Patent Publication Number: US-2019183638-A1

Title: Method and apparatus for adhering a capsular bag to an intraocular lens

Description:
FIELD 
     This present disclosure relates generally ophthalmic lenses and, more particularly, to a method and apparatus for adhering a capsular bag to an intraocular lens. 
     BACKGROUND 
     Intraocular lenses (IOLs) may be implanted in patients&#39; eyes to replace a patient&#39;s natural lens. An IOL typically includes (1) an optic that corrects the patient&#39;s vision (e.g., typically via refraction or diffraction), and (2) haptics that constitute support structures that hold the optic in place within the patient&#39;s eye (e.g., within capsular bag). In general, a physician selects an IOL for which the optic has the appropriate corrective characteristics for the patient. During ophthalmic surgery, often performed for conditions such as cataracts, the surgeon implants selected IOL by making an incision in the capsular bag of the patient&#39;s eye (a capsulorhexis) and inserting the IOL through the incision. Typically, the IOL is folded for insertion into the capsular bag via a corneal incision and unfolded once in place within the capsular bag. During unfolding, the haptics may expand such that a small section of each bears on the capsular bag, retaining the IOL in place. 
     Although existing IOLs may function acceptably well in many patients, they also have certain shortcomings. For example, existing IOL designs may result in posterior capsule opacification (PCO), a condition in which residual lens epithelial cells from the equator of the capsular bag migrating inward along the posterior side of the capsular bag towards the optic. Because the cell growth may opacify the posterior surface of the capsular bag, PCO may negatively impact the patient&#39;s vision. Certain current IOL design attempt to address PCO by adding a sharp edge around the posterior surface of the optic. Although such sharp edges may inhibit the migration of lens epithelial cells, they generally do not completely eliminate PCO. Once PCO has occurred, it may be addressed via a laser procedure called a posterior capsulotomy in which the opacification is removed by creating an opening in the posterior surface of the capsule. The added cost, time, and risk to the patient associated with a posterior capsulotomy may make the procedure undesirable. 
     Accordingly, what is needed is an improved mechanism that may address PCO. 
     SUMMARY 
     A method for performing an ophthalmic procedure on an eye, the eye having a capsular bag in which an intraocular lens (IOL) has been implanted, includes applying energy to a portion of the capsular bag. The applied energy is sufficient to melt the portion of the capsular bag without cauterization such that the portion of the capsular bag adheres to an adjacent portion of the IOL. 
     In certain embodiments, the above-described ophthalmic procedure may provide one or more technical advantages. For example, the above-described ophthalmic procedure may result in the capsular bag being adhered to the IOL around an entire periphery of the optic, thereby forming a seal between the capsular bag and the IOL. As a result, lens epithelial cells may be prevented from migrating along the optic from the equatorial region of the capsular bag, thereby reducing or eliminating the incidence of PCO. Moreover, because the seal is created on the haptics and/or periphery of the optic (i.e., outside the patient&#39;s optical path), the above described PCO reduction/elimination may be achieved without significantly adversely affecting the patient&#39;s vision. As another example, the above-described ophthalmic procedure may result in the capsular bag being adhered to the IOL around a sufficient portion of the IOL to ensure the IOL is stable against rotations or other undesirable motion. Because rotational stability may be particularly important for certain types of IOLs (e.g., toric IOLs), the above-described ophthalmic procedure, by increasing stability, may result in better patient outcomes. 
    
    
     
       BRIEF DESCRIPTION OF SEVERAL VIEWS OF THE DRAWINGS 
       For a more complete understanding of the present disclosure and the advantages thereof, reference is now made to the following description taken in conjunction with the accompanying drawings in which like reference numerals indicate like features and wherein: 
         FIG. 1  is a flow chart depicting an exemplary embodiment of a method for performing an ophthalmic procedure that adheres a capsular bag to an IOL; 
         FIG. 2  is a block diagram of an exemplary embodiment of an apparatus for adhering a capsular bag to the IOL; 
         FIG. 3  is a flow chart depicting an exemplary embodiment of a method for performing a non-surgical ophthalmic procedure for adhering a capsular bag to the IOL; 
         FIGS. 4A-4F  depict exemplary embodiments of the eye before and during a non-surgical procedure for adhering the capsular bag to the IOL; and 
         FIGS. 5A-5G  depict exemplary embodiments of images of the IOLs configured to be used with non-surgical procedure for adhering the capsular bag to the IOL. 
