Accommodating intraocular lenses and associated methods

Abstract

To provide accommodating intraocular lenses and associated methods.SOLUTION: An accommodating intraocular lens (AIOL) can include a base lens having an anterior base lens component, an optical axis, and a posterior base lens component. The base lens can include a plurality of retaining structures formed in the anterior base lens component and / or the posterior base lens component. The base lens can include an optical chamber and a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir being in fluid communication with the optical chamber. The AIOL can include a fixed lens configured to be removably coupled with the base lens, the fixed lens having a lens portion and a plurality of tabs extending radially outward from the lens portion, each tab being configured to enter one of the plurality of retaining structures when the fixed lens is coupled to the base lens.SELECTED DRAWING: Figure 13A

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Patent Application No. 62 / 970,612, entitled "ACCOMMODATING INTRAOCULAR LENSES AND ASSOCIATED METHODS," filed February 5, 2020, and U.S. Provisional Patent Application No. 63 / 038,624, entitled "ACCOMMODATING INTRAOCULAR LENSES AND ASSOCIATED METHODS," filed June 12, 2020, the entire disclosures of which are incorporated herein by reference.

[0002] The present technology relates to accommodating intraocular lenses (AIOLs) and methods for implanting and assembling the same. [Background technology]

[0003] Cataracts affect a large portion of the world's adult population by clouding the natural lens and resulting in loss of vision. Patients with cataracts can be treated by removing the natural lens and surgically implanting an artificial intraocular lens (IOL).

[0004] Millions of IOL implantation procedures are performed annually worldwide. In the United States, 3.5 million cataract procedures are performed, while more than 20 million procedures are performed annually worldwide.

[0005] Although IOL implantation procedures are effective in restoring vision, traditional IOLs have several drawbacks. For example, many traditional IOLs cannot change focus (known as accommodation) like the natural lens can. Other drawbacks of traditional IOLs include the development of refractive errors after implantation that can result in the need for glasses to correct distance vision, or in other cases, the IOL may be effective in providing good distance vision, but the patient will require glasses for intermediate and near vision.

[0006] To address these shortcomings, several multifocal IOLs have been developed, but they can have drawbacks. For example, while multifocal IOLs generally work well for reading and distance vision, such multifocal IOLs can, at least in some cases, produce noticeable glare, halos, reduced contrast sensitivity, and other visual disturbances.

[0007] AIOLs have been proposed to provide adjustable refractive power depending on the distance at which a patient views an object. However, such AIOLs are generally still under development and have various drawbacks. For example, conventional AIOLs may not provide sufficient accommodation or may not provide optimal ocular refractive correction after implantation. Also, the amount of accommodation of conventional AIOLs may be reduced after implantation, at least in some cases. Conventional AIOLs may also be too large to be inserted through a small incision in the eye, requiring a somewhat larger incision than would be ideal. Also, at least some of the conventional AIOLs may be unstable when placed in the eye, leading to improper accommodation and other errors.

[0008] An improved implantable intraocular lens that responds to the natural mechanisms that control focusing of the eye and overcomes at least some of the above-mentioned shortcomings is desirable. Ideally, such an improved AIOL, when implanted, would provide an increased amount of accommodation, provide refractive stability, introduce little, if any, perceptible visual disturbance, and change the refractive power of the eye from distance to near vision depending on the distance of the object viewed by the patient. Summary of the Invention [Means for solving the problem]

[0009] The present technology is directed to AIOLs, as well as methods for making and using such devices. In many of the embodiments disclosed herein, the AIOL includes an accommodating lens portion and a fixed lens portion configured to removably connect to the accommodating lens portion. The AIOL can include recesses (e.g., crevices, channels, valleys, depressions, trenches, etc.) and protrusions (e.g., convex walls, ridges, bumps, etc.) at the leading edge of the bellows of the AIOL to facilitate the passage of fluid through the AIOL when the AIOL is implanted in the patient's capsular bag. In some embodiments, the AIOL includes a haptic portion comprising a plurality of spring elements connected to each other by one or more frame components. In some embodiments, the AIOL includes a removable fixed lens and a removable accommodating lens. The present invention provides, for example, the following items. (Item 1) An accommodating intraocular lens (AIOL), A base lens, an anterior base lens component having a first optic portion and a first haptic portion at least partially surrounding the first optic portion; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; a plurality of retention structures formed on one or both of the anterior and posterior base lens components, the retention structures being open toward the optical axis; an optical chamber between the first optical portion and the second optical portion; a base lens having a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber; A fixed lens configured to be removably coupled to the base lens, the fixed lens comprising: a lens portion having a front surface and a rear surface, the lens portion being aligned with first and second optical portions when the fixed lens is bonded to the base lens; and a fixed lens having a plurality of tabs extending radially outward from the lens portion, each tab configured to enter one of the plurality of retention structures when the fixed lens is coupled to the base lens. (Item 2) 2. The AIOL of claim 1, wherein when the fixed lens is bonded to the base lens, the anterior surface of the fixed lens is positioned rearward of a front-most edge of the anterior base lens component. (Item 3) 2. The AIOL of claim 1, further comprising a hole through one of the tabs, the hole being configured to receive a portion of a tool for manipulating the fixed lens relative to the base lens. (Item 4) the anterior base lens component includes a first annular mating portion surrounding the first optic portion; the posterior base lens component includes a second annular mating portion surrounding the second optic portion; the first annular mating portion includes a plurality of protrusions configured to mate with the second annular mating portion; 2. The AIOL of claim 1, wherein circumferential gaps between the plurality of protrusions at least partially define a fluid flow path between the tactile reservoir and the optical chamber. (Item 5) the anterior base lens component includes a first annular mating portion surrounding the first optic portion; the posterior base lens component includes a second annular mating portion surrounding the second optic portion; the second annular mating portion includes a plurality of protrusions configured to mate with the first annular mating portion; 2. The AIOL of claim 1, wherein circumferential gaps between the plurality of protrusions at least partially define a fluid flow path between the tactile reservoir and the optical chamber. (Item 6) Item 1. The AIOL of item 1, further comprising one or more indentations on the anterior-most surface of the anterior base lens component. (Item 7) 7. The AIOL of claim 6, further comprising a radial indentation on a radially outermost surface of one or both of the anterior base lens component and the posterior base lens component, the radial indentation being circumferentially aligned with each of the one or more indentations on the anterior-most surface of the anterior base lens component. (Item 8) 2. The AIOL of claim 1, further comprising a fluid chamber between the fixed lens and the first optical portion of the anterior base lens component when the fixed lens is coupled to the base lens, wherein circumferential gaps between the tabs of the fixed lens allow fluid to pass around the fixed lens into and out of the fluid chamber. (Item 9) 2. The AIOL of claim 1, further comprising a channel in an outer wall of the base lens, the channel extending along the entire circumference of the base lens. (Item 10) Item 10. The AIOL of item 9, wherein the channel is positioned at a seam between the anterior and posterior base lens components. (Item 11) An accommodating intraocular lens (AIOL), There is a base lens, an anterior base lens component having a first optic and a first haptic at least partially surrounding the first optic, the first optic having an annular channel extending along a periphery of a posterior surface of the first optic; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; an optical chamber between the first optical portion and the second optical portion; a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber; and one or more recesses configured to releasably receive a portion of a fixed lens or other optical structure. (Item 12) Item 12. The AIOL of item 11, wherein the one or more depressions are open toward the optical axis. (Item 13) An accommodating intraocular lens (AIOL), a haptic structure including a plurality of spring elements distributed in a circumferential array about a central axis, each of the spring elements having a rearward portion and a forward portion hingedly connected to the rearward portion, each of the rearward and forward portions extending from the hinge toward the central axis; a forward ring connected to the forward portions of the plurality of spring elements; a rear ring connected to the rearward portions of the plurality of spring elements; an accommodative lens positioned between the front ring and the rear ring and surrounded by the plurality of spring elements, the accommodative lens comprising: A front lens portion, The rear lens portion, a fluid chamber between the anterior lens portion and the posterior lens portion, applying a radially inward force to the spring element; increasing the distance between the front ring and the rear ring in a direction parallel to the central axis; increasing the refractive power of the AIOL; An AIOL, wherein one or both of the front and rear rings include mating structure configured to releasably couple with a fixed lens. (Item 14) Item 14. The AIOL of item 13, wherein the anterior lens portion is secured to the anterior portion of the spring element and the posterior lens portion is secured to the posterior portion of the spring element. (Item 15) Item 14. The AIOL of item 13, wherein the hinge is formed at a seam between the anterior lens portion and the posterior lens portion. (Item 16) Item 14. The AIOL of item 13, further comprising the fixed lens removably coupled to the mating structure. (Item 17) Item 17. The AIOL of item 16, wherein the mating structure is an annular channel on a radially inward facing surface of one or both of the forward and aft rings. (Item 18) An accommodating intraocular lens (AIOL), a haptic structure including a plurality of spring elements distributed in a circumferential array about a central axis, each of the spring elements having a rearward portion and a forward portion hingedly connected to the rearward portion, each of the rearward and forward portions extending from the hinge toward the central axis; a forward ring connected to the forward portions of the plurality of spring elements; a rear ring connected to the rearward portions of the plurality of spring elements; an accommodative lens coupled to one of the rear ring or the front ring, the accommodative lens comprising: A front lens portion, The rear lens portion, a fluid chamber between the anterior lens portion and the posterior lens portion, applying a radially inward force to the spring element; compressing the periphery of the accommodating lens in a direction parallel to the central axis; and increasing the refractive power of the AIOL; a mating structure configured for releasably coupling with a fixed lens, said mating structure being configured such that one of said rear ring or said front ring is releasably coupled with a fixed lens, when the accommodating lens is coupled to the front ring, the mating structure is on the rear ring; An AIOL comprising a mating structure such that when the accommodating lens is coupled to the posterior ring, the mating structure is on the anterior ring. (Item 19) Item 19. The AIOL of item 18, wherein application of a radially inward force to the spring element tilts the outer periphery of the accommodating lens away from the hinge. (Item 20) The fixed lens further includes an annular channel in a radially outward portion of the fixed lens, the annular channel comprising: the fixed lens receives a portion of the front ring when coupled to the front ring; or Item 19. The AIOL of item 18, wherein the fixed lens is configured to receive a portion of the posterior ring when coupled to the posterior ring. (Item 21) An accommodating intraocular lens (AIOL), an anterior lens component having a first optic and a first haptic at least partially surrounding the first optic; The optical axis, a posterior lens component coupled to the anterior lens component and having a second optic aligned with the first optic along the optical axis and a second haptic at least partially surrounding the second optic and aligned with the first haptic in a direction parallel to the optical axis; an optical chamber between the first optical portion and the second optical portion; a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber; a first side channel in a radially outward surface of the anterior lens component relative to the optical axis, the first side channel extending around an outer periphery of the anterior lens component; a second posterior channel in a radially outward facing surface of the anterior lens component and / or the posterior lens component, the second side channel extending around an outer periphery of the anterior lens component and / or the posterior lens component, the second side channel being spaced apart from the first side channel in a direction parallel to the optical axis; a plurality of channels in a radially outward surface of the anterior lens component and / or the posterior lens component, the channels intersecting the first and second side channels and extending in an oblique direction relative to the first and second side channels; and one or more mating structures configured to releasably receive a portion of a fixed lens or other optical structure. (Item 22) Item 22. The AIOL of item 21, further comprising a plurality of indentations in a front-most surface of the anterior lens component, each of the indentations being circumferentially aligned with one of the plurality of channels. (Item 23) 22. The AIOL of item 21, comprising at least 15 channels. (Item 24) An accommodating intraocular lens (AIOL), A base lens, an anterior base lens component having a first optic portion and a first haptic portion at least partially surrounding the first optic portion; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; a plurality of cavities formed in one or both of the anterior base lens component and the posterior base lens component, the plurality of cavities being open toward the optical axis; an optical chamber between the first optical portion and the second optical portion; a base lens having a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber; a fixed lens configured to be removably coupled to the base lens; and a visual marker on one or both of the fixed lens and the base lens, the visual marker configured to confirm proper alignment between the fixed lens and the base lens and / or complete bonding of the fixed lens and the base lens. (Item 25) 25. The AIOL of claim 24, wherein the visual marker comprises one or more markings on the first optical portion, each marking being visible through the fixed lens when the fixed lens is bonded to the base lens. (Item 26) 26. The AIOL of claim 25, wherein each marking is circumferentially aligned with a depression in the radially outward portion of the base lens. (Item 27) the fixed lens includes a lens portion and a skirt extending posteriorly from the lens portion; the visual marker is a colored portion of the skirt having a first color; when the fixed lens is bonded to the base lens, at least a portion of the base lens overlaps with at least a portion of the tinted portion of the skirt in a direction perpendicular to the optical axis; Item 25. The AIOL of item 24, wherein the tinted portion appears as a second color when viewed through the portion of the base lens overlapping the tinted portion. (Item 28) 28. The AIOL according to item 27, wherein the first color is yellow and the second color is green. (Item 29) Item 28. The AIOL of item 27, wherein the portion of the base lens overlapping the tinted portion has a third color. (Item 30) 30. The AIOL according to item 29, wherein the third color is blue. (Item 31) An accommodating intraocular lens (AIOL), A base lens, an anterior base lens component having a first optic portion and a first haptic portion at least partially surrounding the first optic portion; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; a plurality of cavities formed in one or both of the anterior base lens component and the posterior base lens component, the plurality of cavities being open toward the optical axis; a plurality of slots, each slot adjacent one of the plurality of cavities; an optical chamber between the first optical portion and the second optical portion; a base lens having a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber; A fixed lens configured to be removably coupled to the base lens, the fixed lens comprising: a lens portion having a front surface and a rear surface, the lens portion being aligned with first and second optical portions when the fixed lens is bonded to the base lens; a plurality of tabs extending radially outward from the lens portion; each tab is configured to fit into one of the slots when the fixed lens is initially translated to a position where the fixed lens is at least partially surrounded by the haptic reservoir; an AIOL, wherein each tab is configured to enter one of the plurality of cavities when the fixed lens is rotated about the optical axis after the tabs are positioned within the slots. (Item 32) Item 32. The AIOL of item 31, further comprising a plurality of radially inward protrusions on an interface between the slot and the cavity, the protrusions configured to flex radially outward when the fixed lens rotates about the optical axis after the tabs are positioned in the slots, the protrusions preventing the tabs from moving from the cavity into the slots under the force of a patient's eye. (Item 33) Item 32. The AIOL of item 31, further comprising a plurality of steps in an interface between the slot and the cavity, the steps preventing movement of the tab from the cavity into the slot under the force of a patient's eye. [Brief description of the drawings]

