially inward force on the lens within the capsule. When the patient's natural lens is present within the capsule, the natural lens becomes more curved than normal (e.g., the anterior portion of the lens becomes more curved), increasing the lens power and allowing the eye to focus on closer objects. In this configuration, the patient's natural lens is in an accommodated state or is in the process of accommodating.

[0093] Therefore, an AIOL implanted in the capsular bag should also have a mechanism that increases the base power of the AIOL when the ciliary muscle contracts and decreases the base power of the AIOL when the ciliary muscle relaxes.

[0094] In the present case, when the toric AIOL 100 is implanted or introduced into the patient's natural capsular bag, the radially outer portions 144 of the haptics 104 of the toric AIOL 100 directly engage or physically contact the zonules or portions of the capsular bag connected to the zonules. Thus, the radially outer portions 144 of the haptics 104 may be configured to respond to radially applied capsular bag deformation forces as the zonules relax and stretch as a result of ciliary muscle movement.

[0095] When the ciliary muscles contract, the periphery of the elastic lens capsule deforms and applies a radially inward force to the radially outer portion 144 of the haptic 104 (e.g., the elastic lens capsule applies a radially inward force to the radially outer portion 144 of the first haptic 104A and the radially outer portion 144 of the second haptic 104B). The radially outer portion 144 of the haptic 104 deforms, which reduces the volume of the haptic fluid chamber 120. The reduction in the volume of the haptic fluid chamber 120 moves or pushes the fluid in the haptic fluid chamber 120 to the optical fluid chamber 110 in the optics 102. As described above, fluid moves from the haptic fluid chamber 120 to the optical fluid chamber 110 through a fluid channel 122 (e.g., a pair of fluid channels 122) formed in the optics 102.

[0096] The optic 102 (anterior element 106, posterior element 108, or any combination thereof) may deform (increase in curvature) in response to fluid entering the optical fluid chamber 110 from the haptic fluid chamber 120. This increases the base power or base sphere of the toric AIOL 100, allowing a patient implanted with the toric AIOL 100 in the patient's eye to focus on nearby objects. The toric AIOL 100 may also be considered to have undergone an accommodative state or accommodation.

[0097] When the ciliary muscles relax, the periphery of the elastic capsule stretches radially outward, stretching the capsule and creating more room within the capsule. The radially outer portions 144 of the haptics 104 may respond to this capsule deformation by returning to their undeformed or unforced configuration. This causes the volume of haptic fluid chamber 120 to increase or return to its pre-deformation volume. This increase in the volume of haptic fluid chamber 120 causes the fluid in optical fluid chamber 110 to be drawn or flowed out of optical fluid chamber 110 and back into haptic fluid chamber 120. As previously described, fluid travels from optical fluid chamber 110 to haptic fluid chamber 120 through the same fluid channel 122 (e.g., a pair of fluid channels 122) formed in optical portion 102.

[0098] As previously mentioned, the optic 102 (anterior element 106, posterior element 108, or any combination thereof) may deform (reduce curvature or flatten) in response to the outflow of fluid from the optical fluid chamber 110 into the haptic fluid chamber 120. This lowers the base power or base sphere of the toric AIOL 100, allowing a patient implanted with the toric AIOL 100 in the patient's eye to focus on distant objects or provide distant vision. The toric AIOL 100 may also be considered to have undergone a disaccommodated state or disaccommodation.

[0099] 1B and 1C, the radially inner portion 146 of the haptics 104 may be thicker or larger (compared to the radially outer portion 144) to provide the haptics 104 with stiffness or resilience in the anterior-posterior direction. In this manner, when a capsular force is applied to the haptics 104 in the anterior-posterior direction, less deformation occurs and less fluid transfer occurs between the haptic fluid chamber 120 and the optical fluid chamber 110 than when a radial force is applied. With less fluid transfer occurring, the base power of the toric AIOL 100 changes less when a force is applied to the toric AIOL 100 in the anterior-posterior direction. Thus, the design and material attributes of the haptics 104 and optic 102 allow the toric AIOL 100 to maintain high sensitivity to radial forces applied to the haptics 104 by deformation of the capsular bag due to ciliary muscle movement.

[0100] In some embodiments, the anterior element 106 may have an anterior optical surface 112 that deforms from a spherical configuration to an aspheric configuration in response to fluid entering the optical fluid chamber 110. The aspheric configuration can correct higher order astigmatism, such as spherical aberration. In response to ciliary muscle movement, fluid can enter the optical fluid chamber 110 from one or more haptic fluid chambers 120 connected to the optic 102.

[0101] The anterior optical surface 112 may be pressurized such that the center or central portion of the anterior element 106 bends or bulges outward from the outer periphery of the anterior element 106, which is held down by adhesive or bonding layer 148 (see FIG. 1B), resulting in an aspheric configuration.

[0102] In other embodiments, the posterior element 108 may have a posterior optical surface 116 that deforms from a spherical configuration to an aspheric configuration in response to the entry of fluid into the optical fluid chamber 110 .

[0103] The posterior optical surface 116 may be compressed such that the center or central portion of the posterior element 108 bends or bulges outward from the outer periphery of the anterior element 106 which is held down by the adhesive or bonding layer 148, resulting in an aspheric configuration.

[0104] The anterior element 106 may be attached or adhered to the posterior element 108 via an adhesive layer 148. The adhesive layer 148 may be generally annular. The adhesive layer 148 may be located between the anterior element 106 and the posterior element 108 at a peripheral edge 150 (see FIG. 1C ) of the optic 102. For example, the adhesive layer 148 may be located on the raised inner surface 132 of the posterior element 108.

[0105] The adhesive layer 148 or glue may be a biocompatible adhesive. The adhesive layer 148 or glue may be a biocompatible polymer adhesive.

[0106] The adhesive layer 148 or adhesive may include or consist in part of a crosslinkable polymer precursor composition. The crosslinkable polymer precursor composition may include or consist in part of a copolymer mixture, a hydroxyl functional acrylic monomer, and a photoinitiator (e.g., Darocur 4265, or a 50:50 mixture of diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide and 2-hydroxy-2-methylpropiophenone). The copolymer mixture may include an alkyl acrylate (e.g., n-butyl acrylate in an amount of about 41% to about 45% (wt%)), a fluoroalkyl acrylate (e.g., trifluoroethyl methacrylate in an amount of about 20% to about 24% (wt%)), and a phenylalkyl acrylate (e.g., phenylethyl acrylate in an amount of about 28% to about 32% (wt%)). The hydroxyl functional acrylic monomer may be 2-hydroxyethyl acrylate (HEA) in an amount of about 0.5 to 5.0 wt%, preferably about 1.0% to about 2.0 wt%. A photoinitiator may be used to accelerate the cure of the hydroxyl functional prepolymer.

[0107] The first step in the preparation of the adhesive is to prepare a hydroxyl-functional polymer precursor by photopolymerizing the crosslinkable polymer precursor composition to obtain a cured composition. The second step is the conversion of the pendant hydroxyl moieties or groups of the precursor polymer to pendant methacrylate functional groups by reacting with methacrylic anhydride or methacrylic chloride to form a methacrylic functional crosslinkable polymer comprising alkyl acrylate or methacrylate (e.g., n-butyl acrylate), fluoroalkyl (meth)acrylate (e.g., trifluoroethyl methacrylate), phenyl alkyl acrylate (phenyl ethyl acrylate), and 2-(2-methylacryloyloxy)ethyl acrylate.

