Accommodating intraocular lenses and methods of manufacture

Abstract

To improve accommodating intraocular lenses and methods of manufacture.SOLUTION: Methods of manufacturing an optic of an accommodating intraocular lens to have an aspheric lens surface include: providing an optic comprising an anterior element and a posterior element that at least partially define an optic fluid chamber, where at least one of the anterior and posterior elements has an external surface that is spherical; and, prior to inserting the accommodating intraocular lens into an eye, changing the shape of the at least one of the anterior and posterior elements from the spherical configuration to an aspherical configuration.SELECTED DRAWING: Figure 16

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims priority to U.S. Provisional Patent Application No. 62 / 252,260, filed on November 6, 2015; U.S. Provisional Patent Application No. 62 / 321,678, filed on April 12, 2016; U.S. Provisional Patent Application No. 62 / 357,785, filed on July 1, 2016; U.S. Provisional Patent Application No. 62 / 321,704, filed on April 12, 2016; U.S. Provisional Patent Application No. 62 / 321,666, filed on April 12, 2016; U.S. Provisional Patent Application No. 62 / 321,665, filed on April 2, 2016; U.S. Provisional Patent Application No. 62 / 321,705, filed on April 12, 2016; U.S. Provisional Patent Application No. 62 / 321,684, filed on April 12, 2016; U.S. Provisional Patent Application No. 62 / 321,670, filed on April 12, 2016; and U.S. Provisional Patent Application No. 62 / 377,402, filed on August 19, 2016, the disclosures of which are hereby incorporated by reference in their entirety.

[0002] Incorporation by Reference All publications and patent applications mentioned in this specification are hereby incorporated by reference to the same extent as if each individual publication and patent application were specifically and individually indicated to be incorporated by reference.

[0003] Fluid - actuated accommodative intraocular lenses are described. This disclosure describes a wide variety of exemplary intraocular lenses that can provide benefits to some fluid - actuated accommodative intraocular lenses. For example, it may be beneficial for a fluid - actuated intraocular lens to have an aspherical configuration after being manufactured.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Patent Document 2

Patent Document 3

Patent Document 4

Patent Document 5

Patent Document 6

Patent Document 7

Patent Document 8

Summary of the Invention

[0005] One aspect of the present disclosure is a method of manufacturing an optical portion of an adjustable intraocular lens so as to have a non-spherical lens surface, the method comprising providing an optical portion comprising a front element and a rear element that at least partially define an optical portion fluid chamber, wherein at least one of the front element and the rear element has an outer surface that is spherical; and changing the shape of at least one of the front element and the rear element from a spherical configuration to a non-spherical configuration before inserting the adjustable intraocular lens into the eye.

[0006] In some embodiments, changing the shape of at least one of the front element and the rear element from a spherical configuration to a non-spherical configuration comprises adding fluid to the optical portion fluid chamber so as to increase the fluid pressure therein and deform at least one of the front element and the rear element from a spherical configuration to a non-spherical configuration. Before adding the fluid, the method may comprise securing at least one haptic to the optical portion.

[0007] In some embodiments, providing the optical portion comprises joining the front element to the rear element.

[0008] In some embodiments, the method also includes machining at least one of the front element and the rear element.

[0009] In some embodiments, prior to changing the shape of at least one of the front element and the rear element from a spherical configuration to a non-spherical configuration, the optical section has a base state of 10D to 15D.

[0010] One aspect of the present disclosure is an optical section comprising a front element having a front optical surface and a rear element having a rear optical surface, wherein the front element and the rear element define an optical section fluid chamber, and at least one of the front optical surface and the rear optical surface has a non-spherical configuration in the as-manufactured state prior to insertion into the eye, and is a fluid-filled intraocular lens.

[0011] One aspect of the present disclosure is an intraocular lens comprising an optical section and a peripheral portion having a peripheral fluid chamber, the peripheral portion having a cross-section in a plane transverse to the optical axis of the optical section, the fluid chamber being disposed in the radially outer portion of the peripheral portion and there being no fluid in the radially inner portion of the peripheral chamber.

[0012] One aspect of the present disclosure is an intraocular lens comprising an optical section and a peripheral portion having a peripheral fluid chamber, the peripheral portion having a wall thickness of the radially inner fluid chamber that is between 4 times and 20 times the wall thickness of the radially outer fluid chamber in a direction orthogonal to the optical axis of the optical section passing through the midpoint of the peripheral portion in a cross-section of a plane transverse to the optical axis of the optical section.

[0013] One aspect of the present disclosure is an intraocular lens comprising an optical section and a peripheral portion having a peripheral fluid chamber, the peripheral portion having an outer surface that is not symmetric about all axes parallel to the optical axis of the optical section passing through the peripheral portion in a cross-section of a plane transverse to the optical axis of the optical section, and the peripheral portion having a wall thickness of the radially inner fluid chamber that is greater than the wall thickness of the radially outer fluid chamber in a direction orthogonal to the optical axis of the optical section passing through the midpoint of the peripheral portion.

[0014] One aspect of the present disclosure provides an intraocular lens comprising an optical portion and a peripheral portion having a peripheral fluid chamber, the peripheral portion having a height dimension measured in the front-to-back direction in a cross-section of a plane transverse to the optical axis of the optical portion, wherein the greatest height of the peripheral portion in the radially outer half of the peripheral portion is greater than the greatest height of the peripheral portion in the radially inner half of the peripheral portion.

[0015] One aspect of the present disclosure provides an intraocular lens comprising an optical portion coupled to a peripheral portion at a junction, the junction comprising a radially inner surface of the peripheral portion that is continuous with a radially outer periphery of the optical portion.

[0016] In some embodiments, the radially inner surface of the peripheral portion has a first end having a configuration different from a second end of the inner surface. The peripheral portion can comprise a haptic having a coupled end and a free end, and the first end is closer to the free end than to the coupled end of the haptic. The haptic can be configured to follow the curvature of the radially outer periphery of the optical portion from the coupled end to the free end of the haptic.

[0017] In some embodiments, the first end has a larger surface area than the second end of the radially inner surface. The first end can have a tapered end configuration, with the taper directed toward the free end of the peripheral portion.

[0018] In some embodiments, the radially inner surface of the peripheral portion defines a peripheral portion fluid port.

[0019] One aspect of the present disclosure provides an intraocular lens comprising an optical body, a protrusion extending radially outward from a peripheral surface of the optical body, and a peripheral non-optical body having a first portion fixed to the protrusion.

[0020] In some embodiments, a radially inner surface of the first portion of the peripheral non-optical body follows a radially peripheral surface of the protrusion.

[0021] In some embodiments, the protrusion and the first portion interface at an abutting joint with optionally flat or curved opposing surfaces.

[0022] In some embodiments, the radial peripheral surface of the protrusion comprises a flat surface, optionally a surface that is entirely flat. The radial inner surface of the first portion of the peripheral non-optical body may comprise a flat surface, optionally a surface that is entirely flat.

[0023] In some embodiments, the radial peripheral surface of the protrusion comprises a curved surface, optionally a surface that is entirely curved. The radial inner surface of the first portion of the peripheral non-optical body may comprise a curved surface, optionally a surface that is entirely curved.

[0024] In some embodiments, the radial peripheral surface of the protrusion is radially spaced from the peripheral surface of the optical body by between 10 microns and 1 mm, optionally between 10 microns and 500 microns.

[0025] In some embodiments, the protrusion extends from the peripheral surface of the optical body by between 10 microns and 1 mm, optionally between 10 microns and 500 microns.

[0026] In some embodiments, the optical body and the protrusion are a single integral object.

[0027] In some embodiments, the protrusion is attached to the optical body.

[0028] In some embodiments, the optical body comprises a rear element and a front element that optionally define a fluid chamber therebetween. The rear element may comprise a protrusion. The front element may comprise a protrusion.

[0029] In some embodiments, the peripheral non-optical body further comprises a free second portion that is disposed spaced apart from the first portion.

[0030] In some embodiments, the peripheral non-optical body comprises a peripheral fluid chamber.

[0031] In some embodiments, the projection comprises at least one passage that is in fluid communication with the peripheral fluid chamber in the peripheral non-optical body, and optionally comprises at least two passages.

[0032] In some embodiments, the peripheral non-optical body has a radially inner surface that is optionally slightly curved and is coupled to the projection, and the projection is disposed at the radially outer periphery of the optical body.

[0033] In some embodiments, the peripheral non-optical body is adapted to deform in response to forces in the peripheral non-optical body by the movement of the ciliary muscle, thereby moving fluid between the peripheral fluid chamber in the peripheral non-optical body and the optical portion fluid chamber in the optical body to change the optical parameters of the intraocular lens.

[0034] In some embodiments, the peripheral non-optical body comprises an opening configured to interface-join with the projection.

[0035] In some embodiments, the projection is sized and configured to be disposed within the opening in the peripheral non-optical body and to interface-join with the opening.

[0036] One aspect of the present disclosure is an intraocular lens comprising an optical body and a peripheral non-optical body, wherein the optical body has an outer edge that is at least partially arcuate in top view, and the peripheral non-optical body is coupled to an optical body projection at a location radially outward of the curvature of the arc.

[0037] One aspect of the present disclosure is an intraocular lens in which the adhesive between the first component and the second component has an elastic modulus in the range of about 0.4 MPa to about 1000 MPa, such as in the range of about 1 MPa to about 600 MPa.

[0038] One aspect of the present disclosure is an intraocular lens in which the adhesive is 50-85% of the crosslinkable polymer of the first polymeric material of the intraocular lens.

[0039] One aspect of the present disclosure is an intraocular lens in which the adhesive contains a reactive acrylic monomer diluent in the range of 7.5% to 30%.

[0040] One aspect of the present disclosure is an intraocular lens in which the adhesive contains lauryl methacrylate or a similar substance in an amount between 2.5% and 30%.

[0041] One aspect of the present disclosure is an optionally adjustable intraocular lens comprising an optical portion, a peripheral portion, and at least one ridge extending along at least a portion of the length of the peripheral portion.

[0042] One aspect of the present disclosure is an intraocular lens in which the tip of the first haptic overlaps the second haptic, optionally tapered, in top view.

[0043] One aspect of the present disclosure is an optionally adjustable intraocular lens comprising an optical portion and a peripheral portion coupled to the optical portion and comprising a first haptic and a second haptic, the first haptic and the second haptic being configured to optionally overlap in top view and fit snugly together to reduce the gap therebetween.

[0044] One aspect of the present disclosure is an optionally adjustable intraocular lens comprising an optical portion with an opaque peripheral portion around at least a portion thereof and a peripheral non-optical portion fixed to the optical portion and disposed radially outwardly of the optical portion.

[0045] One aspect of the present disclosure is a method for removing air during the implantation of an intraocular lens, the method including the steps of providing an intraocular lens, mounting the intraocular lens in a cartridge, inserting a viscoelastic delivery device across the intraocular lens, injecting a fluid from the viscoelastic delivery device, and removing air from a portion of the intraocular lens to release the air from the intraocular lens.

[0046] One aspect of the present disclosure is a mounting and transporting device for removing air over a portion of an intraocular lens in preparation for mounting the intraocular lens and delivering the intraocular lens to the eye, the mounting and transporting device comprising a base member having an intraocular lens receiving region, a mounting member configured to advance the intraocular lens toward a delivery lumen, and an opening configured to allow insertion of a viscoelastic delivery device over a portion of the intraocular lens to remove air from the intraocular lens.

[0047] One aspect of the present disclosure is a method of bleeding air in an intraocular lens delivery system, the method including providing a mounting and transporting device to the intraocular lens, mounting the intraocular lens from the mounting and transporting device to a cartridge, attaching a plunger assembly to the cartridge, injecting a viscoelastic fluid from the plunger assembly, and removing air from the plunger assembly.

[0048] One aspect of the present disclosure is a method of removing air from an area adjacent to an intraocular lens, the method including providing the intraocular lens in a mounted configuration within a mounting device and delivering a viscoelastic material, optionally by syringe, in the vicinity of the intraocular lens to remove air bubbles proximate to the intraocular lens.

[0049] One aspect of the present disclosure is a device for delivering an intraocular lens to the eye, the device comprising a distal end adapted to deliver the intraocular lens to the eye and a lumen extending from a proximal region to the distal end, the lumen having a cross-section with a first axis and a second axis of an internal ellipse, a first portion configured to fold the intraocular lens without stretching the intraocular lens, a second portion configured to form a substantial seal between the inner wall and the intraocular lens, and a third portion configured to compress the intraocular lens to stretch the length of the intraocular lens.

[0050] One aspect of the present disclosure is a method for delivering an intraocular lens to an eye, the method including engaging a delivery device with a loading and transporting device for receiving the intraocular lens, folding the intraocular lens without stretching the intraocular lens, forming a seal between an inner wall of the delivery device and the intraocular lens, compressing the intraocular lens to stretch the length of the intraocular lens, and delivering the intraocular lens to the eye.

[0051] One aspect of the present disclosure is a delivery device for delivering an intraocular lens to an eye, the delivery device comprising a delivery lumen configured to internally deform the intraocular lens during delivery out of a distal port, wherein in a first cross-section the inner lumen has an elliptical shape, in a second cross-section distal to the first cross-section the inner lumen has an elliptical shape, in the first cross-section the elliptical shape has a major axis and a minor axis, in the second cross-section the elliptical shape has a major axis and a minor axis, and the major axis of the first cross-section is perpendicular to the major axis of the second cross-section. BRIEF DESCRIPTION OF THE DRAWINGS

[0052]

Figure 1A

Figure 1B

Figure 1C

Figure 1D

Figure 1E

Figure 1F

Figure 1G

Figure 1H

Figure 2A

Figure 2B

Figure 2C

Figure 2D

Figure 2E

Figure 2F

Figure 2G

Figure 3

Figure 4

Figure 5A

Figure 5B

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Figure 11

Figure 12

Figure 13

Figure 14

Figure 15

Figure 16

Figure 17

Figure 18

Figure 19

Figure 20

Figure 21

Figure 22

Figure 23A

Figure 23B

Figure 24

Figure 25A

Figure 25B

Figure 25C

Figure 26A

Figure 26B

Figure 26C

Figure 27

Figure 28A

Figure 28B

Figure 28C

Figure 28D

DETAILED DESCRIPTION OF THE INVENTION

[0053] This disclosure generally relates to adjustable intraocular lenses. In some embodiments, the adjustable intraocular lenses disclosed herein are adapted to be positioned within the native lens capsule from which the native lens has been removed. In these embodiments, the peripheral non-optical portion (i.e., the portion not specifically adapted to focus light onto the retina) is adapted to respond to the reformation of the lens capsule due to the relaxation and contraction of the ciliary muscle. The response is a deformation of the peripheral portion that moves fluid between the peripheral portion and the optical portion to change the optical parameters (e.g., magnification) of the intraocular lens.

