Devices, systems, and methods for objectively assessing accommodation of intraocular lenses

Abstract

The present technology relates to systems and methods for objectively assessing accommodation of adjustable intraocular lenses ("AIOLs"). In some embodiments, a method of objectively assessing accommodation of an AIOL implanted within an eye of a patient includes receiving, via an accommodation assessment system, (a) first optical coherence tomography (OCT) geometric data associated with the AIOL when the eye is in a first accommodative state, and (b) second OCT geometric data associated with the AIOL when the eye is in a second accommodative state. The method next includes determining, based in part on a comparison of the OCT data, a first change to a thickness of an adjustable lens of the AIOL and / or a second change to a curvature of an optical surface of the AIOL. The method then includes determining, based in part on the first change and / or second change, a third change to an optical power of the AIOL.

Description

DEVICES, SYSTEMS. AND METHODS FOR OBJECTIVELYASSESSING ACCOMMODATION OF INTRAOCULAR LENSESCROSS-REFERENCE TO RELATED APPLICATION(S)

[0001] The present application claims priority to U.S. Provisional App. No. 63 / 518.156, filed August 8, 2023, the entirety of which is hereby incorporated by reference.TECHNICAL FIELD

[0002] The present technology relates to devices, systems, and methods for objectively assessing accommodation of intraocular lenses.BACKGROUND

[0003] Cataracts can affect a large percentage of the worldwide adult population with clouding of the native crystalline lens and resulting loss of vision. Patients with cataracts can be treated by native lens removal and surgical implantation of a synthetic intraocular lens (IOL). Worldwide, there are millions of IOL implantation procedures performed annually. In the U.S., there are 3.5 million cataract procedures performed, while worldwide there are over 20 million annual procedures performed. Although IOL implantation procedures can be effective at restoring vision, conventional IOLS have several drawbacks. For example, many prior IOLS are not able to change focus and / or optical power as a natural lens would (known as accommodation).

[0004] Accommodating intraocular lenses (AIOLs) have been proposed to provide accommodative optical power in response to the distance at which a patient views an object. However, such AIOLs are generally still in development and have different drawbacks. For example, many AIOLs provide insufficient accommodation after implantation and / or produce suboptimal refractive correction of the eye. In at least some instances, the level of accommodation provided by current AIOLs decreases after implantation. Moreover. ANSI regulations (i.e.. ANSI Z80.29-2015, B.4.8.1) provide strict guidelines as to the measured, objective degree of change in the optical power that an AIOL must provide for that change to qualify as accommodation.

[0005] To address these problems, others have proposed ways to objectively assess accommodation of AIOLs implanted in a patient’s eye. However, conventional techniques of doing so have a number of drawbacks. For example, some techniques rely on feedback from a patient. The patient may, for example, be asked to describe the accommodative performance orchange in visual acuity they experience during a test. This feedback is inherently subjective and not an objective assessment. Still other techniques rely on biometric analysis, for example, using ultrasound to image the patient eye and measure changes in optical power of the AIOL. However, ultrasound requires an ultrasound probe be placed on / in contact with the patient’s eye, increasing the risk of infection and requiring pharmacologically-induced accommodation of the eye, e.g., because the probe blocks the patient's vision and prevents them from focusing on near and far targets. Moreover, it is difficult to obtain repeatable measurements from a common baseline because placement and / or alignment of the ultrasound probe can vary between individual measurements. Further techniques are ray-based and rely on autorefractors or wavefront aberrometry. However, these methods have questionable reliability when assessing IOLS with multiple optical surfaces, and often produce results that do not align with other, more subjective measures of accommodation. Moreover, autorefractors are known to provide inconsistent measurements and wavefront aberrometry requires significant training.BRIEF DESCRIPTION OF THE DRAWINGS

[0006] Many aspects of the present technology can be better understood with reference to the following drawings. The components in the drawings are not necessarily drawn to scale. Instead, emphasis is placed on illustrating clearly the principles of the present technology. Furthermore, components can be shown as transparent in certain views for clarity7of illustration only and not to indicate that the component is necessarily transparent. Components may also be shown schematically.

[0007] FIG. 1 A is a side view of a human eye.

[0008] FIGS. IB and 1C are sides view of the human eye illustrating accommodation of the eye.

[0009] FIGS. 2A and 2B are side views of a human eye and an AIOL illustrating accommodation of the eye and the AIOL, in accordance with embodiments of the present technology.

[0010] FIGS. 3A and 3B are perspective views of an AIOL configured in accordance with embodiments of the present technology.

[0011] FIG. 3C is a side cross-sectional view of the AIOL of FIG. 3A.

[0012] FIG. 3D is a side cross-sectional view of the AIOL of FIG. 3 A implanted within a capsular bag of a human eye in accordance with embodiments of the present technology.

[0013] FIG. 4A is a perspective view of an objective accommodation assessment system configured in accordance with embodiments of the present technology.

[0014] FIGS. 4B-4D are different views of select portions of the objective accommodation assessment system of FIG. 4A, with other portions of the objective accommodation assessment system omitted for illustrative purposes.

[0015] FIG. 5 is a perspective view illustrating operation of the objective accommodation assessment system of FIG. 4A.

[0016] FIG. 6 is an example output of the objective accommodation assessment system of FIG. 4A in accordance with embodiments of the present technology.

[0017] FIG. 7 is a plot of example data based, at least in part, on the output of the objective accommodation assessment system of FIG. 6, in accordance with embodiments of the present technology.DETAILED DESCRIPTION

[0018] The present technology is directed to devices, systems, and methods for objectively assessing a change in optical power (i.e., accommodation) of an AIOL implanted in a patient’s eye. In some embodiments, the AIOL includes an accommodating base lens and a nonaccommodating fixed lens configured to be removably coupled to the accommodating base lens, and the change in the optical power of the AIOL can be determined based, at least in part, on a change to a thickness of at least the accommodating base lens. In at least some embodiments, for example, an accommodation assessment system can receive optical coherence tomography (OCT) geometric data associated with the implanted AIOL and determine, based at least in part on the OCT data, a change in the thickness of at least the adjustable lens. The accommodation assessment system can then determine a change in the optical power based, at least in part, on the change in the thickness of at least the adjustable lens.

[0019] In some embodiments, the AIOL includes one or more optical surfaces, and the change in the optical power of the AIOL can be determined based, at least in part, on a change to a curvature of at least one of the optical surfaces. In at least some embodiments, for example, the accommodation assessment system can determine, based at least in part on the OCT data, a change to the curvature of at least one of the optical surfaces. The accommodation assessment system can then determine a change in the optical power based, at least in part, on the change to the curvature of at least one of the optical surfaces. In these and / or other embodiments, the accommodationassessment system can determine the change in optical power based, at least in part, on one or more other parameters, including a change in distance between a patient's eye and the accommodation assessment system, a change in distance between the accommodation assessment system and a visual target, and / or a change in dimension of the visual target.

