Modular intraocular lens system

Abstract

To provide modular intraocular lens (IOL) systems that allow a lens to be adjusted or replaced while leaving a base in place, either intra-operatively or post-operatively.SOLUTION: A modular IOL system comprises: a base comprising an annular ring; and a lens configured for insertion into and removal from the base. The base comprises: an upper rim surrounding an anterior opening; a lower rim surrounding a posterior opening; a wall extending therebetween; a passage extending through the base from the anterior opening to the posterior opening; and a recess surrounding the passage. The system has prescribed dimensions. The lens comprises: an optic; and at least one tab protruding from the optic and received in the recess of the base.SELECTED DRAWING: Figure 4A

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 62 / 318,272, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed April 5, 2016, U.S. Provisional Patent Application No. 62 / 256,579, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed November 17, 2015, and U.S. Provisional Patent Application No. 62 / 250,780, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed November 4, 2015, each of which is incorporated herein by reference. This application claims the benefit of priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application No. 62 / 110,241, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed on January 30, 2015, which is related to U.S. Provisional Patent Application No. 14 / 828,083, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed on August 17, 2015, now U.S. Patent No. 9,364,316. No. 15 / 150,360, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed on July 25, 2016, which is related to now U.S. Patent No. 9,421,088, and U.S. Patent Application No. 15 / 218,658, filed on July 25, 2016, each of which is incorporated herein by reference. This application also relates to U.S. Patent Application No. 14 / 610,360, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed on January 30, 2015, which claims the benefit of priority under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 61 / 941,167, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed on February 18, 2014, each of which is incorporated herein by reference.This application is also related to U.S. patent application Ser. No. 13 / 969,115, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed Aug. 16, 2013, which claims the benefit of priority under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 61 / 830,491, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed Jun. 3, 2013, and U.S. patent application Ser. No. 15 / 054,915, entitled “MODULAR INTRAOCULAR LENS DESIGNS, TOOLS AND METHODS”, filed Feb. 26, 2016, which is related to now U.S. Patent No. 9,289,287, each of which is incorporated herein by reference.This application also claims the benefit of priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application No. 61 / 589,981, filed January 24, 2012, entitled "LASER ETCHING OF IN SITU INTRAOCULAR LENS AND SUCCESSIVE SECONDARY LENS IMPLANTATION," and U.S. Provisional Patent Application No. 61 / 677,213, filed July 30, 2012, entitled "MODULAR INTRAOCULAR LENS DESIGNS & METHODS," filed July 9, 2013, which is related to U.S. Provisional Patent Application No. 13 / 748,207, filed January 23, 2013, entitled "MODULAR INTRAOCULAR LENS DESIGNS & METHODS," now U.S. Patent No. 9,095,424. No. 13 / 937,761, entitled “MODULAR INTRAOCULAR LENS DESIGNS AND METHODS”, filed on July 24, 2015, which relates to now U.S. Patent No. 9,125,736; and U.S. Patent Application No. 14 / 808,022, entitled “MODULAR INTRAOCULAR LENS DESIGNS AND METHODS”, filed on July 8, 2016, which relates to now U.S. Patent No. 9,387,069, each of which is incorporated herein by reference.

[0002] The present disclosure relates generally to intraocular lenses (IOLs). More particularly, the present disclosure relates to modular IOL designs, methods, and associated tools. [Background technology]

[0003] The human eye functions to provide vision by transmitting light through a clear outer portion called the cornea and focusing the image onto the retina by the lens. The quality of the focused image depends on a number of factors, including the size and shape of the eyeball and the transparency of the cornea and lens.

[0004] When the lens becomes less transparent (e.g., clouded) due to aging or disease, vision is impaired because less light can pass through to the retina. This abnormality of the eye's lens is medically known as a cataract. The accepted treatment for this condition is to surgically remove the lens from the capsule and place an artificial intraocular lens (IOL) in the capsule. In the United States, most cataractous lenses are removed using a surgical procedure called phacoemulsification. During this procedure, an incision (capsulorhexis) is made in the anterior lens capsule and a thin phacoemulsification tip is inserted into the diseased lens and vibrated with ultrasound. The vibrating tip liquefies or emulsifies the lens, preparing it for aspirating out of the capsule. Once the diseased lens is removed, it is replaced with an IOL.

[0005] After cataract surgery for IOL implantation, the optical result may not be optimal or may need to be adjusted after some time. For example, it may be determined shortly after surgery that the power correction is incorrect, causing a refractive error sometimes called a "power surprise." Also, for example, long after surgery, the patient may need or desire another correction, such as a stronger power correction, an astigmatism correction, or a multifocal correction.

[0006] In each of these cases, the surgeon may be reluctant to attempt to remove the suboptimal IOL from the capsule and replace it with a new IOL. Generally, manipulation of the capsule to remove the IOL carries with it the risk of damaging the capsule, such as rupturing the posterior capsule. This risk increases over time as the capsule collapses around the IOL and tissue ingrowth surrounds the haptics of the IOL. It would therefore be desirable to be able to correct or modify the optical result without removing the IOL and without manipulating the capsule. Summary of the Invention [Problem to be solved by the invention]

[0007] Thus, a need remains for an IOL system and method that can correct or modify the optical result using a lens that can be attached to a base or primary lens without manipulating the capsular bag. [Means for solving the problem]

[0008] Embodiments of the present disclosure provide a modular IOL system that includes an intraocular base and an optic that combine to form a modular IOL. Generally, modular IOLs allow the lens to be adjusted or replaced while the base remains in place, either intraoperatively or postoperatively.

[0009] In one embodiment, the modular IOL system includes an annular base having two haptics extending radially outward. The base defines a central hole and an inner circumferential surface with a recess along the inner circumferential surface that opens radially inward. The modular IOL system also includes a lens having an optic body with first and second tabs extending radially outward from the optic body. The base and lens may be assembled by placing the first and second tabs of the lens into the recesses of the base. The first tab may be a movable spring and the second tab may be a non-movable extension. The first tab may require radial compression to assemble the lens with the base. The first tab may include a pair of cantilever springs, each having one end attached to the optic body and one end free.

[0010] Various techniques for delivering and / or assembling the modular IOL systems are also disclosed, which may be applied to modular IOL embodiments not specifically described herein.

[0011] Modular IOL systems, tools, and methods according to embodiments of the present disclosure may be applied to various types of IOLs, including fixed monofocal, multifocal, toric, accommodative, and combinations thereof. In addition, modular IOL systems, tools, and methods according to embodiments of the present disclosure may be used to treat severe refractive errors in eyes with cataracts, myopic (near-sighted), hyperopic (far-sighted), astigmatic eyes, cataracts, cataracts, aphakia, pseudophakia, and nuclear sclerosis, for example.

