U.S. patent application number 11/431176 was filed with the patent office on 2006-11-16 for intraocular lens for correcting presbyopia.
This patent application is currently assigned to Minu Telesystems LLC. Invention is credited to Gholam A. Peyman.
Application Number | 20060259138 11/431176 |
Document ID | / |
Family ID | 38694673 |
Filed Date | 2006-11-16 |
United States Patent
Application |
20060259138 |
Kind Code |
A1 |
Peyman; Gholam A. |
November 16, 2006 |
Intraocular lens for correcting presbyopia
Abstract
The present invention relates to an intraocular lens. The
intraocular lens includes a lens having an opening therein and an
ocular system capable of being inserted into the opening after
implantation into an eye. Wherein the first lens is adapted to
project a first image onto the retina and the second lens is
adapted to project a second image onto the retina.
Inventors: |
Peyman; Gholam A.; (Sun
City, AZ) |
Correspondence
Address: |
BELL, BOYD, & LLOYD LLC
P. O. BOX 1135
CHICAGO
IL
60690-1135
US
|
Assignee: |
Minu Telesystems LLC
Pittsboro
NC
|
Family ID: |
38694673 |
Appl. No.: |
11/431176 |
Filed: |
May 9, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10436234 |
May 13, 2003 |
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11431176 |
May 9, 2006 |
|
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60461194 |
Apr 9, 2003 |
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Current U.S.
Class: |
623/6.22 ;
623/6.28; 623/6.34 |
Current CPC
Class: |
A61F 2250/0053 20130101;
A61F 2/1602 20130101; A61F 2/1651 20150401; A61F 2/1648 20130101;
A61F 2/1613 20130101 |
Class at
Publication: |
623/006.22 ;
623/006.34; 623/006.28 |
International
Class: |
A61F 2/16 20060101
A61F002/16 |
Claims
1. An intraocular lens, comprising: a lens having an opening
therein; and an ocular system capable of being inserted into said
opening after implantation into an eye; wherein said first lens is
adapted to project a first image onto the retina and said second
lens is adapted to project a second image onto the retina.
2. An intraocular lens according to claim 1, wherein said lens has
a slit extending from said opening radially outwardly.
3. An intraocular lens according to claim 1, wherein said ocular
system includes a negative lens and a positive lens positioned in
series.
4. An intraocular lens according to claim 1, wherein said ocular
system is configured such that it frictionally fits with said
opening.
5. an intraocular lens according to claim 1, wherein said ocular
system is configured to be a telescopic lens system.
6. An intraocular lens according to claim 1, wherein said lens is
adapted to be adjusted after implantation.
7. An intraocular lens according to claim 6, wherein said lens is
at least partially formed of a silicone polymer with loose
monomers.
8. An intraocular lens according to claim 1, wherein said opening
is substantially in the center of said lens.
9. An intraocular lens, comprising: a lens having a peripheral
portion substantially surrounding an opening, a slit extends from
said opening and into said peripheral portion; and a telescopic
system configured to frictionally fit into said opening.
10. An intraocular lens according to claim 9, wherein said
telescopic system includes a negative lens and a positive lens
positioned in series.
11. An intraocular lens according to claim 9, wherein said lens is
adapted to be adjusted after implantation.
12. An intraocular lens according to claim 11, wherein said lens is
at least partially formed of a silicone polymer with loose
monomers.
13. An intraocular lens according to claim 9, wherein said opening
is substantially in the center of said lens.
14. An intraocular lens according to claim 9, wherein said first
lens is adapted to project a first image onto the retina and said
second lens is adapted to project a second image onto the
retina.
15. A method of altering vision of an eye, comprising the steps of
inserting a lens into the eye, said lens having an opening therein
and adapted to project a first image on the retina, inserting an
ocular system in said opening, said ocular system adapted to
project a second image on the retina, and applying energy to said
lens to alter the shape thereof.
16. A method according to claim 15, wherein said step of inserting
a lens into the eye includes inserting a lens having a slit
extending from said opening in the direction of a peripheral
portion of said lens.
17. A method according to claim 15, wherein said step of inserting
a lens into the eye includes inserting a lens at least partially
formed of a silicone polymer with loose monomers.
18. A method according to claim 17, wherein said step of applying
energy to said lens includes irradiating said lens to polymerize a
portion thereof.
19. A method according to claim 15, wherein said step of inserting
an ocular system in said opening includes frictional fitting said
ocular system in said opening after said lens has been inserted
into said eye.
20. A method according to claim 15, wherein said step of inserting
an ocular system in said opening includes an ocular system
configured to be a telescopic lens system.
Description
[0001] This application is a continuation-in-part of application
Ser. No. 10/436,234, entitled "Intraocular Lens for Correcting
Presbyopia", filed May 13, 2003, which claims benefit under 35
U.S.C. .sctn.119(e) from U.S. Provisional Patent Application Ser.
