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  Capsular intraocular lens implant having a refractive liquid thereinUSPTO Application #: 20060212116Title: Capsular intraocular lens implant having a refractive liquid therein Abstract: An intraocular lens having a light-transmitting optic (32, 94a, 94b, 142, 216) comprised of a synthetic light-refractive material (40, 102) operably coupled with a flexible optic positioning member (34, 62, 74, 84, 100, 210) to refract light onto the retina in order to correct refractive errors in the eye (10). The refractive material has an index of refraction of from about 1.36 to 1.5 or higher. The optic positioning member (34, 62, 74, 84, 100, 210) is constructed of a flexible synthetic resin material such as polymethylmethacrylate and permits focusing upon objects located near to and far from the viewer. The optic (32, 94a, 94b, 142, 216) of the present invention possess greater refractive capability than optics conventionally used in IOL construction, and permits retinal receipt of the image being viewed in order to correct refractive errors. (end of abstract) Agent: Advanced Medical Optics, Inc. - Santa Ana, CA, US Inventor: Randall Woods USPTO Applicaton #: 20060212116 - Class: 623006130 (USPTO) Related Patent Categories: Prosthesis (i.e., Artificial Body Members), Parts Thereof, Or Aids And Accessories Therefor, Eye Prosthesis (e.g., Lens Or Corneal Implant, Or Artificial Eye, Etc.), Intraocular Lens, Having Fluid-filled Chamber The Patent Description & Claims data below is from USPTO Patent Application 20060212116. Brief Patent Description - Full Patent Description - Patent Application Claims
BACKGROUND OF THE INVENTION [0001] 1. Field of the Invention [0002] The present invention relates to an accommodating intraocular lens implant (IOL), containing a refractive material therein, for surgical replacement of the natural crystalline lens to treat refractive errors in the human eye. [0003] 2. Description of the Prior Art [0004] Refractive errors in the eye affect one's ability to properly focus an image upon the retina due to a change in the refractive medium of the eye, e.g., the cornea, the natural crystalline lens, or both. The refractive errors pertinent to this application include myopia, hyperopia, and presbyopia. A myopic lacks the ability to focus an image located at a distance from the viewer because the cornea has become elongated, thereby increasing the eye's focal length. A hyperopic lacks the ability to focus on objects located near the viewer because the cornea is not elongated enough or is too flat, and cannot refract light properly upon the retina. Instead, light entering the eye does not bend sharply enough to focus upon the retina. In contrast to myopia wherein the image is brought to focus in front of the retina, hyperopia causes the image to focus behind the retina. Presbyopia is another type of refractive error which results in the inability of the eye to focus because of hardening of the natural crystalline lens. The hardened natural crystalline lens prevents focusing upon objects located near to the viewer. Presbyopia occurs in conjunction with myopia or hyperopia. [0005] The known treatment varies with the type of refractive error to be corrected. Each of the refractive errors may be corrected by external spectacle lenses. Also, refractive surgery is known in the art for correcting the aforementioned refractive errors, and includes radial keratotomy, astigmatic keratotomy, photoreflective keratectomy, and laser in situ keratomileusis (LASIK). Each of the refractive surgical methods mentioned above involve making multiple incisions into the cornea in order to reshape it. Possible side effects of refractive surgery include irregular astigmatism, infection, or haze formation which could result in permanent changes in the cornea and possible loss of best-corrected visual acuity. A possibility of under or over correction also exists with the aforementioned refractive surgeries. Furthermore, none of these refractive surgeries can be used to correct all of the above-referenced refractive errors. [0006] Various IOLs have been used to treat cataracts. The first implant of an IOL within the eye to treat cataracts occurred in 1949. This experimental surgery attempted to place the replacement lens in the posterior chamber of the eye behind the iris. Problems such as dislocation after implantation forced abandonment of this approach, and for some period thereafter IOLs were implanted in the anterior chamber of the eye. [0007] Others returned to the practice of inserting the IOL in the area of the eye posterior to the iris, known as the posterior chamber. This is the area where the patient's natural crystalline lens is located. When the IOL is located in this natural location, substantially normal vision may be restored to the patient, and the problems of forward displacement of the vitreous humor and retinal detachment encountered in anterior chamber IOLs are less likely to occur. IOLs implanted in the posterior chamber are disclosed in U.S. Pat. Nos. 3,718,870, 3,866,249, 