[0012] Various other aspects of the embodiments of the present disclosure are set forth in the following detailed description and drawings. The drawings illustrate exemplary embodiments of the present disclosure. The drawings are not necessarily to scale, may include similar elements numbered the same, and dimensions (in millimeters) and angles (in degrees) may be included by way of example and not necessarily by way of limitation. In the drawings: [Brief description of the drawings]

[0013] [Figure 1] FIG. 1 is a schematic diagram of the human eye shown in cross-section. [Diagram 2] FIG. 1 is a perspective view of a base of a modular IOL according to the present disclosure. [Diagram 3] FIG. 1 is a perspective view of a lens of a modular IOL according to the present disclosure. [Figure 4A] 1A-1D are various views of an alternative base. [Figure 4B] 1A-1D are various views of an alternative base. [Figure 4C] 1A-1D are various views of an alternative base. [Figure 4D] 1A-1D are various views of an alternative base. [Figure 5A] 1A-1C are various views of alternative lenses. [Figure 5B] 1A-1C are various views of alternative lenses. [Figure 5C] 1A-1C are various views of alternative lenses. [Figure 5D] 1A-1C are various views of alternative lenses. [Figure 5E] 1A-1C are various views of alternative lenses. [Figure 6A] 1A-1C are top views of various alternative lens variations. [Figure 6B] 1A-1C are top views of various alternative lens variations. [Figure 6C] 1A-1C are top views of various alternative lens variations. [Figure 6D] 1A-1C are top views of various alternative lens variations. [Figure 7] FIG. 1 is a perspective view of a pinhole lens according to the present disclosure. [Figure 8A] 1A-1D are various views of an alternative pinhole component according to the present disclosure; [Figure 8B] 1A-1D are various views of an alternative pinhole component according to the present disclosure; [Figure 8C] 1A-1D are various views of an alternative pinhole component according to the present disclosure; [Figure 8D] 1A-1D are various views of an alternative pinhole component according to the present disclosure; [Figure 9] FIG. 2 is a top view of a base having drug delivery features according to the present disclosure. [Figure 10A] 1A-1D are various views of an alternative base having drug delivery capabilities according to the present disclosure. [Figure 10B] 1A-1D are various views of an alternative base having drug delivery capabilities according to the present disclosure. [Figure 10C] 1A-1D are various views of an alternative base having drug delivery capabilities according to the present disclosure. [Figure 11] 1 is a flowchart illustrating one exemplary procedure for using a modular IOL. [Figure 12A] 1 illustrates an exemplary technique for implanting a modular IOL. [Figure 12B] 1 illustrates an exemplary technique for implanting a modular IOL. [Figure 12C] 1 illustrates an exemplary technique for implanting a modular IOL. [Figure 12D] 1 illustrates an exemplary technique for implanting a modular IOL. [Figure 12E] 1 illustrates an exemplary technique for implanting a modular IOL. [Figure 13A] 1 illustrates an embodiment of a probe for use with a modular IOL according to the present disclosure. [Figure 13B] 1 illustrates an embodiment of a probe for use with a modular IOL according to the present disclosure. [Figure 14A] 1 illustrates an embodiment of a forceps for use with a modular IOL according to the present disclosure. [Figure 14B] 1 illustrates an embodiment of a forceps for use with a modular IOL according to the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] Referring to FIG. 1, a human eye 10 is shown in cross section. The eye 10 has been described as a light-responsive organ for several purposes. As a sensory organ with perceptual responses, the eye provides vision. The rod and cone cells of the retina 24 provide light perception and vision with perceptual responses including color differences and depth perception. In addition, non-imaging light-sensitive ganglion cells within the retina 24 of the human eye receive light signals that affect the regulation of pupil size, the regulation and inhibition of the hormone melatonin, and the entrainment of the body clock.

[0015] The eye 10 is not exactly a sphere, but rather a fusion of two parts. The smaller, anterior part is more curved and is called the cornea 12, and is connected to the larger part called the sclera 14. The cornea 12 typically has a radius of about 8 mm (0.3 inches). The sclera 14 makes up the remaining 5 / 6ths and typically has a radius of about 12 mm. The cornea 12 and sclera 14 are connected by a ring called the limbus. The cornea 12 is transparent, so instead of the cornea 12, the iris 16, which is the color of the eye, and its black center, the pupil, are seen. To see inside the eye 10, an ophthalmoscope is needed, as light is not reflected outwards. The fundus (the area opposite the pupil), which contains the macula 28, shows the characteristic pale optic disc (optic nerve head), the location where the blood vessels entering the eye pass and where the optic nerve fibers exit the eye.

[0016] Thus, the eye 10 is composed of three membranes, which surround three transparent structures. The outermost layer is composed of the cornea 12 and the sclera 14. The middle layer is composed of the choroid 20, the ciliary body 22, and the iris 16. The innermost layer is the retina 24, which gets its circulation from the blood vessels of the choroid 20 and the retinal blood vessels, which can be seen under an ophthalmoscope. Among these membranes are the aqueous humor, the vitreous body 26, and the flexible crystalline lens 30. The aqueous humor is a transparent fluid contained in two regions: the anterior chamber between the cornea 12 and the exposed area of ​​the iris 16 and the crystalline lens 30, and the posterior chamber between the iris 16 and the crystalline lens 30. The crystalline lens 30 is suspended from the ciliary body 22 by the ciliary ridge ligament 32 (zonules of Zinn), which are composed of fine transparent fibers. The vitreous body 26 is a transparent jelly that is much larger than the aqueous humor.

[0017] The crystalline lens 30 is a transparent, biconvex structure within the eye which, together with the cornea 12, helps refract light so that it is focused on the retina 24. By changing its shape, the crystalline lens 30 functions to change the focal length of the eye, allowing it to focus on objects at various distances, so that a sharp, real image of the object of interest is formed on the retina 24. This adjustment of the crystalline lens 30 is known as accommodation, and is similar to the way a photographic camera focuses by moving its lens.

[0018] The lens has three main parts: the lens capsule, the lens epithelial cells, and the lens fiber cells. The lens capsule forms the outermost layer of the lens, and the lens fiber cells form most of the interior of the lens. The lens epithelial cells are located between the lens capsule and the outermost layer of lens fiber cells, primarily on the anterior side of the lens, but also extend posteriorly a little beyond the lens equator.

[0019] The lens capsule is a smooth, transparent basement membrane that completely surrounds the lens. It is elastic and composed of collagen. It is synthesized by the lens epithelial cells and its main components are type IV collagen and sulfated glycosaminoglycans (GAGs). The lens capsule is elastic, which allows the lens to become more spherical when the zonular fibers that connect it to the ciliary body 22 are not under tension. The thickness of the lens capsule varies from about 2 to 28 micrometers from its thickest point near the equator of the lens to its thinnest point near the posterior pole of the fundus. The lens capsule may be associated with a greater anterior curvature than the posterior portion of the lens.

