U.S. patent application number 11/155559 was filed with the patent office on 2005-10-20 for intraocular lens implant having accommodative capabilities.
Invention is credited to Khoury, Elie.
Application Number | 20050234285 11/155559 |
Document ID | / |
Family ID | 9924947 |
Filed Date | 2005-10-20 |
United States Patent
Application |
20050234285 |
Kind Code |
A1 |
Khoury, Elie |
October 20, 2005 |
Intraocular lens implant having accommodative capabilities
Abstract
An intraocular implant including a lens and a shell component.
The shell component includes a shell peripheral wall encompassing a
shell inner volume for protectively enclosing the lens and allowing
the latter to move therein between lens accommodating positions.
The lens is pivotable within the shell inner volume between a lens
first position wherein the lens is in a substantially proximal
relationship relative to a shell wall first segment and a lens
second position wherein the lens is in a substantially proximal
relationship relative to a shell wall second segment. In one
embodiment of the invention, the lens peripheral edge defines a
lens edge pivot portion and the shell segment joining edge defines
a corresponding shell edge pivot portion, the lens and shell edge
pivot portion being complementarily configured and sized so that
when the lens abuttingly rests against the peripheral wall inner
surface, the lens and shell edge pivot portions interact with each
other for allowing the lens to pivot between the lens first and
second positions. In another embodiment of the invention, the lens
is pivotally suspended within the shell component for pivotal
movement between the lens first and second position. In both
embodiments, the lens may also pivot to a lens intermediate
position in a spaced relationship relative to both the shell wall
first and second segments.
Inventors: |
Khoury, Elie; (St-Laurent,
CA) |
Correspondence
Address: |
Elie Khoury
587, Decarie
St-Laurent
QC
H4L 3L1
CA
|
Family ID: |
9924947 |
Appl. No.: |
11/155559 |
Filed: |
June 20, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11155559 |
Jun 20, 2005 |
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10285640 |
Nov 1, 2002 |
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6921416 |
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Current U.S.
Class: |
600/1 |
Current CPC
Class: |
A61F 2/1613 20130101;
A61F 2/1627 20130101; A61F 2/1648 20130101 |
Class at
Publication: |
600/001 |
International
Class: |
A61N 005/00 |
Foreign Application Data
Date |
Code |
Application Number |
Nov 1, 2001 |
GB |
0126234.4 |
Claims
I claim:
1. An intraocular implant comprising: a lens, said lens including a
lens body defining a lens first surface and a generally opposed
lens second surface, said lens defining a lens geometrical plane
intercepting the latter between said lens first and second
surfaces; a shell, said shell including a shell peripheral wall
defining a peripheral wall inner surface, said shell peripheral
wall also defining a shell wall first segment and an opposed shell
wall second segment, said shell wall first and second segments
being joined together about a peripheral shell segment joining
edge, said shell segment joining edge defining an intercepting
geometrical plane intercepting the latter; said shell peripheral
wall encompassing a shell inner volume for protectively enclosing
said lens; said lens being mounted within said shell such that upon
said intercepting geometrical plane being tilted, said lens
geometrical plane is allowed to tilt relative to said intercepting
geometrical plane for varying the spacing between said lens first
and second surfaces and said peripheral wall inner surface.
2. An intraocular implant as recited in claim 1 wherein said lens
is mounted within said shell so as to allow said lens geometrical
plane to be tilted relative to said intercepting geometrical plane
by an angle having a value greater then 2 degrees.
3. An intraocular implant as recited in claim 2 wherein said lens
is mounted within said shell so as to allow said lens geometrical
plane to be tilted relative to said intercepting geometrical plane
by an angle having a value of between 2 degrees and 40 degrees.
4. An intraocular implant as recited in claim 3 wherein said lens
is mounted within said shell so as to allow said lens geometrical
plane to be tilted relative to said intercepting geometrical plane
by an angle having a value of approximately 20 degrees.
5. An intraocular implant as recited in claim 1 wherein said lens
is pivotally coupled to said shell about a lens coupling region,
said lens defining a free distal segment located substantially
opposed said lens coupling region, said free distal segment being
unattached to said shell.
6. An intraocular implant as recited in claim 5 wherein said lens
is pivotable about said lens coupling region between a lens first
position wherein said lens first surface is in a substantially
proximal relationship relative to said shell wall first segment and
a lens second position wherein said lens second surface is in a
substantially proximal relationship relative to said shell wall
second segment.
7. An intraocular implant as recited in claim 6 wherein said lens
includes a lens peripheral edge, said coupling region including a
lens edge pivot portion located about said lens peripheral edge;
said shell segment joining edge defining a corresponding shell edge
pivot portion, said lens and shell edge pivot portion being
complementarily configured and sized so that when said lens
abuttingly rests against said peripheral wall inner surface, said
lens and shell edge pivot portions interact with each other for
allowing said lens to pivot between said lens first and second
positions.
8. An intraocular implant as recited in claim 7 further comprising
a lens stabilizing means for at least partially stabilizing said
lens in a lens intermediate position between said lens first and
second positions wherein said lens first and second surfaces are
both in a spaced relationship respectively relative to said shell
wall first and second wall segments.
9. An intraocular implant as recited in claim 8 wherein said lens
stabilizing means includes a stabilizing protrusion extending from
said shell edge pivot portion.
10. An intraocular implant as recited in claim 5 wherein said lens
hangs freely from a coupling arm.
11. An intraocular implant as recited in claim 10 wherein said
coupling arm is pivotally attached to said lens about said lens
coupling region.
12. An intraocular implant as recited in claim 11 wherein said
coupling arm is pivotally attached to said lens by a first arm
pivotal link and said coupling arm is pivotally attached to said
shell wall inner surface by a second arm pivotal link.
