Patent Publication Number: US-2022211488-A1

Title: Lenses, systems, and methods for reducing negative dysphotopsia

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 63/134,946, filed Jan. 7, 2021, which is incorporated herein by reference in its entirety. 
    
    
     BACKGROUND 
     Ophthalmic lenses may be utilized to correct optical aberrations of an individual&#39;s eye. For example, glasses and contact lenses may be utilized to correct for spherical aberration or astigmatism present in an individual&#39;s eye. 
     Ophthalmic lenses in the form of intraocular lenses may also be utilized to correct optical aberrations of an individual&#39;s eye. Intraocular lenses are typically implanted within the capsular bag of an individual&#39;s eye and often replace the natural lens present within an individual&#39;s eye. The natural lens may have become clouded due to cataracts or may need to be replaced due to other maladies of the individual&#39;s eye. 
     The intraocular lens preferably improves the vision of the individual&#39;s eye such that additional ophthalmic lenses in the form of glasses or contact lenses may not be needed. However, certain side effects may result from the implantation of the ophthalmic lens. One such side effect that may impact vision is negative dysphotopsia. Negative dysphotopsia may have high prevalence immediately after cataract surgery and may reduce over months and years. Improved methods of determining and reducing negative dysphotopsia is thus desired. 
     SUMMARY 
     Apparatuses, systems, and methods disclosed herein may be directed to reducing negative dysphotopsia in an individual&#39;s eye. Such apparatuses, systems, and methods may include determining an angle kappa of an individual&#39;s eye. Such apparatuses, systems, and methods may further include tilt adjustable intraocular lenses. 
     Embodiments of the present disclosure include a method including selecting an intraocular lens providing angle kappa correction in an individual&#39;s eye, the intraocular lens being selected based on a determination of negative dysphotopsia in the individual&#39;s eye based on one or more measurements of angle kappa. 
     Embodiments of the present disclosure include a method including providing a tilt adjustment of an optical axis of an optic of an intraocular lens with respect to a platform of the intraocular lens, the tilt adjustment being provided based on a determination of negative dysphotopsia in an individual&#39;s eye based on one or more measurements of angle kappa. 
     Embodiments of the present disclosure include a method including determining an angle kappa of an individual&#39;s eye. The method may include producing a determination, based on the angle kappa of the individual&#39;s eye, of negative dysphotopsia in the individual&#39;s eye based on implantation of an intraocular lens in the individual&#39;s eye. 
     Embodiments of the present disclosure include an intraocular lens including an optic having an optical axis whose orientation can be modified respect to the mechanical axis of the platform. The intraocular lens may include a platform coupled to the optic and configured to support the optic. A tilt of the optical axis may be adjustable with respect to the platform. 
     Embodiments of the present disclosure include an intraocular lens including an optic having an optical axis whose orientation can be modified respect to the mechanical axis of the platform. The intraocular lens may include a platform coupled to the optic and configured to support the optic. The optical axis is tilted with respect to the platform to provide angle kappa correction in an individual&#39;s eye. 
     Embodiments of the present disclosure include a method including implanting an intraocular lens in an individual&#39;s eye. The intraocular lens may include an optic having an optical axis, and a platform coupled to the optic and configured to support the optic. A tilt of the optical axis is adjustable with respect to the platform. 
     Embodiments of the present disclosure include a method including implanting an intraocular lens in an individual&#39;s eye. The intraocular lens may include an optic having an optical axis, and a platform coupled to the optic and configured to support the optic. The optical axis is tilted with respect to the platform to provide angle kappa correction in the individual&#39;s eye. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Features and advantages of the systems, apparatuses, and methods as disclosed herein will become appreciated as the same become better understood with reference to the specification, claims, and appended drawings wherein: 
         FIG. 1  illustrates a cross sectional view of a phakic eye including a natural crystalline lens. 
         FIG. 2  illustrates a cross sectional view of the eye shown in  FIG. 1  in which the natural lens has been replaced by an intraocular lens. 
         FIG. 3  illustrates a top view of an intraocular lens according to an embodiment of the present disclosure. 
         FIG. 4  illustrates a side cross sectional view of the intraocular lens shown in  FIG. 3  along line IV-IV shown in  FIG. 3 . 
         FIG. 5  illustrates a top view of an intraocular lens according to an embodiment of the present disclosure. 