     
    
    
     The skilled person in the art will understand that the drawings, described below, are for illustration purposes only. The drawings are not intended to limit the scope of the applicant&#39;s disclosure in any way. 
     DETAILED DESCRIPTION 
     The exemplary embodiments relate to mechanisms for sealing a portion of the capsular bag to a portion of the intraocular lens (IOL). The following description is presented to enable one of ordinary skill in the art to make and use the invention and is provided in the context of a patent application and its requirements. Various modifications to the exemplary embodiments and the generic principles and features described herein will be readily apparent. The exemplary embodiments are mainly described in terms of particular methods and systems provided in particular implementations. However, the methods and systems will operate effectively in other implementations. Phrases such as “exemplary embodiment”, “one embodiment” and “another embodiment” may refer to the same or different embodiments as well as to multiple embodiments. The embodiments will be described with respect to systems and/or devices having certain components. However, the systems and/or devices may include more or less components than those shown, and variations in the arrangement and type of the components may be made without departing from the scope of the invention. Further, although specific blocks are depicted, various functions of the blocks may be separated into different blocks or combined. The exemplary embodiments will also be described in the context of particular methods having certain steps. However, the method and system operate effectively for other methods having different and/or additional steps and steps in different orders that are not inconsistent with the exemplary embodiments. Thus, the present invention is not intended to be limited to the embodiments shown, but is to be accorded the widest scope consistent with the principles and features described herein. 
     The method and system are also described in terms of singular items rather than plural items. One of ordinary skill in the art will recognize that these singular terms encompass plural. For example, a step that is described as melting a portion of the capsular bag may melt multiple contiguous or noncontiguous sections of the capsular bag. In certain embodiments, the system includes one or more processors and a memory. The one or more processors may be configured to execute instructions stored in the memory to cause and control the process set forth in the drawings and described below. As used herein, a processor may include one or more microprocessors, field-programmable gate arrays (FPGAs), controllers, or any other suitable computing devices or resources, and memory may take the form of volatile or non-volatile memory including, without limitation, magnetic media, optical media, random access memory (RAM), read-only memory (ROM), removable media, or any other suitable memory component. Memory may store instructions for programs and algorithms that, when executed by a processor, implement the functionality described herein with respect to any such processor, memory, or component that includes processing functionality. Further, aspects of the method and system may take the form of an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, micro-code, etc.) or an embodiment combining software and hardware aspects. Aspects of the method and system may take the form of a software component(s) executed on at least one processor and which may be embodied in one or more computer readable medium(s) having computer readable program code embodied thereon. 
     In general, the present disclosure relates to an ophthalmic procedure performed in conjunction with a cataract procedure in which an IOL has been implanted in capsular bag of a patient&#39;s eye. More particularly, the procedure involves applying energy to a portion of the capsular bag (e.g., by firing a laser at the portion of the capsular bag) after the IOL has been implanted. The applied energy may be sufficient to melt the portion of the capsular bag without cauterization such that the portion of the capsular bag adheres to a peripheral portion of the IOL. Adhering the capsular bag to the IOL may inhibit the migration of lens epithelial cells from the equatorial region of the capsular bag toward the optical axis, thereby reducing or eliminating the incidence of PCO. Additionally, adhering the capsular bag to the IOL may increase the rotational stability of the IOL, which may be important for certain types of IOLs (e.g., toric IOLs). 