[0054] FIG. 1A is a top view showing an adjustable intraocular lens 10 comprising an optical portion 12 and, in this embodiment, first and second haptics 14 coupled to the optical portion 12 and extending peripherally therefrom. The optical portion 12 is adapted to refract light entering the eye onto the retina. The haptics 14 are configured to couple to the lens capsule and are adapted to deform in response to the reformation of the lens capsule associated with the ciliary muscle. FIG. 1B is a perspective view of the intraocular lens 10 showing the optical portion 12 and the haptic 14 coupled to the optical portion 12.

[0055] The haptic is in fluid communication with the optical portion. Each haptic has a fluid chamber in fluid communication with an optical chamber in the optical portion. The haptic is formed of a deformable material, is configured to couple to the lens capsule, and is adapted to deform in response to the reformation of the lens capsule associated with the ciliary muscle. When the haptic deforms, the volume of the haptic fluid chamber changes, moving the fluid disposed in the haptic fluid chamber and the optical portion fluid chamber from the haptic fluid chamber to the optical portion fluid chamber or from the optical portion fluid chamber to the haptic fluid chamber. When the volume of the haptic fluid chamber decreases, the fluid moves to the optical portion fluid chamber. When the volume of the haptic fluid chamber increases, the fluid moves from the optical portion fluid chamber to the haptic fluid chamber. The flow of fluid into and out of the optical portion fluid chamber changes the configuration of the optical portion and the magnification of the intraocular lens.

[0056] Figure 1C is a side cross-sectional view taken through cross-section A-A as indicated in Figure 1A. The optical portion 12 includes a deformable front element 18 fixed to a deformable rear element 20. Each haptic 14 includes a fluid chamber 22 that is in fluid communication with an optical portion fluid chamber 24 in the optical portion 12. Only the junction between the haptic 14 and the optical portion 12 on the left side in the figure is shown in the cross-sectional view of Figure 1C (although it is unclear). The haptic fluid chamber 22 on the left side in the figure is shown to be in fluid communication with the optical portion fluid chamber 24 via two openings 26 formed in the rear element 20. The haptic 14 on the right side in Figure 1C is in fluid communication with the optical chamber 24 through two additional openings (not shown) similarly formed in the rear element, substantially 180 degrees shifted from the shown openings.

[0057] Figure 1D is a top view of the rear element 20 (the front element 18 and the haptic 14 are not shown). The rear element 20 includes a buttless portion 29 in which a passage 32 is formed. The passage 32 provides fluid communication between the optical portion 12 and the haptic 14. The opening 26 is disposed at one end of the passage 32. Thus, the optical portion fluid chamber 24 is in fluid communication with a single haptic via two fluid passages. The buttless portion 29 is configured and sized to be disposed within an opening formed in the haptic 14 that defines one end of the haptic fluid chamber, as described later. Each of the buttless portions 29 includes two passages formed therein. The first passage in the first buttless is aligned with the first passage in the second buttless. The second passage in the first buttless is aligned with the second passage in the second buttless.

[0058] Having two passages in each scleral ring has exemplary advantages as contrasted with having one passage. A design with two passages rather than one helps maintain dimensional stability during assembly, which can be important when assembling flexible thin components. Also, it has been observed through experimentation that some single-passage designs may not be able to provide adequate optical quality throughout the range of adjustment. In particular, spherical aberration of the lens can occur in some single-passage designs, especially when the intraocular lens is adjusted. It has been found that the two-passage scleral ring designs described herein can help reduce spherical aberration or the potential for spherical aberration, especially when the lens is adjusted. Spherical aberration is reduced in these embodiments because the rigidity of the scleral ring is increased by the ribbing portion between the two passages. With the additional rigidity, there is little flexure due to pressure changes in the passages. With little flexure due to pressure changes in the passages, there is little spherical aberration. In some embodiments, the passages are between about 0.4 mm and about 0.6 mm in diameter. In some embodiments, the passages are about 0.5 mm in diameter. In some embodiments, the distance between the openings is between about 0.1 mm and about 1.0 mm.

[0059] FIG. 1E is an assembled side view through cross-section A-A of the optical portion 12 including the front element 18 and the rear element 20 (the haptics are not shown for clarity). The fluid passage 32 is included in the rear element 20 As a result, the rear element 20 needs to have sufficient structure through which the passage 32 can be formed. The scleral ring portion 29 provides the structure through which the passage 32 can be formed. In most of its peripheral portions, the rear element 20 is higher than the front element 18 in the front-to-back direction. In an alternative embodiment, the passage may be formed in the front element 18 rather than the rear element 20. The front element will have the scleral ring portion 29 or some other similar structure to provide the structure through which the passage can be formed. In these alternative embodiments, the rear element may be formed similarly to the front element 18.

[0060] As shown in FIG. 1E, the rear element 20 is fixed to the front element 18 at the peripheral surface 28, which extends near the periphery of the rear element 20 and is a flat surface. The elements 18 and 20 can be integrally fixed using a biocompatible adhesive known already. The front element 18 and the rear element 20 may be formed from one material to eliminate the need to integrally fix the two elements. In some embodiments, the diameter of the region where the front element 18 and the rear element 20 are fixed to each other is from about 5.4 mm to about 6 mm in diameter.

[0061] In some embodiments, the thickness of the front element 18 (measured in the front-rear direction) is greater along the optical axis (“OA” in FIG. 1C) than at the periphery. In some embodiments, the thickness continuously increases along the optical axis from the periphery towards the thickest part.

[0062] In some embodiments, the thickness of the rear element 20 decreases from a location along the optical axis towards the edge of the central region “CR” identified in FIG. 1C. The thickness increases again radially outwards from the central region CR towards the periphery as seen in FIG. 1C. In some particular embodiments, the central region CR is about 3.75 mm in diameter. The aperture is formed in the inclined surface 30.

[0063] In some embodiments, the thickness of the rear element 20 along the optical axis is between about 0.45 mm and about 0.55 mm, and the thickness at the periphery of the rear element 20 is between about 1.0 mm and about 1.3 mm.

[0064] In some embodiments, the thickness of the rear element 20 along the optical axis is about 0.5 mm, and the thickness at the periphery of the rear element 20 is about 1.14 mm.

[0065] In some embodiments, the thickness of the front element 18 along the optical axis is between about 0.45 mm and about 0.55 mm, and in some embodiments, it is between about 0.50 mm and about 0.52 mm. In some embodiments, the thickness at the periphery of the front element 18 is between about 0.15 mm and about 0.4 mm, and in some embodiments, it is between about 0.19 mm and about 0.38 mm.

[0066] In certain embodiments, the thickness of the front element 18 along the optical axis is about 0.52 mm, the thickness at the periphery of the front element 18 is about 0.38 mm, the thickness of the rear element 20 along the optical axis is about 0.5 mm, and the thickness at the periphery of the rear element 20 is about 1.14 mm.

[0067] In certain embodiments, the thickness of the front element 18 along the optical axis is about 0.5 mm, the thickness at the periphery of the front element 18 is about 0.3 mm, the thickness of the rear element 20 along the optical axis is about 0.5 mm, and the thickness at the periphery of the rear element 20 is about 1.14 mm.

[0068] In certain embodiments, the thickness of the front element 18 along the optical axis is about 0.51 mm, the thickness at the periphery of the front element 18 is about 0.24 mm, the thickness of the rear element 20 along the optical axis is about 0.5 mm, and the thickness at the periphery of the rear element 20 is about 1.14 mm.

[0069] In certain embodiments, the thickness of the front element 18 along the optical axis is about 0.52 mm, the thickness at the periphery of the front element 18 is about 0.19 mm, the thickness of the rear element 20 along the optical axis is about 0.5 mm, and the thickness at the periphery of the rear element 20 is about 1.14 mm.

[0070] The optical portion is adapted to maintain optical quality throughout the adjustment. This ensures that the optical portion maintains optical quality when transitioning between a configuration where the adjustable intraocular lens is unadjusted and a configured state. A number of factors contribute to this beneficial feature of the adjustable intraocular lens here. These factors include the peripheral region where the front element 18 is fixed to the rear element 20, the shape profiles of the front element 18 and the rear element 20 inside the central region CR of the optical portion (see FIG. 1C), and the thickness profiles of the front element 18 and the rear element 20. These contributing factors ensure that both the front element and the rear element bend to maintain the shape necessary to maintain optical quality over a range of optical magnifications.

[0071] FIG. 1F shows one haptic 14 from the intraocular lens 10 (the optical portion 12 and the second haptic are not shown for clarity). The haptic 14 includes a radially outer portion 13 adapted to face the ciliary body and a radially inner portion 11 facing the periphery of the optical portion (not shown). The haptic 14 includes a first end region 17 fixed to the optical portion 12 and a closed second end region 19. The haptic 14 also includes an opening 15 in the first end region 17 that provides fluid communication with the haptic. In this embodiment, the opening 15 is sized and configured to receive the aspheric portion 29 of the optical portion 12 therein.

[0072] FIG. 1G is an enlarged view of the opening 15 in the haptic 14 adapted to receive the aspheric portion 29 therein. The opening 15 has curved surfaces 33 and 35 that are shaped to conform to the curved surface in the optical aspheric 29. The surface 31 surrounds the opening 15 and provides a surface to which the corresponding surface of the optical portion can be fixed.

[0073] FIG. 1H is an enlarged view from above of the buttress portion 29 (phantom line) from the rear element 20 disposed within the aperture 15 in the haptic 14 (the front element of the optical portion is not shown for clarity). The passage 32 is shown as a phantom line. The haptic 14 includes a fluid chamber 22 defined by an inner surface 21. The fluid moves between the optical portion fluid chamber and the haptic fluid chamber 22 through the passage 32 when the haptic 14 is deformed.

[0074] FIG. 2A is a top view showing one of the haptics 14 shown in FIGS. 1A - 1H. The optical portion and the second haptic are not shown. Four cross-sections A - D are identified through the haptic. FIG. 2B shows a side view of the haptic 14, showing the aperture 15 and the closed end 19. FIG. 2C is a side view of the haptic 14, showing the radially outer portion 13 and the closed end 19.

[0075] FIG. 2D is a cross-sectional view of cross-section A - A shown in FIG. 2A. Of the four cross-sections shown in FIG. 2A, cross-section A - A is the cross-section closest to the closed end 19. The radially inner portion 11 and the radially outer portion 13 are identified. The fluid passage 22 defined by the surface 21 is also shown. In this cross-section, the radially inner portion 40 is thicker in the radial direction (in the direction "T") than the radially outer portion 42. The inner portion 40 provides the rigidity of the haptic that reforms the capsule more predictably in the anterior-posterior direction in the anterior-posterior direction. The radially inner portion 40 has a maximum thickness dimension 41 along the axis of symmetry in this cross-section. The outer surface of the haptic 14 has a generally elliptical configuration where the maximum height dimension in the anterior-posterior direction ("A - P") is greater than the maximum thickness dimension (measured in the dimension of "T"). The fluid chamber 22 has a generally D-shaped configuration, and the radially inner wall 43 has a smaller curvature than the radially outer wall 45 (however, it is not completely straight). The radially outer portion 42 is connected to the lens capsule to which the ciliary body attaches, and the thicker radially portion 40 is disposed adjacent to the optical portion.

[0076] Figure 2E shows cross-section B-B shown in Figure 2A. Cross-section B-B is substantially the same as cross-section A-A, and Figure 2E provides exemplary dimensions for both cross-sections. The radially inner portion 40 has a maximum thickness of about 0.75 mm along the centerline (in the radial "T"). The radially outer portion 42 has a maximum thickness of about 0.24 mm along the centerline. The fluid chamber 22 has a thickness of about 0.88 mm. The haptic 14 has a thickness of about 1.87 mm along the centerline. The height of the haptic in the front-to-back dimension is about 2.97 mm. The height of the fluid chamber is about 2.60 mm. In this embodiment, the thickness of the radially inner portion 40 is about three times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is about two times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is about two to about three times the thickness of the radially outer portion 42. In some embodiments, the thickness of the radially inner portion 40 is about one to about two times the thickness of the radially outer portion 42.

[0077] The fluid chamber 22 is disposed in the radially outer portion of the haptic 14. Substantially, the entire radially inner region of the haptic 14 in this cross-section is bulk material. Since the fluid chamber 22 is defined by surfaces 43 and 45 (see Figure 2D), the positioning and size of the fluid chamber 22 depend on the thicknesses of the radially inner portion 40 and the radially outer portion 42.

