Patent Description:
From <CIT> an intraocular lens is known which comprises an optic portion and a peripheral portion which are mechanically coupled to each other and both comprise a fluid chamber which are fluidly connected with each other.

An intraocular lens with the features of claim <NUM> is provided. Further, optional features are defined in the dependent claims.

The disclosure relates generally to intraocular lenses. In some embodiments the intraocular lenses described herein are adapted to be positioned within a native capsular bag in which a native lens has been removed. In these embodiments a peripheral non-optic portion (i.e., a portion not specifically adapted to focus light on the retina) is adapted to respond to capsular bag reshaping due to ciliary muscle relaxation and contraction. The response is a deformation of the peripheral portion that causes a fluid to be moved between the peripheral portion and an optic portion to change an optical parameter (e.g., power) of the intraocular lens.

<FIG> is a top view illustrating accommodating intraocular lens <NUM> that includes optic portion <NUM> and a peripheral portion that in this embodiment includes first and second haptics <NUM> coupled to and extending peripherally from optic portion <NUM>. Optic portion <NUM> is adapted to refract light that enters the eye onto the retina. Haptics <NUM> are configured to engage a capsular bag and are adapted to deform in response to ciliary muscle related capsular bag reshaping. <FIG> is a perspective view of intraocular lens <NUM> showing optic portion <NUM> and haptics <NUM> coupled to optic portion <NUM>.

The haptics are in fluid communication with the optic portion. Each haptic has a fluid chamber that is in fluid communication with an optic chamber in the optic portion. The haptics are formed of a deformable material and are adapted to engage the capsular bag and deform in response to ciliary muscle related capsular bag reshaping. When the haptics deform the volume of the haptic fluid chamber changes, causing a fluid disposed in the haptic fluid chambers and the optic fluid chamber to either move into the optic fluid chamber from the haptic fluid chambers, or into the haptic fluid chambers from the optic fluid chamber. When the volume of the haptic fluid chambers decreases, the fluid is moved into the optic fluid chamber. When the volume of the haptic fluid chamber increases, fluid is moved into the haptic fluid chambers from the optic fluid chamber. The fluid flow into and out of the optic fluid chamber changes the configuration of the optic portion and the power of the intraocular lens.

<FIG> is a side sectional view through Section A-A indicated in <FIG>. Optic portion <NUM> includes deformable anterior element <NUM> secured to deformable posterior element <NUM>. Each haptic <NUM> includes a fluid chamber <NUM> that is in fluid communication with optic fluid chamber <NUM> in optic portion <NUM>. Only the coupling between the haptic <NUM> to the left in the figure and option portion <NUM> is shown (although obscured) in the sectional view of <FIG>. The haptic fluid chamber <NUM> to the left in the figure is shown in fluid communication with optic fluid chamber <NUM> via two apertures <NUM>, which are formed in posterior element <NUM>. The haptic <NUM> to the right in <FIG> is in fluid communication with optic chamber <NUM> via two additional apertures also formed in posterior element (not shown) substantially <NUM> degrees from the apertures shown.

<FIG> is a top view of posterior element <NUM> (anterior element <NUM> and haptics <NUM> not shown). Posterior element <NUM> includes buttress portions <NUM> in which channels <NUM> are formed. Channels <NUM> provide fluid communication between optic portion <NUM> and haptics <NUM>. Apertures <NUM> are disposed at one end of channels <NUM>. The optic fluid chamber <NUM> is therefore in fluid communication with a single haptic via two fluid channels. Buttress portions <NUM> are configured and sized to be disposed within an opening formed in haptics <NUM> that defines one end of the haptic fluid chamber, as described below. Each of buttress portions <NUM> includes two channels formed therein. A first channel in a first buttress is in alignment with a first channel in the second buttress. The second channel in the first buttress is in alignment with the second channel in the second buttress.

