WO2015134784A1 - Optique de fonctionnement multi-mode pour la correction de la presbytie - Google Patents

Optique de fonctionnement multi-mode pour la correction de la presbytie Download PDF

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Publication number
WO2015134784A1
WO2015134784A1 PCT/US2015/019026 US2015019026W WO2015134784A1 WO 2015134784 A1 WO2015134784 A1 WO 2015134784A1 US 2015019026 W US2015019026 W US 2015019026W WO 2015134784 A1 WO2015134784 A1 WO 2015134784A1
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WIPO (PCT)
Prior art keywords
blocking
channel
holding chamber
lai
chamber
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Ceased
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PCT/US2015/019026
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English (en)
Inventor
Valdemar Portney
Nathaniel G. PORTNEY
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Individual
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Individual
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Publication date
Priority claimed from US14/637,407 external-priority patent/US9510939B2/en
Application filed by Individual filed Critical Individual
Publication of WO2015134784A1 publication Critical patent/WO2015134784A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1601—Lens body having features to facilitate aqueous fluid flow across the intraocular lens, e.g. for pressure equalization or nutrient delivery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses or corneal implants; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A61F2/1624—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside
    • A61F2/1635—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside for changing shape

Definitions

  • the present invention relates generally to a fluidic lens that changes its operating mode in terms of imaging at its focus portion upon remotely affecting a surface shape of the fluidic lens. More particularly, the present invention relates to a blocking mechanism that maintains shape of a fluidic lens constant in order to maintain the lens in specific mode of operation. The blocking mechanism is remotely unblocked by a laser beam action to change the fluidic lens to a different mode of operation with different shape of a fluidic lens surface.
  • U.S. Patent Application Serial Number 14/039,322 introduced a remote conversion of the switchable implant from multifocal to monofocal mode of operation without a need for an invasive surgery for the lens exchange.
  • a blocking mechanism applicable to any fluidic lens including a switchable implant to allow a change in mode of operation, for instance between multifocal and monofocal mode of operations or between monofocal and accommodating mode of operations of different focus positions due to optical power change.
  • the U.S. Patent Application Serial Number 14/039,322 is to be incorporated in its entirety into this application with this reference.
  • An ophthalmic implant in the present invention is defined as a fluidic lens suitable for placement inside the eye such as aphakic and phakic intraocular lenses or implants placed in posterior or anterior eye chamber and also included are artificial corneas and corneal implants or inlay.
  • the fluidic lens per the present invention consists of two fluid chambers, one, so called transparent chamber of the implant, is the chamber contributing to image forming performance of the fluidic lens and another, so called holding chamber of the implant, is for a fluid balance for fluid communication with the transparent chamber.
  • the fluid communication between transparent and holding chambers is severed in one mode of operation of the fluidic lens and opened in another mode of operation.
  • the ophthalmic application for presbyopia correction by refractive-diffractive switchable (RDS) intraocular implant is disclosed in U.S. Patent Application Publication Number 2014/0085726.
  • the present invention describes optic for presbyopia correction that includes multi-mode operation that a surgeon can remotely switch at certain conditions.
  • multi-mode operation that a surgeon can remotely switch at certain conditions.
  • the remote switching from multifocal to monofocal mode of operation occurs if the patient can't tolerate multifocal image quality, i.e. too low image contrast or experiencing significant photic phenomena such as halos or glare.
  • the remote switching from monofocal to accommodating mode of operation occurs in the condition of stability with post-operative healing as well as lens position, shape or other characteristics that had been established as necessary for effective
  • Multi-mode optic is a fluidic lens of any configuration that includes two fluid chambers (transparent and holding chambers) with blocking mechanism between them that severs fluid communication between the fluid chambers in one mode of operation and allows fluid communication between the fluid chambers with remote unblocking the blocking mechanism in another mode of operation.
  • the lens also can be a gas lens.
  • the present invention discloses a configuration of the blocking mechanism that prevents fluid communication between the fluid chambers and an unblocking procedure for unblocking to then allow fluid communication between the fluid chambers.
  • RDS lens includes optical substrate with diffraction (or refractive) surface called guiding surface, elastic film in contact with the guiding surface, optical fluid called matching fluid that fills a space between the film and guiding surface and called transparent chamber and a channel to transfer the matching fluid in and out of the transparent chamber to a holding chamber.
  • An operation of a RDS optic relies on the ability of matching fluid to optically mask the guiding surface resulting in light interaction with a matching fluid surface shaped by the elastic film instead of the guiding surface itself.
