CN101039635A - Foldable intraocular lens with adaptable haptics - Google Patents

Foldable intraocular lens with adaptable haptics Download PDF

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CN101039635A
CN101039635A CN 200580034519 CN200580034519A CN101039635A CN 101039635 A CN101039635 A CN 101039635A CN 200580034519 CN200580034519 CN 200580034519 CN 200580034519 A CN200580034519 A CN 200580034519A CN 101039635 A CN101039635 A CN 101039635A
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haptic
lens
base
tail
optical system
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李·T·诺丹
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VISION MEMBRANE TECHNOLOGIES I
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VISION MEMBRANE TECHNOLOGIES I
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Abstract

A foldable low-compression intraocular lens configured for installation into the anterior chamber of a phakic, pseudophakic or aphakic eye, or a combination thereof. The lens is preferably rolled for insertion through a small corneal incision. Preferably, the implant comprises a resiliently flexible haptic body(100), an optical lens(102), and haptics that position the lens within the anterior chamber(103) without excessive compressive forces. The disclosed lens uses refractive or diffractive optics, or a combination of both. One embodiment of the lens contains an optical lens that uses a multi-order diffractive (MOD) structure. An advantage of the disclosed lens(102) is that a single sized device will fit any eye, thus the disclosed invention provides a ''one-size-fits-all'' intraocular lens.

Description

Foldable intraocular lens with adaptable haptics
Technical field
The present invention relates to a kind of Foldable intraocular lens implantation piece, it combines prosthese optical lens and flexible haptic structure, the suitable inside dimension that the eyes of lens will be installed of this haptic structure.The disclosure lens are fit to each individual eye, and the circumferential compressive force of the minimizing that is produced by anterior chamber's inwall.Attempt refraction and diffraction types monofocal, bifocally use with the present invention with the multiple focus optical system.
Background technology
Intraocular lens (IOLs) can be used for correcting defects of vision unusually.In 1949, Harold Mr. Ridley made a kind of artificial intraocular lenses, and it is implanted in the eyes of cataract patient.Although the initial lens design of Ridley is inflexible, painful and can cause or inspire glaucoma, this method plays effect.Because Mr.'s Ridley pioneer work, intraocular lens or " IOL " have developed and have been generally used for treating the cataract patient now.
Intraocular lens has multiple shape and size.Usually, all IOLs have two parts: be used for improving or repair the optical lens of visual sensitivity and be used for lens are remained on the haptic structure of the fixed position in the patient's eye.Haptic structure (" haptic structure ") has multiple structure.For example, 6, the disclosed haptic element of 224, No. 628 United States Patent (USP)s " Haptics for an Intraocular Lens (haptic element that is used for intraocular lens) " has designed a kind of rodding structure that stretches out from optical lens, and it carries out the transition on the cross bar that extends perpendicular to this bar.Then, the bar with bulbous end extends from this cross bar on the channeling direction that is parallel to bar usually.Another haptic structure is 6,475, No. 240 United States Patent (USP)s " Anterior ChamberIntraocular Lens and Method for Reducing Pupil Ovalling (being used for reducing the anterior chamber's of pupil ovalisation intraocular lens and method) " are described, it has described a haptic element system that comprises the bar of the equidistant separation of radially extending away from the center of optical lens, wherein each bar terminates in the backing plate, the inwall of this backing plate contact camera oculi anterior.6,517, No. 577 United States Patent (USP)s " Crossed Haptics forIntraocular Lenses (the intersection haptic element that is used for intraocular lens) " have been described the haptic element that is used for IOLs, it has with the obtuse angle from the extended sense of touch bar of haptic element pedestal, this obtuse angle with respect to the center longitudinal axis of lens usually greater than 100 degree.6,616, No. 693 United States Patent (USP)s " Flexible Fixation Membersfor Angle-Supported Anterior Chamber Intraocular Lenses (the flexible fixed part that is used for the intraocular lens of angle supported anterior chamber) " provide the haptic element with rectangle haptic pads, this pad to be set to usually apart from about 90 degree of haptic base.U.S. Patent application 10/394,906, publication number US2004/0186568 A1, " Foldable Angle-Fixed Intraocular Lens (intraocular lens of folding fixed angle) " described a kind of United States Patent (USP) 6 that is very similar to, 616, the IOL of disclosed IOL in 693 is except the backing plate in this application is globular and is set to about 80 degree.U.S. Patent application 09/794,990, publication number US2002/0120331 A1, described multiple in " Refractive Anterior ChamberIntraocular Implant (implantation piece in the refractive camera oculi anterior) " and the bonded IOL structure of extension pad haptic pads, this extension pad intention helps IOL to be fixed on patient's the eyes.U.S. Patent application 10/394,906, publication number US2003/0199978 A1 has described a kind of IOL in " Stable Anterior ChamberPhakic Lens (stable anterior chamber's lens) ", and it has the sense of touch bar that extends away from haptic base with the angle of about 65 degree.U.S. Patent application 10/918,078, publication number US2005/0021140 A1, described a kind of IOL in " Accommodating Intraocular Lens with Textured Haptics (adjusting has the intraocular lens of texture haptic element) ", it has perpendicular to the bar that extends from eyeglass and from haptic base about 70 spends the haptic element that is provided with.Optical lens and haptic structure can be formed by the common material piece, are perhaps formed by the assembly assembling.
IOL can be installed in to take place no matter whether there is the crystalline lens of nature among the anterior chamber.If lack the crystalline lens of nature, IOL optionally implants in the phacocyst.Under any situation, need IOL enough little of passing the corneal incision of the minimum that is used to implant, so that reduce the probability of corneal distortion and other surgical side effects or complexity subsequently.
The limiting factor of regulating corneal incision size is the diameter of optical lens, and it need regulate the pupil diameter scope according to different ambient light level.If, when the optical lens of prosthese is not large enough to the pupil that hides whole expansion, may dazzle the eyes and other distortion for showing suitable night.Reduce and dazzle the eyes the approach that reduces the incision size in the cornea simultaneously to be, after independent piece passes the corneal incision insertion,, disclosed in 5,769, No. 889 United States Patent (USP)s as Charles D.Kelman application by a plurality of block structure IOL that link together.The complexity of this class IOL makes them be difficult to install, and causes compromising between incision size that reduces and the peripheral glare relevant with the night vision of infringement.