[0108] The methacrylic functional crosslinkable polymer may be mixed with a reactive acrylic monomer diluent such as 1-adamantyl methacrylate (ADMA) and a photoinitiator of the same, such as Darocur 4265. For example, the final composition of the adhesive may include the methacrylic functional crosslinkable polymer in an amount of about 50% to about 85% (wt%) (e.g., about 61% to about 65%), the reactive acrylic monomer diluent in an amount of about 10% to about 40% (wt%) (e.g., about 32% to about 36%), and the photoinitiator in an amount of about 2% to about 3% (wt%) (e.g., Darocur 4265).

[0109] The adhesive or adhesive layer 148 may adhere or bond the anterior element 106 to the posterior element 108. The adhesive may adhere or bond the haptics 104 to the optic 102.

[0110] In some embodiments, the anterior optical surface 112 of the anterior element 106 may be manufactured to have an aspheric optical surface before the toric AIOL 100 is implanted in a patient's eye. In these embodiments, the anterior optical surface 112 may be aspheric regardless of fluid pressure changes in the optical fluid chamber 110. In these embodiments, the anterior optical surface 112 may maintain its asphericity regardless of changes in base power.

[0111] In other embodiments, the posterior optical surface 116 of the posterior element 108 may be manufactured to have an aspheric optical surface before the toric AIOL 100 is implanted in a patient's eye. In these embodiments, the posterior optical surface 116 may be aspheric regardless of fluid pressure changes in the optical fluid chamber 110. In these embodiments, the posterior optical surface 116 may maintain its asphericity regardless of changes in base power.

[0112] In some embodiments, the anterior element 106 may have a greater thickness at the center or central portion compared to the periphery. In certain embodiments, the posterior element 108 may also have a greater thickness at the center or central portion compared to the periphery.

[0113] 1B and 1C, the optic 102 may have an optical axis 152. The optical axis 152 may extend in a front-to-back direction through a center or midpoint of the optic 102. The optical axis 152 may extend through a center or midpoint of both the anterior element 106 and the posterior element 106.

[0114] The thickness of the anterior element 106 may be greater at or near the optical axis 152 as compared to the periphery of the anterior element 106. In some embodiments, the thickness of the anterior element 106 may gradually increase from the periphery of the anterior element 106 toward the optical axis 152.

[0115] In certain embodiments, the thickness of the anterior element 106 at or near the optical axis 152 may be between about 0.200 mm and about 0.300 mm (or about 0.280 mm). In these and other embodiments, the thickness of the anterior element 106 near the periphery may be between about 0.100 mm and about 0.200 mm (or about 0.135 mm). This difference in thickness may contribute to the deformation of the anterior optical surface 112 from a spherical configuration to an aspherical configuration as fluid flows from the haptic fluid chamber 120 into the fluid-filled optical fluid chamber 110.

[0116] Additionally, the anterior inner surface 114 of the anterior element 106 may have less curvature or be flatter than the anterior optical surface 112. This difference in surface curvature between the anterior inner surface 114 and the anterior optical surface 112 may also contribute to the anterior optical surface 112 deforming from a spherical configuration to an aspheric configuration as fluid flows from the haptic fluid chamber 120 into the fluid-filled optical fluid chamber 110.

[0117] In other embodiments, the thickness of the rear element 108 may be greater at or near the optical axis 152 than the portion of the rear element 108 radially outward from the optical axis 152 but before reaching the raised inner surface 132. The thickness of the rear element 108 may gradually decrease from the optical axis 152 radially outward from the optical axis 152 (but before reaching the raised inner surface 132). The thickness of the rear element 108 may increase again from the start of the raised inner surface 132 toward the outer circumferential edge 150.

[0118] In certain embodiments, the thickness of the posterior element 108 at or near the optical axis 152 may be between about 0.40 mm and about 0.50 mm (or about 0.43 mm). In these and other embodiments, the thickness of the posterior element 108 radially outward from the optical axis 152 (but before reaching the raised inner surface 132) may be between about 0.30 mm and about 0.40 mm (or about 0.38 mm). The thickness of the posterior element 108 near the outer periphery 150 may be between about 1.00 mm and 1.20 mm (or about 1.188 mm). This difference in thickness may contribute to the deformation of the posterior optical surface 116 from a spherical configuration to an aspherical configuration as fluid flows from the haptic fluid chamber 120 into the fluid-filled optical fluid chamber 110.

[0119] Additionally, the posterior inner surface 118 of the posterior element 108 may have a smaller curvature or be flatter than the posterior optical surface 116. This difference in surface curvature between the posterior inner surface 118 and the posterior optical surface 116 may also contribute to the deformation of the posterior optical surface 116 from a spherical configuration to an aspherical configuration as fluid flows from the haptic fluid chamber 120 into the fluid-filled optical fluid chamber 110.

[0120] One technical problem faced by applicants is how to introduce toricity and asphericity into an accommodating intraocular lens. An accommodating intraocular lens that can correct both corneal astigmatism and spherical aberration may enable cataract patients who suffer from such high order astigmatism to correct their astigmatism using only a pair of accommodating intraocular lenses, rather than still relying on corrective spectacles.

[0121] One solution discovered by applicants is to separate the optical surface that transitions to an aspheric configuration from the toric lens surface or the outer optical surface that has cylinder. For example, a toric AIOL 100 can be configured such that the optical surface that is aspheric is on the lens element opposite the lens element that has the toric optical surface or cylinder.

[0122] In some embodiments, the posterior element 108 may be shaped with a toric lens surface or a cylindrical profile, and the anterior element 106 may have an anterior optical surface 112 that is aspheric or may deform from a spherical configuration to an aspheric configuration in response to fluid flowing from the haptic fluid chamber 120 into the fluid-filled optical fluid chamber 110.

[0123] In other embodiments, the anterior element 106 may be shaped with a toric lens surface or a cylindrical profile, and the posterior element 108 may have an aspheric posterior optical surface 116 or may deform from a spherical configuration to an aspheric configuration in response to fluid flowing from the haptic fluid chamber 120 into the fluid-filled optical fluid chamber 110.

[0124] 1A, the toric AIOL 100 may be oriented with a midline 154. The midline 154 may be a line or axis that generally bisects the optic 102 or that generally divides the optic 102 in half. In some embodiments, the midline 154 may generally bisect the haptic-optical interface 124 or extend through a central portion of the haptic-optical interface 14. For example, the midline 154 may generally bisect both the first haptic-optical interface and the second haptic-optical interface that is diametrically opposed from the first haptic-optical interface. The midline 154 may also pass through or generally bisect the first reinforcement portion 126A and the second reinforcement portion 126B.

[0125] As previously discussed, the optics 102 may include at least one pair of fluid channels 122 that place the fluid-filled optical fluid chamber 110 in fluid communication with the haptic fluid chamber 120. The midline 154 may extend between the pair of fluid channels 122 or may generally bisect a portion of the optics 102 that separates the pair of fluid channels 122.