[0020] Various pathologies and disorders of the lens 30 may be treated with an IOL. For example, but not necessarily by way of limitation, modular IOLs according to embodiments of the present disclosure may be used to treat cataracts, myopic (near-sighted), hyperopic (far-sighted), and severe refractive errors in astigmatic eyes, cataract transitions, aphakia, pseudophakia, and nuclear sclerosis. However, for purposes of explanation, modular IOL embodiments of the present disclosure will be described with respect to cataracts.

[0021] In the following detailed description, various embodiments of a modular IOL system are described that include an intraocular base configured to releasably receive first and second intraocular components, i.e., intraocular optics. Features described with respect to any one embodiment may be applicable and incorporated in the other embodiments.

[0022] 2 and 3, the base 100 and lens 200, when assembled, form one embodiment of a modular IOL. A general description of the base 100 and lens 200 is provided below, but is described in more detail in U.S. patent application Ser. No. 14 / 828,083, which is incorporated herein by reference in its entirety.

[0023] 2, the base 100 portion of the modular IOL includes an annular ring 102 defining a central bore 104. A pair of haptics 106 extend radially outward from the annular ring 102. The annular ring 102 includes a lower edge 108, an upper edge 110, and an inwardly facing sidewall defining an inwardly facing recess 112 into which a lens 200 may be inserted to form the modular IOL.

[0024] The lower edge 108 of the base 100 may include one or more evacuation notches 114, which aid in the removal of ocular viscoelastic agents during surgery. The upper edge 110 may include one or more notches 116, which provide an opening for inserting a probe (e.g., a Sinske hook) during surgery, thereby making the base 100 easier to manipulate. The base 100 may include an outer edge 118 that extends along the periphery of the annular ring 102 and aids in reducing cellular growth on the lens 200.

[0025] With particular reference to FIG. 3 , the lens 200 of the modular IOL includes an optic portion 202 and one or more tabs 204 and 206. As shown, tab 204 is fixed, whereas tab 206 may be movable. Fixed tab 204 may include a through hole 208 whereby a probe 450 (e.g., a Sinske hook) or similar instrument may be used to engage and manipulate tab 204. Movable tab 206 may be actuated between a compressed position for delivery into hole 104 of base 100 and an uncompressed extended position (as shown) for placement into recess 112 of base 100 to form a mating connection between base 100 and lens 200. It is also envisioned that the movable tab 206 may be inserted into the recess 112 and actuated between a compressed position to facilitate entry of the fixed tab 104 into the recess 112 and an uncompressed, extended position to insert the fixed tab 104 further into the recess 112 to form a mating connection between the base 100 and the lens 200.

[0026] The movable tab 206 may include two members 210 and 212, one end of each connected to a rim 214 around the optic 202 and the other end free, thus forming two cantilever springs. The outer diameter of the rim 214 may be larger than the inner diameter of the trailing edge 108 of the base 100, so that the lens 200 does not fall out of the opening 104 of the base 100 and the lens 200 is circumferentially supported by the trailing edge 108 of the base 100 along its periphery. A notch 216 may be formed between the two members 210 and 212 of the rim 214, which adds a hinge-like flexibility. A notch 218 may be provided in the fixed tab 204, which provides an entry point for a probe (e.g., a Sinske hook) or similar instrument to manipulate the fixed tab 204 into the recess 112 of the base 100. The free ends of the members 210 and 212 may extend in opposite directions. It is also contemplated that one or more of members 210 and 212 may be curved to facilitate bending. For example, the radially outer surfaces of members 210 and 212 may be convex, while the radially inner surfaces of members 210 and 212 may be concave.

[0027] In general, when assembling the base 100 and the lens 200, these features may be configured such that the central plane of the optic 202 is parallel to the central plane of the base 100 and the central (anterior-posterior) axis of the optic 202 coincides with and is collinear with the central (anterior-posterior) axis of the base 100. Assuming that the natural lens capsule is anatomically symmetrical and the base 100 is centered within the lens capsule, this configuration essentially aligns the central axis of the optic 202 with the center of the capsule, centering the optic 202. However, there are cases where the visual axis (foveal axis) does not align with the anatomical axis (pupil centerline), and this difference is referred to as the γ angle. In such instances, it may be desirable to offset the central axis of the optic 200 with respect to the base 100, thus providing an offset. This may be accomplished, for example, by configuring the tabs 204 and 206, the recess 112, and / or the haptic 106 such that the central (anterior-posterior) axis of the optic 202 is offset laterally (nasally or temporally) with respect to the central (anterior-posterior) axis of the base 200. For example, but not by way of limitation, the sidewalls defining the recess 112 of the base may be offset with respect to the haptic 106, thereby offsetting the central axis of the optic 202. Different offsets could be provided, for example, from 0.5 mm to 2.0 mm in 5 mm intervals. Angular orientation marks may be provided on the base 100 and the lens 200, indicating the direction of offset (nasally or temporally). Similarly, the midplane of the assembled base 100 and optic 200 may be tilted with respect to the equatorial plane of the natural lens capsule. To compensate for this tilt, for example, tabs 204 and 206, recesses 112, and / or haptics 106 may be tilted away from the mid-plane of optic portion 202.

[0028] As will be explained in more detail below, the lens 200 may be rolled about an axis 220 or an axis 222, for example, for delivery via an injector. Axes 220 and 222 essentially bisect the lens 200. Axis 220 passes through the center of the optic 202 and the centers of the two tabs 204 and 206. Axis 222 passes through the center of the optic 202 between the tabs 204 and 206, such that diametrically opposed tabs 204 and 206 are on each side of axis 222.

[0029] The base 100 and lens 200 may be formed by cryogenically cutting and grinding a hydrophobic acrylic material, including the alternative embodiments described herein. Optionally, the base 100 may be manufactured by forming two pieces (front and back) and connecting them together with an adhesive. For example, the two pieces may be cryogenically cut from hydrophilic acrylic connected together with a UV-curable adhesive. Alternatively, the two pieces may be formed from different materials that are connected together with an adhesive. For example, the front piece may be formed from a hydrophilic acrylic that does not adhere to ocular tissue, and the back piece may be formed from a hydrophobic acrylic that adheres to ocular tissue.

[0030] As another alternative, the base 100 may be manufactured by cryogenically machining a first piece and overmolding a second piece. The first piece may include features that mate together when overmolded, thus eliminating the need for adhesives to connect the pieces. For example, the base 100 may be manufactured by cryogenically machining a hydrophilic acrylic to form a rear piece and overmolding a front piece of a moldable material such as silicone.

