Abstract:
An accommodating intraocular lens is disclosed that provides vision accommodation in response to contraction of an eye&#39;s ciliary muscle. The intraocular lens comprises a deformable elastic dynamic lens having a non-accommodating surface curvature and a lens-shaping member having flexible portions in contact with peripheral edge regions of the dynamic lens for enabling compressive deformation thereof for changing the lens surface curvature to achieve accommodation. Included are an elastically flexible coil member mounted around the lens-shaping member flexible portions. A first lens-supporting member has a proximal end region that engages the flexible coil member and a second lens-supporting member has a proximal end region connected to the lens-shaping member. In one embodiment in which the intraocular lens is implanted in the capsular bag of an aphakic eye, distal end regions of both lens-supporting members are configured for attachment to the capsular bag adjacent to zonules connected to opposite regions of the ciliary body. In another embodiment in which the intraocular lens is implanted in the capsular bag of an aphakic eye, distal end regions of both lens-supporting members are configured to bear directly against opposite regions of the ciliary body. In a third embodiment in which the intraocular lens is implanted in the anterior chamber of a phakic eye, the distal end region of first lens-supporting member is configured to bear directly against a region of the ciliary body and the second lens-supporting member attaches the intraocular lens to the individual&#39;s iris.

Description:
BACKGROUND OF THE INVENTION  
         [0001]    1. Field of the Invention  
           [0002]    The present invention relates generally to the field of ophthalmics, more particularly to ophthalmic devices, still more particularly to ophthalmic devices known as intraocular lenses (IOLs), and especially to accommodating intraocular lenses.  
           [0003]    2. Background Discussion  
           [0004]    At the onset it may helpful to the understanding of the present invention to define the terms “phakic” and “aphakic” as related to human eyes. The term “phakic” is applied to an eye in which the natural ocular lens is still present. This is in contrast to an “aphakic” eye from which the natural ocular lens has—for any reason—been removed. A phakic eye is considered a dynamic or active eye because the living natural lens is subject to change over time, while an aphakic eye is considered a static eye because the natural lens has been removed.  
           [0005]    Vision in a normal, healthy eye is enabled by light from a viewed object being refracted to the retina in turn by the cornea and the natural lens located rearwardly of the cornea. An important function of the natural lens, through a process of ciliary muscle contraction and zonular relaxation, is the providing of accommodation, that is, the ability of the elastic natural lens to change its curved shape to enable the eye to focus on objects at distances from near to far in response to the eye and brain sensing an out-of-focus image.  
           [0006]    A relatively common ocular problem is impaired or complete loss of vision due to the natural ocular lens becoming cloudy or opaque—a condition known as cataract. The formation of cataracts is typically age related, most individuals over the age of about 60 years suffering from cataracts at least to some extent.  
           [0007]    Cataracts cannot currently be cured, reversed, or even significantly arrested. Accordingly, treatment of cataracts involves surgically removing the natural lens when the lens becomes so cloudy that vision is greatly impaired, the result being that a phakic eye becomes an aphakic eye. After a defective natural lens has been surgically removed, the current vision-restoring practice (since about the 1940&#39;s) is to implant in the aphakic eye an artificial refractive lens called an intraocular lens (IOL). Previously, thick, heavy, high diopter spectacles were prescribed for aphakic eyes. However, most patients dislike such spectacles because of their uncomfortable weight and unattractive appearance.  
           [0008]    Although the implanting of an IOL can generally restore vision in an aphakic eye, corrective spectacles or contact lenses are still usually required for near or far vision, depending upon whether the implanted IOL is selected for far or near vision. This is because, to the knowledge of the present inventor, IOLs providing accommodation comparable to that of a natural healthy lens have not heretofore been available; although, the development of accommodating IOLs has been widely sought.  
           [0009]    In addition to the desirability of implanting accommodating IOLs in aphakic eyes in place of the removed natural lens, the implanting of accommodating IOLs would be advantageous in phakic eyes in which the intact natural lens, while still otherwise clear, has lost all or much of its accommodating properties, for example, by becoming less flexible. Nevertheless, the ciliary muscle, which normally functions to provide accommodation of the natural lens generally, remains active for most of an individual&#39;s life.  
           [0010]    Efforts toward developing accommodating IOLs have relied upon axial IOL movement in the eye and/or IOL lens surface shape change to create dynamic change in ocular power and thus provide accommodation.  
           [0011]    Axial movement of implanted IOLs in the eye to provide accommodation is disclosed, for example, in U.S. Pat. Nos. 5,476,514; 5,496,366; 5,674,282 and 6,197,059 to Stuart Cumming. Difficulties associated with axial IOL movement to provide accommodation are due both to the extremely limited ocular space for axial IOL movement that limits the achievable diopter variation necessary for full accommodation, and to satisfactory ocular mechanisms for causing such axial IOL movement.  
           [0012]    On the other hand, lens surface shape changing, exemplified in the disclosures of U.S. Pat. Nos. 4,842,601; 4,888,012; 4,932,966; 4,994,082; 5,489,302 have required a spherical lens shape to interact with the rim of ciliary muscle in more then one meridian or even from all 360° orientations. This requires perfect lens centration in regard to the ciliary rim and equal interaction from all meridians; otherwise, absence of central symmetry leads to unequal lens surface curvature in different meridians with resulting reduction in image quality.  