By researching and developing thin folding ophthalmic implantation piece, Nordan and Morris improve on the basis of Kelman, this implantation piece is specifically designed to structure and is installed in the phacocyst of the crystalline lens (phakic) with nature or has in the eyes of false crystalline lens (pseudophakic), it has wide sense of touch sheet, wherein the wall of the relative eyes of contact area of Yan Shening provides the surge pressure that reduces, but the minimizing of the flow of the aqueous humor in anterior capsule may cause complicated.(see U.S. Patent Publication 20030220687 and 20030097176, and WO 02/41806, they with full content as a reference) at this.The installation of disclosed intraocular lens (IOLs) comprises by little corneal incision rolls and the insertion lens.
(MOD) lens of multistage diffraction can be used for the spectral components of a plurality of different wave lengths is introduced a common focus.(see the United States Patent (USP) 5,589,982 of Faklis and Morris, these the application with they full content as with reference in conjunction with).The MOD lens generally include many annular regions, and these zones have the step height on defined range border, and it can be diffracted on the common focus with the light of the different orders of diffraction with each wavelength.
Summary of the invention
At this, the invention provides a kind of low-compression, Foldable intraocular lens, so that correcting vision to be provided, it allows the flowing of nutrition carrying object (nutrient bearing fluids) in the anterior chamber.The present invention attempts to construct monofocal, bifocal and multifocal lens.Described invention can be used with refraction and diffraction lens.In one embodiment, multistage diffraction lens can be used for disclosed intraocular lens (IOL).
Disclosed lens can use with the optical system of refractive or diffraction.An embodiment of disclosed invention is a kind of low-compression IOL of use monofocal multistage diffraction (MOD) correcting lens.This low-compression IOL comprises: monofocal lens body of definition perforate, wherein said lens comprise the multistage diffraction structure with a plurality of zones, these zone definitions the zone boundary, locate in the zone boundary, be incident on this structural light the optical phase transfer can take place, and with different order of diffraction m (m>1) light of each wavelength is diffracted into described focus, thereby makes multistage order diffractive singlet (singlet) is provided.
Description of drawings
Fig. 1 a shows the top perspective of low-compression according to an embodiment of the invention intraocular lens (IOL).
Fig. 1 b shows the end perspective view of the IOL of Fig. 1 a.
Fig. 2 illustrates the cutaway view after the dissection of human eye.
Fig. 3 shows the cutaway view of the IOL among the anterior chamber who implants human eye according to an embodiment of the invention.
Fig. 4 a shows the top view of IOL according to an embodiment of the invention.
Fig. 4 b shows the side view at the IOL shown in Fig. 4 a.
Fig. 5 a shows position and the shape of IOL according to the present invention before the anterior chamber who implants human eye with schematic top view.
Fig. 5 b shows position and the shape of IOL after the anterior chamber who implants human eye according to the embodiments of the invention of Fig. 5 a with schematic top view.
Fig. 6 a shows the schematic side elevation of the IOL of Fig. 5 a.
Fig. 6 b shows the schematic side elevation of the IOL of Fig. 5 b.
The IOL that Fig. 7 a schematically shows the alternate embodiments according to the present invention before the anterior chamber who implants human eye the position and the top view of shape.
Fig. 7 b shows the schematic side elevation at the embodiment of Fig. 7 a.
Fig. 8 a shows the schematic side elevation of the embodiment of Fig. 7 a before the anterior chamber who implants human eye.
Fig. 8 b shows the schematic side elevation of the embodiment of Fig. 7 b after the anterior chamber who implants human eye.
Fig. 9 shows the relation for active force and the compression property of IOL embodiment.
Figure 10 a shows the embodiment of the IOLs with different optical lens position to 10d.
The specific embodiment
The invention provides a kind of folding low-compression intraocular lens (IOL), be used for implanting eyes to proofread and correct ametropia.Traditional IOLs is actually compression, and they rely on the compression of the haptic structure of eyes inwall, frictionally to remain on the IOL position in the eyes.In traditional IOL, this compression stress can be twisted the structure of the IOL of implantation usually, causes optical lens to overarch away from iris with towards corneal epithelium.
Because many, rely on the compressing mechanism that is used for being provided with in the room before eyes lens to have problems.Because not every human eye all has identical anterior chamber diameter, the clinicist of installation intraocular lens in the anterior chamber has to use the trial and error pricing to lens arrangement, to select to be fit to the intraocular lens of particular patient size.If lens arrangement is too loose, then lens can not correctly be fixed on the appropriate location.If lens arrangement is too tight, the excessive arch of implant infrastructure can make lens position along light shaft offset, thus the infringement optical property.In addition, if the lens arrangement tension, the shape of cornea can be twisted, and except the potential problems that the contact force too much with respect to the eyes inwall produces, also causes the damage of vision potentially.Usually, 10% to 15% necessary removal that is used for the anterior chamber IOL implantation piece of unsuitable assembling.Low-compression IOL of the present invention is better than traditional IOL, is because it adapts to the increase scope of anterior chamber diameter, thereby can uses single size to be fit to the IOL of all models.This IOL has eliminated the clinicist and has inferred which size IOL can be used for the needs of correction of refractive errors, and has eliminated the needs that transport the IOLs of many sizes among the clinical stock equally.
Low-compression intraocular lens described here can be used for the surgical intervention of optical distortion, and this optical distortion meeting reduces the visual sensitivity of human eye.By understanding use of the present invention, help to understand the construction features of human eye.
Fig. 2 shows the cross section of human eye 020 and has described the many features after the ocular anatomy.Eyes 020 are formed by three layers: skin, and it is made up of the thick sheath that is called sclera 021 at the rear portion that covers eyes and the transparent cover layer that is called cornea 022 that covers on the place ahead 1/6; The intermediate layer that is called choroid 023, vasculature (vasculature) and muscular tissue that it comprises eyes connect corpus ciliare 024 and iris 025 in front; With the internal layer that is called retina 026, it comprises neurolemma.These layers run through by optic nerve 027 and amphiblestroid blood vessel.Cornea 022 comprises with tight sequential system arrangement collagen fibers, thereby makes that the structure that produces is transparent basically.