No. 60/461,194, filed on Apr. 9, 2003, the entire contents of both
of which are incorporated herein by reference
CROSS-REFERENCE TO RELATED APPLICATIONS
[0002] This application is related to U.S. Pat. No. 6,197,057 to
Peyman et al. entitled "LENS CONVERSION SYSTEM FOR TELEDIOPTIC OR
DIFFRACTIVE CONFIGURATIONS", and copending U.S. patent application
Ser. No. 10/356,730 entitled "SUBEPITHILIAL IMPLANT AND METHOD OF
TREATMENT OF PRESBYOPIAN AND OTHER REFRACTIVE ERRORS", the entire
contents of both of which are incorporated herein by reference
BACKGROUND
[0003] A normal ametropic eye includes a cornea, lens and retina.
The cornea and lens of the normal eye cooperatively focus light
entering the eye from a far point, i.e., infinity, onto the retina.
However, an eye can have a disease known as macular degeneration
which can greatly degrade vision.
[0004] Macular degeneration has become one of the leading causes of
blindness in adults. This disease affects the central retinal area
known as the macula, which receives light focused by the cornea and
lens and acute vision. Macular degeneration can lead to a gradual
or sudden loss of vision to the level of 20/200 or less. Commonly,
loss of vision only affects the central retinal area of about 0.25
to 4 square millimeters, and does not usually progress beyond this
area, thereby leaving 95-99% of the retina unaffected. Thus,
reading and driving vision can be lost, while peripheral vision
remains intact.
[0005] U.S. Pat. Nos. 4,666,446 and 4,581,031, both to Koziol and
Peyman, and both of which are incorporated by reference herein,
each disclose intraocular lenses which are implanted in the eye in
place of the natural lens to redirect the rays of light to minimize
the adverse affect on vision caused by the macular degeneration of
the eye. For example, U.S. Pat. No. 4,666,446 discloses an
intraocular lens comprising a first portion including a diverging
lens and a second portion including a converging lens. The
converging lens provides the eye with substantially the same
focusing ability of the natural lens prior to implantation of the
intraocular lens. Thus, the eye will have decreased visual acuity
due to the macular degeneration, but will also have unrestricted
peripheral vision. The diverging lens, on the other hand, when
combined with a converging lens positioned outside of the eye
(e.g., a spectacle lens), provides a magnified image with increased
visual acuity but a restricted visual field. Therefore, this type
of intraocular lens creates a teledioptic lens system, which
provides the patient with the choice of unmagnified but
peripherally unrestricted vision or magnified but peripherally
restricted vision.
[0006] U.S. Pat. No. 4,581,031 discloses an intraocular lens
including a convex portion and a prismatic portion. The combined
convex/prismatic lens directs rays of light away from the center of
the retina that has been damaged by macular degeneration, and
focuses those rays onto an undiseased area of the retina, thus
providing greater visual acuity.
[0007] As discussed above, U.S. Pat. Nos. 4,666,446 and 4,581,031
clearly disclose that it is known to use particular types of
intraocular lenses in place of the natural lens to reduce the
adverse affect of macular degeneration on vision.
[0008] U.S. Pat. Nos. 5,098,444, 5,366,502, 5,358,520, and
4,932,971, as well as world patent application WO 94/07435, the
entire contents of these documents being incorporated by reference
herein, each disclose that it is known to attach a supplemental
intraocular lens to an existing artificial intraocular lens to
correct for ongoing degradation of vision. That is, if the ability
of the eye to focus grows worse over time, instead of replacing the
entire intraocular lens with a new intraocular lens having a
different refractive power, a supplemental intraocular lens can be
attached to the existing intraocular lens. This technique is less
invasive and hence, less traumatic to the eye.
[0009] U.S. Pat. No. 6,197,057, the entire contents of which are
herein incorporated by reference, relates to a lens system that
combines a high plus lens with a plus and minus intraocular lens
(IOL), so that the lens system works in a manner similar to a
Galilean telescope. Generally, as shown in FIGS. 1 and 2 of the
'057 patent, the high plus lens is outside the eye (i.e., in
glasses or spectacles, or in a contact lens) and the plus and minus
lens is an IOL that replaces or works in conjunction with the
natural lens of the patient.
[0010] Additionally, if desired, the plus and minus lens can have a
high minus portion in the center of the eye, while the portions
surrounding the minus portion have no or substantially no
refractive power, that is, the surrounding portion can be flat or
substantially flat.
[0011] The Peyman '057 patent also discloses a supplemental
intraocular lens that can be attached to the natural lens or an
existing artificial lens to make the lens adaptable to function as
a teledioptic or diffractive prismatic lens of the type described
above.
[0012] Presbyopia, which is blurred vision of close up objects, for
example, objects positioned for reading, typically occurs due to
aging of the eye. A conventional method for correcting the
refractive error in a cornea is keratophakia, that is, implantation
of a lens inside the comea. Keratophakia uses an implant which is
placed into the cornea approximately equidistant from the exterior
and interior surfaces of the comea. The procedure is usually done
by first preparing a lens from corneal donor tissue or synthetic
material using a cryo-lathe. The lens is implanted by removing a
portion of the cornea with a device called a microkeratome, and the
tissue is sutured back into place over the lens. However, problems
can arise when microkeratomes are used for cutting the comea.