           [0013]    Because of these and other problems, a principal objective of the present invention is to provide an improved, surface shape changing accommodating IOL that relies on the interaction with the ciliary muscle in only one meridian. Such improved surface shape changing IOLs may be configured for implanting in aphakic eyes or may alternatively configured for implanting in phakic eyes.  
         SUMMARY OF THE INVENTION  
         [0014]    In accordance with the present invention, there is provided an accommodating intraocular lens for implanting in an individual&#39;s eye. The accommodating intraocular lens comprises a deformable elastic dynamic lens, which is preferably formed from a silicone or acrylic material, having a non-accommodating surface curvature and a lens-shaping member having flexible portions in contact with peripheral edge regions of the dynamic lens for enabling deformation of the lens for changing the lens surface curvature.  
           [0015]    Included in the accommodating intraocular lens are an elastically flexible member, which may be constructed from a shape memory metallic alloy, in contact with the lens-shaping member flexible portions and first and second lens-supporting members. The first lens-supporting member has a proximal end region engaging the flexible member and the second lens-supporting member has a proximal end region connected to the lens-shaping member. A distal end region of at least the first lens supporting member is shaped for engaging, upon implanting the intraocular lens in an individual&#39;s eye, regions of the individual&#39;s eye that are responsive to contraction and relaxation of a ciliary muscle disposed in a ciliary body region of the individual&#39;s eye.  
           [0016]    Preferably, the first and second lens supporting members are configured so their respective distal end regions are aligned with generally opposite regions of the ciliary body when the intraocular lens is implanted in the individual&#39;s eye. Also preferably each of the first and second lens supporting members are relatively rigid as compared with the dynamic lens, preferably being formed as is the lens shaping member from polymethyl methacrylate, with the second lens supporting member being rigidly connected to the lens-shaping member or the two may be constructed in one piece. The elastically flexible member is formed in a coil to encircle the flexible portions of the lens-shaping member.  
           [0017]    The second lens supporting member may include a static, non-accommodating lens having an optical axis aligned with an optical axis of the dynamic lens.  
           [0018]    In one embodiment, the intraocular lens is implanted in an individual&#39;s capsular bag from which a natural lens has been removed with the distal end regions of the first and second lens supporting members are configured for direct contact with the ciliary body. Correspondingly, the elastically flexible member and the flexible portion of the lens-shaping member each have a larger diameter unstressed condition and a smaller diameter stressed condition, and are configured for elastically returning to the larger diameter, unstressed conditions, thereby enabling the outer diameter of the dynamic lens to elastically expand to its non-accommodating condition, in response to the reduction of the compressive force applied to distal ends of the first and second lens support members by the ciliary body when the ciliary muscle relaxes.  
           [0019]    Moreover, the elastically flexible member is constructed for tightening and squeezing the flexible portions of the lens-shaping member, thereby reducing the outer diameter of the dynamic lens by the lens-shaping member and increasing the surface curvature of the dynamic lens for achieving accommodation, in response to a compressive force applied to distal ends of the first and second lens support members by the ciliary body when the ciliary muscle contracts.  
           [0020]    In another embodiment, the intraocular lens is implanted in an individual&#39;s capsular bag from which a natural lens has been removed with the distal ends of the first and second lens supporting members being configured for attachment to the capsular bag adjacent opposing ciliary body-connected zonules. In which case, the elastically flexible member is configured for being pulled to a larger diameter, stressed condition and the flexible portions of the lens-shaping member is configured for elastically returning to a larger diameter, unstressed condition, thereby enabling the outer diameter of said dynamic lens to attain its unstressed, non-accommodating condition, in response to an increase in tension applied to distal end regions of the first and second lens supporting members by the zonules when the ciliary muscle relaxes.  
           [0021]    Correspondingly, the elastically flexible member is constructed for elastically contracting from the larger diameter stressed condition to a smaller diameter unstressed condition, thereby squeezing the flexible portions of the lens-shaping member to a smaller diameter stressed condition and reducing the outer diameter of the dynamic lens and increasing the surface curvature for achieving accommodation, in response to a release of tension applied to distal end regions of the first and second lens supporting members by the zonules when the ciliary muscle contracts.  