13. An intraocular implant as recited in claim 11 wherein said lens
said lens is pivotable about said lens coupling region between a
lens first position wherein said lens first surface is in a
substantially proximal relationship relative to said shell wall
first segment and a lens second position wherein said lens second
surface is in a substantially proximal relationship relative to
said shell wall second segment, said lens being pivotally attached
to said shell so as to be substantially stabilized when said lens
is in a lens intermediate position between said lens first and
second positions wherein said free distal segment abuttingly
contacts said shell wall first segment.
14. An intraocular implant as recited in claim 13 wherein when said
free distal segment abuttingly contacts said shell wall first
segment, said free distal segment acts as a pivot for allowing said
lens pivot region to pivot relative to said shell.
Description
BACKGROUND OF THE INVENTION
[0001] The human eye has three concentric layers of tissue
enclosing the lens and the inner media. The eyes outermost covering
is the tough, fibrous sclera and its anterior transparent
modification, the cornea. The cornea is the major light refractor
of the eye. Below the sclera is the pigmented vascular layer of the
eye, which includes the choroid, ciliary body and the iris.
[0002] The vitreous cavity constitute two-thirds (2/3) of the
volume of the eye. It is filled with transparent jell, the vitreous
humor. The portion of the eye in front of the vitreous is divided
into two compartments, the anterior chamber (between the cornea and
iris) and the posterior chamber (between the iris and vitreous).
The chambers are filled with aqueous humor. The innermost layer of
the eye, or sensory retina, lines the posterior two-thirds (2/3) of
the globe and has several distinct histologic layers.
[0003] The natural lens of the eye comprises a transparent
envelope, called the capsular bag, which contains the crystalline
structure and is suspended by the zonules from the surrounding
ciliary body. The front and rear walls of the capsular bag are
known as interior and posterior capsules, respectively.
[0004] The ability of ciliary muscle to contract and the lens to
become more convex is called accommodation which increases the
ability to see near objects. With increasing age, the lens of every
eye undergoes a progressive hardening, with loss of ability to
change its shape. Loss of accommodation is manifested by a
decreased ability to focus on near objects (commonly referred to as
presbyopia), while corrected distance visual acuity remains
normal.
[0005] Accommodation is thus the natural process by which the lens
of the eye can increase the curvature of its front and back
surfaces and thereby change its refractive power in order to adjust
from distance vision to near vision. This typically occurs in
response to contractions of the ciliary muscle.
[0006] A cataract is any opacity or discoloration of the lens
whether a small, local opacity or the complete loss of
transparency.
[0007] Clinically, the term cataract is usually reserved for
opacities that effect visual acuity. The most common cause of
cataract is age related change.
[0008] Other causative factors include inflammation, trauma,
metabolic and nutritional defects, and radiation damage. Cataracts
may develop very slowly over the years or may progress rapidly
depending on the cause and the type of cataract.
[0009] The cataracts may be in both eyes and, being a progressive
condition may cause fading vision and eventual blindness. If a
cataract interferes with patient's daily pattern of living, the
patient may benefit from cataract extraction, which can be
performed using many different surgical techniques.
[0010] Cataracts were once surgically removed along with the
interior wall of the capsule of the eye. The patient then wore eye
glasses or contact lenses which restored vision but did not permit
focusing and gave only limited depth perception.
[0011] The first implant of a replacement lens within the eye
occurred around 1949 and attempted to locate the replacement lens
in the posterior chamber of the eye behind the iris. Problems such
as dislocation after implantation forced abandonment of this
approach, and for some period thereafter intraocular lenses were
implanted in the anterior chamber of the eye. Lenses implanted in
the anterior chamber of the eye were of various designs.
[0012] Others returned to the practice of inserting the lens in the
area of the eye posterior to the iris, known as the posterior
chamber. This is the area where the patient's natural crystalline
lens is located. When the intraocular lens is located in this
natural location, substantially normal vision may be restored to
the patient and the problem of forward displacement of the vitreous
humor and retinal detachment encountered in anterior chamber
intraocular lenses are less likely to occur. Many designs of lenses
for implantation in the posterior chamber have been proposed.
However, most of these designs suffer from lack of sharp variable
focusing capability.
[0013] The prior art has proposed some examples of lenses of
capable of focusing thus offering the wearer the closest possible
substitute to the crystalline lens. However, the prior art
accommodative lenses suffer from numerous drawbacks including
overall complexity leading to increased costs and decreased overall
reliability. Accordingly, there exists a need for an improved
intraocular lens implant having accommodative capabilities.
SUMMARY OF THE INVENTION
[0014] In accordance with an embodiment of the present invention,
there is provided an intraocular implanting support for movably
supporting a lens and allowing the lens to be implanted within an
eye, the lens including a lens body defining a lens first surface,
a generally opposed lens second surface and a lens peripheral edge
extending substantially peripherally therebetween, the implanting
support comprising: a shell component, the shell component
including a shell peripheral wall, the shell peripheral wall at
least partially encompassing a shell inner volume for protectively
receiving the lens and allowing the latter to move therein; a
shell-to-lens coupling means extending between the shell component
and the lens for coupling the shell component to the lens and
allowing the lens to move within the shell inner volume according
to a generally predetermined pattern upon movement of the shell
component.
[0015] Typically, the shell component is provided with at least one
haptic extending generally outwardly from the shell peripheral
wall. Also, typically, the shell peripheral wall encloses the shell
inner volume for protectively separating the external environment
located outside the shell peripheral wall.
[0016] Conveniently, the shell peripheral wall defines a peripheral
wall inner surface, the shell-to-lens coupling means allowing the
lens to move within the shell inner volume so as to vary the
relative position between the lens and the peripheral wall inner
surface. Also, preferably, the shell-to-lens coupling means allows
the lens to be pivotally coupled to the shell component within the
shell inner volume for pivotal movement therein between lens
accommodating positions.