       FIG. 1  is a flow chart depicting an exemplary embodiment of a method  100  for performing an ophthalmic procedure that adheres a capsular bag to an IOL. For simplicity, some steps may be omitted, interleaved, performed in another order and/or combined. The method  100  may include executing instructions on one or more processors and/or actions by an individual such as a physician. Further, the method  100  is described in the context of a non-invasive procedure (e.g., a separate procedure performed after the cataract procedure). However, the method  100  may be alternatively be performed as part of the cataract procedure. 
     The method  100  generally commences after an IOL has been implanted in the capsular bag of a patient&#39;s eye. In some embodiments, the method  100  may start a sufficient time after IOL implantation such that the patient&#39;s eye has healed and the environment in which the IOL resides has reached an equilibrium. For example, in such an embodiment, the method  100  may begin after the capsular bag has had an opportunity to collapse/seal around the IOL. In some embodiments, the method  100  occurs between forty-eight hours and two weeks after the IOL implantation (e.g., during a follow-up visit for the patient). 
     The implanted IOL typically includes an optic and one or more support structures referred to herein as haptics. In some embodiments, the optic and haptics may be formed of the same material. In other embodiments, the optic and haptics may be formed of different materials. The optic forms the lens through which the patient sees. The haptics aid in maintaining the IOL in place within the capsular bag. For example, the haptics may bear on and/or be bonded to the capsular bag using the method  100 . 
     The IOL may include one or more mechanisms to facilitate the method  100 . In certain embodiments, the haptics and/or a periphery of the optic may have a coating that improves the bonding of the melted portion of the capsular bag to the IOL. As one particular example, the haptics and/or a periphery of the optic may have a coating of Rose bengal, which may increase adherence when irradiated with certain wavelengths of laser light (e.g., green laser). In certain embodiments, the haptics and/or a periphery of the optic may include ridges or another textured feature that provides greater surface area or another mechanism for improving the adhesion between the melted portions of the capsular bag and the IOL. In certain embodiments, all or a portion of the IOL may be formed of a material selected to improve the adhesion between the IOL and the melted portion of the capsular bag. For example, some or all of the IOL may be formed of a non-hydrophobic material that is more likely to allow better adhesion of the collagen of the capsular bag to the IOL. 
     Energy is applied to a portion of the capsular bag adjacent to a portion of the IOL, via step  102 . For example, energy may be applied to part(s) of the capsular bag that are in proximity to or in physical contact with selected portion(s) of the optic and/or haptics. The energy applied in step  102  may be sufficient to melt the portion of the capsular bag without cauterization and, therefore, without forming a hole in the capsular bag. The melted portion of the capsular bag may adhere to the adjacent portion of the IOL. In certain embodiments, energy may be applied to parts of the capsular bag adjacent to the haptics and/or periphery of the optic such that the melted portion of the capsular bag is not within the patient&#39;s optical path and quality of vision is not negatively impacted. 
     The capsular bag is formed mainly of collagen (Type IV collagen). Type IV collagen has multiple melting points. The specific temperatures of the melting points may depend upon the age of the patient or other factors. In step  102 , the portion of the capsular bag desired to be melted may receive enough energy to raise its temperature to a target temperature or target temperature range. For example, the temperature may be raised to at or near the lowest melting temperature, between the lowest and the middle melting temperatures or to another temperature that allows for reflow of the melted collagen without compromising the capsular bag&#39;s structural integrity. 
     In certain embodiments, step  102  may further include determining the local temperature to which each portion of the capsular bag is desired to be raised as well as the amount of energy required to achieve that temperature in the desired volume (portion) of the capsular bag. Because the melting temperatures may depend upon the age of the patient, the local temperature desired for melting the capsular bag may also be determined based on factors specific to the patient. Alternatively, these and other variables relevant to the method  100  may be determined prior to the start of the method  100 . 