[0078] Figure 2E shows cross-section C-C shown in Figure 1A. In cross-section C-C, the radially inner portion 40 is not as thick as the radially inner portion 40 in cross-sections A-A and B-B, but in cross-section C-C, the radially inner portion 40 is slightly thicker than the radially outer portion 42. In this particular embodiment, the radially inner portion 40 is about 0.32 mm in cross-section C-C. The radially outer portion 42 has approximately the same thickness as the radially outer thickness in cross-sections A-A and B-B and is about 0.24 mm. The outer surface of the haptic 14 does not have the same configuration as the outer surfaces in cross-sections A-A and B-B. In cross-section C-C, the radially inner outer surface of the haptic 14 is closer to being straight than in cross-sections A-A and B-B, generally giving a D-shape to the outer surface of the haptic in cross-section C-C. In cross-section C-C, the fluid chamber 22 generally has a D-shape as in cross-sections A-A and B-B. The haptic has, in cross-section C-C, a fluid chamber configuration that is substantially the same as the fluid chamber configuration in cross-sections A-A and B-B, but has an outer surface with a configuration different from the configuration of the outer surface of the haptic 14 in cross-sections A-A and B-B.

[0079] The radially inner portion 40, which is thinner in cross-section C-C, also creates the access path 23 shown in Figure 1A. This space between the optical portion 12 and the haptic 14 allows a physician to insert one or more irrigation and / or aspiration devices into the space 23 during the procedure and apply aspiration to remove the viscoelastic fluid used in the delivery of the intraocular lens to the eye. The path 23 may be located anywhere along the length of the haptic, and there may be two or more paths 23. This application incorporates by reference the disclosure in Figures 23 and 24 and the description of the original text from U.S. Patent Application Publication No. 2008 / 0306588, which includes a plurality of paths in the haptic.

[0080] Figure 2G shows a view of cross-section D-D from Figure 2A. The haptic 14 has an opening 15 inside, which is adapted to receive the bateless from the optical part as described herein. The height of the opening 15 in this embodiment is about 0.92 mm. The width or thickness of the opening is about 2.12 mm.

[0081] Figure 3 shows the relative diameters of the optical part 12 (not shown) and the peripheral part including two haptics 14 (only one haptic is shown). In this embodiment, the optical part has a diameter of about 6.1 cm, while the adjustable intraocular lens as a whole including the peripheral part has a diameter of about 9.95 cm. The provided dimensions are not intended to be strictly limiting.

[0082] Figure 4 is a top view of the haptic 14, showing that the haptic 14 corresponds to an angle of about 175 degrees (i.e., substantially 180 degrees) around the optical part. The optical part is not shown for clarity. Thus, the two haptics each correspond to an angle of about 180 degrees around the optical part. The first region 61 of the haptic 14 is shown to correspond to an exemplary angle of about 118 degrees. This is the outermost part in the radial direction of the haptic 14, which is adapted to connect with the lens capsule and is adapted to be most responsive to the shape change of the capsule. Region 61 can be considered as the most responsive part of the haptic 14.

[0083] The angle between cross-sections A-A and B-B, which is regarded as the boundary of the more rigid radially inner part of the haptic, is about 40 degrees. The rigid radially inner part of the haptic 14 is positioned directly adjacent to the periphery of the optical part. The provided dimensions and angles are not intended to be strictly limiting.

[0084] Figures 5A and 5B show a portion of an adjustable intraocular lens 10 positioned in the capsular bag (the "CB") after the native lens has been removed from the capsular bag. In each figure, the forward direction is upward and the rearward direction is downward. Figure 5A shows the adjustable intraocular lens in a lower magnification configuration, or an unaccommodated configuration, relative to the higher magnification configuration, or accommodated configuration, shown in Figure 5B.

[0085] The elastic capsular bag "CB" is connected to zonular fibers "Z" that are connected to the ciliary muscle "CM". As shown in Figure 5A, when the ciliary muscle relaxes, the zonular fibers are stretched. This stretch pulls the capsular bag generally in a radially outward direction by a radially outward force "R" due to the generally equatorial connection position between the capsular bag and the zonular fibers. The stretching of the zonular fibers generally stretches and thins the capsular bag. When the native lens is still present in the capsular bag, the native lens becomes flatter (in the anterior-posterior direction) and higher in the radial direction, which results in a lower magnification of the lens. As shown in Figure 5A, relaxation of the ciliary muscle provides hyperopia. However, when the ciliary muscle contracts, as occurs when the eye is trying to focus on a nearby object, the radially inner portion of the muscle moves radially inward and relaxes the zonular fibers. This is shown in Figure 5B. The relaxation of the zonular fibers can move the capsular bag toward a generally more curved configuration with a greater curvature of the anterior surface than in the unaccommodated state, providing a higher magnification and allowing the eye to focus on a nearby object. This is generally referred to as "accommodation", and the lens can be said to be in an "accommodated" configuration.

[0086] In cross-section A-A of the haptic 14 (same as cross-section B-B) shown in FIGS. 5A and 5B, the radially inner portion 40 includes a thicker bulk material that provides the haptic 14 with rigidity in the anterior-posterior direction. When the force of the lens capsule is applied to the haptic in the anterior-posterior direction, the inner portion 40 deforms in a more repeatable and predictable manner due to its rigidity, making the base state of the lens more predictable. Also, due to its more rigid inner portion, the haptic deforms the capsule in a repeatable manner in the anterior-posterior direction. Also, since the haptic is not very flexible along the length of the haptic, the base state of the adjustable intraocular lens is more predictable, because bending along the length of the haptic is one way that fluid can move into the optical portion (thereby changing the magnification of the lens). A further advantage realized with the more rigid inner portion is that the haptic is more rigid against other forces such as twisting and spreading due to the additional bulk in the inner portion.

[0087] The radially outer portion 42 is a portion of the haptic that is directly connected to a portion of the lens capsule that is connected to the ciliary body. The outer portion 42 of the haptic is adapted to respond generally to the capsular reformation force "R" applied radially when the ciliary body relaxes and extends. This allows the haptic to be deformed in response to forces associated with the ciliary muscle (i.e., contraction and relaxation of the capsule), such that fluid flows between the haptic and the optical portion in response to relaxation and contraction of the ciliary muscle. This is shown in FIG. 5B. When the ciliary muscle contracts (FIG. 5B), the peripheral region of the elastic lens capsule is reformed, applying a radially inward force "R" to the radially outer portion 42 of the haptic 14. The radially outer portion 42 is adapted to deform in response to this reformation of the capsule. The deformation reduces the volume of the fluid passage 22, which pushes fluid from the haptic chamber 22 into the optical chamber 24. This raises the fluid pressure in the optical chamber 24. The increase in fluid pressure deforms the flexible front element 18 and the flexible rear element 20, increasing the curvature and thereby increasing the magnification of the intraocular lens.

[0088] The haptic is adapted to be stiffer in the longitudinal direction than in the radial direction. In this embodiment, the outer radial portion 42 of the haptic 14 has a radial flexibility (i.e., less stiffness) that exceeds the more rigid inner portion 40 in the longitudinal direction. This is due to the relative thickness of the outer portion 42 and the inner portion 40. Thus, the haptic is adapted to be less deformable in response to longitudinal forces than to radial forces. This results in less fluid moving from the haptic to the optical portion in response to longitudinal forces than in response to radial forces. The haptic will also deform in a more predictable and reproducible manner due to its more rigid inner radial portion.

[0089] Accordingly, the peripheral portion is more sensitive to the lens capsule reforming in the radial direction than to the lens capsule reforming in the longitudinal direction. The haptic is adapted to deform to a greater extent in the radial direction than in the longitudinal direction. Thus, the disclosure herein includes a peripheral portion that is less sensitive to forces along a first axis but more sensitive to forces along a second axis. In the above example, the peripheral portion is less sensitive along the longitudinal axis and more sensitive along the radial axis.

[0090] The benefit of the exemplary peripheral portion described above is that the peripheral portion deforms the lens capsule in a repeatable manner during accommodation while still maintaining a high sensitivity to radial forces. The peripheral portion described above is stiffer in the longitudinal direction than in the radial direction.

[0091] An example of additional capsular force in the anterior-posterior direction is the capsular force to the peripheral portion after the accommodative intraocular lens has been positioned in the lens capsule and after a healing response has generally occurred in the lens capsule. The healing response generally causes a force of contraction to the haptic in the anterior-posterior direction identified by force "A" in FIG. 5A. These and other post-implant lens capsule reformation forces, such as those associated with non-accommodative, are described in U.S. Patent Application No. 12 / 685,531, filed Jan. 11, 2010, which is incorporated herein by reference. For example, as described in U.S. Patent Application No. 12 / 685,531, also filed Jan. 11, 2010, there are patient-to-patient differences in the size of the lens capsule. When the intraocular lens is positioned in the lens capsule location, the size difference between the capsule and the intraocular lens can apply force to one or more portions of the intraocular lens in the anterior-posterior direction.

[0092] In an example of capsular healing force in the anterior-posterior direction, the force may be capable of deforming the deformable haptic before accommodation occurs. This deformation changes the volume of the haptic fluid chamber and causes fluid to flow between the optical portion fluid chamber and the haptic fluid chamber. This can, in some undesirable examples, shift the base magnification of the lens. For example, fluid may be pushed into the optical portion during capsular healing, increasing the magnification of the accommodative intraocular lens and creating a permanent shift to myopia of the accommodative intraocular lens. Fluid may also be pushed out of the optical portion into the haptic, decreasing the magnification of the accommodative intraocular lens.

[0093] As used herein, "radial direction" need not be limited to being exactly orthogonal to the anterior-posterior plane and includes a plane that is 45 degrees from the anterior-posterior plane.

[0094] The exemplary fluid is described in U.S. Patent Application No. 12 / 685,531, filed on January 11, 2010, and U.S. Patent Application No. 13 / 033,474, filed on February 23, 2011, both of which are incorporated herein by reference. For example, the fluid can be a silicone oil having a refractive index matched to the polymeric materials of the front and rear elements or an unmatched silicone oil. When using a fluid having a refractive index matched to the bulk material of the optical portion, the entire optical portion acts as a single lens whose outer curvature changes with increases and decreases in fluid pressure within the optical portion.

[0095] In the embodiments of FIGS. 2A - 2G above, the haptic is a deformable polymeric material having a substantially uniform composition in cross - sections A - A, B - B, and C - C. The more rigid radially inner body portion 40 is thought to be due to its thickness. In an alternative embodiment, the radially inner body portion has a different composition than the outer body portion, in which case the material of the radially inner body portion is more rigid than the material of the radially outer body portion. In these alternative embodiments, the thickness of the radially inner portion can be the same as the thickness of the radially outer portion.

[0096] FIG. 6 shows the haptic 50, which has the same configuration as shown in FIG. 2B. The radially outer portion 54 is identified. The haptic has an axis "A" in the middle through the height of the haptic, or, in other words, the axis A passes through the mid - point of the height of the haptic in the front - to - back direction. The opening 52 in which the optical portion bezel is disposed is on the rear side of the axis A. In this embodiment, the optical portion is located slightly closer to the most rear portion of the haptic than to the most front portion of the haptic. That is, in this embodiment, the optical portion is not centered by the haptic in the front - to - back direction.

[0097] FIG. 7 shows an alternative haptic 60 (the optical portion is not shown), with a radially outer portion 64 identified. The haptic 60 has an axis "A" in the middle through the height of the haptic, or, put another way, the axis A passes through the midpoint of the height of the haptic in the front-to-back direction. The opening 62 is symmetric about the axis A, and the axis passing through the midpoint of the opening 62 is aligned with the axis A. Also, the axis A is the axis of symmetry for the haptic 60. The symmetry of the haptic along the axis A can improve the ability to form relatively small stress components. FIG. 8 shows an embodiment of an intraocular lens 70 in which the optical portion 72 is coupled to two haptics 60 that are the haptics shown in FIG. 7. The optical portion is located further forward in embodiments where the opening is not along the centerline of the haptic. In this embodiment, the optical portion 72 is centered by the haptic in the front-to-back direction. The cross-sections A-A, B-B, and C-C of the haptic 60 are the same as those shown in the other embodiments shown previously, but the haptic may have any alternative configuration.

[0098] FIG. 9 shows an intraocular lens 80 comprising an optical portion 82 and two haptics 84. The optical portion is the same as the optical portions described herein. The haptic 84 does not have as great a height as the haptic 60, the haptic 50, or the haptic 14 when measured in the front-to-back direction. In the exemplary embodiment, the haptic 84 has a height between about 2.0 mm and about 3.5 mm, and in some embodiments, the haptic 84 has a height of about 2.8 mm. The intraocular lens 80 can be considered a "small" accommodative intraocular lens in size for patients having a capsular bag that is less than a particular threshold size. The rear surface of the rear element 86 is disposed slightly further rearward than the rearmost portion 90 of the haptic 84.

[0099] FIG. 10 shows an adjustable intraocular lens 98 comprising an optical body 100 and a peripheral non-optical body which in this embodiment comprises haptics 160 and 180. The optical body 100 can be in fluid communication with one or both of the haptics 160 and 180, and the magnification of the intraocular lens can be varied by fluid movement between the optical portion and the haptic in response to movement of the ciliary muscle. This general process of fluid-driven adjustment in response to deformation of the haptic can be found herein. The optical portion 100 comprises a front element 120 fixed to the rear element 140 and defining, together with the rear element 140, an optical fluid chamber in communication with the haptic fluid chambers 170 and 190 in the haptic. The “height” of components in the present disclosure is measured in the front-to-back direction. The optical portion 100 has a maximum height “H1” dimension measured in the front-to-back direction along the optical axis. The haptics 160 and 180 have a maximum height “H2” dimension measured in the front-to-back direction parallel to the optical axis. The optical body has a centerline B measured perpendicular to the optical axis and passing through the midpoint of H1. The haptic also has a centerline B measured perpendicular to the optical axis and passing through the midpoint of H1. In this embodiment, the centerlines coincide and are the same centerline B. In other words, the foremost surface or point of the front element 120 is spaced apart by the same distance from the foremost point or surface of the haptic as from the rearmost surface or point of the haptic to the rearmost surface or point of the rear element 140. The centerlines, even if they do not coincide, can be considered to be substantially the same line in some embodiments if they are close to each other in space (e.g., a few millimeters apart). The optical portion centered by the haptic is also shown in FIG. 8.

