Abstract:
An lens for correcting human vision, for example an IOL, contact lens or corneal inlay or onlay, that carries and interior phase or layer comprising a pattern of individual transparent adaptive displacement structures. In one embodiment, the displacement structures are actuated by a shape memory polymer (SMP) material or other polymer that is adjustable in shape in response to applied energy. The SMP can be designed to be selectively adjustable in volumetric dimension, modulus of elasticity and/or permeability. The adaptive optic means of the invention can be used to create highly localized surface corrections in the lens to correct higher order aberrations—which types of surfaces cannot be fabricated into and IOL and then implanted. The system of displacement structures also can provide spherical corrections in the lens.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]    This application claims benefit under 35 U.S.C. § 119(e) of Provisional U.S. Patent Applications: Ser. No. 60/402,746 filed Aug. 12, 2002 (Docket No. S-AKO-002) titled Intraocular Lens Implant. This application also is a Continuation-In-Part of U.S. patent application Ser. No. 10/360,091 filed Feb. 6, 2002 (Docket No. S-AKO-002) titled Adapive Optic Lens System and Method of Use. Both of the above applications are incorporated herein by this reference. 
     
    
     
       BACKGROUND OF THE INVENTION  
         [0002]    1. Field of the Invention  
           [0003]    The present invention pertains to an ophthalmic lens that allows for post-fabrication correction of higher order aberrations or spherical corrections. More in particular, the invention can be used in IOLs and contact lenses wherein lens components respond to an external energy source, such as a laser, to allow adaptive structures in an interior lens phase to be altered in dimension to thereby adjust or flex the lens shape in a manner akin to methods used in the field of adaptive optics (AO) in astronomical telescopes for higher order wavefront corrections.  
           [0004]    2. Description of the Related Art  
           [0005]    Post-fabrication adjustment of optical characteristics of lenses is needed in various ophthalmic lens types. In one case, cataract patients would benefit from post-implant power adjustability of an IOL implant. In another case, posterior chamber phakic IOLs could benefit from post-implant power adjustability since biometry cannot insure proper power selection. Also, contact lenses would benefit from post-fabrication curvature adjustment to limit the number of lenses that needed to be maintained in inventories.  
           [0006]    Cataracts are major cause of blindness in the world and the most prevalent ocular disease. Visual disability from cataracts accounts for more than 8 million physician office visits per year. When the disability from cataracts affects or alters an individual&#39;s activities of daily living, surgical lens removal with intraocular lens implantation is the preferred method of treating the functional limitations. In the United States, about 2.5 million cataract surgical procedures are performed annually, making it the most common surgery for Americans over the age of 65. About 97 percent of cataract surgery patients receive intraocular lens implants, with the annual costs for cataract surgery and associated care in the United States being upwards of $4 billion.  
           [0007]    A cataract is any opacity of a patient&#39;s lens, whether it is a localized opacity or a diffuse general loss of transparency. To be clinically significant, however, the cataract must cause a significant reduction in visual acuity or a functional impairment. A cataract occurs as a result of aging or secondary to hereditary factors, trauma, inflammation, metabolic or nutritional disorders, or radiation. Age-related cataract conditions are the most common.  
           [0008]    In treating a cataract, the surgeon removes material from the lens capsule and replaces it with an intraocular lens (IOL) implant. The typical IOL provides a selected focal length that allows the patient to have fairly good distance vision. Since the lens can no longer accommodate, the patient typically needs prescription eyeglasses for reading.  
           [0009]    The surgeon selects the power of the IOL based on analysis of biometry of the patient&#39;s eye prior to the surgery. In a significant number or cases, after the patient&#39;s eye has healed from the cataract surgery, there is a refractive error was beyond the margin of error in the biometric systems. Thus, there remain intractable problems in calculating the proper power of an IOL for any particular patient. To solve any unpredicted refractive errors following IOL implantation, the ophthalmologist can perform a repeat surgery to replace the IO for the patient can live with the refractive error and may require prescription eyeglasses to correct for both near and distant vision.  
           [0010]    What is needed is a lens system that provides means for post-fabrication or post-implant adjustment of optical characteristics and dioptic power. What also is needed is a lens system that can correct higher order aberrations.  