           [0022]    In another embodiment, the intraocular lens is implanted in an anterior chamber of an individual&#39;s eye, with the distal end region of the first lens supporting member is configured for bearing against the ciliary body and with the second lens supporting member being configured for attaching to an iris region of the eye. The elastically flexible member and the flexible portion of the lens-shaping member each have a larger diameter unstressed condition and a smaller diameter stressed condition and are configured for elastically returning to the larger diameter, unstressed conditions, thereby enabling the outer diameter of the dynamic lens to elastically expand to its non-accommodating condition, in response to the reduction of the compressive force applied to the distal end region of the first lens supporting member by the ciliary body when the ciliary muscle relaxes. In such case, the elastically flexible member is constructed for tightening and squeezing the flexible portions of the lens-shaping member, thereby reducing the outer diameter of the dynamic lens by the lens-shaping member and increasing the surface curvature of the dynamic lens for achieving accommodation, in response to a compressive force applied to the distal end region of the first lens supporting member by the ciliary body when the ciliary muscle contracts. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0023]    The present invention can be more readily understood by a consideration of the following detailed description when taken in conjunction with the accompanying drawings, in which:  
         [0024]    [0024]FIG. 1 is a front view of an aphakic accommodation intraocular lens of the present invention implanted in the crystalline lens capsule (capsular bag) of an aphakic eye, showing the accommodating intraocular lens in its unaccommodating condition in which the ciliary muscle in the ciliary body is in its relaxed state that creates tension in the zonules attached to the capsule, and showing an elastically deformable dynamic lens supported in the lens capsule by a static haptic and a dynamic haptic, showing haptic-engaged regions of the capsular bag connected by zonules to the surrounding ciliary body on a single meridian that passes through an optical axis of the dynamic lens, and showing ends of a wishbone-shaped region of the dynamic haptic connected to opposite side regions of a lens compressing spring coil disposed around the periphery of the lens and showing the spring coil in its stressed state thereby releasing the dynamic lens to its unstressed, non-accommodating state;  
         [0025]    [0025]FIG. 2 is a vertical cross sectional view taken along line  2 - 2  of FIG. 1 showing a static lens that forms part of the static haptic and showing the lens compressing spring coil supported on a peripheral flange region of the static lens portion of the static haptic that also surrounds the periphery of the dynamic lens, and also showing a guide portion of the static haptic that extends through a movement-limiting slot in the dynamic haptic;  
         [0026]    [0026]FIG. 3 is a front view of the aphakic accommodating intraocular lens of FIG. 1, showing the dynamic haptic in its accommodating condition in which the ciliary muscle is in its contracted state thereby releasing tension in the zonules and enabling the lens compressing spring coil to return from its stressed state to its unstressed state that causes radial compression of the dynamic lens, thereby increasing its anterior surface curvature for near object viewing;  
         [0027]    [0027]FIG. 4 is a vertical cross sectional view taken along line  4 - 4  of FIG. 3, similar to the cross sectional view of FIG. 2, showing the accommodating intraocular lens in its accommodating condition;  
         [0028]    [0028]FIG. 5 is a front view of the dynamic lens of FIGS.  1 - 4 , showing the lens in its unstressed, flatter non-accommodating state and showing in phantom lines the lens in its stressed, more curved accommodating state;  
         [0029]    [0029]FIG. 6 is a vertical cross sectional view taken along line  6 - 6  of FIG. 5 showing features of the dynamic lens in its unstressed non-accommodating state and showing in phantom lines the lens in its stressed accommodating state;  
         [0030]    [0030]FIG. 7 is a front view of the lens compressing spring coil of FIGS.  1 - 4 , showing the spring coil in its in its unstressed state;  
         [0031]    [0031]FIG. 8 is a vertical cross sectional view taken along line  8 - 8  of FIG. 7 showing features of the lens compressing spring coil in its un stressed state;  
         [0032]    [0032]FIG. 9 is a front view of the lens compressing spring coil similar to FIG. 7, but showing the spring coil in its in its stressed state;  
         [0033]    [0033]FIG. 10 is a front view of the dynamic haptic of FIGS.  1 - 4 , showing its wishbone shape and showing other features of the dynamic haptic;  
         [0034]    [0034]FIG. 11 is a vertical cross sectional view taken along line  11 - 11  of FIG. 10 showing additional features of the dynamic haptic;  
         [0035]    [0035]FIG. 12 is a front view of the static haptic of FIGS.  1 - 4 , showing its shape and showing other features of the static haptic;  
         [0036]    [0036]FIG. 13 is a vertical cross sectional view taken along line  13 - 13  of FIG. 12 showing an integral static lens and additional features of the static haptic;  
         [0037]    [0037]FIG. 14 is a vertical cross sectional view corresponding generally to FIG. 13 of a variation static haptic that is formed as an annular frame without a static lens;  
         [0038]    [0038]FIG. 15 is a series of enlarged drawings of variations of shape of a dynamic lens confining peripheral edge rim or flange of the static haptic: FIG. 15A showing a first rim shape, FIG. 15B showing a second rim shape, FIG. 15C showing a third rim shape, FIG. 15D showing a fourth rim shape;  
         [0039]    [0039]FIG. 16 is a vertical cross sectional view corresponding to FIG. 2, of a first variation accommodating intraocular lens in a non-accommodating condition, showing a dynamic lens installed in a shape-changing lens support member that causes both the anterior and posterior surfaces of the dynamic lens to change surface curvature for accommodation;  
         [0040]    [0040]FIG. 17 is a view looking along line  17 - 17  of FIG. 16 showing a wedge-shaped cutout the shape-changing lens support member that enables compression of the member;  
         [0041]    [0041]FIG. 18 is a vertical cross sectional view corresponding to FIG. 4, of a second variation accommodating intraocular lens in an accommodating condition, the second variation accommodating intraocular lens being shown as an aphakic lens similar to the aphakic accommodating intraocular lens of FIGS.  1 - 4  except showing that both a dynamic haptic and a static haptic are directly attached to ciliary body containing the ciliary muscle; and  
         [0042]    [0042]FIG. 19 is a vertical cross sectional view corresponding generally to FIG. 4, of a third variation accommodating intraocular lens, the third variation accommodating intraocular lens being a phakic lens, showing a static haptic fixated to an iris and showing a dynamic haptic directly attached to the ciliary body containing the ciliary muscle. 