[0126] In some embodiments, the midline 154 may extend between a pair of apertures (either the internal apertures 128 or the external apertures 130) or may bisect a portion of the optics 102 that separates a pair of apertures located at the ends of a pair of fluid channels 122. For example, the optics 102 may have a first pair of fluid channels 122A and a second pair of fluid channels 122B. The midline 154 may extend between the portion separating the first pair of fluid channels 122A and the second pair of fluid channels 122B, or may generally bisect a portion of the optic. The midline 154 is discussed in more detail with respect to a particular meridian orientation or placement of the toric AIOL 100.

[0127] 2A is a plan view of an embodiment of the posterior element 108 of the toric AIOL 100. The posterior optical surface 116 may be formed such that the radius of curvature of the posterior optical surface 116 is different along different optical surface meridians. For example, the radius of curvature along a flat meridian 200 of the posterior optical surface 116 is different from the radius of curvature along a steep meridian 202 of the posterior optical surface 116.

[0128] In some embodiments, the radius of curvature of the posterior optical surface 116 may vary periodically around the posterior optical surface 116. The radius of curvature of the posterior optical surface 116 may vary periodically around the posterior optical surface 116 when the radius of curvature varies continuously periodically along different optical surface meridians (e.g., as the optical surface meridians rotate around the optical axis 152 or the center point of the posterior optical surface 116). In certain embodiments, the radius of curvature of the posterior optical surface 116 may vary sinusoidally around the posterior optical surface 116.

[0129] 2A, the posterior optical surface 116 may include a flat meridian 200 and a steep meridian 202 disposed generally perpendicular to the flat meridian 200. For example, the flat meridian 200 may be rotated approximately 90 degrees away from the steep meridian 202.

[0130] Figure 2B is a cross-sectional view of the posterior element 108 along the steep meridian 202 (shown as cross-section AA in Figure 2A). Figure 2C is a cross-sectional view of the posterior element 108 along the flat meridian 200 (shown as cross-section BB in Figure 2A). Furthermore, Figure 2D is a cross-sectional view of the posterior element 108 along the intermediate meridian 204, which is located at about 45 degrees from both the flat meridian 200 and the steep meridian 202 (shown as cross-section CC in Figure 2A).

[0131] The refractive power of the posterior optical surface 116 may be greatest along a steep meridian 202 of the posterior optical surface 116. The refractive power of the posterior optical surface 116 may be least along a flat meridian 200 of the posterior optical surface 116. The steep meridian 202 and the flat meridian 200 may be the principal meridians of the lens. The flat meridian 200 may also be referred to as the cylindrical axis or simply the "axis" of the toric lens.

[0132] As shown in Figures 2B-2D, the posterior optical surface 116 may comprise or be defined by a steep meridian radius of curvature (ROC) 206, a flat meridian ROC 208, and an intermediate meridian ROC 210. More specifically, as shown in Figure 2B, the intermediate meridian ROC 210 may be greater than the steep meridian ROC 206. The surface profile along the intermediate meridian 204 of the posterior optical surface 116 is shown in dashed lines in both Figures 2B and 2C. In these embodiments, the steep meridian ROC 206 is also less than the flat meridian ROC 208.

[0133] 2C, the flat meridian ROC 208 may be greater than the intermediate meridian ROC 210. In addition, the flat meridian ROC 208 may also be greater than the steep meridian ROC 206.

[0134] 2A-2D, the radius of curvature of the posterior optical surface 116 may vary sinusoidally around the posterior optical surface 116. For example, the radius of curvature of the posterior optical surface 116 may gradually increase (when looking at the radius of curvature along different surface meridians) from the steep meridian 202 to the intermediate meridian 204, and continue to increase until the flat meridian 200 is reached. The radius of curvature of the posterior optical surface 116 may then gradually decrease from the flat meridian 200 to the intermediate meridian 204, and continue to decrease until the steep meridian 202 is reached again after a 180 degree rotation. This cyclical variation in the radius of curvature of the posterior optical surface 116 may continue for the entire 360 ​​degrees, or until the steep meridian 202 is reached again.

[0135] 2B-2D also show that the posterior element thickness 212 may vary along different optical surface meridians. The posterior element thickness 212 may be the thickness or height of the posterior element 108 measured from the posterior inner surface 118 to the posterior optical surface 116.

[0136] The posterior element thickness 212 at or near a radially outer portion 214 of the posterior element 108 may vary along different optical surface meridians. The radially outer portion 214 may be a portion of the posterior element 108 located at the outer periphery of the posterior element 108. In some embodiments, the radially outer portion 214 may be a portion of the posterior element 108 located between the optical axis 152 and the raised inner surface 132. More specifically, the radially outer portion 214 may be a portion of the posterior element 108 that is closer (in terms of radial distance) to the raised inner surface 132 than to the optical axis 152.

[0137] In some embodiments, the posterior element thickness 212 at or near the radially outer portion 214 may be greatest (or thickest) along the flat meridian 200. In these embodiments, the posterior element thickness 212 at or near the radially outer portion 214 may be smallest (or thinnest) along the steep meridian 202. The posterior element thickness 212 at or near the radially outer portion 214 may also vary periodically around the posterior element 108 (e.g., as the optical surface meridian rotates around the optical axis 152 or the center point of the posterior optical surface 116). Furthermore, the posterior element thickness 212 at or near the radially outer portion 214 may also vary sinusoidally around the posterior element 108.

[0138] In certain embodiments, the posterior element thickness 212 at or near the optical axis 152 (or at or near the center point of the posterior optical surface 116) may be the same along different optical surface meridians. For example, the posterior element thickness 212 at or near the optical axis 152 (or at or near the center point of the posterior optical surface 116) may be the same along both the steep meridian 202 and the flat meridian 200.

[0139] In some embodiments, the posterior element thickness 212 at or near the radially outer portion 214 along the flat meridian 200 may be between about 0.38 mm and about 0.45 mm. In these embodiments, the posterior element thickness 212 at or near the radially outer portion 214 along the steep meridian 202 may be between about 0.30 mm and about 0.40 mm.

[0140] The rear element 108 may further comprise a rear inner surface 118. The rear inner surface 118 may be a surface of the rear element 108 that faces the optical fluid chamber 110. In some embodiments, at least a portion of the rear inner surface 118 may serve as a chamber wall of the optical fluid chamber 110. The rear inner surface 118 may be rotationally symmetric, or approximately rotationally symmetric. The rear inner surface 118 may be rotationally symmetric if the radius of curvature of the rear inner surface 118 is the same along all surface meridians. For example, the radius of curvature of the rear inner surface 118 may be between about 50.0 mm and 70.0 mm (or about 60.0 mm).

[0141] The toric AIOL 100 may also be constructed or designed to have a set cylinder power. Cylinder power may refer to the refractive power along the steep meridian of the toric AIOL 100. Cylinder power is often expressed as the difference in refractive power (e.g., +1.0D or +3.0D) caused by the steep curvature along the steep meridian of the toric lens.