3,913,148, 3,925,825, 4,014,049, 4,041,552, 4,053,953, and 4,285,072. None of these IOLs have accommodation capability. [0008] IOLs capable of focusing offered the wearer the closest possible substitute to the natural crystalline lens. U.S. Pat. No. 4,254,509 to Tennant discloses an IOL which moves in an anterior direction upon contraction of the ciliary body and which is located anterior to the iris. Although the Tennant IOL claims to possess accommodation capabilities, it presents the same disadvantages as other anterior chamber lenses. U.S. Pat. No. 4,253,199 to Banko approaches the problem of providing a focusable IOL in a different manner, by providing a replacement IOL of deformable material sutured to the ciliary body. This IOL functions in much the same manner as the natural crystalline lens, but may cause bleeding because it requires sutures. [0009] U.S. Pat. No. 4,409,691 to Levy claims to provide an accommodating IOL positioned within the capsule. This IOL is located in the posterior area of the capsule and is biased toward the fovea or rear of the eye. The Levy IOL is deficient because it requires the ciliary muscle to exert force through the zonules on the capsule in order to compress the haptics inward and drive the optic forward for near vision. However, the ciliary muscles do not exert any force during contraction because the zonules, being flexible filaments, exert only tension, not compression on the capsule. The natural elasticity of the IOL causes the capsule to become more spherical upon contraction of the ciliary muscle. Thus, there is no inward force exerted on the capsule to compress the haptics of the Levy IOL, and therefore accommodate for near vision. Even if such force were somehow available, the Levy IOL's haptics are loaded inward when accommodating for near vision. Since accommodation for near vision is the normal status of the capsule, the Levy IOL's haptics are loaded, reducing the fatigue life of the springlike haptics. [0010] U.S. Pat. No. 5,674,282 to Cumming is directed towards an allegedly accommodating IOL for implanting within the capsule of an eye. The Cumming IOL comprises a central optic and two plate haptics which extend radially outward from diametrically opposite sides of the optic and are movable anteriorly and posteriorly relative to the optic. However, the Cumming IOL suffers from the same shortcomings as the Levy IOL in that the haptics are biased anteriorly by pressure from the ciliary bodies. This will eventually lead to pressure necrosis of the ciliary body. [0011] Finally, U.S. Pat. No. 4,842,601 to Smith discloses an allegedly accommodating IOL having anterior and posterior members which urge against the anterior and posterior walls of the capsule. The muscular action exerted on the capsule will cause the IOL to flatten, thereby changing the focus thereof. The Smith IOL is formed of first and second plastic lens members connected to one another adjacent their peripheral edges so as to provide a cavity therebetween. The connection between the lens members is accomplished by way of a U-shaped flange on the first member which forms an inwardly facing groove for receiving an outwardly extended flange on the second member. The Smith IOL is faulty because the structure of the lens members makes surgical implantation thereof extremely difficult to accomplish, even for highly skilled surgeons. Furthermore, the Smith IOL requires sutures which increases the risk of bleeding. [0012] The IOLs discussed above replaced the opaque crystalline lens symptomatic of cataracts through a small incision in the iris and anterior wall of the biological capsule. The IOLs for the treatment of cataracts differed from the present invention in that the present invention utilizes a highly refractive material to compensate for defects in the eye's natural refractive media, e.g, the cornea and the natural crystalline lens. [0013] There is a great need in the art for a lightweight IOL which can be used to correct a variety of refractive errors in conjunction with other eye defects which require replacement of the natural crystalline lens, such as cataracts. This IOL should be readily insertable into the capsule and should last for a substantial number of years without damaging any of the eye components. SUMMARY OF THE INVENTION [0014] The IOL of the present invention addresses this need because it provides a lightweight accommodating IOL, containing a highly refractive material therein, which is safe for long term use in an eye. The present invention presents a significant advance in the art because it provides an IOL for the safe and effective treatment of refractive errors in combination with other defects such as cataracts. [0015] In more detail, the IOL comprises a resilient optic formed of a highly refractive material operably coupled to a flexible optic positioning member to change shape in response to ciliary body movement, i.e., contraction and retraction of the ciliary body. When the ciliary body relaxes or retracts, it causes the zonules to elongate and exert a tensional pull upon the