         FIG. 6  illustrates a side cross sectional view of the intraocular lens shown in  FIG. 5  along line VI-VI shown in  FIG. 5 . 
         FIG. 7  illustrates a side cross sectional view of the intraocular lens shown in  FIG. 6  with the optic tilted from the position shown in  FIG. 6 . 
         FIG. 8  illustrates a top view of an intraocular lens according to an embodiment of the present disclosure. 
         FIG. 9  illustrates a side cross sectional view of the intraocular lens shown in  FIG. 8  along line IX-IX shown in  FIG. 8 . 
         FIG. 10  illustrates a schematic view of a system. 
     
    
    
     DETAILED DESCRIPTION 
       FIG. 1  illustrates a cross sectional view of a phakic eye  10  including a natural crystalline lens  12 . The lens  12  may be positioned within a capsular bag  14  (more clearly shown in  FIG. 2 ). The capsular bag  14  may be coupled to a ciliary muscle  16  via zonules  18 . The ciliary muscle  16 , via the zonules  18 , controls the shape and position of the natural lens  12 , which allows the eye  10  to focus on distant and near objects. Distant vision is provided when the ciliary muscle  16  pulls the zonules  18 , which thus pull the natural lens  12  so that the capsular bag  14  is generally flatter and has a longer focal length (lower optical power). Near vision is provided as the ciliary muscle  16  contracts, thereby relaxing the zonules  18  and allowing the natural lens  12  to return to a more rounded, unstressed state that produces a shorter focal length (higher optical power). 
     The eye  10  includes a cornea  20  and an iris  22  disposed between the cornea  20  and the natural lens  12 . The iris  22  provides a variable pupil  24  that dilates under lower lighting conditions (scotoptic vision) and contracts under brighter lighting conditions (photopic vision). 
     The eye  10  includes a retina  26  that receives light in the form of an image. The retina  26  includes the fovea  28 , which is a small depression in the retina  26  at which visual acuity is the highest. 
     The eye  10  has a pupillary axis  30 , which is a line perpendicular to the cornea  20  that intersects the center of the pupil  24 . The eye  10  also has a visual axis  32 , which is a line joining the fixation point of the eye  10  to the nodal point of the eye  10 . An angle  34  between the pupillary axis  30  and the visual axis  32  is referred to as “angle kappa.” 
     Angle kappa  34  is typically in the nasal direction of an eye  10 , as the fovea  28  is typically in the temporal direction of the eye  10 . Notably, the magnitude of angle kappa  34  may vary for different individuals&#39; eyes based on the particular physiology of the individual&#39;s eye. An average magnitude of angle kappa  34  is about five degrees, with a standard deviation of about 2.5 degrees. However, greater variation may be observed for different individuals. For example, an angle kappa  34  may be about 7.5 degrees or greater (e.g., about ten degrees or greater). An angle kappa  34  may be between about 2.5 degrees and about zero degrees in certain individuals, and may be about zero degrees in certain individuals. The amount of angle kappa may vary greatly in different individuals. The orientation of the angle kappa  34  may vary in different individuals as well. 
       FIG. 2  illustrates a cross sectional view of the eye  10  in which the natural lens  12  has been replaced by an intraocular lens  36 . The natural lens  12  may be replaced by the intraocular lens  36  for a variety of reasons, which may include for example, clouding of the natural lens  12  due to cataracts. Other maladies of the eye may require replacement of the natural lens  12 . 
     The intraocular lens  36  may include an optic  38  and a platform including haptics  40  extending outward from the optic  38 . The intraocular lens  36 , and the optic  38 , may include an anterior surface  42 , and a posterior surface  44  facing opposite the anterior surface  42 . One or more of the surfaces  42 ,  44  of the optic  38  may be configured to form an image on the retina  26  of the eye  10 . The optic  38  may be configured to improve the vision of the eye such that other ophthalmic lenses (e.g., contact lenses, glasses) may not be needed. One or more of the surfaces  42 ,  44 , for example, may be a refractive surface, a diffractive surface, or a combination of refractive or diffractive surfaces to form the image on the retina  26 . In one embodiment, the intraocular lens  36 , and the optic  38 , may be multifocal, to provide a plurality of focuses. For example, a far focus corresponding to distance vision, and a near focus corresponding to near vision may result. In other embodiments, one or more intermediate focuses between the far focus and the near focus may result. In one embodiment, the intraocular lens  36  may be configured as an extended depth of focus lens, with an extended depth of focus between a far focus and a near focus. 