     
    
       [0043]    In the various FIGS., the same elements and features are given the same reference numbers. In the various variation, corresponding elements and features are given the same reference numbers as first set forth, followed by an “a”, “b”, “c”, and so on, as appropriate and/or as will otherwise be evident in the following DESCRIPTION.  
       DESCRIPTION OF THE PREFERRED EMBODIMENT  
       [0044]    There is shown in plan view in FIG. 1, an aphakic accommodating intraocular lens (AIOL)  20  in accordance with the present invention. AIOL  20  is depicted in its non-accommodating condition, as described below, implanted in a collapsed crystalline lens capsule or capsular bag  22  of a human eye designated generally by reference number  24 .  
         [0045]    Comprising AIOL  20 , as more particularly described below, is an elastically deformable dynamic, accommodating lens  26 , the anterior surface curvature of which is changed in the manner described below to provide vision accommodation of the AIOL. Further comprising AIOL  20  are a first lens supporting member or dynamic haptic  28 , a second lens supporting member or static haptic  30  and an elastically flexible dynamic lens spring coil or member  32  (FIG. 2).  
         [0046]    Dynamic lens  26 , which is shown in FIG. 2, by way of example, as a plano-convex lens, is supported on static haptic  30  within a thin, flexible peripheral rim or portion  34  of static haptic  30  and around which is installed spring coil  32  that is shown in its expanded, stressed state. Considering flexible rim or portion  34  within which dynamic lens  26  is received for lens shaping, static haptic  30  may be considered as a lens-shaping member. Sidewardly projecting ends  40  and  42  of spring coil  32  are connected to ends of opposite legs  44  and  46  of dynamic haptic  28 .  
         [0047]    As described below relative to FIGS. 3 and 4, the releasing of spring coil  32  from its stressed state by first, dynamic haptic  28 , in response to contraction of ciliary muscle  60  and consequent reduced tension in zonules  56  connected to capsular bag  22 , results in a returning of the spring coil towards its unstressed diameter. This diameter reduction of spring coil  32  causes radial squeezing (through static haptic flexible rim  34 ) of a peripheral edge  48  of dynamic lens  26 , resulting in an increased curvature of a curved anterior surface  50  of the dynamic lens  26  to provide visual accommodation for near viewing.  
         [0048]    Arcuate foot regions  52  and  54 , respectively, of dynamic haptic  28  and static haptic  30  are anchored in capsular bag  22  and are thereby operatively connected by zonules  56  (which are connected to the periphery of the capsular bag) to a ciliary body  58  containing a ciliary muscle  60  that is depicted in its relaxed, non-accommodating state in FIG. 2. Such anchoring of haptic feet  52  and  54  may be accomplished by cell growth resulting from ocular immobility chemically induced for several days. As depicted in FIG. 1, haptic foot regions  52  and  54  are centered on a single meridian  62  that passes through an optical axis  64  of lens  26 . An iris  66  is shown in FIG. 2 but is omitted in FIG. 1 for clarity reasons.  
         [0049]    Shown in FIG. 2, by way of example with no limitation being thereby intended or implied, static haptic  30 , which, as described above, confines accommodating lens  26  within flexible peripheral rim or flange  34 , incorporates a fixed, static or non-accommodating lens  70 . Static lens  70  is depicted as a plano-convex lens aligned along optical axis  64 . Static lens  70  has a curved posterior surface  72  and a flat anterior surface  74  that abuts a flat posterior surface  76  of dynamic lens  26 .  
         [0050]    It is, however, to be appreciated that dynamic lens  26  and/or static lens  70  may alternatively be formed as plano-convex lenses or meniscus (concave-convex) lenses (not shown), according to desired optical power to be provided by AIOL  20 . By way of example, with no limitation being thereby implied or intended, dynamic lens  26  and static lens  70  in combination may be configured to provide between about −25 diopter and about +35 diopter correction. As depicted in FIG. 2, dynamic lens  26  may be laser tacked to static lens  70  at a point  78  at respective abutting surfaces  76  and  74  on optical axis  64  (FIG. 2) to assist in the confining of the dynamic lens in static haptic  30 .  
         [0051]    Formed as part of static haptic  30  is a slender, curved guide element  80  (FIG. 2) that extends upwardly and forwardly from an upper region of static lens  70 . Static haptic guide element  80  extends forwardly through a narrow slot  82  generally centrally located in dynamic haptic  28  adjacent foot  52  (FIG. 1) to provide a radially sliding connection between static haptic  30  and the dynamic haptic.  
         [0052]    It will be appreciated that when ciliary muscle  60  in its relaxed state tension is created in zonules  56 . Such zonule tension in pulls on haptics  28  and  30 , thereby pulling spring coil  32  to its open, stressed state, thereby permitting dynamic lens  26  to resume its unstressed, non-accommodating, flatter state due to dynamic lens elasticity and the flexibility of static haptic rim  34 .  