[0010] Many aspects of the present technology can be better understood with reference to the following drawings. Components in the drawings are not necessarily drawn to scale. Instead, emphasis has been placed on clearly illustrating the principles of the present technology. Additionally, components may be shown as transparent in certain figures for clarity of illustration only, and are not intended to imply that the components shown are necessarily transparent. Components may also be shown in schematic form.

[0011] [Figure 1A] 1A-1D show front and rear elevation views of one embodiment of an AIOL. [Figure 1B] The regulatory structure of the AIOL of FIG. 1A is shown in an exploded configuration. [Figure 1C] 1B shows a cross-sectional view of the AIOL of FIG. 1A along section plane AA of FIG. 1A. [Figure 1D]1B shows a cross-sectional view of the AIOL of FIG. 1A along section plane BB of FIG. 1A. [Figure 2A] 1 shows a perspective view of an AIOL configured in accordance with one embodiment of the present technology. [Figure 2B] 2B shows a cross-sectional view of the AIOL of FIG. 2A taken along a cutting plane parallel to and passing through the central optical axis of the AIOL of FIG. 2A. [Figure 2C] 2B shows a perspective cross-sectional view of a first component of an accommodation structure of the AIOL of FIG. 2A taken along a cutting plane parallel to and passing through the central optical axis of the AIOL of FIG. 2A. [Figure 2D] FIG. 2D shows a bottom perspective view of the first component of FIG. 2C. [Figure 2E] 2B shows a cross-sectional view of a portion of the accommodation structure of the AIOL of FIG. 2A taken along a cut plane parallel to and passing through the central optical axis of the AIOL of FIG. 2A. [Figure 2F] 2B shows a cross-sectional view of a portion of the adjustment structure of the AIOL of FIG. 2A along a cut plane parallel to and passing through the central optical axis of the AIOL of FIG. 2A, with a groove added to the rear surface of a first portion of the adjustment structure of the AIOL of FIG. 2A. [Figure 2G] 1 illustrates a bottom perspective view of a first component of an AIOL configured in accordance with an embodiment of the present technology, where a ring portion includes standoffs extending in a direction parallel to the central optical axis of the first component. [Figure 2H] 2H shows a cross-sectional view of a portion of an adjustment structure of an AIOL having the first component of FIG. 2G taken along a cutting plane parallel to and passing through the central optical axis of the first component of FIG. 2G. [Figure 3A] 1 shows a perspective view of an AIOL configured in accordance with another embodiment of the present technology. [Figure 3B] 3B shows a cross-sectional view of the AIOL of FIG. 3A along a cutting plane parallel to and passing through the central optical axis of the AIOL of FIG. 3A. [Figure 3C] 3B shows a cross-sectional view of a portion of the accommodation structure of the AIOL of FIG. 3A taken along a cut plane parallel to and passing through the central optical axis of the AIOL of FIG. 3A. [Figure 3D]3B illustrates a cross-sectional view of a portion of the AIOL of FIG. 3A, taken along a cut plane parallel to and passing through the central optical axis of the AIOL of FIG. 3A, where the outer bellows has been shortened. [Figure 4] 1 shows a perspective view of an AIOL configured in accordance with one embodiment of the present technology. [Figure 5A] FIG. 1 shows a perspective view of a fixed lens configured in accordance with an embodiment of the present technology. [Figure 5B] 5B shows a perspective view of an AIOL having a fixed lens of FIG. 5A and configured in accordance with one embodiment of the present technology. [Figure 5C] 5C shows a plan view of the front side of the AIOL of FIG. 5B. [Figure 6A] FIG. 1 shows a perspective view of a fixed lens configured in accordance with an embodiment of the present technology. [Figure 6B] 6B shows a perspective view of an AIOL having a fixed lens of FIG. 6A and configured in accordance with one embodiment of the present technology. [Figure 6C] 6C shows a plan view of the front of the AIOL of FIG. 6B. [Figure 7A] FIG. 1 shows a perspective view of a fixed lens configured in accordance with an embodiment of the present technology. [Figure 7B] 7B shows a perspective view of an AIOL having a fixed lens of FIG. 7A and configured in accordance with one embodiment of the present technology. [Figure 7C] 7C shows a plan view of the front of the AIOL of FIG. 7B. [Figure 8] 1 illustrates a plan view of the front of an AIOL configured in accordance with one embodiment of the present technology. [Figure 9A] 1 shows a perspective view of an AIOL configured in accordance with one embodiment of the present technology. [Figure 9B] 9B shows a side plan view of the side of the AIOL of FIG. 9A. [Figure 9C] 9B shows a plan view of the front of the AIOL of FIG. 9A. [Figure 9D] 9C shows a cross-sectional view of the AIOL of FIG. 9A taken along section plane 9-9. [Figure 10A] 1 shows an exploded perspective view of an AIOL constructed in accordance with one embodiment of the present technology. [Figure 10B]10B shows a plan view of the front of the AIOL of FIG. 10A. [Figure 10C] FIG. 10B shows a side plan view of the AIOL of FIG. 10A in a lateral disaccommodated configuration. [Figure 10D] FIG. 10B shows a side plan view of the AIOL of FIG. 10A in a lateral accommodation configuration. [Figure 10E] 10B shows a cross-sectional view of the AIOL of FIG. 10A in a disaccommodated configuration along section plane 10-10 of FIG. 10B. [Figure 10F] 10B shows a cross-sectional view of the AIOL of FIG. 10A in an accommodation configuration along section plane 10-10 of FIG. 10B. [Figure 10G] An enlarged view of the cross-sectional view of FIG. 10E is shown. [Figure 10H] An enlarged view of the cross-sectional view of FIG. 10F is shown. [Figure 11A] 1 shows an exploded perspective view of an AIOL constructed in accordance with one embodiment of the present technology. [Figure 11B] 11B shows a perspective view of the AIOL of FIG. 11A when the fixed lens is received in the receiving structure of the accommodation structure. [Figure 11C] 11B shows a perspective view of the AIOL of FIG. 11A when the fixed lens is received in the receiving structure of the accommodation structure. [Figure 11D] 11C shows a cross-sectional view of the AIOL of FIG. 11A taken along the optical axis of the AIOL of FIG. [Figure 11E] 11B shows a top cross-sectional view of the AIOL of FIG. 11A with a hump on the inner surface of the accommodation portion and with the fixed lens in a first position. [Figure 11F] 11E shows the AIOL with the fixed lens in a second position. [Figure 11G] 11B illustrates a top cross-sectional view of the AIOL of FIG. 11A with a step on the inner surface of the accommodation portion and with the fixed lens in a first position. [Figure 11H] 11G shows the AIOL of FIG. 11G with the fixed lens in a second position. [Figure 12A] 1 shows an exploded perspective view of an AIOL constructed in accordance with one embodiment of the present technology. [Figure 12B] 12B shows a perspective view of the AIOL of FIG. 12A. [Figure 13A]1 illustrates an exploded view of an AIOL constructed in accordance with one embodiment of the present technology. [Figure 13B] 13B shows the AIOL of FIG. 13A in which the fixed lens of the AIOL is bonded to the base lens of the AIOL. [Figure 13C] 13C shows a plan view of the front of the AIOL of FIG. 13B. [Figure 13D] 13C shows a cross-sectional view of the AIOL of FIG. 13B taken along section plane 13D-13D of FIG. 13C. [Figure 14A] 1 shows an exploded perspective view of an AIOL constructed in accordance with one embodiment of the present technology. [Figure 14B] 14B shows a front plan view of the AIOL of FIG. 14A. [Figure 15A] 1 illustrates a front plan view of a second component of an adjustment structure of an AIOL configured in accordance with an embodiment of the present technology. [Figure 15B] FIG. 15B shows an enlarged perspective view of the filling portion of the second component of FIG. 15A. [Figure 15C] 15B shows an enlarged cross-sectional view of the filling portion of the second component of FIG. 15A with a needle passing therethrough. [Figure 15D] 15B shows an enlarged cross-sectional view of the filled portion of the second component of FIG. 15A with a needle passing therethrough at a non-zero angle relative to the optical axis of the second component of FIG. 15A. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] Specific details of various embodiments of the present technology are described below with reference to Figures 1A-10H. Although a number of embodiments are described below with respect to AIOLs and related methods, other embodiments are within the scope of the present technology. Additionally, other embodiments of the present technology may have configurations, components, and / or procedures that differ from those described herein. For example, an AIOL configured in accordance with the present technology may include additional elements and features beyond those described herein, or other embodiments may not include some of the elements and features shown and described herein.

[0013] For ease of reference, the same reference numbers are used throughout this disclosure to identify like or similar components or features, but the use of the same reference numbers does not imply that the parts are to be construed as being identical. Indeed, in many of the examples described herein, identically numbered parts are distinct in structure and / or function.

[0014] 1-1D show one embodiment of an AIOL 100 including a channel for fluid to flow from an outer fluid reservoir to an inner fluid chamber. With joint reference to FIGS. 1A and 1B, the AIOL 100 includes an accommodation structure 140 (e.g., a base lens) having a first component 140a (e.g., an anterior lens component) and a second component 140b (e.g., a posterior lens component). In some embodiments, the first and second components 140a and 140b are assembled to form an outer fluid reservoir 103 (e.g., a haptic reservoir) (FIG. 1A), an intermediate bellows channel 173 (FIG. 1D), and an inner fluid chamber 105 (e.g., an optical chamber) (FIGS. 1C-1D). The first component 140a of the accommodation structure 140 can have an inner portion having a first optical component 110, standoffs 155, and a recess 157 between the standoffs 155. The standoffs 155 project radially outward from the recess 157. The second component 140b of the regulating structure 140 can have an inner portion having the second optical component 150 and a wall 158. With reference to Figures 1C and 1D, which are cross-sectional views taken along lines AA and BB, respectively, of Figure 1A, the standoffs 155 contact the wall 158 (Figure 1D) such that the recess 157 (Figure 1B) defines a channel for fluid to flow from the intermediate bellows channel 173 to the fluid chamber 105.