[0020] Whether the accommodation assessment system uses the thickness, the curvature, and / or one or more other parameters, the accommodation assessment system can determine the change in the thickness and / or the change to the curvature based on first OCT geometric data received when the eye is in a first (e.g.. at least generally less accommodated) state and second OCT geometric data received when the eye is in a second (e.g., at least generally more accommodated) state. For purposes of this disclosure, “geometric” data can include spatial relationships between various components of the AIOL. In some embodiments, for example, the AIOLs can include one or more dynamic / adjustable surfaces (e.g., an accommodating base lens portion) while other surfaces are fixed (e.g.. a lens of fixed optical power), and the fixed surfaces can be used as reference points to measure accommodation / changes / movement of the dynamic / adjustable surfaces. In addition to assessing relationships between portions of the AIOL, the system may also be configured to measure changes in relationship between the AIOL and landmark portions of the eye itself (comeal surface, iris, etc.) Accordingly, using these data, the system can objectively assess the change in optical power of the AIOL in response to accommodation of the patient’s eye (e.g., change(s) in accommodative state of the eye).

[0021] Specific details of various embodiments of the present technology are described below with reference to FIGS. 1A-7. Although many of the embodiments are described below' with respect to AIOLs and associated methods, other embodiments are within the scope of the present technology. Additionally, other embodiments of the present technology can have different configurations, components, and / or procedures than those described herein. For instance, AIOLs configured in accordance with the present technology may include additional elements and features beyond those described herein, or other embodiments may not include several of the elements and features shown and described herein.

[0022] As used herein, the use of relative terminology, such as “about,” “approximately,” “substantially” and the like refer to the stated value plus or minus ten percent. For example, the use of the term “about 100” refers to a range of from 90 to 1 10, inclusive. In instances in w hich the context requires otherwise and / or relative terminology is used in reference to something thatdoes not include a numerical value, the terms are given their ordinary meaning to one skilled in the art.

[0023] FIGS. 1 A- 1 C are side views of a human eye 100. The eye 100 has a native or natural lens 102 contained within a capsular bag 104. a ciliary muscle 106. and one or more zonules 108 (individually identified as first or superior zonules 108a and second or inferior zonules 108b). The capsular bag 104 is coupled to the ciliary muscle 106 by the zonules 108. The ciliary muscle 106 can transition between a contracted state and a relaxed state. This change in the ciliary muscle 106 can be transmitted to the capsular bag 104 via the zonules 108 and produce or otherwise cause a corresponding change to a shape of the capsular bag 104 and thereby change an optical power, depth of focus, and / or other optical property of the eye 100 (e.g., the native lens 102). This process of changing the shape of the capsular bag 104 to produce a corresponding change in the optical power, depth of focus, and / or other optical property of the eye 100 is known as accommodation.

[0024] In FIG. IB, the ciliary muscle 106 is in a relaxed state. When relaxed, the ciliary muscle 106 stretches (e.g.. tensions) the zonules 108 to apply a tensile force to the capsular bag 104. The tensile force can elongate and / or flatten the capsular bag 104, reducing its curvature and / or thickness and thereby reduce the focusing / optical power of the native lens 102, e.g., a first accommodative state 101a. In the first accommodative state 101a, the eye 100 can focus on generally distant or far-away objects. The first accommodative state 101a can include a state of no accommodation or relatively / comparatively low accommodation.

[0025] In FIG. 1C, the ciliary muscle 106 has contracted relative to the relaxed state (FIG. IB). This contraction moves the ciliary muscle 106 inwardly toward the capsular bag 104, reducing or even eliminating the tension applied to the zonules 108. This, in turn, can allow the capsular bag 104 to compress (e.g., inwardly), increasing its curvature and / or thickness and thereby increasing the focusing / optical power of the native lens 102, e.g., a second accommodative state 101b. In the second accommodative state 101b. which can include a greater amount / degree of accommodated than the first state 101a, the eye 100 can focus on generally close or nearby objects.

[0026] FIGS. 2A and 2B are side views of an adjustable intraocular lens or AIOL 210 implanted within the eye 100 in accordance with embodiments of the present technology. Specifically, the AIOL 210 is positioned within the capsular bag 104 via an opening 205 formed (e.g.. via capsulorrhexis) in an anterior optical surface of the capsular bag 104, e.g.. to replace the eye’s natural lens 102 (FIG. 1 A). The AIOL 210 is shown spaced apart from the inner surface ofthe capsular bag 104 for illustrative clarity; it will be appreciated that, in practice, the AIOL 210 can conform to and / or otherwise contact all. or at least a portion, of the inner surface of the capsular bag 104.

[0027] The AIOL 210 can be configured to mimic the native accommodative operation of the eye’s natural lens 102 (FIG. 1 A). For example, with the eye 100 in the first accommodative state 101a shown in FIG. 2 A, the AIOL 210 can have a generally elongate shape to provide a reduced focus / optical power. Similarly, with the eye 100 in the second accommodative state 101b shown in FIG. 2B, the AIOL 210 can have increased curvature and / or thickness, thereby- increasing its focusing / optical power. The relaxation of the zonules 108 in the second accommodative state 101b can allow the capsular bag 104 to compress the AIOL 210 which, in turn, can, e.g., redistribute fluid within the AIOL 210 to increase its focusing / optical power. Further details regarding one example of an AIOL are described in greater detail below with reference to FIGS. 3A-3D.

[0028] Referring to FIGS. 2A and 2B, an accommodation assessment system 250 (“system 250”) can measure the degree to which the AIOL 210 changes in response to changing forces from the patient’s eye 100. In some embodiments, the system 250 uses optical coherence tomography (OCT) to determine a change in a curvature and / or a thickness of at least a portion of the AIOL 210 as the eye transitions between the first accommodative state 101a and the second accommodative state 101b. Based at least in part on this change, the system 250 can determine a change in an optical power of the AIOL, e.g., in response to accommodation of the eye 100. The system 250 and its operation are described in further detail below with reference to FIGS. 4A-7.

[0029] FIGS. 3 A and 3B are perspective views of an adjustable intraocular lens 310 (“AIOL 310”) configured in accordance with embodiments of the present technology. The AIOL 310 can include an adjustable or base lens structure 312 (“base 312”) and a fixed power and / or fixed depth of focus lens 314 (“fixed lens 314”). The base 312 can include a first or anterior component 316 and a second or posterior component 318, e.g., coupled to one another to form the base 312. As described in detail below with reference to FIG. 3C, the first component 316 and the second component 318 can together at least partially define an adjustable lens or optical element (e.g., a lens having an adjustable optical power and / or depth of focus) configured to provide an adjustable optical power / correction. The first component 316 of the base 312 can define a concavity or a lens-receiving area or volume 320 (“volume 320”) configured to receive at least a portion of the fixed lens 314. The volume 320 can include a chamber or cavity- 321 having an opening 323. Thevolume 320, the cavity 321, and / or the opening 323 can have one or more dimensions (e.g., diameter, circumference, depth, volume, etc.) corresponding to one or more dimensions of the fixed lens 314, such that the fixed lens 314 can be positioned within the volume 320 by inserting the fixed lens 314 through the opening 323 and into the cavity 321.