First, irregular keratectomies or perforations of the eye can
result. Second, the recovery of vision can be rather prolonged.
[0013] Another surgical technique exists that uses a femtosecond
laser to separate layers inside the stromal portion of the eye, at
least two-thirds of the distance from the top surface of the cornea
to the inside of the eye. An incision is made to access this area
and a solid inlay is inserted to help correct myopia in the eye. By
separating the layers in the bottom two-thirds of the stromal
portion, it is difficult to access the separated area to insert the
inlay and virtually impossible to change or modify the inlay
without another extensive surgical procedure. This procedure
requires making an incision which is parallel or substantially
parallel to the visual axis and is limited in the lateral direction
by a maximum size of 0.3 mm to encase a relatively rigid inlay that
forces the tissue in the lateral direction.
[0014] Additional surgical techniques exist that use ultraviolet
light and short wavelength lasers to modify the shape of the
cornea. For example, excimer lasers, such as those described in
U.S. Pat. No. 4,840,175 to Peyman, which is incorporated herein by
reference, emit pulsed ultraviolet radiation that can be used to
decompose or photoablate tissue in the live cornea so as to reshape
the comea.
[0015] Specifically, the Peyman '175 patent discloses the laser
surgical technique known as laser in situ keratomycosis (LASIK). In
this technique, a portion of the front of the live cornea can be
cut away in the form of a flap having a thickness of about 160
microns. This cut portion is removed from the live cornea to expose
an inner surface of the comea. A laser beam is then directed onto
the exposed inner surface to ablate a desired amount of the inner
surface up to 150-180 microns deep. The cut portion is reattached
over the ablated portion of the cornea and assumes a shape
conforming to that of the ablated portion. Additionally, in the
LASIK procedure, a femtosecond laser can be used to cut and
separate the flap.
[0016] Other conventional methods that have been employed
specifically to correct presbyopia have been unsuccessful. Some of
those methods include using an excimer laser to ablate the
peripheral part of the cornea, expanding the sclera behind the
limbus area of the cornea, implanting a plus lens inside the comeal
stroma, using a multifocal intraocular lens after removal of the
cataractous lens, and using bifocal glasses and bifocal contact
lenses.
[0017] However, because only certain amount of cornea can be
ablated without the remaining cornea becoming unstable or
experiencing outbulging (ectasia), this technique is not especially
effective in correcting very high myopia. That is, a typical cornea
is on average about 500 microns thick. The laser ablation technique
requires that at least about 250 microns of the corneal stroma
remain after the ablation is completed so that instability and
outbulging do not occur. Also, these conventional implants, while
correcting a refractive error of the patient, also distort the
normal vision of the patient.
[0018] Additional methods for correcting the refractive error in
the eye include inserting an implant in-between layers of the
cornea. Generally, this is achieved using several different
methods. The first method involves inserting a ring between layers
of the comea, as described in U.S. Pat. No. 5,405,384 to
Silvestrini, the entire contents of which is incorporated herein by
reference. Typically, a dissector is inserted in the cornea and
forms a channel therein. Once it is removed, a ring is then
inserted into the channel to alter the curvature of the cornea. In
the second method, a flap can be created similarly to the LASIK
procedure and a lens can be inserted under the flap, as described
in U.S. Pat. No. 6,102,946 to Nigam, the entire contents of which
is incorporated herein by reference. The third method involves
forming a pocket using an instrument, and inserting an implant into
the pocket, as described in U.S. Pat. No. 4,655,774 to Choyce, the
entire contents of which is incorporated herein by reference.
[0019] However, with the above described techniques, a knife or
other mechanical instrument is generally used to form the channel,
flap or pocket. Use of these instruments may result in damage or
imprecision in the cut or formation of the desired area in which
the implant is placed. Additionally, these conventional techniques
do not include determination and testing of an appropriate implant
for correcting a refractive error of a particular patient.
[0020] Also, prior methods for the treatment of presbyopia have
been unsuccessful. One prior method involved implantation of a disc
shaped inlay or lens over the central visual axis of the comea. The
disc inlay had a high index of refraction to correct presbyopia
and/or hyperopia. However, because the disc covered the center area
around the visual axis, the patient's farsighted vision was blurred
by the inlay. Another prior method involved a ring shaped inlay
implanted around the visual axis. The ring inlay had a lower index
of refraction or an index of refraction that is the same as the
cornea and therefore corrected myopic refractive errors instead of
hyperopic or presbyopic error.
[0021] Therefore, there exists a need for an IOL and improved
method of correcting refractive error, particularly presbyopia, in
the eye, that does not distort the normal vision of the eye, such
as far sighted vision. Moreover, there exists a need for selecting
the appropriate IOL for correcting the particular refractive error
of the patient.
SUMMARY
[0022] In one embodiment an intraocular lens is provided. The
intraocular lens, includes a lens having an opening therein and an
ocular system capable of being inserted into the opening after
implantation into an eye. The first lens is adapted to project a
first image onto the retina and the second lens is adapted to
project a second image onto the retina.