[0017] In accordance with one embodiment of the invention, the
shell inner volume is at least partially filled with a filling
fluid. In accordance with another embodiment of the invention, the
shell inner volume is at least partially vacuumed.
[0018] Typically, the shell peripheral wall defines a shell wall
first segment and a shell wall second segment, the inner surface of
both the shell wall first and second segments having a generally
concave configuration. Also, typically, the shell second wall
segment is provided with an externally concave portion optically in
line with the lens when the latter is mounted within the shell
component.
[0019] Furthermore, typically, the shell first and second wall
segments are joined together about a common and generally
peripheral shell segment joining edge. Conveniently, the shell
first and second wall segments both have a generally cupolaed
configuration, the shell first and second wall segments being
joined together in a generally opposed relationship relative to
each other about a common and generally peripheral shell segment
joining edge so as to form a generally externally biconvex and
internally biconcave shell peripheral wall.
[0020] In one embodiment of the invention, the shell segment
joining edge has a generally flattened configuration. In another
embodiment of the invention, the shell segment joining edge has a
generally pointed cross-sectional configuration
[0021] Conveniently, the lens peripheral edge is pivotally attached
to the shell wall inner surface generally adjacent the shell
segment joining edge for allowing the lens to pivot between a lens
first position wherein the lens is in a substantially proximal
relationship relative to the shell wall first segment and a lens
second position wherein the lens is in a substantially proximal
relationship relative to the shell wall second segment.
[0022] Optionally, the implanting support further comprises a
suction limiting means positioned between the lens and the shell
component for limiting the suction between the lens and the shell
component when the lens is in the lens first or second positions.
Typically, the suction limiting means includes a spacing protrusion
extending inwardly from at least one of the shell first or second
wall segments.
[0023] Typically, the shell-to-lens coupling means includes at
least one coupling arm pivotally attached between the lens and the
shell wall inner surface. Also, typically, the coupling arm is
pivotally attached to the lens by a first arm pivotal link and the
coupling arm is pivotally attached to the shell wall inner surface
by a second arm pivotal link. Optionally, the coupling arm is made
out of a substantially resiliently deformable material.
[0024] Typically, an abutment tongue protrudes inwardly into the
shell inner volume from a predetermined quadrant of the shell
second wall segment adjacent the shell segment joining edge. In one
embodiment of the invention, the shell second wall segment defines
a shell recessed section located generally in register with the
abutment tongue wherein the shell second wall segment is inwardly
recessed.
[0025] Conveniently, the shell segment joining edge defines an
intercepting geometrical plane generally intercepting the latter,
the abutment tongue defining an abutment surface, the abutment
surface defining an abutment geometrical plane, the abutment
geometrical plane extending at an intercepting-to-abutment plane
angle relative to the intercepting geometrical plane. Typically,
the intercepting-to-abutment plane angle is such that the
intercepting geometrical plane intercepts the abutment geometrical
plane within the shell inner volume.
[0026] In one embodiment of the invention, the lens peripheral edge
is pivotally attached to the shell wall inner surface generally
adjacent the shell segment joining edge for allowing the lens to
pivot between a lens first position wherein the lens is in a
substantially proximal relationship relative to the shell wall
first segment and a lens second position wherein the lens is in a
substantially proximal relationship relative to the shell wall
second segment; the shell-to-lens coupling means including at least
one coupling arm pivotally attached between the lens and the shell
wall inner surface; the coupling arm being pivotally attached to
the lens adjacent a lens coupling region and to the shell wall
inner surface respectively by a first arm pivotal link and by a
second arm pivotal link; the shell second wall segment being
provided with an abutment tongue protruding inwardly into the shell
inner volume from a predetermined quadrant of the shell second wall
segment adjacent the shell segment joining edge; the shell segment
joining edge defining an intercepting geometrical plane generally
intercepting the latter, the abutment tongue defining an abutment
surface, the abutment surface defining an abutment geometrical
plane, the abutment geometrical plane extending at an
intercepting-to-abutment plane angle relative to the intercepting
geometrical plane; the shell-to-lens coupling means allowing the
lens coupling region to be substantially stabilized when the lens
is in a lens intermediate position between the lens first and
second positions wherein a distal segment of the lens located
generally opposite the lens coupling region abuttingly contacts the
shell first wall segment.
[0027] Typically, the shell-to-lens coupling means allows a portion
of the shell-to-lens coupling means to abbutingly contact the
abutment surface when the lens is in both the lens second and
intermediate positions and to be in a spaced relationship relative
to the abutment surface when the lens is in the lens first
position.
[0028] Also, conveniently, the lens forms a lens geometrical plane
substantially bisecting the lens, the implanting support being
configured and sized so that the lens geometrical plane is in a
substantially parallel relationship with the abutment geometrical
plane when the lens is in the lens intermediate position and
wherein the lens geometrical plane intercepts the abutment
geometrical planer when the lens is in both the lens first and
second geometrical planes.
[0029] In accordance with another aspect of the present invention,
there is also provided an intraocular implant comprising: a lens,
the lens including a lens body defining a lens first surface, a
generally opposed lens second surface and a lens peripheral edge
extending substantially peripherally therebetween; a shell
component, the shell component including a shell peripheral wall,
the shell peripheral wall defining a peripheral wall inner surface,
the shell peripheral wall encompassing a shell inner volume for
protectively enclosing the lens and allowing the latter to move
therein between lens accommodating positions.
[0030] Typically, the lens and shell components are complimentarily
configured and sized so as to allow the lens to pivot within the
shell inner volume for varying the spacing between the lens first
and second surfaces and the peripheral wall inner surface.