Iris 025 is opaque film, and the heart has the hole that is called pupil 028 therein, and by the contracture of the ciliary muscle in the corpus ciliare 024 and the opening of lax expansion or contraction pupil 028, enters the flow of the light in the eyes 020 with adjustment.The colorant of iris provides the eye color part.By the ligament of the little band that is called Zinn031 on the muscle that is attached to eyes 020 in the corpus ciliare 024, the crystalline lens 029 of nature is suspended between the iris 025 and crystal afterwards 030 of front.Abutment between iris 025 and corpus ciliare 024 is the shallow depression that is called as ciliary groove (ciliary sulcus) 032.The anterior chamber 033 who is filled with aqueous fluid separates the endothelial layer of posterior surface of cornea from iris.The place ahead lens of prosthese can be implanted in this room.Iris 025 and pupil 028 are separated into anterior chamber 033 and back room 034 with the front region of eyes 020, they all have been full of aqueous humor, fluid is secreted from ciliary process (ciliary sulcus), and enters within the anterior chamber 033 by pupil 022 from back room 034 outflow.Angle 035 (at the abutment of cornea 022 and iris 025) anterior chamber 033 is located, and the tomentum of fluid by spaces of iridocorneal angle and pectination filters, and by sinus venous sclerae or execute tired Mu Shi (Schlemm) pipe 036 and be discharged from.Lens 029 are included within the thin film that is called phacocyst (lens capsule) (not shown).
Light passes cornea 022 and iris 025, and focuses on to form image on retina 026 by crystalline lens 029, and retina transmits the electromagnetic radiation that detects to optic nerve then, and the final brain that is used for handling that arrives.Six ocular muscles that are used to rotate the eyes (not shown) are attached to the outside of sclera.
Can adopt the prothesis (lens) of vision to correct by the error that comprises the visual sensitivity that ametropic many different reasons produce.Myopia, hypermetropia, presbyopia's (loss of regulating power) and astigmatism are the most general ametropia.Low-compression among the different embodiment disclosed herein, Foldable intraocular lens (IOL) provides a kind of rectification this ametropic device.This IOL can be folded to be inserted into by little corneal incision, and launch suitable position in eyes subsequently.The IOL that implants allows fluid (aqueous humor) to flow in the direction of the nutrition that is used for eye health.This IOL can adapt to the adjusting of large-scale anterior chamber diameter, and with the minimizing of the transfer of the axial location of lens and the degeneration of consequential optical property, and do not have over-drastic tactile pressure on eyes.
Fig. 1 a shows the perspective top view of IOL embodiment of the present invention.In this embodiment, haptic body (haptic body) 100 comprises by sense of touch tail region (haptic tail regions) 103 and carries out the transition to haptic base part (haptic base section) 101 on the haptic pads (haptic pads) 104.Optical lens 102 is kept by haptic base 101.In one embodiment, optical lens 102 and haptic body 100 can be by suitable, the biocompatible optical material manufacturings of monolithic.In alternate embodiments, optical lens 102 and haptic body 100 can be formed and assembled subsequently by different materials.The embodiment of this assembling can be used to avoid trading off between the optical property that the mechanical performance and the optical lens 102 of haptic body 100 hope are wished.Lens 102 can be kept by haptic base part 101 by the known multiple device of those of ordinary skill of prior art.Lens 102 can keep by the compression stress that produces from haptic base 101, and selectable tongue and groove with circumference engages the structure of (tongue and groove).Can select or other, optical lens 102 and haptic body 100 can combine under the help of biocompatible jointing material.The selection of the third device is to use heat, compression, hot compression, perhaps the solder technology based on solvent connects optical lens 102 on haptic body 100.The perspective side elevation view of the embodiment of Fig. 1 b presentation graphs 1a.Identical parts have identical Reference numeral in two accompanying drawings.
IOL is designed to be implanted in ophthalmic among the anterior chamber 033, as shown in Figure 3, thereby makes it keep in position with respect to crystalline lens 029, so that the light image that transmits by cornea is corrected, to be used for the correct retina that is presented at.Need along optical axis fixedly the position of IOL to be used for maximum vision correction.Need when implanting, to make IOL not interfere equally with adjacent augen structure 022 and 025.
Fig. 4 a and 4b show top and the lateral drawing in side sectional elevation of current IOL embodiment of the present invention respectively.The same with 1b as Fig. 1 a, parts identical in the accompanying drawing use the same reference numerals to represent.Haptic tail 103 is configured in the cross section, thereby makes it having radial compression under the arcual situation of haptic base 101 restrictions.
Shown in Fig. 4 b, haptic tail 103 is provided with at a certain angle with respect to haptic pads 104 and lens body 101.This angle arches upward on iris or promotes lens body 101.For traditional IOLs, the angle of curvature of lens, and therefore the angle between haptic body and haptic pads can increase along with the increase of the radial compression force on the haptic pads 104 for 20 degree or bigger.At this extreme angles place, arch can cause the degeneration of vision correction basically along the photocentre of optical axis mobile optical lens.If same extreme value is enough, arch can cause optical lens to contact with the inner surface of cornea, causes inflammation and other side effect.
In the embodiments of the invention shown in Fig. 4, arch is irrelevant with the compression on haptic pads 104 basically.Therefore, in case after setting up, optical lens 102 remains on suitable setting along the relative crystalline lens of optical axis is immobilized basically.The lenticular relatively immobilized basically placement of lens body is compared with traditional intraocular lens provides more accurate ametropia to proofread and correct.In the time of in inserting the anterior chamber, haptic pads 104 is inserted in anterior chamber's the angle (zone in cornea and anterior chamber that iris is connected).The correct placement that enters the device among the anterior chamber is important, because the functional role of anterior chamber's angle is to play the part of to be used for the eyes health.