     In certain embodiments, the energy applied at step  102  is provided using a laser. For example, a neodymium-doped yttrium aluminum garnet (Nd:YAG) laser may be utilized. Such a laser may provide pulses having a duration in the femtosecond regime. In other embodiments, another laser or energy source may be used. The energy provided by the laser may be controlled by some combination of spot size (the incident area), irradiance (energy per unit area), laser power, duration of the pulse and/or time the region is illuminated. By changing the pulse duration, time illuminated or spot size, the energy provided to the desired region may be controlled. Thus, step  102  may include determining the desired energy to be applied to each region, focusing the laser to the desired spot size on that portion of the capsular bag, and firing the laser for the appropriate interval to deliver the desired energy to the portion(s) of the capsular bag. 
     Step  102  is optionally repeated until all desired portions of the capsular bag are bonded with the desired portions of the IOL, via step  104 . For example, step  102  may only melt and, therefore, adhere a small region of the capsular bag to the IOL. In such a case, step  104  can repeat step  102  at one or more additional locations. The selected seal between the capsular bag and the IOL may be formed. 
     In certain embodiments, method  100  may provide one or more technical advantages. For example, method  100  may result in the capsular bag being adhered to the IOL around an entire periphery of the optic, thereby forming a seal between the capsular bag and the IOL. As a result, lens epithelial cells may be prevented from migrating along the optic from the equatorial region of the capsular bag, thereby reducing or eliminating the incidence of PCO. Moreover, because the seal is created on the haptics and/or periphery of the optic (i.e., outside the patient&#39;s optical path), the above described PCO reduction/elimination may be achieved without significantly adversely affecting the patient&#39;s vision. As another example, method  100  may result in the capsular bag being adhered to the IOL around a sufficient portion of the IOL to ensure the IOL is stable against rotations or other undesirable motion. Because rotational stability may be particularly important for certain types of IOLs (e.g., toric IOLs), method  100 , by increasing stability, may result in better patient outcomes. 
       FIG. 2  is a block diagram of an exemplary embodiment of an apparatus  200  for adhering a capsular bag to an IOL. The apparatus  200  may include an imaging system  210 , a laser  212 , a controller  220 , a data processing unit  230 , a user interface (U/I)  240 , and a data store  250  including any patient data, parameters and other information. For simplicity, only some components are shown. In addition, the components depicted in  FIG. 2  may be packaged together in a single apparatus. Alternatively, certain components, such as portions of imaging system, laser and data processing, may be implemented separately. Further, the components may be implemented in hardware and/or software. The method  100  may be implemented using the system  200 . 
     The imaging system  210  may include a camera and/or other image capture device that may be managed using the controller  220 . In some embodiments, step  102  may include the controller  220  managing the focusing and magnification of the eye. Thus, the imaging system may or may not include a microscope or other magnification that allows for enhanced detail. In other embodiments, other components may be used in for the imaging system  210 . Such imaging systems  210  may or may not provide three-dimensional data for the eye. In some embodiments, video camera(s) or other mechanism for showing the progression of time may be part of the image(s) received. Further, the resolution of the imaging system  210  is sufficient to allow the relevant features of the eye to be determined. Thus, the physician may use the imaging system when implanting the IOL if the method  100  is performed during surgery. If the method  100  is not performed during surgery, then the imaging system  210  may simply allow the physician to better view portions of the patient&#39;s eye. 
     The laser  212  is used to melt portions of the capsular bag. For example, the laser  212  may be a Nd:YAG laser. The U/I  240  allows output to be provided to the physician and input to be received from the physician. For example, the physician may indicate which portion(s) of the capsular bag to be melted using the method  100  and/or may confirm the portion(s) of the capsular bag to be melted that are selected by the controller  220 . The U/I  240  provides this confirmation to the data processing unit  230 . The U/I  240  may also include a display for rendering image(s) of the eye or providing other visual feedback to the physician. The laser  212  and system  200  might also be used in other procedures not described herein. 
     The data processing unit  230  may receive image data from the imaging system  210 . The data processing unit  230  may also perform some or all of steps  102  and  104 . In some embodiments, the data processing unit  230  also accesses the data store  250 . For example, the data processing unit  230  may access data related to the patient&#39;s age and the melting temperature of Type IV collagen for a patient of that age in order to determine the melting temperature of the capsular bag and/or the amount of energy to be applied using the laser  212 . 