[0030] When the base 312 is implanted within an eye of a patient (e.g., within a capsular bag, as shown regarding the AIOL 210 of FIGS. 2A and 2B), the volume 320, the cavity 321, and / or the opening 323 can face anteriorly to allow the fixed lens 314 to be inserted posteriorly through the opening 323 and be received within the cavity 321. In some embodiments, the volume 320 can include one or more features configured to secure the fixed lens 314 within the volume 320 and / or otherwise prevent, or at least partially prevent, the fixed lens 314 from inadvertently leaving the volume 320 once the fixed lens 314 is positioned therein. In the illustrated embodiment, for example, the volume 320 includes one or more groove or slots 322 (FIG. 3B) extending radially outward toward an outer perimeter of the base 312, and each of the slots 322 is configured to receive a respective portion of the fixed lens 314.

[0031] In some embodiments, the base 312 includes flow-through features 324 (FIG. 3A) that enhance the rate and ease with which Ophthalmic Viscosurgical Devices (OVDs) used during the implantation of AIOLs can be removed from the natural lens capsule. The embodiment of the AIOL 310 illustrated in FIGS. 3 A and 3B comprises three outer flow-through features 324. Each of the outer flow-through features 324 can be detents, such as recesses, distributed circumferentially along the perimeter of the base 312. The flow-through features 324 can create passages between the outer perimeter of the AIOL 310 and an inner surface of an eye capsule (not shown) in which the AIOL 310 is implanted, e.g., to allow fluid flow around an outer perimeter of the AIOL 310. In the illustrated embodiment, for example, the flow-through features 324 are formed in periph eral / outer regions of the first component 316 and second component 318. In other embodiments, the flow-through features 324 can have other suitable positions in the first component 316 and / or the second component 318. Although three outer flow-through features 324 are illustrated in FIGS. 3A and 3B. other embodiments may comprise fewer or more of the flow-through features 324 than illustrated. In these and other embodiments, the outer flow-through features 324 may additionally provide rotational constraint to maintain the rotational orientation of the base 312 with respect to a patient’s capsular bag when the AIOL is positioned therein (e.g., described with reference to FIGS. 2A, 2B. and 3D).

[0032] The fixed lens 314 can include an optical or lens portion 326 and one or more tabs 328 (FIG. 3B) extending radially outward from the lens portion 326. The lens portion 326 can have a fixed (e.g., positive, negative, or zero) optical power and / or a fixed depth of focus. In at least some embodiments, for example, the lens portion 326 can have a diopter of between about 0 D and about 20 D, such as between about 8 D and about 20 D, between about 12.5 D and about 18.5 D, any diopter therebetween, or another suitable diopter. In other embodiments, the lens portion 326 can have a negative diopter, e.g., a diopter of between about -5 D and about -0.01 D, any diopter therebetween, or another suitable diopter. In these and / or other embodiments, the lens portion 326 includes one or more of an asymmetrically powered lens (e.g., atoric lens), a spherical lens, an aspheric lens, a plano-convex lens, a convex-concave lens, a convex-convex lens, a pinhole lens, an extended depth of focus (EDOF) lens, and / or another suitable lens.

[0033] At least a portion of one or more of the tabs 328 can be configured (e.g., sized, shaped, etc.) to be received by the base 312. for example, to couple or otherwise at least partially or fully prevent movement of the fixed lens 314 relative to the base 312. In the illustrated embodiment, for example, at least a portion of each of the tabs 328 are positioned within a corresponding one of the slots 322 when the fixed lens 314 is positioned within the volume 320, as shown in FIG. 3A. The interaction between the tabs 328 and the slots 322 can prevent, or at least partially prevent, unintended rotation of the fixed lens 314. In at least some embodiments, for example, the fixed lens 314 is expected to maintain a generally or substantially consistent rotational alignment relative to the base 312 unless or until one or both of the fixed lens 314 and the base 312 are manipulated by a practitioner or other user.

[0034] In some embodiments, individual ones of the tabs 328 can include one or more apertures or holes 330. Each of the apertures 330 can extend at least partially or fully through the corresponding tab 328. A user can use a surgical tool to engage one or more of the apertures 330 to manipulate the fixed lens 314, such as during implantation and / or removal of the fixed lens 314. In some embodiments, the apertures 330 are arranged in pairs. In some embodiments, the apertures 330 are distributed in a circumferential pattern. In some embodiments, one or more of the apertures 330 have a different size (e.g., width or diameter) and / or shape than other apertures 330. For example, each of the apertures 330 may have a different size than all or a subset of the other apertures 330. Using apertures of varying size can allow for further visual confirmation of the rotational alignment of the fixed lens 314 (e.g., about an optical axis of the AIOL 310). Confirming the alignment / orientation of the fixed lens 314 is expected to reduce the risk that a toric lens or other non-annularly symmetric fixed lens is improperly oriented with respect to the base 312and / or native eye capsule into which the AIOL 310 is implanted. In some embodiments, the fixed lens 314 can include additional visual markers to indicate an orientation of the fixed lens 314 with respect to the base 312 and / or the native eye capsule.

[0035] FIG. 3C is a cross-section of the AIOL 310 taken along line 3C-3C of FIG. 3B. As best seen in FIG. 3C, the base 312 can define a first fluid chamber or reservoir 332 (which can also be referred to as an “outer fluid reservoir 332,” a “haptic reservoir 332,” and / or the like) and a second fluid chamber or reservoir 334 (which can also be referred to as an “inner fluid reservoir 334,” an “optical fluid chamber 334,” and / or the like), each of which can be filled with a fluid. The fluid contained within the base 312 (e.g., within the outer fluid reservoir 332 and the inner fluid reservoir 334) can have a refractive index that is less than, equal to, or greater than the refractive index of aqueous and / or another portion of a patient’s eye. A channel 336 can extend between and fluidly couple the outer fluid reservoir 332 and the inner fluid reservoir 334 to allow the fluid to flow between the outer fluid reservoir 332 and the inner fluid reservoir 334. The outer fluid reservoir 332 can be defined at least partially between a first or outer wall 338 and a second or inner wall 340 of the first component 316 and / or a first or outer wall 342 and a second or inner wall 344 of the second component 318.

[0036] The outer fluid reserv oir 332 can be configured to operate as a bellows to cause fluid flow (e.g., fluid displacement) between the outer fluid reservoir 332 and the inner fluid reservoir in response to forces applied to the AIOL 310. For example, a compressive force applied to a portion of the AIOL 310 can displace fluid within the base 312, e.g., by causing fluid to flow / redistribute (via the channel 336) between the outer fluid reservoir 332 and the inner fluid reservoir 334. In at least some embodiments, for example, a radially compressive force applied to at least a portion of the AIOL 310. such as an outer perimeter of the base 312, can decrease a volume of the outer fluid reservoir 332 and / or increase a pressure within the outer fluid reservoir 332 and cause fluid within the outer fluid reservoir 332 to flow toward and / or into the inner fluid reservoir 334, which can thereby cause expansion of the inner fluid reservoir. A decrease in the radially compressive force can allow the outer perimeter of the base 312 to expand and thereby increase the volume of the outer fluid reservoir 332 and / or decrease the pressure within the outer fluid reservoir 332. In response, fluid within the inner fluid reservoir 334 can flow toward and / or into the outer fluid reservoir 332, which can thereby return the inner toward reservoir 334 toward and / or to an unexpanded state.