[0031] Although the hydrophobic acrylic resin allows the base 100 and lens 200 to be visualized using optical coherence tomography (OCT), it may be desirable to incorporate a material that enhances OCT visualization. Exemplary "OCT-suitable" materials include, but are not limited to, polyvinyl chloride, glycol-modified poly(ethylene terephthalate) (PET-G), poly(methyl methacrylate) (PMMA), and polyphenylsulfone, such as sold under the brand name RADEL™, as described in U.S. Patent Application Publication No. 2013 / 0296694 to Ehlers et al., which is incorporated herein by reference. Such OCT-suitable materials may be applied to or incorporated into portions of the base 100 or lens 200. For example, concentric rings of OCT-suitable material may be applied to each of the lower and upper edges 108 / 110. The rings may have different diameters to aid in detection of tilt of the base. Also, for example, the OCT-suitable material may be applied to the tabs 204 / 206 of the lens 200. This may be useful in determining whether the base 100 and lens 200 have been properly assembled in the eye. Dots of OCT-preferred material may be applied to portions of the base 100 that match corresponding OCT-preferred dots on the optic 200, indicating proper assembly in the eye.

[0032] Instead of a solid material, the base 100 and the lens 200 may be made of a hollow material that can be subsequently inflated in the eye. In this configuration, the base 100 and the lens 200 may be made of molded silicone, for example, and inflated with a liquid, such as saline, silicone gel, etc., using a syringe and needle. The needle may puncture the walls of the base 100 and the lens 200 implanted in the eye, inflating these components. The material may self-seal when the needle is removed. Instead of a hollow material, the base 100 and the lens 200 may be made of a sponge-like material, such as silicone hydrogel, that expands when water is added. Either method may result in a smaller corneal incision size, since the base 100 and the lens 200 may be delivered in a non-inflated or uninflated state, and then inflated or expanded once inside the eye.

[0033] Referring to Figures 4A-4D, an alternative base 400 is shown. Figure 4A is a perspective view, Figure 4B is a top view, Figure 4C is a cross-sectional view along line AA of Figure 4B, and Figure 4D is a detailed cross-sectional view of circle C of Figure 4C. Dimensions (mm) are provided by way of example and not necessarily limitation. The alternative base 400 is similar to the base 100 described with respect to Figure 2, except as otherwise noted below.

[0034] The alternative base 400 includes an annular ring 402 defining a central bore 404. A pair of haptics 106 extend radially outward from the annular ring 402. The annular ring 402 includes a lower edge 408, an upper edge 410, and an inwardly facing recess 412 into which the lens 200 may be inserted to form a modular IOL. As will become apparent from the discussion of Figures 4A-4D, the recess 412 of the base 400 is sized and configured differently than the recess 112 of the base 100.

[0035] The upper edge 410 of the annular ring 402 may include one or more notches 116, which provide an entry point for a probe (e.g., a Sinske hook) to make the base 400 easier to manipulate during surgery. The support 106 may include a hole 416 near the annular ring 402 for the same purpose as the notches 116. A pair of squared edges 417 may extend along the posterior periphery of the annular ring 402 to aid in reducing cellular growth on the lens 200 (posterior capsular opacification, or PCO).

[0036] 4D , the deep portion of the recess 412 may have a square shape defined by a horizontal rear surface 418, a horizontal front surface 420, and vertical side or outer surfaces 422. The recess may also include a flared front surface 426 extending radially inward and forward outward from the horizontal front surface 420, and a flared rear surface 428 extending radially inward and rearward from the horizontal rear surface 418. The inner diameter of the rear edge 408 may be smaller than the inner diameter of the leading edge 410. With this configuration, the lens 200 may be placed through the circular opening defined by the leading edge 410 to seat or rest on the trailing edge, and the flared front wall 426, together with the flared rear wall 428, may act as a funnel to guide the tabs 204 and 206 of the lens 200 into the deep portion of the recess 412. Once fully seated within the recess 412, the horizontal rear wall 418, horizontal front wall 420, and vertical side walls 422 form a shape that mates with corresponding horizontal and vertical surfaces of the tabs 204 and 206, limiting forward, rearward, and radial movement of the lens 200 relative to the base 400.

[0037] Referring to Figures 5A-5E, an alternative lens 500 is shown. Figure 5A is a perspective view, Figure 5B is a top view, Figure 5C is a cross-sectional view along line AA of Figure 5B, Figure 5D is a detailed cross-sectional view of circle B of Figure 5C, and Figure 5E is a detailed top view of circle C of Figure 5B. Dimensions (mm) are provided by way of example and not necessarily limitation. The alternative lens 500 is similar to the lens 200 described with respect to Figure 3, except as otherwise noted below.

[0038] The lens 500 may include an optic portion 502 and one or more tabs 504 and 506. As shown, the tab 504 is fixed while the tab 506 may be movable. The fixed tab 504 may include a through hole 208 whereby a probe (e.g., a Sinske hook) or similar instrument may be used to engage the hole 208 and manipulate the tab 504. The movable tab 506 may be actuated between a compressed position for delivery into the hole 404 of the base 400 and an extended, uncompressed position (as shown) for placement into the recess 412 of the base 400 and thus forming a mating connection between the base 400 and the lens 500. It is also envisioned that the movable tab 506 may be inserted into the recess 412 and actuated between a compressed position to facilitate entry of the fixed tab 504 into the recess 412 and an extended, uncompressed position for further insertion of the fixed tab 504 into the recess 412 and thus forming a mating connection between the base 400 and the lens 500.

[0039] The movable tab 506 may include two members 510 and 512, one end of each connected to the edge of the optic 502 and the other end free, thus forming two cantilever springs. A lip 514 may extend along the periphery of the optic 502 and terminate away from the springs 510 and 512, so that the springs 510 and 512 can fully compress against the edge of the optic 502. The outer diameter of the lip 514 of the lens 500 may be larger than the inner diameter of the trailing edge 408 of the base 400, so that the lens 500 does not fall out of the opening 404 of the base 400, and the lens 500 is supported circumferentially by the trailing edge 408 of the base 400 along its periphery. A gusset with a guide hole 516 may be disposed between the two members 510 and 512, which facilitates manipulation by a probe. Similarly, a guide hole 508 may be provided in the locking tab 504 to provide an entry point for a probe (e.g., a Sinske hook) or similar instrument to manipulate the tab 504 into the recess 412 in the base 400. A notch 518 may be provided in the locking tab 504 to provide an asymmetry that provides a visual indication that the front is up (as opposed to down) when the notch is in a counterclockwise direction relative to the hole 508.

[0040] As seen in FIG. 5C, the anterior and posterior sides of the optic 502 may have a convex radius corresponding to the desired optical power (diopter) of the optic. The locking tabs 504 and spring tabs 510 and 512 may have a flared cross section as shown. More specifically, and as can be seen better from the detailed view shown in FIG. 5D, the locking tabs 504 extend radially outward from the optic 502 from a thinner inner portion 504B to a flared thicker outer portion 504A. A hole 508 may extend through the thinner inner portion 504B. The outermost shape of the thicker portion 504A has a square shape with anterior and posterior horizontal planes and side or outer vertical planes that mate with the recess 412 as described above to minimize anterior-posterior and radial / lateral movement of the lens 500 relative to the base 400. Thicker portion 504A also provides better engagement with the injector plunger, making lens 500 less likely to become stuck in the injector. Thinner portion 504B also provides a forward and rearward offset from the surfaces defining recess 412 in base 400, thereby reducing adhesion between lens 500 and base 400. The same flared configuration and associated benefits apply to each of spring tabs 510 and 512, as shown.