  • a shape of the matching fluid surface is controlled by elastic film shape. By changing a shape of the elastic film one can control a shape of the matching fluid surface thus controlling an image position or quality of the
  • a multi-mode operating lens incorporates (1 ) a fluidic lens with at least two fluid chambers, transparent chamber effecting imaging character of the lens and holding chamber for fluid communication with transparent chamber in order to change transparent chamber shape and, a result, fluidic lens imaging characteristic, (2) blocking mechanism to sever fluid communication between the transparent and holding chambers for fixing fluidic lens shape for one imagine performance condition called mode of operation and (3) a procedure of remote unblocking the blocking mechanism by a laser beam to open fluid communication between transparent and holding chambers in order to change the fluidic lens to a different imaging performance condition, i.e. a different mode of operation.
  • Blocking mechanism includes: (1 ) a blocking channel separating transparent and holding chambers of the fluidic lens, (2) blocking element made of a flowable material, i.e. a material that melts under a laser beam radiation for fluid like flow. The blocking element is placed into the blocking channel to sever a fluid communication between the transparent and holding chambers, (3) cavity within the blocking channel which is filled by flowable blocking element material melted under the laser beam radiation in unblocking procedure. The expansion of the blocking element material within the cavity pulls out the portion of the blocking element that severs fluid communication between transparent and holding chambers thus opening fluid communication between the chambers.
  • a blocking channel separating transparent and holding chambers of the fluidic lens
  • blocking element made of a flowable material, i.e. a material that melts under a laser beam radiation for fluid like flow.
  • the blocking element is placed into the blocking channel to sever a fluid communication between the transparent and holding chambers
  • cavity within the blocking channel which is filled by flowable blocking element material melted under the laser beam radiation in unblock
  • the fluid in holding chamber can be transferred to transparent chamber of the fluidic lens of certain power with unblocking the blocking mechanism in order to increase the curvature of the lens membrane thus increasing the power of the lens in case of convex surface. This occurs if the pressure in the holding chamber is higher the pressure in the transparent chamber.
  • the curvature at the transparent chamber can be reduced upon unblocking the blocking mechanism if the pressure in the chamber is higher the pressure in the holding chamber.
  • the blocking mechanism allows for a conversion of a RDS lens into multi-mode RDS lens per present invention for its mode switching from multifocal to monofocal mode of operation in case of multifocal RDS implant in order to manage its safety issue or from monofocal to accommodating mode of operation in case of accommodating RDS lens in order to manage its efficacy issue.
  • a multifocal RDS lens includes multifocal guiding surface at its optical substrate where "multifocal” means a formation of several foci by the lens.
  • Multifocal guiding surface might be diffractive type that forms images by constrictive
  • the chamber formed between the guiding surface and the film is called transparent chamber.
  • a channel connects transparent chamber with a holding chamber which can be within the lens optic or outside lens optic.
  • the holding chamber holds a balance of fluid if it is to move from the transparent chamber or into the transparent chamber with opening fluid communication between them.
  • the elastic film is taking resting state to form a single focus (monofocal) refractive surface by its external surface resulting in the multifocal RDS lens to become a monofocal refractive lens.
  • the film being a deformable element is converted into active state by largely taking a shape of the multifocal guiding surface and the RDS lens to manifest equivalement multifocal imaging performance.
  • a multifocal multi-mode RDS lens is implanted in the eye in its multifocal mode of operation, i.e. the elastic film is in active state of largely taking the multifocal shape of the guiding surface. No image quality adjustment is required if a patient accepts the resulted multifocal vision provided by the lens.
  • a multi-mode operating characteristic of the multifocal RDS lens comes into play only if a patient is substantially unhappy with the vision outcome. If required, the fluid communication between transparent and holding chambers is remotely opened for the fluid flow from holding to transparent chamber and converting the elastic film from active to resting state resulting in monofocal mode of operation of the lens.
  • Monofocal mode of operation reduces or eliminates a light flow to near focus thus improving far vision quality by this corresponding virtual lens exchange without engaging in present days highly invasive procedure of opening the eye and the physically exchanging the multifocal lens for a monofocal lens.
  • the process is called mode switching.
  • "near" vision in the present invention is used in a general term corresponding to a light not allocated to far vision thus may including also an intermediate focus in addition to the actual near focus where "intermediate” usually references to viewing distance between 4 meter and 0.5 meter form he eye, and “near” usually references to viewing distance of 0.5 meter and closer thus leaving far vision to distance of 4 meter and beyond.
  • An accommodating multi-mode RDS lens includes monofocal diffractive guiding surface usually for near focus. Similar to multifocal RDS lens above, matching fluid covers the guiding surface and matching fluid shape is maintained by the elastic thin film.
  • the chamber formed between the guiding surface and the film i.e. transparent chamber, is connected with a holding chamber which can be within the lens optic or outside lens optic.