[0100] In this embodiment, the position of the optical portion 100 relative to the haptic can provide certain benefits. For example, during folding and / or insertion, an optical portion placed centrally (or substantially centrally) when measured in the front-to-back direction can prevent or reduce the possibility that one or more of the haptics that can occur when the optical body is not substantially centrally placed relative to the haptic will bend at the front element 120 or the rear element 140. For example, an optical portion closer to the rear side of the lens may increase the possibility that the haptic (e.g., the free end of the haptic) can bend at the front surface of the optical portion during deformation, attachment, or implantation.

[0101] An additional benefit of placing the optical body 100 centrally or substantially centrally relative to the peripheral body is that it is easier to use the optical portion for capsulotomy when placed in the eye. When the optical portion is closer to the rear side of the lens, it may become more difficult for the lens to rotate into the crystalline lens capsule.

[0102] An additional benefit is that glare from the intraocular lens is reduced compared to an optical portion that is further back in the rearward direction. By moving the optical portion forward (the optical portion will be closer to the iris when implanted), there is less light that can be reflected from the radially outer periphery of the optical portion, and thus the effect of glare from the edge is reduced.

[0103] In some embodiments of the intraocular lens of FIG. 10, the front element 120 can have a height between 0.2 mm and 0.35 mm, such as between 0.25 mm and 0.30 mm, such as about 0.28 mm, and the rear element 140 can have a height between 0.36 mm and 0.50 mm, such as between 0.40 mm and 0.45 mm, such as about 0.43 mm.

[0104] Prior to insertion, during manufacturing, etc., the intraocular lens shown in FIG. 10 can be filled with fluid. In some embodiments, the intraocular lens has a base state (a state where the fluid pressure in the optical portion is zero, or a state where there is no fluid therein) of less than 15D, such as about 13D. About 13D, as used herein, refers to the base state from about 10D to about 15D. By having a base state of about 13D, it may generally be possible to change the fluid pressure in one direction, i.e., to a higher value. When the base state of the intraocular lens is larger, such as about 20D, depending on the desired vision correction and the intended use of the intraocular lens, it may be necessary to change the fluid pressure either higher or lower. By having a smaller base state, the change to the state of the lens becomes more predictable by changing the base state in one direction.

[0105] One aspect of the present disclosure is an adjustable intraocular lens that is optionally fluid-filled and fluid-driven and has an aspherical optical surface after manufacturing and before implantation. That is, the intraocular lens is manufactured with an aspherical optical surface. The aspherical optical surface can avoid spherical aberration when the pupil is fully dilated. There can be challenges in the manufacture of intraocular lenses, particularly fluid-driven adjustable intraocular lenses having an aspherical optical surface.

[0106] In some embodiments, the accommodative intraocular lens is manufactured with an aspherical front surface and / or an aspherical back surface. One exemplary approach in which a fluid-filled accommodative intraocular lens can have a front or back optical surface with built-in asphericity is to create an optical surface with a spherical configuration prior to fluid filling during manufacture, and thus create asphericity on the optical surface during the filling process. For example, during manufacture, one or both of the front and back surfaces can be manufactured to have a spherical outer optical surface. Thus, the front surface can be fixed to the back surface. Next, one or more haptics can be fixed to the optical portion. In some embodiments, the optical portion is manufactured to have a base state (a state where the fluid pressure in the optical portion is zero or a state where there is no fluid therein) of less than 15D, such as about 13D, prior to filling. About 13D, as used herein, refers to a base state from about 10D to about 15D. When fluid is injected into the accommodative intraocular lens (e.g., via a diaphragm), the fluid filling step can increase the fluid pressure in the optical portion and impart an aspherical configuration to the front surface and / or the back surface of the optical portion. Thus, one aspect of the present disclosure includes a method of manufacturing an accommodative intraocular lens that includes creating an optical portion having asphericity incorporated into one or more optical surfaces, such as the front optical surface, and having a fluid-filled state prior to insertion. The method of manufacture can include manufacturing an optical portion where the optical surface is spherical prior to fluid filling.

[0107] When the optical portion is deformed, either through stopping adjustment or through adjusting, it may be desirable to maintain good optical quality at at least one surface of the central portion of the optical portion. One of the aspects of the present disclosure is an optical portion having a somewhat stable degree of asphericity that is very well controlled over the entire magnification range in the central region of the optical portion. This may be referred to herein as "beneficial asphericity" in the central region of the optical portion. The beneficial asphericity comprises a lens surface with surface aberration configured to correct spherical aberration in the optical system of the eye and contribute to maintaining optical quality. The beneficial asphericity is maintained over all or substantially all of the magnification range during adjusting and during stopping adjustment. In some examples, the asphericity can be controlled such that the spherical aberration of the entire lens system is maintained small (or zero) over all ranges of magnification. The optical region outside the central region may have a greater and less controlled degree of asphericity.

[0108] In some embodiments, the central region of the optical portion, or the region of beneficial asphericity, has a diameter of less than 6.5 mm, less than 6.0 mm, less than 5.5 mm, less than 5.0 mm, less than 4.5 mm, less than 4.0 mm, less than 3.5 mm, or less than 3.0 mm. In some embodiments, the central region has a diameter between 3.5 mm and 5.5 mm. In some embodiments, the central region of the optical portion having beneficial asphericity has a diameter of less than 90%, less than 85%, less than 80%, or less than 75% of the diameter of the optical portion. The diameter of the optical portion can be between 4 mm and 8 mm, such as between 5 mm and 7 mm. In some embodiments, the central region is between 4 mm and 5 mm and the optical portion diameter is between 5 mm and 7 mm. In some embodiments, the central region is between 4.25 mm and 4.75 mm and the optical portion diameter is between 5.75 mm and 6.25 mm.

[0109] The configurations of the front and rear elements can affect the configuration that they take through deformation either through adjustment or through ceasing adjustment. In some embodiments, one or both of the front and rear elements are shaped or configured such that the central region of the optical portion has a beneficial asphericity that is controlled to be beneficial to the overall system of the eye. In this embodiment, the front element 120 and, to a lesser extent, the rear element 140 are configured such that the front surface of the front element 120 and the rear surface of the rear element 140 maintain a beneficial asphericity controlled in the central region of the optical portion during adjustment. In this embodiment, one aspect of the configuration contributing to the central portion maintaining the beneficial asphericity is that the front element 120 and, optionally, the rear element 140 have a greater thickness (also referred to herein as "height") at a location more central than the periphery of the front element 120 (such as at the apex of the front element 120). An additional aspect of the configuration contributing to the beneficial asphericity is that the front element is flat on the inner surface (rear surface) compared to the outer surface (front surface). During adjustment, the central region of the front element 120 becomes steeply sloped at the center (which increases the magnification of the AIOL), but the optical body maintains its beneficial asphericity, at least in part, due to the relatively greater thickness of the central region of the front element. In an exemplary embodiment where the asphericity described later is incorporated into the front element, it may be aspherical prior to adjustment.

[0110] The forms of the thicknesses of the front and rear elements can contribute to an optical portion that maintains a beneficial asphericity over all magnifications, examples of which are the thicknesses of the front and rear elements.

[0111] FIG. 11 shows an exemplary haptic that can be part of any of the accommodative intraocular lenses in this specification, or of other suitable IOLs not described herein. One or both haptics can be configured as shown in FIG. 11. The haptic in FIG. 11 is labeled "160", but it is understood that the haptic in FIG. 11 can be part of an intraocular lens other than that shown in FIG. 10. The haptic includes a surface 220 that is fixed to the outer edge of the optical body. Surface 220 is the radial inner surface of the haptic and is configured with a slight curvature (along the length of the haptic) that is substantially the same as the curvature of the outer edge of the optical portion so that the entire surface 220 interfaces with the outer edge surface of the optical body. Surface 220 is configured with respect to the optical portion such that the extent of the surface does not cross the optical axis of the optical portion. An adhesive can be used to fix surface 220 to the surface of the outer edge of the optical portion. In this embodiment, the junction between the haptic and the optical body does not include one of the haptic and the optical portion being disposed within a passage, hole, or opening in the other, as used in the design of some haptic / optical portion junctions in the embodiments shown in FIGS. 1A-9. Some exemplary advantages of this type of design are described later.

[0112] FIG. 12 shows a perspective view of the optical portion 100, with the haptic removed for clarity. The surface 220 of the haptic (not shown) is fixed to both the front element 120 and the rear element 140 of the optical body 100. Most of surface 220 interfaces with the rear portion 140, but a portion of surface 220 interfaces with the front element 120. This is because the outer edge of the optical body consists mostly of the rear element 140. For different configurations of the optical portion, surface 220 can be fixed to more of the front element than the rear element. It is also noted that the height H3 of surface 220 (see FIG. 11) is substantially the same as the height of the outer edge of the optical body.

[0113] The surface 220 of the haptic 160 has a first end region 230 (see FIG. 11) having a configuration with a surface larger than the second end region 250. The end region 230 of the surface 220 has a larger surface area than the end region 250 of the surface 220 and includes a surface B that is at least partially inclined as shown in FIG. 13. The width W1 of the end region 230 is larger than the width W2 of the end region 250. The configuration of the end region 230 can provide the benefit of illustration. For example, as part of the process of delivering the intraocular lens to the delivery device and / or the patient's eye, one or both of the haptics 160 and 180 can be "spread" relative to the optical portion. That is, one or both of the haptics can be reconfigured from the stable natural state shown in FIGS. 10-14 by moving the free end 170 of the haptic away from the optical body. The degree to which the free end (and most of the haptic) moves away from the optical portion during spreading can vary. In some methods of attachment, one of both haptics is substantially spread so that the haptic is oriented behind or in front of the optical portion. In some examples, the free end of the haptic (i.e., the end of the haptic not directly coupled to the optical portion) is "turned" substantially 180 degrees from where it is oriented in the stable configuration. Generally, spreading the haptic causes stress at the interface where the haptic and the optical portion are coupled. The interface where the optical portion and the haptic are coupled must be able to withstand these forces so that the haptic is not detached from the optical portion. When spreading the haptic, there can be a location of high stress at the optical portion / haptic junction at the end of the interface 230 near the free end. Therefore, the end region 230 is the location where the haptic / optical interface is most likely to malfunction. The end region 230 having a larger surface area and a tapered and inclined configuration serves to distribute the applied stress (or the stress when the haptic is reoriented relative to the optical portion) and prevent the haptic from being detached from the optical portion.

[0114] The configuration of the surface 220 can be varied in many ways to provide a desired coupling between the haptic and the optical portion. Coupling the haptic and the optical portion in this manner (as opposed to fitting one component within the other) allows for many additional interface configurations, which provides additional flexibility in the design.

[0115] In the haptic embodiment of FIG. 11, the fluid opening 240 is centrally located along the centerline of the haptic. The centerline is defined in the same manner as described in FIG. 10. The centerline passes through the midpoint of the height of the haptic (measured in the front-to-back direction) in a side view of the haptic.

[0116] Other aspects of the haptic can be the same as those described herein, such as a thicker radial inner wall thickness along a portion of the haptic, with one or both haptics following the curvature of the perimeter of the optical portion from the coupling end to the free end, and the foremost shape of the haptic extending further forward than the foremost shape of the optical portion.

[0117] The rear element 140 has internally two fluid passages 210 that are in fluid communication with the haptic fluid chambers 170 and 190. The outer edge of the rear element 140 has internally two openings that define the ends of the fluid passages 210. The haptic / optical interface (which can be an adhesive bond) surrounds the two fluid openings in the rear element 140. In some alternatives, the optical portion has only one fluid passage instead of two.

[0118] FIG. 13 is another view of the haptic 160, showing some curvature of the surface 220 of the interface with the optical portion and the internal fluid opening 240.

[0119] FIG. 14 is a perspective view seen from the rear side of the intraocular lens from FIG. 10. The fluid passages 210 are seen in the rear element 140, with two of the fluid passages each associated with a respective haptic. The interface between the haptic and the optical portion is also seen. FIG. 14 shows the cross-section A-A shown in FIG. 10.

[0120] Figure 15 shows additional views of the intraocular lens from Figure 10, where an interval 292 between the outer edge of the optical portion and the haptic can be seen, and a junction between the optical portion and the haptic can also be seen.

[0121] In some embodiments where one or more haptics are adhered to the optical body at separate locations rather than 180 degrees around the optical portion, the curing step of curing the adhesive that fixes the haptic to the optical body can cause shrinkage of the material at the location where the two components are adhered. This shrinkage at separate locations can cause distortion in the lens, such as aberration. Preventing or reducing the degree of distortion can be beneficial or necessary. Figure 16 shows an exploded perspective view of an alternative adjustable intraocular lens 300. Figure 17 shows a top view of the AIOL 300. Figure 18 shows a perspective view of an option 301 of the AIOL 300. Figure 19 is a view of section A-A shown in Figure 17.

[0122] Figures 16-18 show an exemplary interface between an exemplary optical body 301 (see Figure 18) and a haptic 310 that can help reduce distortion due to shrinkage at the location where the optical body and the haptic are fixed. The interface between the optical body 301 and the haptic 310 is repositioned radially away from the optical body 301, specifically from the optical surface, as compared to other embodiments such as in Figures 10-15. By moving the interface, and thus the potential location of shrinkage, away from the optical surface, the magnitude of the distortion caused by the curing step on the optical surface can be reduced. The bonding region 311 of the haptic 310 interfaces with the protrusion 303 of the optical portion at the interface, and thus the interface between the haptic and the protrusion 303 is radially separated from the optical surface of the optical portion. This type of interface can be used in non-adjustable or adjustable intraocular lenses, but in this embodiment, the lens is an adjustable intraocular lens.