[0142] In some embodiments, a toric AIOL 100 having the aforementioned toric posterior optical surface 116 may have a cylinder power between about +0.75 D and about +6.00 D. For example, a toric AIOL 100 having the aforementioned toric posterior optical surface 116 may have a cylinder power of about +0.75 D, +1.50 D, +2.25 D, +3.00 D, +3.75 D, +4.50 D, +5.25 D, or +6.00 D.

[0143] Table 1 below shows values ​​of the radius of curvature and posterior element thickness for two versions of a toric AIOL 100 (each with a different cylinder power) having a toric posterior optical surface 116. Table 1. Toric AIOL parameters for low and high cylinder powers [Table 1]

[0144] As previously discussed, the base power or base sphere of the optic 102 may change based on the fluid pressure inside the fluid-filled optical fluid chamber 110. One technical problem faced by applicants is how to introduce a cylindrical or toric surface into an accommodating intraocular lens (AIOL) such that the cylinder power of the AIOL remains generally unchanged or stable when changes in base power occur upon accommodation or disaccommodation of the lens.

[0145] One solution discovered by applicants is to vary the radius of curvature of posterior optical surface 116 while keeping posterior inner surface 118 (the surface opposite posterior optical surface 116) rotationally symmetric. As will be discussed in more detail in a subsequent section, another solution provided by the present disclosure is to position the flat meridian 200 of the posterior optical surface 116 at an oblique angle relative to the midline 154 that generally bisects the optic 102 .

[0146] By designing the toric AIOL 100 in this manner, the cylinder power of the optic 102 can be maintained substantially constant or stable while the base power of the optic 102 changes in response to changes in the fluid pressure of the fluid-filled optical fluid chamber. For example, the relative refractive power between the steep meridian 202 and the flat meridian 200 can be maintained substantially constant or stable as the base power of the optic 102 changes upon accommodation or disaccommodation.

[0147] 2A also illustrates that the posterior optical surface 116 may include one or more markings 216 disposed thereon. The markings 216 may be visually perceptible by a clinician or physician implanting the toric AIOL 100 into a patient's eye. The one or more markings 216 may be ink markings or dye markings. In other embodiments, the one or more markings 216 may be an etch or texture appearing on the posterior optical surface 116.

[0148] In the embodiment shown in FIG. 2A, the one or markings 216 are shown as small dots or spots. In other embodiments, the one or more markings 216 may be in forms other than lines, dots, or circular dots. The one or more markings 216 serve to orient the flat meridian 200 or cylinder axis relative to markings previously applied to the patient's eye by a clinician or physician to mark the patient's corneal astigmatism. For example, the clinician or physician may align the one or more markings 216 with markings used to indicate the patient's corneal astigmatism to ensure that the toric AIOL 100 is implanted correctly.

[0149] In some embodiments, the anterior optical surface 112 of the toric AIOL 100 may be rotationally symmetric, while the posterior optical surface 116 may be toric or have different radii of curvature along different optical surface meridians. In other embodiments, as previously discussed, the anterior optical surface 112 of the toric AIOL 100 may be aspheric, while the posterior optical surface 116 may be toric or have different radii of curvature along different optical surface meridians.

[0150] 3A is a plan view of an embodiment of an anterior element 106 of a toric AIOL 100. In this embodiment, the anterior element 106 may be formed such that the radius of curvature of the anterior optical surface 112 is different along different optical surface meridians. For example, the radius of curvature along a flat meridian 300 of the anterior optical surface 112 is different from the radius of curvature along a steep meridian 302 of the anterior optical surface 112.

[0151] In some embodiments, the radius of curvature of the anterior optical surface 112 may vary periodically around the anterior optical surface 112. The radius of curvature of the anterior optical surface 112 may vary periodically around the anterior optical surface 112 when the radius of curvature varies periodically along different optical surface meridians (e.g., as the optical surface meridians rotate around the optical axis 152 or the center point of the anterior optical surface 112). In certain embodiments, the radius of curvature of the anterior optical surface 112 may vary sinusoidally around the anterior optical surface 112.

[0152] 3A, the anterior optical surface 112 may have a flat meridian 300 and a steep meridian 302 disposed generally perpendicular to the flat meridian 300. For example, the flat meridian 300 may be rotated approximately 90 degrees away from the steep meridian 302.

[0153] Figure 3B is a cross-sectional view of the anterior element 106 along steep meridian 302 (shown as cross-section AA in Figure 3A), and Figure 3C is a cross-sectional view of the same anterior element 106 along flat meridian 300 (shown as cross-section BB in Figure 3A).

[0154] The refractive power of the anterior optical surface 112 may be greatest along a steep meridian 302 of the anterior optical surface 112, and the refractive power of the anterior optical surface 112 may be least along a flat meridian 300 of the anterior optical surface 112. The steep meridian 302 and the flat meridian 300 may be the principal meridians of the lens. The flat meridian 300 may also be referred to as the cylindrical axis or simply the "axis" of the toric lens.

[0155] 3B-3C, the anterior optical surface 112 may comprise or be defined by a steep meridian radius of curvature (ROC) 304 and a flat meridian ROC 306. The flat meridian ROC 306 may be greater than the steep meridian ROC 304.

[0156] As shown in Figures 3A-3C, the radius of curvature of the anterior optical surface 112 may vary sinusoidally around the anterior optical surface 112. For example, the radius of curvature of the anterior optical surface 112 may gradually increase from the steep meridian 302 towards the intermediate meridian (i.e., a meridian disposed at a rotation angle of about 45 degrees from both the flat meridian 300 and the steep meridian 302) and may continue to increase until the flat meridian 300 is reached. The radius of curvature of the anterior optical surface 112 may then gradually decrease from the flat meridian 300 towards the intermediate meridian and may continue to decrease until the steep meridian 302 is reached again after a rotation of 180 degrees. This cyclical variation in the radius of curvature of the anterior optical surface 112 may continue over the entire 360 ​​degrees or until the steep meridian 302 is reached.

[0157] 3B and 3C also illustrate that the anterior element thickness 308 may vary along different optical surface meridians. The anterior element thickness 308 may be the thickness or height of the anterior element 106 measured from the anterior inner surface 114 to the anterior optical surface 112.

[0158] The anterior element thickness 308 at or near a radially outer portion 310 of the anterior element 106 may vary along different optical surface meridians. The radially outer portion 310 may be a portion of the anterior element 106 located at the outer periphery of the anterior element 106. In some embodiments, the radially outer portion 310 may be a portion of the anterior element 106 located between the optical axis 152 and the adhesive layer 148. More specifically, the radially outer portion 310 may be a portion of the anterior element 106 that is closer (in terms of radial distance) to the adhesive layer 148 than the optical axis 152.

[0159] In some embodiments, the anterior element thickness 308 at or near the radially outer portion 310 may be greatest (or thickest) along the flat meridian 300. In these embodiments, the anterior element thickness 308 at or near the radially outer portion 310 may be smallest (or thinnest) along the steep meridian 302. The anterior element thickness 308 at or near the radially outer portion 310 may also vary periodically around the anterior element 106 (e.g., as the optical surface meridian rotates around the optical axis 152 or the center point of the anterior optical surface 112). For example, the anterior element thickness 308 may vary sinusoidally around the anterior element 106.