[0037] The base 312 can include an adjustable lens 346 at least partially defined by the inner fluid reservoir 334, a first optical portion 348a of the first component 316 of the base 312, and a second optical portion 348b of the second component 318 of the base 312. The adjustable lens 346 can be positioned posterior to the fixed lens 314 and / or the lens portion 326 thereof. One or both of the first optical portion 348a and the second optical portion 348b can be planar members or optical membranes of the first component 316 and the second component 318. respectively. In at least some embodiments, for example, one or both of the first optical portion 348a and the second optical portion 348b can be optical membranes integrally formed with the other portions of the respective first component 316 and the second component 318. In other embodiments, one or both of the first optical portion 348a and the second optical portion 348b can include one or more deformable lenses configured to provide a fixed power that can be positive, negative, or zero, and that are configured to deflect in response to changes to a volume and / or fluid pressure within the inner fluid reservoir 334. In at least some embodiments, for example, fluid flow between the outer fluid reservoir 332 and the inner fluid reservoir 334 can cause one or both of the first component 316 and the second component 318 to bend or deflect (in, e.g., a direction parallel, or at least generally parallel to an optical axis of the adjustable lens 346) in response to an increase or decrease in a volume of fluid and / or a fluid pressure within the inner fluid reservoir 334. This increase or decrease in the volume of fluid within the inner fluid reservoir 334 can, in turn, adjust (e.g.. increase or decrease) the optical power and / or depth of focus of the adjustable lens 346 and / or the range of adjustability of the optical power and / or the depth of focus of the adjustable lens 346. In at least some embodiments, for example, the adjustable lens 346 has a diopter of between about 5 D and about 7.5 D, such as between about 5.8 D and about 7.3D, any diopter therebetween, or another suitable diopter. Additionally, or alternatively, the diopter of the adjustable lens 346 can have a range of adjustment of up to 1.5D, 3D. 4D, 5D, 7.5D, any range therebetween, or another suitable range. In these and / or other embodiments, bending / deflection of the first optical portion 348a and / or the second optical portion 348b in response to fluid redistribution within the base 312 does not change, or does not significantly contribute to the change, in the optical power of the adjustable lens 346.

[0038] As best shown in FIG. 3C, the lens portion 326 of the fixed lens 314 can include a first or anterior optical surface 327a and a second or posterior optical surface 327b. One or both of the anterior optical surface 327a and the posterior optical surface 327b can have a curvature and / or define athickness of the fixed lens 314, e.g., that at least partially defines the fixed optical power of the fixed lens 314. Additionally, the first optical portion 348a and the second opticalportion 348b of the base 312 can include respective first or anterior optical surfaces 349a (individually identified as a primary anterior optical surface 349ai of the first optical portion 348a, and a second anterior optical surface 349a2 of the second optical portion 348b) and second or posterior optical surfaces 349b (individually identified as a primary posterior optical surface 349bi of the first optical portion 348a and a secondary posterior optical surface 349c2 of the second optical portion 348b). All or a subset of the anterior optical surfaces 349a and / or the posterior optical surfaces 349b can change in curvature in response to redistribution of the fluid within the base 312. For example, the curvature of individual ones of the primary anterior optical surface 349ai, the second anterior optical surface 349a2, the primary' posterior optical surface 349bi, and / or the secondary' posterior optical surface 349c2 can increase as fluid displaced inwardly toward and / or into the inner fluid reservoir 334. Generally, the curvatures of the anterior and posterior optical surfaces 349ai, 349bi of the first optical portion 348a are expected to change by an at least generally similar or identical amount, and likewise the curvatures of the anterior and posterior optical surfaces 349a2, 349b2 of the second optical portion 348b are expected to change by an at least generally similar or identical amount. The increased curvature of the primary anterior optical surface 349ai, the second anterior optical surface 349a2, the primary posterior optical surface 349bi, and / or the secondary posterior optical surface 349c2 can increase a spacing between the first optical portion 348a and the second optical portion 348b (e.g., a thickness of the adjustable lens 346) and allow an increased volume of fluid to reside within the inner fluid reservoir 334. This fluid within the inner fluid reservoir 334 can generally or substantially conform to the increased curvature of the primary anterior optical surface 349ai, the second anterior optical surface 349a2, the primary' posterior optical surface 349bi, and / or the secondary posterior optical surface 349C2, leading to a corresponding increase in the curvature of the fluid within the inner fluid reservoir 334. This, in turn, can increase the optical power of the adjustable lens 346. As described in greater detail below with reference to FIGS. 5-7, the change in curvature of individual ones of the anterior optical surfaces 327a, 349ai,2 and / or the posterior optical surfaces 327b, 349bi,2, and / or a change in thickness of at least a portion of the base 312 (e.g., the adjustable lens 346), can be measured to objectively assess the change in optical power of the AIOL 310 in response to accommodation of the patient's eye.

[0039] FIG. 3D is a side cross-sectional view of the AIOL 310 implanted within the capsular bag 104 (FIGS. 1A-2B). As described previously with reference to FIGS. 2A and 2B, the base 312 can be positioned within the capsular bag 104 via the opening 205. The capsular bag 104 can contact all, or at least a portion, of the outer surface of the base 312. The fixed lens 314 can bepositioned within the volume 320 defined by the base 312, as described previously with reference to FIGS. 3A and 3B. Accordingly, when implanted within the eye, the fixed lens 314 is positioned anteriorly of the adjustable lens 346. Additionally, in response to compressive forces F from the capsular bag 104, the fluid within the base 312 can retribute inwardly, as shown by arrow R, to bend / deflect the first optical portion 348a (e.g., anteriorly, in the shown by arrow7SI) and / or the second optical portion 348b (e.g.. posteriorly, in the direction shown by arrow S2). The bending / deflection of the first and / or second optical portions 348a.b can increase a spacing therebetween and, in turn, increase an amount and / or a curvature of fluid within the inner fluid reservoir 334 and thereby increase an optical pow er of the adjustable lens 346.

[0040] FIG. 4A is a perspective view? of an accommodation assessment system 450 (“system 450”) configured in accordance with embodiments of the present technology. The system 450 includes a housing 452, a patient interface 454, a measurement aperture 456. and a beam splitter assembly 460 (“assembly 460”). The housing 452 can contain or be operably coupled to one or more processors 458, individual ones of which can be communicatively coupled to one or more display devices 459. The system 450 can be configured to emit light and receive reflected light via the measurement aperture 456. The patient interface 454 can be configured to support the patient so that the measurement aperture 456 emits light into and receives reflected light from the patient’s eye. In some embodiments, the patient interface 454 includes a forehead rest 457a against which the patient can place their forehead and / or a chinrest 457b on which the patient can place their chin. The one or more processors 458 can be configured to determine a degree of accommodation of an AIOL implanted in the patient’s eye based, at least in part, on the reflected light. The assembly 460 can redirect at least a portion of the emitted light to assist with this determination. The one or more display devices 459 can show information associated with the reflected light, e.g., one or more images, the determined degree of accommodation, etc.