  • the holding chamber holds a balance of fluid if it is to move from or to transparent chamber for switching between far and near foci when in accommodating mode of operation.
  • the elastic film is taking resting state to form a single focus (monofocal) refractive surface by the external surface of the elastic film resulting in monofocal refractive lens usually for far vision.
  • the film being a deformable element is converted into active state by largely taking a shape of the guiding monofocal diffractive surface and the lens manifests equivalement monofocal performance for near focus.
  • Guiding diffractive surface may include intermediate focus in addition to near focus.
  • lens with film in resting state may manifest power for near and in active state, a power for far with or without intermediate focus added either in resting or actives state but for practical reason the resting state of the film is allocated to far focus by the lens.
  • accommodating mode of operation can be verified before the lens is converted into accommodating mode of operation, i.e. into a dynamic lens with variable optical power between far and near foci that switches in between under the action of ciliary muscles relaxation and contraction.
  • a communication between transparent and holding chambers are remotely open to enable fluid communication between transparent and holding chambers.
  • Accommodating lens is designed to change between far and near foci under the actions of ciliary muscles that forces the fluid transfer between transparent and holding chambers, i.e. between resting state of the elastic film for the lens far power and active state of the elastic film that largely follows the shape of the guiding surface for the lens near focus. Both, blocking mechanism in multifocal and accommodating multi-mode RDS lenses are similar.
  • a blocking element of the blocking mechanism is made, for instance, a polypropylene fiber.
  • the fiber can be made of any material that can be melted by an appropriate laser beam and, as a result, unblocking the fluids communication between the transparent and holding chambers for the fluid to flow between them.
  • the blocking element is placed in so called blocking channel to block fluid communication between transparent and holding chambers.
  • the blocking channel includes a cavity where melted by the laser beam portion of the blocking element material flow into during unblocking procedure thus pulling the blocking element along the blocking channel towards the cavity and opening the flow communication between transparent and holding chambers.
  • the unblocking procedure involves blocking element material melting by, for instance, Nd:YAG laser beam or a different laser.
  • the wavelength of the laser beam is such that it does not melt the optic material itself but only the blocking fiber material due to a difference in radiation absorptions.
  • Polypropylene fiber for instance, is readily available and commonly made in blue color thus easily absorbing near infrared laser beam emitted by Nd:YAG laser which is also readily available in ophthalmic practices for posterior capsulotomy procedures.
  • the communication between the chambers forces the fluid to flow from the transparent to this additional holding chamber.
  • it may be multiple blocking mechanisms each with corresponding holding chamber for multiple alteration between the modes of operation, monofocal and multifocal, optical powers.
  • Blocking mechanism is included in accommodating multi-mode operating optic for its initial implantation in the monofocal mode of operation usually for far vision. It may take few months for the eye to heal and during this time the lens performs as a conventional monofocal lens.
  • Optical and ultrasound microscopy allows testing for optic and supporting member positions and configurations to determine if they are in desirable states for effective interaction with the ciliary muscle or any other ocular element responsible for accommodation effect, crystalline lens capsule, for instance.
  • a switchable intraocular lens assembly is configured for implantation in an eye.
  • An optic body defines a body thickness between a first surface opposite a second surface.
  • the optic body includes: at least two supporting members extending from a periphery of the optic body where the at least two supporting members are configured for implant fixation inside the eye; a guiding lens formed in the front surface; at least one fluid transport trench formed in the optic body along a portion of the guiding lens and front surface; a first through hole disposed through the body thickness between the first and second surfaces, wherein the first through hole is disposed outside a guiding lens periphery, and wherein the first through hole is in fluidic communication with the at least one fluid transport trench; a holding chamber formed in the body thickness along the first surface and located outside the guiding lens periphery; a second through hole disposed through the body thickness between the first and second surfaces, the second through hole in fluidic communication with the holding chamber; a blocking channel formed in the body thickness of the optic body, the blocking channel in fluidic communication with the at least one fluid transport trench and the holding chamber, the blocking channel having a blocking channel opening in the optic body at a proximal end of the blocking channel, where the holding chamber
  • An elastic film is disposed over the guiding lens, the first through hole, the second through hole and the holding chamber, wherein the elastic film is sealed at or near the guiding lens periphery along the first surface forming a transparent chamber between the guiding lens and the elastic film, and wherein the elastic film is sealed at a periphery of the holding chamber along the first surface forming an enclosed cavity of the holding chamber.
  • a laser flowable blocking element has an enlarged head connected to an extension portion, where a length of the extension portion is more than a distance along the blocking channel from the blocking channel opening to the connection of the at least one fluid transport trench, wherein the extension portion of the laser flowable blocking element is disposed inside the blocking channel.