[0123] For example, the adjustable intraocular lens 300 may include an optical body 301 (see FIG. 18) and haptics 310. In this embodiment, the haptics 310 are manufactured separately from the optical portion 301 and then fixed to the optical portion 301. The haptics 310 each include a flat surface 312 (only one is labeled in FIG. 16) on the radially inner side that is fixed to the radially peripheral surface 306 of the optical portion 301. In this embodiment, the surface 312 is the radially inner surface of the bonding region 311 of the haptics 310. For example, an adhesive may be used to fix the surface 312 to the radially peripheral surface 306 of the optical portion 301. The process of fixing the haptics to the optical portion may, as described above, affect the optical performance of the optical portion 301. For example, the curing process of the adhesive may cause shrinkage of the optical portion 301 at two separate locations and thus may result in distortion and aberration, such as astigmatism of the intraocular lens.

[0124] In this embodiment, the intraocular lens includes two protrusions 303 that extend radially outward from the peripheral surface 309 of the rear element 304 of the optical portion 301. The protrusions 303 can be considered as protrusions from the generally curved periphery of the optical portion, as defined by the outer edge surface 309. The haptics 310 can each have a first portion 311 fixed to the protrusions 303 and a free second portion 315 disposed away from the first portion 311, and each radially inner surface of the haptics follows the radially outer peripheral surface of the optical portion. The protrusions 303 may be referred to in the present disclosure as "landing" or "landed".

[0125] The protrusion 303 can be a raised area that extends radially outward from the peripheral surface 309 of the optical portion, between 10 microns and 1 mm, optionally between 10 microns and 500 microns. The radially peripheral surface 306 of the protrusion 303 can be radially farther from the center of the optical portion than the peripheral surface 309 of the optical portion, between 10 microns and 1 mm, optionally between 10 microns and 500 microns. For example, the protrusion 303 can be a raised area that extends radially outward from the peripheral surface 309 of the optical portion between 100 microns and 200 microns. The radially outer peripheral surface 305 of the protrusion 303 can be radially farther from the center of the optical portion than the peripheral surface 309 of the optical portion, between 100 microns and 200 microns. Values outside the above ranges are also possible. The protrusion 303 can move to separate the fixed surface or the coupling surface from the optical portion in order to prevent optical interference due to shrinkage when curing the adhesive between the optical portion and the haptic.

[0126] In some embodiments, the optical portion has a circular shape in top view, and the radially outer periphery 309 of the optical portion is generally circular. When the protrusion is described herein as extending radially away from the optical body, it can extend away from the overall curvature of the radially outer periphery of the optical portion.

[0127] In some embodiments, the optical portion of the intraocular lens and the protrusion 303 can be a single integral object. For example, the protrusion 303 can be formed as part of the optical portion. In some other embodiments, the protrusion 303 can be attached to the optical portion by adhesion or the like.

[0128] In some embodiments, the optical portion 301 includes a rear element and a front element that optionally define a fluid chamber therebetween, as in the above embodiments. For example, the protrusion 303 can be part of the rear element because the rear element has a thicker periphery. The protrusion can also be part of the front element. In yet another example, the protrusion can be part of both the rear element and the front element of the optical portion.

[0129] The outer surface 306 of the protrusion 303 and the inner surface 312 of the haptic 310 can be flat such that they are joined at the interface in a butting joint. For example, the peripheral surface 306 on the radially outer side of the protrusion 303 can comprise a flat surface, optionally a surface that is entirely flat. The radially inner surface 312 of the haptic 310 can similarly comprise a flat surface, optionally a surface that is entirely flat. In another example, the peripheral surface 306 on the radially outer side of the protrusion 303 can comprise a curved surface, optionally a surface that is entirely curved. The radially inner surface 312 of the haptic 310 can similarly comprise a curved surface, optionally a surface that is entirely curved. The curvature of the peripheral surface 306 on the radially outer side can be the same as the curvature of the peripheral surface 309 of the optical body, and in some embodiments, can be greater than or less than the curvature of the peripheral surface 309 of the optical body.

[0130] The haptic 310 can comprise a peripheral fluid chamber as described herein. The protrusion 303 can comprise at least one fluid passage 308 in fluid communication with the peripheral fluid chamber in the haptic, and optionally can comprise at least two passages. The raised protrusion 303 can provide additional stability to the fluid passage because there is more optical material at the location of the protrusion.

[0131] Generally, the protrusions can also be disposed in an unaccommodating (fixed magnification) intraocular lens manufactured by coupling a haptic and an optical portion. For example, an intraocular lens that is a fluid-filled optical body (e.g., PMMA material) having a single magnification and two haptics can also comprise protrusions that extend radially outward from the peripheral surface of the optical body.

[0132] The embodiments in FIGS. 16-19 also show an alternative haptic cross-sectional configuration (see FIG. 19 for the cross-section) that can be incorporated into any suitable optical part in this specification, such as the optical part 100 shown in FIG. 10. The height H (measured in the front-rear direction) of the haptic 310 can be from 2 mm to 2.5 mm, and can also be from 2.1 mm to 2.4 mm. This may be smaller than other haptic heights for other intraocular lenses, such as heights exceeding 3 mm. Having a height between 2 mm and 2.5 mm for the haptic may be advantageous, but is not necessarily so. There is some variation from patient to patient in the size of the biological structures in the eye. For example, there is variation in the size of the capsule, or the distance between the capsule and the posterior side of the iris. In some cases of the haptic, there may be some rubbing between the haptic and the posterior side of the iris. Even if there is rubbing, it may not cause any concern. Therefore, it can be advantageous that having a haptic height that minimizes the possibility of such rubbing only requires sufficient attention.

[0133] The haptic 310 may include a radially inner wall portion 313 inside the radial direction of the fluid chamber 316, and the wall portion 313 has a thickness "t o " that is greater than the thickness of the haptic wall on the outer side of the radial direction of the chamber 316, "t i ". In some embodiments, "t i " is "t oIt is between 4 times and 9 times of 」. The radially inner wall portion 313 may be referred to as a "spacer" here. As shown in FIG. 16, the spacer extends along almost the entire length of the haptic, but does not exist in the places where there is a gap between the optical part and the haptic. The radially inner wall of the fluid chamber 316 is flatter than the radially outer wall of the fluid chamber 316 as shown. The haptic 310 is an example of a haptic that has a cross-section in a plane transverse to the optical axis of the optical part, in which the fluid chamber of the haptic is arranged in the radially outer part of the haptic, and there is no fluid in the radially inner part of the haptic. The haptic 310 is an example of a haptic that has a wall thickness of the radially inner fluid chamber between 4 times and 10 times the wall thickness of the radially outer fluid chamber in a cross-section of a plane transverse to the optical axis of the optical part and in a direction orthogonal to the optical axis of the optical part passing through the midpoint of the haptic. The haptic 310 is an example of a haptic that has an outer surface that is not symmetric about all axes parallel to the optical axis of the optical part passing through the peripheral part in a cross-section of a plane transverse to the optical axis of the optical part, and the haptic has a wall thickness of the radially inner fluid chamber that is greater than the wall thickness of the radially outer fluid chamber in a direction orthogonal to the optical axis of the optical part passing through the midpoint of the haptic. The haptic 310 is an example of a haptic that has a height dimension measured in the front-rear direction in a cross-section of a plane transverse to the optical axis of the optical part, and the largest height of the peripheral part in the radially outer half of the peripheral part is greater than the largest height of the peripheral part in the radially inner half of the peripheral part.

[0134] In some embodiments, one or more aspects of the optical body have a refractive index that is between 1.48 and 1.55, such as between 1.50 and 1.53. In some embodiments, the refractive index of one or more components is about 1.48, about 1.49, about 1.50, about 1.51, about 1.52, about 1.53, about 1.54, or about 1.55. There can be designs where the refractive indices are not matched between any of the front element, the fluid, and the rear element, but in some embodiments, there are designs where the refractive indices are matched between at least two of those components and optionally between all three. When all components of the optical section are designed to have the same or substantially the same refractive index, they are said to have a matched refractive index. Any of the characteristics (e.g., refractive index, fluid, monomer composition) of the intraocular lens described in U.S. Patent Application No. 62 / 173,877, filed Jun. 10, 2015, can be implemented in any of the intraocular lens designs herein.

[0135] Exemplary materials that can be used to make any of the IOLs herein, including fluids, can be found in PCT / US2016 / 037055, which is hereby incorporated by reference in its entirety.

[0136] As described in some of the above embodiments, an adjustable intraocular lens may optionally include first and second haptics that are attached to the optical portion at approximately 180 degrees from each other around the optical portion. During lens formation, the haptics are attached or adhered to the optical portion with an adhesive. The haptic / optical portion attachment is important for a variety of reasons. The haptics are deformed or splayed away from the optical portion during implantation and delivery. Having a relatively softer adhesive bond between the optical portion and the haptics can be beneficial to aid in the deformation of the haptics. If the haptic / optical portion bond is too rigid, it can be difficult to deform the haptics or the haptic / optical portion bond during implantation and / or delivery. Second, the haptics are coupled to the optical portion at two separate locations around the optical portion. That is, the bond between the haptics and the optical portion does not extend around the entire perimeter of the optical portion. This creates the potential for the haptic / optical portion bond to interfere with the achievement of the desired optical quality of the optical portion. For example, during curing of the adhesive used to attach the optical portion to the haptics, the adhesive can shrink and create aberrations in the optical portion, which can inhibit the optical quality of the optical portion. In contrast, using a low-elasticity adhesive to attach the front and rear elements of the optical portion may not be as useful because the bond is annular and shrinkage does not occur at separate locations as in the haptic / optical portion bond. In fact, it has been shown that the optical quality of the optical portion can be improved as a result of having a relatively hard adhesive ring that couples the front and rear elements of the optical portion. For these two reasons, in some embodiments, the adhesive for the haptic / optical portion bond can be a relatively low-elasticity adhesive.

[0137] As described above, the adhesive used can include CLP as the first main component and a reactive acrylic monomer diluent (e.g., ADMA) as the second main component, and may include a third component. Generally, as the proportion of CLP increases, the amount of shrinkage during curing decreases. Therefore, it can be beneficial to increase the amount of CLP in the adhesive when used to fix together components that desirably reduce the amount of shrinkage that occurs, at least at the joints of the haptic / optical parts. In some of the above embodiments, the second major component (e.g., ADMA) is present in an amount from about 18% to about 43%. The adhesives in those examples can be used for the haptic / optical part adhesives, but some adhesives at the upper limit of that range may be more suitable for bonding the optical parts between the front and rear elements with less concern about shrinkage occurring throughout around the optical part rather than in separate locations.

[0138] In some embodiments, the adhesive for the haptic / optical part joint has a higher proportion of CLP than the adhesive for the optical part (between the front and rear elements). Similarly, in some embodiments, the adhesive for the haptic / optical part joint has less reactive acrylic monomer diluent (e.g., ADMA) than the adhesive for the optical part. In some embodiments, the adhesive for the haptic / optical part joint has about 5 - 35% reactive acrylic monomer diluent (e.g., ADMA), such as 10 - 30% or 15 - 25%. The CLP can be 50 - 85% of the adhesive. A third component such as lauryl methacrylate may be included to enhance strength, flexibility, and provide small shrinkage. Lauryl methacrylate is an example of a material with low elasticity and low shrinkage and has similar small diffusion characteristics as the reactive acrylic monomer diluent (e.g., ADMA). This helps to make the joint between the haptic and the optical part softer. In some embodiments, by fixing the haptic to the optical part, the change in the optical part during manufacturing is only ±3D.

[0139] Table 1 (Table 1) lists some exemplary adhesives that can be used, for example, as an adhesive for the coupling part of the haptic / optical part. Each example also contains 2.3% of a photoinitiator such as Darocur 4265. SR 313 is lauryl methacrylate and provides water resistance, weather resistance, impact strength, flexibility, low shrinkage, and other advantages described herein. Exemplary shrinkage is provided for some examples.

[0140]

Table 1

[0141] In an alternative to some of the above embodiments, the adhesive for the optical part further contains CLP and HEA instead of HEMA.

[0142] The present disclosure herein includes a description of an exemplary intraocular lens that can help reduce posterior capsule opacification ("PCO: Posterior Capsule Opacification"), and posterior capsule opacification (PCO) can be a major long-term complication of successful cataract surgery with some intraocular lens (IOL: IntraOcular Lens) implantations. Residual lens epithelial cells (LEC: Lens Epithelial Cell) can proliferate and migrate from the peripheral posterior lens capsule into the space between the capsule and the optical part of the intraocular lens (IOL). This phenomenon can lead to PCO and a decrease in visual acuity.

[0143] For example, some accommodative intraocular lenses, such as the aforementioned accommodative intraocular lens, have been demonstrated to have the ability to reduce or delay PCO. For example, the aforementioned haptic fills the peripheral lens capsule and may reduce the proliferation of LECs by intimate contact with the lens capsule. However, this contact may not occur throughout 360° around the capsule, and there may be a gap between the distal tip of one haptic and the other haptic, or there may be a gap between the optical part and the interior of the haptic adjacent to the location of the optical part / haptic coupling part.

[0144] In some situations, there may be an advantage in configuring and adapting the peripheral portion of the intraocular lens to further reduce the effect of PCO in order to improve vision.

[0145] FIG. 17 shows a top view of an exemplary intraocular lens in which the space between the optical portion and the haptic can be seen, and the junction between the optical portion and the haptic can also be seen.

[0146] As shown in FIG. 17, the haptic 310 can substantially fill the peripheral lens capsule and can reduce or prevent cell proliferation by intimate contact with the lens capsule, but this contact is not around the entire 360° of the capsule. There is a small gap between the distal tip 315 of the haptic and the proximal end of the optical portion. Residual LECs can grow and migrate from the peripheral lens capsule, such as from the area of the equator, into the space between the capsule of the IOL and the optical portion. Growth of LECs through the gap can be observed, which can lead to PCO and a decrease in vision. Also, LECs have been observed in the space between the optical portion and the inner haptic adjacent to where the haptic is coupled to the optical portion.