         SUMMARY OF THE INVENTION  
         [0011]    Of particular interest, the lens corresponding to the invention falls into the class of adaptive optics (AO) in the sense that micro-scale actuator means are provided to flex and alter the curvature of the lens surface locally for higher order aberrations or globally for spherical corrections, within a selected range of dimensions. The usual scope of the AO field encompasses flex-surface mirrors wherein piezoelectric or other drivers can flex the optical surface within microsecond intervals to reduce aberrations, for example in astronomical telescopes as shown in FIG. 1A. The actuators of the present invention differ completely in that they only need be actuated one time, or perhaps a few times, and there is no need for rapid actuation response times. Still the invention provides an AO structure wherein the adaptive optics comprise soft actuators at a micro-scale suitable for correcting higher order aberrations disposed in an interior of the lens. The actuators are transparent with an index that matches the material of lens body, as indicated schematically in FIG. 1B. In one preferred embodiment, the adaptive structure is responsive to localized energy application thereto, preferably in the form of light energy. A light source operating in the 400 nm to 1.4 micron range is suitable (not limiting) which will typically comprise a laser but other non-laser light sources fall within the scope of the invention. The light source is coupled to a computer controller, galvanometric scanner (or any other type of scanner), and optional eye-tracking system, all of which are known in the art (e.g., in LASIK systems) and for this reason need no further description for adjusting an IOL. The micro-actuator means, or more particularly the soft adaptive structures are indicated in FIG. 1B, and comprise a plurality of displacement structures that define selected micron scale dimensions across principal and secondary axes thereof, wherein the structures engage at least one deformable lens surface layer. In a contact lens, the light source can be less complex and need not be scanned as will be described below.  
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0012]    In order to better understand the invention and to see how it may be carried out in practice, some preferred embodiments are next described, by way of non-limiting examples only, with reference to the accompanying drawings, in which:  
         [0013]    [0013]FIG. 1A is conceptual view of AO (adaptive optics) as known in the art of deformable mirrors for astronomical telescopes with actuators at an exterior of the reflective mirror plane.  
         [0014]    [0014]FIG. 1B is a conceptual representation of a lens element, for example and IOL or contact lens with, including transparent index-matched soft polymer displacement structures or actuators at an interior plane of the lens in one embodiment of the AO (adaptive optics) structure corresponding to the invention.  
         [0015]    [0015]FIG. 2 is a schematic perspective cut-away view of a portion of a Type “A” intraocular lens (IOL) with an interior plane or phase carrying an AO (adaptive optics) structure corresponding to the invention.  
         [0016]    [0016]FIG. 3 is a sectional view of the IOL of FIG. 2 with the lens components de-mated to illustrate the method of fabricating an adaptive optic IOL or contact lens.  
         [0017]    [0017]FIG. 4 is an enlarged view of a portion of the IOL of FIG. 3 that better illustrates the AO structure and the soft polymer displacement structures of a shape memory polymer.  
         [0018]    [0018]FIG. 5A is a greatly enlarged view of a soft actuator of FIG. 4 that shows the operation of the displacement structure wherein its dimensions are altered to ratably change between a temporary shape and a memory shape in response to localized light energy application.  
         [0019]    [0019]FIG. 5B is an enlarged view of a soft actuator similar to that of FIG. 5A that is adapted for either more local or more global shape changes depending on the level of applied energy.  
         [0020]    [0020]FIG. 6A is a sectional view of a portion of an interior phase of a lens that carries the adaptive displacement structures in its molded memory shape, and its method of making.  
         [0021]    [0021]FIG. 6B is a sectional view of the interior phase portion of FIG. 6A with the adaptive displacement structures secondarily molded into the SMP&#39;s stable temporary shape.  
         [0022]    [0022]FIG. 6C is a sectional view of the interior phase portion of FIGS.  6 A- 6 B in an interior space in a lens.  
         [0023]    [0023]FIG. 7 is a sectional view of lens of FIG. 6C showing the shape modification of the anterior lens surface.  
         [0024]    [0024]FIG. 8 is sectional view of a portion of an alternative interior phase of a lens that carries fluid-filled displacement structures capable of first and second shapes and volumes.  
         [0025]    [0025]FIG. 9 is an exploded sectional view an alternative Type “A” lens with an annular SMP adaptive component at an interior periphery of the lens with a or gel fluid lens core.  
         [0026]    [0026]FIG. 10 is an exploded view of another lens embodiment similar to FIG. 9 wherein the annular SMP component is adapted to displace an interior fluid within a polymer matrix to cause shape change, wherein the combination of the fluid and the polymer comprises the actuator or displacement structure.  
         [0027]    [0027]FIG. 11 is a sectional view of another lens similar to FIG. 9 wherein with an annular SMP component.  