  • a first seal seals the first through hole along the second surface.
  • a second seal seals the second through hole along the second surface.
  • An optical fluid disposed within the holding chamber.
  • FIGURE 1 shows a front view of multifocal two-mode operating RDS lens with exposed guiding surface prior to elastic film bonding and also prior to blocking element installation for blocking mechanism assembly.
  • the RDS lens is used as the way of example to explain the blocking mechanism as well as the example of multi-mode operating RDS lens configuration;
  • FIGURE 2 demonstrates a side view of not fully assembled RDS lens of the Figure 1 ;
  • FIGURE 3 demonstrates a front view of the lens on Figure 1 with the elastic film bonded over the guiding surface;
  • FIGURE 4 illustrates a front view of the lens of the Figure 3 with the blocking element placed into the blocking channel in its initial position with fluid communication between the transparent and holding chambers is still maintained;
  • FIGURE 5 illustrates a front view of the lens of the Figure 4 with the blocking element placed into the blocking channel in its final position to block a fluid communication between the transparent and holding chambers. It shows the final multifocal multi-mode operating RDS lens assembly;
  • FIGURE 6 illustrates a close-up taken from section 6-6 of Figure 5 of the blocking mechanism in assembled form where the blocking element blocks a fluid communication between transparent and holding chambers;
  • FIGURE 7 is similar to Figure 6 but now illustrates an unblocked blocking mechanism as a result of unblocking procedure by the laser beam irradiating the blocking element portion at the location of the blocking hole serving as a cavity of the blocking channel, where the corresponding blocking element portion fills the cavity as it takes a flowable form due to irradiation by the laser beam, and as the result of filling the cavity of the blocking hole, the length of the blocking element is reduced beyond the portion of the blocking chamber located between transparent and holding chambers thus opening the fluid communication between them;
  • FIGURE 8 demonstrates a side view of two-piece multifocal multi-mode operating RDS lens with assembled blocking mechanism in multifocal mode of operation;
  • FIGURE 9 demonstrates a front view of accommodating multi-mode operating RDS lens per present invention where the principle of accommodation of the intra-ocular lens for aphakia described in the U.S. Patent Application
  • FIGURE 10 demonstrates a side view of the accommodating multi- mode operating RDS lens for aphakia of the Figure 9 in monofocal mode of operation which is equivalement to the configuration in the accommodating mode of operation with the elastic film being in resting state for far focus, i.e. optical fluid fills the transparent chamber with the external surface of the elastic film being in the resting state for far focus; and
  • FIGURE 1 1 demonstrates a side view of the accommodating multi- mode operating RDS lens for aphakia of the Figure 9 in the accommodating mode of operation with the elastic film being in active state for near focus, i.e. fluid is pulled out from the transparent chamber for the film largely to take a shape of the diffractive guiding surface for near focus.
  • FIG. 1 demonstrates blocking mechanism according to the present invention for switching between modes of operation on the example of refractive- diffractive switchable intra-ocular implant 100 (RDS IOL) consisting of the optic body 1 10 and two supporting members (haptics) 120 and 1 20' for the implant fixation inside the eye.
  • the implant 1 00 consists of single lens optic body but an optic body may consists of several lenses.
  • Diffractive surface 130 is multifocal diffractive surface in a switchable multifocal implant.
  • the diffractive surface 1 30 is guiding surface of RDS implant though a guiding surface might be a refractive multifocal in other embodiments.
  • the reference to guiding surface is used to describe both types of diffractive surface and refractive surface.
  • Trench channel 140 passes across the diffractive surface to transport fluid to and from the space adjacent to the guiding surface 130. This type of channel is the easiest channel to manufacture though a channel may also pass within the optic body 1 10 itself and the reference to channel is used throughout this application to describe both channel types.
  • the channel 140 connects the space adjacent to diffractive surface for forming transparent chamber with the holding chamber 160.
  • a holding chamber can be any chamber to maintain a balance of fluid and located largely outside the optical zone of an implant where optical zone is an image forming portion of an implant optical body.
  • the holding chamber 1 60 includes holding through hole 170 to allow fluid to fill the space adjacent to the guiding surface 130 and well as the holding chamber 170.
  • Blocking mechanism per the present invention includes blocking channel 180 connecting the holding chamber 160 and channel 140 by its section.
  • the blocking channel 180 also includes a cavity, in this case in a form of blocking through hole 190.
  • FIG. 2 demonstrates a side view of the implant 100 shown on the Figure 1 . It shows diffractive surface 130 on front surface 200 of the optical body 1 10.
  • a diffractive surface is characterized by grooves periodicity and height with the grooves placed over virtual base surface which can be flat, curved and aspheric.