[0031] Conveniently, the shell peripheral wall defines a shell wall
first segment and a shell wall second segment, the shell first and
second wall segments both having a generally cupolaed
configuration, the shell first and second wall segments being
joined together in a generally opposed relationship relative to
each other about a common and generally peripheral shell segment
joining edge so as to form a generally externally biconvex and
internally biconcave shell peripheral wall; the lens being
pivotable within the shell inner volume between a lens first
position wherein the lens is in a substantially proximal
relationship relative to the shell wall first segment and a lens
second position wherein the lens is in a substantially proximal
relationship relative to the shell wall second segment.
[0032] In one embodiment of the invention, the lens peripheral edge
defines a lens edge pivot portion and the shell segment joining
edge defines a corresponding shell edge pivot portion, the lens and
shell edge pivot portion being complementarily configured and sized
so that when the lens abuttingly rests against the peripheral wall
inner surface, the lens and shell edge pivot portions interact with
each other for allowing the lens to pivot between the lens first
and second positions.
[0033] Optionally, the intraocular implant further comprises a lens
stabilizing means for at least partially stabilizing the lens in a
lens intermediate position between the lens first and second
positions wherein the lens first and second surfaces are both in a
spaced relationship respectively relative to the shell wall first
and second wall segments. Typically, the lens stabilizing means
includes a stabilizing protrusion extending from the shell edge
pivot portion.
[0034] In one embodiment of the invention, the intraocular implant
further comprises a shell-to-lens coupling means extending between
the shell component and the lens for coupling the shell component
to the lens and allowing the lens to move between the shell first
and second positions; the shell-to-lens coupling means includes at
least one coupling arm pivotally attached between the lens and the
shell wall inner surface.
[0035] Conveniently, the coupling arm is pivotally attached to the
lens by a first arm pivotal link and the coupling arm is pivotally
attached to the shell wall inner surface by a second arm pivotal
link.
[0036] Typically, an abutment tongue protrudes inwardly into the
shell inner volume from a predetermined quadrant of the shell
second wall segment adjacent the shell segment joining edge.
[0037] Conveniently, the shell segment joining edge defines an
intercepting geometrical plane generally intercepting the latter;
the abutment tongue defining an abutment surface, the abutment
surface defining an abutment geometrical plane, the abutment
geometrical plane extending at an intercepting-to-abutment plane
angle relative to the intercepting geometrical plane; the
shell-to-lens coupling means allowing the lens coupling region to
be substantially stabilized when the lens is in a lens intermediate
position between the lens first and second positions wherein a
distal segment of the lens located generally opposite the lens
coupling region abuttingly contacts the shell first wall
segment.
[0038] Advantages of the present invention includes that the
proposed intraocular lens implant is particular well suited for
lens replacement during cataract surgery or other types of surgery
and is specifically designed so as to emulate the natural process
of accommodation.
[0039] Furthermore, the proposed intraocular lens is designed so as
to provide accommodation over substantial variable range of
refractive power. Still further, the proposed intraocular lens
implant is specifically designed so as to provide for a
transitionally smooth accommodation, the accommodation being
performed gradually by gravitational force as the eye of the
intended user is tilted.
[0040] Still further, the proposed intraocular lens implant is
designed so as to reduce interaction with adjacent intraocular
structures during accommodation movement thereof. Its accommodation
capability is independent of its position inside the eye, or the
size of the pupil. Also, the proposed intraocular lens implant is
configured so as to reduce the risks of posterior capsule fibrosis,
that is fibrosis occurring against the rear section of the
implant.
[0041] Furthermore the proposed intraocular lens implant is
designed so as to reduce friction between the lens and the
surrounding medium. Reduction of the friction between the lens and
its adjacent medium, in turn, provides a smoother and quicker
accomodation.
[0042] Still further, the proposed intraocular lens implant is
specifically designed so as to be compatible with most modern
cataract surgery procedures. Also, the proposed intraocular lens
implant is suitable for use of a laser treatment after cataract
surgery to open an opacified posterior capsule.
[0043] Furthermore, even in situations wherein the capsule is
unintentionally ruptured during surgery or thereafter, the proposed
implant is designed so as to remain relatively functional. Still
furthermore, the proposed implant is designed so as to be
manufacturable using conventional forms of manufacturing and
conventional materials so as to provide an implant that will be
economically feasable, long lasting and relatively trouble free in
operation.
BRIEF DESCRIPTION OF THE DRAWINGS
[0044] Embodiments of the present invention will now be disclosed,
by way of example, in reference to the following drawings, in
which:
[0045] FIG. 1: in a schematic cross sectionnal view, illustrates an
intraocular lens implant in accordance with an embodiment of the
present invention, the implant being implanted within a human
eye;
[0046] FIG. 2: in a front elevational view, illustrates part of the
intraocular lens implant shown in FIG. 1;
[0047] FIG. 3: in a partial cross sectional view with sections
taken out, illustrates the intraocular lens implant shown in FIGS.
1 and 2 in a lens second position;
[0048] FIG. 4: in a partial cross sectional view with sections
taken out, illustrates the intraocular lens implant shown in FIGS.
1 through 3 in a lens intermediate position;
[0049] FIG. 5: in a partial cross sectional view with sections
taken out, illustrates the intraocular lens implant shown in FIGS.
1 through 4 in a lens first position;
[0050] FIG. 6: in a partial cross sectional view with sections
taken out, illustrates a intraocular lens implant in accordance
with an alternative embodiment of the invention, the lens thereof
being shown in a lens second position;
[0051] FIG. 7: in a partial cross sectional view with sections
taken out, illustrates a intraocular lens implant in accordance
with an alternative embodiment of the invention, the lens thereof
being shown in a lens second position;
[0052] FIG. 8: in a front elevational view illustrates the
intraocular lens implant shown in FIG. 7;
[0053] FIG. 9: in a partial cross sectional view with sections
taken out, illustrates the an intraocular lens implant in
accordance with an alternative embodiment of the invention, the
implant being shown with a lens in a lens second position;
[0054] FIG. 10: in a partial cross sectional view with sections
taken out, illustrates the intraocular lens implant shown in FIG. 9
in a lens intermediate position;
[0055] FIG. 11: in a partial cross sectional view with sections
taken out, illustrates the intraocular lens implant shown in FIGS.