[0041] In some embodiments, the system 450 is or includes an lOLMaster® 700 manufactured by Carl Zeiss AG, headquarter in Oberkochen, Baden-Wurttemberg, Germany. In other embodiments, the system 450 is or includes another suitable system configured to measure a curvature and / or thickness of an AIOL using OCT and / or another suitable technique.

[0042] FIGS. 4B-4D are different views of select aspects of the system 450 of FIG. 4A, with other aspects of the system 450 (e.g., the patient interface 454) omitted for illustrative purposes. Referring to FIGS. 4B-4D together, the assembly 460 can include a body 462, one or more arms 464 (individually identified as a first or upper arm 464a and a second or lower arm464b), and a visual target holder 466 over and / or around at least a portion of the measurement aperture 456. The arms 464 can be coupled to the visual target holder 466 and support the visual target holder 466 at a distance X (FIG. 4C) from the body 462. The distance X can be between about 0.1 m and about 1 m, such as up to 0.2 m, 0.5 m, 0.0 m, or another suitable distance. Additionally, individual ones of the arms 464 can be movably received by corresponding mounting features 468 of the body 462 (individually identified as a first mounting feature 468a and a second mounting feature 468b) to allow the arms 464 to be moved relative to the body 462 to increase or decrease the distance X between the body 462 and the visual target holder 466. In the illustrated embodiment the mounting features 468 includes bores configured to slidably receive the arms 464. In other embodiments the mounting features can include one or more clips, threaded members, or other suitable mounting features. The visual target holder 466 can be configured to receive a visual target (shown in FIG. 5), e.g., including one or more letters, numbers, pictures, and / or other visual indicia to be viewed by a patient. As best shown in FIG. 4C, the body 462 can define one or more cut outs 463, individual ones of which can be aligned with a corresponding emitter and / or sensor within the measurement aperture 456. e.g., to allow light to pass through the body 462.

[0043] The assembly 460 can further include a beam splitter 470. The beam splitter 470 can be carried by the body 462, aligned (e.g., centered) with the measurement aperture 456, and angled to direct (i) a first portion of light to / from the system 450 and the patient’s eye and (ii) a second portion of light from the visual target holder 466 toward the eye to allow' the patient to view' the visual target carried thereby. For example, the arms 464 can define a vertical plane, and the beam splitter 470 be at a 45-degree angle relative to the vertical plane. Accordingly, the assembly 460 can allow the patient to view the visual target at multiple (difference) distances, e.g., while the system 450 measures a change in optical power of an AIOL within the patient’s eye.

[0044] FIG. 5 is a perspective view' illustrating operation of the system 450 of FIG. 4A. A user can secure a visual target 567 to the visual target holder 466 and position the visual target 567 at the distance X from the body 462. A patient can look into the system 450 (e g., using their eye 100) through the beam splitter 470 while simultaneous focusing on the visual target 567. The patient may interact with the patient interface 454 (FIG. 4A), e.g., to maintain a generally or substantially constant distance Y between the patient’s eye 100 and the system 450. As the patient focuses on the visual target 567, the patient’s eye 100 can accommodate and change an optical power of an AIOL 510 positioned within the patient’s eye. The system 450 can use OCT, and / or one or more other suitable visualization techniques, to image the AIOL 510. After a predeterminedamount of time and / or after the system 450 has received sufficient data, the user can ask the patient to focus on visual indicia at a different (e.g., increased or decreased) distance. For example, the user can change the distance X the visual target 567 is positioned from the body 462. Additionally, or alternatively, the user can ask the patient to focus on another visual target positioned elsewhere. The patient’s focusing on a target at this changed distance can cause the patient’s eye to accommodate lead to a corresponding change in the AIOL 510. The system 450, using OCT and / or other suitable visualization techniques, can image the AIOL 510 in this changed state. After a predetermined amount of time and / or after the system 450 has received sufficient data at the second distance, the process can end or the distance X can be changed again and the system can receive data at this additional distance.

[0045] FIG. 6 is an example output of the system 450 in accordance with embodiments of the present technology. As described previously, the system 450 can be used to visualize an AIOL and various features / parameters thereof, such as the AIOL 310. after implantation in the eye 100. For example, the system 450 can image one or more optical surfaces of the AIOL 310, including one or both of the anterior optical surface 327a and / or the posterior optical surface 327b of the fixed lens 314, and / or one or more of the primary anterior optical surface 349ai, the second anterior optical surface 349a2. the primary posterior optical surface 349bi. and / or the secondaryposterior optical surface 349c2 of the base 312. Based at least in part on one or more of these optical surfaces, the system 450 can determine a first thickness T1 of the fixed lens 314 and / or a second thickness T2 of the adjustable lens 346. The first thickness T1 can include, for example, an axial distance between the anterior optical surface 327a and the posterior optical surface 327b. The second thickness T2 can include, for example, an axial distance between the primary anterior optical surface 349ai and the secondary posterior optical surface 349c2. In the illustrated embodiment, the first thickness T1 and the second thickness T2 are measured along an optical axis of the AIOL 310. In other embodiments, the first thickness T1 and / or the second thickness T2 can be measured parallel to (but, e.g.. spaced apart from) the optical axis of the AIOL 310. Additionally, or alternatively, the system 450 can determine a curvature of one or more of the optical surfaces of the AIOL 310.

[0046] Using multiple images of the eye obtained while the eye and the AIOL 310 are in different accommodative states, the system 450 can determine a change in the second thickness T2 of the adjustable lens 346 of the AIOL 310 and / or a change in curvature of one or more of the optical surfaces of the adjustable lens 346. The determined change in thickness and / or curvature can be used to determine a change in optical power of the AIOL 310. In some embodiments, themultiple images are precisely aligned relative to each other prior to the system 450 making the above-referenced determinations of change(s) in geometric characteristics of the AIOL. The fixed lens is expected to have an at least generally or substantially fixed optical power and, accordingly, the first thickness T1 and / or the curvature of the fixed lens 314 is not expected to change during accommodation of the eye 100. As shown in FIG. 7, which is a plot comparing the change in thickness of the base 312 (e g., the adjustable lens 346) with the change in spherical equivalent power (SEP) of the AIOL 310, it is expected that changes in the thickness of the base 312 are at least generally or substantially correlated with changes to the SEP of the AIOL 310 (and, e g., the optical power of the adjustable lens 346).

[0047] Referring again to FIG. 6, although one first thickness T1 and one second thickness T2 are shown in the illustrated embodiment, in other embodiments the system 450 can determine (i) multiple first thicknesses at various locations along the fixed lens 314 and / or (ii) multiple second thicknesses at various locations along the adjustable lens 346. In at least some embodiments, for example, the system 450 can, while the eye is in a given accommodative state, determine a primary first thickness of the fixed lens 314 along the optical axis of the AIOL 310 and / or one or more secondary first thicknesses of the fixed lens 314 along one or more first axes parallel to but spaced apart from the optical axis. Additionally, or alternatively, the system 450 can, while the eye is in a given accommodative state, determine a primary second thickness of the adjustable lens 346 along the optical axis of the AIOL 310 and / or one or more secondary second thicknesses of the adjustable lens 346 along one or more second axes parallel to but spaced apart from the optical axis. In at least some aspects, determining the curvature or the change in curvature of the fixed lens 314 and / or the adjustable lens 346 can be at least generally similar to obtaining multiple thickness measurements of the fixed lens 314 and / or the adjustable lens 346 in that the curvature of the fixed lens 314 and / or the adjustable lens 346 can be representative of how' the respective thicknesses of these lenses change in a direction perpendicular to the optical axis.