This angle of anterior chamber comprises the structure of the drainage system of a plurality of composition eyes.This angle is by the part of the outermost of iris, ciliary muscle (corpus ciliare) fibrae circulares, and the reticular tissue of girder and the venous sinus of sclera (schlemm's canal) limit.Aqueous fluid flows out from the rear surface and enters in the anterior chamber by iris.Aqueous fluid, is discharged from the anterior chamber by the venous sinus of sclera by the structure such as the reticular tissue of girder in the angle.The intraocular pressure (eye ' s intraocularpressure) that eyes have been determined in the generation of aqueous fluid and discharge (IOP).The obstruction of angle is called as angle closure, causes the raising of IOP, and this can be to the health of infringement eyes.Therefore, it is important that device enters suitable placement in anterior chamber's the angle the same with other reason, to keep suitable IOP.
The feature of haptic tail 104 allows device to be fit among the anterior chamber of eyes, is necessary to hinder aqueous fluid and leaves the anterior chamber.For example, referring to the embodiment of Fig. 5 b, the opening angle θ of haptic pads 1' and θ 2' be limited in keeping a passage, can be by this passage aqueous fluid by the discharge structure of this device and arrival eyes.Therefore, the structure of haptic tail can stop or reduce at least closure and unacceptable IOP raising of angle.
Fig. 4 b illustrates the side view of the embodiment of IOL.From then on side view, people it is contemplated that from haptic tail 104 upwards by the transition portion 103 of haptic base 101 to optical lens 102.Should note leading to the angle of the haptic base of optical lens 102.Haptic base provides vault with respect to the angle of haptic pads 104 and lens for IOL, and it is remained on away from crystalline lens.The radial compression force that produces from anterior chamber's inwall is sent to IOL by haptic pads 104, causes filling up 104 splay apart, keeps IOL fixing basically with respect to crystalline lens simultaneously.Haptic pads 20 (Fig. 4 b) compared with prior art provides many advantages for present disclosed device with respect to the position of haptic base 101 (Fig. 4 b).For example, haptic base 101 provides the pre-vault of determining on lenticular body with respect to the skew of haptic pads 104, thereby makes lenticular body 102 be separated from iris.Preferably, the IOL in the anterior chamber has avoided and the contacting of corneal epithelium and iris.
Refer again to Fig. 4 b, haptic tail 103 is configured to towards haptic base 101 thickness gradually little at cross section.These rears 103 can be compressed under radial compression force, and do not increase the vault of haptic base 101 basically.Therefore, there is the simultaneous mechanism of two IOL unanimities, to adapt to different anterior chamber diameter.First mechanism is opening of haptic pads.The secondth, the radial compression of haptic tail.
Fig. 5 a and 5b show conforming two mechanism with the schematic top view of IOL.The anterior chamber's that circle 500 expressions of dotted line contact with haptic pads inwall.Fig. 5 a is described in the embodiment before transplanting, and Fig. 5 b is described in the embodiment after transplanting.Angle θ 1And θ 2Be the opening angle of the haptic pads before transplanting, and θ 1' and θ 2' be the opening angle after transplanting.Nominally θ 1Be approximately equal to θ 2, and θ 1' be approximately equal to θ 2', but these are not essential conditions.By θ 1' greater than θ 1And θ 2' greater than θ 2Produced open adaptation, as shown in the figure.Yet this opens and is not to cause L pTo L p' minimizing with unique mechanism of the diameter that adapts to anterior chamber 500, respectively shown in Fig. 5 a and 5b.Second mechanism is the radial compression of haptic tail, as respectively at the L shown in Fig. 5 a and the 5b BTo L B' minimizing.
Radial compression can be better understood in the schematic side view in the cross section of Fig. 6 a and 6b.Haptic tail 103 is along with radial compression force (be haptic pads 104 by mutually towards effect) distortion enters clearer and more definite " S " or " Z " shape.The distortion of haptic tail adapts to L BTo L B' minimizing, have the minimum change (being that H is approximately equal to H ') of optical lens 102 positions.
Fig. 7 a and 7b have described the side view in the top and the cross section of an alternative embodiment of the invention respectively.In two accompanying drawings, the parts that Reference numeral is identical are consistent.The 703rd, haptic base, it keeps optical lens 702.Aforesaid haptic pads 704 is about Fig. 1,4,5 and 6 embodiment.Yet in this embodiment, haptic tail 705 is not to be directly connected to haptic base 703, is connected with 707 but alleviate part 706 by means of terminal with contiguous tension force respectively.As mentioned above, haptic pad accommodation mechanism can be applied among this embodiment.As mentioned above, haptic tail compression mechanism also can be applied among this embodiment.This embodiment has the further coping mechanism that alleviates portion-form with tension force.
Terminal and proximal strain alleviate the operation of part 706 and 707 can be respectively about sectional view 8a and 8b relax and compression is better understood.Notice that in response to compression part 706 and neighbouring part 707 effectively is connected and acted on endways downwards, with the trend that moves up of counteracting in the effective connection between haptic tail 705 and the end portion 706, between neighbouring part 707 and the haptic base 703.Like this, because IOL by radial compression to allow wider L p(perhaps corresponding anterior chamber diameter is wider), the upright position (being that H is approximately equal to H ') of having stablized haptic base 703.In other embodiments, additional tension force alleviates part and can be introduced into, with further increase L pRange accommodation.
Fig. 9 is an active force to the chart of the example of the radial compression characteristics that is used for IOLs.Straight line 870 is reference characteristic, according to the Hooke's law that is used for desirable spring, F=KC, its simple declaration active force and compression (being measured as displacement) be proportional.In real elastic construction, such as the IOL haptic element, active force-compression property always departs from ideal situation, owing to structurally related to mechanical constraint.Adopt under the situation of IOL haptic element, for example, elastic deformation structure's actual size helps restricted mechanical range like ideal force-compression behavior.By comprising additional mechanical accommodation mechanisms, as mentioned above, can expand the scope of the force-compression behavior of ideal-like.