[0023] In another embodiment an intraocular lens is provided. The
intraocular lens includes a lens having a peripheral portion
substantially surrounding an opening, a slit extending from the
opening and into said peripheral portion and a telescopic system
configured to frictionally fit into said opening.
[0024] In another embodiment a method of altering vision of an eye
is provided. The method includes the steps of inserting a lens into
the eye, the lens having an opening therein and adapted to project
a first image on the retina, inserting an ocular system in the
opening, the ocular system adapted to project a second image on the
retina, and applying energy to said lens to alter the shape
thereof.
[0025] Additional features and advantages are described herein, and
will be apparent from, the following Detailed Description and the
figures.
BRIEF DESCRIPTION OF THE FIGURES
[0026] FIG. 1 illustrates an intraocular lens (IOL) according to an
embodiment of the present invention;
[0027] FIG. 2 illustrates an IOL according to another embodiment of
the present invention;
[0028] FIGS. 3 and 3A show front and cross-sectional views,
respectively, of a lens portion for an IOL such as that shown in
FIG. 1, that has diffractive optics to achieve a change in
refractive power;
[0029] FIG. 4 shows a further configuration of a lens portion for
the IOL of FIG. 1, wherein the lens portion is substantially
ring-shaped and has a first portion, and a second portion with an
edge that creates a gradual change in the refractive properties
thereof;
[0030] FIG. 5 shows a lens similar to the lens in FIG. 2, with an
edge that creates a gradual change in the refractive properties
thereof;
[0031] FIG. 6 shows the presbyopia lens portion of FIG. 2 relative
to the main optical axis of the eye, and having glare-free material
disposed thereon;
[0032] FIG. 7 shows the presbyopia lens portion of FIG. 6 taken
along lines 7-7 of FIG. 6, with glare-free material disposed on the
peripheral edges thereof;
[0033] FIG. 8 shows the presbyopia lens portion of FIG. 1 relative
to the main optical axis of the eye, and having glare-free material
disposed thereon;
[0034] FIG. 9 shows the IOL of FIG. 1 implanted in the anterior
chamber of the eye;
[0035] FIG. 10 shows the IOL of FIG. 1 implanted in the posterior
chamber of the eye;
[0036] FIG. 11 shows an IOL of the type shown in FIG. 1 coupled to
the iris;
[0037] FIG. 12 illustrates another embodiment of an IOL lens system
for correcting presbyopia, which includes a lens portion that is
movable with respect to the haptics;
[0038] FIG. 13 illustrates a further embodiment of an IOL lens
system for correcting presbyopia, which includes a sectional lens
portion that is movable with respect to the haptics;
[0039] FIG. 14 illustrates the IOL lens system shown in FIG. 13 in
which the lens portions have been moved to increase the opening in
the lens;
[0040] FIG. 15 illustrates the IOL lens system shown in FIG. 13 in
which the lens portions have been moved to decrease the opening in
the lens;
[0041] FIG. 16 illustrates variations to the haptics and lens of
the lens system shown in FIG. 13;
[0042] FIG. 17 illustrates an IOL according to another embodiment
of the present invention having a slit for ease of insertion of an
ocular system into an opening therein;
[0043] FIG. 18 illustrates the IOL of FIG. 17 with an ocular system
positioned within the opening therein;
[0044] FIG. 19 illustrates the IOL of FIG. 18 with substantially
all of the peripheral portion being exposed to energy thus changing
the refractive properties thereof;
[0045] FIG. 20 illustrates the IOL of FIG. 18 with on portion of
the peripheral portion increasing in thickness and another portion
of the peripheral portion decreasing in thickness; and
[0046] FIG. 21 illustrates the IOL of FIG. 18 inserted in an eye
and in combination with external spectacles.
DETAILED DESCRIPTION
[0047] As shown in FIGS. 1 and 2, a lens system 100 according to an
embodiment of the present invention includes an optical portion 102
for use in correcting presbyopia. In this example, the optical
portion 102 is preferably circular, substantially circular or
doughnut-shaped to act as a plus lens, but can be any shape
desired. For instance, as shown in FIG. 2, the optical portion
102-1 can be semi-circularly shaped or crescent shaped. The optical
portion 102 includes an opening 104 that can be centered or
substantially centered in the optical portion 102, or can be
located anywhere in the optical portion 102 as appropriate.
Similarly, the optical portion 102-1 can be shaped such that the
opening 104-1 is centered with respect to the optical portion 102-1
or such that the opening 104-1 is off-centered by a desired
distance.
[0048] The optical portion 102 (102-1), which can also be referred
to as a lens, is preferably made of synthetic material, organic
material, or a combination of both synthetic and organic material.
Additionally, the lens can be formed from any suitable material.
For example the lens can be formed from collagen, copolymer
collagen, polyethylene oxide, polypropylene, polyproledine or
hydrogel, or cross-linked organic material such as collagen,
hyaluronic acid, mucopolysacoharide, glycoprotein,
polymethylmethacrylate or silcone, to name a few, or a combination
thereof. Further details of types of lens materials and structures
are described in U.S. patent application of Gholam A. Peyman,
entitled "ADJUSTABLE INLAY WITH MULTIZONE POLYMERIZATION", Ser. No.