         [0028]    [0028]FIG. 12 is a schematic view of a Type “B” lens with an interior phase similar to that of FIGS.  8 A- 8 C wherein the fluid-filled displacement structures are actuated by a sacrificial element in flow channels communicating with the displacement structures.  
         [0029]    [0029]FIG. 13 is a sectional view of another lens similar to FIG. 4.  
         [0030]    [0030]FIG. 14 is an exploded view of the lens of FIG. 13 showing a method of making the lens. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0031]    I. Principles of Shape Memory in Polymers for Use in Adaptive Lenses  
         [0032]    Several alternative embodiments of the invention utilize a shape memory polymer (SMP) to enable the transparent index-matched actuator system corresponding to the invention. For this reason, a background on shape memory polymers is provided.  
         [0033]    Shape memory polymers demonstrate the phenomena of shape memory based on fabricating a segregated linear block co-polymer, typically of a hard segment and a soft segment. The shape memory polymer generally is characterized as defining phases that result from glass transition temperatures in the hard and a soft segments. The hard segment of SMP typically is crystalline with a defined melting point, and the soft segment is typically amorphous, with another defined transition temperature. In some embodiments, these characteristics may be reversed together with the segment&#39;s glass transition temperatures.  
         [0034]    In one embodiment, when the SMP material is elevated in temperature above the melting point or glass transition temperature T g  of the hard segment, the material then can be formed into a memory shape. The selected shape is memorized by cooling the SMP below the melting point or glass transition temperature of the hard segment. When the shaped SMP is cooled below the melting point or glass transition temperature of the soft segment while the shape is deformed, that temporary shape is fixed. The original shape is recovered by heating the material above the melting point or glass transition temperature of the soft segment but below the melting point or glass transition temperature of the hard segment. (Other methods for setting temporary and memory shapes are known which are described in the literature below). The recovery of the original memory shape is thus induced by an increase in temperature, and is termed the thermal shape memory effect of the polymer. The temperature can be body temperature or another selected temperature above 37° C. for the present invention.  
         [0035]    Besides utilizing the thermal shape memory effect of the polymer, the memorized physical properties of the SMP can be controlled by its change in temperature or stress, particularly in ranges of the melting point or glass transition temperature of the soft segment of the polymer, e.g., the elastic modulus, hardness, flexibility, permeability and index of refraction. The scope of the invention of using SMPs in IOLs extends to the control of such physical properties.  
         [0036]    Examples of polymers that have been utilized in hard and soft segments of SMPs include polyurethanes, polynorborenes, styrene-butadiene co-polymers, cross-linked polyethylenes, cross-linked polycyclooctenes, polyethers, polyacrylates, polyamides, polysiloxanes, polyether amides, polyether esters, and urethanebutadiene co-polymers and others identified in the following patents and publications: U.S. Pat. No. 5,145,935 to Hayashi; U.S. Pat. No. 5,506,300 to Ward et al.; U.S. Pat. No. 5,665,822 to Bitler et al.; and U.S. Pat. No. 6,388,043 to Langer et al. (all of which are incorporated herein by reference); Lui et al.,  Thermomechanical Characterization of a Tailored Series of Shape Memory Polymers , J. App. Med. Plastics, Fall 2002; Gorden,  Applications of Shape Memory Polyurethanes , Proceedings of the First International Conference on Shape Memory and Superelastic Technologies, SMST International Committee, pp. 115-19 (1994); Kim, et al.,  Polyurethanes having shape memory effect , Polymer 37(26):5781-93 (1996); Li et al.,  Crystallinity and morphology of segmented polyurethanes with different soft-segment  length, J. Applied Polymer 62:631-38 (1996); Takahashi et al.,  Structure and properties of shape-memory polyurethane block copolymers , J. Applied Polymer Science 60:1061-69 (1996); Tobushi H., et al.,  Thermomechanical properties of shape memory polymers of polyurethane series and their applications , J. Physique IV (Colloque C1) 6:377-84 (1996)) (all of the cited literature incorporated herein by this reference).  