For example, in Fig. 9, curve 871 expressions are used for IOL active force-compression property of IOL embodiment, only have liner and open coping mechanism.Haptic pads only can open up into this degree, and after this, it becomes more and more that difficulty makes it further open by shown in the curve.Curve 872 expressions are used for active force-compression property of IOL embodiment, and it adopts liner to open and haptic tail compression accommodation mechanisms.By in conjunction with these two mechanism, the scope of better force-compression behavior is expanded.This embodiment can adapt to wider anterior chamber diameter, and can not apply over-drastic active force (pressure) on augen structure.Curve 873 expressions are used for active force-compression property of IOL embodiment, and it adopts liner to open, and haptic tail compression and tension force alleviate partial adaptation mechanism.The adding that tension force alleviates partial adaptation mechanism has further expanded the compression zone of the active force compression performance that is used for ideal-like, has further expanded the scope of the anterior chamber diameter that can be adapted to.
The foregoing description shows how to use a plurality of elastic constituents, and/or is used to make a plurality of mechanical types of those part distortion to expand the scope of the force-compression behavior of ideal-like, and can not increase the actual size of IOL.For example, the liner flare up tangentially occurs in the plane perpendicular to optical axis, and tail compression radially occurs in the plane perpendicular to optical axis.
Though all IOL embodiment of Miao Shuing have two haptic tail that diameter is relative up to now, in general, can use the structure of any amount of haptic tail.For example, can consider to have three, four, and above afterbody, concrete, the embodiment with three above afterbodys can be provided in perpendicular to the IOL in the plane of optical axis and fixes.The defective of using the haptic tail that surpasses two is the potential minimizing at the aqueous humor flow.Simultaneously, this embodiment more is difficult to fold during implanting.The invention provides pliability, to be configured to this compromise of different clinical cases.
Figure 10 a is illustrated in the exemplary devices of the optical lens 904 on the haptic base 901, and it has the front side 902 and the dorsal part 903 of sense of touch body 900.Optical lens 904 has front side 905 and rear side 906.Front side 905 faces cornea and rear side 906 is faced pupil.In the embodiment shown in Figure 10 a, optical lens is biased to the rear side of sense of touch body.(Figure 10 b) in another embodiment, optical lens can be biased to the front side of sense of touch body.Selectable, in a further embodiment, optical lens is extensible to surpass the both sides (Figure 10 c) of haptic base or from the both sides indentation (Figure 10 d) of haptic base.
The concrete preferred embodiment of disclosed device is the embodiment of Fig. 9 a, and wherein optical lens 904 is biased in the space between the rear side of sense of touch body 900 and pupil (not shown).This of optical lens preferably be provided with permission corneal epithelium and optical lens 905 between clearance space appears.Angle in the rear portion of optical lens 904 and the gap between the iris by haptic tail provides.
Correcting unit disclosed herein is used the light focusing technology of any kind in lenticular body.Therefore, disclosed correcting unit can be used dioptric system, diffraction optical system, and the combination of refraction and diffraction optical system, and the optical system of other type are among the embodiment as lenticular body.The use of refractor technology equals 5,089, No. 022 of in February, 1992 application at Koester, example in the United States Patent (USP) of " Rectifiedintraocular lens (gauged intraocular lens) " by name, and the full content of this application carries out combination as a reference.
Diffractive lens technology is to use another the feasible optical system in invention disclosed.An example of the diffraction optical system that uses with the present invention is 5 of David Hamblen " Intraocular gradient-index lenses used in eye implantation (lens that are used for the gradient index that eyes implant of ophthalmic) " by name, 152, open in No. 787 United States Patent (USP)s, this application is carried out combination at this as a reference with its full content.The other example that is used for the diffractive lens technology of intraocular lens comprises United States Patent (USP) 5,120,120,5,358,520,5,366,502,5,384,606,5,448,312,5,485,228 and 6,634,751, all these carry out combination at this as a reference with its full content.
Preferred diffractive lens technology is called in the name of applications such as Faklis in 5,589, No. 982 United States Patent (USP)s of " Polychromatic diffractivelens (pleochroic diffraction lens) " and discloses, and this application is carried out combination as a reference at this.This multistage diffraction (MOD) lens technologies can be used for the opticator of structural lenticular body.The MOD lens can focus on the light of different wave length on multistage order diffractive singlet.Multistage diffraction structure has a plurality of annular regions, and they have defined with the light of different each wavelength of the order of diffraction diffraction zone boundary on the focus, thereby plural number or multistage order diffractive singlet are provided.The MOD lens are better than other lens technologies because they can be under the situation of image fault still less focus light.
Disclosed correcting unit can be used with monofocal, bifocal or multifocal corrigent eyeglass.In one embodiment, use monofocal MOD correcting lens and the light focusing that will form by a plurality of wavelength on single focus.Therefore, bifocal MOD correcting lens focuses on light to two focus of being made up of a plurality of wavelength, on while many focuses MOD correcting lens focused ray to three or the above focus.For example, the name of applications such as Morris is called " lens that are used for the Bifocal multiorder diffraction of correcting vision " U.S. Patent application 10/462,294, and this application is carried out combination at this as a reference with its full content, and it has described bifocal and multifocal MOD lens.The lens technologies that should be noted that other type can be used for producing monofocal, bifocus and multifocal lens.
It should further be appreciated that by the optical region at the center that changes the MOD lens, can make lens body 130 with different capacity.Higher MOD number allows " optical region " at bigger center.The MOD optical region is the scope of from 1 to 20 individuality preferably.More preferably from 10 to 20, and most preferably lens body has 10 MOD number.Improve battery of lens by changing the character of MOD lens, producing, under the ametropic situation of the running in advance with change, they can realize being used for the contrast sensitivity of patient's optimum.
The thickness of optical lens 904 is key characters of described device, but its importance is owing to haptic element described here reduces.Generally speaking, preferably reduce the overall size of IOL, to reduce unintentional change of the shape of corneal during installation procedure.Yet as long as avoid optical lens 904 itself to contact with iris with corneal epithelium, optical lens 904 can be to the necessary thickness of the reparation of the visual sensitivity of eyes.The thickness of optical lens is generally from about 25 to 1000 microns, and 50 to 600 microns, 75 to 250 microns scope, most preferred, the thickness of optical lens approximately is 100 microns.