[0041] Commercially available IOLs typically have an equatorial diameter (excluding haptics) of approximately 6 mm, an anterior-posterior thickness of approximately 0.2 mm at the 6 mm diameter and 0.7 mm at the center, and an overall volume of approximately 12 mm. 3 The lens 500 is of similar dimensions, but the base 400 provides a substantially larger volume. The base 400 has an equatorial diameter (excluding haptics) of about 7.8 mm, a front-to-back thickness of about 1 mm, and an overall volume of about 26 cubic millimeters when the lens is placed in the base [13.4 mm for the base]. 3 , support part is 12.5mm 3

[0036] The size of the assembled base 400 and lens 500 is therefore much larger in volume than conventional IOLs available on the market. This relatively large volume allows the capsular bag to fill more like a natural lens, thus increasing the stability of the base 400 and lens 500 and reducing post-operative displacement due to capsular bag collapse around the base 400. By way of comparison, a corresponding 180 mm 3 For a volume of 130 mm, a typical natural lens has an equatorial diameter of about 10.4 mm and an anterior-posterior dimension of about 4.0 mm. Due to anatomical variations, the volume of the natural lens may be as large as 130 mm. 3 ~250mm 3 Therefore, the base 400 and the lens 500 occupy more than 10% (about 20% to 10.4%) of the volume of the capsular bag after the natural lens is extracted, whereas a conventional IOL occupies less than 10% (about 10% to 5%) of the volume of the lens. In other words, the base 400 and the lens 500 use about twice the volume of the capsular bag as a conventional IOL.

[0042] 6A-6D, various lenses 500 are shown in schematic top view. In FIG. 6A, lens 500A includes a movable tab 500A having spring tabs 510A and 512A with holes 520 for manipulation by a probe or similar instrument. Spring tabs 510A and 512A are relatively longer than the embodiment described with respect to FIGS. 5A-5E, and extend radially outward from optic 502 with corresponding ends extending toward each other. This allows easy manipulation of the movable tab, and fixed tab 504 may be inserted into recess 412 of base 400, after which spring tabs 510A and 512B may be individually manipulated and packed into recess 412 using a probe set in hole 520. Hole 520 may be positioned and dimensioned such that it is partially visible over spring tabs 510A and 512A when seated in recess 412. In other words, if the hole 520 is fully visible, the spring tabs 510A and 512A are in front of the leading edge 410 of the base 400, if the hole 520 is not visible, the spring tabs 510A and 512A are behind the trailing edge 408 of the base 400, and if the hole 520 is partially visible (e.g., half visible), the spring tabs 510A and 512A are properly seated in the recess 412 of the base 400. Because the ends of the spring tabs 510A and 512A are closer together than the ends of the arms 510 and 512 of the lens 500, less visual area is needed to confirm that the movable tab 506A is in the recess 412 of the base 400 when viewed under a microscope during surgery. FIG. 6B shows a similar lens 500B, but with shorter spring tabs 510B and 512B, providing more spring loading and stability in the recess 412 of the base 400.

[0043] In Fig. 6C, the movable tab 506C includes spring tabs 510C and 512C that extend radially outward from the optic 502, with corresponding ends extending away from one another. By extending away from one another, the spring tabs 510C and 512C provide a wider base for contacting the recess 412 of the base 400, thereby reducing tilt of the lens 500C within the base. Fig. 6D shows a similar lens 500D, but with a wider attachment of the spring tabs 510D and 512D to the optic 502, providing a greater spring load and stability within the recess 412 of the base 400.

[0044] With reference to FIG. 7, the optic portion 202 of the lens 200 may include an opaque ring 230 that defines a small 1.0-2.0 mm central aperture 232 (pinhole) to allow only focused light to enter the eye, providing a deep depth of focus. The opaque ring 230 may include a light blocking mask or other surface treatment applied to the surface of the optic portion 202 to partially or completely block visible light. The surface treatment may be applied to the optic portion 202 pre-implantation (i.e., during manufacture) or post-operatively (i.e., after implantation) to customize the characteristics (e.g., size and location) of the aperture 232 to suit the patient's needs. The surface treatment may include laser etching or frosting the surface of the optic portion 202 to define or modify the opaque ring 230. Alternatively, the surface treatment may include selectively activating or deactivating chromophores on or embedded in the optic 202 to change its color or contrast (making it lighter or darker), thereby defining or modifying the aperture 232. The aperture 232 may be centered in the optic 202 as shown, or may be off-center so that the lateral position of the aperture 232 may be adjusted with respect to the visual axis by rotating the lens 200 with respect to the base 100.

[0045] Alternatively, the opaque ring may include a third (alternative) component 800 with a pinhole as shown in Figures 8A-8D. Figure 8A is a perspective view of the pinhole component 800, Figure 8B is a cross-sectional view along line AA in Figure 8A, Figure 8C is a side view, and Figure 8D is a bottom view. The pinhole component 800 may include an opaque anterior ring 830 that defines a small 1.0-2.0 mm central opening 832 (pinhole) to allow only focused light to enter the eye and increase the depth of focus. Fixed tabs 804 extend radially outward from the rear riser ring 820. Similarly, movable tabs 806, including spring members 810 and 812, may extend radially outward from the riser ring 820 on diametrically opposite sides. The height of the rear raised ring 820 may be slightly greater than the thickness of the lens 200, so that the tabs 804 and 806 align with the recesses 112 on the base 100 when the pinhole component 800 is placed on the front surface of the lens 200. This configuration allows the pinhole component 800 to be positioned on top of the lens 200 with both the lens 200 and the pinhole component 800 connected to the base 100. The pinhole component 800 may be attached to the base 100 such that the tabs 804 and 806 of the pinhole component 800 are positioned offset (e.g., 90 degrees) from the tabs 204 and 206 of the lens 200. In other words, the tabs 804 and 806 of the pinhole component 800 utilize the portion of the recesses 112 on the base 100 that is not occupied by the tabs 204 and 206 of the lens 200. Optionally, a similar configuration may be used for a third component, including a toric lens, a multifocal lens, a telescopic lens, etc.

[0046] Optionally, a drug may be incorporated into or carried by the base 100, as shown in FIG. 9. Using the base 100 as a carrier of the drug rather than the lens 200 has numerous advantages. For example, it avoids any interference that the drug(s) may have with the optical performance of the lens 200. Also, since the base 100 does not require tumbling as part of the manufacturing process required for the lens 200, the drug carried by the base 100 is not exposed to potential damage. The drug may be incorporated into the base 100 by connecting one or more separate drug carriers to the base 100, or by having the material of the base 100 act as a carrier for the drug (e.g., sponge-like), or by incorporating one or more drug-eluting materials into the base 100, or by incorporating one or more refillable drug-carrying reservoirs into the base 100. One or more parts of the base 100 may carry the drug(s), and these parts may be separated from each other, for example to avoid interactions between different drugs. The drug-carrying portion(s) of the base 100 may be selectively activated with light or thermal energy (e.g., laser, UV light, etc.) to release the stored drug(s) all at once or continuously over a period of time.