         [0053]    [0053]FIGS. 3 and 4 correspond respectively to FIGS. 1 and 2 but depict AIOL  20  in its accommodating condition rather than in its non-accommodating condition. In response to ciliary muscle  60  (FIG. 4) being activated by eye  22  to its contracted state, tension in zonules  60  is relaxes, thereby releasing tension on dynamic and static haptics  28  and  30 . This permits spring coil  32  (which is connected to dynamic haptic  28 ) to return toward (or to) its smaller diameter, unstressed state from its stressed state depicted in FIG. 1, thereby applying a compressive force, through static haptic flexible rim  34 , to dynamic lens peripheral edge  48 . The applying of a compressive force to dynamic lens peripheral edge  48  causes the curvature of dynamic lens anterior surface  50  to increase to the extent needed to focus eye  24  on closer objects. In that manner, AIOL  20  provides accommodation in the same way as the natural lens that is replaced by the AIOL.  
         [0054]    As described above, when ciliary muscle  60  then relaxes, the resulting increased zonule tension pulls dynamic haptic  28  radially outwardly (direction of Arrow A, FIGS. 3 and 4) and static haptic  30  radially outwardly (direction of Arrow B) thereby stretching spring coil  32  toward its stressed, larger diameter state depicted in FIG. 1. This enables the elastic restoring action of dynamic lens  26  and flexibility of static haptic rim  34  to return the dynamic lens toward its flatter unstressed condition or state. This automatic restoring action results in decreasing the previously increased curvature of dynamic lens anterior surface  50  to the extent needed to focus eye  24  on more distant objects.  
         [0055]    [0055]FIG. 5 depicts in solid lines dynamic lens  26  in its flatter, unstressed, non-accommodation condition of FIGS. 1 and 2, and depicts in phantom lines the lens in its more rounded stressed accommodating condition of FIGS. 3 and 4. In its unstressed, non-accommodating condition, dynamic lens  26  has an outside diameter, D 1 , that may, for example, be about 6.1 mm (millimeters); in its stressed, accommodating condition, dynamic lens  26  has an outside diameter, D 2 , that may, for example, be about 5.6 mm.  
         [0056]    As shown in the cross section of FIG. 6, dynamic lens  26  may, for example, have an unstressed, non-accommodating center thickness, t 1 , of about 1.2 mm and a stressed, accommodating center thickness, t 2 , of about 1.4 mm. Dynamic lens posterior surface  50  may, for example, have a corresponding unstressed, non-accommodating radius of curvature, R 1 , of about 7.0 mm and a stressed, accommodating radius of curvature, R 2 , of about 6.0 mm. Dynamic lens  26  may be constructed, for example, by cast molding, from an elastomeric silicone or acrylic material having a index of refraction of about 1.4 or greater. It will be appreciated that dynamic lens  26  may be constructed having a varying stiffness profile from optical axis  64  to lens periphery  48  to assist the uniform curvature change of lens surface  50  during the lens accommodation process.  
         [0057]    [0057]FIG. 7 depicts compression spring coil  32 , which is preferably formed in 1½ circular coils, in its smaller inside diameter, unstressed state (depicted in FIGS. 3 and 4) having a preferred inside diameter, D 4 , of about 6.0 mm and a thickness, t 3 , of preferably about 0.25 mm. Coil ends  40  and  42 , which are formed at 90 degree angles, may extend radially outwardly distances, d 1 , of about 0.5 mm, and are formed having holes (not shown) for receiving connecting ends of haptic legs  44  and  46 . Spring coil  32  is preferably constructed from an elastically flexible, shape memory spring alloy such as Nitinol or Elgiloy.  
         [0058]    As shown in FIG. 8, coil  32  has a width, w 1 , that is preferably between about 0.2 mm and about 0.5 mm. Coil  32  is depicted in FIG. 9 in its larger inside diameter stressed state of FIGS. 1 and 2, having an inside diameter, D 3 , which is preferably about 6.5 mm.  
         [0059]    First, dynamic haptic  28  is depicted in plan view in FIG. 10, as being generally wishbone or saddle shaped with arcuate legs  44  and  46  having a preferred inner radius, R 3 , of about 3.3 mm from optical axis  64  and nominal widths, w 2 , of about 0.3 mm. Respective distal ends  86  and  88  of haptic legs  44  and  46  taper to spring coil attachment points. Foot  52  of dynamic haptic  28  preferably has a height, h 1 , and a width, w 3 , along an arc of radius, R 4 , on which a radially outward surface  90  of the foot lies. Preferably, foot height, h 1 , is about 0.3 mm; width, w 3 , is about 7.0 mm; and radius, R 4 , from axis  64  is about 4.6 mm. A slender haptic neck region  92  interconnecting foot  52  and legs  42  and  44 , and in which guide slot  82  is formed, has a preferred width, w 4 , of about 1.0 mm.  
         [0060]    Shown in cross section in FIG. 11, dynamic haptic foot  52  has a preferred thickness, t 5 , of about 0.3 mm. Slot  82  in neck region  92  has a preferred length, l 1 , of about 0.7 mm and representative haptic leg  46 , along with neck region  92  has a preferred thickness, t 4 , of about 0.3 mm.  