10/272,402, filed Oct. 17, 2002, the entire contents of which are
herein incorporated by reference.
[0049] It is noted that although this embodiment of the present
invention includes a plus lens for the correction of presbyopia,
the lens can be configured in any manner desired. For example, the
lens can be a minus lens for correcting vision that is adversely
affected by macular degeneration, or can have alternative shapes
such as touric and the like for correcting astigmatism, or can be
shaped and have suitable power and refractivity to correct for
hyperopia, myopia and the like.
[0050] As further shown in FIGS. 1 and 2, the lens systems 100
includes haptics 106 and 108 have foot plates 110 and 112,
respectively, for mounting the lens systems 100 in the eye 116. The
diameter of the hole 104 in the lens 102 is preferably between
about 0.5 mm to about 5 mm, but can have any suitable size. It is
also noted that it is not necessary to have a hole 104 or opening
in the lens 102. For example, the hole 104 or opening can be
replaced with a thin transparent portion that does not alter the
path of light therethrough. In other words, the thin transparent
portion can be nonrefractive or substantially nonrefractive. The
thickness of the lens 102 is preferably within the range of at or
about 0.025 mm to at or about 3 mm, and more preferably about 0.07
mm. However, the lens 102 can have any other suitable thickness.
The diameter of the lens 102 is preferably within the range of at
or about 0.5 mm to at or about 6 mm, but can be any suitable
diameter.
[0051] In addition, the lens 102 (lens 102-1) is preferably curved
(instead of flat) and has the center portion thicker than the
edges. However, if desired, the edges can be thicker than the
center. It is noted that the lens can have any shape that would
improve the vision in the eye of a particular patient. Furthermore,
as shown in FIGS. 3 and 3A, the lens 102 can be configured as a
diffractive lens 102-2, if desired. For example, the lens can have
grooves 102-21 at different diameters along the surface thereof.
These grooves, along with the multiple zones 102-22 separated by
the grooves, act as prisms in the diffractive technology discussed
above. Specifically, the multiple zones 102-22 can be recessed, or
bumps, and have different refractive powers, such as +3 diopters,
+6 diopters, or any other suitable power which can enable the lens
to correct for hyperopia, myopia, presbyopia, or astigmatism.
[0052] As shown in FIGS. 4 and 5, the edges of the lens portion can
be configured to effect a gradual change in the refractive power
thereof. For example, as shown in FIG. 4, the lens 102 can be
configured as lens 102-3 having a first portion 102-31 that can
have little or no refractive power, and a second portion 102-32
that has a varying thickness or shape so that its refractive power
gradually changes. As shown in FIG. 5, the semicircularly shaped
lens 102-1 shown in FIG. 2 can be configured as lens 102-4 having
first portions 102-41 that can have little or no refractive power,
and a second portion 102-42 that has a varying thickness or shape
so that its refractive power gradually changes. For a further
discussion of this type of configuration, see copending U.S.
application Ser. No. 10/356,730 entitled "SUBEPITHILIAL IMPLANT AND
METHOD OF TREATMENT OF PRESBYOPIAN AND OTHER REFRACTIVE ERRORS",
the entire contents of which are incorporated herein by
reference.
[0053] Furthermore, as shown in FIGS. 6-8, the edges of the lenses
102, 102-1 and all other lenses discussed above, as well as the
haptics 106 and 108, can be pigmented or painted with a suitable
light absorbing material 103 of a suitable color, such as black, to
prevent light reflection and glare. A more detailed description of
glare free IOLs is set forth in U.S. Pat. Nos. 6,277,146 and
6,280,471 both to Peyman et al., which are incorporated herein by
reference.
[0054] As shown in FIG. 9, the lens system 100 can be positioned
either in the anterior chamber 118 of the eye 116 in front of the
iris 120 and behind the cornea 122. Alternatively, as shown in FIG.
10, the lens system 100 can be positioned in the posterior chamber
124 of the eye 116 behind the iris 120 and in front of the natural
lens 124 or another artificial lens (not shown). Specifically, the
lens system 100 can be positioned such that the lens 102 (102-1) is
spaced from the front of the natural lens 124 (or artificial lens),
or can be positioned in contact with the front of the natural lens
124 (or artificial lens) as a piggyback lens. Also, the lens system
100 can be implanted in place of the natural lens 124 of the eye
116 as shown in FIG. 11. The lens is coupled to the interior
portion of the eye using haptics having a footplate or with any
type of haptics or in any manner desired. For a further discussion
of acceptable haptics, see U.S. Pat. Nos. 6,277,146 and 6,280,471
discussed above. As shown in FIGS. 3-6 and 8-11, the lens 102 (and
all the variations discussed above) is positioned with the radial
center of the lens 102 positioned to coincide with the main optical
axis of the eye 116. The positioning allows the center portion to
be used for far vision and the outer lens portion to be used for
near vision, such as reading. Since there is no refractive portion
in the center, there is no correction for far vision, while the
outer portion of the lens corrects for presbyopia or any other
vision problems desired.