[0048] In some embodiments, the system 450 can determine a thickness between any two optical surfaces of the AIOL 310. For example, the system 450 can determine a thickness between any two of: the anterior optical surface 327a, the posterior optical surface 327b, the primary anterior optical surface 349ai, the second anterior optical surface 349a2, the primary posterior optical surface 349bi, and the secondary7posterior optical surface 349C2. In some embodiments, the system 450 can use one or more other parameters to determine the change in optical power, in addition to or instead of the change in curvature and / or the change in thickness. These other parameters can include, for example, a change in the distance X (FIG. 5) between the patient’seye 100 and the accommodation assessment system 450 (e.g., the beam splitter 470, FIGS. 4B- 4D), a change in the distance Y (FIG. 5) between the accommodation assessment system 450 and the visual target 567 (FIG. 5), a change in one or more aspects of dimensions (e.g., length, width, resolution, content, appearance, etc.) of the visual target 567, and / or one or more other suitable parameters.

[0049] The AIOL devices described herein may be implanted by preparing the eye and removing the native lens from the capsule in any appropriate manner. The fluid-filled structure may then be placed in the capsule of the eye. The patient may then be evaluated for a base optical power and / or astigmatic correction, and a fixed lens can be selected to provide the desired based power or astigmatic correction for the fluid-filled structure in the implanted state in the capsule of the eye. The specific fixed lens to provide the post-implant base power or astigmatic correction is then inserted into the previously implanted fluid-filled structure of the AIOL. The chosen fixed lens may then be coupled to the fluid-filled structure within the eye capsule. This is possible in the AIOLs of the present technology because the fixed lenses are anteriorly-positioned when implanted, e.g., positioned anterior to the adjustable lens and / or attached to the anterior first component of the AIOLs. As described above, one or more of the fluid-filled accommodating structure or fixed lens may each be flexible such that they may be reconfigured (e.g.. folded) to a reduced-profile delivery configuration for delivery into the lens capsule. In some instances, it may be required to make a further correction to the fixed portion after the time of the surgery. Such instance may occur anywhere from days to years after the surgery. At such times, the patient may return to the physician and the fixed lens may be replaced with a new fixed lens having a different optical power or other prescription. In such instances, the new prescription may be characterized prior to or after removal of the original fixed lens. In some instances, the new fixed lens may be fabricated and implanted at the time of the examination, in others the patient may return for implantation of the fixed lens sometime after the examination.

[0050] Several embodiments of the present technology are directed to a kit having an accommodating structure and a first fixed lens that has no optical base power. The kit can further include one or more second fixed lenses having various based powers or other optical properties. In practice, the accommodating structure can be implanted into the native eye capsule, and then the first fixed lens can be coupled to the accommodating structure. The optical properties of the implanted accommodating structure can then be assessed in situ with the first fixed lens in place to determine the desired optical properties of the fixed lens. If the optical properties of the assembled accommodating structure and first fixed lens without a base power are appropriate.then the system can remain implanted without additional changes. However, if a different base power or some other optical property is desired (e.g., toric or other asymmetrical optics), then the first fixed lens without a base power can be replaced with a second fixed lens having the desired optical properties based on the optical properties of the implanted accommodating portion with a fixed lens attached.

[0051] In some embodiments, the fixed portion of the AIOL may be fabricated from materials different from the accommodating portion. Such materials include hydrophilic or hydrophobic methacrylate or silicones and any other materials traditionally used in nonaccommodating IOLS. The fixed lens may be fabricated from materials harder than those used for the accommodating portion. One or both of the accommodating portion / lens and the fixed portion / lens may be machined, cast molded (e.g., reactive cast molded), injected molded, and / or formed by other processes or combinations of processes. Any or all of the structures described herein may be constructed from a transparent or translucent material. For example, the abovedescribed accommodating structures and fixed lenses can be constructed from transparent materials, even if they are illustrated as opaque in the associated figures.

[0052] Any of the features of the intraocular lens systems described herein may be combined with any of the features of the other intraocular lenses described herein and vice versa. Additionally, several specific examples of embodiments in accordance with the present technology are set forth below in the following examples.Examples