  • a guiding surface can be also placed on back surface 210.
  • the channel 140 passes across the diffractive surface and intersects the blocking channel 180 connected with the holding chamber 160 which also includes holding through hole 170.
  • the Figure 2 also shows a blocking though hole 190 that crosses the blocking channel 180 with an opening at least at one of anterior and posterior surfaces. In general a cavity at the blocking channel may be inside the optic body. It is also shown blocking channel opening 220 of the blocking channel 1 80 at the peripheral edge of the optic body 1 10 though the opening might be at any part of the optic body periphery including anterior or posterior surface.
  • FIG. 3 shows front view of the implant 100 of the Figure 1 with addition of elastic film 240 placed over the guiding surface 130 together forming implant 230.
  • the elastic film 240 is bonded to surface outside the guiding surface 130 to be over the connecting through hole 150 and holding chamber 1 60 to form enclosed cavity of the holding chamber and also over the guiding surface 130, to form so called transparent chamber.
  • the film 240 is sized to leave the blocking though hole 1 90 connected with the blocking channel 180 uncovered by the film.
  • FIG. 4 illustrates front view of the implant 230 of Figure 3 with the introduction of a blocking element 260 into the blocking channel 180 forming together the implant 250.
  • the blocking element 260 can be made of polypropylene material which was commonly used as a fixation member in three-piece intra-ocular lenses or any other biologically compatible material that can melt into flowable state under a laser radiation.
  • the blocking element 260 is inserted into the blocking channel 180 reaching just before the intersection between the channel 140 and blocking channel 180 thus leaving the channel 140 communication with the holding chamber 1 60 opened but blocking a communication between the blocking through hole 1 90 at the blocking channel 180 and the channel 140.
  • the blocking element 260 is another member of the blocking mechanism.
  • the blocking element 260 is shown as extending out (extension portion) of the blocking chamber 180 by the certain length and having an expansion at its end called blocking element head (cap) 270.
  • a diameter of the blocking element head 270 is larger the internal diameter of the blocking channel 180.
  • Optical fluid is injected into one of the connecting through hole 150 and holding through hole 170 enough to fill the space between the elastic film 240 and diffractive surface 130 through the channel 140 to form transparent chamber as well as filling the holding chamber 160.
  • the film in the resting state can be radially stretched as the resting state characterized by the refractive optical property of the exterior surface of the elastic film as described in the U.S. Patent Application Serial Number 14/039,322 with no elastic film conformance to the guiding surface shape.
  • the openings of the connecting through hole 150 and holding through hole 170 at the posterior surface are closed with a glue or cork (a seal) made of a biocompatible material to seal the matching fluid inside the transparent and holding chambers.
  • FIG. 5 demonstrates the final step of multi-mode operating multifocal RDS implant assembly according to the present invention.
  • a special stamp sized to the diameter of the guiding surface and having the surface shape that faces towards the film 240 to be the mirror shape of the guiding surface shape is pressed against the elastic film thus forcing the elastic film 240' to take the shape of the guiding multifocal diffractive surface 130 and squeezing out the matching fluid from the transparent chamber into the holding chamber 160 via the channel 140 and the section of the blocking channel 180 between the channel 140 and holding chamber 160.
  • the portion of the elastic film over the holding chamber 1 60 bulges as the additional matching fluid is pushed into the holding chamber cavity thus putting the corresponding portion of the elastic film over the holding chamber under tension.
  • the communication between the channel 140 of the transparent chamber and holding chamber 160 is blocked by pushing the blocking element 260 into the blocking chamber 180 further in until the blocking element head 270 comes in contact with the implant surface.
  • the length of the blocking element 260 is such that it fills the section blocking channel 180 between the channel 140 and holding chamber 160 thus severing a fluid communication between the transparent chamber over the guiding surface 1 30 and holding chamber 1 60.
  • the stamp then is removed from pressing the elastic film in. The result is implant 280 as the final multifocal multi-mode operating RDS lens.
  • the outcome of the process is that the elastic film is maintained in the active state that confirms to the shape of the guiding diffractive surface 1 30 thus forming the multifocal multi-mode operating RDS lens in multifocal mode of operation with the optical multifocal performance defined by the guiding multifocal diffractive surface.
  • FIG. 6 demonstrates a close-up of the blocking mechanism as a side view of the portion of the implant shown on Figure 5.
  • the blocking mechanism consists of blocking channel 180 with the cavity in a form of blocking through hole 190 crossing the blocking channel 180 with the section that connects the channel 140 and holding chamber 160.
  • the blocking mechanism also includes blocking element 260 inserted into the blocking channel 180 to sever optical fluid
  • the blocking element 260 includes blocking element head 270 to secure its position inside the blocking channel 180.