[0047] Examples of clinical indications for such drugs include dry or wet macular degeneration, open or closed angle glaucoma, uveitis, secondary cataract, post-operative management after cataract surgery, etc. Examples of drugs that may be used for wet macular degeneration include aflibercept, bevacizumab, pegaptanib, ranibizumab, steroids, and aptamers. Examples of drugs that may be used for dry macular degeneration include complement factors, antioxidants, and anti-inflammatory agents. Examples of drugs that may be used for open angle glaucoma include brimonidine, latanoprost, timolol, pilocarpine, brinzolamide, and other drugs that belong to the general categories of beta blockers, alpha agonists, ROCK inhibitors, adenosine uptake inhibitors, carbonic anhydrase inhibitors, adrenergic and acetylcholine receptor activators, and prostaglandin analogues. Examples of drugs that may be used for uveitis include methotrexate, antibodies, dexomethasone, triamcinolone, and other steroids. Examples of drugs that may be used for secondary cataracts include antiproliferative, antimitotic, anti-inflammatory, and other drugs that inhibit the functioning of lens epithelial cells. Examples of drugs that may be used for postoperative care after cataract surgery include antibiotics such as fluoroquinolones, nonsteroidal drugs such as ketorolac, and steroids such as prednisolone. Other drugs that may be used to treat various ophthalmic diseases and conditions include antifibrotic agents, anti-inflammatory agents, immunosuppressants, anti-cancer agents, migration inhibitors, anti-proliferative agents, rapamycin, triamcinolone acetonide, everonimus, tacrolimus, paclitaxel, tasotimiramycin, azathioprine, dexamethasone, cyclosporine, bevacizumab, anti-VEGF agents, anti-IL-1 agents, canakinumab, anti-IL-2 agents, viral vectors, beta blockers, alpha agonists, muscarinic antagonists, steroids, antibiotics, non-steroidal anti-inflammatory agents, prostaglandin analogs, ROCK inhibitors, nitric oxide, endothelin, matrix metalloproteinase inhibitors, CNPA, corticosteroids, and antibody-based immunosuppressants. These drugs may be used individually or in combination depending on the patient's particular clinical indication.

[0048] Additionally, the portion(s) of base 100 carrying the drug(s) may face in a particular direction(s) while being masked or blocked in other directions to better concentrate the drug in a particular portion of the lens capsule. For example, posterior ocular structures may be drug delivery targets (e.g., for mitigating macular degeneration) and / or anterior ocular structures may be drug delivery targets (e.g., for delivery of glaucoma medication near the angle, for delivery of medication for uveitis, or for surgical management following cataract surgery).

[0049] For example, FIG. 9 shows a top (front) view of the base 100 incorporating one or more drug carriers 90. As shown, the drug carriers 90 are spaced around the circumference of the front surface of the body of the base 100. The drug carriers 90 may include refillable reservoirs (e.g., silicone reservoirs), eluting porous materials (e.g., biocompatible sponges), biodegradable or bioelutable materials (e.g., PLGA), etc. The reservoirs may also be intended to expose the drug to an aqueous environment through laser, UV light, RF signals, magnetic manipulation, or other methods to remotely remove the diffusion barrier. The carriers 90 may be placed on the surface of the base 100, for example, or may be embedded. To focus the delivery of the drug to a specific area of ​​the eye, the carriers 90 may be exposed on one side (e.g., the front side as shown), while the other side is covered by the material of the base 100.

[0050] An alternative drug-loaded base 100 is shown in Figures 10A-10C. Figure 10A is a perspective view, Figure 10B is a cross-sectional view along line BB of Figure 10A, and Figure 10C is a cross-sectional view along line CC of Figure 10A. As seen in Figures 10B and 10C, the base 100 may include an inner passageway 96 extending along the circumference of the annular ring 102. The inner passageway 96 is in fluid communication with the exterior of the base 100 via a series of ports 92 that may be evenly distributed along the front surface of the annular ring 102. A ring-shaped material 94 may be disposed within the passageway 96. The dehydrated volume of the ring-shaped material 94 may be less than the volume of the passageway 96, and the hydrated volume of the ring-shaped material 94 may be greater than its dehydrated volume, up to the volume of the passageway 96. The ring 94 material may include, for example, a high equilibrium water content (EWC) silicone hydrogel, or other similar hydratable or sponge-like material. In use, prior to implantation, the base 100 with the dehydrated ring 94 may be immersed in a fluid containing the desired drug(s), such as steroids and NSAIDs. The ports 92 allow the drug-containing fluid to flow into the dehydrated ring 94, which causes the dehydrated ring 94 to increase in volume (swell) as it becomes hydrated with the drug-containing fluid. The hydrated ring 94 may then occupy the entire volume of the passage channel 96. When the base 100 is implanted, the aqueous humor of the eye contacts the hydrated ring-shaped material 96 near the ports 92, rather than being exposed to the entire ring 94 within the passage 96. Thus, drug elution from the ring 94 into the eye may be controlled by the number and size of the ports 92, which may be selected to achieve a desired elution rate for a drug or drug combination.

[0051] In general, a modular IOL that includes an assembled base 100 and lens 200, including the alternative embodiments described herein, can have the lens 200 adjusted or replaced either intraoperatively or postoperatively while the base 100 remains in place. Examples of when this may be desirable include, but are not limited to, replacing the lens 200 to correct a suboptimal refractive result detected intraoperatively, replacing the lens 200 to correct a suboptimal refractive result (residual refractive error) detected postoperatively, adjusting the lens 200 rotationally with respect to the base 100 to fine-tune the toric correction, adjusting the lens 200 laterally with respect to the base 100 to align the optic with the true optical axis (which may not be the center of the capsular bag), and replacing the lens 200 to accommodate the changing optical needs or desires of a patient over time. Examples of this case include, but are not limited to, adult or pediatric IOL patients whose initial optical correction needs change with age or growth, patients who wish to upgrade from a monofocal IOL to a premium IOL (lens technology with toric, multifocal, accommodative or other features) and who are dissatisfied with their premium IOL and wish to downgrade to a multifocal IOL, and patients who have developed a medical condition that contraindicates an IOL or a particular type of IOL.