Optical lens 904 preferably has at least 3 millimeters diameter.Preferred lens body has from about 3 to 10 millimeters diameter.The concrete example that is used for the diameter of lens body comprises 3.0,3.1,3.2,3.3,3.4,3.5,3.6,3.7,3.8,3.9,4.0,4.1,4.2,4.3,4.4,4.5,4.6,4.7,4.8,4.9,5.0,5.1,5.2,5.3,5.4,5.5,5.6,5.7,5.8,5.9,6.0,6.1,6.2,6.3,6.4,6.5,6.6,6.7,6.8,6.9,7.0,7.1,7.2,7.3,7.4,7.5,7.6,7.7,7.8,7.9,8.0,8.1,8.2,8.3,8.4,8.5,8.6,8.7,8.8,8.9,9.0,9.1,9.2,9.3,9.4,9.5,9.6,9.7,9.8,9.9 or 10.0 millimeters diameter.
Another feature of optical lens 104 relates to its shape.Optical lens 904 can be smooth or crooked.Optical lens 904 can be arranged on the haptic structure 900 (Figure 90 4b), is lower than haptic structure 900 (Figure 90 4a), and perhaps with the top side of haptic structure, bottom side or both sides flush.When optical lens 904 was bending, sweep may be recessed or protruding.Optical lens 904 also may be plano-concave or plano-convex.Preferred optical lens 904 has the gap below corneal epithelium and on iris.
The optical lens 904 that is equipped with haptic structure 900 preferably has during installation or is provided for afterwards the radius of curvature of the amount of deflection of IOL.This radius of curvature is preferably from about 1 to 50 millimeter, and 5 to 40,10 to 30, and most preferably the radius of curvature of optical lens 904 is approximately 12.5 millimeters.The radius of curvature that is used for optical lens is preferably determined at external (ex vivo), and above-mentioned scope relates to the radius of curvature that is not installed in the lens in the eyes.
The size of described correcting unit also depends on the character of haptic structure 900.IOL embodiment is preferably by the material structure of generator, and this device is that 7 to 20 millimeters and width are 3 to 10 millimeters with preferred length.
Different with WO02/41806, its instruction is used to approach, the MOD lens technologies of the implantation piece structure of folding ophthalmic, and current described invention does not require this thin lens.With respect to intraocular lens, the present invention designs a kind of intraocular lens, and wherein lens arrangement can be any thickness, as long as within the anterior chamber who is assemblied in eyes that the structure that produces can be effective and safe.In one embodiment, the thickness of lens is greater than 125 microns.More particularly, the thickness of monofocal lens embodiment is 130,135,140,145,150,155,160,165,170,175,180,185,190,195,200,205,210,215,220,225,230,235,240,245,250,255,260,265,270,275,280,285,290,295,300,305,310,315,320,325,330,335,340,345,350,355,360,365,370,375,380,385,390,395,400,405,410,415,420,425,430,435,440,445,450 microns or more than.These thickness ranges are preferably applied to comprise among the embodiment of monofocal MOD corrective lens.
Though it is required that specific optical lens thicknesses is not used for optical property, some embodiment can benefit to have has the to a certain degree optical lens of thickness.This structure can be used to help to stablize IOL, therefore better optical lens is remained on the amphiblestroid settling position with respect to the eyes that lens are installed.In addition, in case when lens are installed on the eyes of object, the increase of the thickness of IOL will prevent lens distortion.Therefore, the increase of lens thickness can make light be sent to by intraocular lens to twist still less on the retina.
Disclosed optical lens is made of transmissible material on the optics, such as being generally used for traditional IOLs, glasses, the perhaps contact of other types corrective lenses, the manufacturing of opticator (for example, plastics, silicones, acrylic acid, glass perhaps is generally used for the polymer on specific contact, IOL or the eyewear applications).This lens can use common to well known to a person skilled in the art method construct, for example: grind, car is cut (lathing), corrodes, molded or their combination.For example, the optics pin of correcting unit can be cut by car and prepare.
When IOL was designed for the anterior chamber and installs, it preferably included lens body 904 and haptic body 900, and wherein, described lens body is fixed, connects or is arranged in addition above the described haptic body.Also can attempt to design a structure and make wherein that lens body 904 and haptic body 900 comprise single sequential cells.
Haptic body 900 is preferably by such as from California, and the material number that the NuSil SiliconeTechnology of Carpenteria buys is that the silicones of the flexibility of MED-6820 is made.Can use other elastomeric material such as PMMA or hydrogel.Haptic body 900 supporting and location optical lens 904, and is not preferably corrected performance as support.In alternate embodiments, can form haptic body 900 to improve or to promote the rectification effect of optical lens 904.
In addition, haptic body 900 can scribble unlikely and the interactional material of parts in the eyes.The example of this coating is a heparin, the coating of the saccharide of nature, and it suppresses blood coagulation and protein adhesion.Haptic body material also comprises one or more ultraviolet blocker (ultraviolet lightblocking agents).
Haptic body 900 is preferably made the thickness of about 25-1000 micron, and perhaps this film is from 50 to 600 microns, and 75 to 250 microns, most preferred, optical lens 904 is about 100 micron thickness.Although be flexible, it turns back to resting position in radius of curvature for centering under the situation in about 0 to the 20 millimeter scope of vertical axis.This scope comprises around 1.0,1.5,2.0,2.5,3.0,3.5,4.0 of the longitudinal axis, 4.5,5.0,5.5,6.0,6.5,7.0,7.5,8.0,8.5,9.0,9.5,10.0,10.5,11.0,11.5,12.0,12.5,13.0,13.5,14.0,14.5,15.0,15.5,16.0,16.5,17.0,17.5,18.0,18.5,19.0,19.5,20.0 millimeters radius of curvature.Binder course is shown as about 475 and adds or deduct 10 microns gross thickness.The length of overall size approximately is 12 millimeters, and width is 8 millimeters.This IOL can be crooked even rolls or folding, with by preferably be no more than 3.0 millimeters, more preferably the little otch of 2.75 millimeters or less in length inserts in the interior chamber.IOL has preroll or the pre-folding arcuate shape of enough elasticity to turn back to it.