[0015] 1D, the standoffs 155 protrude radially outward and engage the wall 158. Thus, the standoffs 155 of the AIOL 100 do not extend into the optical region of the AIOL which would increase the field of view of the AIOL 100.

[0016] 1B and 1C, one or both of the first and second components 140a, 140b of the adjustment structure 140 can include axial protrusions, standoffs, spacers, protrusions, or other features configured to space a portion of the first component 140a from the second component 140b in a direction parallel to the optical axis of the AIOL 100. For example, the second component 140b can include one or more protrusions 171 extending from a leading edge of the wall 158 toward the first component 140a. The space between the protrusions 171 can form an intermediate bellows channel 173, which will be described below. In some embodiments, one or both of the first and second components 140a, 140b include a recess that at least partially defines the intermediate bellows channel 173. Such a recess can be included in addition to or instead of the protrusion 171. For example, the leading edge of the wall 158 can include one or more recesses and / or channels.

[0017] In some embodiments, the AIOL 100 includes flow-through features 181 that improve the speed and ease with which an ophthalmic viscosurgical device (OVD) used during implantation of the AIOL can be removed from the natural lens capsule. The embodiment of the AIOL 100 shown in FIGS. 1A-1D includes three outer flow-through features 181. The outer flow-through features 181 can be detents, such as recesses, distributed circumferentially along the outer periphery of the outer fluid reservoir 103. The flow-through features 181 can create a passage between the outer periphery of the AIOL 100 and the inner surface of the ocular capsule in which the AIOL 100 is implanted to allow for fluid flow around the periphery of the AIOL 100. In the illustrated embodiment, the flow-through features 181 are formed in the area of ​​the first and second components 140a and 140b. Although three outer flow-through features 181 are shown, other embodiments may include fewer or more than shown. The outer flow-through feature 181 may further provide a rotational constraint to maintain the rotational orientation of the accommodating structure 140 relative to the patient's eye capsule when implanted.

[0018] 1C-D includes an optic portion 136, a skirt 132 extending from the optic portion 136, and a passageway 120. The optic portion 136 can have a fixed power that can comprise an asymmetric power lens (e.g., a toric lens) or other lens, and the passageway 120 is a hole, slot, orifice, etc. that extends through the skirt 132 to the peripheral region but does not extend into the optic portion 136.

[0019] 1C, the fixed lens assembly 130 can have an engagement feature 131, such as an annular groove extending around the skirt 132, and the first component 140a of the adjustment structure 140 can have a thickened region 168, such as an annular protrusion (e.g., a ledge) extending radially inward. The fixed lens assembly 130 can be releasably attached to the adjustment structure 140 by engaging the continuous thickened region 168 of the first component 140a with the engagement feature 131 of the fixed lens 130. In other embodiments (not shown), the thickened region 168 and the engagement feature 131 can be discontinuous features (e.g., segmented or other recesses or protrusions that extend around less than the entire circumference of the fixed lens assembly 130 and adjustment structure 140). Such discontinuous thickened regions 168 and engagement features 131 can facilitate maintaining a particular radial alignment between the fixed lens assembly 130 and the adjustment structure 140, such as when the fixed lens 130 includes a toric lens or other asymmetric lens. Alternatively, the grooves may be on the fixed lens 130 and the protrusions on the adjustment structure 140.

[0020] The AIOL 100 can have a fluidically regulated lens 112 defined by a fluid chamber 105 (FIGS. 1C and 1D) bounded between the first optical component 110 and the second optical component 150. The fluid chamber 105 is in fluid communication with the outer reservoir 103 via a separate fluid channel 149 between the standoffs 155 when the first and second components 140a and 140b are assembled. The first and second optical components 110 and 150 can be planar members (e.g., optical films) of the first and second components 140a and 140b, respectively. The first and second optical components 110 and 150 can be integrally formed as an optical film with other portions of the first and second components 140a and 140b, for example. In an alternative embodiment, either or both of the films of the first and second optical components 110 and 150 can be lenses (i.e., have optical power).

[0021] The AIOL 100 can further include a square shaped (e.g., stepped) annular region 151 that inhibits migration of cells from the periphery of the patient's capsule into the optic portion of the AIOL 100 (shown in FIGS. 1C-D at the posterior-most region of the lens). By inhibiting migration of cells from the periphery of the patient's capsule into the optic portion of the AIOL 100, the risk of opacification of the optical system after surgery can be reduced.

[0022] The peripheral portions of the first and second components 140a and 140b define the outer fluid reservoir 103, and the inner portions of the first and second components 140a and 140b define the regulating structure element 140. The first and second components 140a and 140b can be joined together at a seam 101. Joining means are described in detail in PCT Publication No. WO2018 / 119408, attached at the end of this disclosure. The first and second components 140a and 140b can also be joined at other areas, such as standoffs 155. The standoffs 155 are separated by a space that defines a fluid channel between the outer fluid reservoir 103 and the inner fluid chamber 105. The outer fluid reservoir 103 may be a bellows 108 having an outer bellows region 103 a and an inner bellows region 103 b , which may be defined by channels between the standoffs 155 .

[0023] In some embodiments, the volume of the inner bellows region 103b is smaller than the outer bellows region 103a. By reducing the volume of the inner bellows region 103b, the additional space surrounding the optical region of the AIOL allows the optical aperture of the fixed lens 130 to be larger compared to embodiments having a larger inner bellows region. Additionally, the passageway 120 of the fixed lens 130 that allows aqueous humor to freely enter and exit the chamber 141 is configured to pass through the outer skirt 132 and, in some embodiments, not through the top optical portion 136. This is expected to reduce unwanted scattered light due to internal reflection that may pass through the optical system and reach the retina.

[0024] The first component 140a may also include one or more thickened regions 160, for example, for use in filling the AIOL with optical fluid. The thickened regions 160 allow a longer path for the needle used to fill the regulating structure with optical fluid, while a second needle in a different region is used to remove the gas that the fluid is displacing. As shown, the fluid-filled thickened regions 160 are located adjacent to one or more of the outer fluid through-flow portions 181. In some embodiments, the optical fluid may be comprised of high refractive index polyvinyl alcohol.

[0025] 1D , the outer fluid reservoir 103 of the AIOL 100 may include (a) a first bellows structure 103a having a forward portion 104a and a rearward portion 104b, (b) a second bellows structure 103b radially inward of the first bellows structure 103a, and / or (c) an intermediate bellows channel 173 defining a horizontal passage between the first and second bellows structures 103a and 103b. During a sac deflation operation, the intermediate portion of the first bellows structure 103a may be constrained by the intermediate bellows channel 173 while the forward portion 104a and the rearward portion 104b of the first bellows structure 103a move radially inward relative to the intermediate bellows channel 173. Thus, the forward portion 104a and the rearward portion 104b of the first bellows structure 103a may flex radially inward in response to a corresponding movement of the native sac. This allows more fluid to flow from the outer fluid reservoir 103 into the inner fluid chamber 105, which may provide more conditioning since collapsing the outer fluid reservoir 103 back and forth is less efficient than radial compression of the outer fluid reservoir 103. Without limitation, embodiments as shown herein may be constructed from parts where some or all of the portions not in the optical path are dyed or treated to reduce light overall, to limit the ability of stray light entering portions outside the optical path to be scattered into the optical path.

[0026] The fixed lenses described in any of the embodiments described herein may have a spherical, aspheric, toric, or any other known lens configuration. Alternatively, or in combination, the fixed solid lenses may be plano-convex, convex-concave, or convex-convex. The fixed lenses may be configured to have a positive fixed power or a negative fixed power.

[0027] The fluid lenses described herein may be configured to have one or more conditioning surfaces (eg, two conditioning surfaces).

[0028] In some embodiments, instead of a membrane with no power, the accommodating structure can include one or more deformable lenses that deflect based on fluid pressure in the internal fluid chamber. Each or both of the deformable lenses can have a fixed power, which can be positive or negative.

[0029] 2A-2E show an AIOL 200 having many or all of the same features of the AIOL 100 described above with respect to FIGS. 1A-1D. For example, like reference numbers between FIGS. 2A-2E and 1A-1D indicate the same or similar features (e.g., fixed lens 230 vs. fixed lens 130). As shown, the AIOL 200 can include one or more recesses 282. The recesses 282 can be on the leading edge of the first component 240a of the accommodating structure 240. A protrusion 283 can be formed between the recesses 282. The inclusion of the recesses 282, protrusions 283, and / or flow-through features 281 is expected to improve fluid flow and aqueous circulation within the capsular bag past the leading edge of the accommodating structure 240 when the AIOL 200 is implanted within the patient's capsule. For example, the protrusions 283 can contact the anterior and / or posterior portions of the sac while the recesses 282 form a fluid path through the protrusions 283. In some embodiments, the protrusions 283 are sized such that the contact area between each protrusion 283 and the sac is minimized. For example, one or more of the protrusions 283 can be sized such that the maximum distance between the center of gravity of the contact area and the edge of the contact area is less than 300% of the thickness of the sac membrane, less than 250% of the thickness of the sac membrane, less than 200% of the thickness of the sac membrane, less than 150% of the thickness of the sac membrane, and / or less than 110% of the thickness of the sac membrane. In some embodiments, the maximum distance between the center of gravity of the contact area and the edge of the contact area is approximately 100% of the thickness of the sac membrane. Reducing the size of the contact area between the protrusions 283 and the sac can promote / improve uniform diffusion of fluid through the sac membrane at and near the contact area.

[0030] The recesses 282 can have an arcuate width of 5° to 30°, 10° to 15°, 20° to 25°, 15° to 20°, and / or 10° to 20°. In some embodiments, the arcuate width of the recesses 282 is less than 30°, less than 25°, less than 20°, less than 15°, and 10°, and / or less than 5°. In some embodiments, each of the recesses 282 has an approximately equal arcuate width. One or more recesses 282 can have a larger arcuate width than one or more other recesses 282. Similarly, the protrusions 283 can have an arcuate width of 5° to 30°, 10° to 15°, 20° to 25°, 15° to 20°, and / or 10° to 20°. In some embodiments, the arcuate width of the protrusions 283 is less than 30°, less than 25°, less than 20°, less than 15°, and less than 10°, and / or less than 5°. In some embodiments, each of the protrusions 283 has an approximately equal arcuate width. One or more of the protrusions 283 may have a larger arcuate width than one or more of the other protrusions 283. These arcuate widths are measured relative to the central optical axis of the adjustment structure 240. In some embodiments, one or more of the protrusions 283 have an arcuate width that is smaller or larger than the arcuate width of one or more of the indentations 282. Additionally, one or more of the protrusions 283 may have an arcuate width equal to the arcuate width of one or more of the indentations 282.

[0031] As shown in FIGS. 2B-2E, the first component 240a of the adjustment structure 240 can include a ring portion and / or a reinforcing portion 284. The reinforcing portion 284 can extend around the periphery of the first optical component 210 of the first component 240a. The reinforcing portion 284 can be, for example, a thickened portion of the first optical component 210. In some embodiments, the reinforcing portion 284 is configured to reduce the likelihood of buckling and / or other undesirable deformation of the first optical component (which may induce aberrations in the optical wavefront passing through the AIOL) when a compressive force is applied to the bellows 208 (FIG. 2B). For example, the reinforcing portion 284 can reduce the likelihood of the first optical component 210 deflecting or deforming non-uniformly around the periphery of the first optical component 210. In some embodiments, the reinforcing portion 284 has a thickness (measured parallel to and along the central optical axis of the adjusting structure 240) that is 110%-150%, 115%-200%, 120%-140%, 125%-145% of the thickness of the first optical component 210 (measured parallel to and along the central optical axis of the adjusting structure 240). In some embodiments, the reinforcing portion 284 has a thickness of approximately 125% of the thickness of the first optical component 210. In some embodiments, the reinforcing portion 284 has a radial thickness (as measured perpendicular to the central optical axis of the adjusting structure 240) that is 5%-40%, 10%-35%, 10%-20%, and / or 15%-30% of the radius of the first optical component 210 (measured perpendicular to the central optical axis of the adjusting structure 240). In some embodiments, the reinforcing portion 284 has a radial thickness (e.g., width) that is approximately 15% of the radius of the first optical component 210. The reinforcing portion 284 can be formed as a monolithic part with the first optical component 210 or as a separate part that is later combined with the first optical component 210.