[0160] In certain embodiments, the anterior element thickness 308 at or near the optical axis 152 (or at or near the center point of the anterior optical surface 112) may be the same along different optical surface meridians. For example, the anterior element thickness 308 at or near the optical axis 152 (or at or near the center point of the anterior optical surface 112) may be the same along both the steep meridian 302 and the flat meridian 300. In one embodiment, the anterior element thickness 308 at or near the optical axis 152 may be about 0.40 mm.

[0161] In some embodiments, the anterior element thickness 308 at or near the radially outer portion 310 along the flat meridian 300 may be between about 0.140 mm and about 0.210 mm. In these embodiments, the anterior element thickness 308 at or near the radially outer portion 310 along the steep meridian 302 may be between about 0.050 mm and about 0.125 mm.

[0162] The front element 106 may further comprise a front inner surface 114. The front inner surface 114 may be a surface of the front element 106 that faces the optical fluid chamber 110. In some embodiments, at least a portion of the front inner surface 114 may act as a chamber wall of the optical fluid chamber 110. The front inner surface 114 may be rotationally symmetric, or approximately rotationally symmetric. The front inner surface 114 may be rotationally symmetric if the radius of curvature of the front inner surface 114 is the same along all surface meridians. For example, the radius of curvature of the front inner surface 114 may be between about 50.0 mm and 70.0 mm (or about 60.0 mm).

[0163] The toric AIOL 100 may also be constructed or designed to have a set cylinder power. Cylinder power may refer to the refractive power along the steep meridian 302 of the toric AIOL 100. Cylinder power is often expressed as the difference in refractive power (e.g., +1.0D or +3.0D) caused by the steep curvature along the steep meridian of the toric lens.

[0164] In some embodiments, a toric AIOL 100 having a toric anterior surface 112 as described above may have a cylinder power between about +0.75 D and about +6.00 D. For example, a toric AIOL 100 having a toric anterior surface 112 as described above may have a cylinder power of about +0.75 D, +1.50 D, +2.25 D, +3.00 D, +3.75 D, +4.50 D, +5.25 D, or +6.00 D.

[0165] Table 2 below shows values ​​of the radius of curvature and anterior element thickness for two versions of a toric AIOL 100 (each with a different cylinder power) having a toric anterior optical surface 112. Table 2. Toric AIOL parameters for low and high cylinder powers [Table 2]

[0166] As previously discussed, the base power or base sphere of the optic 102 may change based on the fluid pressure inside the fluid-filled optical fluid chamber 110. One technical problem faced by applicants is how to introduce a cylindrical or toric surface into an accommodating intraocular lens (AIOL) such that the cylinder power of the AIOL remains generally unchanged or stable when changes in base power occur upon accommodation or disaccommodation of the lens.

[0167] One solution discovered by applicants is to vary the radius of curvature of the anterior optical surface 112 while keeping the anterior inner surface 114 (the surface opposite the anterior optical surface 112) rotationally symmetric. As will be discussed in more detail in a subsequent section, another solution provided by the present disclosure is to orient the flat meridian 300 of the anterior optical surface 112 at an oblique angle relative to the midline 154 that generally bisects the optic 102.

[0168] By designing the toric AIOL 100 in this manner, the cylinder power of the optic 102 can be maintained substantially constant or stable while the base power of the optic 102 changes in response to changes in the fluid pressure of the fluid-filled optical fluid chamber. For example, the relative refractive power between the steep meridian 302 and the flat meridian 300 can be maintained substantially constant or stable as the base power of the optic 102 changes upon accommodation and disaccommodation.

[0169] 3A also illustrates that the anterior optical surface 112 may include one or more markings 312 disposed thereon. The markings 312 may be visually perceptible by a clinician or physician who implants the toric AIOL 100 into a patient's eye. The one or more markings 312 may be ink markings or dye markings. In other embodiments, the one or more markings 312 may be an etch or texture appearing on the anterior optical surface 112.

[0170] In the embodiment shown in FIG. 3A, the one or markings 312 are shown as small dots or spots. In other embodiments, the one or more markings 312 may be in forms other than lines, dots, or circular dots. The one or more markings 312 serve to orient the flat meridian 300 or cylinder axis relative to markings previously applied to the patient's eye by a clinician or physician to mark the patient's corneal astigmatism. For example, the clinician or physician may align the one or more markings 312 with markings used to indicate the patient's corneal astigmatism to ensure that the toric AIOL 100 is implanted correctly.

[0171] In some embodiments, the posterior optical surface 116 of the toric AIOL 100 may be rotationally symmetric, while the anterior optical surface 112 may be toric or have different radii of curvature along different optical surface meridians. In other embodiments, as previously discussed, the posterior optical surface 116 of the toric AIOL 100 may be aspheric, while the anterior optical surface 112 may be toric or have different radii of curvature along different optical surface meridians.

[0172] 4 is a diagram illustrating the cylindrical axis orientation of a flat meridian relative to the midline 154 of a toric AIOL 100. The cylindrical axis orientation may refer to the direction or position of a lens meridian relative to other features of the toric AIOL 100 (such as the midline 154). For example, the cylindrical axis orientation may refer to the direction or position of a flat meridian (i.e., "cylinder axis"), a steep meridian, or a combination thereof, relative to the eye. The cylindrical axis orientation may also refer to the direction or position of one meridian of a lens relative to another meridian.

[0173] Although FIG. 4 is shown with respect to the posterior element 108 and the posterior optical surface 116 (including the flat meridian 200 and the steep meridian 202), it should be considered in the present disclosure and understood by one of ordinary skill in the art that the flat meridian 300 and the steep meridian 302 of the anterior optical surface 112 may also be disposed at an oblique angle 400 with respect to the midline 154.

[0174] The technical problem faced by applicants is how to make the cylinder axis orientation of a toric AIOL remain generally constant or fixed through changes in the base power of the lens, i.e., accommodation or disaccommodation. An unstable cylinder axis orientation, at best, offers no benefit (i.e., no astigmatism correction) and at worst, adversely affects the patient's vision (e.g., induces astigmatism on other meridians).

[0175] One solution discovered by applicant is to place a flat meridian (e.g., any of flat meridians 200 or 300) at an oblique angle 400 with respect to the midline 154. As previously discussed, in some embodiments, the midline 154 may approximately bisect the optic 102. For example, the midline 154 may be a line or axis that approximately bisects the optic 102 or divides the optic 102 in half.

[0176] In other embodiments, midline 154 may generally bisect haptic-optical interface 124 or extend through a central portion of haptic-optical interface 124. For example, midline 154 may generally bisect both the first haptic-optical interface and the second haptic-optical interface (in the case where toric AIOL 100 has two haptics 104).

[0177] The midline 154 may also extend through or generally bisect the reinforcement portion 126. For example, the midline 154 may extend through or generally bisect the first reinforcement portion 126A and the second reinforcement portion 126B.