         [0037]    Shape memory polymers foams within the scope of the invention typically are polyurethane-based thermoplastics that can be engineered with a wide range of glass transition temperatures. These SMP foams possess several potential advantages for intraocular implants, for example: very large shape recovery strains are achievable, e.g., a substantially large reversible reduction of the Young&#39;s Modulus in the material&#39;s rubbery state; the material&#39;s ability to undergo reversible inelastic strains of greater than 10%, and preferably greater that 20% (and up to about 200%-400%); shape recovery can be designed at a selected temperature between about 30° C. and 45° C. which may be useful for the implants; and injection molding is possible thus allowing complex shapes. As described above, these polymers also demonstrate unique properties in terms of capacity to alter the material&#39;s water or fluid permeability, thermal expansivity, and index of refraction. However, the material&#39;s reversible inelastic strain capabilities leads to its most important property-the shape memory effect. If the polymer is strained into a new shape at a high temperature (above the glass transition temperature T g ) and then cooled it becomes fixed into the new temporary shape. The initial memory shape can be recovered by reheating the foam above its T g .  
         [0038]    II. Exemplary Lens that Utilizes Transparent Interior Displacement Structures  
         [0039]    1. Type “A” Soft Adaptive Optic System.  
         [0040]    The adaptive optic system of the invention can be used in an ophthalmic lens, such as an IOL (intraocular lens) or a contact lens to allow for post-fabrication power adjustment or post-implant adjustment. For purposes of explanation, the principles of the invention are first shown in FIG. 2 in an intraocular lens  100  for cataract treatment, but also can be for any phakic IOL for the anterior chamber of posterior chamber.  
         [0041]    In FIGS. 2 and 3, the IOL  100  defines an optic part  110  and non-optic part  111  (or haptic) wherein the lens defines an optical axis  112  and has an interior phase  115  that carries a pattern of adaptive optic structures or displacement structures  120  therein for adjusting the optical power of the lens. The non-optic portions  111  defines an optic periphery  114  in a radially outward part of body lens body  118  that transitions to any type of loop haptics or plate haptics, with one haptic indicated at  111   a  in FIG. 3, as is known in the art. The lens typically would range from about 4.5 mm to 6.5 mm in diameter (not limiting) of an IOL with different dimensions for inlays (e.g., 3.0 to 5.0 mm. in diameter or contact lenses.  
         [0042]    As can be seen in FIG. 2, the optic portion  110  defines a first anterior lens surface  122 A and a second posterior lens surface  122 B that extend toward the optic periphery  114 . The first and second polymer body portions or layers  124   a  and  124   b  that define the anterior and posterior surfaces  122 A and  122 B, respectively, are substantially fluid impermeable transparent polymers with any suitable refractive index as is known in the art. In this embodiment, the first and second polymer layers  124   a  and  124   b  envelope the interior phase  115  that carries a patterned displacement structures  120 . Each displacement structures  120  has an index of refraction that matches body portions or layers  124   a  and  124   b . The anterior surface layer  124   a  of the lens is deformable by application of forces by each displacement structure  120  or any collective number of structures or actuators after actuation from a first stable volume or shape to a second volume or shape. Of particular interest, the displacement structures  120  define a micro-scale that makes the system suitable for correcting higher order aberrations. The lens carries from about 20 to 1000 displacement structures  120 , and more preferably carries from about 25 to 125 such displacement structures  120  in any fixed pattern such as each structure  120  having a center about set of concentric circles about the lens axis  115 . The structures  120  can be designed with similar or different amplitudes of adjustment for different strategies in post-implant correction.  
         [0043]    The scope of the invention includes displacement structures  120  of a transparent shape change material, any material that changes density or porosity in a fluid environment, or any displaceable media such as a fluid or gel that is moved or pressurized In other words, the displacement structures comprise media that is adjustable from a first stable functional parameter to a second stable parameter in response to energy applied to a subpattern of locations on the lens body to individually alter each displacement structures  120 , the functional parameters being in the class consisting of media volume, media shape, media porosity, media density and the media&#39;s internal pressure. As will be described below, the preferred method of applying energy to the lens body is the use of a laser.  