[0055] Additionally, the lens shape and size can be altered (i.e.,
the lens can increase in size and/or volume or decrease in size
and/or volume when exposed to the appropriate energy or altered in
a desired manner) as described in U.S. patent application of Gholam
A. Peyman entitled "A METHOD AND APPARATUS FOR CORRECTING THE
REFRACTION OF AN INTRAOCULAR LENS AFTER IMPLANTATION IN THE EYE",
Ser. No. 10/197,885, filed Jul. 19, 2002, and U.S. Pat. No.
6,436,092 to Gholam A. Peyman ENTITLED "ADJUSTABLE UNIVERSAL
IMPLANT BLANK FOR MODIFYING CORNEAL CURVATURE AND METHODS OF
MODIFYING CORNEAL CURVATURE THEREWITH", the entire contents of both
of which are herein incorporated by reference.
[0056] Another embodiment of a lens system 200 for correcting
presbyopia is shown in FIGS. 12-15. Specifically, lens system 200
includes an optical portion 202 that can be preferably ring or
doughnut shaped and has an opening 204 therein. However, the lens
202 can have any desired shape and the features of lenses 102,
102-1 and their variations discussed above, and can be made of any
of the materials discussed above. The lens 202 can have no
refractive power or any degree of refractive depending on the
application in which it is used. The lens can also have diffractive
optical characteristics, and thus can be made very thin.
Furthermore, the lens 202 can be adjustable by light as described
in U.S. Pat. No. 6,436,092 to Peyman, the entire contents of which
are incorporated herein by reference. In addition, as discussed
above and is shown in FIGS. 9-11, the lens can be a piggy-back type
lens, or can be placed in the anterior chamber of the eye 116, or
in the posterior chamber of the eye 116 along with or in place of
the natural lens 124 or another artificial lens in the eye 116.
[0057] As will now be further described, the lens system 200 can be
made adjustable so that the hole 204 in the center of the lens 202
can be increased or decreased in size. Specifically, as shown in
FIG. 12, the lens 202 has a tube arrangement 206 and 208 that can
receive the ends of haptics 210 and 212, respectively. Similar to
haptics 106 and 108 discussed above, haptics 210 and 212 have foot
plates 214 and 216, respectively. As indicated, the ends of the
haptics 210 and 212 can be received in the tube arrangements 206
and 208 or the pulled out of the tube arrangements 206 or 208 to
increase the overall lens of the lens system 200. Furthermore, in
order to adjust the position of the opening 204 with regard to the
optical axis of the eye 116, the lens 202 can be moved in a upward
direction along arrow A so that the end of haptics 210 is received
into tube arrangement 206 while the end of haptics 212 is moved in
a direction out of tube arrangement 208. Likewise, the lens 202 can
be moved down in a direction along arrow B so that the end of
haptic 212 is further received into tube arrangement 208 while
allowing the end of haptic 210 to move in the direction out of tube
arrangement 206. This movement can be effected by inserting a small
surgical tool into an opening in the eye 116, and then using the
tool to move the haptics 210 and 212 as appropriate. Furthermore,
an adhesive can be used, if desired, to more permanently attach the
haptics 210 and 212 to the lens 202 once the lens has been
positioned as appropriate and the desired overall length of the
lens system 200 has been established.
[0058] As further shown in FIGS. 13-15 specifically, the lens 202
can be configured as lens 202-1 which includes a top portion 202-11
and a bottom portion 202-12. As indicated, the lens 202-1 (as well
as lens 202 shown in FIG. 12) can have a glare-free material 203 on
its edges, such as pigmented edge or any of the glare free
materials discussed above. Accordingly, by moving the top portion
202-11 and bottom portion 202-12 up or down with respect to the
haptics 210-1 and 212-1 as shown in FIG. 14, the portions 202-11
and 202-12 of the lens 202-1 can be moved away from each other and
therefore increase the size of opening 204-1. This movement can be
effected by inserting a small surgical tool into an opening in the
eye 116, and then using the tool to move the portions 202-11 and
202-12 as appropriate. Alternatively, as shown in FIG. 15, the
upper portion 202-11 and lower portion 202-12 can be moved closer
to each other to make the opening 204-1 smaller. As further
discussed above, the lens portions 202-11 and 202-12 can have no
refractive properties or any refractive properties as discussed
above.
[0059] In addition, as shown in FIG. 16, the haptics 210, 210-1,
212 and 212-1 and engaging portions of the lens 204 or 204-1 can
have any particular configuration. For example, the haptics 210,
210-1, 212 and 212-1 need not be tube-shaped. Rather, they can be
slotted, or the haptics and engaging portions of the lens 204 or
204-1 have a tongue and groove arrangements or any other type of
arrangement that allows for mating and movement between the lens
and the haptics. Furthermore, the anterior of the haptics 210,
210-1, 212 and 212-1 can have a serrated portion 213 which can mate
with a serrated portion 205 of the engaging portions of the optic
lens 204-1 so as to allow the mating portion to gradually mate with
the haptics as shown in FIG. 16.