[0178] As previously discussed, the optics portion may include at least one pair of fluid channels 122 that place the fluid-filled optical fluid chamber 110 in fluid communication with the haptic fluid chamber 120. The midline 154 may extend between the pair of fluid channels 122 or may generally bisect a portion of the optics portion 102 that separates the pair of fluid channels 122. In some embodiments, the midline 154 may extend between a pair of apertures (e.g., the inner aperture 128) or may bisect a portion of the optics portion 102 that separates a pair of apertures (e.g., the inner aperture 128) located at the ends of the pair of fluid channels 122. For example, the optic portion 102 may include a first pair of fluid channels 122A and a second pair of fluid channels 122B, and the midline 154 may extend between or generally bisect a portion of the optic portion 102 that separates the first pair of fluid channels 122A and the second pair of fluid channels 122B.

[0179] The flat meridian (either flat meridian 200 or flat meridian 300) may be oriented or disposed at an oblique angle 400 with respect to the midline 154. In some embodiments, the oblique angle 400 may be an angle of clockwise rotation. For example, the oblique angle 400 may be an angle of clockwise rotation between about 30 degrees and 60 degrees. In certain embodiments, the oblique angle may be an angle of clockwise rotation of about 45 degrees. As previously discussed, the flat meridian 200 may be approximately at a right angle, or at a 90 degree angle, with respect to the steep meridian 202.

[0180] By designing the toric AIOL 100 in this manner, the cylindrical axis orientation of the optic 102 can remain substantially constant while the base power of the optic 102 changes in response to changes in fluid pressure inside the fluid-filled optical fluid chamber 110. For example, once the toric AIOL 100 is implanted in a patient's eye, the orientation or location of the flat and steep meridians of the toric AIOL 100 can remain substantially constant or fixed relative to the corneal astigmatism axis of the patient's eye (even as the base power of the optic changes through accommodation or disaccommodation).

[0181] Figure 5 is a graph showing the change in a specific power of the toric AIOL 100 as a function of the internal fluid pressure of the optical fluid chamber 110. As shown in Figure 5, the base power of the toric AIOL 100 (or the ability of the toric AIOL 100 to combat defocus aberrations) is highly responsive to the fluid pressure of the fluid-filled optical fluid chamber 110. As the internal fluid pressure of the fluid-filled optical fluid chamber 110 increases, the base power of the toric AIOL 100 increases.

[0182] 5 also shows that the cylinder power of the toric AIOL 100 remains relatively constant and stable despite changes in fluid pressure within the fluid-filled optical fluid chamber 110. Furthermore, the ability of the toric AIOL 100 to correct spherical aberration also remains relatively constant despite changes in fluid pressure within the fluid-filled optical fluid chamber 110.

[0183] FIG. 6 is a graph showing cylinder stability as a function of cylinder axis alignment. Changes to cylinder axis orientation (expressed as the angle of "toric rotation" along the y-axis) were recorded for different versions of the toric AIOL100 with different cylinder axis alignment angles. All of these versions of the toric AIOL100 were axially loaded and unloaded using finite element analysis. As shown in FIG. 6, all cylinder axis (i.e., flat meridian) alignment angles are measured as clockwise rotation angles relative to the midline 154 of the toric AIOL100. The preferred cylinder axis orientation (i.e., cylinder axis alignment angle) is one that maintains cylinder stability throughout all stages of accommodation and disaccommodation of the lens.

[0184] As can be seen in FIG. 6, the toric AIOL100, with a cylinder axis alignment angle of +45 degrees relative to the midline, exhibited nearly 0 degrees of toric rotation (or little change in cylinder axis orientation) despite axial loading and unloading.

[0185] The toric accommodating intraocular lens disclosed herein comprises an optic having an anterior element having an anterior optical surface, a posterior element having a posterior optical surface, and a fluid-filled optical fluid chamber defined therebetween, at least one of the anterior optical surface and the posterior optical surface having a radius of curvature that differs along different optical surface meridians.

[0186] The toric accommodating intraocular lenses disclosed herein are configured such that the posterior optical surface has different radii of curvature along different optical surface meridians of the posterior optical surface.

[0187] The toric accommodating intraocular lenses disclosed herein have a posterior surface with a radius of curvature that varies periodically around the circumference of the posterior surface.

[0188] In the toric accommodating intraocular lens disclosed herein, the posterior element further comprises a posterior inner surface.

[0189] The toric accommodating intraocular lenses disclosed herein have rotational symmetry on the inner posterior surface.

[0190] The toric accommodating intraocular lenses disclosed herein have a posterior element having a posterior element thickness measured from the posterior optical surface to the posterior inner surface, where the posterior element thickness varies periodically around the circumference of the posterior element.

[0191] The toric accommodating intraocular lenses disclosed herein have aspheric anterior optical surfaces.

[0192] The toric accommodating intraocular lenses disclosed herein are configured such that the anterior optical surface has different radii of curvature along different optical surface meridians of the anterior optical surface.

[0193] The toric accommodating intraocular lenses disclosed herein have an anterior surface with a radius of curvature that varies periodically around the circumference of the anterior surface.

[0194] The toric accommodating intraocular lenses disclosed herein further comprise an anterior inner surface where the anterior element is rotationally symmetric.

[0195] The toric accommodating intraocular lenses disclosed herein have a rotationally symmetric anterior inner surface.

[0196] The toric accommodating intraocular lenses disclosed herein have an anterior element having an anterior element thickness measured from the anterior optical surface to the anterior inner surface, where the anterior element thickness varies periodically around the circumference of the anterior element.

[0197] The toric accommodating intraocular lenses disclosed herein have aspheric posterior optical surfaces.

[0198] The toric accommodating intraocular lenses disclosed herein change the base power of the optic based on the pressure within the fluid-filled optical fluid chamber.

[0199] The toric accommodating intraocular lenses disclosed herein have a generally constant optic cylinder power while the optic base power changes in response to changes in pressure in the fluid-filled optical fluid chamber.

[0200] The toric accommodating intraocular lenses disclosed herein have a generally constant cylindrical axis orientation of the optic while the base power of the optic changes in response to changes in pressure within the fluid-filled optical fluid chamber.

[0201] The toric accommodating intraocular lens disclosed herein has at least one of the anterior and posterior optical surfaces having a flat meridian and a steep meridian disposed approximately perpendicular to the flat meridian, with the radius of curvature being smallest along the steep meridian and the radius of curvature being largest along the flat meridian.

[0202] The toric accommodating intraocular lenses disclosed herein are positioned such that the planar meridian is at an oblique angle to the midline that generally bisects the optic zone.

[0203] The toric accommodating intraocular lenses disclosed herein have a cant angle of rotation between about 30 and 60 degrees clockwise.

[0204] The toric accommodating intraocular lenses disclosed herein have a cant angle of approximately 45 degrees clockwise rotation.

[0205] The toric accommodating intraocular lens disclosed herein comprises a first haptic connected to the optic at a first haptic-optical interface and a second haptic connected to the optic at a second haptic-optical interface located diametrically opposite the first haptic-optical interface, with a midline generally bisecting the first haptic-optical interface and the second haptic-optical interface.

[0206] The toric accommodating intraocular lens disclosed herein has an optical portion comprising a first pair of fluid channels fluidly connecting a fluid-filled optical fluid chamber with a haptic fluid chamber and a second pair of fluid channels fluidly connecting the fluid-filled optical fluid chamber with another haptic fluid chamber, and a midline extends between the first pair of fluid channels and the second pair of fluid channels.