     The haptics  40  may be configured to center the optic  38  within the capsular bag  14 . The haptics  40  may have a variety of configurations as desired. 
     The implantation of the intraocular lens  36  may produce negative dysphotopsia in the individual&#39;s eye. The negative dysphotopsia may be based on the implantation of the intraocular lens  36  in the individual&#39;s eye. According to embodiments herein, it is believed that an indicator of negative dysphotopsia based on the implantation of the intraocular lens  36  in the individual&#39;s eye may be the tilt of the optic  38  of the intraocular lens  36  with respect to the visual axis  32 . The tilt of the optic  38  of the intraocular lens  36  with respect to the visual axis  32  may be caused by factors. 
     Such factors may include the angle kappa  34  (the angle between the pupillary axis  30  and the visual axis  32 ) and the tilt of the optic  38  of the intraocular lens  36  with respect to the pupillary axis  30  (the angle  46  between the pupillary axis  30  and the optical axis  48  of the optic  38 ). 
     As such, according to embodiments disclosed herein, the angle kappa  34  may be determined for an individual&#39;s eye. The angle kappa  34  of the individual&#39;s eye in embodiments may be determined by being measured pre-operatively, prior to the intraocular lens  36  being implanted into the patient&#39;s eye. The angle kappa  34  may be determined via a variety of methods. Such methods may include utilizing one or more of Purkinje images or a distance between a center of Placido rings and a center of the cornea  20  of the individual&#39;s eye. In embodiments, a method utilizing ultrasound biomicroscopy and corneal topography may be utilized. The methods utilized may involve measurements of the biometry of an individual&#39;s eye. A variety of other methods may be utilized as desired. The angle kappa  34  may be determined based on these measurements. 
     A determination of the likelihood of having negative dysphotopsia after cataract surgery may be produced in the individual&#39;s eye. In embodiments, the determination may be produced based on the angle kappa  34  of the individual&#39;s eye, and may include a determination of the risk of negative dysphotopsia in the individual&#39;s eye based on implantation of an intraocular lens in the individual&#39;s eye. 
     A variety of methods may be utilized to produce the determination of the likelihood of having negative dysphotopsia after cataract surgery in the individual&#39;s eye. In embodiments, the determined angle kappa  34  may be compared to a threshold value of angle kappa  34 . It may be determined whether the angle kappa  34  meets such a threshold (by equaling or being higher than the threshold) to produce the determination of negative dysphotopsia. For example, if the determined angle kappa  34  is equal to or higher than a threshold value of five degrees, then a determination may be made that negative dysphotopsia in the individual&#39;s eye may occur. Other thresholds may be utilized. It is envisioned that the threshold value may be equal to or greater than two, three or four degrees. It is also envisioned that the threshold value may be equal to or greater than six, seven, eight, nine or even 10 degrees. 
     The threshold value may be determined in a variety of manners. For example, data from patients that have already had intraocular lenses implanted in their eyes may be utilized. Such data may include parameters of the angles of the intraocular lenses and the angle kappas, and whether negative dysphotopsia is experienced by such individuals. As an example, an average tilt of the optic  38  of the intraocular lens  36  with respect to the pupillary axis  30  (the angle  46  between the pupillary axis  30  and the optical axis  48  of the optic  38 ) may be four degrees. Further, a minimum tilt of the optic  38  of the intraocular lens  36  with respect to the visual axis  32  in individuals experiencing negative dysphotopsia may be eight degrees. As such, a threshold value of angle kappa  34  may be set at five degrees, at which a measured value of angle kappa  34  at or greater than this threshold may result in negative dysphotopsia in the individual&#39;s eye based on implantation of the intraocular lens in the individual&#39;s eye. 
     The determination of negative dysphotopsia in the individual&#39;s eye accordingly may be based on one or more measurements of angle kappa, which may include a measurement of angle kappa of the individual&#39;s eye, and may include measurements of angle kappa of other individuals. Other forms of biometry may be utilized to produce the determination of negative dysphotopsia in the individual&#39;s eye. Such forms of biometry may be those used to perform a power calculation for the intraocular lens. 