9 through 10 in a lens first position;
[0056] FIG. 12: in a partial cross sectional view with sections
taken out, illustrates a intraocular lens implant in accordance
with an alternative embodiment of the invention, the lens thereof
being shown in a lens second position;
[0057] FIG. 13: in a front elevational view illustrates the
intraocular lens implant shown in FIG. 12;
[0058] FIG. 14: in a partial cross sectional view with sections
taken out, illustrates the an intraocular lens implant in
accordance with an alternative embodiment of the invention, the
implant being shown with a lens in a lens second position;
[0059] FIG. 15: in a partial cross sectional view with sections
taken out, illustrates the intraocular lens implant shown in FIG.
14 in a lens first position.
DETAILED DESCRIPTION
[0060] Referring to FIG. 1, there is shown an intraocular lens
implant (10) in accordance with an embodiment of the present
invention. The intraocular lens implant (10) is shown implanted
within a schematized human eye (12).
[0061] As is well known in the art, the eye (12) has an outermost
covering including a fibrous sclera (14) and a cornea (16). A
pigmented vascular layer is positioned inwardly relative to the
sclera (14). The pigmented vascular layer includes the choroid
(18), the ciliary body (20) and the iris (22).
[0062] The eye (12) also includes a retina (24) positioned
immediately under a pigmented epithelial layer. The eye (12) also
includes a vitreous cavity (26) filled with a transparent gel
called the vitreous humor.
[0063] The portion of the eye (12) located in front of the vitreous
cavity (26) is divided into two chambers. An anterior chamber (28)
extends between the cornea (16) and the iris (22). A posterior
chamber (30) extends between the iris (22) and the vitreous chamber
(26). The anterior and posterior chambers (28), (30) are filled
with aqueous humor.
[0064] It is to be understood that the eye (12) schematically
illustrated in FIG. 1 includes only certain basic parts thereof
believed to be sufficient to disclose some of the benefits to be
derived from the present invention. Typically, zonules (not shown)
extend from the ciliary body (20) to a biologically existing
capsule or capsular bag (also not shown) having an interior portion
or wall frequently termed an anterior capsule and a posterior
portion or wall frequently termed a posterior capsule (both of
which not shown). As is well known, the zonules typically exert a
pulling or tensional force on the capsular bag, causing the latter
to assume a more flattened configuration than its usual more
spherical shape.
[0065] Also, as is well known in the art, cataract removal may be
accomplished by various methods. For example, cataract removal may
be accomplished by intracapsular extraction, that is removal of the
entire length or by extracapsular extraction, that is removal of
the cataractous nucleus and cortex through the anterior side of the
lens capsular bag. Extracapsular extraction may be performed
utilizing either nucleus expression and a relatively large opening
in the eye or phacoemulsification and a relatively small opening in
the eye. The essentially empty lens capsule remaining after removal
of the cataract is referred to as the capsular bag. Removal of the
nucleus and cortex of the natural or biological lens from the
capsular bag creates a space immediately behind the iris (22)
between the latter and the posterior capsule of the bag.
[0066] It should be understood that although the intraocular lens
(10) is shown in FIG. 1 as being implanted in the posterior chamber
(30), the intraocular lens implant (10) is implantable in any of
the eye chambers, that is the anterior chamber (28), the posterior
chamber (30) or the capsular bag without departing from the scope
of the present invention. Also, it should be understood that the
intraocular lens implant (10) is designed so as to be implantable
within an eye (12) through any suitable method.
[0067] The intraocular lens implant (10) typically includes an
optical lens (34). The lens (34), in turn, includes a lens body
defining a lens first surface (36) and a generally opposed lens
second surface (38). The lens body also defines a lens peripheral
edge (40) extending substantially peripherally therebetween.
[0068] It should be understood that although the lens (34) is shown
throughout FIGS. as having a generally biconvex configuration, the
lens (34) could have other general configurations such as
plano-convex, plano-covex with a planar Fresnel surface, planar
with one Fresnel surface, planar with two opposed Fresnel surfaces,
concave-convex or other suitable configurations without departing
from the scope of the present invention. Also, the lens (34) may be
of the single vision or multifocal type or have other suitable
optical characteristics without departing from the scope of the
present invention. Furthermore, the lens (34) could be made out of
PMMA, an other type of polymeric resin or any other suitable
material without departing from the scope of the present
invention.
[0069] The intraocular lens implant (10) also includes an
intraocular implanting support (42) for movably supporting the lens
(34) and allowing the latter to be implanted within the eye (12).
In fact, although the intraocular implanting support (42) is shown
throughout the FIGS. as having a lens (34) mounted therein, it
should be understood that the intraocular implanting support (42)
could be manufactured, used or sold independently of the lens (34)
without departing from the scope of the present invention.
[0070] In other words, the present invention is concerned both with
an intraocular implanting support (42) and with an intraocular
implant including both an intraocular implanting support (42) and a
lens (34) movably supported thereby. Also, the intraocular
implanting support may take any suitable form.
[0071] Typically, the intraocular implanting support (42) includes
a shell component (44). The shell component (44), in turn, includes
a shell peripheral wall (46) at least partially encompassing a
shell inner volume (48) for protectively receiving the lens (34)
and allowing the latter to move therein. Typically, the lens (34)
and the shell component (44) are complimentarily configured and
sized so as to allow the lens (34) to pivot within the shell inner
volume (48) for varying the spacing between the lens first and
second surfaces (36), (38) and the inner surface (50) of the shell
peripheral wall (46).