[0147] FIG. 20 is a top view showing an exemplary IOL having one or more blunt tips 37 and 39 of the haptic. One or both of the tip of the first haptic and the proximal end of the second haptic can fit integrally closer together and be configured to reduce or eliminate the gap between the free tip 37 of the first haptic 36 and the proximal end of the second haptic 38, and the gap between the free tip 39 of the second haptic 38 and the proximal end of the first haptic 36. The blunt 90° tips 37, 39 can reduce the gap and prevent or reduce cell movement and proliferation, thereby reducing the effect of PCO.

[0148] In some embodiments, the distal tip of the first haptic may overlay or overlap the proximal portion of the second haptic (in top view) to reduce or eliminate the gap. For example, the distal tip of the first haptic may be tapered to overlay the second haptic. The free end of the second haptic may be overlaid (e.g., tapered) to overlay the first haptic to reduce or eliminate the gap. The proximal ends of both of these exemplary haptics are tapered toward the location of coupling with the optical portion, and thus, the distal ends of adjacent haptics may similarly be tapered (such as with complementary tapering) to form an overlapping region of the first and second haptics. Since the IOL is rotated clockwise, the proximal end can be configured to have a taper while the distal tip can be configured in various shapes. In some other embodiments, the distal tip may further comprise a radial barrier to prevent circular movement of the LEC that may cause growth of the LEC in the gap.

[0149] FIG. 21 shows a cross-sectional view of an exemplary IOL having one or more circumferential ridges (e.g., 46a, 46b, 48a, and 48b) in haptics 46 and 48. Only the cross-section of the ridges is shown, but the ridges extend along at least a portion of the length of the haptic. Haptic / capsule contact can be improved by one or more circumferential ridges (e.g., 46a, 46b, 48a, and 48b) having sharp edges (i.e., non-smooth). For example, one or more ridges 46a, 46b having sharp edges can extend on the outer surface of haptic 46 along at least a portion of the length of haptic 46. Ridge 46a can be disposed on the upper surface of haptic 46, while ridge 46b can be disposed on the lower surface of haptic 46. Similarly, one or more ridges 48a, 48b having sharp edges can extend on the outer surface of haptic 48 along at least a portion of the length of haptic 48. Ridge 48a can be disposed on the upper surface of haptic 48, while ridge 48b can be disposed on the lower surface of haptic 48. In this exemplary embodiment, "upper" is considered the front portion and "lower" is the rear portion. Axis (or plane) B-B is considered to divide the IOL between the front and rear sides, and axis or plane B can be configured to pass through the "equidistant circle" of the haptic (generally aligned with the equidistant circle of the lens capsule). For example, ridges 48a and 46a are disposed on the front side of the haptic, and ridges 48b and 46b are disposed on the rear side of the haptic.

[0150] The ridges (e.g., 46a, 46b, 48a, and 48b) in the haptics 46, 48 can have a cross-section with a sharp edge, such as the edge of a square. The optical portion provided with the square edge can reduce the occurrence of the influence of PCO following cataract surgery. In early attempts dating back to the early 1990s, it has been shown that the optical portion provided with the square edge reduced the development of PCO. The bending of the discontinuous capsule can be an important factor for the PCO prevention effect. Generally, proliferating LECs start from the equator, divide, and move towards the center. The ridges (e.g., 46a, 46b, 48a, and 48b) in the haptic 46 or 48 can create a barrier to the movement of LECs by creating bending of the capsule and create the effect of the square edge. Therefore, the movement of LECs can be significantly reduced or eliminated by one or more of the ridges.

[0151] FIG. 22 is a bottom (rear) view of an exemplary IOL, showing the ridges 46b and 48b of the two haptics (from FIG. 21), and both ridges are labeled with the symbol "R" in FIG. 22. In FIG. 22, the ridges extend along the entire length of both haptics, but in some embodiments, they do not extend along the entire length. For example, in some embodiments, the ridges can extend along at least 75%, 80%, 85%, 90%, or 95% of the length of the haptic. The length of the haptic is measured along the equator of the haptic from the coupling location with the optical portion to the distal free end. Thus, the length of the haptic is generally measured along a curved line. The length of the haptic can, in some cases, be considered as a straight line measured as the shortest distance from the coupling location of the optical portion to the distal free end.

[0152] The ridge portions (e.g., 46a, 46b, 48a, and 48b) can extend along at least a portion of the length of the peripheral portion of the IOL. The peripheral portion can comprise one or more haptics, such as, for example, reference numerals 46 and 48, although the IOL can generally comprise two haptics. For example, the IOL can have a single annular peripheral portion having one or more ridge portions. The IOL can also have, for example, four haptics that couple to the optical portion by themselves, and one or more of the four haptics comprise one or more ridge portions.

[0153] The ridge portions (e.g., 46a, 46b, 48a, and 48b) can create a "square edge effect", although the ridge portions need not be square. Triangular ridge portions can also be sufficient. However, other shapes having at least one sharp edge can also function. The expression "sharp edge" as used herein refers to an edge that is not rounded. In some embodiments, the ridge portions can have at least one 90-degree edge in cross-section. In some embodiments, the ridge portions can have at least one edge less than 100 degrees in cross-section. In some embodiments, the ridge portions can have at least one edge less than 120 degrees in cross-section. In some other embodiments, the ridge portions do not have a 90-degree edge in cross-section, for example, the ridge portions can have a 60-degree triangular edge. In some embodiments, at least two ridge portions (e.g., 46a and 46b) have the same configuration. In some other embodiments, the first ridge portion has a unique configuration from the second ridge portion (not shown). One or all of the ridge portions can have the same configuration, or some can have one configuration while others have a different configuration. For example, the ridge portions on one side (e.g., the front) can have a triangular configuration while the ridge portions on the other side (e.g., the back) have a square configuration.

[0154] The height of the rib portion (measured in the front-rear direction) can be, for example, from about 100 μm to about 300 μm, or in some embodiments, from about 50 μm to about 500 μm. When the rib portion has a cross-section of the edge of a square, the width (measured in the radial direction) can be, for example, from about 100 μm to about 300 μm, or in some embodiments, from about 50 μm to about 500 μm. The rib portion can be configured to have a width sufficient to prevent the rib portion from folding over when embedded. The cross-section of the edge of the square herein comprises at least one edge of less than 100 degrees. When the rib portion has a triangular cross-section, the base of the rib portion can be of a similar size, for example, from about 100 μm to about 300 μm, or in some embodiments, from about 50 μm to about 500 μm. The rib portions do not have to be of the same size (for example, one or more rib portions can have different height values and width values). Values outside the above ranges are also possible.

[0155] The haptic (e.g., reference numerals 46, 48) can include rib portions (e.g., 46b, 48b) disposed on the rear side (lower surface) in some embodiments. The haptic (e.g., reference numerals 46, 48) can include rib portions (e.g., 46a, 48a) disposed on the front side (upper surface) in some other embodiments. In some embodiments, the haptic (e.g., reference numerals 46, 48) can include one or more rib portions (e.g., 46a, 48a) disposed on the front side and one or more rib portions (e.g., 46b, 48b) disposed on the rear side to block the LEC from both sides. The second rib portion can further reduce the influence of the PCO, but in some examples, the second rib portion may not be required. One or both of the haptics can have two or more rib portions on the front side or two or more rib portions on the rear side. For example, the haptic 48 can include two rib portions 48b that are spaced apart from each other in the haptic but are both disposed on the rear side of the haptic.

[0156] In some additional embodiments, the haptic(s) (e.g., 46, 48) may comprise one ridge (not shown) disposed on the circumferential circle of the peripheral portion. For example, in FIG. 8, one or both haptics may comprise ridges that are symmetric about an axis or plane B-B and extend radially outward to the left or right in the figure. However, the ridge(s) in the circumferential circle of the haptic may be optional. The number of ridges in the haptic may be, for example, one, two, three, four, six, eight, twelve, twenty, any number in between, or other numbers. For example, two ridges may optionally be disposed in the circumferential direction 180° apart in the front (upper) and rear (lower) portions, along with one or more additional ridges between the front (upper) and rear (lower) portions. In FIG. 21, ridges 48a and 48b are 180 degrees apart, but this is not necessary. For example, ridge 48a may be moved 45 degrees towards the circumferential circle of haptic 48 while ridge 48b remains in the same position as shown. The ridges may be symmetrically placed about the haptic, but need not be symmetrically placed.

[0157] The ridges described herein may generally be considered as extensions that extend away from the natural curvature of the haptic. For example, when the edge of a square is used, the transition between the curvature of the haptic and the ridge may be a region where the haptic has a sharp or tight bend, since the ridge extends away from the surface of the haptic. The ridges may be described in this manner in both transition regions having the general curvature of the haptic.

[0158] The ribbed portion can be formed in many ways. The haptic can be molded with one or more ribbed portions formed together (considered integral with the haptic material). Alternatively, after the haptic is molded, a separate portion of material may be attached to the outer surface of the haptic (considered not integral with the haptic material). Any of the ribbed portions can be the same or a different material than the haptic material. For example, one or more ribbed portions can be a material harder than the haptic material that can be attached (e.g., adhered) to or co-molded with the haptic.

[0159] For some intraocular lenses, scattering from the periphery of the optical portion of the intraocular lens can reduce the optical quality of the intraocular lens. It may not be necessary but can be beneficial for the intraocular lens to be further adapted and configured to reduce peripheral scattering. FIG. 23A is a top view of an exemplary IOL with an opaque peripheral portion. FIG. 23B is a perspective cross-sectional view of the IOL with the opaque peripheral portion from FIG. 23A. Referring to FIGS. 23A-23B, an intraocular lens (IOL), such as an accommodating intraocular lens, can include an optical portion 510, an opaque peripheral portion 510b around the optical portion 510, and a peripheral portion optionally including at least two haptics 516 and 518 coupled to the optical portion 510. The opaque peripheral portion 510b can be adapted to limit light scattering by absorbing the scattered light.

[0160] In some embodiments, the opaque peripheral portion 510b comprises a layer of an opaque material that is optionally a polymer disposed at the periphery of the optical portion. The layer of opaque material may need to meet the requirements for an implantable material. The layer of opaque polymer may need to be biocompatible and have stable properties. In some embodiments, the opaque polymer can be co-molded with the optical portion 510 during the IOL manufacturing process. In some embodiments, the opaque polymer can be placed at the periphery of the optical portion 510 after the IOL has already been manufactured.

[0161] In some embodiments, the opaque peripheral portion 510b can comprise a layer of black adhesive placed at the periphery of the optical portion, and the layer of black adhesive can be used as an adhesive for adhering the optical portion to the haptic.

[0162] In some embodiments, the opaque peripheral portion 510b comprises a layer of black paint disposed at the periphery of the optical portion.

[0163] In some embodiments, the opaque peripheral portion 510b comprises a cylindrical structure such as a black cylindrical structure attached to the edge of the optical portion 510. This approach can reduce the complexity in IOL manufacturing. Various methods can be used to attach the cylindrical structure to the IOL.

[0164] Figures 24 - 26C described herein are related to the entire disclosure in WO2014 / 145562A1 which is incorporated herein by reference. Devices, systems, and methods of wearing and delivering various intraocular lenses ( "IOLs") have been described over the years. However, important problems regarding residual air have not yet been adequately addressed. For example, residual air around the IOL and within the fluid chamber of the injection system can pose significant problems during IOL delivery. For example, air in the viscoelastic flow in front of and around the IOL during delivery can reduce the visibility of the IOL and the eye, such as within the capsule, during manipulation and final placement of the IOL in the eye, both during and after delivery. Also, the compressed residual air behind the IOL during delivery of the IOL body at the highest pressure can result in an uncontrolled delivery of the IOL into the eye. This can occur because the IOL body passes through the most constricted portion of the delivery device, expanding the compressed air near the IOL and pushing the IOL forward without user input. While this can be used theoretically as an advantage in some types of delivery, an uncontrolled delivery of the IOL is generally undesirable.

[0165] There is a need for an apparatus, system, and method of use for effective air management, including removal of residual air prior to loading and delivery.

[0166] FIG. 24 is a cross-sectional view of a cartridge 660 with an IOL 640 mounted therein by a pushing member 630, according to an embodiment of the present disclosure. The IOL 640 can be any of the IOLs described above, or in some embodiments, an IOL not described herein. For example, the IOL 640 can be the same as or similar to the IOL 340 in FIG. 22 of WO2014 / 145562A1. The IOL 640 can include an optical portion 643, a front haptic 641, and a rear haptic 642, as shown in FIG. 24. The front haptic 641 is disposed distally of the optical portion 643, and the rear haptic 642 is generally proximally of the optical portion 643. The cartridge 660 can be any type of cartridge, such as those described herein or other cartridges not described herein. For example, the cartridge 660 can be the same as or similar to the exemplary cartridge 360 in FIG. 18. The transport device 600 can be any type of transport device shown or not shown herein. For example, the transport device 600 can be the same as or similar to the cartridge 400 in FIGS. 16, 17, and 18 of WO2014 / 145562A1. The cartridge 660 can be fixed in a cartridge receiving region distally of the transport device 600.

[0167] Prior to use, the loading and transporting device 600 can be sterilized and shipped with the IOL 640 disposed therein. Optionally, the cartridge 660 can be attached prior to sterilization, or the cartridge 660 can be attached during loading. The viscoelastic material 680 can be introduced into the transporting device 600 through a port on the side of the loading and transporting device 600 that has a communication port adjacent to the IOL 640. For example, the viscoelastic port (not shown) can be the same or similar to the side ports 319 in FIGS. 16 and 17 of WO2014 / 145562A1. The viscoelastic port can be designed to mate with a standard syringe and have a path leading to the vicinity of the IOL 640. The port transports the viscoelastic material from a syringe or other viscoelastic delivery aid to the area around the IOL 640 prior to the spreading step and the loading step.