         [0044]    In one embodiment, referring to FIGS. 3 and 4, the displacement structures or actuators  120  are shape memory polymer actuators, of any SMP materials described above or in the literature identified above. The anterior lens layer  124   a  defines a selected thickness dimension D and modulus of elasticity (E) that cooperates with the surface area A of the soft actuator  120  to insure that the radius of curvature in the deformed layer  124   a  is within selected parameters. The thickness dimension D of the deformable anterior layer  124   a  is from about 1 micron to 100 microns. More preferably, the dimension D of anterior layer  124   a  is from about 5 microns to 50 microns. Referring to FIGS. 5A and 5B, an exemplary displacement structure  120  can take on any cylindrical or other form in its temporary shape and provide a surface area A of at least about 5 sq. microns and preferably at least about 20 sq. microns. Referring to FIGS. 2 and 3, the first and second polymer portions  124   a  and  124   b  envelope the interior phase or plane  115  that consists of the displacement structures  120  and an intermediate media  126  that is a very low modulus index-matched material, an indexed-matched gel or a porous structure with an index-matched fluid media  140  therein. In these exemplary embodiments, the intermediate media or phase portion  126  is adapted to occupy the lens volume and provide stable refraction before and after adjustment lens with actuation of the displacement structures  120 . In the embodiments that utilize a fluid media  140  therein, a silicone of a selected viscosity can be used. Silicone fluids are linear polymers whose chains contain between 2 and well over 1,000 silicon atoms, each of which is linked to the next by an oxygen atom. Together, these materials join to form what we know as a polydimethylsiloxane. Of particular interest for the invention, silicone fluids can be fabricated to provide the matching index of refraction as described above. Silicones change very little in viscosity over a wide temperature range, which together with their high wetting power can will provide the properties needed for the functioning of the adaptive structure of lens corresponding to the invention. Further, silicones fluids are inherently inert towards the other substrates that are anticipated to be used in the invention. All these characteristics, low viscosity change vs. temperature, dielectric stability, chemical inertness, shear stability, low surface tension, oxidative stability, thermal stability and high compressibility make silicone a logical candidate for use in the invention. Further, it is believed that silicone fluids, in this application, will be found to be a biocompatible material for the interior of a lens implant following FDA regulatory reviews.  
         [0045]    The viscosity of silicones is typically measured in units called centistokes (cSt) wherein the lower the number, the thinner and less viscous the material. A silicone fluid  140  for use in the lens can have a viscosity ranging from about 0.65 cSt to about 1,000,000 cSt, which ranges from a very low viscosity fluid upward to a high viscosity fluid. More preferably, the silicone fluid  140  can have a fluid viscosity ranging from about 5.0 cSt to 100,000 cSt, which at the upper range resembles a slow moving gel. More preferably, a silicone fluid  140  can have a fluid viscosity ranging from about 10 cSt to 5,000 cSt. A wide number of commercial sources of silicone fluids are known, for example, NuSil Silicone Technology, Inc. (www.nusil.com); General Electric, Inc. (www.gesilicones.com) and Dow Corning, Inc. (www.dowcorning.com). While silicone fluid is a preferred material for use in the invention, it should be appreciated that hydrogels and any other fluids fall with suitable matching indices, viscosities and biocompatibility fall within the scope of the invention. The fluid  140  is provided in the interior phase  115  by post-assembly fluid injection, or by fluid-immersion assembly means as is known in the art.  
         [0046]    The exemplary lens of FIGS. 2 and 3 is bi-convex, but the invention can be extended to plano-convex, concavo-convex lens or any other type of lens or DOE (diffraction optical element), for example that utilize kinoforms or binary optics, or the invention can be extended to thin film diffractive optics. In one embodiment, referring to FIGS. 1B and 2, the lens surface and each adaptive element or portion is assigned an address indicated at  127  (collectively). By the term address, it is meant that the spatial location of the lenticular surface overlying the adaptive element is assigned surface coordinates in relation to reference markers indicated at  129 . The reference markers  129  may be singular or plural and located anywhere in the lens, but are most likely in a peripheral region. The reference points are utilized to allow the light source and its computer-controlled scanning system to assign addresses  127  to the locations of the adaptive structures (see FIG. 1B). The reference markers typically would function based on reflectivity with a reference light beam and sensing system similar to that used in a CD (compact disc), which is known in the art and need not be described further. While typically, the spaced apart adaptive structures  120  are arranged in concentric circles within the lens, the structures also can be in any fixed pattern such as a spiral pattern, or in a grid. While the shape recoverable polymer elements of FIG. 1B are generally described herein for convenience as being adapted to change shape and to thereby push the anterior surface  124   a  (FIG. 3) outwardly, it should be appreciated that the shape recoverable elements can extend substantially axially through the lens body (FIG. 1B), or orthogonal to the lens axis and pull or tension the lens surface inwardly.  
         [0047]    In another embodiment described below, it should be appreciated that the scope of the invention includes a deformable anterior layer  124   a  that is a surface treatments or surface modifications of a polymeric actuator layer  115  rather than a discrete layer of a bonded-on additional layer. Such surface treatments can be accomplished to provide substantially uniform thicknesses D as described immediately above. See for example, U.S. Pat. No. 5,235,003 to R. Ward et al, which is incorporated herein by reference together with other patents by R. Ward claiming benefit of, or connection to, this patent that related to the creation of polymer surface modifications.  