[0072] Typically, although by no means exclusively, the shell
component (46) may be provided with at least one and preferably two
haptics (not shown) extending generally outwardly from the shell
peripheral wall (46). As illustrated in FIG. 1, the intraocular
lens implant (10) may be arranged in the posterior chamber (30) or
other suitable chamber while bearing against the margin of the
chamber for holding the intraocular lens implant (10) in position.
As is well known in the art, the haptics, when present, are
preferably made out of a generally resiliently deformable material
such as a suitable polymeric resin.
[0073] In accordance with at least one set of embodiments, the
intraocular implanting support (42) includes a shell-to-lens
coupling means extending between the shell component (44) and the
lens (34) for coupling the shell component (44) to the lens (34)
and allowing the lens (34) to move within the shell inner volume
(48) according to a generally predetermined pattern of movement,
upon movement of the shell component (44). The shell-to-lens
coupling means hence allows the lens (34) protectively enclosed
within the shell inner volume (48) to move therein between lens
accommodating positions.
[0074] Typically, the shell-to-lens coupling means allows the lens
(34) to be pivotally coupled to the shell component (44) within the
shell inner volume (48) for pivotal movement therein between lens
accommodating positions. Conveniently, the shell peripheral wall
(46) encloses the shell inner volume (48) for protectively
separating the external environment located outside the shell
peripheral wall (46) from the shell inner volume (48).
[0075] In at least one embodiment of the invention, the shell inner
volume (48) is at least partially filled with a filling fluid.
Typically, the shell inner volume (48) is filled with air or
another suitable gas in order to reduce frictional drag forces on
the lens (34) when the latter moves within the shell inner volume
(48). In an alternative embodiment of the invention, the shell
inner volume (48) is at least partially vacuumed so as to further
reduce frictional drag forces on the lens (34) when the latter
moves within the shell inner volume (48).
[0076] In the embodiments shown throughout the FIGS., the shell
peripheral wall (46) defines a shell wall first segment (52) and a
shell wall second segment (54). Also, throughout the FIGS., the
inner surface (50) of both the shell wall first and second segments
(52), (54) have a generally concave configuration. Again, it should
be understood that although the shell component (44) shown
throughout the FIGS. has a generally biconvex configuration, the
shell component (44) could have other suitable configurations such
as plano-convex, concave-convex or any other suitable
configurations without departing from the scope of the present
invention.
[0077] For example, as shown more specifically in FIG. 6, the shell
second wall segment (54) may be provided with a recessed or concave
portion (56). The concave portion (56) is configured, sized and
positioned so as to creatre a diverging effect and so as to be
generally optically in line with the lens (34) when the latter is
mounted within the shell component (44). The concave portion (56)
is intended to increase the convergence power of the intraocular
implant (10). Accomodation may hence be produced with comparatively
less displacement of the lens 34. This may prove to be particularly
usefull, for example, with patient having a pronounced myopia.
[0078] Typically, the shell first and second wall segments (52),
(54) both have a generally cupolaed configuration. The shell first
and second wall segments (52), (54) are typically joined together
in a generally opposed relationship relative to each other about a
common and generally peripheral shell segment joining edge (58).
The shell first and second wall segments (52), (54) hence typically
form a generally externally biconvex and internally biconcave shell
peripheral wall (46).
[0079] Although the shell segment joining edge (58) is shown in
FIGS. 1 through 5 as having a generally pointed cross sectional
configuration, it should be understood that the shell segment
joining edge (58) could assume other configurations without
departing from the scope of the present invention. For example, as
shown in FIGS. 6 through 15, the shell segment joining edge (58')
may have a generally flattened cross sectional configuration. The
generally flattened cross sectional configuration of the shell
segment joining edge (58') may potentially reduce the progression
of fibrosis on the posterior capsule behind the intraocular implant
(10) and, hence, posterior capsular opacification.
[0080] Typically, the lens peripheral edge (40) is pivotally
attached to the shell wall inner surface (50) at a position
generally adjacent the shell segment joining edge (58). The
shell-to-lens coupling means typically allows the lens (34) to
pivot between a lens first position, illustrated in FIGS. 5, and
11, wherein the lens (34) is in a substantially proximal
relationship relative to the shell wall first segment (52) and a
lens second position, illustrated in FIGS. 3 and 9, wherein the
lens (34) is in a substantially proximal relationship relative to
the shell wall second segment (54). Preferably, the shell-to-lens
coupling means allows the lens first surface (36) to be in a
generally proximal relationship relative to the shell wall first
segment (52) when the lens (34) is in the lens first position and
the shell-to-lens coupling means allows the lens second surface
(38) to be in a generally proximal relationship relative to the
shell wall second segment (54) when the lens (34) is in the lens
second position.
[0081] Conveniently, the shell-to-lens coupling means allows the
lens first and second surfaces to (36), (38) to respectively
contact the shell wall first and second segments (52), (54) when
the lens (34) is respectively in the first and second lens
positions. Also, typically, the interior surface (50) of the shell
wall first and second segments (52), (54) is configured and sized
so as to substantially complementarily conform respectively to the
lens first and second surfaces (36), (38).
[0082] In order to reduce potential suction forces between the lens
component (34) and the shell wall inner surface (50) that may
potentially alter or hinder movement of the lens component (34),
the implanting support (42) is optionally provided with a suction
limiting means positioned between the lens (34) and the shell
component (44) for limiting the suction between the lend (34) and
the shell component (44) when the lens (34) is in the lens first or
second position. As illustrated more specifically in FIGS. 7 and 8,
the suction limiting means may optionally include at least one and
typically four symetrically disposed spacing protrusions (60)
extending inwardly from the inner surface of at least one and
preferably both the shell first and/or second wall segments (52),
(54).