[0060] It should be understood that various changes and
modifications to the presently preferred embodiments described
herein will be apparent to those skilled in the art. Such changes
and modifications can be made without departing from the spirit and
scope of the present subject matter and without diminishing its
intended advantages. It is therefore intended that such changes and
modifications be covered by the appended claims.
FIGS. 17-20
[0061] FIGS. 17-20 illustrate another embodiment of the present
invention wherein an IOL 300 includes a lens 302 with opening 304
that is adapted to receive an ocular system 306. Each lens
prefereably has a refractive index of about 1.48, but can have any
suitable refractive index.
[0062] Lens 302 preferably has a peripheral portion 308 and an
opening 304 that are generally defined by an inner wall or edge 303
and an outer wall or edge 305. This configuration allows lens 302,
when not in combination with ocular system 306, to have two
different zones for focusing light; however, it is noted that lens
302 can have any number of zones of portions capable of focusing,
including one or more than two. The peripheral portion can be any
suitable configuration desired and/or be adapted to change or
correct the refractive properties of the eye in any manner desired
or have no corrective properties, thus allowing light to merely
pass therethrough. Lens 302 is preferably formed from PHMA (HEMA),
but can be formed from any suitable material(s). Preferably, lens
302 is formed from flexible material so that it can be folded when
inserted into the eye to reduce any incisions made therein;
however, if desired the lenses described herein can be formed from
any material desired.
[0063] Peripheral portion 308 of lens 302 is a generally a
converging lens (i.e., a biconvex asphere) and preferably has a
diameter about 6.0 mm; but it can be any suitable type of lens or
any number of lenses and have any suitable diameter.
[0064] Opening 304 preferably has a diameter of about 1.0 mm to
about 1.5 mm, but can have any suitable diameter. Additionally, it
is noted that the opening can be a substantially non-refractive
portion, such that light passing therethrough is unaltered.
[0065] Lens 302 can replace the natural and/or existing artificial
lens or it can be used in conjunction with the natural and/or
artificial lens(es) (i.e., a piggyback lens). For example, lens 302
can attach to the posterior surface, the anterior surface or any
other suitable portion of an existing natural lens, an existing
artificial lens or lens that is being implanted at about the same
time. Lens 302 can be positioned in any suitable portion of the
eye, including but not limited to the anterior and posterior
chambers of the eye.
[0066] Lens 302 preferably has an a slit 309 that extends from the
inner edge 303 radially outwardly toward the outer edge 305 and is
preferably about 0.1 mm in length; however, it is noted that the
slit can be positioned in any suitable position on the lens 302,
extend in any suitable direction and be any suitable length. For
example, the slit can extend from inner edge 303 to outer edge 305.
Slit 309 facilitates insertion of ocular system 306 into the
opening. Slit 309 facilitates insertion of ocular system 306 into
opening 304. It is noted that lens 302 does not necessarily need a
slit therein and slit 309 is merely to assist in insertion of
system 306. Preferably, the slit is not visible to the patient
after implantation. If desired after insertion of ocular system 306
or if an ocular system is not implanted in the eye, the slit can be
sealed or closed in any suitable manner.
[0067] Ocular system 306 preferably includes a first lens 310 and a
second lens 312; however it is noted that ocular system 306 can
have any suitable number of lenses, including one lens or more than
two lenses. Lens 310 is prefereably a diverging lens with a high
negative refractive index (i.e. a biconcave lens having a power of
about -790 diopters) and has a diameter of about 1.0 mm to about
1.5 mm, but can have any suitable diameter and/or power or any
number or combination of lenses. However, it is noted that lens 310
can be any suitable configuration desired and/or be adapted to
change or correct the refractive properties of the eye in any
manner desired or have no corrective properties, thus allowing
light to merely pass therethrough. Lens 310 is preferably formed
from PHMA (HEMA), but can be formed from any suitable
material(s).
[0068] Lens 312 is prefereably a preferably a converging lens
(i.e., a biconvex asphere having a power of about 250 diopters) and
has a diameter of about 1.0 mm to about 1.5 mm, but can have any
suitable diameter and/or power. However, it is noted that lens 312
can be any suitable configuration desired and/or be adapted to
change or correct the refractive properties of the eye in any
manner desired or be any number or combination of lenses or have no
corrective properties, thus allowing light to merely pass
therethrough. Lens 312 is preferably formed from PHMA (HEMA), but
can be formed from any suitable material(s).
[0069] Lens 310 and 312 are preferably coupled together using a
sleeve 314 or any other device, such as a strut or multiple struts.
Prefereably, sleeve 314 or the struts allow aqueous fluid to pass
between lens 310 and lens 312 and fill the space therebetween.
However, any desired substance (e.g., gas, liquid or solid) or a
vacuum can fill the space between lens 310 and 312. Prefereably,
sleeve 314 and/or the struts connecting lens 310 and 312 are formed
from a flexible material, so that the ocular system can be folded
and more easily be inserted into the eye, but they can be formed of
any suitable material. It is noted that lenses 302, 310 and 312 do
not each need to be coupled together as described herein and any
one of each lens can be coupled to any other lens or coupled to no
lenses.