  • FIG. 7 demonstrates blocking mechanism in unblocked state together with unblocking process of mode switching from one mode operation to another, in the case of the implant on Figure 5 from multifocal to monofocal mode of operation.
  • the laser beam 290 is focused on the blocking element 260 within the blocking through hole 190.
  • the blocking element material absorb laser radiation and melts within the blocking through hole 190 into flowable portion 300 that fills the space of the blocking through hole 1 90.
  • the material volume increase at the flowable portion 300 is at the expanse of the blocking element portion internal to the location of the blocking through hole because wider blocking element head 270 does not allow the material feeding into flowable portion 300 at the exterior side of the blocking element, i.e.
  • a blocking through hole can be a cavity (aperture/hole/void) within the blocking channel characterized by an expanded space over the blocking channel for the blocking element to expand into with the blocking element portion within the cavity becoming a flowable material under the laser radiation.
  • the described above blocking mechanism and unblocking process allow a conversion of any single mode fluidic implant into multi-mode fluidic implant by introducing a holding chamber for managing a balance of fluid at the fluidic lens and placing the blocking channel for communicating the fluidic lens fluid of, so called transparent chamber, with the holding chamber.
  • a blocking element placed into the blocking channel is to sever the fluid communication between the transparent chamber and holding chamber to freeze the lens in one mode operation and then unblocking fluid communication between transparent and holding chambers with the help of a laser beam to convert the fluidic lens in a different mode of operation now allowing fluid either flow to or from the holding chamber depending upon where the pressure is higher.
  • FIG 8 demonstrates a side view of two-piece multifocal multi-mode RDS lens 320 according to the present invention.
  • the implant 320 consists of two parts - front optic body 330 and back optic body 340 with supporting members similar to a single piece lens such as 100 shown on the Figure 2. The arrangement might be in reverse with haptic attached to front optic body or blocking mechanism together with an elastic film being at the front optic body.
  • the back optic body 340 includes posterior surface 350 and front diffractive surface 360 within optical zone with largely flat base surface and the elastic film 370 adjacent to the diffractive surface ridges.
  • the front optic body 330 includes anterior surface 380 and largely flat back surface 390.
  • the front optic body 330 and back optic body 340 are connected to each other by connecting element 400, however it could be multiple connecting elements.
  • the front optic body 330 and back optic body 340 are separated by the space, so called internal space 410.
  • the internal space 410 allows the external to the diffractive surface 360 surface of the elastic film 370 to be in contact with the aqueous when the implant is placed in eye.
  • the back optic body 340 can be made of a constant shape and far power of the implant 320 can be controlled by variable anterior surface 380 of the front optic body 330 to simplify the fabrication purpose.
  • the blocking mechanism 420 similar to one described above in Figures 5 and 6 is located at the periphery of back optic body 340. The unblocking procedure is equivalent to one descried by the Figure 7.
  • the implant 320 is placed in the eye in multifocal mode of operation with the film 370 and implant in active state, i.e. conforming to diffractive multifocal surface 360.
  • the unblocking procedure converts the film and implant in resting state for monofocal mode of operation.
  • the material of the implant is transparent to the laser beam to allow for unblocking procedure.
  • the diffractive multifocal surface might also be a refractive multifocal surface of multizone structure of zones of different powers for far and near foci.
  • FIG 9 demonstrates front view of an accommodating multi-mode operating RDS lens 450.
  • the overall construction of the implant 450 can be equivalent to the implant 320 of Figure 8, i.e. two-piece construction of front and back optic bodies with blocking mechanism placed at the back optic body together with the elastic film 460 adjacent to the guiding diffractive surface 440.
  • the diffractive surface 440 is to produce single focus imaging for near vision, i.e. kinoform for first order focus or optic for higher order focus.
  • the diffractive surface may also include significant spherical aberration to provide intermediate focus.
  • the guiding diffractive surface is a monofocal diffractive surface for near focus but it might also be a multifocal surface with near and intermediate foci.
  • the guiding surface might also be refractive monofocal surface for near focus or for near intermediate foci.
  • accommodating implant 450 and multifocal implant 320 related to the fact that multifocal implant provides static imaging at multifocal or monofocal modes of operation but implant 450 provides dynamic imaging with alternating far and near foci in the accommodating mode of operation under the action of ciliary muscle of the eye.
  • front and back optic bodies are attached to each other by spring elements 470 and 470', i.e. two elements in this case though it might be a different number, which are of flexible nature.
  • activation member 480 attached to the front optic body 490 and close to the supporting member 480.
  • the posterior (internal) surface of the front optic body 490 includes a post with a height that is close to the internal space width between front and back optic bodies.