[0083] In at least one embodiment of the invention, the
shell-to-lens coupling means includes at least one coupling arm
(62) pivotally attached between the lens (34) and the shell wall
(44). Typically, the coupling arm (62) is pivotally attached to the
lens (34) by a first arm pivotal link (64) and the coupling arm
(62) is pivotally attached to the shell wall inner surface (50) by
a second arm pivotal link (66). The coupling arm (62) may take any
suitable form. For example, the coupling arm (62) may include a
strip of substantially resiliently deformable material such as a
suitable elastomeric or polymeric resin. The coupling arm (62) may
be made out of a string, a spring or any other generally elongated
components. Also, the linking arm (62) may be segmented or assume
different configurations without departing from the scope of the
present invention. As illustrated more specifically in FIGS. 2 and
8, the shell-to-lens coupling means typically includes two coupling
arms (62) positioned in a generally parallel relationship relative
to each other. However, the shell-to-lens coupling means may
include any suitable number of coupling arms (62) positioned in any
suitable configuration relative to each other without departing
from the scope of the present invention.
[0084] Similarly, the first and second arm pivotal links (64), (66)
may take any suitable form. In the embodiments shown throughout the
FIGS., the first and second arm pivotal links (64), (66) include
linking rings extending from their respective attachment surfaces.
However, the first and/or second pivotal links (64), (66) may
include attachment apertures, hooks or any other suitable
means.
[0085] Typically, the implanting support (42) also includes an
abutment tongue (68) protruding inwardly into the shell inner
volume (48) from a predetermined quadrant (70) of the shell second
wall segment (54) adjacent the shell segment joining edge (58). In
the embodiments shown throughout the FIGS. 1 through 5, the shell
second wall segment (54) also defines a shell recessed section (72)
located generally in register with the abutment tongue (68) and
wherein the shell second wall segment (54) is inwardly recessed. In
the embodiment shown in FIGS. 6 through 15 and more specifically in
FIGS. 9 through 11, the shell wall second segment (54) is deprived
of the shell recessed section.
[0086] As illustrates more specifically in FIGS. 3 through 5, the
shell segment joining edge (58) defines an intercepting geometrical
plane (74) generally intercepting the latter. In situations wherein
the shell component (44) is generally symmetrical, the intercepting
geometrical plane (74) typically bisects the shell component (44).
The abutment tongue (68) defines a corresponding abutment surface
(76). The abutment surface (76), in turn, defines an abutment
geometrical plane (78).
[0087] The abutment geometrical plane (78) typically extends at an
intercepting-to-abutment plane angle (80) relative to the
intercepting geometrical plane (74). Typically the
intercepting-to-abutment plane angle (80) is such that the
intercepting geometrical plane (74) intercepts the abutment
geometrical plane (78) within the shell inner volume (48).
Typically, although by no means exclusively, the
intercepting-to-abutment plane angle has a value substantially in
the range of 20.degree..
[0088] Referring now more specifically to FIG. 4, there is shown
that the lens (34) typically defines a lens coupling region (84)
located generally adjacent the first arm pivotal link (64) and a
generally opposed distal segment (82). FIGS. 4 and 10 illustrate
the lens (34) in an intermediate position between the lens first
and second positions shown respectively in FIGS. 5, 11 and 3, 9. In
the intermediate position shown in FIGS. 4 and 10, the distal
segment (82) abuttingly contacts the inner surface (50) of the
shell first wall segment (52). Preferably, the shell-to-lens
coupling means further allows the lens coupling region (84) to be
substantially stabilized when the lens (34) is in the lens
intermediate position, shown in FIGS. 4 and 10. Preferably, the
shell-to-lens coupling means allows a portion of the shell-to-lens
coupling means to abuttingly contact the abutment surface (76) when
the lens (34) is in both the lens second and intermediate positions
shown respectively in FIGS. 3 and 4 and to be in a spaced
relationship relative to the abutment surface (76) when the lens
(34) is in the lens first position shown in FIG. 5.
[0089] Typically, the lens (34) forms a lens geometrical plane (86)
generally intercepting the latter. In situations wherein the lens
(34) is generally symmetrical, the lens geometrical plane (86)
typically bisects the lens (34). The implanting support (42) is
configured and sized so that the lens geometrical plane (86) is in
a substantially parallel relationship with the abutment geometrical
plane (78) when the lens (34) is in the lens intermediate position,
shown in FIG. 4. Also, the implanting support (42) is configured
and sized so that the lens geometrical plane (86) intercepts the
abutment geometrical plane (78) when the lens (34) is the lens
second geometrical planes shown respectively in FIGS. 3 and 9.
[0090] As shown in FIGS. 12 and 13, the lens (34) is optionally
provided with at least one and preferably two magnetizable or
magnetized magnet components 104 embedded therein, mounted thereon
or otherwise coupled thereto. The magnet components 104 are adapted
to allow a magnet positioned outside the eye (12) to be used for
displacing the lens (34) should the latter be stuck in an unwanted
position or in situations wherein the wearer of the implant (10)
wishes to look in a proximal visual field with the head thereof
tilted rearwardly.
[0091] The shell component (44) may be made out of any suitable and
biocompatible material. For example, the shell component (44) could
be made out of PMMA or any other suitable polymeric resin.
Optionally, the shell component (44) could be made out of a
resiliently deformable material to facilitate implantation thereof
through a relatively small implantation aperture.
[0092] In use, the shell component (44) is typically implanted
within the eye (12) so that the intercepting geometrical plane (74)
forms an implanting angle (88) having a value substantially in
range of 10.degree. relative to a vertical axis (90). Movement of
the head of the intended user causing movement of the lens (34)
within the shell component (44) is adapted to provide accommodation
to the eye of the intended user.