There are exemplary advantages to having two channels in each buttress as opposed to one channel. A design with two channels rather than one channel helps maintain dimensional stability during assembly, which can be important when assembling flexible and thin components. Additionally, it was observed through experimentation that some one-channel designs may not provide adequate optical quality throughout the range of accommodation. In particular, lens astigmatism may occur in some one-channel designs, particularly as the intraocular lens accommodated. It was discovered that the two-channel buttress designs described herein can help reduced astigmatism or the likelihood of astigmatism, particularly as the lens accommodated. Astigmatism is reduced in these embodiments because the stiffness of the buttress is increased by the rib portion between the two channels. The additional stiffness results in less deflection due to pressure changes in the channels. Less deflection due to the pressure changes in the channels results in less astigmatism. In some embodiments the channels are between about <NUM> and about <NUM> in diameter. In some embodiments the channels are about <NUM> in diameter. In some embodiments the distance between the apertures is about <NUM> to about <NUM>.

<FIG> is a side assembly view through section A-A of optic portion <NUM>, which includes anterior element <NUM> and posterior element <NUM> (haptics not shown for clarity). By including fluid channels <NUM> in posterior element <NUM>, posterior element <NUM> needs to have enough structure through which the channels <NUM> can be formed. Buttress portions <NUM> provide that structures in which channels <NUM> can be formed. At its peripheral-most portion posterior element <NUM> is taller than anterior element <NUM> in the anterior-to-posterior direction. In alternative embodiments, the channels can be formed in anterior element <NUM> rather than posterior element <NUM>. The anterior element would include buttress portions <NUM> or other similar structure to provide structure in which the channels can be formed. In these alternative embodiments the posterior element could be formed similarly to anterior element <NUM>.

As shown in <FIG>, posterior element <NUM> is secured to anterior element <NUM> at peripheral surface <NUM>, which extends around the periphery of posterior element <NUM> and is a flat surface. Elements <NUM> and <NUM> can be secured together using known biocompatible adhesives. Anterior element <NUM> and posterior element <NUM> can also be formed from one material to eliminate the need to secure two elements together. In some embodiments the diameter of the region at which anterior element <NUM> and posterior element <NUM> are secured to one another is about <NUM> to about <NUM> in diameter.

In some embodiments the thickness of anterior element <NUM> (measured in the anterior-to-posterior direction) is greater along the optical axis ("OA" in <FIG>) than at the periphery. In some embodiments the thickness increases continuously from the periphery towards the thickest portion along the optical axis.

In some embodiments the thickness of posterior element <NUM> decreases from the location along the optical axis towards the edge of central region "CR" identified in <FIG>. The thickness increases again radially outward of central region CR towards the periphery, as can be seen in <FIG>. In some particular embodiments central region CR is about <NUM> in diameter. The apertures are formed in beveled surface <NUM>.

In some embodiments the thickness of posterior element <NUM> along the optical axis is between about <NUM> and about <NUM> and the thickness at the periphery of posterior element <NUM> is between about <NUM> and about <NUM>.

In some embodiments the thickness of posterior element <NUM> along the optical axis is about <NUM> and the thickness at the periphery of posterior element <NUM> is about <NUM>.

In some embodiments the thickness of anterior element <NUM> along the optical axis is between about <NUM> to about. <NUM>, and in some embodiments is between about <NUM> to about <NUM>. In some embodiments the thickness at the periphery of anterior element <NUM> is between about <NUM> and about <NUM>, and in some embodiments is between about <NUM> and about <NUM>.

In one particular embodiment the thickness of anterior element <NUM> along the optical axis is about <NUM> and the thickness of the periphery of anterior element <NUM> is about <NUM>, and the thickness of posterior element <NUM> along the optical axis is about <NUM> and the thickness at the periphery of posterior element <NUM> is about <NUM>.

The optic portion is adapted to maintain optical quality throughout accommodation. This ensures that as the accommodating intraocular lens transitions between the dis-accommodated and accommodated configurations, the optic portion maintains optical quality. A number of factors contribute to this beneficial feature of the accommodating intraocular lenses herein. These factors include the peripheral region at which anterior element <NUM> is secured to posterior element <NUM>, the shape profile of the anterior element <NUM> and posterior element <NUM> inside central region CR of the optic portion (see <FIG>), and the thickness profiles of anterior element <NUM> and posterior element <NUM>. These contributing factors ensure that both the anterior and posterior elements flex in such a way as to maintain the shape necessary to maintain optical quality across a range of optical powers.