[0052] FIG. 11 illustrates an example of a procedure for implanting a modular IOL. In this example, intraoperative measurements may be performed to select a desired lens 200 and / or to determine whether intraoperative adjustment or replacement is required. An IOL implantation procedure, e.g., cataract surgery, may begin 310 using conventional practices. The natural lens capsule may then be prepared 312 to receive the modular IOL using conventional steps, such as creating a corneal access incision, creating a capsulotomy of the anterior capsule, and removing the cataractous lens by phacoemulsification or other means. The base 100 is then placed 314 into the capsular bag. At this point, intraoperative measurements 316 may be performed to determine the position of the base 100 relative to the anatomy. This information may be used, for example, to adjust the position of the base 100 and / or to aid in the selection of a desired optical power for the optical portion 202 of the lens 200.

[0053] As a specific example, optical coherence tomography (OCT) may be used to measure the effective base position (EBP) along the visual axis, which determines the effective lens position (ELP) when the lens 200 is connected to the base 100. Since the ELP affects the refractive power result, the EBP information may be used to select the lens 200 with the appropriate refractive power. This may reduce residual refractive error, especially since the EBP is relatively stable postoperatively. OCT may also be used to detect the offset and tilt of the base 100, so that adjustments therefor may be made intraoperatively. As described elsewhere herein, the base 100 may incorporate materials to enhance OCT visualization.

[0054] Optionally, the temporary lens 200 may be placed in the eye and connected to the base 100 prior to the OCT measurement. This may be beneficial when the iris is small and OCT visualization of the base 100 is difficult. The temporary lens 200 may be very thin (e.g., 0-2 diopters) so that it can be easily removed after the OCT measurement is completed. Instead of a thin temporary lens, a thin disk of OCT reflective material may be placed on or connected to the base 100 prior to the OCT measurement and then removed.

[0055] The lens 200 is then placed in the capsular bag 320. The base 100 and lens 200 are then assembled 322, as described in more detail below. At this point, intraoperative measurements may be taken 324 to determine whether the base 100 and lens 200 have been assembled correctly, to determine the position of the assembled base 100 and lens 200 relative to the anatomical structures, and / or to determine whether the optical correction is satisfactory 326.

[0056] For example, OCT may be used to determine whether the tabs 204 and 206 of the lens 200 are in the recesses 112 of the base, and steps may be taken to properly assemble the lens 200 and base 100, if necessary. Additionally or alternatively, OCT may be used to measure ELP, decentering or tilt, and steps may be taken to adjust the position of the lens 200 and / or base 100, if necessary. Additionally or alternatively, wavefront aberration may be used to measure the optical result. If the optical result is determined to be satisfactory 326, the procedure may be terminated 328 according to conventional practice. If the optical result is determined to be unsatisfactory 326, it is determined 330 whether adjustments (e.g., rotation, lateral movement, etc.) of the lens 200 and / or base 100 will result in a satisfactory optical result. If yes, adjustments are made 332 and the procedure is completed 328. If no, the lens 200 is detached 334 from the base 100, removed 336 from the eye, and a new lens 200 is selected 318 and implanted following the same steps 320-328.

[0057] 12A-12D show a procedure for implantation of a modular IOL 100 / 200. As shown in FIG. 12A, the modular IOL may be implanted by first delivering the base 100 in a rolled state into the capsular bag 34 using an injector 300 (also called an inserter or delivery tube) that is inserted through the corneal incision 13, through the incision 36, and into the capsular bag 34. A conventional injector 300 (also called an inserter) may be used to deliver the base 100 and lens 200. Examples of suitable injectors are described in U.S. Patent No. 5,123,905 to Kelman, U.S. Patent No. 4,681,102 to Bartell, U.S. Patent No. 5,304,182 to Rheinish, and U.S. Patent No. 5,944,725 to Cicenas.

[0058] 12B, the base 100 may be expelled from the injector and deployed. With careful manipulation, the haptics 106 of the base 100 engage the inner equator of the lens capsule 34 and the hole 104 in the base 100 is centered with respect to the incision capsule 36.

[0059] The lens 200 may also be delivered in a rolled state using an injector 300, with the distal tip of the injector positioned near the base 100. The lens 200 may be expelled from the injector and unfolded. With careful manipulation, the lens 200 may float in front of the base 100 and centered over the hole 104 in the base 100. The lens 200 may be connected to the base 100 by placing tabs 204 and 206 into the recesses 112 to provide a mating connection between the base 100 and the lens 200.

[0060] As shown in Figures 12C-12D, the lens 200 may be connected to the base 100 by first inserting the movable tab 206 into the recess 112. With respect to Figure 12C, it should be understood that the movable tab may have the features of the movable tab 206 of Figure 3. The movable tab 206 may be inserted into the recess 112 using a probe 450. Alternatively, the movable tab 206 may be inserted into the recess 112 during an injection step in which the lens 200 is guided using an injector 300. In this alternative, the lens 200 is only partially ejected from the injector 300, with the movable tab 206 entering the recess 112 of the base 100, while the fixed tab 204 remains within the injector 300. Once the movable tab 206 is in the recess 112, the lens 200 may be fully ejected from the injector 300.

[0061] The movable tab 206 may then be compressed by applying a lateral force using a probe 450 or similar instrument inserted into the hole 208 of the fixed tab 204, which advances the lens 200 into the hole 104 of the base 100 until the lens 200 and base 100 are flush with each other. The compression force may then be released from the movable tab 206, which causes the fixed tab 204 to slide into the recess 112 of the base 100, connecting the lens 200 to the base 100. The lens 200 may be removed from the base 100 by following the reverse steps.

[0062] Alternatively, the movable tab 206 may be compressed using the injector 300. In this alternative, the lens 200 is only partially ejected from the injector 300, with the movable tab 206 entering the recess 112 of the base 100 and the fixed tab 204 remaining within the injector 300. The injector 300 is used to push the lens 200, compressing the movable tab 206 within the recess 112. A probe may be inserted into the second corneal incision to apply an opposing force to the base 100 as the movable tab 206 is compressed. The injector 300 may then be used to position the lens 200 flush with the base 100, such that the fixed tab 204 is aligned with the recess 112. The lens 200 may then be fully ejected from the injector 300, which decompresses the movable tab 206 and allows the fixed tab 204 to move into the recess 112 of the base 100.

[0063] Prior to delivery of the lens 200, the lens 200 may be folded or rolled and placed into the injector 300 for delivery as described above. As described with respect to FIG. 3, the lens 200 may be rolled, for example, around an axis 220 or axis 222 that essentially bisects the lens 200. The lens 200 may be rolled forward or backward. In one example, the lens 200 may be rolled from one end to the other in a manner similar to rolling a poster. Alternatively, in other examples, both ends of the lens 200 may be folded or rolled inward toward the axis 220 or axis 222.

[0064] The lens 200 may be curled around the axis 220 to facilitate only partial expulsion of the lens 200 from the injector 300 as described above (i.e., when the movable tab 206 is outside the injector 300 and the fixed tab 204 remains inside the injector 200). Alternatively, if the lens 200 is curled back around the axis 222, the tabs 204 and 206 may naturally move into the recess 112 of the base 100 as the lens 200 unfolds after being positioned flush with the annular ring 102 in the central bore 104. With this approach, it may not be necessary to compress the movable tab 206 to connect the lens 200 to the base 100.