[0032] 2B, the second optical component 250 can be thicker than the first optical component 210 when measured parallel to the central optical axis of the adjustment structure 240. Increasing the thickness of the second optical component 250 is expected to reduce undesirable / uneven deformation of the second optical component 250 when a radial compressive force is applied to the bellows 208. In some embodiments, for example, the second optical component 250 is up to 5% thicker, up to 10% thicker, up to 15% thicker, up to 20% thicker, up to 30% thicker, and / or up to 50% thicker than the first optical component 210.

[0033] In some embodiments, the first component 240a of the adjustment structure 240 includes a plurality of standoffs 255 similar or identical to the standoffs 155 described above with respect to the AIOL 100. The standoffs 255 can extend in an approximately radially outward direction relative to a central optical axis of the adjustment structure 240. In some embodiments, the radially outward surface of the standoffs 255 can be positioned during manufacturing at any distance from the central optical axis that is 95%-98% of the distance between the central optical axis and the surface of the second component 240b to which the standoffs 255 are connected. In some embodiments, the radially outward surface of the standoffs 255 is positioned during manufacturing at approximately the same radial distance from the central optical axis as the surface of the second component 240b to which the standoffs 255 are connected. By sizing the standoff 255 to approximately 100% of the radial distance to the connecting surface of the second component 240b, the mechanical stress applied to the first optical component 210 from the second component 240b of the adjustment structure 240 can be reduced or eliminated.

[0034] In some embodiments, as shown in FIG. 2D , the first component 240a includes an axial standoff 256. The axial standoff 256 can be connected to the standoff 255 or separate from the standoff 255. In the illustrated embodiment, for example, the axial standoff 256 is connected to the standoff 255 and protrudes in a direction parallel to the central optical axis of the adjustment structure 240. In some embodiments, the axial standoff 256 has an arcuate width that is greater than or less than the arcuate width of the standoff 255. In some embodiments, the axial standoff 256 has an arcuate width that is approximately equal to the arcuate width of the standoff 255. Including the axial standoff 256 in addition to the standoff 255 can increase the stiffness and rigidity of the joint between the first component 240a of the adjustment structure 240 and the second component 240b of the adjustment structure 240. Increasing the stiffness of the bond between the first component 240a and the second component 240b is expected to reduce the likelihood of undesirable deformation of one or both of the first optical component 210 and the second optical component 250 in response to radial compression of the bellows 208.

[0035] FIG. 2F illustrates an embodiment of a first component 240a' substantially similar or identical to the first component 240a described above with respect to FIGS. 2A-2E. The first portion 240a' differs from the first component 240a described above in that the first portion 240a' includes one or more channels or grooves formed (e.g., cut, molded, or otherwise created) in the first optical component 210'. For example, a groove 287 can be formed in the rear surface of the first optical component 210'. The groove 287 can be annular. In some embodiments, two or more grooves are formed in the rear surface of the first optical component 210'. The groove 287 can be positioned in contact with or near the reinforcement portion 284'. In some embodiments, the groove 287 is positioned at or near a radially outward edge (as measured perpendicular to the central optical axis of the adjustment structure 240) of the first optical component 210'. In some embodiments, the groove 287 is formed in the front surface of the first optical component 210'. The groove 287 may create a weakened portion of the first optical component 210'. This weakened portion may create a hinge point around which the first optical component 210' may flex when transitioning between an accommodating configuration and a non-accommodating configuration. By creating a weakened portion (measured perpendicular to the central optical axis of the accommodating structure 240) spaced radially inward from the outer edge of the first optical component 210', the diameter of the portion of the first optical component 210' that flexes in response to fluid ingress from the outer fluid reservoir 203 to the inner fluid chamber 205 may be reduced. By reducing the diameter of the flexed portion of the first optical component 210', the amount of fluid ingress required to achieve a given optical change of the first optical component 210' may be reduced (e.g., less fluid is required to move the radial center of the first optical component 210' a given distance in a direction parallel to the central optical axis of the accommodating structure 240). In some embodiments, creating weakened portions in the first optical component 210' can increase the circumferential uniformity of the deflection or deformation of the first optical component 210'.

[0036] 2G and 2H show an AIOL 240' configured in accordance with one embodiment of the present technology. Elements having similar structural and / or functional features as those described above with respect to FIGS. 2A-2F are designated using an apostrophe ('). For example, the first portion 240a' of the AIOL 240' is similar to the first portion 240a of the AIOL 240 described above. With reference to FIG. 2G, the first portion 240a' can include one or more standoffs 290 extending from the reinforcement portion 284' in a direction parallel to the central optical axis of the first portion 240a'. As best seen in FIG. 2H, when the AIOL 240' is assembled, these standoffs 290 extend toward the second optical component 250' of the second component 240b' of the AIOL 240'. The standoffs 290 can contact the second optical component 250' (e.g., a peripheral portion thereof). 2G and 2H together, the gap 292 between the standoffs 290 allows fluid to pass between the inner fluid chamber 205' of the AIOL 240' and the outer fluid reservoir 203' of the AIOL 240'. Using the standoffs 290 as a connection point between the first and second components 240a', 240b' of the AIOL 240' can enhance the bond between the two components 240a', 240b' and reduce the risk of unintentional separation between the two components 240a', 240b' during storage, embedding, and / or operation. The standoffs can reduce the risk of aberrations (e.g., non-circular bending during accommodation) of one or both of the first optical component 210' and the second optical component 250'.

[0037] 3A-3C show an AIOL 300 having many or all of the same features of the AIOLs 100, 200 described above with respect to FIGS. 1A-2E. For example, like reference numbers between FIGS. 3A-3C and 1A-2E indicate the same or similar features (e.g., second optical component 150 vs. second optical component 250 vs. second optical component 350). The AIOL 300 includes recesses 382 and / or protrusions 383 disposed around the periphery of the device. The recesses 382 and / or protrusions 383 of the AIOL 300 have a shorter arcuate width than the recesses 282 and / or protrusions 283 of the AIOL 200 described above. In some embodiments, the fixed lens 330 of the AIOL 300 has a greater maximum height relative to the adjustment structure 240 as a percentage of the maximum height of the adjustment structure 340 (as measured parallel to the central optical axis of the adjustment structure 340) than the fixed lens 230. For example, as shown in FIG. 2B, fixed lens 230 can have a height H1 that is 30%-60%, 20%-70%, 50%-60%, and / or 40%-55% of height H2 of accommodating structure 340. In some embodiments, fixed lens 230 can have a height H1 that is approximately 55% of height H2 of accommodating structure 240. As shown in FIG. 3B, fixed lens 330 can have a height H3 that is 35%-70%, 45%-75%, 40%-60%, and / or 60%-65% of height H4 of accommodating structure 340. In some embodiments, height H3 of fixed lens 330 is approximately 62.5% of height H4 of accommodating structure 340. In some embodiments, reducing the height of fixed lens 330 can allow for easier cleaning of materials (e.g., OVD or other materials) used during implantation of AIOL 300.

[0038] In some embodiments, as best seen in FIG. 3C, the second optical component 350 can include one or more ridges, undulations, or other surface features on the front surface of the second optical component 350. For example, one or more annular ridges 388 can protrude from the front surface of the second optical component 350. The ridges 388 can block or prevent a surface treatment applied to the front surface of the second optical component 350 from passing beyond the ridges 388. Blocking or preventing the surface treatment from passing beyond the ridges 388 can reduce the likelihood that the surface treatment material will interfere with the bond between the first and second components 340a, 340b of the regulating structure 340. In some embodiments, a hydrophobic coating is applied to the components 340a, 340b that are to be bonded when a hydrophilic adhesive is used.

[0039] In some embodiments, the second component 340b of the adjustment structure 340 includes a notch 389 or other cutout along all or a portion of the posterior circumference of the second optical component 350. In some embodiments, the notch 389 is filleted or otherwise curved.

[0040] Referring again to FIG. 3C, in some embodiments, the adjustment structure 340 can include one or more sharp internal edges or corners. For example, the folded portion of the second component 340b between the outer bellows 303 and the second optical component 350 can include one or more sharp internal corners 393. In some embodiments, the sharp internal corners 393 have an internal radius that is close to or equal to zero inches. In some embodiments, the rear of the outer bellows 303 includes one or more internal sharp corners 394. The one or more internal sharp corners 394 can have a radius of curvature that is close to or equal to zero inches. The corners 393, 394 can provide mechanical points of weakness that can facilitate efficient collapse of the outer bellows 303 and / or other portions of the bellows of the AIOL 300 when a radially inward force is applied to the outer bellows 303 from the capsule. Efficient collapse of the outer bellows 303 is expected to improve the performance of the regulating structure 340 by increasing fluid flow between the outer bellows and the inner fluid chamber 305 .

[0041] In some embodiments, as shown in FIG. 3D, the height of the outer bellows 303' (e.g., when measured in the anterior-posterior direction) can be shortened compared to other embodiments of the present disclosure. For example, the height H5 of the outer bellows 303' can be less than 75%, less than 70%, less than 65%, and / or less than 60% of the height H6 of the regulating structure 340'. In some embodiments, the height H5 of the outer bellows 303' is approximately 70% of the height H6 of the regulating structure 340'. As a comparative example, the height H7 of the outer bellows 303 of the regulating structure 340 of FIG. 3C can be approximately 75% to 85% of the height H8 of the regulating structure 340. In some embodiments, shortening the height H5 of the outer bellows 303' is expected to improve the fit of the outer bellows 303' in the radially outer portion of the pouch. The exact ratio of height H5 of outer bellows 303' to height H6 of adjustment structure 340 can be adjusted to fit a given patient's pouch and improve the fit of AIOL 300 within the pouch.

[0042] FIG. 4 illustrates a first portion 440a of an accommodation structure of an AIOL having many or all of the same features as the AIOL 100, 200, 300 described above with respect to FIGS. 1A-3D. For example, like reference numbers between FIGS. 3A-3C and 1A-2E indicate the same or similar features (e.g., indentation 282 vs. indentation 382 vs. indentation 482). In some embodiments, the first portion 440a (e.g., anterior lens component) includes one or more channels 490 in a radially outward surface that extends in the anterior-posterior direction. In some embodiments, the first portion 440a includes one or more side channels 491 that extend at an oblique angle to the channel 490. For example, the side channels 491 can extend perpendicular to and intersect the channel 490. In some embodiments, the side channel 491 is tangent to a radially outward surface of the first portion 440a and extends around all or part of the circumference of the first portion 440a in a direction perpendicular to the central optical axis of the first portion 440a. The first portion 440a may also include one or more secondary side channels 492 on the outer surface of the first portion 440a. For example, the one or more secondary side channels 492 may extend parallel to and / or in front of the first side channel 491 and may be spaced apart from the first side channel 491 in a direction parallel to the central optical axis of the first portion 440a. In some embodiments, the one or more secondary side channels 492 extend rearward of the side channel 491. In some embodiments, the secondary side channels 492 extend in an oblique direction relative to the direction of the first side channel 491 and / or the direction of the channel 490. The use of channel 490, first lateral channel 491, and / or second lateral channel 492 can improve fluid flow and / or aqueous humor circulation within the ocular capsule through and / or around the AIOL. Improved fluid flow can improve hydration, inhibit capsule fibrosis, and maintain native capsule performance during accommodation.

[0043] In some embodiments, the bellows and / or other portions of the AIOL can include indentations, rivulets, channels, and / or other surface modifications configured to facilitate the passage of fluid between the AIOL within the patient's native ocular capsule. The surface modifications can include temples, indentations, notches, and / or other features. Preferably, the surface modifications have a depth on the order of the thickness of the ocular capsule to reduce or eliminate the risk of the ocular capsule filling or substantially filling the surface modifications. In some embodiments, the surface modifications of the AIOL described herein can be positioned and configured to direct fluid into the notches (e.g., notches 181, 281, 381, 481) to increase the flow of fluid through the AIOL. The use of such surface modifications is expected to promote and / or facilitate the distribution of fluid across all or a majority of the inner surface of the ocular capsule.