         [0048]    In exemplary embodiment illustrated in FIGS. 2 and 3, the materials  124   a  and  124   b  that provide the surface layers around the interior phase  115  are of a resilient polymeric material with a selected thickness and deformation characteristics, and can be a silicone, hydrophilic acrylic polymeric material, hydrophobic acrylic material, hydrogel material, collamer or the like, all of which are known in the art IOL fabrication. This material preferably has an index of refraction above about 1.40. More preferably, the index of refraction is above about 1.45. These materials will allow the lens to be folded or rolled for carrying in a small cross-section introducer device for deployment into the eye through a small incision. As will be described below, the functionality of the lens depends on the resilient characteristic of at least one lens surface layer. The lens body, or at least one surface layer, also can be fabricated of a slightly stiffer biocompatible material if very thin in cross section, such as polymethyl methacrylate (PMMA). Thus, it is possible that the lens material layers can be formed of different materials, such as one silicone layer and one PMMA layer. The material layers, depending on the material, can be injection-molded, or fabricated with cast or compression molding techniques or turned by a lathe as is known in the art, including the adaptive structures described below.  
         [0049]    The SMP of the displacement structures  120  have a selected T g  (as described above) at which the actuator will move toward its memory shape (see FIG. 5A) to thereby impinge on surface  124   a  of layer  122 A to alter the optical characteristics of the lens  100 . FIG. 4 shows a method of the invention wherein light energy is applied to a single displacement structure  120  to alter it shape axially and deform the surface layer  124  to correct an aberration. The light energy in scanned and tracked as is known in the art, and intraoperative wavefront diagnostics can be used to during energy delivery. It is believed that nomograms can be developed so that the SMP of the displacement structures  120  can be gradually changed to provide a plurality of stable actuation positions between its temporary shape and memory shape. The selected T g  is any selected temperature above body temperature which can be achieved by irradiation of the displacement structures  120  with a selected light wavelength. The selected T g  of the SMP of each structure  120  can be in the range of about 40° C. to about 80° C. More preferably, the selected T g  of the SMP is in the range of about 42° C. to about 70° C. Still more preferably, the selected T g  of the SMP is in the range of about 42° C. to about 55° C. The SMP can carry any suitable chromophore to cooperate with a selected wavelength that can range from the UV to the infrared. It should be appreciated that the soft actuator can comprise a two-way shape memory material as described above to thereby provide two memory shapes.  
         [0050]    [0050]FIG. 5B shows a similar soft SMP member that can adjust and displace and surface layer for both locally and more global shape changes. The actuator&#39;s temporary shape at its anterior surface is indicated at  135 . Upon a first level of applied energy, the SMP is altered to  135 ′ to locally adjust a surface layer  124   a  (not shown). Upon a second level of applied energy, the SMP is altered to  135 ″ to globally adjust surface layer  124   a  wherein all of layer  115  is adaptive.  
         [0051]    [0051]FIGS. 6A and 6B illustrate a method of manufacturing the interior phase  115  of the adaptive optic lens. The shape memory polymer displacement structures  120  can be molded in a memory shape of FIG. 6A, and then insert molded into intermediate media or phase portion  126 , which in this case is an index matched polymer. Micromolding technology has developed easily allow molding on the scale of FIG. 6A. FIG. 6B next shows the assembly of FIG. 6A after the displacement structures  120  are being the compressed into its stable temporary shape. FIG. 6C shows the assembly of FIGS. 6B within a space  148  between surface layer  124   a  and lens body portion  124   b . The space  148  is also occupied by a fluid media  140  as described above. It can easily be understood how the displacement structures  120  will function as in the embodiment depicted in FIGS. 4, 5A and  5 B. Referring again to FIG. 6C, the SMP structures  120  have a memory shape that defines a first greater lesser dimension about its axis  149  that is substantially orthogonal to the phase  115 , with the second temporary shape defining a second lesser dimension about its axis  149 . As can be understood from FIG. 4, the displacement structures  120  can be irradiated singularly or in any pattern to push axially (upwardly) on the thin resilient layer  124   a  to alter the optical characteristics of the lens wherein the intermediate phase portion  126  will float in space  148  within fluid  140 . In another embodiment, the phase portion  126  between the actuators  120  can be a resilient open cell foam with an index matching fluid therein that migrates about the open cells. It can be easily understood from FIGS. 4, 6C and  7 , the lens is suited for adjusting a selected local portion for higher order wavefront correction, astigmatisms and the like. Alternatively, all the displacement structures  120  can be adjusted for a global diopter change.  