     The determination of the likelihood of having negative dysphotopsia after cataract surgery in the individual&#39;s eye may be produced in a variety of forms. In embodiments, the determination may comprise a probability of negative dysphotopsia occurring. The probability may be a probability of negative dysphotopsia in the individual&#39;s eye based on one or more measurements of angle kappa, and may be based on implantation of the intraocular lens in the individual&#39;s eye. For example, upon the angle kappa  34  being determined, a likelihood of negative dysphotopsia may be produced. A clinician accordingly may use such a probability to determine whether there is a high likelihood of negative dysphotopsia occurring following implantation of the intraocular lens. The clinician accordingly may determine whether to proceed with implantation of the intraocular lens based on the likelihood of negative dysphotopsia occurring. 
     In embodiments, the determination may comprise a binary result of negative dysphotopsia occurring in the individual&#39;s eye (e.g., a yes or no determination based on the measured angle kappa  34 ). 
     In embodiments, the clinician may determine a type of intraocular lens that may be implanted in the patient&#39;s eye based on the likelihood of negative dysphotopsia occurring (e.g., a risk estimation of negative dysphotopsia). A clinician may select an intraocular lens that may be designed to address the presence of negative dysphotopsia, for example a tilt adjustable intraocular lens or a lens having an optical axis that is tilted, or other form of lens as disclosed herein. 
     A clinician may select an intraocular lens that may provide angle kappa correction in the individual&#39;s eye. The correction may be a whole or partial correction in embodiments. The intraocular lens may have an optic with an optical axis that is tilted with respect to a platform to provide the angle kappa correction in the individual&#39;s eye. Such an optic may comprise an optic as shown in  FIGS. 8 and 9  for example. The type of intraocular lens may be selected based on a degree of tilt of the optical axis with respect to the platform that provides the angle kappa correction in the individual&#39;s eye. For example, if six degrees of angle kappa correction are needed, then the clinician may select an optic with an optical axis the provides the six degrees of angle kappa correction. In embodiments, the intraocular lens may be selected from a plurality of intraocular lenses having a different degree of tilt of an optical axis of an optic with respect to a platform. For example, the intraocular lens having six degrees of angle kappa correction may be selected from a set of intraocular lenses having five degrees, six degrees, and seven degrees of angle kappa correction. The clinician may select the intraocular lens having six degrees of angle kappa correction from this set. 
     The determination of negative dysphotopsia in the individual&#39;s eye based on implantation of the intraocular lens in the individual&#39;s eye may be made in a variety of manners. For example, a processor  50  as shown in  FIG. 10  may be utilized to make such a determination. The processor  50  may receive an input  52  of the angle kappa  34 . The processor  50  may operate an algorithm stored in memory  54  to produce an output  56  of the determination of negative dysphotopsia in the individual&#39;s eye based on implantation of the intraocular lens in the individual&#39;s eye. In embodiments, a machine learning algorithm may be utilized. The machine learning algorithm may utilize feedback of negative dysphotopsia following implantation of one or more intraocular lenses in one or more individual&#39;s eyes to determine if negative dysphotopsia will occur in this particular individual&#39;s eye. As such, the processor  50  may rely on data from other procedures, which may include parameters of the angles of the intraocular lenses and the angle kappas, and whether negative dysphotopsia is experienced by such individuals. The data may be collected as a pre-cataract surgery angle kappa, and a post-cataract surgery negative dysphotopsia occurrence, among other forms of data that may be utilized. 
     In embodiments, a tilt adjustable intraocular lens may be selected and utilized. The tilt adjustable intraocular lens may be utilized to address the determination of negative dysphotopsia in the individual&#39;s eye. For example, if there is a high likelihood of negative dysphotopsia determined for an individual&#39;s eye, then a tilt adjustable intraocular lens may be selected for implantation in the individual&#39;s eye. Such a tilt adjustable intraocular lens may be configured to have the optic centered with respect to the visual axis  32  by adjusting the tilt of the optic, and may be centered with a relatively small variation in the angle from the visual axis. 
       FIG. 3 , for example, illustrates an embodiment of a tilt adjustable intraocular lens  58 . The lens  58  may include an optic  60  and a platform  62  coupled to the optic  60  and configured to support the optic  60 . The optic  60  may have an optical axis  64  (marked in  FIG. 4 ) that may be adjustable with respect to the platform  62 . The platform  62  may include haptics  66  extending outward from the optic  60  and configured to support the optic  60 .  FIG. 3  illustrates a top view of such an embodiment. A tilt of the optical axis  64  may be adjustable with respect to the platform  62 . 