         [0061]    Dynamic haptic  28  is preferably constructed from a material, for example, polymethyl methacrylate (PMMA), that is stiffer than that from which dynamic lens  26  is constructed. At least foot  52  and neck region  92  may be roughened or provided with small holes (not shown) to assist cell growth anchoring of the haptic inside capsular bag  22 .  
         [0062]    Second, static haptic  30  is depicted in FIGS. 12 and 13. As shown in FIG. 12, static haptic foot  54  is preferably the same size and shape as above-described foot  52  of dynamic haptic  28 , a radially outer foot surface  94  being on an arc of the same radius R 4  and foot  54  having the same height, h 1 , width, w 3 , and thickness t 5  (FIG. 13). A static haptic neck region  96  that joins foot  54  to static lens  70  is preferably sized the same as above-described dynamic haptic neck region  92  (except for slot  82 ), having the same width, w 4 , (FIG. 12) and thickness t 4  (FIG. 13). At least foot  54  and neck region  96  may be roughened or provided with small holes (not shown) to assist cell growth anchoring of the haptic inside capsular bag  22 .  
         [0063]    As shown in FIG. 13, haptic flexible rim or portion  34  extends parallel to optical axis  64  from flat surface  70  a distance, d 1 , that is preferably about 0.4 mm. Rim  34 , as seen in cross section, has a recessed inner annular surface groove  98  for receiving and retaining peripheral edge  48  of dynamic lens  26 , and has a recessed outer annular surface groove  100  for receiving and retaining spring coil  32 . Inner surface groove  98  has a diameter, D 1 , equal to outer, unstressed diameter, D 1 , of dynamic lens  26  (FIG. 5) and outer surface groove has a diameter, D 3 , equal to inner, unstressed diameter, D 3 , of spring coil  32  (FIG. 7).  
         [0064]    As shown in FIG. 12, rim  34  is formed having a number of radial notches  102  equally spaced around the rim in order to enhance rim flexibility and enable the rim to be squeezed to a smaller diameter by action of spring coil  32  in the dynamic lens accommodating process described above.  
         [0065]    Preferred static, non-accommodating lens  70  may have a center thickness, t 6 , of about 4.0 mm and a posterior surface  102  may have a radius of curvature, R 5 , centered on optical axis  64 , of about 200 mm (FIG. 13). Guide  80  is angled in the direction of rim  34  a distance, d 2 , of preferably about 0.5 mm. An overall height, h 2 , (FIG. 12) of haptic  30  from optical axis  64  to the tip of guide  80  is preferably about 3.9 mm.  
         [0066]    It is within the scope of the present invention to provide a variation static haptic  30   a  (shown in cross section in FIG. 14) that is similar to above-described static haptic  30 , but is constructed without a static lens, such as static lens  70  depicted for static haptic  30  in FIG. 13. As such, static haptic  30   a  comprises an open annular frame  104  that supports above-described rim or flange  34 . Annular frame  104 , which is connected by neck region  96  to foot  54 , has a thickness, t 5 , that may be about 0.3 mm, or may be the same as thickness t 4  of neck region  96  of static haptic  30  (FIG. 13).  
         [0067]    Preferably static haptics  30  and  30   a  are constructed from the same relatively stiff (as compared to dynamic lens  26 ) material, for example, PMMA, as above-described dynamic haptic  28  is constructed.  
         [0068]    FIGS.  15 A- 15 D depict in cross section four static haptic flexible rim or portion variations that may be used to advantage to transmit compressing forces from spring coil  32  to dynamic lens  26 . As such, FIGS. 15 a - 15   d  correspond generally to corresponding portions of the cross sections of FIGS. 13 and 14.  
         [0069]    [0069]FIG. 15A depicts a first variation rim  34   a  formed on a variation static haptic  30   a  having a radially inwardly directed lip  110 , having a height, h 3 , of about 0.4 mm, that assists in confining peripheral edge  48   a  of dynamic lens  26   a  and may thereby help to prevent undesirable lens bulging at its periphery during the above-described lens accommodating process.  
         [0070]    [0070]FIG. 15B depicts a second variation rim  34   b  formed on a second variation static haptic  30   b  also having a radially inwardly directed lip  110 , having a height, h 3 , of about 0.4 mm, that assists in confining peripheral edge  48   b  of dynamic lens  26   b . In this variation, a static lens  70   b  is shown having a shallow arcuate annular recess  112  into which a corresponding curved peripheral dynamic lens region  114  fits. Again the objective is to help assure uniform curvature change of dynamic lens posterior surface  50   b  during the lens accommodating process.  
         [0071]    [0071]FIG. 15C depicts an inner annular surface  98   c  of a third variation static haptic rim  34   c  that is more curved than surface  98  of rim  34  depicted in FIGS. 13 and 14 as sometimes may be desired. FIG. 15D depicts a fourth variation static haptic rim  34   d  that is a compromise between rim  34   c  depicted in FIG. 15C and rim  34  depicted in FIGS. 13 and 14.  
         [0072]    It is to be appreciated, however, that still other configurations of static haptic rim  34  are within the scope of the present invention.  