IOL keeps arcuate shape in its resting position.IOL in circle has about 12.5 millimeters radius R.Because adapt to the scope of haptic body 900, in fact these sizes can adapt to all eye sizes.In other words, according to anterior chamber's scope, when installing, by reducing or being increased in radius of curvature R in about 0 to 20 millimeter scope, IOL can adjust its length.
IOL can be used on aphakic, the vision of damaging with rectification in pseudophakia or the crystalline lens eyes.For example, open lens can be used for the lens replacement process, for example use in aphakic eye.So, after this process, the eyes of object can comprise a plurality of lens, include but not limited to natural lens and at least one corrective lens or a plurality of IOLs.In a preferred embodiment, multistage MOD corrective lens design is used for correcting error of refraction.Usually, the nature and extent of the error of refraction in object forms the MOD corrective lens after having determined.Corrective lens can be monofocal, and is bifocal or multifocal.The MOD corrective lens is present in the ametropia of not proofreading and correct in the eyes in case formation just is provided to the subject to alleviate.
As mentioned above, the size that is used for correcting unit is determined by the use intention of this device.For example, an IOL embodiment is designed for installing and using in the anterior chamber of eyes.
The size of folding IOL is important, because known in the prior art: the otch that length is installed IOLs greater than 5 millimeters be used to is easy to cause astigmatism or other distortion, and these distortions may itself can cause the dysopia.Therefore, to be inserted into the ophthalmic correcting unit among the anterior chamber of eyes will be fully flexible to preferred intention.Preferably, this device is fully flexible, so that can be folding, be less than or equal in 4.0 millimeters the otch thereby can be inserted into preferred length.Most preferably incision size is 1.0 to 5.0 millimeters or still less.Specifically, length is 1.0,1.1,1.2,1.25,1.3,1.4,1.5,1.6,1.7,1.75,1.8,1.9,2.0,2.1,2.2,2.3,2.4,2.5,2.6,2.7,2.8,2.9,3.0,3.1,3.2,3.3,3.4,3.5,3.6,3.7,3.8,3.9,4.0,4.1,4.2,4.3,4.4,4.5,4.6,4.7,4.8,4.9 and 5.0 millimeters incision size.Sew up or other stitching vehicle of reeling, such as glue, binding agent, protein cross agent or the like may or can not be used to seal this otch.
Disclosed embodiment implants among the anterior chamber of eyes.Disclosed embodiment can use separately or combine with other IOL being used to and correct defects of vision.For example, the bifocal IOL of disclosed structure is used among the anterior chamber, and to be provided at the additional correction in the eyes, wherein crystalline lens has been removed and has adopted IOL to replace.
Following Example is to be used for describing rather than restriction the present invention.
Example 1
The implantation and the explanation of phakic intraocular lens (IOL)
Use syringe to implant folding phakic IOL, this syringe is introduced IOL by the unimpeded corneal incision less than 3 millimeters.The implanted prosthetics that is used for these lens is similar to the technology that is used for pseudophakia IOL after cataract is extractd.The part splashes into 1% pilocarpine (pilocarpine) and helps to produce the pupil of myosis.The surgeon guides phakic IOL to enter in the lubricated syringe case, produces side cutout, and sprays viscoelastic vehicle and enter within the anterior chamber.Then, IOL is injected into.Remove this box tip among the anterior chamber before, the surgeon engages the haptic element of the below of IOL within the angle that enters the below.Bimanual flushing/attraction (I/A) is removed all viscoelasticity things from the anterior chamber, and if necessary, the surgeon uses the VA apparatus to adjust the position of lens.The anterior chamber is pressurized under the normal pressure of BSS (Alcon laboratory, Ft.Worth, TX company), and checks otch.At last, the surgeon is placed on a binder contact lens and a ZYMAR (CA, Irvine, Allergan company) on the eyes.Whole surgical procedure has only been used a few minutes, and only adopts the topical anesthesia of using in outpatient's situation to implement.After implanting, object is directly enjoyed improved visual sensitivity.
The surgeon can adopt tweezers to pass through promptly its good haptic element, implants IOL by otch, and the pull strength by means of tenderness forms entire I L profile then.Also can use the stitching of this otch of sealing or other method.

Claims (34)

1. intraocular lens, it comprises:
Lens body;
Haptic base, it comprises near-end and end, and wherein the near-end of haptic base is connected on the lens body by first engaging zones of vertical flexibility, and the relative lens body of wherein said first engaging zones is warpage vertically; With
Haptic tail, wherein, this haptic tail comprises: the haptic pads that is connected to this haptic tail by the flexible structure of level, the relative lens body of the flexible structure of this level warpage flatly wherein, and wherein the end of haptic base is connected to haptic tail by second engaging zones of vertical flexibility, and relative this lens body of wherein said second engaging zones is warpage vertically.
2. intraocular lens as claimed in claim 1, wherein, described lens body, first engaging zones, haptic base, second engaging zones and haptic tail form sigmoid curve.
3. intraocular lens as claimed in claim 1, wherein, described lens body contacts with haptic base forming acute angle at first engaging zones, and haptic base contact with haptic tail with at second engaging zones formation acute angle.
4. intraocular lens as claimed in claim 3, wherein, when described intraocular lens was implanted to receiver's eyes, the angle at first engaging zones and the second engaging zones place reduced.
5. intraocular lens as claimed in claim 4, wherein, after described intraocular lens adapted to receiver's eyes, the angle at first engaging zones and the second engaging zones place increased.
6. intraocular lens as claimed in claim 5 wherein, after implanting 1 to 6 hour, is stablized in the angle at first engaging zones and the second engaging zones place.
7. intraocular lens as claimed in claim 1 wherein, when described intraocular lens is implanted in receiver's the eyes, move, and the first and second vertical flexible engaging zones vertically moves the haptic pads plate level, thereby reduces the vertical arcuate of lens body.
8. intraocular lens as claimed in claim 1, wherein, the width of sense of touch backing plate is greater than the width of flexible member.
9. intraocular lens as claimed in claim 1, wherein, described lens body also comprises optical system.
10. lens as claimed in claim 9, wherein, described optical system is a dioptric system.
11. lens as claimed in claim 9, wherein, institute's optical system is a diffraction optical system.