  • the post shape is similar to the shape of the holding chamber. It is shown that spring elements 470, 470' and activation member 480 are spaced by about 1 20 degrees.
  • the surface of the post facing the back optic body is bonded to the exterior surface of the film at the area of the holding chamber 540.
  • the blocking mechanism As the blocking mechanism is in the blocking condition where the blocking element 51 0 placed into the blocking channel 520 to sever the fluid communication between the channel 530 and holding chamber 540 in order to maintain the implant 450 in the monofocal mode of operation where the elastic film 460 is in the relaxed state to produce refractive monofocal surface for far focus.
  • the space between the film 460 and guiding surface 440 is filled with matching optical fluid to mask the guiding surface shape and to control the optical power of the implant 450 only by the film's external surface which is a monofocal refractive surface in the film resting state.
  • the blocking mechanism in the blocking condition to fix the implant 450 in the corresponding monofocal mode of operation of a monofocal power for far vision.
  • FIG 1 0 shows side view of the implant 450 of the Figure 9. It demonstrates front optic body 490 and back optic body 550 separated by internal space 560 and connected by spring elements shown on the figure 9.
  • the elastic film 460 covers the guiding diffractive surface 440 and holding chamber 540 similar to the description on the Figure 2 but in this case for the monofocal mode of operation.
  • post 570 protruded from the posterior surface of the front optic body 490 and bonded to the exterior surface of the film 460 at the location of the holding chamber 540.
  • the blocking mechanism placed at the back optic body 550 includes blocking element 51 0 in the blocking channel 520 to sever fluid communication between the channels 530 and holding chamber 540 in order to maintain the film 460 in resting state for monofocal focus, i.e. the optical power of the implant is such that when added to the optical power of the eye the image of an object at far.
  • the accommodating implant 450 is in the monofocal mode of operation as a monofocal refractive lens. In this condition the periphery of supporting member 500 is at the distance LF form the plane of the external edge of the back optic body 550.
  • activation element 480 attached to the anterior optic body 490 and being in contact with the supporting member 500 connected to the back optic body 550.
  • the activation element 480 serves for mechanical interaction between front optic body 490 and back optic body 500 of the implant 450. It could be more than one activation elements connected to the front optic and each in contact with a supporting member or members. Instead of the activation element, a front optic body might be oversized as compared with the size of the back optic body in order to be in contact with a supporting member at the front optic periphery
  • FIG 1 1 demonstrates side view of the implant 450' after the implant 450 of Figure 1 0 converted into accommodating mode of operation with unblocking the blocking mechanism as described at the Figure 8.
  • the fluid communication between the holding chamber 540 and channel 530 is open for the fluid to travel in and out of the transparent chamber.
  • Under the action of eye ciliary muscle the angulation of the supporting member 500' bends into higher separation LN between the member 500' and the plane at he external edge of the back optic body 550'.
  • the back optic body is designated with a different number from one on the Figure 1 0 because the internal blocking mechanism now in the different unblocking
  • the activation element is fairly rigid member to avoid its bending with the haptic pressure.
  • the supporting member 500' pushes the activation element 480 forward with ciliary muscle contraction, this in turn pushes the front optic body 490 forward thus increasing separation between front 490 and back 550' optic bodies.
  • the spring members 470 of Figure 9 help to maintain the front body position possibly very slightly tilting the front optic body 490 in relationship to back optic body 550' .
  • the central aspect of the increase in the internal space 560' is that the post 570 lifts the film 460 at the location of the holding chamber thus increasing the volume of the holding chamber 540 to pull the optical fluid out of the transparent chamber between the film 460' and guiding surface 440. This in turn, forces the film 460' to take the shape of the guiding surface 440 to manifest equivalent optical power for near focus.
  • Near focus means that a combination of optical powers of the implant 450' with optical power for near and eye's optical power results in the image of a near object.
  • the accommodating implant 450' becomes diffractive monofocal lens with the power for near focus.
  • the haptic takes the original shape of LF shown on the Figure 1 0 to allow bringing the internal space 560 between front and back optic parts closer to each other releasing pressure at the holding chamber 540 by the post 570.
  • the matching fluid flows back from the holding chamber to the space between the elastic film and the guiding diffractive surface (transparent chamber) thus switching the accommodating implant 450' back from the monofocal diffractive implant 450' for near focus into the monofocal refractive implant 450 for far focus.
  • the accommodating multi-mode operating RDS implant upon the implantation, is in the monofocal mode of operation as a monofocal refractive lens for far vision.
  • the implant In a month or two, upon eye healing and establishing lens stabled and necessary position inside the capsular bag, the implant is remotely converted into accommodating mode of operation which allows the matching fluid transfers between resting and active states of the elastic film to provide far vision with ciliary muscles relaxation and near vision with the ciliary muscles contraction.