         [0073]    First Variation AIOL of FIGS. 16 and 17:  
         [0074]    [0074]FIG. 16 is a cross sectional drawing, corresponding to the cross section of FIG. 2, of a first variation aphakic AIOL  220  depicted in a non-accommodating condition (elements and features corresponding to previously described features and elements are given the same reference number as the original elements and features preceded by the digit “2”; newly introduced features and elements are given a new, 200 series number).  
         [0075]    AIOL  220 , which implanted in capsular bag  22  in the manner of above-described AIOL  20 , is shown, by way of example, having a biconvex dynamic lens  226  (shown in solid lines) and alternatively, also by way of illustration, having a concave-convex dynamic lens  220   a  (shown in broken lines).  
         [0076]    A static haptic  228  of AIOL  220  is preferably constructed the same as above-described dynamic haptic  28  of AIOL  20 . A static haptic  230  of AIOL  220  is preferably constructed the same as above-described static haptic  30  of AIOL  20 , except that static haptic  230  is constructed without a rim or flange corresponding to rim or flange  34  of static haptic  30 . In place of a rim or flange corresponding to rim or flange  34  of static haptic  30 , AIOL  220  includes a dished flexible, dynamic lens-shaping member  202  that is centrally attached (as by laser tack welding) to static haptic  230  at a point  278  on optical axis  64  and thus can be considered part of the static haptic.  
         [0077]    Dynamic lens-shaping member  202  is formed having a radius, R 6 , which may be about 14 mm centered on optical axis  64 . Radius, R 6 , also defines the radius of posterior surface  276  of dynamic lenses  226  or  226   a  depending on the lens used in AIOL  220 .  
         [0078]    Formed around the periphery of lens-shaping member is a dynamic lens retaining rim  204  having an arcuate inner annular surface  208  that has the same diameter as the outside diameter of lenses  226  or  226   a , as is above-described for inner annular groove  98  of static haptic rim  34  (FIGS.  12 - 14 ). Lens-shaping member  202  is further formed having an annular rib  206  protruding from a posterior surface  210 .  
         [0079]    As shown in FIG. 17, lens-shaping member rib  206  has an outer diameter, D 4 , that is the same as the inner diameter of spring coil  32  in its unstressed state (FIG. 17) and has a width, w 5 , that may be about 0.2 mm. Rib  206  has a height, h 2 , (FIG. 16) that depends upon the radius of curvature, R 6 , of lens shaping member  202 , being such that the member rests on flat anterior surface  274  of static lens  270 . In any event, rib height, h 2 , is at least the width, w 1 , of spring coil  32  that is installed onto rib  206 . Member  202  is formed, as depicted in FIG. 17, having a wedge shaped slit or cutout  212  with a peripheral width, w 6 , of about 0.5 mm to enable its reduction in diameter for accommodation of dynamic lens  226  or  226   a , as described below. Member  202  preferably has a thickness, t 6 , (FIG. 16) of about 0.05 mm and is preferably constructed of the same stiff, elastically flexible material as haptics  28 ,  228  and  30 , 230 .  
         [0080]    AIOL  220  provides accommodation in the same manner as above described for AIOL  20  (FIGS.  1 - 4 ). In the non-accommodating state of AIOL  220  depicted in FIG. 16, ciliary muscle  60  is in its relaxed state with the result that zonules  56  attached to dynamic and static haptics  228  and  230  are in tension. Such tension pulls spring coil  32  to its stressed more-open state, depicted in FIG.  19 , thereby releasing the compressive stress on rib  206  of flexible lens-shaping member  202 . This release of compressive stress on member  202  permits the member to expand to its unstressed state and permits dynamic lens  226  (or  226   a , as the case may be) to expand from its compressed, accommodating state to its flatter, non-accommodating, normal state by the elastic restoring properties of the lens.  
         [0081]    In the accommodation condition for which ciliary muscle  60  is contracted as depicted for AIOL  20  in FIGS. 3 and 4, tension in zonules  56  is relaxed, permitting spring coil  32  to return to its normal uncompressed state depicted in FIG. 17, thereby causing a compressive stress to be applied to lens-shaping member  202 , through rib  206 . This compressive stress on member  202  applies a compressive force to peripheral edge  248  of dynamic lens  226  (or  226   a ) causing the dynamic lens to elastically deform to a more rounded, accommodating shape.  
         [0082]    Second Variation AIOL of FIG. 18:  
         [0083]    It may in some instances be desirable or necessary to attach an aphakic AIOL implanted in capsular bag  22  directly to ciliary body  58 , as depicted in FIG. 18 for a second variation aphakic AIOL  320 . As a result, AIOL  320  is responsive for accommodation to compression forces from ciliary body  58 , caused by ciliary muscle  60  contraction, rather than from zonular tension relaxation to which above-described AIOL  20  is responsive for accommodation. Elements and features of second variation AIOL  320  that correspond to previously described features and elements of above-described AIOL  20  are given the same reference number as the original elements and features preceded by the digit “3”, with newly introduced features and elements being given a new, 300 series number)  
         [0084]    [0084]FIG. 18, which is a cross sectional drawing of second variation aphakic AIOL  320  in the accommodation condition, corresponds to the FIG. 4 cross section of aphakic AIOL  20  in its accommodation condition. Second variation AIOL  320  is in most respects similar to above-described AIOL  20  except that respective neck regions  392  and  396  of dynamic and static haptics  328  and  330  are made longer to enable associated haptic feet  352  and  354  to bear against ciliary body  58  adjacent capsular bag  22 . In this regard, dynamic and static haptics  328  and  330  are constructed so that respective outer surfaces  390  and  394  of haptic feet  352  and  354  are on a diameter, D 5 , that is about 11.5 mm. Preferably, haptic feet  352  and  354  are made having a width, w 7 , that is about 1.0 mm to provide a greater ciliary body contact area.  