12. lens as claimed in claim 11, wherein, described diffraction optical system is the structure with the multistage diffraction in a plurality of zones that defined the zone boundary, wherein, at place, described zone boundary, be incident on this structural light and optical phase can take place shift, and the light of each wavelength is diffracted into described focus with different order of diffraction m, thereby provide multistage order diffractive singlet, wherein m 〉=1.
13. lens as claimed in claim 9, wherein, described optical system comprises refractive component and diffractive part.
14. an intraocular lens, it comprises:
Lens body;
Haptic base, it comprises near-end and end, wherein the near-end of haptic base is connected on the lens body by first engaging zones of vertical flexibility, and forms first angle; With
Haptic tail, wherein this haptic tail comprises: be connected to the haptic pads of this haptic tail by the flexible structure of level, wherein the end of haptic base is connected to haptic tail by second engaging zones of vertical flexibility, and forms second angle,
When intraocular lens was implanted in receiver's the eyes, described first angle and second angular dimension reduced, thereby reduced or eliminated the vertical arcuate of lens body.
15. an intraocular lens haptic element, it comprises:
Engaging zones, it has near-end and end;
Flexibly be connected to the haptic base of engaging zones near-end; With
Be connected to the haptic pads of the end of engaging zones by the horizontal flexible structure, wherein engaging zones is wider than haptic pads or haptic base.
16. an intraocular lens, it comprises:
Haptic element;
Lens body in first plane, wherein this lens body comprises front surface and rear surface; With
Optical system in second plane, wherein optical system comprises front surface and rear surface, and wherein first plane is different with second plane, wherein, perhaps the front surface of the front surface of lens body or optical system is relatively more near iris, rather than the both is near iris.
17. the correcting lens of an ophthalmic, it comprises:
Be arranged on the optical system in the lens body, wherein lens body is flat basically; With
Extend to first haptic base of first haptic tail from lens body, wherein lens body, first haptic base and first haptic tail form the sigmoid curve of the first area with deflection;
Extend to second haptic base of second haptic tail from lens body, wherein lens body, second haptic base and second haptic tail form the sigmoid curve of the second area with deflection; With
Second haptic base of extending from second haptic tail in first haptic base of extending from first haptic tail in being arranged essentially parallel to the plane of lens body and the plane that is being arranged essentially parallel to lens body,
Wherein when the correcting lens of ophthalmic was implanted in receiver's eyes, the distance between the zone of first and second deflections reduced.
18. the correcting lens of an ophthalmic, it comprises:
Have the optical system that is arranged on the diameter in the lens body, wherein lens body has the width that is approximately equal to the optical system diameter;
From the extended haptic base of lens body, this haptic base comprises near-end and end with acute angle at least one, and wherein the width of the near-end of haptic base is approximately equal to the width of lens body; With
Haptic tail, it comprises with acute angle from extended two the feeler pads of haptic base at least, and wherein, described pad to be extending from haptic base less than the angles of 65 degree, and wherein, and described pad is extending in the parallel plane with respect to lens body basically.
19. lens as claimed in claim 18, wherein, the diameter of described optical system is less than 7 millimeters.
20. lens as claimed in claim 19, wherein, the width of described haptic base end is less than half of optical system diameter.
21. lens as claimed in claim 18, wherein, at least one haptic base is to extend from lens body less than the angle of 45 degree.
22. lens as claimed in claim 21, wherein, at least one haptic base is to extend from lens body less than the angle of 30 degree.
23. lens as claimed in claim 18, wherein said optical system is a dioptric system.
24. lens as claimed in claim 18, wherein said optical system is a diffraction optical system.
25. lens as claimed in claim 24, wherein said diffraction optical system is to have a plurality of multistage diffraction structures that defined the zone of zone boundary, at place, described zone boundary, be incident on described structural light the optical phase transfer can take place, and the light of each wavelength is diffracted into described focus with different order of diffraction m, thereby provide multistage order diffractive singlet, wherein m 〉=1.
26. lens as claimed in claim 18, wherein, described optical system comprises refractive component and diffractive part.
27. a haptic tail, it comprises:
Haptic base; With
Haptic pads, it comprises the end and the end of contiguous haptic base, wherein said haptic pads is extending from haptic base less than the angles of 65 degree, and the width of the near-end of wherein said haptic pads is width only about half of of the end of described haptic pads.
28. the haptic tail of claim 27, wherein, described haptic base is extended from haptic pads with the rising curve form.
29. the haptic tail of claim 28, wherein, described haptic base is to extend from haptic tail less than the angle of 45 degree.
30. the haptic tail of claim 29, wherein, described haptic base is to extend from haptic tail less than the angle of 30 degree.
31. an intraocular lens, it comprises:
Limit the optical system of vertical optical axis;
Haptic base, it has the proximal part that links to each other with optical system, and outside optical axis direction, extend into end portion by transition portion, wherein transition portion extends into end portion from proximal part vertically downward by two roughly opposite angles of curvature, and does in order to promote proximal part from end portion far away; With
Haptic tail, it has the proximal part that links to each other with the end portion of haptic body, and approximate horizontal ground stretches out and enters in a pair of haptic pads.
32. intraocular lens as claimed in claim 31, wherein, described haptic base comprises thin film.
33. a method of implanting anterior chamber's intraocular lens, it comprises
Intraocular lens is provided, described intraocular lens comprises: be arranged on the optical system in the lens body, with have to haptic tail tilt with the descending arc form from the extended haptic base of lens, wherein said haptic tail comprises the haptic pads of stretching out from haptic base, wherein when the correcting lens of ophthalmic was implanted in receiver's eyes, the inclination of the arc of described haptic base increased;
Produce otch in eyes, wherein eyes comprise anterior chamber and Fang Jiao, and wherein incision length is approximately less than 2 millimeters and the passage that leads to the eyes anterior chamber is provided; And
Intraocular lens is introduced in the anterior chamber of eyes, thereby haptic pads is introduced in the angle, room of eyes.
34. method as claimed in claim 33 wherein, is not implemented the peripheral excision of iris.
CN 200580034519 2004-08-24 2005-08-24 Foldable intraocular lens with adaptable haptics Pending CN101039635A (en)

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