[0070] Ocular system 306 is preferably inserted into opening 204
before, after or during the surgical procedure. Additionally,
ocular system 306 can be inserted into opening 304 before or after
lens 302 has been inserted therein. Once inserted into the opening,
ocular system 306 preferably is held in a static position by
friction, but can be held in any suitable manner, for example (but
not limited to), adhesives. Furthermore, ocular system 306 can be
removed and replaced with any other suitable device or similar
system with different refractive powers and/or capabilities at
anytime before after or during surgery. For example, as the patient
ages, the patient may require an optical system 306 with different
refractive properties.
[0071] Prefereably, portion 308 has about the same refractive
properties as a normal or natural lens and operates by itself or in
conjunction with the natural lens to focus the peripheral light
passing therethrough onto the retina to allow a patient to view far
objects; however, it is noted that portion 308 can operate in any
suitable manner, including focusing on close objects.
[0072] While focusing on far objects, preferably the image produced
by lenses 310 and 312 is diverged and does not produce a suitable
image on the retina. However, it is noted that if desired, the
image produced by lenses 310 and 312 and the image or images
produced by lens 308 can by projected onto the retina at
substantially the same time to form a substantially continuous
image or any other suitable combination of images.
[0073] Similarly, when focusing on near objects through lenses 310
and 312, the imaged produced by lens 308 is converged such that the
image is not suitably projected onto the retina, and the image
produced by lenses 310 and 312 is an enlarged or magnified image
that is projected onto the retina. However, as described above, any
suitable combination of images can be produced.
[0074] As shown in FIG. 21, lens 340 is preferably used in
conjunction with lens system 300; however it is noted that lens
system 300 can operate without an external lens if desired. Lens
340 can be any suitable external lens, such as spectacles, glasses,
contact lenses or any other suitable lens that is easily positioned
in front of or proximal to the eye. Preferably lens 340 is a
converging lens with a power of about 20 diopters, but lens 340 can
have any suitable power or no power. Additionally, lens 340 can be
partially or fully implanted into the cornea or other portion of
the eye is desired. For example, intrastromal corneal inlays and
subepithelial corneal onlays and other suitable lenses are suitable
for use in conjunction with lenses 302, 310 and 312.
[0075] Lens 340 is preferably a plus lens or converging lens that
is configured to facilitate focusing of light through lens 310 and
lens 312. In other words, when lens 340 is positioned adjacent or
in front of the eye, light is focused through lens 310 and lens
312, thus forming an image on the retina that is magnified about
3.5.times.; however, it is noted that any suitable combination of
lenses can be used to great any magnification desired. When lens
340 is removed, light passes through the cornea and is focused on
the retina by peripheral portion 308, as described above.
[0076] In another embodiment, lens 310 and lens 312 can be
polarized to permit light oriented in a first direction to pass
therethrough and portion 308 can be polarized to permit light
oriented in a second to pass therethrough. Prefereably, the
polarized first direction is 90.degree. offset from the polarized
second direction.
[0077] Additionally, lens 340 can have a first portion 342 and a
second portion 344 that are similarly polarized. That is, for
example, second portion 344 can be polarized to permit light having
substantially the same orientation as lens 310 and lens 312 and
first portion 342 can be polarized to permit light having
substantially the same orientation as portion 308. Therefore, when
the patient views an object through the first portion 342 the
object is projected onto the retina through portion 308 and
substantially no light passes through lens 310 and lens 312.
Conversely, when an object is viewed through second portion 344 the
object is projected onto the retina through lens 310 and lens 312
and substantially no light passes through portion 308. It is noted
that is not necessary for lens 340 to merely have two portions.
Lens 340 can have any number of portions desired, including one and
more than two. For example, if lens 340 has only one portion, lens
310 and lens 312 can be polarized to substantially match the
polarization of lens 340. In this instance, when the lens is
adjacent the eye the light would be polarized and pass through lens
310 and lens 312, and when the lens 340 is removed or not adjacent
the eye the light would pass through portion 308. Portion 308 can
be the polarized portion (i.e., lens 310 and lens 312 would not be
polarized) in this example, if desired.
[0078] Furthermore, lens 302 preferably has haptics 311 extending
therefrom to couple the lens system 300 in the eye. Haptics are
merely exemplary and lens system 300 can be positioned in the eye
in any suitable manner.
[0079] Preferably, lens 310 and lens 312 are coupled together prior
to insertion into the eye and/or prior to examination a patient. By
fixing these lenses together, it is possible to determine the
optimal distance to produce a telescopic effect. Additionally, lens
302 can be coupled substantially at the same time to accurately fix
the optimal distance. However, it is noted that the lenses 302, 310
and 312 can be coupled together at anytime before or after
examination of the patient.
[0080] It should be understood that various changes and
modifications to the presently preferred embodiments described
herein will be apparent to those skilled in the art. Such changes
and modifications can be made without departing from the spirit and
scope of the present invention and without diminishing its intended
advantages. It is therefore intended that such changes and
modifications be covered by the appended claims.
* * * * *