       FIG. 4  illustrate a cross sectional view of the embodiment of  FIG. 3  along line IV-IV. The lens  58  may include a screw coupling  65  that may couple the platform  62  to the optic  60  and may allow the optical axis  64  to tilt with respect to the platform  62 . For example, as the screw coupling  65  is rotated in one direction, the optical axis  64  may tilt as shown in  FIG. 4 , and as the screw coupling  65  is rotated in the other direction, the optical axis  64  may tilt in another direction. The amount of tilt of the optical axis  64  may be controlled by the amount that the screw coupling  65  is rotated. 
       FIG. 5  illustrates an embodiment of a tilt adjustable intraocular lens  68 . The lens  68  includes an optic  70  and a platform  72  coupled to the optic  70  and configured to support the optic  70 . The platform  72  may include haptics  74  extending outward from the optic  70  and configured to support the optic  70 .  FIG. 5  illustrates a top view of such an embodiment. A tilt of the optical axis may be adjustable with respect to the platform  72 . 
       FIG. 6  illustrates a cross sectional view of the embodiment of  FIG. 5  along line VI-VI. The optic  70  may be positioned upon a portion  76  of the platform  72  that may be configured to be ablated, for example with a laser. The portion  76  may be ablated to allow the optical axis  78  to tilt with respect to the platform  72 .  FIG. 7 , for example, illustrates the portion  76  ablated to vary a shape of the portion  76  to cause the optic  70  to tilt. The optical axis  78  has tilted from the position marked as  78 ′ to the position of the optical axis  78 . In embodiments, one or more of the optic  70  or the platform  72  may be ablated to tilt the optical axis  78 . For example, one or more surfaces of the optic  70  may be laser ablated according to embodiment herein to provide an angle kappa correction. 
     Implantation of a tilt adjustable intraocular lens may include determining the visual axis  32  of the individual&#39;s eye. The tilt of the optical axis of the intraocular lens may then be adjusted to center the optic with respect to the visual axis  32 . The adjustment may occur prior to implantation of the intraocular lens, or during or after implantation. Further, the determination of the visual axis  32  of the individual&#39;s eye may occur prior to, during, or after implantation of the intraocular lens. The clinician may iteratively determine the visual axis  32  and adjust the tilt of the optical axis to center the optic with respect to the visual axis  32 . 
     In embodiments, the clinician may provide a tilt adjustment of an optical axis of an optic of an intraocular lens with respect to a platform of the intraocular lens, with the tilt adjustment being provided based on the determination of negative dysphotopsia in the individual&#39;s eye based on one or more measurements of angle kappa. The tilt adjustment may be provided as a determination of whether to provide the tilt adjustment, based on the determination of negative dysphotopsia in the individual&#39;s eye based on one or more measurements of angle kappa. For example, if a low propensity of negative dysphotopsia is determined, then a clinician may determine that no tilt adjustment is needed. Conversely, if a high propensity of negative dysphotopsia is determined, then a clinician may determine that a tilt adjustment is needed. 
     In embodiments, the tilt adjustment may be provided as an amount of tilt adjustment based on the determination of negative dysphotopsia in the individual&#39;s eye based on one or more measurements of angle kappa. For example, the clinician may be able to determine how much of a tilt adjustment may be needed, based on the determination of negative dysphotopsia in the individual&#39;s eye based on one or more measurements of angle kappa. The clinician may determine the degree to which the tilt should be adjusted. Such an adjustment, in embodiments, may be performed post-implantation of the intraocular lens into the individual&#39;s eye. For example, a corrective procedure may be performed to provide an angle kappa correction after the individual&#39;s eye already has been implanted with the intraocular lens. 
     The tilt adjustment may provide an angle kappa correction in the individual&#39;s eye. The clinician may perform the tilt adjustment intraoperatively in embodiments. One or more of a mechanical adjustment or a laser ablation, as disclosed herein, may be utilized. For example, according to methods herein, a laser ablation may be performed to one or more surfaces of the optic  70  to provide an angle kappa correction. The amount of material to be ablated may be determined based on the desired angle kappa correction. The tilt of the optical axis may be set based on the measured angle kappa of the individual&#39;s eye (e.g., the tilt to center with the visual axis). 
     The amount of tilt may be scaled so that the clinician may control the tilt during implantation within a tilt correction range. The tilt correction range may be based on pre-existent analytical models. The analytical models, in embodiments, may be configured to collect pre and post-surgery biometry (such as intraocular lens tilt, angle kappa, etc.) and produce a prediction model. In embodiments, average values may be utilized. 