[0093] FIG. 3 and 9, illustrate the relative positioning between
the lens (34) and the shell component (44) when the head of an
intended user is substantially vertically alligned position and the
intended user is looking generally horizontally. In such a
situation, the lens (34) is typically in the lens second position
wherein the lens second surface (36) is in a proximal or abutting
relationship relative to the peripheral wall second segment (54).
The coupling arms (62) typically abuttingly contact the abutment
surface (76) and are in a generally parallel relationship relative
to the latter. The implantation angle (88) is adapted to ensure
that the lens (34) remains in the lens first position despite
decellarational forces or other factors acting thereon.
[0094] As the head of the intended user tilts frontwardly, the
intercepting geometrical plane (74) is similarly pivoted according
to arrow (92) in FIG. 4. Since the lens (34) hangs freely from the
shell-to-lens coupling means, the distal segment (82) remains
relatively stationary while the relative distance between the
distal segment (82) and the inner surface of the peripheral wall
first segment (52) decreases.
[0095] The spacing (94) between the distal segment (82) and the
inner surface (50) of the peripheral wall first segment (52)
decreases to a position wherein the distal segment (82) abuttingly
contacts the inner surface (50) of the peripheral wall first
segment (52). In such a position referred to as the lens
intermediate position, shown in FIGS. 4 and 10, the distal segment
(82) of the lens (34) is stabilized by the abutting contact between
the distal segment (82) and the peripheral wall first segment (52)
while the lens coupling region (84) is stabilized by the abutting
relationship between the shell-to-lens coupling means and the
abutment surface (76).
[0096] The intraocular implant (10) hence provides an intermediate
lens position wherein the lens (34) is substantially, and at least
partially stabilized and wherein the convex power of the lens (34)
is increased by the augmentation of the spacing (96). Typically,
the lens (34) and shell component (44) are configured and sized so
that abutment of the distal segment (82) occurs when the pivotal
movement of the shell component (44) reaches an angular value
substantially in the range of the intercepting-to-abutment plane
angle (80).
[0097] Once the lens (34) has reached the lens intermediate
position shown in FIGS. 4 and 10, further forward tilting of the
head of the intended user causes the distal segment (82) to act as
a contacting area or pivot for allowing the lens coupling region
(84) to pivot forwardly. As the lens coupling region (84) pivots
forwardly, the shell-to-lens coupling means becomes spaced relative
to the abutment surface (76) and the lens (34) eventually reaches
the lens first position shown in FIGS. 5 and 11 wherein the lens
first surface (36) is in a generally proximal or abutting
relationship relative to the inner surface of the peripheral wall
first segment (52). The spacing (96") being further increased, the
convex power of the lens (34) is also increased thus providing
further accommodation.
[0098] Hence, the intraocular implant (10) provides at least three
different lens positions wherein the lens (34) is substantially
stabilized and offers a generally predetermined degree of
accommodation. In the lens first and second position, the lens
first and second surfaces (36), (38) are preferably in a generally
complimentary mating relationship relative to the inner surface
(50) of the peripheral wall first and second segments (52), (54) so
as to reduce the risk of refraction. The lens offers progressive
accommodation through movement of the distal end coupling regions
(82), (84) of the lens relative to the shell component (44).
[0099] Since the lens moves within the shell and since the latter
remains relatively stable, accommodation is achieved with minimal
interference with surrounding intraocular structures. Also, since
friction is reduced between the lens (34) and its surrounding
environment, accommodation is performed through a generally smooth
and relatively quick movement of the lens (34).
[0100] Still furthermore, in the event that the shell-to-lens
coupling means becomes damaged or otherwise altered, the lens (34)
will remain within the shell component (44) and may still provide
for some degree of accommodation by allowing the lens (34) to
contact the inner surface of the shell peripheral wall adjacent the
base thereof allowing the distal segment (82) to act as a
pivot.
[0101] Referring now more specifically to FIG. 10, there is shown
an intraocular implant (10') in accordance with an alternative
embodiment of the invention. The intraocular implant (10') is
substantially similar to the intraocular implant (10) shown in
FIGS. 1 through 9 and, hence, similar reference numerals will be
used to denote similar components. One of the main differences
between the intraocular implant (10') and the hereinabove disclosed
intraocular implant (10) resides in that the intraocular implant
(10') is deprived of coupling arms (62) and corresponding first and
second arm pivotal links (64), (66). The lens (34) of the
intraocular implant (10') typically rests at the bottom or base of
the shell component (44) and is typically free to rotate about its
center axis. The lens peripheral edge (40) defines a lens edge
pivot portion (98).
[0102] Similarly, the shell segment joining edge (58) defines a
corresponding shell edge pivot portion (100). The lens and shell
edge pivot portions (98), (100) are complementarily configured and
sized so that when the lens (34) abuttingly rests against the
peripheral wall inner surface (50), the lens and shell edge pivot
portions (98), (100) interact with each other for allowing the lens
(34) to pivot between the lens first and second positions
illustrated respectively in FIGS. 14 and 15.
[0103] Optionally, the intraocular implant (10') may be further
provided with a lens stabilizing means for at least partially
stabilizing the lens (34) in a lens intermediate position between
the lens first and second positions wherein the lens first and
second surfaces (36), (38) are both in a spaced relationship
relative to the shell wall first and second wall segments (52),
(54).
[0104] The lens stabilizing means typically includes a stabilizing
protrusion (102) extending from the shell edge pivot portion. The
stabilizing protrusion (102) is configured and sized for receiving
and releasably retaining the lens pivot portion (98) so that the
lens (34) is releasably stabilized in the lens intermediate
position.
* * * * *