     The controller  220  may communicate with the laser  212 , imaging system  220 , data processing unit  230 , and user interface  240 . The controller  220  may manage the operation of laser  212 . For example, the control  220  may aim the laser  212 , set the spot size of the laser and turn the laser  212  on/off. Using the apparatus  200 , therefore, the method  100  may be implemented. One or more of the benefits of the method  100  may thus be achieved. 
       FIG. 3  is a flow chart depicting an exemplary embodiment of a method  150  for performing an ophthalmic procedure that adheres a capsular bag to an IOL. Some steps may be omitted, interleaved, performed in another order and/or combined. The method  150  may include executing instructions on one or more processors. Further, the method  150  is described in the context of the system  200 . However, the method  150  may be performed by or using other apparatuses (not shown). 
       FIGS. 4A-4F  depict exemplary embodiments of portions of an eye  300  before and during the method  150 .  FIGS. 4A-4F  are not to scale and only portions of the eye may be shown. A particular patient, condition and/or IOL is not intended to be shown in  FIGS. 4A-4F . 
     Referring to  FIGS. 2-4F ,  FIG. 4A  depicts the eye  300  as well as the device to be implanted, IOL  330 . The eye  300  is shown as including a cornea  302 , capsular bag  304 , iris  306 , pupil  308 , and vitreal cavity  310 . Also shown by dashed lines is optical path  312 . The optical path  312  includes regions within the eye  300  through which light may travel in order to allow the patient to see. The IOL  330  includes an optic axis  331 , a haptics  332 , and an optic  334 . The optic  334  functions as the lens which may replace the patient&#39;s lens. The haptics  332  hold the IOL substantially in place within the capsular bag. Incision(s) used in implanting the IOL  330  into the eye  300  are not shown for clarity. 
       FIG. 4B  depicts the eye  300  and the IOL  330  has been placed in capsular bag  304 . During implantation, the capsular bag  304  is typically artificially supported by a positive flow of fluid through the eye. Thus the capsular bag  304  is shown as significantly larger than the implanted IOL  330 . Although no incision is shown,  FIG. 4B  may be considered to depict the eye  300  during surgery. The method  150  may commence once the eye  300  is in the situation shown in  FIG. 4B .  FIG. 4C  depicts the eye  300  and IOL  330  after the capsular bag  304  is no longer artificially supported. The volume of the IOL  330  is typically significantly less than that of the natural lens of the patient (not shown). Thus, the capsular bag  304  has collapsed around the IOL  330 . The situation shown in  FIG. 4C  may represent the patient&#39;s eye a few days through a few weeks after the surgical procedure that implants the IOL  330  has been completed. Consequently, step the method  150  might also commence once the eye is in the situation shown in  FIG. 4C . 
     In method  150 , the physician may determine whether the IOL  330  is in the desired location within the eye  300  and, if not, may maneuver the IOL  330  into the desired location, via step  152 . Step  152  may be performed as part of surgery. For example, step  152  may be performed while incision(s) (not shown) are still open and the surgeon can manipulate the IOL. 
     The energy to be provided by the laser  212  is determined, via step  154 . Step  154  may include accessing patient data, such as the patient&#39;s age, in the data store  250  and using this information to determine the target temperature(s) for melting a portion of the capsular bag  304 . This determination may be made via data processing unit  230 . The energy for a laser pulse that corresponds to the target temperature(s) may also be calculated by the data processing unit. The spot size for the laser  212  and duration of each pulse may also be determined by the data processing unit  230 . 