IOL. Thus, the IOL becomes discoid in shape and allows the viewer to focus upon objects located at a distant therefrom. Similarly, when the ciliary body contracts, it becomes thicker and causes the zonules to ease the tensional pull. Thus, the IOL becomes spheroid in shape and allows the viewer to focus upon objects located near to the viewer. As noted above, the optic is formed of refractive material that has an index of refraction of from about 1.36 to 1.5 or higher (e.g., hydrocarbon oil, silicone oil, or silicone gel). In one type of IOL in accordance with the invention, use is made of a pre-formed capsule having a thin, continuous wall wherein the refractive material is enveloped. [0016] The optic may be coupled with various optic positioning members commonly used in IOL construction depending upon the user's eyesight. The optic may be positioned within the capsule of the eye such that the anterior surface of the optic faces either the anterior or the posterior portion of the eye. When the optic is positioned to face the posterior portion of the eye, the optic will vault posteriorly in response to contraction of the ciliary body. However, the change in the radius of curvature of the optic will counteract the effects of the negative accommodation, i.e., movement of the optic posteriorly. The resiliency of the optic permits a small change in radius of curvature which, when coupled with the relatively high index of refraction of the refractive material, results in an optic having greater light-bending properties than conventional optics. [0017] Another preferred embodiment presents a resilient optic and a posterior rigid optic both operably coupled on opposed sides of an optic positioning member to change shape in response to ciliary body movement. The optics are positioned on opposite segments of the optic positioning members such that they share the same focal point. A similar embodiment transposes the structure described immediately above by implanting the IOL within the eye such that the rigid optic is the anterior optic and the resilient optic is the posterior optic. [0018] Another embodiment of the present invention presents two optics positioned on the same segment of the optic positioning member wherein a rigid optic surrounds a resilient optic. Another embodiment similar to the embodiment discussed immediately above, presents two optics positioned on the same segment of the optic positioning member wherein a resilient optic surrounds a rigid optic. In this embodiment, the resilient optic changes shape in response to ciliary body movement while the rigid optic essentially retains its shape. [0019] Yet another preferred embodiment of the IOL of the present invention includes an optic positioning member comprised of an enclosed flexible bag having resilient fill material therein. The enclosed flexible bag presents an anterior segment and an opposed posterior segment, each having an optic. The optic positioning member is pre-formed to present opposed optic surfaces, hence, the optics are integral with the optic positioning member. The resilient fill material is comprised of the same refractive material used in the above-referenced resilient optic construction. This embodiment also functions similarly to the IOLs discussed above because the anterior optic surface moves anteriorly and the posterior optic surface moves posteriorly in response to contraction of the ciliary body. The optic surfaces of the flexible bag optic positioning member present a small change in the radius of curvature (e.g., 5-4.6 mm) from the accommodated to disaccommodated shapes, coupled with high refractive power thereby permitting retinal receipt of an observed image. [0020] Another embodiment of the present invention is similar to the embodiments having opposed optics, described above, except that the optic positioning member of this embodiment does not completely house the refractive material. The refractive material of this IOL protrudes outward to extend beyond the outer margins of the anterior segment through an opening in the optic positioning member to define a resilient optic. The posterior segment of the optic positioning member supports a second posterior rigid optic positioned in opposition to the resilient optic. The rigid optic is constructed of the same material as the optic positioning member. The resilient material is captively retained by the segments of the optic positioning member, but also directly contacts the biological capsule. Contraction of the ciliary body transfers sufficient force to the resilient and protuberant refractive material which in turn defines an optic operable to change shape in response to ciliary body movement. This embodiment may be constructed without the addition of a second opposed rigid optic depending upon identifiable surgical needs. BRIEF DESCRIPTION OF THE DRAWINGS [0021] FIG. 1 is a vertical sectional view showing an IOL of the invention within the capsule of an eye, with the eye focused on an object distant from the viewer; Continue reading... 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