[0065] Another technique that can eliminate the need to compress the movable tab 206 to connect the lens 200 to the base 100 involves applying a torque to the fixed tab 204. With reference to FIG. 12E, the lens 200 is ejected from the injector 300 and positioned in front of the base 100. The movable tab 206 is placed in the recess 112 of the base. A probe 450 is placed in the hole 208 of the fixed tab 204. A torque is applied to the fixed tab 204 by rotating the probe 450, which causes the fixed tab 204 to flex rearward and radially inward, and the optic 202 to bend forward. The fixed tab 204 then aligns with the recess 112 of the base 100 and the torque is released, which causes the fixed tab 204 to extend radially outward in the recess 112 of the base 100 to its rest position.

[0066] 13A and 13B, one embodiment of a probe 450 is shown generally. The probe 450 may be similar to a Sinske hook commonly used in cataract surgery today, with some modifications. As shown in FIG. 13A, the probe 450 includes a shaft 460 and a distal portion 470. The proximal handle portion of the probe 450 is not shown, but may be a standard Sinske handle. The distal portion 470, shown in detail in FIG. 13B, includes a distal shaft 472, an elbow 474, an elbow extension 476, an insertion tip 478, and a collar 480. The insertion tip 478 is sized to fit into and manipulate the hole 208 of the lens 200. The collar 480 is larger than the hole 208, which prevents the tip 478 from reaching too far into the hole 208 and thus preventing the probe 450 from becoming stuck on the lens 200.

[0067] 14A and 14B, one embodiment of a bending forceps 600 is shown. The bending forceps 600 includes a pair of leaf spring arms 602, each having a gripping portion 604 and an angled distal portion 606. The arms 602 are proximally connected at a joint 608. The distal portions 606 include a tip 610 associated with each of the arms. The arms 602 are biased as shown, but may be squeezed and squeezed to separate the distal tips 610, which are limited by a stop 612. With this configuration, the arms 602 may be squeezed and squeezed to insert the tips 610 into diametrically opposed holes or notches in a lens, such as hole 208 and notch 216 in lens 200 or holes 516 and 518 in lens 500. When the arms 602 are released, the tips 610 move closer to each other, causing the lens 200 or 500 to bend and the corresponding tabs 204 / 206 or 504 / 506 to move closer to each other. Once the tabs 204 / 206 or 504 / 506 are closer to each other, they may be inserted into the recesses 112 / 412 of the base 100 / 400 without the need to compress the movable tabs 206 / 506 of the lens 200 / 500.

[0068] The above description of the disclosure has been presented for purposes of illustration and description. The above is not intended to limit the disclosure to the form(s) disclosed herein. Although the disclosure includes one or more embodiments and descriptions of certain variations and modifications, other variations and modifications, such as those that become part of the skill and knowledge of those skilled in the art after appreciating the present disclosure, are also within the scope of the disclosure. The intention is to obtain the right to include alternative embodiments, including alternative, interchangeable, and / or equivalent structures, functions, ranges, or steps, in what is claimed to the fullest extent possible, regardless of whether such alternative, interchangeable, and / or equivalent structures, functions, ranges, or steps are disclosed herein, and without the intention of dedicating any patentable subject matter to the public.

Claims

1. In a modular intraocular lens (IOL) system, A base including an annular ring, the annular ring comprising: an upper edge having a front end and surrounding a front opening; a lower edge having a rear end and surrounding the rear opening; a wall extending between the upper edge and the lower edge, the wall including a radially inner surface; and (a) a dimension of the base between the leading end and the trailing end is about 1.01 mm, measured along a front-to-rear direction; and (b) the diameter of the base is about 7.78 mm; and a wall that is at least one of a passageway extending through the base from the front opening to the rear opening; A recess surrounding the passage, (a) the upper edge and the lower edge, and (b) a radially inner surface of said wall a recess defined by a surface of A base comprising: A lens configured to be inserted into and removed from the base, optical department, a first fixation tab protruding from the optic, the first fixation tab being asymmetrical by including a notch; and a second movable tab protruding from the optic, the second movable tab including a pair of spring members, each spring member having a first end connected to an edge of the optic and a second free end, the second free ends of the pair of spring members extending in opposite directions away from each other; Lenses including when the lens is inserted into the base, the first fixed tab and the second movable tab are received in the recess of the base and the optical portion extends across the passage of the base.

2. 2. The modular IOL system of claim 1, wherein: (a) the dimension of the base between the anterior end and the posterior end is approximately 1.01 mm; and (b) the diameter of the base is approximately 7.78 mm.

3. The modular IOL system of claim 1 , wherein the dimension of the base between the anterior end and the posterior end is approximately 1.01 mm.

4. The modular IOL system of claim 1 , wherein the base has a diameter of approximately 7.78 mm.

5. The modular IOL system of claim 1 , wherein the base has a diameter of about 7.68 mm to about 7.88 mm.

6. The modular IOL system of claim 1 , wherein the lower edge includes a rim surrounding the posterior opening, the rim having a dimension of approximately 0.15 mm measured along the anterior-posterior direction.

7. (a) the diameter of the front opening is about 6.40 mm; (b) the diameter of the recess is about 7.00 mm; and / or (c) the diameter of the rear opening is about 5.30 mm; The modular IOL system of claim 1 .

8. The modular IOL system of claim 1 , wherein the base further includes a pair of haptics protruding radially outward from the wall, the distance between tips of the pair of haptics being approximately 13.00 mm.

9. 9. The modular IOL system of claim 8, wherein the base has a hole passing through one of the support portions, and the distance between a central longitudinal axis of the base and a central longitudinal axis of the hole is approximately 4.25 mm.

10. At least one of the following: (a) the lens has a maximum width of about 6.92 mm; (b) the first fixation tab has a radially outer curved edge having a radius of curvature of about 3.5 mm; (c) the optical zone has a diameter of 5.36 mm to 5.66 mm; (d) the optical zone edge has a thickness measured along the anterior-posterior direction of 0.20 mm; (e) the outermost portion of the first fixation tab has a thickness measured along the front-to-rear direction of between 0.28 mm and 0.32 mm; and / or (f) the first fixation tab has a through hole, the through hole having a diameter of about 0.28 mm; The modular IOL system of claim 1 ,

11. The modular IOL system of claim 1 , wherein each of the upper and lower edges is angled relative to the wall.

12. The modular IOL system of claim 1 , wherein each second free end of each spring member of the second movable tab is fully compressible against an edge of the optic.

13. The modular IOL system of claim 1 , wherein the second movable tab further includes a radially inner portion protruding from an edge of the optical portion, the radially inner portion being positioned between the pair of spring members.

14. The modular IOL system of claim 13 , wherein the second movable tab further includes a hole extending through the radially inner portion.

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