       FIGS. 8 and 9  illustrate an embodiment of an intraocular lens  81  having an optic  83  having an optical axis  85 , and a platform  87  coupled to the optic  83  and configured to support the optic  83 . The platform  87  may include haptics in embodiments. Such an embodiment may comprise an intraocular lens having a tilted optical axis that is non-adjustable. The angle of the tilted optical axis, for example, may be pre-set. 
     As shown in  FIG. 9 , the optical axis  85  may be tilted with the respect to the platform  87 . The platform  87 , for example, may have an orientation plane  89  that the platform  87  is configured to position the intraocular lens  81  within the eye in. However, the optical axis  85  may be tilted with respect to this plane  89  such that the optical axis  85  is not perpendicular  91  with the plane  89  (as shown in  FIG. 9 ) 
     The optical axis  85  may be tilted to provide angle kappa correction in an individual&#39;s eye. As such, the tilt of the optical axis  85  may be set such that the optical axis  85  is centered with respect to the visual axis  32 . In embodiments, the optical axis  85  may be set based on the measured angle kappa of the individual&#39;s eye (e.g., the tilt to center with the visual axis). 
     The optical axis  85 , in embodiments, may be pre-set based on an angle kappa of one or more individual&#39;s eyes. For example, the angle kappa of many individuals may be known and the optical axis  85  may be pre-set based on an average angle kappa of these many individuals. As such, a clinician may select the intraocular lens  81  having an average value of angle kappa correction. In embodiments, the type of intraocular lens (including the angle of the optical axis) may be selected according to methods disclosed herein, including selection for providing an angle kappa correction in an individual&#39;s eye, with the intraocular lens being selected based on a determination of negative dysphotopsia in the individual&#39;s eye based on one or more measurements of angle kappa. 
     Centering the optic with respect to the visual axis  32  may beneficially reduce the prevalence of negative dysphotopsia in the individual&#39;s eye. The embodiments disclosed herein may be utilized with one or more of a monofocal optic, a multifocal optic, or an extended depth of focus optic. The optics may be refractive and/or diffractive. Tilt adjustable intraocular lenses may be applied to compensate for the negative impact of large angle kappa in image quality, particularly for multifocal intraocular lenses. 
     Features of embodiments may be modified, substituted, excluded, or combined as desired. 
     In addition, the methods herein are not limited to the methods specifically described, and may include methods of utilizing the systems and apparatuses disclosed herein. 
     In embodiments, a method may include implanting an intraocular lens in an individual&#39;s eye. In embodiments, the intraocular lens may include features as disclosed herein, including an optic having an optical axis, and a platform coupled to the optic and configured to support the optic, wherein a tilt of the optical axis is adjustable with respect to the platform. 
     A method may include determining a visual axis of the individual&#39;s eye. The method may include adjusting the tilt of the optical axis with respect to the platform to center the optic with respect to the visual axis of the individual&#39;s eye. 
     In embodiments, a screw coupling may couple the platform to the optic, and the method may further comprise adjusting the screw coupling to adjust the tilt of the optical axis with respect to the platform to center the optic with respect to the visual axis of the individual&#39;s eye. 
     In embodiments, a method may include laser ablating a portion of one or more of the optic or the platform to adjust the tilt of the optical axis with respect to the platform to center the optic with respect to the visual axis of the individual&#39;s eye. 
     A method may include adjusting the tilt of the optical axis prior to implantation of the intraocular lens in the individual&#39;s eye. A method may include adjusting the tilt of the optical axis during or after implantation of the intraocular lens in the individual&#39;s eye. 
     In embodiments, the visual axis of the individual&#39;s eye may be determined based on an angle kappa of the individual&#39;s eye. 
     A method may include measuring the angle kappa utilizing one or more of Purkinje images or a distance between a center of Placido rings and a center of a cornea of the individual&#39;s eye. 
     In embodiments, a method may include implanting an intraocular lens in an individual&#39;s eye. The intraocular lens may include an optic having an optical axis, and a platform coupled to the optic and configured to support the optic. The optical axis may be tilted with respect to the platform to provide angle kappa correction in the individual&#39;s eye. 
     In embodiments, the intraocular lens may be selected based on an angle kappa of the individual&#39;s eye. The optical axis may be tilted with respect to the orientation plane of the haptics for the intraocular lens. 