         [0052]    In another embodiment, shape memory polymers can be utilized in adaptive optic lens designs wherein the light energy is applied only in the non-optic portion  111  instead of the optic portion  110 . In some lens designs, it may be preferable to use higher energy densities which are not transmitted to the retina. The non-optic portion  111  that is targeted can have a backing that prevents light transmission therethrough. FIG. 8 illustrates a small portion of an interior phase  155  that has displacement structures  120  that carry an index-matched fluid  160  within an interior space  162  in the displacement structures  120 . FIG. 8 shows a manner of fabricating the assembly wherein first and second thin elastic layers  164   a  and  164   b  are bonded together to defines spaces  162  and channels  170  therein that extend to a non-optic portion  111  of the lens. In one example, the core layer  165  can be fabricated with spaces and flow channels by fabricating an open cell member and then using light to cure an infused polymer in all portions of the core layer  165  except the spaces and flow channels. To provide an actuatable displacement structure  120 , the lens periphery  114  carries a plurality of shape memory polymer body portions  172  (collectively) that surrounds or are adjacent to the channels  170  that carries fluid media  160 . It can be easily understood that light energy applied to a subpattern of SMP regions  172  about the periphery of the lens, with each SMP portion  172  is adapted to swell and impinge upon a flow channel to thereby push fluid media  160  into the displacement structure  120  to thereby deform the lens surface. It can be easily understood that the interior phase  155  of FIG. 8 can be assembled in a fluid-filled space exactly as in FIG. 6C to provide an adaptive optic. The system also can include a similar targetable SMP region adjacent a flow channel wherein the SMP is adapted to shrink or bend to different memory shape to draw fluid media  160  from the displacement structure  120  to reverse the shape change in the lens. Numerous variations are possible wherein irradiation of selected peripheral regions can alter polymer density, volume, shape or permeability to alter fluid pressure in a channel that communicates with a displacement structure  120 .  
         [0053]    Referring to FIG. 9, another IOL embodiment  190  is illustrated in exploded view wherein light energy again is applied only in the non-optic portion  111  instead of the optic portion  110 . The embodiment of FIG. 9 comprises simplified adaptive optic that is designed only for spherical corrections and not high order aberration correction. The exemplary IOL of FIG. 9 has an annular SMP member  195  that can be moved from a temporary shape or porosity to a memory shape or porosity to achieve large diopter changes. The central portion or interior phase  196  of the lens can carry a fluid media  140  in an open chamber as described above, for example a silicone of a selected viscosity that may be gel-like. As in previous embodiments, the lens has non-permeable first and second surface layers  124   a  and  124   b  that envelope the interior phase  196 . As can be seen in FIG. 9, it can be understood that light energy can be scanned and applied to the a annular SMP member  195  to move it toward its memory shape in phantom view to thereby apply pressure on the constrained media  140  in the interior phase  196  to alter the lens shape at its anterior surface from  122 A to  122 A′ in phantom view.  
         [0054]    In another very similar embodiment as in FIG. 10, the central portion  196  can be a very low modulus index-matched polymer or an open cell SMP foam with a migrating fluid media  140  therein. In another similar embodiment as depicted in FIG. 11, the lens  190  has a central interior phase  196  of a very low modulus index-matched polymer or an open cell SMP foam with a migrating fluid media  140  therein. The annular SMP member  195  comprises the peripheral portion  114  of the lens body  118 . This embodiment differs in that the non-permeable first and second surface layers  124   a  and  124   b  are very thin and preferably comprise a “surface modification” of the polymer of the a central interior phase  196 . Such surface modifications of a polymers to provide an interior polymer portion that comprises a diffusion network while the micron thick surface layer is impermeable in known, as was described above (see. e.g., U.S. Pat. No. 5,235,003 to R. Ward et al.) This type of lens  190  would then be assembled of a limited set of components: the peripheral annular shape memory polymer portion  195  and the central interior phase  196  with its surface modification, and an optional fluid media  140  if the central phase  196  is porous polymer rather that a gel-like low modulus polymer.  
         [0055]    2. Type “B” Soft Adaptive Optic System.  