[0044] 5A-7C show fixed lenses 530, 630, 730 having cleaning features configured to facilitate the passage of OVDs or other fluids from a space between the fixed lens and the accommodative lens of an AIOL. For example, as shown in FIGS. 5A-5C, the fixed lens 530 can include one or more openings 595 extending through the lens component. The openings 595 can facilitate the passage of one or both of OVDs and natural ocular fluids through the fixed lens 530. In some embodiments, as shown in FIGS. 6A-6C, the fixed lens 630 can include one or more slots 695 through the lens component. The slots 695 can facilitate the passage of one or both of OVDs and natural ocular fluids through the fixed lens 630. In some embodiments, the slots 695 have an arcuate length of 20°-60°, 25°-70°, 30°-55°, and / or 40°-50°, measured relative to a central optical axis of the fixed lens 630. In some embodiments, the slot 695 has an arcuate length of approximately 45°.

[0045] As in the embodiment shown in FIGS. 7A-7C, the fixed lens 730 can include one or more cutouts 795 from the outer periphery of the fixed lens 730. The cutouts 795 can be, for example, notches cut or otherwise formed into the periphery of the fixed lens 730. In some embodiments, the fixed lens 730 includes one cutout 795. The fixed lens 730 can include two or more cutouts 795 (e.g., two, three, four, or more cutouts 795). One or more of the cutouts 795 can extend into the fixed lens 730 to a depth of approximately 20% of the radius of the fixed lens 730 in a direction perpendicular to the central optical axis of the fixed lens 730. In some embodiments, the depth of the cutouts 795 is between 5% and 40%, between 10% and 30%, and / or between 20% and 50% of the radius of the fixed lens 730. The cutout 795 may have an arc length of 20°-60°, 25°-70°, 30°-55°, and / or 40°-50°, measured relative to the central optical axis of the fixed lens 730. The cutout 795 may extend across the fixed lens 730 and in the anterior-posterior direction. In some embodiments, the cutout 795 does not extend through the rear flange 733 of the skirt of the fixed lens 730. Maintaining the annular rear flange 733 on the skirt of the fixed lens is expected to improve the structural integrity of the adjustment structure 740. In some embodiments, the fixed lens may include one of the cleaning features 595, 695, 795 described above, or a combination of two or more of the cleaning features 595, 695, 795.

[0046] FIG. 8 illustrates an AIOL 800 configured in accordance with another embodiment of the present technology. The AIOL 800 has many or all of the same features as the AIOL 100 described above. In some embodiments, for example, the accommodating structure 840 of the AIOL 800 is the same as or similar to the accommodating structure 140 of the AIOL 100. The accommodating structure 840 of the AIOL 800 can have markings 896 positioned on one or both of the first and second optical components of the accommodating structure 840. The markings 896 are visible from outside the patient's eye and / or through the fixed lens 830 of the AIOL 800. The markings 896 allow a surgeon or other medical personnel to locate the flow-through features 881 (e.g., dimples) or other particular features of the AIOL 800. For example, the AIOL 800 can include markings 896 aligned with each of the flow-through features 881. Preferably, the markings 896 are positioned at or near the periphery of the optical portion of the AIOL to avoid optical distortion for the patient. Accurate and reliable placement of flow-through feature 881 allows medical personnel to orient a cannula or other irrigation device to efficiently irrigate OVDs or other materials from the ocular capsule posterior to AIOL 800. For example, knowing the location of flow-through feature 881 allows medical personnel to direct irrigation fluid to flow-through feature 881 when irrigating a portion of the capsule posterior to AIOL 800.

[0047] 9A-9D show one embodiment of an AIOL 900 configured in accordance with another embodiment of the present technology. The AIOL 900 includes a haptic structure 902 and an accommodating lens 904 positioned at least partially within the haptic structure 902. In some embodiments, the AIOL 900 includes a fixed lens 906. The fixed lens 906 can be connected to an anterior side of the haptic structure 902. In some embodiments, the AIOL 900 is oriented such that the fixed lens 906 is connected to a posterior side of the haptic structure 902. As described in more detail below, the haptic structure 902 can be configured to transfer force from the capsular bag of the eye to the accommodating lens 904 and / or the fixed lens 906.

[0048] 9B, in some embodiments, the haptic structure 902 can include individual spring elements 908. The individual spring elements 908 can be distributed in a generally circular, elliptical, or other shaped arrangement around the periphery of the haptic structure 902 (e.g., around the center or optical axis of the haptic structure 902). The spring elements 908 can be configured to allow fluid to pass around and over the haptic structure 902 (e.g., between the spring elements 908) when the haptic structure 902 is implanted in a patient's eye.

[0049] In some embodiments, the spring element 908 has a first end connected to a first frame or ring 912 (e.g., a front ring) and a second end connected to a second frame or ring 914 (e.g., a rear ring). The first frame 912 may be positioned at a front end of the haptic structure 902 and the second frame 914 may be positioned at a rear end of the haptic structure 902. In some embodiments, one or both of the first and second frames 912, 914 have a ring shape, are annular, are donut shaped, and / or define a central opening.

[0050] In some embodiments, the spring element 908 has a curved shape. Alternatively, the spring element 908 may have a bent and / or chevron shape. For example, the spring element 908 can include an anterior portion 918 connected to the first frame 912 and a posterior portion 922 connected to the second frame 914. The anterior portion 918 and the posterior portion 922 can be connected to each other at each corner of the spring element 908. In some embodiments, the corners of the spring element 908 are coplanar with each other on a plane perpendicular to the optical axis of the AIOL 900. The corners of the spring element 908 can define a radially outward perimeter of the haptic structure 902 relative to the optical axis of the AIOL 900. The corners can be, for example, hinges that allow the anterior portion 918 and the posterior portion 922 to rotate relative to each other (e.g., in response to a force exerted on the spring element 908 from the natural ocular capsule in which the AIOL 900 is implanted).

[0051] As shown in FIG. 9D , the fixed lens 906 may be coupled to the haptic structure 902. The fixed lens 906 may be connected to the first frame 912, for example. However, in other embodiments, the fixed lens 906 is connected to the second frame 914. The fixed lens 906 is preferably removably coupleable to one of the frames 912, 914. In some embodiments, the fixed lens 906 may be coupled to and / or detached from one of the frames 912, 914 after the haptic structure 902 is implanted into the lens of the patient's eye. In some embodiments, the first frame 912 (and / or the second frame 914) includes a recess, channel, detent, or other structure configured to receive the fixed lens 906. For example, the first frame 912 may include a channel 932 (e.g., an annular channel) in a radially inwardly facing surface of the first frame 912. In some embodiments, the first frame 912 includes two or more separate, isolated channels in a radially inward surface of the first frame 912. The periphery 936 of the fixed lens 906 may be configured to releasably couple with one or more channels (e.g., channel 932) in the radially inward surface of the first frame 912. In some embodiments, the periphery 936 of the fixed lens includes one or more channels configured to receive ridges, protrusions, and / or other features of the inner periphery of the first frame 912 for the second frame 914.

[0052] The accommodating lens 904 can include an anterior lens portion 926 and a posterior lens portion 928. The accommodating lens 904 (e.g., a fluid chamber) can be filled with a fluid between the anterior lens portion 926 and the posterior lens portion 928. The fluid can include a solution, an oil, a silicone oil, a solution of dextran, a solution of high molecular weight dextran, and / or a solution of another high molecular weight compound.

[0053] In some embodiments, the anterior and posterior lens portions 926, 928 are joined together at the periphery 930 of each lens portion. In such embodiments, the accommodative lens 904 may be removably coupled to the haptic structure 902. For example, the accommodative lens 904 may be inserted into the haptic structure 902 through an opening in the anterior frame 912 or through an opening in the posterior frame 914. The accommodative lens 904 may be held in place with the haptic structure 902 via an interface between the accommodative lens 904 and a radially inward facing side of the spring element 908. For example, the periphery of the accommodative lens 904 may contact an inner corner of the spring element 908.

[0054] The spring element 908 may be configured to exert a radially inward force on the accommodative lens 904 when a radially inward force is applied to the spring element 908. Radial compression of the accommodative lens 904 by the spring element 908 may push the anterior and posterior lens portions 926, 928 away from one another. Relief of radial compression of the accommodative lens 904 by the spring element 908 may allow the anterior and posterior lens portions 926, 928 to move back toward one another. Movement of the anterior and posterior lens portions 926, 928 toward and away from one another in a direction parallel to the optical axis of the AIOL 900 may allow a change in the optical power of the accommodative lens 904. The first and second frames 912, 914 may be configured to move away from one another (e.g., the distance between the first and second frames 912, 914 may increase) in response to a radially compressive force on the spring element 908.

[0055] In some embodiments, the anterior lens portion 926 is integral with, formed with, or otherwise connected to the anterior portion 918 of the spring element 908. The posterior lens portion 928 of the accommodative lens 904 may be integral with, formed with, or otherwise connected to the posterior portion 922 of the spring element 908. In such embodiments, the anterior and posterior lens portions 926, 928 may be bonded together such that the anterior and posterior portions 918, 922 are bonded together. Bonding these respective portions together may include bonding, gluing, welding, friction fitting, and / or some other bonding method.

[0056] 10A-10H show an AIOL 1000 configured according to another embodiment of the present technology. The AIOL 1000 can include some features similar or the same as those of the AIOL 900 described above. For example, like numbered components can be similar or the same as each other (e.g., fixed lens 906 vs. fixed lens 1006). The AIOL 1000 includes a haptic structure 1002 configured to be removably coupled to one or both of the fixed lens 1006 and the accommodative lens 1004. The accommodative lens 1004 can include anterior and posterior lens portions similar or the same as the anterior and posterior lens portions 926, 928 described above with respect to FIG. 9D, and a fluid chamber between the anterior and posterior lens portions. The haptic structure 1002 can be configured to contact the patient's lens capsule when implanted in the capsule. The haptic structure 1002 of the AIOL 1000 is configured to transfer mechanical forces from the capsule to one or both of the accommodative lens 1004 and the fixed lens 1006.

[0057] The haptic structure 1002 can include a front portion 1018 and a rear portion 1022 connected to one another at or near the circumference of the haptic structure 1002, as shown in FIG. 10A. In some embodiments, the front portion 1018 of the haptic structure 1002 is similar or the same size as the rear portion 1022. In some embodiments, the front portion 1018 and the rear portion 1022 of the haptic structure 1002 are connected to an outer ring 1003 of the haptic structure 1002. The outer ring 1003 can be a continuous annular ring around the entire circumference of the haptic structure 1002, or a broken ring separated into segments along the circumference of the haptic structure 1002. The spaces between the front portions 1018 around the circumference of the haptic structure 1002 and the rear portions 1022 around the circumference of the haptic structure 1002 can define windows 1038 through the haptic structure 1002. These windows 1038 may allow fluid to pass through the haptic structure 1002 when the haptic structure 1002 is implanted in a patient's eye.

[0058] As best seen in FIG. 10G, the periphery of the fixed lens 1006 includes a recess 1036 configured to releasably receive the forward ring 1012 of the forward portion 1018 and the haptic structure 1002. The recess 1036 can have a curved, elliptical, and / or semicircular shape as observed in a cut plane parallel to and passing through the optical axis of the AIOL 1000. The interface between the forward portion 1018 of the haptic structure 1002 and the periphery of the fixed lens 1006 can allow the forward portion 1018 to be tilted relative to the fixed lens 1006 and the cut plane shown in FIGS. 10E-10H. For example, the rounded surfaces of the recess 1036 of the forward portion 1018 and the forward ring 1012, respectively, can allow such tilting. Tilting of the forward portion 1018 can then cause a tilting of the periphery of the accommodative lens 1004.

[0059] In some embodiments, the rear portion 1022 of the haptic structure 1002 includes a recess 1040 (e.g., in the rear ring 1014) configured to receive a portion (e.g., periphery 1042) of the accommodative lens 1004. The periphery 1042 of the accommodative lens 1004 can be flexible or semi-flexible. In some embodiments, the interface between the rear portion 1022 of the haptic structure 1002 and the accommodative lens 1004 can form a hinge that allows the accommodative lens 1004 and / or the rear portion 1022 of the haptic structure 1002 to rotate (e.g., tilt) relative to one another in a cut plane (e.g., a cut plane passing through and parallel to the central optical axis of the AIOL 1000) shown in FIGS. 10E-10H. As the accommodating lens 1004 rotates (e.g., rearward and / or away from the outer ring / hinge 1003), the radially outward portion of the lens 1004 (e.g., at or near the periphery of the lens 1004) may compress axially, forcing fluid radially inward within the accommodating lens 1004. This radially inward flow of fluid may stretch the radially inward portion of the accommodating lens 1004, thereby changing the optical power of the accommodating lens 1004.