[0168] The pushing member 630 can be any type of pushing member or loading member shown herein or elsewhere. The pushing member or loading member 630 can be moved distally to connect with the IOL 640 and advance the IOL 640 into the cartridge 660 (or other delivery device or delivery lumen), and place the IOL 640 in a predetermined position in the cartridge 660 so as to be ready for further assembly of a delivery device such as a plunger. In some embodiments, the pushing member 630 can be the same or similar to the pushing member 330 in FIGS. 17 and 20 of WO2014 / 145562A1. The pushing member or loading member 630 can include an elongated body, a first extension extending distally in an upward direction relative to the upper portion of the elongated body at a hinge, and a second extension extending distally in a generally linear orientation relative to the proximal portion of a loading body similar to the loading member in FIG. 20 of WO2014 / 145562A1. In some other embodiments, the pushing member 630 can be the same or similar to the pushing member 40 in FIG. 14 of WO2014 / 145562A1.

[0169] The transporting device 600 may include a cover or lid 650 of the transporting device, which can be any of the lids described herein. The lid 650 can cover a portion of the base 610 where the IOL 640 is positioned.

[0170] As shown in FIG. 24, mounting the IOL 640 from the mounting and transporting device 600 to the cartridge can place the IOL 640 in the cartridge 660 and surround it with the viscoelastic material 680, but air bubbles will be localized near the proximal haptic 642 across the front portion of the IOL 640. If this air is not removed, the air will move in front of the IOL 640 during delivery and, as described above, may reduce visibility during surgery.

[0171] The present disclosure includes an exemplary method of air management in a system for mounting and delivering an IOL. The method is generally described without reference to specific components of the devices herein, but examples are provided in the context of specific embodiments. Not all steps are necessarily performed, and the order may vary.

[0172] FIGS. 25A - 25C show a method of removing air (or "degassing") from around the IOL 640 before connecting the delivery device to the cartridge 660 during mounting. Generally, air across the front portion of the IOL 640 and air near the proximal haptic 642 can be removed or moved away from the IOL 640 before attaching a delivery device, such as a plunger assembly, to the cartridge 660.

[0173] In some embodiments, the method may include removing the cartridge from the transporting device and passing a syringe with a cannula across the top of the IOL, and the syringe can be filled with a viscoelastic material. The viscoelastic material can be used to move air towards the proximal side of the IOL. The syringe can pass across the top of the IOL from the distal end in some embodiments. In some other embodiments, the syringe can pass across the top of the IOL from the proximal end. The cannula may be near the optical portion 643 of the IOL 640. Care needs to be taken to avoid damaging the optical portion 643 of the IOL 640.

[0174] In some embodiments, air across the front portion of the IOL 640, and air near the proximal haptic 642, can be removed when the mounting member or pushing member 630 is retracted, as shown in FIGS. 25A-25C. The lid 650 of the delivery device can include an opening 655 for inserting a syringe 658 with a cannula, as shown in FIG. 25A. The cannula of the syringe 658 can be inserted through the opening 655, but the pushing member 630 is advanced across the front portion of the IOL 640 during the last step of the mounting. The cannula can be advanced to a predetermined position across the front portion of the IOL 640. The syringe 658 can insert a viscoelastic material 682 to displace air across the front portion of the IOL 640, or air at any other location within the cartridge. The viscoelastic material 682 can be the same as or different from the viscoelastic material 680 inserted through the side port of the delivery device 600. In some other embodiments, the base of the delivery device 600 can include an opening for inserting a syringe with a cannula to displace air adjacent to the IOL. In some alternative embodiments, the side of the delivery device 600 can include an opening for inserting a syringe with a cannula to displace air across the front portion of the IOL or other regions adjacent to the IOL.

[0175] A method of removing air from the IOL 640 during mounting can include placing the cannula of a viscoelastic syringe across the front portion of the IOL 640 while the pushing member 630 is advanced during the last step of the mounting, and inserting a viscoelastic material across the front portion of the IOL 640 while the pushing member 630 is being retracted.

[0176] FIG. 25B shows a cross-sectional view when the pushing member is retracted. The volume around the pushing member can be filled with the viscoelastic material 682 such that after the pushing member is retracted, the displaced volume is replaced with the viscoelastic material 682 instead of air. After the pushing member is fully retracted, the proximal passageway can remain filled with the viscoelastic material 682. This method has the advantage of reducing the need for the cannula to be in proximity to the optical portion 643 of the IOL. In some embodiments, the method may further include forming an indication on the delivery carrier 600 at a location where the viscoelastic material 682 needs to be filled to be effective at a predetermined volume.

[0177] FIGS. 25A - 25C show a method of venting air from an IOL during the delivery process. The cartridge 660 with the IOL 640 mounted therein may be connected to a delivery system that can deliver the IOL 640 to a patient's eye. For example, the delivery system of the IOL 640 can be the delivery system described in U.S. Patent No. 8,968,396, entitled "Intraocular Lens Delivery Systems and Methods of Use," filed on March 15, 2013, the entire disclosure of which is incorporated herein by reference. The delivery system can comprise a plunger assembly 690 as shown in FIG. 25A. The plunger assembly 690 can comprise a lumen extending from a proximal end to a distal end. This allows a viscoelastic fluid or other material to be delivered from the proximal end of the plunger 690 to the cartridge 660, pushing the mounted IOL 640 out of the cartridge 660 to the distal tip (shown in an inclined manner) and then to the patient's eye. The plunger 690 has a proximal portion adapted to interact with a fluid delivery device such as a syringe, so that fluid can be advanced from the fluid delivery device into the internal lumen within the plunger 690. The distal end of the plunger 690 is disposed within the cartridge 660, and thus the fluid is delivered to locations that are radially and axially within the lumen even if it does not exit the plunger 690.

[0178] When the IOL640 is mounted from the transport device to the cartridge 660, the cartridge 660 is removed from the transport device, and the plunger assembly 690 is attached to the cartridge 660 proximal to the IOL640. At this point, the IOL640 in the cartridge 660 is encapsulated in a viscoelastic material. At this point, the plunger 690 is not filled with viscoelastic material and there is only air in the open fluid path. There is no viscoelastic body proximal to the IOL640.

[0179] After the IOL640 is mounted to the cartridge 660 as shown in Figure 26A, a viscoelastic fluid or other type of fluid can be delivered from a syringe into the lumen of the plunger 690 (see Figure 26B). The viscoelastic fluid is delivered from the distal port of the plunger 690 to contact the IOL640, pushing the IOL640 distally within the cartridge 660 and out of the distal end of the cartridge 660. Generally, the delivery of the IOL640 from the cartridge 660 relies on the generation of a pressure differential across the viscoelastic body over the IOL640 to move the IOL640 into the narrowed region of the cartridge 660 and then into the eye.

[0180] The compressed residual air behind the IOL640 during delivery of the IOL640 at the highest pressure can result in an uncontrolled delivery of the IOL640 into the eye when the IOL body passes through the most constricted portion of the cartridge 660. The compressed air proximal to the IOL640 expands and pushes the IOL forward without user input, which can potentially damage the IOL640 or the capsule in the eye in some cases, or even deliver the IOL640 outside of the capsule. The release of air is important for a smooth and controlled delivery of the IOL640.

[0181] When the tip of the cartridge is placed in the eye and the screw drive starts to advance, the viscoelastic fluid of the plunger 690 fills the luer fitting and the support tube through the semi-porous expanded PTFE tube, and is redirected back to the support tube to pass through the exhaust vent 695, thereby moving air forward from the plunger 690. The forward direction is towards the tip of the delivery device 600. Since the vent 695 is the path of the lowest pressure due to the IOL 640 being completely or partially sealed against the wall of the cartridge 660, the venting viscoelastic fluid is pushed by the air towards the vent 695. The forward path to the tip is blocked by the IOL 640 and the viscoelastic material being implanted. When sealing the vent 695 with the viscoelastic fluid, the system can generate a pressure to move the IOL 640 towards the tip of the cartridge 660 so that there is no significant amount of air behind the IOL 640, as shown in FIG. 26C.

[0182] As shown in FIGS. 26A - 26C, the viscoelastic fluid travels from the syringe through the support tube and exits near the posterior haptic of the IOL 640 within a plug element such as an EPTFE membrane. The front of the fluid proceeds to both fill the plug element distally and vent the volumetric air through the vent 695 to the rear. The vent 695 does not allow the viscoelastic body to pass through, and thus can maintain pressure when completely exhausted. This effect removes air from the system posteriorly and reduces the spring effect of the trapped air during the release of the IOL 640 during delivery.

[0183] In some embodiments, the delivery system includes a vent and does not include a plug or sealing element. In these embodiments, a fluid such as a viscoelastic body is delivered towards the IOL 640 as part of the delivery process. Venting to reduce the volume of air bubbles moving forward through the tip towards the eye while increasing controllability during delivery provides significant advantages even in the absence of a plug element.

[0184] The following disclosure of FIGS. 27-28D relates to the entire disclosure of WO2013 / 142323, which is incorporated herein by reference in its entirety. An intraocular lens is positioned within a patient's eye, such as in the anterior chamber or posterior chamber. After making a small incision in the eye, the physician typically positions the distal opening of the delivery device within or adjacent to the opening. The physician then delivers the intraocular lens from the delivery device through the opening to a target location within the eye. In some, but not all, procedures, the intraocular lens is delivered to the native capsule after the native lens has been removed.

[0185] Some intraocular lenses need to be reconfigured, and / or have at least a first portion that is reoriented with respect to a second portion to be delivered to the eye, because of their size and / or their configuration, and because of the possible desired incision size. When some intraocular lenses are advanced through a delivery device and / or are delivered from a delivery device, the forces in the intraocular lens can damage the intraocular lens.

[0186] What is needed is a delivery system and method of use that can deliver an intraocular lens without damaging the intraocular lens.

[0187] FIG. 27 is a top view of an exemplary cartridge 401 that can be used to deliver an intraocular lens to the eye. Cartridge 401 is an example of any of the cartridges described herein. Cartridge 401 can include a proximal opening 405 arranged to be coupled to a mounting carrier for receiving an intraocular lens (not shown), and a distal tip 411 adapted to deliver the intraocular lens to the eye. Cartridge 401 can include a lumen 410 extending from proximal opening 405 to distal tip 411. Lumen 410 can have a cross-section having a first axis X and a second axis Y of an internal ellipse. Lumen 410 can further include a first portion 491 adapted to couple to a mounting carrier and initiate folding of the intraocular lens without stretching the intraocular lens without limitation, a second portion 492 adapted to form a seal (or at least substantially a seal) between the inner wall and the intraocular lens without limitation, and a third portion 493 adapted to compress the intraocular lens to extend the length of the intraocular lens without limitation.

[0188] The intraocular lens can be disposed within lumen 410 and positioned to be deployed from distal tip 411 of cartridge 401. The distal end of a plunger, such as any of the plungers herein, can be disposed within proximal opening 405 in cartridge 401 when assembled. Cartridge 401 can be adapted to receive an intraocular lens from a mounting carrier into cartridge 401 and has a tapered distal end for deforming, compressing, and optionally stretching the intraocular lens to deliver the intraocular lens to the eye.

[0189] Figures 28A-28D are exemplary internal cross-sections DD, CC, BB, and AA of the cartridge 401 in FIG. 27. Cross-section DD represents the proximal opening 405. Cross-section CC represents the intersection of the first portion 491 and the second portion 492. Cross-section BB represents the intersection of the second portion 492 and the third portion 493. Cross-section AA represents the distal end of the third portion 493 and shows the cross-section of the most distal region of the cartridge 401. Referring to FIGS. 27 and 28A-28D, as the intraocular lens is pushed through the cartridge 401 (from right to left as shown in FIG. 27), the internal cross-section of the cartridge 401 transitions from a lumen 410 large enough to hold the lens without compressing the lens in cross-section DD (assuming the haptic is spread out away from the lens body) to a final compressing lumen 410 all the way.

[0190] In some embodiments, the transition from cross-section DD to CC is such that both the first diameter 410a along the first axis X and the second diameter 410b along the second axis Y in the cross-section contract from the proximal opening 405 to cross-section CC, which interfaces with the lens carrier, receives the lens into the cartridge 401, and acts to fold the lens body without stretching the lens body. In some embodiments, both the first diameter 410a and the second diameter 410b in the cross-section contract from the proximal opening 405 to cross-section CC. In some embodiments, the first diameter 410a in the cross-section at the proximal opening 405 is from about 2 mm to about 7 mm. For example, the first diameter 410a in the cross-section at the proximal opening 405 is from about 4.6 mm to about 5.6 mm. Values outside the above ranges are also possible. In some embodiments, the second diameter 410b in the cross-section at the proximal opening 405 is from about 1 mm to about 6 mm. For example, the second diameter 410b in the cross-section at the proximal opening 405 is from about 3.5 mm to about 4.5 mm. Values outside the above ranges are also possible.

[0191] In some embodiments, the first diameter 410a is greater than the second diameter 410b in a cross-section from the proximal opening 405 to the intersection CC of the first portion and the second portion. In some embodiments, the first diameter 410a at the intersection CC of the first portion 491 and the second portion 492 is from about 1.5 mm to about 6.5 mm. For example, the first diameter 410a at the cross-section in region CC can be from about 4.0 mm to about 5.0 mm. Values outside the above ranges are also possible. In some embodiments, the second diameter 410b at the cross-section at the intersection CC is from about 0.5 mm to about 5.5 mm. For example, the second diameter 410b at the cross-section in region CC is from about 2.6 mm to about 3.6 mm. Values outside the above ranges are also possible.

[0192] Between regions CC and BB, the lens forms a substantial seal against the inner wall of the lumen 410. In some embodiments, the first diameter 410a and the second diameter 410b in cross-section decrease from the intersection CC of the first portion 491 and the second portion 492 to the intersection BB of the second portion 492 and the third portion 493.