         [0056]    In another adaptive lens embodiment  200  depicted in FIG. 12, the lens again has an optic portion  210  and a non-optic portion  211 . The lens has an interior form or phase  215  as depicted in FIGS.  6 A- 6 C that is enveloped by anterior body portion or surface layer  224   a  and posterior body portion  224   b . In this embodiment, the displacement structures  220  (collectively) operate as described previously to deform an anterior surface layer  224   a . This embodiment differs in that shape memory polymers are in the same role to alter the volume of the fluid  225  in the displacement structures  220 . In the exemplary embodiment of FIG. 12, the lens carries sacrificial elements  250   a - 250   n  in channels  222  (collectively) that individually communicate with space in each individual displacement structures  220   a - 220   n.    
         [0057]    In use, the lens is selected for a patient to have a positive power that exceeds the power indicated by biometry. When the lens  200  is implanted, the patient&#39;s intraocular pressure will cause interior pressure of the displacement structures  220  apply fluid pressure to sacrificial element, or the lens can be fabricated to provide an interior pressure in the displacement structures  220 . After implantation, the sacrificial elements  250   a - 250   n  are individually targeted with light energy and sacrificed to thereby allow fluid flow through the channels  222  (collectively) to a potential space  252  in the non-optic portion  211  to receive the fluid  225 . The sacrificial element can be a polymer that degrades under applied light energy, a polymer that becomes irreversibly (or reversibly) porous under applied light energy, a phase change polymeric material or any dissolvable metallic element known in the art.  
         [0058]    It should be appreciated that lens can carry multiple layers of adaptive optic structures in fluid permeable planes for flexing the lens surface. The lens can carry adaptive optic structures that operate in a single lens that operate to apply forces both parallel to the optical axis and for applying forces orthogonal to the optical axis for flexing the lens surface. The lens can layered adaptive optic structures for flexing the lens surface in opposing directions to allow for very fine adjustments or reversible adjustments. In one preferred embodiment, the adaptive optic structures can be spaced apart with individual addresses or coordinates to cooperate with a scanned light source, wherein the number of discrete adaptive optic features can range in number from as few as about 100 to as high as several million. In another preferred embodiment, a layer of material in the lens may be “adaptive” in any location thereof to allow targeting of any location or region thereof.  
         [0059]    In another embodiment, the intraocular lens can be combined with a wavefront sensing system (e.g. a Shack Hartman system) to allow computer-controlled correction of aberrations in the lens.  
         [0060]    Referring now to FIGS. 13 and 14, an exemplary lens  300  with its adaptive structure or interior phase is shown to illustrate the manner of making an adaptive lens for localized surface curvature change. The “adaptive” surface relief elements  345  comprise a shape memory polymer that is molded into a unitary surface layer or body  348   a  that can be coupled a molded base or body surface  348   b . In a first dimensional configuration or shape profile of each adaptive structure  344 , the lens is provided with a first anterior curvature AC. As can be understood from FIGS.  4 - 5 B, the adaptive elements  345  of FIGS.  13 - 14  each have an address that is targetable. The method of making the lens consists of molding the first and second body portions  348   a  and  348   b  and thereafter bonding together these body portions together with an index-matched fluid. Again, the method of the invention utilizes energy from an external light source for example in a scanned beam, as directed by the computer controller to irradiate each address. In this exemplary embodiment, the light source (and controller and scanner) with a selected wavelength, scan rate, power level, pulse duration, dwell time, beam profile (also possible repetition rate) is scanned to irradiate the selected locations to alter the axial or cross-axial dimension of the individual adaptive structures. By this means, it can easily be understood how the adaptive structure can be used to alter a selected portion of the lens surface from its initial anterior curvature to a modified anterior curvature. Of particular interest, as the adaptive structure alters the lens curvature, the matching index fluid  140  self-directs itself to move or flow into the newly shaped volume of the interior phase or plane.  
         [0061]    Those skilled in the art will appreciate that the exemplary embodiments and descriptions thereof are merely illustrative of the invention as a whole, and that variations in controlling the of intervals of energy delivery may be made within the spirit and scope of the invention. Specific features of the invention may be shown in some figures and not in others, and this is for convenience only and any feature may be combined with another in accordance with the invention. While the principles of the invention have been made clear in the exemplary embodiments, it will be obvious to those skilled in the art that modifications of the structure, arrangement, proportions, elements, and materials may be utilized in the practice of the invention, and otherwise, which are particularly adapted to specific environments and operative requirements without departing from the principles of the invention. The appended claims are intended to cover and embrace any and all such modifications, with the limits only of the true purview, spirit and scope of the invention.