[0207] The toric accommodating intraocular lens disclosed herein comprises an optical portion having an outer optical surface and an optical fluid chamber defined within the optical portion and filled with a fluid, the refractive power of the outer optical surface being greatest along a steep meridian of the outer optical surface and the refractive power of the outer optical surface being least along a flat meridian of the outer optical surface.

[0208] The toric accommodating intraocular lenses disclosed herein change the base power of the optic based on the pressure within the fluid-filled optical fluid chamber.

[0209] The toric accommodating intraocular lenses disclosed herein have a generally constant relative refractive power between the flat and steep meridians while the base power of the optic changes in response to changes in pressure in the fluid-filled optical fluid chamber.

[0210] The toric accommodating intraocular lenses disclosed herein have a planar meridian orientation that remains generally constant while the optic's base power changes in response to changes in pressure within the fluid-filled optical fluid chamber.

[0211] The toric accommodating intraocular lenses disclosed herein have an optical surface opposite the outer optical surface that is aspheric.

[0212] The toric accommodating intraocular lenses disclosed herein are positioned such that the planar meridian is at an oblique angle to the midline that generally bisects the optic zone.

[0213] The toric accommodating intraocular lenses disclosed herein have a cant angle of rotation between about 30 and 60 degrees clockwise.

[0214] The toric accommodating intraocular lenses disclosed herein have a cant angle of approximately 45 degrees clockwise rotation.

[0215] The toric accommodating intraocular lens disclosed herein further comprises a first haptic connected to the optic at a first haptic-optical interface and a second haptic connected to the optic at a second haptic-optical interface located diametrically opposite the first haptic-optical interface, with a midline generally bisecting the first haptic-optical interface and the second haptic-optical interface.

[0216] The toric accommodating intraocular lens disclosed herein has an optical portion comprising a first pair of fluid channels fluidly connecting a fluid-filled optical fluid chamber with a haptic fluid chamber and a second pair of fluid channels fluidly connecting the fluid-filled optical fluid chamber with another haptic fluid chamber, and a midline extends between the first pair of fluid channels and the second pair of fluid channels.

[0217] The toric accommodating intraocular lens disclosed herein comprises a modified optical portion having an outer optical surface, the refractive power of the outer optical surface being greatest along a steep meridian of the outer optical surface and the refractive power of the outer optical surface being least along a flat meridian of the outer optical surface, and the base power of the optical portion changing in response to deformation by the modified optical portion.

[0218] The toric accommodating intraocular lens disclosed herein has a transforming optic that transforms in response to physiological muscle movements of the patient when the toric accommodating intraocular lens is implanted in the patient's body.

[0219] The toric accommodating intraocular lenses disclosed herein have a relative refractive power between the flat and steep meridians that remains substantially constant while the base power of the optic is changed.

[0220] The toric accommodating intraocular lenses disclosed herein have a planar meridian orientation that remains generally constant while the optic base power is changed.

[0221] The toric accommodating intraocular lenses disclosed herein have an optical surface opposite the outer optical surface that is aspheric.

[0222] The toric accommodating intraocular lenses disclosed herein are positioned such that the planar meridian is at an oblique angle to the midline that generally bisects the optic zone.

[0223] The toric accommodating intraocular lenses disclosed herein have a cant angle of rotation between about 30 and 60 degrees clockwise.

[0224] The toric accommodating intraocular lenses disclosed herein have a cant angle of approximately 45 degrees clockwise rotation.

[0225] The toric accommodating intraocular lens disclosed herein comprises a first haptic connected to the optic at a first haptic-optical interface and a second haptic connected to the optic at a second haptic-optical interface located diametrically opposite the first haptic-optical interface, with a midline generally bisecting the first haptic-optical interface and the second haptic-optical interface.

[0226] The toric accommodating intraocular lenses disclosed herein have a minimum radius of curvature of the outer optical surface along the steep meridian and a maximum radius of curvature of the outer optical surface along the flat meridian.

[0227] A number of embodiments have been disclosed. Nevertheless, it will be understood by those skilled in the art that various changes and modifications may be made to the present disclosure without departing from the spirit and scope of the embodiments. The systems, devices, equipment, and methods shown with the embodiments are illustrated for certain embodiments and may be used in combination with or with other embodiments within the present disclosure. For example, the methods shown in the figures or described within the present disclosure do not require the specific order or sequential order shown or described to achieve the desired results. In addition, other operational steps may be provided, or steps or operations may be deleted or omitted from the described method or process to achieve the desired results. Furthermore, components or portions of the devices or systems described in the present disclosure or shown in the figures may be removed, deleted, or omitted to achieve the desired results. In addition, certain components or portions of the systems, devices, or equipment described herein have been omitted for brevity and clarity.

[0228] Accordingly, other embodiments are within the scope of the following claims, and the specification and / or figures may be regarded as illustrative rather than restrictive.

[0229] Each modification or embodiment described and illustrated has independent components and functions which may be readily separated or combined with the functions of the other modifications or embodiments. Modifications may be made to adapt a particular situation, material, composition of matter, process, process acts or steps, to the objective, spirit or scope of the present invention.

[0230] For methods recited herein, the recited events may be carried out in any order that is logically possible, in addition to the recited order of events, and additional steps or operations may be provided or steps or operations may be omitted in order to achieve desired results.

[0231] Furthermore, when a range of values ​​is provided, all values ​​between the upper and lower limits of that range, as well as any other values ​​within the stated or stated range, are encompassed within the scope of the invention. Also, any optional features of the described inventive modifications may be disclosed and claimed independently or together with any one or more of the features described herein. For example, a description of a range from 1 to 5 should be considered to disclose subranges of 1 to 3, 1 to 4, 2 to 4, 2 to 5, 3 to 5, etc., as well as the individual numbers within the range, such as 1.5, 2.5, etc., and whole or partial increments of numbers therebetween.

[0232] All existing subject matter (e.g., publications, patents, patent applications) mentioned herein is hereby incorporated by reference in its entirety, except to the extent that the subject matter conflicts with the subject matter of the present invention, in which case the content of this specification shall take precedence. The referenced items are provided solely for their disclosure prior to the filing date of this application. Nothing herein should be construed as an admission that the present invention is not entitled to antedate such material by virtue of prior invention.

[0233] Reference to a singular item includes the possibility of a plural of the same item. More specifically, in this specification and the appended claims, the singular forms "a," "an," and "said" also include plural references unless the context clearly indicates otherwise. It is further noted that the claims may be drafted to exclude optional elements. Accordingly, this statement is intended to serve as a predicate for the use of exclusive terminology such as "solely," "solely," or "negative" limitations in connection with the recitation of claim elements. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.

[0234] The phrase "at least one of," when used to modify a plurality of items or components (or an enumerated list of items or components), is meant to indicate a combination of one or more of those items or components. For example, "at least one of A, B, and C" means (i) A, (ii) B, (iii) C, (iv) A, B, and C, (v) A and B, (vi) B and C, or (vii) A and C.

