Prosthesis (i.e. – artificial body members) – parts thereof – or ai – Eye prosthesis – Intraocular lens
Reexamination Certificate
2000-05-03
2003-04-29
Isabella, David J. (Department: 3738)
Prosthesis (i.e., artificial body members), parts thereof, or ai
Eye prosthesis
Intraocular lens
C623S006320, C623S006340
Reexamination Certificate
active
06554859
ABSTRACT:
BACKGROUND OF THE INVENTION
The present invention is directed to intraocular lenses (IOLs). More particularly, the invention relates to multifocal IOLs which are adapted to provide accommodating movement in the eye and which have reduced add powers.
The human eye includes an anterior chamber between the cornea and iris, a posterior chamber, defined by a capsular bag, containing a crystalline lens, a ciliary muscle, a vitreous chamber behind the lens containing the vitreous humor, and a retina at the rear of this chamber. The human eye has a natural accommodation ability. The contraction and relaxation of the ciliary muscle provides the eye with near and distant vision, respectively. This ciliary muscle action shapes the natural crystalline lens to the appropriate optical configuration for focusing light rays entering the eye on the retina.
After the natural crystalline lens is removed, for example, because of cataract or other condition, a conventional, monofocal IOL can be placed in the posterior chamber. Such a conventional IOL has very limited, if any, accommodating ability. However, the wearer of such an IOL continues to require the ability to view both near and far (distant) objects. Corrective spectacles may be employed as a useful solution. Recently, multifocal IOLs have been used to provide near/far vision correction. See, for example, Portney U.S. Pat. No. 5,225,858, Roffman et al U.S. Pat. No. 5,448,312 and Menezes et al U.S. Pat. No. 5,682,223. Monofocal IOLs with a depth of focus features has been suggested and are shown and described in Portney U.S. Pat. No. 5,864,378.
Another approach to overcoming loss of accommodation is to use ophthalmic lenses, such as contact lenses or IOLs, with different optical characteristics for each eye. For example with a system known as monovision one lens has a distance vision correction power and the other lens has a near vision correction power. Another example is shown and described in Roffman et al U.S. Pat. No. 5,485,228. It is also known to implant a distant dominant multifocal IOL in one eye and a near dominant multifocal IOL in the other eye as disclosed in the January 1999 issue of Clinical Sciences by Jacobi et al entitled“Bilateral Implantation of Asymmetrical Diffractive Multifocal Intraocular Lenses,” pages 17-23.
Whether monovision or multifocal ophthalmic lenses are employed, nighttime images may not be the same for both eyes and/or possess halos as when the headlights of an oncoming vehicle are observed. This can significantly reduce the ability of the observer to identify and locate objects near the headlights. For example, halos tend to be created when the patient views a distant object through the near vision portion of the lens, and the greater the add power, the more perceptible is the halo.
For example, this is shown and described in commonly assigned application Ser. No. 09/302,977 filed on Apr. 30, 1999. This application discloses a reduced add power multifocal IOL which reduces the effects of halos. This reduced add power IOL is implanted in a phakic eye in which the natural lens has lost some degree of accommodation, i.e. in partially presbyopic eyes.
Commonly assigned application Ser. No. (Atty. Docket No.: D-2857) filed concurrently herewith also discloses multifocal reduced add power lenses, such as IOLs, which are asymmetric, i.e., have different optical characteristics. However, one of these lenses has an add power for full near vision.
The disclosure of each of the patent applications and patent identified herein is incorporated in its entirety herein by reference.
SUMMARY OF THE INVENTION
New multifocal intraocular lenses (IOLs) adapted to provide accommodating movement in the eye and which have reduced add powers have been discovered. Such IOLs are particularly useful in aphakic eyes in which the natural lens has been removed. The present IOLs have multiple optical powers, that is are multifocal, have at least one reduced add power and provide substantial benefits. The combination of a multifocal IOL with at least one reduced add power together with the ability of the IOL to move to provide accommodation very effectively provides for enhanced vision over a relatively wide range of distances, for example, from distance through near, and, in addition, reduces the size and/or occurrence of halos and other nighttime vision phenomena which can adversely affect vision.
In one broad aspect of the present invention, intraocular lenses for implantation in an eye of a patient are provided. Such lenses comprise a multifocal optic having a maximum add power which is less than the add power required for full near vision for the pseudophakic eye, that is an eye including the IOL but not including the natural lens. The maximum add power of the multifocal optic preferably is about the add power required for intermediate vision for a pseudophakic eye. In addition, a movement assembly is provided. This movement assembly is coupled to the optic and is adapted to cooperate with the eye of the patient to effect accommodating movement of the optic in the eye.
In one embodiment, the multifocal optic has add powers for providing distance and intermediate vision for a pseudophakic eye and the movement assembly provides sufficient accommodating movement of the optic to obtain near vision for a pseudophakic eye. Thus, the patient in whose eye the present IOL is implanted has a range of vision from distance through near.
As can be seen, the present IOLs utilize a combination of an optic with multifocal characteristics and a movement assembly adapted to provide accommodating movement of the optic in the eye. This combination very effectively provides vision over a range of distances. At the same time, the present IOLs reduce the size and/or occurrence of halos and other nighttime phenomena which can adversely affect the vision of the patient. Such reductions in the size and/or occurrence of one or more of such phenomena are relative to a full add power, for example, full near add power, multifocal IOL located in a fixed position, that is without accommodating movement, in the eye.
To illustrate the present invention, the maximum add power of the present multifocal optic is, for example, no more than about 1.25 diopters or about 1.5 diopters, and the movement assembly is adapted to provide at least about 1.0 diopter or at least about 1.5 diopters of accommodation. Thus, the total or maximum effective optical add power apparent to the patient is about 2.25 diopters or about 3.0 diopters or more, which is well within the range of full near vision. All of the add powers set forth herein are in the spectacle plane.
The movement assembly preferably is adapted to provide at least about 0.5 mm or at least about 0.75 mm of accommodating movement.
In one embodiment, the optic has a distance vision correction power for infinity, for example, with the optic in the rest position or in the unaccommodated state in the eye.
The movement assembly of the present IOLs can be of any configuration suitable to provide the desired accommodating movement. One particularly useful movement assembly is that shown and described in commonly assigned application Ser. No. 09/532,910, filed Mar. 22, 2000.
In one useful embodiment, the movement assembly circumscribes the optic and comprises a member including a proximal end region coupled to the optic and a distal end region extending away from the optic and adapted to contact a capsular bag of the eye. The movement assembly preferably is positioned relative to the optic so that, with the intraocular lens at rest, the optic vaults anteriorly of the distal end region of the movement assembly. In order to enhance the accommodating movement of the present IOLs, the movement assembly may include a hinge assembly positioned proximally of the distal end region.
The present intraocular lenses are preferably deformable for insertion through a small incision in the eye.
In a further broad aspect of the present invention, intraocular lenses are provided which include a multifocal optic having a range of optical powers
Gwon Arlene
Lang Alan J.
Advanced Medical Optics, Inc.
Chattopadhyay Urmi
Gluck Peter Jon
Isabella David J.
Stout, Uxa Buyan & Mullins, LLP
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