[0053] Several aspects of the present technology are set forth in the following examples:1. A computer-implemented method of objectively assessing accommodation of an adjustable intraocular lens (AIOL) implanted within an eye of a patient, the AIOL having an accommodating base lens and a non-accommodating fixed lens configured to be removably coupled to the accommodating base lens, the method comprising: receiving, via an accommodation assessment system, first optical coherence tomography (OCT) geometric data associated with the AIOL at a first time when the eye is in a first accommodative state; receiving, via the accommodation assessment system, second OCT geometric data associated with the AIOL at a second time when the eye is in a second accommodative state different than the first accommodative state;determining, based at least in part on a comparison of the first and second OCT geometric data from the first and second accommodative states, respectively, a first change to a thickness of at least an adjustable lens of the AIOL and / or a second change to a curv ature of an optical surface of the AIOL; and determining, based at least in part on the first change and / or the second change, a third change to an optical power of the AIOL.2. The computer-implemented method of example 1 wherein the method comprises determining the first change, and wherein the third change is determined based, at in least part, on the first change.3. The computer-implemented method of example 2 wherein the thickness is an axial distance between two optical surfaces of the adjustable lens, as measured parallel to an optical axis of the AIOL.4. The computer-implemented method of example 2 or example 3 wherein the thickness is an axial distance between anterior and posterior optical surfaces of the adjustable lens, as measured along an optical axis of the AIOL.5. The computer-implemented method of example 4 wherein: the thickness is a first thickness, the method further comprises determining a fourth change to a second thickness of at least the adjustable lens. the second thickness is a second axial distance between the anterior and posterior optical surfaces, as measured along an axis parallel to but spaced apart from the optical axis, and the third change to the optical power is determined based at least in part on the first change and the fourth change.6. The computer-implemented method of any of examples 1-5 wherein the method comprises determining the second change, and wherein the third change is determined based, at in least part, on the second change.7. The computer-implemented method of any of examples 1-6 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first thickness of at least the adjustable lens when the eye of the patient is in the first accommodative state; determining, based at least in part on the first thickness, a first optical power of the AIOL; determining, based at least in part on the second OCT geometric data, a second thickness of at least the adjustable lens when the eye of the patient is in the second accommodative state; determining, based at least in part on the second thickness, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.8. The computer-implemented method of any of examples 1-7 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first curvature of the optical surface when the eye of the patient is in the first accommodative state; determining, based at least in part on the first curvature, a first optical power of the AIOL; determining, based at least in part on the second OCT geometric data, a second curvature of the optical surface when the eye of the patient is in the second accommodative state; determining, based at least in part on the second curvature, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.9. The computer-implemented method of any of examples 1-8 wherein, in the second accommodative state, the eye has an increased degree of accommodation relative to the first accommodative state.10. The computer-implemented method of any of examples 1-9 wherein, in the first accommodative state, the eye is not accommodated.11. An obj ective accommodation assessment system, comprising: a housing; a measurement aperture configured to emit light into an eye of a patient comprising an adjustable intraocular lens (AIOL) and / or receive reflected light from the eye of the patient comprising the AIOL; a beam splitter assembly coupled to the housing and aligned with at least a portion of the measurement aperture, wherein the beam splitter assembly includes — a beam splitter positioned over the measurement aperture; and a visual target supported at an adjustable distance from the beam splitter, wherein the beam splitter is configured to direct at least a first portion of light incident on the beam splitter from the visual target toward the eye of the patient and at least a second portion of light incident on the beam splitter from the eye of the patient toward the measurement aperture; one or more processors; and one or more non-transitory, computer-readable media carrying instructions that, when executed by the one or more processors, cause the one or more processors to — detect a change in an accommodative state of the eye of the patient comprising the AIOL based, at least in part, on light reflected from the eye of the patient and received via the measurement aperture, and based at least in part on the detected change, determine a change in an optical power of the AIOL.12. The objective accommodation assessment system of example 11 wherein the beam splitter assembly further includes — a body configured to be coupled to the housing, one or more arms configured to be coupled to the body, and a visual target holder configured to be coupled to the one or more arms and spaced from the body, wherein the visual target holder is configured to receive and hold the visual target at the adjustable distance.13. The objective accommodation assessment system of example 12 wherein body of the beam splitter assembly includes one or more mounting features configured to receive corresponding ones of the one or more arms.14. The objective accommodation assessment system of any of examples 11-13 wherein the beam splitter is oriented to direct at least the first portion of the light incident on the beam splitter toward the visual target and at least the second portion of the light incident on the beam splitter toward the measurement aperture.15. The objective accommodation assessment system of any of examples 11-14 wherein the beam splitter is at a 45-degree angle relative to a vertical plane defined by measurement aperture.16. The objective accommodation assessment system of any of examples 11-15 wherein the visual target is configured to reflect at least part of the first portion of light back toward the beam splitter and / or the eye of the patient.17. The objective accommodation assessment system of any of examples 11-16 wherein the instructions that cause the objective accommodation assessment system to detect the change in the accommodative state include instructions that, when executed, cause the objective accommodation assessment system to detect a change in a curvature and / or thickness of one or more optical surfaces of the AIOL.18. The objective accommodation assessment system of any of examples 11-17 wherein the change in the thickness is a change in an axial distance between two optical surfaces of the AIOL, as measured parallel to an optical axis of the AIOL.19. One or more non-transitory, computer-readable media having instructions that, when executed by one or more processors, cause the one or more processors to perform operations comprising: receiving, via an accommodation assessment system, first optical coherence tomography (OCT) geometric data associated with an AIOL at a first time when an eye of a patient is in a first accommodative state; receiving, via the accommodation assessment system, second OCT geometric data associated with the AIOL at a second time when the eye is in a second accommodative state different than the first accommodative state;determining, based at least in part on a comparison of the first and second OCT geometric data from the first and second accommodative states, respectively, a first change to a thickness of at least an adjustable lens of the AIOL and / or a second change to a curvature of an optical surface of the AIOL; and determining, based at least in part on the first change and / or the second change, a third change to an optical power of the AIOL.20. The one or more non-transitory. computer-readable media of example 19 wherein the operations comprise determining the first change, and wherein the third change is determined based, at in least part, on the first change.21. The one or more non-transitory, computer-readable media of example 19 or example 20 wherein the thickness is an axial distance between two optical surfaces of the adjustable lens, as measured parallel to an optical axis of the AIOL.22. The one or more non-transitory, computer-readable media of any of examples 19-21 wherein the operations comprise determining the second change, and wherein the third change is determined based, at in least part, on the second change.23. The one or more non-transitory, computer-readable media of any of examples 19-22 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first thickness of at least the adjustable lens when the eye of the patient is in the first accommodative state; determining, based at least in part on the first thickness, a first optical power of the AIOL; determining, based at least in part on the second OCT geometric data, a second thickness of at least the adjustable lens when the eye of the patient is in the second accommodative state; determining, based at least in part on the second thickness, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.24. The one or more non-transitory, computer-readable media of any of examples 19-23 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first curvature of the optical surface when the eye of the patient is in the first accommodative state; determining, based at least in part on the first cur ature, a first optical power of the AIOL; determining, based at least in part on the second OCT geometric data, a second curvature of the optical surface when the eye of the patient is in the second accommodative state; determining, based at least in part on the second curvature, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.25. The one or more non-transitory, computer-readable media of any of examples 19-24 wherein receiving the second OCT geometric data includes receiving the second OCT geometric data when the eye is in a state of accommodation.26. The one or more non-transitory, computer-readable media of any of examples 19-25 wherein receiving the first OCT geometric data includes receiving the first OCT geometric data when the eye is not accommodated.Conclusion

[0054] The above detailed description of embodiments of the technology are not intended to be exhaustive or to limit the technology to the precise form disclosed above. Although specific embodiments of. and examples for, the technology are described above for illustrative purposes, various equivalent modifications are possible within the scope of the technology as those skilled in the relevant art will recognize. For example, any of the features of the systems and methods for objectively assessing accommodation described herein may be combined with any of the features of the other systems and methods for objectively assessing accommodation described herein and vice versa. Moreover, although steps are presented in a given order, alternative embodiments may perform steps in a different order. The various embodiments described herein may also be combined to provide further embodiments.

[0055] From the foregoing, it will be appreciated that specific embodiments of the technology have been described herein for purposes of illustration, but well-known structures, functions, and / or properties associated with measurement and / or visualization techniques have not been shown or described in detail to avoid unnecessarily obscuring the description of the embodiments of the technology. Where the context permits, singular or plural terms may also include the plural or singular term, respectively.

[0056] Moreover, unless the word "or" is expressly limited to mean only a single item exclusive from the other items in reference to a list of two or more items, then the use of "or" in such a list is to be interpreted as including (a) any single item in the list, (b) all of the items in the list, or (c) any combination of the items in the list. Additionally, the term "comprising" is used throughout to mean including at least the recited feature(s) such that any greater number of the same feature and / or additional types of other features are not precluded. It will also be appreciated that specific embodiments have been described herein for purposes of illustration, but that various modifications may be made without deviating from the technology. Further, while advantages associated w ith some embodiments of the technology have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and not all embodiments need necessarily exhibit such advantages to fall within the scope of the technology. Accordingly, the disclosure and associated technology can encompass other embodiments not expressly shown or described herein.

Claims

CLAIMSI / 'W e claim:

1. A computer-implemented method of objectively assessing accommodation of an adjustable intraocular lens (AIOL) implanted within an eye of a patient, the AIOL having an accommodating base lens and a non-accommodating fixed lens configured to be removably coupled to the accommodating base lens, the method comprising: receiving, via an accommodation assessment system, first optical coherence tomography (OCT) geometric data associated with the AIOL at a first time when the eye is in a first accommodative state; receiving, via the accommodation assessment system, second OCT geometric data associated with the AIOL at a second time when the eye is in a second accommodative state different than the first accommodative state; determining, based at least in part on a comparison of the first and second OCT geometric data from the first and second accommodative states, respectively, a first change to a thickness of at least an adjustable lens of the AIOL and / or a second change to a curvature of an optical surface of the AIOL; and determining, based at least in part on the first change and / or the second change, a third change to an optical power of the AIOL.