  • accommodating RDS implant in the monofocal mode of operation can also move as a whole along the optical axis in the order of about ten or more microns.
  • Optical or ultrasound posterior chamber depth measurement allows testing for the implant's movement in its monofocal mode of operation and ultrasound microscopy allows observation of ciliary muscle contraction and relaxation in order to assess the movement in sync with the ciliary muscles actions before unblocking the fluid communication between the holding chamber and transparent chamber, i.e. converting the implant into accommodating mode of operation.
  • This observation of the accommodating RDS implant movement offers addition indication of the likelihood of switching between far and near foci to be in sync with ciliary muscle contraction and relaxation upon unblocking procedure for the accommodating mode of operation.
  • the described above unblocking procedure can also be used for a phakic switchable optic introduced in the eye in a form of RDS corneal inlay or RDS phakic implant with operation between resting state for Far and active state for Near by communicating with the Sensor Cell for a direct interaction with the ciliary muscles of phakic presbyops.
  • a description of the Sensor Cell is provided in the U.S. Patent Number 8,608,600 and incorporated in this application.
  • a communication between the Sensor Cell and RDS implant can be provided by RF communication in general and by near field communication (NFC) in particular.
  • NFC near field communication
  • accommodating mode of operation where the first step is to install the implant in the monofocal mode of operation for far focus to allow testing for a potential issue and efficacy assessment before pursuing the second step of remote unblocking for the accommodating mode of operation, is the unique characteristic of the multi-mode operating implant. It allows either performing the second step, aborting it or conducting an adjustment of the implant before switching it to the accommodating mode of operation. Due to dynamic nature of an optical system for accommodation and likely differences between the patients, the multi-mode operation is necessary for matching the individual patient conditions with the expected performance for accommodation.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Fluid Mechanics (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un ensemble de lentilles intra-oculaires commutables comprenant un corps optique ayant une surface de guidage, une chambre de retenue, un canal de blocage et une cavité accessible par laser au niveau d'une partie du canal de blocage. Un film élastique est disposé sur la surface de guidage, où le film élastique est scellé au niveau ou à proximité de la périphérie de la surface de guidage pour former une chambre transparente entre la surface de guidage et le film élastique. Un élément de blocage de laser liquide a une tête agrandie reliée à une partie d'extension, où une longueur de la partie d'extension est supérieure à une distance le long du canal de blocage à partir de l'ouverture du canal de blocage à la connexion fluidique de la chambre transparente. La partie d'extension de l'élément de blocage de laser liquide est disposée à l'intérieur du canal de blocage. Un fluide optique est disposé à l'intérieur de la chambre de maintien sous une pression supérieure ou inférieure en comparaison à une pression dans la chambre transparente.
PCT/US2015/019026 2014-03-06 2015-03-05 Optique de fonctionnement multi-mode pour la correction de la presbytie Ceased WO2015134784A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US201461949111P 2014-03-06 2014-03-06
US61/949,111 2014-03-06
US14/637,407 US9510939B2 (en) 2012-10-08 2015-03-04 Multi-mode operating optic for presbyopia correction
US14/637,407 2015-03-04

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WO2015134784A1 true WO2015134784A1 (fr) 2015-09-11

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070088433A1 (en) * 2005-10-17 2007-04-19 Powervision Accommodating intraocular lens system utilizing direct force transfer from zonules and method of use
US20080208335A1 (en) * 2007-01-22 2008-08-28 Blum Ronald D Flexible electro-active lens
US20130035760A1 (en) * 2011-08-02 2013-02-07 Valdemar Portney Switchable diffractive accommodating lens
US20130110235A1 (en) * 2010-06-29 2013-05-02 The Arizona Board Of Regents On Behalf Of The University Of Arizona Accommodating intraocular lens with deformable material
US20130268070A1 (en) * 2002-12-12 2013-10-10 Victor Esch Accommodating Intraocular Lenses

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20130268070A1 (en) * 2002-12-12 2013-10-10 Victor Esch Accommodating Intraocular Lenses
US20070088433A1 (en) * 2005-10-17 2007-04-19 Powervision Accommodating intraocular lens system utilizing direct force transfer from zonules and method of use
US20080208335A1 (en) * 2007-01-22 2008-08-28 Blum Ronald D Flexible electro-active lens
US20130110235A1 (en) * 2010-06-29 2013-05-02 The Arizona Board Of Regents On Behalf Of The University Of Arizona Accommodating intraocular lens with deformable material
US20130035760A1 (en) * 2011-08-02 2013-02-07 Valdemar Portney Switchable diffractive accommodating lens

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