[0060] In some embodiments, the haptic structure 1002 can include weakened portions 1050 configured to facilitate bending and / or rotation of the rearward portion 1022 of the haptic structure 1002 relative to the forward portion 1018, and vice versa. The weakened portions 1050 can be, for example, one or more notches, recesses, channels, or other features in the radially inward portions of the outer ring 1003, the rearward portion 1022, and / or the forward portion 1018. In some embodiments, the radially outward portion (e.g., periphery) of the haptic structure 1002 includes one or more indentations, notches, recesses, channels, and / or other features configured to facilitate fluid flow around and over the radially outward portion of the haptic structure 1002. Although various features of the AIOL 1000 having an accommodating lens 1004 connected to the rearward ring 1014 are described above, the AIOL 1000 can be inverted such that the rearward 1014 ring is on the front side of the AIOL 1000 and the forward ring 1018 is on the rear side.

[0061] 10C, 10E, and 10G show the AIOL 1000 in a disaccommodated configuration, and FIG. 10D, 10F, and 10H show the AIOL 1000 in an accommodated configuration. Stated another way, FIG. 10D, 10F, and 10H show the AIOL 1000 in a configuration in which a radially inward force is applied to the haptic structure 1002 (e.g., by the patient's lens capsule). In the accommodated configuration, the haptic structure 1002 is radially compressed and axially stretched (e.g., parallel to the optical axis of the AIOL 1000). The axial stretching of the haptic structure 1002 increases the axial height of the haptic structure 1002 from a disaccommodated height H9 (FIG. 10C) to an accommodated height H10 (FIG. 10D). In some embodiments, the accommodated height H10 of the haptic structure 1002 is 10%-50%, 20%-40%, or 30%-35% greater than the unaccommodated height H9 of the haptic structure 1002. During the transition between the accommodated and unaccommodated configurations, the haptic structure 1002 and / or the accommodative lens 1004 can pivot and / or rotate relative to one another as described above.

[0062] 11A-11D show an AIOL 1100 configured in accordance with another embodiment of the present technology. The AIOL 1100 may include several features similar or the same as those of the AIOL 1000 described above. Thus, like numbered components may be similar or the same as one another (e.g., fixed lens 1006 vs. fixed lens 1106). The AIOL 1100 may include a fixed lens 1106 having one or more mating structures 1170 extending from an optical portion of the fixed lens 1106. The mating structures 1170 may be, for example, fins, protrusions, flanges, extensions, or other structures extending from the optical portion of the fixed lens 1106 in a direction perpendicular or nearly perpendicular to the optical axis of the fixed lens 1106. In the illustrated embodiment, the fixed lens 1106 includes three mating structures 1170 evenly distributed in a circumferential pattern around the circumference of the optical portion of the fixed lens 1106. In some embodiments, more or fewer mating structures may be used, and patterns other than a circumferential distribution may be used. A first component 1140a (e.g., an anterior component) of the accommodation structure (e.g., base lens) of the AIOL 1100 can include one or more receiving structures 1174 configured to receive and releasably mate with a mating structure 1170 of the fixed lens 1106. A second component of the accommodation structure is not shown, but can be the same as or similar to one or more of the second components 140b, 240b, 340b described above. One or more of the receiving structures 1174 can be, for example, a slot or other recess configured to receive a corresponding mating structure 1170 (e.g., in a direction parallel to the optical axis of the AIOL 1100), as shown in FIG. 11B. The first component 1140a can include retention structures 1178 (e.g., one retention structure 1178 for each receiving structure 1174) configured to secure the fixed lens 1106 to the first component 1140a when the fixed lens 1106 is fully coupled with the first component 1140a. The retention structures 1178 can be, for example, pockets, recesses, depressions, cavities, or other structures configured to retain at least a portion of the mating structure 1170 of the fixed lens 1106.These fixed lens mating structures may be singular or multiple structures. In the illustrated embodiment, the retaining structure 1178 is a circumferentially extending cavity extending from the receiving structure 1174. After the mating structure 1170 is received into / through the receiving structure 1174 (e.g., a slot), the fixed lens 1106 may be rotated (e.g., in a counterclockwise direction) such that the mating structure 1170 is at least partially received and retained within the retaining structure 1178 (FIGS. 11C-11D).

[0063] The retaining structure 1178 can be configured to inhibit or prevent inadvertent detachment of the fixed lens 1106 from the first component 1140a. For example, the retaining structure 1178 can include a front wall 1179 (FIG. 11D) positioned to inhibit or otherwise impede movement of the mating structure 1170 when the mating structure 1170 is at least partially positioned within the retaining structure 1178.

[0064] In some embodiments, the mating structure 1170 is sized / shaped to deflect a portion of the retaining structure 1178 and / or increase friction between the mating structure and the retaining structure 1178 when the mating structure is positioned at least partially within the retaining structure 1178. For example, the portion of the mating structure 1170 can be larger in one or more dimensions (e.g., parallel and / or perpendicular to the optical axis of the AIOL 1100) than the retaining structure 1178 such that one or more of the retaining structures 1178 deflect and / or deform when the mating structure 1170 is received therein.

[0065] 11E-11H illustrate additional features that may be used in combination with the AIOL 1100 described above. For example, with reference to FIGS. 11E-11F, the first component 1140a may include a hump 1180, protrusion, or other structure configured to prevent rotation of the fixed lens 1106 when the mating structure 1170 is at least partially positioned within the retaining structure 1178. The hump 1180 may be positioned on a radially inward wall of the first component 1140a between the receiving structure 1174 and the retaining structure 1178. The hump 1180 may be configured to deflect outwardly when the mating structure 1170 moves from the receiving structure 1174 to the retaining structure 1178 (e.g., as the fixed lens 1106 rotates relative to the first component 1140a, as shown by the arcuate arrow in FIG. 11E). As the mating structure 1170 passes the hump 1180 , the hump 1180 may flex radially inwardly and prevent the mating structure 1170 from rotating back into the receiving structure 1174 .

[0066] 11G and 11H show features that can be used instead of or in addition to the hump 1180 described above. Specifically, the receiving structure 1174 can have a radius (e.g., as measured perpendicular to the optical axis of the AIOL 1100) that is smaller than the radius of the retaining structure 1178. The radius of the receiving structure 1174 can be smaller than the radius of the mating structure 1170 of the fixed lens 1106. In some embodiments, when the fixed lens 1106 or its mating structure 1170 is received in the receiving structure 1174, the mating structure 1170 can deflect the receiving structure 1174 radially outward. When the mating structure 1170 is moved into the retaining structure 1178 (e.g., see the arcuate arrow in FIG. 11G), the receiving structures 1174 can return to their undeflected positions. The step 1181 between the radius of the receiving structure 1174 and the radius of the retaining structure 1178 is positioned to inhibit or prevent inadvertent movement of the mating structure 1170 from the retaining structure 1178 to the receiving structure 1174.

[0067] 12A-12B show an AIOL 1200 configured according to another embodiment of the present technology. The AIOL 1200 can include several features similar or the same as those of the AIOLs described above (e.g., AIOLs 1000 and 1100). Thus, like-numbered components can be similar or the same as one another (e.g., fixed lens 1106 vs. fixed lens 1206). The adjustment structure 1240 of the AIOL 1200 can include a plurality of cavities 1282 or other cavities configured to releasably receive the mating structures 1270 (e.g., fins, protrusions, flanges, or other mating structures) of the fixed lens 1206. The cavities 1282 can include a front wall 1283. The front wall 1283 can be configured to bend, flex, and / or otherwise deform to allow the mating structures 1270 of the fixed lens 1206 to move at least partially in and out of the cavities 1282. The accommodating structure 1240 can include interior walls 1284 that separate the cavities 1282. The interior walls 1284 can inhibit or prevent free rotation of the fixed lens 1206 when the fixed lens 1206 is mated with the accommodating structure 1240 (as shown in FIG. 12B ).

[0068] 13A-13D show an AIOL 1300 configured in accordance with another embodiment of the present technology. The AIOL 1300 can include several features similar or identical to those of the AIOLs 100, 200, 300, 1100, and 1200 described above. Thus, like-numbered components can be similar or identical to one another (e.g., cavity 1282 vs. cavity 1382, fixed lens 1206 vs. fixed lens 1306, etc.). With reference to FIGS. 13A and 13B, a fixed lens assembly 1330 can include a lens portion 1306 (e.g., a fixed lens) and one or more tabs 1370 extending radially outward from the lens portion 1306. One or more holes 1371 can extend at least partially through the one or more tabs 1370. The holes 1371 (e.g., or recesses) can be engaged by a surgical instrument to manipulate the fixed lens assembly 1330 during implantation and / or removal of the fixed lens assembly 1330. In some embodiments, the holes 1371 are arranged in pairs. In some embodiments, the holes 1371 are distributed in a circumferential pattern. In some embodiments, one or more of the holes 1371 have a different size (e.g., width or diameter) and / or shape than the other holes 1371. For example, each of the holes 1371 may have a different size than each of the other holes 1371. The use of holes of various sizes can provide additional visual confirmation of the rotational alignment of the fixed lens assembly 1330 (e.g., about the optical axis of the AIOL 1300). Confirming the alignment / orientation of the fixed lens assembly 1330 can reduce the risk of the toric lens or other non-circularly symmetric fixed lens 1306 being improperly oriented relative to the natural ocular capsule in which the base lens 1340 and / or AIOL 1300 are implanted. In some embodiments, the fixed lens assembly 1330 may include an additional visual marker (e.g., similar to or the same as the marking 896 described above with respect to FIG. 8) to indicate the orientation of the fixed lens assembly 1330 relative to the base lens 1340 and / or the natural eye capsule.

[0069] The AIOL 1300 further comprises a base lens 1340 (e.g., an accommodation structure). As best seen in FIG. 13A, the base lens 1340 can include one or more cavities 1382 or other mating structures configured to releasably couple with one or more tabs 1370 of the fixed lens assembly 1330. The cavities 1382 can be open toward the optical axis of the base lens 1340. In some embodiments, there are three cavities 1382 that receive three tabs 1370 of the fixed lens assembly 1330. The cavities 1382 can be positioned in portions of the base lens 1340 and separated from each other by walls adjacent to the flow-through features 1381 and / or depressions 1383 of the base lens 1340. The depressions 1383 can be aligned with the flow-through features 1381 of the base lens 1340 having similar or identical characteristics to the flow-through features 181 described above. The depression 1383 and / or flow-through feature 1381 can facilitate fluid flow around the periphery of the base lens 1340 when the base lens 1340 is implanted within a patient's ocular capsule. When the AIOL is assembled, the tab 1370, fixed lens 1306, and / or cavity 1382 can be flush with one another.

[0070] The base lens 1340 may include an outer channel 1391 on a radially outward surface of the base lens 1340 (e.g., on the anterior base lens component 1340a and / or the posterior base lens component 1340b, as shown in FIG. 13D). The outer channel 1391 may extend around the entire circumference of the base lens 1340. In some embodiments, the outer channel 1391 extends along the seam 1395 (FIG. 13D) between the anterior and posterior base lens components 1340a, 1340b. The outer channel 1391 may facilitate increased fluid flow and / or OVD flow around the outside of the base lens 1340 when the base lens is implanted in a patient's ocular capsule. In some embodiments, the outer channel 1391 may reduce the likelihood of the base lens 1340 adhering to the inner wall of the ocular capsule upon implantation.

[0071] FIG. 13C is a plan view of the front of the AIOL 1300, and FIG. 13D shows a side cross-sectional view of the AIOL 1300 taken along section plane 13D-13D of FIG. 13C. As best seen in FIG. 13D, the cavity 1382 can be at least partially defined by an anterior flange 1385. The flange 1385 can overlap the tab 1370 in a direction parallel to the optical axis of the base lens 1340 when the tab 1370 is positioned within the cavity 1382. The flange 1385 can inhibit or prevent inadvertent separation of the fixed lens assembly 1330 from the base lens 1340 (e.g., under natural capsule forces).