2. The computer-implemented method of claim 1 wherein the method comprises determining the first change, and wherein the third change is determined based, at in least part, on the first change.

3. The computer-implemented method of claim 2 wherein the thickness is an axial distance between two optical surfaces of the adjustable lens, as measured parallel to an optical axis of the AIOL.

4. The computer-implemented method of claim 2 wherein the thickness is an axial distance between anterior and posterior optical surfaces of the adjustable lens, as measured along an optical axis of the AIOL.

5. The computer-implemented method of claim 4 wherein: the thickness is a first thickness, the method further comprises determining a fourth change to a second thickness of at least the adjustable lens, the second thickness is a second axial distance between the anterior and posterior optical surfaces, as measured along an axis parallel to but spaced apart from the optical axis, and the third change to the optical power is determined based at least in part on the first change and the fourth change.

6. The computer-implemented method of claim 1 wherein the method comprises determining the second change, and wherein the third change is determined based, at in least part, on the second change.

7. The computer-implemented method of claim 1 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first thickness of at least the adjustable lens when the eye of the patient is in the first accommodative state; determining, based at least in part on the first thickness, a first optical power of the AIOL; determining, based at least in part on the second OCT geometric data, a second thickness of at least the adjustable lens when the eye of the patient is in the second accommodative state; determining, based at least in part on the second thickness, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.

8. The computer-implemented method of claim 1 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first curvature of the optical surface when the eye of the patient is in the first accommodative state; determining, based at least in part on the first curvature, a first optical power of the AIOL;determining, based at least in part on the second OCT geometric data, a second curvature of the optical surface when the eye of the patient is in the second accommodative state; determining, based at least in part on the second curvature, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.

9. The computer-implemented method of claim 1 wherein, in the second accommodative state, the eye has an increased degree of accommodation relative to the first accommodative state.

10. The computer-implemented method of claim 1 wherein, in the first accommodative state, the eye is not accommodated.

11. An obj ective accommodation assessment system, comprising: a housing; a measurement aperture configured to emit light into an eye of a patient comprising an adjustable intraocular lens (AIOL) and / or receive reflected light from the eye of the patient comprising the AIOL; a beam splitter assembly coupled to the housing and aligned with at least a portion of the measurement aperture, wherein the beam splitter assembly includes — a beam splitter positioned over the measurement aperture; and a visual target supported at an adjustable distance from the beam splitter, wherein the beam splitter is configured to direct at least a first portion of light incident on the beam splitter from the visual target toward the eye of the patient and at least a second portion of light incident on the beam splitter from the eye of the patient toward the measurement aperture; one or more processors; and one or more non-transitory. computer-readable media carrying instructions that, when executed by the one or more processors, cause the one or more processors to —detect a change in an accommodative state of the eye of the patient comprising the AIOL based, at least in part, on light reflected from the eye of the patient and received via the measurement aperture, and based at least in part on the detected change, determine a change in an optical power of the AIOL.

12. The objective accommodation assessment system of claim 1 1 wherein the beam splitter assembly further includes — a body configured to be coupled to the housing, one or more arms configured to be coupled to the body, and a visual target holder configured to be coupled to the one or more arms and spaced from the body, wherein the visual target holder is configured to receive and hold the visual target at the adjustable distance.

13. The objective accommodation assessment system of claim 12 wherein body of the beam splitter assembly includes one or more mounting features configured to receive corresponding ones of the one or more arms.

14. The objective accommodation assessment system of claim 11 wherein the beam splitter is oriented to direct at least the first portion of the light incident on the beam splitter toward the visual target and at least the second portion of the light incident on the beam splitter toward the measurement aperture.

15. The objective accommodation assessment system of claim 1 1 wherein the beam splitter is at a 45-degree angle relative to a vertical plane defined by measurement aperture.

16. The objective accommodation assessment system of claim 11 wherein the visual target is configured to reflect at least part of the first portion of light back toward the beam splitter and / or the eye of the patient.

17. The objective accommodation assessment system of claim 11 wherein the instructions that cause the objective accommodation assessment system to detect the change in the accommodative state include instructions that, when executed, cause the objectiveaccommodation assessment system to detect a change in a curvature and / or thickness of one or more optical surfaces of the AIOL.

18. The objective accommodation assessment system of claim 11 wherein the change in the thickness is a change in an axial distance between two optical surfaces of the AIOL, as measured parallel to an optical axis of the AIOL.

19. One or more non-transitory, computer-readable media having instructions that, when executed by one or more processors, cause the one or more processors to perform operations comprising: receiving, via an accommodation assessment system, first optical coherence tomography (OCT) geometric data associated with an AIOL at a first time when an eye of a patient is in a first accommodative state; receiving, via the accommodation assessment system, second OCT geometric data associated with the AIOL at a second time when the eye is in a second accommodative state different than the first accommodative state; determining, based at least in part on a comparison of the first and second OCT geometric data from the first and second accommodative states, respectively, a first change to a thickness of at least an adjustable lens of the AIOL and / or a second change to a curvature of an optical surface of the AIOL; and determining, based at least in part on the first change and / or the second change, a third change to an optical power of the AIOL.

20. The one or more non-transitory. computer-readable media of claim 19 wherein the operations comprise determining the first change, and wherein the third change is determined based, at in least part, on the first change.

21. The one or more non-transitory, computer-readable media of claim 19 wherein the thickness is an axial distance between two optical surfaces of the adjustable lens, as measured parallel to an optical axis of the AIOL.

22. The one or more non-transitory, computer-readable media of claim 19 wherein the operations comprise determining the second change, and wherein the third change is determined based, at in least part, on the second change.

23. The one or more non-transitory, computer-readable media of claim 19 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first thickness of at least the adjustable lens when the eye of the patient is in the first accommodative state; determining, based at least in part on the first thickness, a first optical power of the AIOL; determining, based at least in part on the second OCT geometric data, a second thickness of at least the adjustable lens when the eye of the patient is in the second accommodative state; determining, based at least in part on the second thickness, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.

24. The one or more non-transitory, computer-readable media of claim 19 wherein determining the third change includes — determining, based at least in part on the first OCT geometric data, a first curvature of the optical surface when the eye of the patient is in the first accommodative state; determining, based at least in part on the first curvature, a first optical power of the AIOL; determining, based at least in part on the second OCT geometric data, a second curvature of the optical surface when the eye of the patient is in the second accommodative state; determining, based at least in part on the second curvature, a second optical power of the AIOL; and determining the third change to the optical power of the AIOL based, at least in part, on a difference between the first optical power and the second optical power.

25. The one or more non-transitory, computer-readable media of claim 19 wherein receiving the second OCT geometric data includes receiving the second OCT geometric data when the eye is in a state of accommodation.

26. The one or more non-transitory, computer-readable media of claim 19 wherein receiving the first OCT geometric data includes receiving the first OCT geometric data when the eye is not accommodated.

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