     In embodiments, a degree of the tilt of the optical axis is set based on an angle kappa of one or more individuals&#39; eyes. 
     The method may include determining a visual axis of the individual&#39;s eye. A tilt of the optical axis with respect to the platform may center the optic with respect to the visual axis of the individual&#39;s eye. The visual axis of the individual&#39;s eye may be determined based on an angle kappa of the individual&#39;s eye. The method may include measuring the angle kappa utilizing one or more of Purkinje images or a distance between a center of Placido rings and a center of a cornea of the individual&#39;s eye. 
     According to embodiments herein, the processor  50  shown in the system of  FIG. 10  may comprise a central processing unit (CPU) or other form of processor. In certain embodiments the processor  50  may comprise one or more processors. The processor  50  may include one or more processors that are distributed in certain embodiments, for example, the processor  50  may be positioned remote from other components of the system or may be utilized in a cloud computing environment. The memory  54  may comprise a memory that is readable by the processor  50 . The memory  54  may store instructions, or features of intraocular lenses, or other parameters that may be utilized by the processor  50  to perform the methods disclosed herein. The memory  54  may comprise a hard disk, read-only memory (ROM), random access memory (RAM) or other form of non-transient medium for storing data. The input  52  may comprise a port, terminal, physical input device, or other form of input. The port or terminal may comprise a physical port or terminal or an electronic port or terminal. The port may comprise a wired or wireless communication device in certain embodiments. The physical input device may comprise a keyboard, touchscreen, keypad, pointer device, or other form of physical input device. The input  52  may be configured to provide an input to the processor  50 . The output  56  may comprise a variety of forms of output, including non-transitory digital signals, a computer screen output, a printed output, or other forms of output as desired. Other configurations of systems may be utilized in embodiments. 
     In closing, it is to be understood that although aspects of the present specification are highlighted by referring to specific embodiments, one skilled in the art will readily appreciate that these disclosed embodiments are only illustrative of the principles of the subject matter disclosed herein. Therefore, it should be understood that the disclosed subject matter is in no way limited to a particular methodology, protocol, and/or reagent, etc., described herein. As such, various modifications or changes to or alternative configurations of the disclosed subject matter can be made in accordance with the teachings herein without departing from the spirit of the present specification. Lastly, the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to limit the scope of systems, apparatuses, and methods as disclosed herein, which is defined solely by the claims. Accordingly, the systems, apparatuses, and methods are not limited to that precisely as shown and described. 
     Certain embodiments of systems, apparatuses, and methods are described herein, including the best mode known to the inventors for carrying out the same. Of course, variations on these described embodiments will become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventor expects skilled artisans to employ such variations as appropriate, and the inventors intend for the systems, apparatuses, and methods to be practiced otherwise than specifically described herein. Accordingly, the systems, apparatuses, and methods include all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described embodiments in all possible variations thereof is encompassed by the systems, apparatuses, and methods unless otherwise indicated herein or otherwise clearly contradicted by context. 
     Groupings of alternative embodiments, elements, or steps of the systems, apparatuses, and methods are not to be construed as limitations. Each group member may be referred to and claimed individually or in any combination with other group members disclosed herein. It is anticipated that one or more members of a group may be included in, or deleted from, a group for reasons of convenience and/or patentability. When any such inclusion or deletion occurs, the specification is deemed to contain the group as modified thus fulfilling the written description of all Markush groups used in the appended claims. 
     The terms “a,” “an,” “the” and similar referents used in the context of describing the systems, apparatuses, and methods (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein is intended merely to better illuminate the systems, apparatuses, and methods and does not pose a limitation on the scope of the systems, apparatuses, and methods otherwise claimed. No language in the present specification should be construed as indicating any non-claimed element essential to the practice of the systems, apparatuses, and methods. 
     All patents, patent publications, and other publications referenced and identified in the present specification are individually and expressly incorporated herein by reference in their entirety for the purpose of describing and disclosing, for example, the compositions and methodologies described in such publications that might be used in connection with the systems, apparatuses, and methods. These publications are provided solely for their disclosure prior to the filing date of the present application. Nothing in this regard should be construed as an admission that the inventors are not entitled to antedate such disclosure by virtue of prior invention or for any other reason. All statements as to the date or representation as to the contents of these documents is based on the information available to the applicants and does not constitute any admission as to the correctness of the dates or contents of these documents.