[0193] In some other embodiments, the first diameter 410a decreases, but the second diameter 410b remains the same in cross-section from the intersection CC to the intersection BB. In some embodiments, the first diameter 410a is greater than the second diameter 410b at the cross-section at the intersection CC, and the first diameter 410a is smaller than the second diameter 410b at the cross-section at the intersection BB. In some embodiments, the first diameter 410a at the cross-section at the intersection BB of the second portion 492 and the third portion 493 is from about 0.5 mm to about 5 mm. For example, the first diameter 410a at the cross-section at the intersection BB is from about 2.6 mm to about 3.6 mm. In some embodiments, the second diameter 410b at the cross-section at the intersection BB is from about 0.5 mm to about 5.5 mm. For example, the second diameter 410b at the cross-section at the intersection BB is from about 2.2 mm to about 3.2 mm. Values outside the above ranges are also possible.

[0194] Between regions BB and AA, the lens is stretched by a sharp reduction in cross-sectional area (down to less than the minimum cross-sectional area of the lens itself). This increases the length of the lens. In some embodiments, both the first diameter 410a and the second diameter 410b in the cross-section decrease from the intersection BB of the second portion 492 and the third portion 493 to the distal end AA of the third portion 493. In some embodiments, the first diameter 410a is different from the second diameter 410b in the cross-section at the intersection BB, and the first diameter 410a is the same as the second diameter 410b in the cross-section at the distal end AA. In some embodiments, the cross-section changes from elliptical to circular in the third portion.

[0195] In some embodiments, the first diameter 410a and the second diameter 410b in the cross-section decrease at a first average rate from the proximal opening 405 to the intersection CC, and the first diameter 410a and the second diameter 410b in the cross-section decrease at a second average rate from the intersection BB to the distal end AA, and the second average rate is greater than the first average rate. In some embodiments, the first diameter 410a is the same as the second diameter 410b in the cross-section at the distal end AA. In some embodiments, the diameter of the cross-section at the distal end AA of the third portion is from about 0.1 mm to about 4 mm. For example, the diameter 410c in the cross-section at the distal end AA is from about 1.5 mm to about 2.5 mm. Values outside the above ranges are also possible.

[0196] From the cross-section AA to the tip, there is no change in the cross-sectional area. In some embodiments, the device may further comprise a fourth portion extending from the distal end AA of the third portion 493 to the distal tip 411. In some embodiments, the cross-section remains the same from the distal end AA of the third portion 493 to the distal tip 411.

[0197] One aspect of the present disclosure is a method of delivering an intraocular lens to the eye. The method can include coupling a delivery device to a carrying device for receiving the intraocular lens. The method can include folding the intraocular lens without stretching the intraocular lens. The method can include forming a seal between the inner wall of the delivery device and the intraocular lens. The method can include compressing the intraocular lens to stretch the length of the intraocular lens and delivering the intraocular lens to the eye.

[0198] In some embodiments, the step of folding the intraocular lens includes reducing a first diameter along a first axis of an ellipse inside a cross-section of the delivery device and a second diameter along a second axis at a first average rate. In some embodiments, compressing the intraocular lens includes reducing a first diameter along a first axis of an ellipse inside a cross-section of the delivery device and a second diameter along a second axis at a second average rate. In some embodiments, the second average rate during the step of compressing the intraocular lens is greater than the first average rate during the folding step.

[0199] The features of the intraocular lens described herein are equally applicable to non-fluid-driven adjustable intraocular lenses. For example, a non-fluid-driven adjustable intraocular lens can include a peripheral portion having a first stiffer region that provides a region of the peripheral portion that is insensitive in a first direction. For example, in an intraocular lens adapted such that two lenses move away from each other to change the magnification of the lens, the peripheral portion of the lens can be adapted such that a first type of capsular reformation does not change the distance between the lenses, and thus the magnification of the intraocular lens remains the same.

[0200] Also, the adjustable intraocular lens herein may be adapted to be positioned outside the native lens capsule. For example, the adjustable intraocular lens may be adapted to be positioned in front of or anterior to the lens capsule after the native lens has been removed or while the native lens is still in the lens capsule, and the peripheral portion of the lens is adapted to respond directly to the ciliary muscle rather than relying on capsular reformation. Further, the present disclosure includes the following inventions. The first aspect is a method for manufacturing an optical portion of an accommodative intraocular lens, wherein the method comprises providing an accommodative intraocular lens having an optical portion comprising a front element, a rear element, and an optical portion fluid chamber formed between the front element and the rear element, the front element having a front optical surface, the rear element having a rear optical surface, and at least one of the front optical surface and the rear optical surface being in a spherical configuration before insertion into the eye; changing the shape of at least one of the front optical surface and the rear optical surface from the spherical configuration to a non-spherical configuration before inserting the accommodative intraocular lens into the eye. The second aspect is wherein the step of changing the shape of at least one of the front optical surface and the rear optical surface from the spherical configuration to a non-spherical configuration before inserting the accommodative intraocular lens into the eye comprises adding fluid to the optical portion fluid chamber to increase the fluid pressure therein and deform at least one of the front optical surface and the rear optical surface from the spherical configuration to the non-spherical configuration, in the method according to the first aspect. The third aspect is wherein the method comprises fixing at least one haptic to the optical portion before the step of adding the fluid, in the method according to the second aspect. The fourth aspect is wherein the optical portion comprises protrusions extending radially outward from the peripheral surface of the optical portion, and the at least one haptic is fixed to the optical portion at the protrusions, in the method according to the third aspect. The fifth aspect is In the fourth aspect, the optical part has an outer edge that is at least partly an arc in top view, and the at least one haptic is fixed to the protrusion at a location radially outward with respect to the curvature of the arc. The sixth aspect is The method in the first aspect, wherein the step of providing the adjustable intraocular lens comprises joining the front element to the rear element. The seventh aspect is The method in the first aspect, wherein at least one of the front element and the rear element is machined. The eighth aspect is The method in the first aspect, wherein the optical part has a base state of 10D to 15D before the step of changing the shape of at least one of the front optical surface and the rear optical surface from the spherical configuration to the aspherical configuration. The ninth aspect is The method in the first aspect, wherein the front optical surface is changed from the spherical configuration to the aspherical configuration. The tenth aspect is The method in the first aspect, wherein the rear optical surface is changed from the spherical configuration to the aspherical configuration. The eleventh aspect is In an adjustable intraocular lens, the adjustable intraocular lens comprises an optical part including a front element, a rear element, and an optical part fluid chamber formed between the front element and the rear element, the front element has a front optical surface, the rear element has a rear optical surface, at least one of the front optical surface and the rear optical surface is in a spherical configuration before the adjustable intraocular lens is inserted into the eye, An adjustable intraocular lens, wherein at least one of the front optical surface and the rear optical surface is changed from the spherical configuration to an aspherical configuration before the adjustable intraocular lens is inserted into the eye. The twelfth aspect is In the adjustable intraocular lens according to the eleventh aspect, by adding fluid to the optical part fluid chamber so as to increase the fluid pressure in the optical part fluid chamber and deform at least one of the front optical surface and the rear optical surface from the spherical configuration to the aspherical configuration, at least one of the front optical surface and the rear optical surface is changed from the spherical configuration to the aspherical configuration. The thirteenth aspect is The adjustable intraocular lens according to the twelfth aspect further comprises at least one haptic fixed to the optical part. The fourteenth aspect is The optical part in the 13th aspect of the adjustable intraocular lens includes a protrusion extending radially outward from the peripheral surface of the optical part, and the at least one haptic is fixed to the optical part at the protrusion. The 15th aspect is The optical part in the 14th aspect of the adjustable intraocular lens has an outer edge that is at least partially an arc in a top view, and the at least one haptic is fixed to the protrusion at a location radially outward with respect to the curvature of the arc. The 16th aspect is The adjustable intraocular lens in the 11th aspect, wherein the front element is joined to the rear element. The 17th aspect is The adjustable intraocular lens in the 11th aspect, wherein at least one of the front element and the rear element is machined. The 18th aspect is The optical part has a base state of 10D to 15D in the 11th aspect of the adjustable intraocular lens before changing the shape of at least one of the front optical surface and the rear optical surface from the spherical configuration to the aspherical configuration. The 19th aspect is The adjustable intraocular lens in the 11th aspect, wherein the front optical surface is changed from the spherical configuration to the aspherical configuration. The 20th aspect is The adjustable intraocular lens in the 11th aspect, wherein the rear optical surface is changed from the spherical configuration to the aspherical configuration.

Explanation of Symbols

[0201] 10 Adjustable intraocular lens 11 Radially inner part 12 Optical part 13 Radially outer part 14 Haptic 15 Opening 17 First end region 18 Front element 19 Second end region, closed end 20 Rear element 22 Haptic fluid chamber, fluid passage, haptic chamber 23 Path, space 24 Optical part fluid chamber, optical chamber 28 Peripheral surface 29 Bevel-less part 30 Oblique surface 31 Surface 32 Fluid passage 33, 35 Curved surface 36 First haptic 37, 39 Tip 38 Second haptic 40 Radially inner body part 41 Maximum thickness dimension 42 Radially outer part 43 Radially inner wall 45 Radially outer wall 46, 48 Haptic Peripheral ridge portions 46a, 46b, 48a, 48b 50 Haptic 54 Radial outer portion 60 Haptic 61 First region 62 Opening 64 Radial outer portion 70 Intraocular lens 72 Optical portion 86 Rear element 90 Most rear portion 98 Adjustable intraocular lens 100 Optical body, optical portion 120 Front element 140 Rear element 160, 180 Haptic 170, 190 Haptic fluid chamber 210 Fluid passage 220 Surface 230 Interface surface, first end region 240 Fluid opening 250 Second end region 292 Spacing 300 Adjustable intraocular lens 301 Optical body, optical portion 303 Protrusion 304 Rear element 305 Peripheral surface 306 Radial peripheral surface, outer surface 308 Fluid passage 309 Peripheral surface, outer edge surface, periphery 310 Haptic 311 Coupling region, first portion 312 Surface, radial inner surface 313 Radially inner wall portion 315 Second portion, distal tip 316 Fluid chamber 360 Cartridge 401 Cartridge 405 Proximal opening 410 Lumen 410a First diameter 410b Second diameter 411 Distal tip 491 First part 492 Second part 493 Third part 510 Optical part 510b Opaque periphery 516, 518 Haptic 600 Mounting and transporting device 610 Base part 630 Pushing member, mounting member 640 IOL 641 Anterior haptic 642 Posterior haptic, proximal haptic 643 Optical part, optical section 650 Cover, lid 655 Opening 660 Cartridge 680 Viscoelastic material 690 Plunger assembly 695 Discharge vent Axis A AA Distal end Center line B B Partially inclined surface BB Intersection CB Capsule CC Intersection CM Ciliary muscle Optical axis OA H, H1, H2, H3 Maximum height R Radially outward force, capsule reformation force, radially inward force R Ridge Direction T to, ti Thickness W1, W2 Width Axis X Axis Y Z Ciliary body

Claims

1. In intraocular lenses, The intraocular lens is An optical section; An intraocular lens comprising: a haptic having one or more ridges extending along at least a portion of the length of the haptic, the length of the haptic following the curvature of the optical portion, each of the one or more ridges having a plurality of edges that meet at a corner and protruding from a rounded anterior side of the haptic.

2. The intraocular lens of claim 1 , wherein the corner is defined by a 90 degree angle.

3. The intraocular lens of claim 1 , wherein the corner is defined by a 60 degree angle.

4. The intraocular lens of claim 1 , wherein the corner is defined by an angle of 120 degrees.

5. The intraocular lens of claim 1 , wherein at least one of the edges extends from an equator of the haptic.

6. The intraocular lens of claim 1 , wherein at least one of the edges extends along an entire length of the haptic.

7. The intraocular lens of claim 1 , wherein at least one of the plurality of edges extends along at least one of 75%, 80%, 85%, 90% and 95% of the length of the haptic.

8. 10. The intraocular lens of claim 1, wherein at least one of the one or more ridges has a ridge height between 50 μm and 500 μm.

9. The intraocular lens of claim 1 , wherein at least one of the one or more ridges is a square ridge.

10. The intraocular lens of claim 9, wherein the square ridge has a ridge width between 50 μm and 500 μm.

11. The intraocular lens of claim 1 , wherein at least one of the one or more ridges is a triangular ridge.

12. The intraocular lens of claim 11, wherein the triangular ridge has a base width between 50 μm and 500 μm.

13. The optical portion includes an optical portion fluid chamber, the haptic comprises a haptic fluid chamber; The intraocular lens of claim 1 , wherein the haptic fluid chamber is in fluid communication with the optic fluid chamber.

14. In intraocular lenses, The intraocular lens is an optic comprising an anterior element, a posterior element, and an optic fluid chamber formed between the anterior element and the posterior element, the optic comprising an opaque periphery, the opaque periphery being disposed on only a periphery-most side of the optic; An intraocular lens comprising: a haptic having a haptic fluid chamber in fluid communication with the optical portion fluid chamber, the haptic fluid chamber being disposed between a radially inner fluid chamber wall and a radially outer fluid chamber wall, the radially inner fluid chamber wall being thicker than the radially outer fluid chamber wall.

15. The intraocular lens of claim 14 , wherein the opaque peripheral portion comprises a layer of opaque material.

16. The intraocular lens of claim 15, wherein the opaque material is an opaque polymer.

17. The intraocular lens of claim 16 , wherein the opaque polymer is co-molded with the optic portion.

18. 17. The intraocular lens of claim 16, wherein the opaque polymer is placed along a peripheral side of the optic after the intraocular lens has already been manufactured.

19. The intraocular lens of claim 14 , wherein the opaque peripheral portion comprises a black adhesive disposed along a peripheral side of the optic.

20. The intraocular lens of claim 14 , wherein the opaque peripheral portion comprises black paint covering a peripheral side of the optic portion.

21. The intraocular lens of claim 14 , wherein the opaque peripheral portion is cylindrical.

22. 22. The intraocular lens of claim 21, wherein the opaque peripheral portion is a black cylindrical structure surrounding the peripheral side of the optic portion.

23. The intraocular lens of claim 14 , wherein the opaque peripheral portion is configured to absorb scattered light.

Images