[0072] In some embodiments, the circumferential spaces between the tabs 1370 can at least partially define a passageway 1373 between the fixed lens 1306 and the base lens 1340 when the fixed lens assembly 1330 is coupled to the base lens 1340. The passageway 1373 can allow fluid (e.g., aqueous humor) to enter or exit the chamber 1341 between the fixed lens 1306 and the optic portion 1310 of the anterior base lens component 1340a.

[0073] As shown in FIG. 13D, the haptic reservoir 1303 of the base lens 1340 may be at least partially defined by the haptic portions 1341a, 1341b of the anterior and posterior base lens components 1340a, 1340b, respectively. The haptic reservoir 1303 may be in fluid communication with a fluid chamber 1305 between the optic portion 1310 of the anterior base lens component 1340a and the optic portion 1350 of the posterior base lens component 1340b. This fluid communication may be facilitated by one or more fluid flow channels 1349. These fluid flow channels 1349 may be defined by gaps between protrusions 1397 (e.g., standoffs) along the perimeter of the optic portion 1310 of the anterior base lens component 1340a. These protrusions 1397 may be similar or the same as the standoffs 290 described above with respect to FIGS. 2G and 2H. In some embodiments, the posterior base lens component 1340b includes protrusions or standoffs to form the fluid flow paths 1249. These protrusions can extend from the periphery of the optic portion 1350 of the posterior base lens component 1340b and can be used in addition to or instead of the protrusions 1397 described above.

[0074] 14A-14B show an AIOL 1400 configured according to another embodiment of the present technology. The AIOL 1400 can include several features similar or the same as those of the AIOLs 100 and 200 described above. Thus, similarly numbered components can be similar or the same as one another (e.g., fixed lens 206 vs. fixed lens 1406). The fixed lens 1406 of the AIOL 1400 can include a skirt 1432 sized and shaped to engage with an engagement feature 1431 of an adjustment structure 1440 (e.g., a base lens) in a manner similar or the same as described above with respect to the engagement feature 131 and skirt 132 of FIGS. 1C-1D. In the embodiment shown in FIGS. 14A and 14B, all or a portion of the skirt 1432 can be colored a first color (e.g., a visual marker). All or a portion of the engagement feature 1431 (e.g., visual marker) may be colored a second color such that a third color is observed (e.g., through the engagement feature 1431) from a forward position of the AIOL 1400 (FIG. 14B) when the fixed lens 1406 is mated with the adjustment structure 1440. The third color is created from a front-to-back overlap of the skirt 1432 and the engagement feature 1431. For example, the first color may be blue and the second color may be yellow such that the third color is green. Other first and second color combinations (e.g., red-yellow, red-blue, etc.) may also be used. In some embodiments, the entire circumference of the skirt 1432 is colored a first color such that a complete annular engagement between the fixed lens 1406 and the adjustment structure 1440 can be visually confirmed.

[0075] 15A-15D show a second component 1540b of an adjustment structure of an AIOL configured according to another embodiment of the present technology. The second component 1540b can be used in combination with the first component of an adjustment structure of an AIOL described above. With reference to FIGS. 15A and 15B, the second component 1540b can include a thickened portion 1560 adjacent to a flow-through feature 1581, similar to the thickened portion 160 and flow-through feature 181 described above in FIGS. 1A-1D with respect to the AIOL 100. The second component 1540b can also include an outer bellows region 1503a between the thickened portion 1560 (e.g., circumferentially) and at least partially surrounding the optical portion 1536 of the second component 1540b. The outer bellows region 1503a can include a rear wall 1585 extending circumferentially along all or a portion of the length of the outer bellows region 1503a.

[0076] One or more of the rear walls 1585 can include a filler portion 1586 or other portion of a thicker construction. The filler portion 1586 can be thicker than the remainder of the rear wall 1585 (e.g., in a direction parallel to the optical axis of the optical portion 1536) and / or thinner than the thickened portion 1560. The filler portion 1586 can be positioned, for example, at one or more of the ends (e.g., circumferential ends) of the rear wall 1585 and / or adjacent to the thickened portion 1560.

[0077] 15C and 15D show enlarged cross-sectional views of an individual filling portion 1586 of the second component 1540b of FIG. 15A with a needle N extending therethrough. With joint reference to FIGS. 15C and 15D, the filling portion 1586 may be configured to allow the needle N to pass therethrough to fill the regulating structure with an optical fluid (not shown). The thickness T1 of the filling portion 1586 may be sufficient to ensure that when the needle N is removed from the regulating structure, the material of the filling portion 1586 maintains a seal around the needle N and inhibits or prevents leakage of fluid as the needle N exits the regulating structure. In some embodiments, for example, the thickness T1 of the filling portion 1586 is 150%-200%, 200%-300%, 125%-400%, 250%-500%, and / or 110%-2500% of the thickness T2 of the rear wall 1585. In some embodiments, the thickness T1 of the infill portion 1586 is between 25% and 75%, between 10% and 80%, between 40% and 60%, between 50% and 90%, and / or between 40% and 70% of the thickness T3 of the thickened portion 1560. In some embodiments, the infill portion 1586 is approximately 2 millimeters (mm) thick, between 1.5 and 2.1 mm thick, between 1.9 and 2 mm thick, and / or between 1.75 and 2.2 mm thick.

[0078] Setting the thickness of the filling portion 1586 as described above allows for a needle clearance NC1 (e.g., the amount of space between the front of the filling portion 1586 and the front wall of the first component 1540a of the AIOL, as shown in FIG. 15C) that is greater than the needle clearance provided by the thickened portion 1560. The greater needle clearance allows for the use of needles with steeper beveled ends than could be used with a shorter clearance. In some embodiments, the needle clearance NC1 in front of the filling portion 1586 is approximately 1.25 mm, 1.1-1.5 mm, 1.2-1.3 mm, and / or 1-1.6 mm. The angled needle clearance NC2 (FIG. 15D) provided by the filling portion 1586 can be approximately 1.33 mm, 1.1-1.4 mm, 1.15-1.45 mm, and / or 1.3-1.35 mm. In some embodiments, the inclusion of the filler portion 1586 can reduce the risk of aberrations (eg, non-circular bending or other deformations) of the optic portion 1536 during accommodation.

[0079] The multi-part AIOL device described herein can be implanted by preparing the eye and removing the natural lens from the capsule in any suitable manner. A fluid-filled structure can then be placed in the ocular capsule. The patient can then be evaluated for base refractive power and / or astigmatism correction, and a fixed lens is selected to provide the desired base refractive power or astigmatism correction in the fluid-filled structure as implanted in the capsule of the eye. The particular fixed lens that provides the post-implant base power or astigmatism correction is then inserted into the fluid-filled structure of the previously implanted AIOL. The selected fixed lens can then be bonded to the fluid-filled structure in the capsule. This is possible in current technology AIOLs because the fixed lens is attached to the anterior first component of the AIOL. As mentioned above, one or more of the fluid-filled adjustment structure or the fixed lens can each be flexible so that they can be reconfigured (e.g., folded) into a reduced profile delivery configuration for delivery into the capsule. In some cases, it may be necessary to further correct the fixed portion after surgery. Such instances may occur any time between a few days and several years after surgery. At such times, the patient may return to the physician and exchange the fixed lens for a new one having a different power or other prescription. In such cases, the new prescription may be characterized before or after removal of the original fixation lens. In some cases, a new fixation lens may be manufactured and implanted at the time of the examination, and in other cases, the patient may return for implantation of the fixation lens some time after the examination.

[0080] Some embodiments of the present technology are directed to a kit having an accommodating structure and a first fixed lens with no optical base power. The kit may further include one or more second fixed lenses with various base powers or other optical characteristics. In practice, the accommodating structure may be implanted in the natural ocular capsule, and then the first fixed lens may be bonded to the accommodating structure. The optical characteristics of the implanted accommodating structure may then be evaluated in situ with the first fixed lens in place to determine the desired optical characteristics of the fixed lens. If the optical characteristics of the assembled accommodating structure and the first fixed lens with no base power are appropriate, the system may remain implanted without additional modification. However, if a different base power or other optical characteristics (e.g., a toric or other asymmetric optical system) are desired, the first fixed lens with no base power may be replaced with a second fixed lens with the desired optical characteristics based on the optical characteristics of the implanted accommodating portion to which the fixed lens is attached.

[0081] In some embodiments, the fixation portion of the AIOL may be made from a different material than the accommodative portion. Such materials include hydrophilic or hydrophobic methacrylates or silicones, and other materials traditionally used in non-accommodative IOLs. The fixation lens may be made from a harder material than the material used for the accommodative portion. One or both of the accommodative portion / lens and the fixation portion / lens may be formed by machining, casting (e.g., reactive casting), injection molding, and / or other processes, or a combination of processes. Any or all of the structures described herein may be constructed from transparent or translucent materials. For example, the accommodative structures and the fixation lens described above may be constructed from transparent materials, even if they are shown as opaque in the relevant figures.

[0082] Any of the features of the intraocular lens systems described herein can be combined with any of the features of the other intraocular lenses described herein, and vice versa. Additionally, some specific examples of embodiments in accordance with the present technology are described below in the Examples below.