     The portions of the capsular bag  304  to be adhered to the IOL  330  are determined, via step  156 . Step  156  may include allowing the physician to input whether the optic  334  is desired to be sealed to mitigate PCO or whether the location of the IOL  330  is simply desired to be stabilized by bonding with the capsular bag. The data processing unit  230  may then image the eye  300  and determine the regions of the capsular bag  304  that are in proximity to or in contact with the desired portions of the IOL. Alternatively, the physician may manually select the portions of the capsular bag  304  to be heated. In certain embodiments, the portions of the capsular bag  304  to be heated may be located adjacent the haptics  332  and/or the periphery of the optic  334  of the IOL  330 . As a result, the portions of the capsular bag  304  to be heated may be outside of the optical path  312 . As one example,  FIG. 4D  depicts the eye  300  with the IOL  330  in place and the capsular bag  304  collapsed around the IOL  330 . Also shown by a dashed line are the portions  340  of the capsular bag desired to be heated. For the embodiment depicted in  FIG. 4D , the periphery of the posterior surface of the optic  334  is desired to be adhered to the capsular bag  304 . 
     A particular region of the capsular bag  304  to be heated next is selected, via step  158 . Step  158  may be performed automatically by the system  200  or may be selected manually by the physician. The laser  212  may be focused to target the selected region of the capsular bag  304 , via step  160 . The data processing unit  230  may provide the region and controller  210  may target the laser  212  in step  160 . As part of step  160 , the controller  210  may set the pulse duration and spot size determined in strep  154 . Alternatively, step  160  may be performed manually by the physician. 
     The laser  212  may be fired at the target region for the desired time with one or more pulses of the desired duration, via step  162 . Thus the desired energy is provided to the selected portion of the capsular bag  304 . The energy applied in step  162  may be sufficient to melt the portion of the capsular bag  304  without cauterization without forming an aperture in the capsular bag  304 . The melted portion of the capsular bag  304  may adhere to the selected portion of the IOL  330 . 
     It is determined whether there are additional regions of the capsular bag  304  to heat, via step  164 . If not, the method  150  has completed. If so, another region is selected in step  158  and heated in steps  160  and  162 . Thus, the desired regions of the capsular bag  304  are heated and adhere to the desired portions of the IOL  330 . 
     For example,  FIG. 4E  depicts a side view of the capsular bag  304  and the IOL  330  after the capsular bag  304  has collapsed. Thus,  FIG. 4E  may be considered a different view of the capsular bag  304  and IOL  330  shown in  FIG. 4D . Also indicated are regions  340  that are to be sealed using the method  150 . The anterior side (closer to the cornea  302 ) and posterior side of the optic  304  are also indicated.  FIG. 4F  depicts the capsular bag  304 A and IOL  330  after the method  150  is completed. The capsular bag  304  has been sealed to the haptic  332  at selected locations  340 A. A portion  304 A of the capsular bag  304  thus seals the posterior surface of the optic  334 . Consequently, the position of the IOL  330  in the capsular bag  304  is stabilized by the locations  340 A at which the IOL is adhered to the capsular bag. As can be seen in  FIG. 4F , the capsular bag  304  is bonded to the IOL  330  at locations  340 A outside of the optic  334  and far from the optic axis. 
       FIGS. 5A-5G  depict various views of IOLs that may be used in conjunction with the methods  100  and/or  150 .  FIG. 5A  depicts an IOL  350 A including an optic  352  and a support structure  354 A, or haptic  354 A. In this embodiment, the optic  352  and haptic  354  may be formed of different materials. For example, the haptic  354  may be formed of hydrophilic material(s) or other materials that may provide a better bond to the heated capsular bag. In this embodiment, the capsular bag is desired to be bonded to the haptic  354 A at region  360 A shown by a dashed line. Thus, the posterior surface of the optic  352  may be sealed. Because of the seal at locations  360 A, the haptic  354 A can but need not include a sharp edge for mitigating PCO. 