         [0085]    In order for AIOL  320  to provide accommodation in response to compression forces applied to dynamic haptic  328  and static haptic  330  by ciliary body  58  when ciliary muscle  60  contracts, spring coil  332  is, in its normal, non-accommodating, unstressed state made as depicted in FIG. 9 for above-described spring coil  32  in its non-accommodating stressed state. In its stressed, accommodating state, spring coil  332  is as depicted in FIG. 7 for spring coil  32  in its unstressed, accommodating state. Accordingly, responsive to compressive forces from ciliary body  58 , dynamic haptic  328  acts on spring coil  332  to compress it from its non-accommodating, unstressed condition to its smaller diameter stressed, accommodating state, thereby decreasing the coil diameter and applying a compressive, accommodating stress, through flexible rim or portion  334  of static haptic  330 , to dynamic lens  326 .  
         [0086]    When ciliary muscle  60  relaxes, the compressive force from ciliary body  58  on dynamic haptic  328  is reduced permitting spring coil  332  to expand to its normal, unstressed state, thereby permitting dynamic lens  326  and static haptic rim  334  to elastically return to their flatter, non-accommodating condition.  
         [0087]    It will be appreciated that the dynamic lens configuration described above with respect to FIGS. 16 and 17 may be applied to second variation AIOL  320  instead of the lens configuration depicted in FIG. 18.  
         [0088]    Third Variation AIOL of FIG. 19:  
         [0089]    It may in some instances be desirable to implant an AIOL in a phakic eye, for example, when its natural lens has lost the ability to provide complete or at least substantial accommodation but is otherwise healthy. Accordingly, FIG. 19 depicts, in a cross section corresponding generally to the cross section of FIG. 18, a third variation, phakic AIOL  420  that is fixated to iris  66  and that is responsive in the manner described above for second variation, aphakic AIOL  320  for accommodation to compression forces from ciliary body  58 , caused by ciliary muscle contraction.  
         [0090]    Third variation, phakic AIOL  420  is depicted in FIG. 19, by way of illustrative example with no limitation being thereby intended or implied, as corresponding in many respects to first variation, aphakic AIOL  220  depicted in FIG. 16. Elements and features of third variation AIOL  420  that correspond to previously described features and elements of above-described AIOL  20  are given the same reference number as the original elements and features preceded by the digit “4”, that correspond to previously described features and elements newly introduced relative to above-described first variation AIOL  220  are given the same reference number followed by an “a” and newly introduced features and elements are given a 400 series number.  
         [0091]    Shown comprising third variation AIOL  420  are a dynamic haptic  428 , a static haptic  430 , a dynamic lens  426 , a dynamic lens shaping member  202   a  and a spring coil  32 . Dynamic haptic  428  is shaped generally like above-described dynamic haptic  28 , except that for being formed having an elongated, curved neck region  492  that provides an offset distance, d 3 , of about 0.8 mm between haptic foot  452  that engages ciliary body  58  beneath ciliary muscle  60  and spring coil  32 . Static haptic  430 , shown by way of example as incorporating a plano-concave static lens  270   a , is configured as disclosed in my prior U.S. Pat. No. 6,152,959, which is incorporated herein in its entirety by specific reference, for fixation to iris  66  forward of an intact natural lens  400 .  
         [0092]    Dynamic lens  426 , shown by way of example as a biconvex lens is similar to above-described dynamic lens  226  (FIG. 16) and is installed in lens shaping member  202   a  that is preferably identical to above described lens shape changing member  202 .  
         [0093]    Accommodation of phakic AIOL  420  is achieved by the compression of spring coil  32  installed around lens shaping member rib  206   a  in the manner described above for first variation, aphakic AIOL in response to contraction of ciliary muscle  60 .  
         [0094]    It will be appreciated that the dynamic lens configuration depicted in FIG. 18 may alternatively be used in phakic AIOL  420 .  
         [0095]    It will also be appreciated that accommodation of both phakic AIOL  420  and aphakic AIOL  220  can be achieved by installing a spring coil, corresponding to spring coil  32  around the inside of lens shaping member rib  206  and  206   a  instead of around the outside thereof as depicted in respective FIGS. 16 and 19. In such case, accommodation of dynamic lens  226  or  426  is provided by expanding the spring coil diameter in response to contraction of ciliary muscle  60  in a manner evident from the above-disclosures.  
         [0096]    Although there have been described above an accommodating intraocular lens and several variations thereof, in accordance with the present invention for purposes of illustrating the manner in which the present invention maybe used to advantage, it is to be understood that the invention is not limited thereto. Consequently, any and all variations and equivalent arrangements that may occur to those skilled in the applicable art are to be considered to be within the scope and spirit of the invention as set forth in the claims that are appended hereto as part of this application.