[0235] In understanding the scope of the present disclosure, "comprises" and its derivatives, as used herein, are intended to be open-ended terms specifying the mentioned features, elements, components, groups, integers, and / or steps, but not excluding other unmentioned features, elements, components, groups, integers, and / or steps. The same also applies to terms of similar meaning, such as "include," "have," and their derivatives. The terms "part," "portion," "part," "member," "element," or "component," when used in the singular, have the dual meaning of one part and multiple parts. As used herein, the directional terms "front, back, up, down, vertically, horizontally, below, across, laterally, and longitudinally" and other similar directional terms refer to the location of a device or equipment, or the direction in which a device or equipment is moved or moved.

[0236] Finally, terms indicating degree, such as "generally," "about," and "approximately," as used herein, refer to a particular value or a reasonable amount of variation from a specified value such that the particular value and end result will not be significantly or substantially different (e.g., a variation of up to ±0.1%, ±1%, ±5%, or ±10%, where such variation is appropriate). For example, "about 1.0 cm" may be interpreted as meaning "1.0 cm" or "between 0.9 cm and 1.1 cm." Terms indicating degrees such as "about" or "approximately" are used to indicate numbers or values ​​that are part of a range, and the terms may be used to modify the lower and upper numbers or values.

[0237] The present disclosure is not intended to be limited in scope to any particular form, but is intended to cover alternatives, modifications, and equivalents of the modifications or embodiments described herein. Moreover, the scope of the present disclosure fully encompasses other modifications or embodiments that may become apparent to those skilled in the art in view of the present disclosure.

Claims

1. an optic having an anterior element having an anterior optical surface, a posterior element having a posterior optical surface, and an optical fluid chamber filled with a fluid defined therebetween; At least one of the anterior optical surface and the posterior optical surface has a radius of curvature that differs along different optical surface meridians; the base power of the optical portion varies based on the pressure in the optical fluid chamber filled with the fluid; the cylinder power of the optic portion remains substantially constant while the base power of the optic portion changes in response to changes in the pressure of the fluid-filled optical fluid chamber; Toric accommodating intraocular lens.

2. The toric accommodating intraocular lens of claim 1 , wherein the posterior optical surface is configured such that the radii of curvature of the posterior optical surface are different along different optical surface meridians of the posterior optical surface.

3. The toric accommodating intraocular lens of claim 2 , wherein the radius of curvature of the posterior optical surface varies periodically around the circumference of the posterior optical surface.

4. The toric accommodating intraocular lens of claim 2 , wherein the posterior element further comprises a rotationally symmetric posterior inner surface.

5. 5. The toric accommodating intraocular lens of claim 4, wherein the posterior element has a posterior element thickness measured from the posterior optical surface to the posterior inner surface, the posterior element thickness varying periodically around a circumference of the posterior element.

6. The toric accommodating intraocular lens of claim 2 , wherein the anterior optical surface is aspheric.

7. The toric accommodating intraocular lens of claim 1 , wherein the anterior optical surface is configured such that the radii of curvature of the anterior optical surface are different along different optical surface meridians of the anterior optical surface.

8. The toric accommodating intraocular lens of claim 7 , wherein the radius of curvature of the anterior optical surface varies periodically around the circumference of the anterior optical surface.

9. The toric accommodating intraocular lens of claim 8 , wherein the anterior element further comprises an anterior inner surface that is rotationally symmetric.

10. 10. The toric accommodating intraocular lens of claim 9, wherein the anterior element has an anterior element thickness measured from the anterior optical surface to the anterior inner surface, the anterior element thickness varying periodically around a circumference of the anterior element.

11. The toric accommodating intraocular lens of claim 7 , wherein the posterior optical surface is aspheric.

12. The toric accommodating intraocular lens of claim 1 , wherein the cylindrical axis orientation of the optical portion remains substantially unchanged while the base power of the optical portion undergoes said change in response to changes in the pressure within the fluid-filled optical fluid chamber.

13. 2. The toric accommodating intraocular lens of claim 1, wherein the at least one of the anterior optical surface and the posterior optical surface has a flat meridian and a steep meridian disposed generally perpendicular to the flat meridian, the radius of curvature being smallest along the steep meridian and the radius of curvature being largest along the flat meridian.

14. The toric accommodating intraocular lens of claim 13 , wherein the flat meridian is disposed at an oblique angle to a midline that generally bisects the optic zone.

15. 15. The toric accommodating intraocular lens of claim 14, wherein the oblique angle is between 30 and 60 degrees of clockwise rotation.

16. The toric accommodating intraocular lens of claim 14, further comprising a first haptic connected to the optical portion at a first haptic-optical interface, and a second haptic connected to the optical portion at a second haptic-optical interface located diametrically opposite the first haptic-optical interface, wherein the midline approximately bisects the first haptic-optical interface and the second haptic-optical interface.

17. The toric accommodating intraocular lens of claim 14, wherein the optical portion comprises a first pair of fluid channels fluidly connecting the fluid-filled optical fluid chamber with a haptic fluid chamber and a second pair of fluid channels fluidly connecting the fluid-filled optical fluid chamber with another haptic fluid chamber, and the midline extends between the first pair of fluid channels and the second pair of fluid channels.

18. an optic having an outer optical surface and a fluid-filled optical fluid chamber defined within the optic; the refractive power of the outer optical surface is greatest along a steep meridian of the outer optical surface and the refractive power of the outer optical surface is least along a flat meridian of the outer optical surface; the base power of the optical portion varies based on the pressure in the optical fluid chamber filled with the fluid; the relative refractive power between the flat meridian and the steep meridian remains substantially constant while the base power of the optical portion changes in response to changes in the pressure of the fluid-filled optical fluid chamber. Toric accommodating intraocular lens.

19. 19. The toric accommodating intraocular lens of claim 18, wherein the direction of the flat meridian remains substantially constant while the base power of the optical portion undergoes said change in response to changes in the pressure within the fluid-filled optical fluid chamber.

20. 20. The toric accommodating intraocular lens of claim 18, wherein another optical surface opposite the outer optical surface is aspheric.

21. 20. The toric accommodating intraocular lens of claim 18, wherein the flat meridian is disposed at an oblique angle to a midline that generally bisects the optic zone.

22. The toric accommodating intraocular lens of claim 21, further comprising a first haptic connected to the optical portion at a first haptic-optical interface, and a second haptic connected to the optical portion at a second haptic-optical interface located diametrically opposite the first haptic-optical interface, wherein the midline approximately bisects the first haptic-optical interface and the second haptic-optical interface.

23. The toric accommodating intraocular lens of claim 21, wherein the optical portion comprises a first pair of fluid channels fluidly connecting the fluid-filled optical fluid chamber with a haptic fluid chamber and a second pair of fluid channels fluidly connecting the fluid-filled optical fluid chamber with another haptic fluid chamber, and the midline extends between the first pair of fluid channels and the second pair of fluid channels.

24. a modified optic having an outer optical surface; the refractive power of the outer optical surface is greatest along a steep meridian of the outer optical surface and the refractive power of the outer optical surface is least along a flat meridian of the outer optical surface; The base power of the deforming optical unit changes in response to the deformation caused by the deforming optical unit; When the toric accommodating intraocular lens is implanted in a patient's body, the transforming optic transforms in response to physiological muscle movements of the patient; the relative refractive power between the flat meridian and the steep meridian remains substantially unchanged while the base power of the deformation optic changes; Toric accommodating intraocular lens.

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