       FIG. 5B  depicts another embodiment of an IOL  350 B including an optic  352 B and a support structure  354 B. In this embodiment, the optic  352 B and haptic  354 B may be formed of the same material(s). Thus, the optic  352 B and haptic  354 B may be molded together. In this embodiment, the capsular bag is desired to be bonded to the haptic  354 B at region  360 B shown by a dashed line. Thus, the posterior surface of the optic  352 B may be sealed. Because of the seal at locations  360 A, the haptic  354 A can but need not include a sharp edge for mitigating PCO. 
       FIG. 5C  depicts another embodiment of an IOL  350 C including an optic  352 C and a support structure  354 C. In this embodiment, the optic  352 C and haptic  354 C may be formed of the same material(s). The capsular bag is desired to be bonded to the haptic  354 C at regions  360 C- 1 ,  360 C- 2 ,  360 C- 3  and  360 C- 4 , shown by dashed lines. Thus, the posterior surface of the optic  352 C may not be sealed. Instead, the IOL  350 C is merely desired to be stabilized in the capsular bag. 
       FIG. 5D  depicts another embodiment of an IOL  350 D including an optic  352 D and a support structure  354 D. In this embodiment, the optic  352 D and haptic  354 D may be formed of the same material(s). The capsular bag is desired to be bonded to the haptic  354 D at regions  360 D- 1  and  360 D- 2 , shown by dashed lines. Thus, the IOL is to be adhered to the capsular bag along the arms of the haptic  354 D. The IOL  350 C is thus stabilized in the capsular bag. 
       FIG. 5E  depicts another embodiment of an IOL  350 E including an optic  352 E. Although not explicitly depicted in  FIG. 5E , the IOL  350 E additionally includes haptics extending from the periphery of optic  352 E. In this embodiment, the capsular bag is desired to be bonded to the IOL  350 E at regions  360 E, which may be a region on the posterior surface of IOL  350 E surrounding the periphery of optic  352 E. Additionally, the capsular bag may be bonded to the haptics of IOL  350 E. In certain embodiments, region  360 E may include a coating  356 E. The coating  356 E may improve the bonding between the IOL  350 E and the capsular bag. Thus, the coating  356 E may be configured to bond to Type IV collagen that has been heated to the desired temperature range. After cooling, the coating  356 E better adheres to the capsular bag. Thus, bonding between the IOL  350 E and the capsular bag may be improved. As just one example, the coating may be Rose bengal stain, which may increase bonding when heated using green laser light. 
       FIG. 5F  depicts another embodiment of an IOL  350 F including an optic  352 F. Although not explicitly depicted in  FIG. 5F , the IOL  350 F additionally includes haptics extending from the periphery of optic  352 F. In this embodiment, the capsular bag is desired to be bonded to the IOL  350 F at regions  360 F, which may be a region on the posterior surface of IOL  350 E surrounding the periphery of optic  352 E. IOL  350 F may include structure  358 F to improve ingress of melted collagen. Stated differently, the structure  358 F is used to improve bonding between the IOL  350 F and the capsular bag (not shown). In certain embodiments, the structure  358 F may take the form of ridges or other texturing and may improve the bonding between the haptic  354 F and the capsular bag. Thus, bonding between the IOL  350 F and the capsular bag may be improved. 
       FIG. 5G  depicts another embodiment of an IOL  350 G including an optic  352 G. Although not explicitly depicted in  FIG. 5G , the IOL  350 G additionally includes haptics extending from the periphery of optic  352 G. In this embodiment, the capsular bag is desired to be bonded to the IOL  350 G at regions  360 G, which may be a region on the posterior surface of IOL  350 G surrounding the periphery of optic  352 G. IOL  350 G may include both a coating  356 G to improve bonding (as described above with regard to  FIG. 5E ) and structure  358 G to improve ingress of melted collagen (as described above with regard to  FIG. 5F ). 
     It will be appreciated that various of the above-disclosed and other features and functions, or alternatives thereof, may be desirably combined into many other different devices or applications. It will also be appreciated that various presently unforeseen or unanticipated alternatives, modifications, variations or improvements therein may be subsequently made by those skilled in the art which alternatives, variations and improvements are also intended to be encompassed by the following claims.