[0083] Working Example Several aspects of the present technology are described in the following examples. 1. An accommodating intraocular lens (AIOL), comprising: A base lens, an anterior base lens component having a first optic portion and a first haptic portion at least partially surrounding the first optic portion; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; a plurality of retention structures formed on one or both of the anterior and posterior base lens components, the retention structures being open towards the optical axis; an optical chamber between the first optical portion and the second optical portion; a base lens having a haptic reservoir between a first haptic portion and a second haptic portion, the haptic reservoir in fluid communication with the optical chamber; A fixed lens configured to be removably coupled to a base lens, the fixed lens comprising: a lens portion having a front surface and a rear surface, the lens portion being aligned with the first and second optical portions when the fixed lens is bonded to the base lens; and a fixed lens having a plurality of tabs extending radially outward from a lens portion, each tab configured to enter one of a plurality of retention structures when the fixed lens is coupled to the base lens. 2. An AIOL as described in Example 1, wherein when the fixed lens is bonded to the base lens, the anterior surface of the fixed lens is positioned posterior to the forward-most edge of the anterior base lens component. 3. An AIOL as described in Example 1, further comprising a hole through one of the tabs, the hole being configured to receive a portion of a tool for manipulating the fixed lens relative to the base lens. 4. an anterior base lens component including a first annular mating portion surrounding the first optic portion; the posterior base lens component includes a second annular mating portion surrounding the second optic portion; the first annular mating portion includes a plurality of protrusions configured to mate with the second annular mating portion; The AIOL of example 1, wherein a circumferential gap between the plurality of protrusions at least partially defines a fluid flow path between the haptic reservoir and the optical chamber. 5. an anterior base lens component including a first annular mating portion surrounding the first optic portion; the posterior base lens component includes a second annular mating portion surrounding the second optic portion; the second annular mating portion includes a plurality of protrusions configured to mate with the first annular mating portion; The AIOL of example 1, wherein a circumferential gap between the plurality of protrusions at least partially defines a fluid flow path between the haptic reservoir and the optical chamber. 6. The AIOL of example 1, further comprising one or more indentations on the anterior-most surface of the anterior base lens component. 7. The AIOL of example 6, further comprising a radial indentation on a radially outermost surface of one or both of the anterior and posterior base lens components, the radial indentation being circumferentially aligned with each of the one or more indentations on the anterior most surface of the anterior base lens component. 8. An AIOL as described in Example 1, further comprising a fluid chamber between the fixed lens and the first optical portion of the anterior base lens component when the fixed lens is combined with the base lens, and circumferential gaps between the tabs of the fixed lens permit fluid to pass around the fixed lens into and out of the fluid chamber. 9. The AIOL of example 1, further comprising a channel in an outer wall of the base lens, the channel extending along the entire circumference of the base lens. 10. The AIOL of example 9, wherein the channel is located at the seam between the anterior and posterior base lens components. 11. An accommodating intraocular lens (AIOL), A base lens, an anterior base lens component having a first optic and a first haptic at least partially surrounding the first optic, the first optic having an annular channel extending along a periphery of a posterior surface of the first optic; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; an optical chamber between the first optical portion and the second optical portion; a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber; and one or more recesses configured to releasably receive a portion of a fixed lens or other optical structure. 12. The AIOL of embodiment 11, wherein the one or more recesses are open toward the optical axis. 13. An accommodating intraocular lens (AIOL), a haptic structure including a plurality of spring elements distributed in a circumferential array about a central axis, each of the spring elements having a rearward portion and a forward portion hingedly connected to the rearward portion, each of the rearward and forward portions extending from the hinge toward the central axis; a forward ring connected to a forward portion of the plurality of spring elements; a rear ring connected to a rear portion of the plurality of spring elements; an accommodative lens positioned between the front ring and the rear ring and surrounded by a plurality of spring elements, the accommodative lens comprising: A front lens portion, The rear lens portion, a fluid chamber between the anterior lens portion and the posterior lens portion; Application of a radially inward force to the spring element increasing the distance between the front and rear rings in a direction parallel to the central axis; Increase the refractive power of the AIOL, An AIOL, wherein one or both of the front and rear rings include mating structures configured to releasably couple with a fixed lens. 14. The AIOL of example 13, wherein the anterior lens portion is secured to an anterior portion of the spring element and the posterior lens portion is secured to a posterior portion of the spring element. 15. The AIOL of example 13, wherein the hinge is formed at the seam between the anterior and posterior lens portions. 16. The AIOL of example 13, further comprising a fixed lens removably coupled to the mating structure. 17. The AIOL of example 16, wherein the mating structure is an annular channel on a radially inward facing surface of one or both of the forward and rearward rings. 18. An accommodating intraocular lens (AIOL), a haptic structure including a plurality of spring elements distributed in a circumferential array about a central axis, each of the spring elements having a rearward portion and a forward portion hingedly connected to the rearward portion, each of the rearward and forward portions extending from the hinge toward the central axis; a forward ring connected to a forward portion of the plurality of spring elements; a rear ring connected to a rear portion of the plurality of spring elements; an accommodative lens coupled to one of the rear ring or the front ring, the accommodative lens comprising: A front lens portion, The rear lens portion, a fluid chamber between the anterior lens portion and the posterior lens portion; Application of a radially inward force to the spring element compressing the periphery of the accommodating lens in a direction parallel to the central axis; and Increase the refractive power of the AIOL, a mating structure configured to releasably couple to a fixed lens, said mating structure being one of said rear ring or said front ring, When the accommodating lens is coupled to the front ring, the mating structure is on the rear ring; and The AIOL includes a mating structure that enables the mating structure to be on the front ring when the accommodating lens is coupled to the rear ring. 19. The AIOL of example 18, wherein application of a radially inward force to the spring element tilts the outer periphery of the accommodating lens away from the hinge. 20. A method according to claim 1, further comprising the steps of: providing a fixed lens, the fixed lens including an annular channel in a radially outward portion of the fixed lens; the annular channel comprising: A portion of the front ring when the fixed lens is attached to the front ring, or The AIOL of example 18, wherein the fixed lens is configured to receive a portion of the posterior ring when coupled to the posterior ring. 21. An accommodating intraocular lens (AIOL), an anterior lens component having a first optic and a first haptic at least partially surrounding the first optic; The optical axis, a posterior lens component coupled to the anterior lens component and having a second optic aligned with the first optic along the optical axis and a second haptic at least partially surrounding the second optic and aligned with the first haptic in a direction parallel to the optical axis; an optical chamber between the first optical portion and the second optical portion; a haptic reservoir between the first haptic portion and the second haptic portion, the haptic reservoir in fluid communication with the optical chamber; a first side channel in a radially outward surface of the anterior lens component relative to the optical axis, the first side channel extending around an outer periphery of the anterior lens component; a second posterior channel in a radially outwardly facing surface of the anterior lens component and / or the posterior lens component, the second side channel extending around an outer periphery of the anterior lens component and / or the posterior lens component, the second side channel being spaced apart from the first side channel in a direction parallel to the optical axis; a plurality of channels in a radially outwardly facing surface of the anterior lens component and / or the posterior lens component, the plurality of channels intersecting the first and second side channels and extending in an oblique direction relative to the first and second side channels; and one or more mating structures configured to releasably receive a portion of a fixed lens or other optical structure. 22. The AIOL of example 21, further comprising a plurality of depressions on the anterior-most surface of the anterior lens component, each of the depressions being circumferentially aligned with one of the plurality of channels. 23. An AIOL as described in example 21, comprising at least 15 channels. 24. An accommodating intraocular lens (AIOL), A base lens, an anterior base lens component having a first optic and a first haptic portion at least partially surrounding the first optic; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; a plurality of cavities formed in one or both of the anterior and posterior base lens components, the cavities opening towards the optical axis; an optical chamber between the first optical portion and the second optical portion; a base lens having a haptic reservoir between a first haptic portion and a second haptic portion, the haptic reservoir in fluid communication with the optical chamber; a fixed lens configured to be removably coupled to the base lens; and a visual marker on one or both of the fixed lens and the base lens, the visual marker configured to confirm proper alignment between the fixed lens and the base lens and / or complete bonding between the fixed lens and the base lens. 25. An AIOL as described in Example 24, wherein the visual marker comprises one or more markings on the first optical portion, each marking being visible through the fixed lens when the fixed lens is bonded to the base lens. 26. The AIOL of example 25, wherein each marking is circumferentially aligned with a depression in the radially outward portion of the base lens. 27. the fixed lens includes a lens portion and a skirt extending posteriorly from the lens portion; the visual marker is a colored portion of the skirt having a first color; when the fixed lens is bonded to the base lens, at least a portion of the base lens overlaps at least a portion of the tinted portion of the skirt in a direction perpendicular to the optical axis; The AIOL of Example 24, wherein the tinted portion appears as a second color when viewed through a portion of the base lens overlapping the tinted portion. 28. The AIOL of example 27, wherein the first color is yellow and the second color is green. 29. The AIOL of example 27, wherein the portion of the base lens overlapping the tinted portion has a third color. 30. The AIOL of example 29, wherein the third color is blue. 31. An accommodating intraocular lens (AIOL), A base lens, an anterior base lens component having a first optic and a first haptic portion at least partially surrounding the first optic; The optical axis, a posterior base lens component coupled to the anterior base lens component and having a second optic portion aligned with the first optic portion along the optical axis and a second haptic portion at least partially surrounding the second optic portion and aligned with the first haptic portion in a direction parallel to the optical axis; a plurality of cavities formed in one or both of the anterior and posterior base lens components, the cavities opening towards the optical axis; a plurality of slots, each slot adjacent one of the plurality of cavities; an optical chamber between the first optical portion and the second optical portion; a base lens having a haptic reservoir between a first haptic portion and a second haptic portion, the haptic reservoir in fluid communication with the optical chamber; A fixed lens configured to removably couple to a base lens, the fixed lens comprising: a lens portion having a front surface and a rear surface, the lens portion being aligned with the first and second optical portions when the fixed lens is bonded to the base lens; a fixed lens having a lens portion and a plurality of tabs extending radially outward from the lens portion; each tab is configured to fit into one of the slots when the fixation lens is initially translated to a position where the fixation lens is at least partially surrounded by the haptic reservoir; The AIOL, wherein each tab is configured to enter one of the plurality of cavities when the fixed lens is rotated about the optical axis after the tab is positioned within the slot. 32. The AIOL of Example 31, further comprising a plurality of radially inward protrusions on a contact surface between the slot and the cavity, the protrusions being configured to flex radially outward when the fixed lens rotates about the optical axis after the tabs are positioned in the slots, and the protrusions preventing the tabs from moving from the cavity into the slots under the force of the patient's eye. 33. An AIOL as described in example 31, further comprising a plurality of steps on the contact surface between the slot and the cavity, the steps preventing movement of the tab from the cavity to the slot under the force of the patient's eye. 34. An accommodating intraocular lens (AIOL), an accommodating lens comprising a front lens, a rear lens, and a fluid chamber between the front lens and the rear lens, the fluid chamber being an enclosed volume within the accommodating lens; a bellows portion positioned radially outward from the accommodating lens relative to a central optical axis of the accommodating lens; and a non-accommodating lens configured to be removably connected to the bellows portion. 35. The AIOL of example 34, wherein the non-accommodating lens is configured to be removably connected to a front bellows portion of the accommodating lens. 36. The AIOL of example 34 or 35, wherein the bellows portion includes a recess and a protrusion formed in a front surface of the bellows portion. 37. An AIOL according to any one of examples 34-36, wherein the bellows portion includes one or more dents, channels, depressions, and / or other recesses in an outer surface of the bellows portion. 38. An AIOL described in any one of examples 34-37, wherein when the non-accommodating lens is connected to the bellows, the anterior portion of the non-accommodating lens is positioned rearward of the anterior portion of the bellows. 39. An AIOL according to any one of examples 34-38, further comprising a reinforcing ring on the posterior surface of the anterior lens of the accommodative lens. 40. The AIOL of example 39, wherein the reinforcing ring is integrally formed with the anterior lens of the accommodating lens. 41. An AIOL described in any one of Examples 34 to 40, wherein the non-accommodative lens includes one or more cleaning features extending through the anterior surface of the fixed lens. 42. An AIOL as described in Example 41, wherein the cleaning feature comprises one or more of an opening, a slot, and / or a notch extending in an anterior-posterior direction through the fixed lens. 43. An AIOL described in any one of Examples 34 to 42, further comprising one or more markers visible through the non-accommodating lens from outside the patient's eye capsule. 44. The AIOL of embodiment 43, wherein the one or more markers are aligned with a radially outer recess of the bellows portion. 45. AIOL, a haptic structure comprising a spring element configured to contact a patient's lens capsule when implanted in the patient's eye, an anterior frame connected to the spring element, and a posterior frame connected to the spring element; an accommodating lens positioned at least partially within the haptic structure and in contact with the spring element, the accommodating lens comprising an anterior membrane and a posterior membrane; and a non-accommodating lens removably coupled to a front frame of the haptic structure. 46. ​​An AIOL as described in example 45, wherein the anterior frame of the haptic structure includes radially inward grooves configured to engage with the outer periphery of the non-accommodating lens. 47. The AIOL of example 45 or 46, wherein each of the spring elements includes a forward portion and a rearward portion connected to the forward portion. 48. The AIOL of any one of examples 45-47, wherein the spring elements each have a chevron shape. 49. An AIOL described in any one of Examples 45-48, wherein the accommodative lens is removably coupled to the posterior frame of the haptic structure. 50. An AIOL described in any one of examples 47-49, wherein the haptic structure further comprises a ring to which the anterior and posterior portions of the spring element are connected. 51. The AIOL of example 50, further comprising a channel formed in the radially inner surface of the ring.

[0084] conclusion The above detailed description of the embodiments of the present technology is not intended to be exhaustive or to limit the present technology to the precise forms disclosed above. Although specific embodiments of the technology and examples of the technology have been described above for illustrative purposes, various equivalent modifications are possible within the scope of the technology, as those skilled in the art will recognize. For example, any of the features of the AIOL described herein can be combined with any of the features of the other AIOL described herein, and vice versa. For example, although steps are presented in a given order, steps may be performed in a different order in alternative embodiments. Various embodiments described herein may also be combined to provide further embodiments.

[0085] In view of the above, although specific embodiments of the present technology have been described herein for illustrative purposes, well-known structures and functions associated with AIOL have not been shown or described in detail to avoid unnecessarily obscuring the description of the embodiments of the present technology. Where the context permits, singular or plural terms may also include the plural or singular terms, respectively.

[0086] Furthermore, unless the term "or" is expressly limited to mean only a single item in relation to a list of two or more items, the use of "or" in such a list shall be interpreted as including (a) a single item in the list, (b) all items in the list, or (c) any combination of items in the list. Furthermore, the term "comprising" is used throughout to mean including at least the recited features, so as not to exclude any greater number of additional types of the same and / or other features. It will also be understood that although certain embodiments have been described herein for illustrative purposes, various modifications may be made without departing from the technology. Furthermore, although advantages associated with some embodiments of the technology have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and not all embodiments necessarily need to exhibit such advantages to fall within the scope of the technology. Thus, the present disclosure and related technology may encompass other embodiments not expressly shown or described herein.

Claims

[Claim 1] The invention described in this specification.

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