<FIG> illustrates one haptic <NUM> from intraocular lens <NUM> (optic portion <NUM> and the second haptic not shown for clarity). Haptic <NUM> includes radially outer portion <NUM> adapted to face the direction of the zonules, and radially inner portion <NUM>, which faces the periphery of the optic (not shown). Haptic <NUM> includes a first end region <NUM> which is secured to optic portion <NUM>, and second end region <NUM> that is closed. Haptic <NUM> also includes opening <NUM> in first end region <NUM> that provides the fluid communication with the haptic. In this embodiment opening <NUM> is sized and configured to receive buttress portion <NUM> of optic portion <NUM> therein.

<FIG> is a close up view of opening <NUM> in haptic <NUM>, which is adapted to receive buttress portion <NUM> therein. The opening <NUM> has curved surfaces <NUM> and <NUM> that are shaped to mate with curved surfaces on the optic buttress <NUM>. Surface <NUM> surrounds opening <NUM> and provides a surface to which a corresponding surface of the optic can be secured.

<FIG> is a top close up view of buttress portion <NUM> (in phantom) from posterior element <NUM> disposed within opening <NUM> in haptic <NUM> (anterior element of the optic not shown for clarity). Channels <NUM> are shown in phantom. Haptic <NUM> includes fluid chamber <NUM> defined by inner surface <NUM>. Fluid moves between the optic fluid chamber and haptic fluid chamber <NUM> through channels <NUM> upon the deformation of haptic <NUM>.

<FIG> is a top view showing one haptic <NUM> shown in <FIG>. The optic portion and the second haptic are not shown. Four sections A-D are identified through the haptic. <FIG> illustrates a side view of haptic <NUM>, showing opening <NUM> and closed end <NUM>. <FIG> is a side view of haptic <NUM> showing radially outer portion <NUM> and closed end <NUM>.

<FIG> is the cross sectional view through section A-A shown in <FIG>. Of the four sections shown in <FIG>, section A-A is the section closest to closed end <NUM>. Radially inner portion <NUM> and radially outer portion <NUM> are identified. Fluid channel <NUM> defined by surface <NUM> is also shown. In this section the radially inner portion <NUM> is radially thicker (in the direction "T") than radially outer portion <NUM>. Inner portion <NUM> provides the haptic's stiffness in the anterior-to-posterior direction that more predictably reshapes the capsule in the anterior-to-posterior direction. Radially inner portion <NUM> has a greatest thickness dimension <NUM>, which is along an axis of symmetry in this cross section. The outer surface of haptic <NUM> has a generally elliptical configuration in which the greatest height dimension, in the anterior-to-posterior direction ("A-P"), is greater than the greatest thickness dimension (measured in the "T" dimension). The fluid chamber <NUM> has a general D- shaped configuration, in which the radially inner wall <NUM> is less curved (but not perfectly linear) than radial outer wall <NUM>. Radially outer portion <NUM> engages the capsular bag where the zonules attach thereto, whereas the thicker radially portion <NUM> is disposed adjacent the optic.

<FIG> illustrates section B-B shown in <FIG>. Section B-B is substantially the same as section A-A, and <FIG> provides exemplary dimensions for both sections. Radially inner portion <NUM> has a greatest thickness along the midline of about. <NUM> (in the radial direction "T"). Radially outer portion <NUM> has a thickness along the midline of about. Fluid chamber <NUM> has a thickness of about. Haptic <NUM> has a thickness along the midline of about <NUM>. The height of the haptic in the anterior to posterior dimension is about <NUM>. The height of the fluid chamber is about <NUM>. In this embodiment the thickness of the radially inner portion <NUM> is about <NUM> times the thickness of the radially outer portion <NUM>. In some embodiments the thickness of the radially inner portion <NUM> is about <NUM> times the thickness of the radially outer portion <NUM>. In some embodiments the thickness of the radially inner portion <NUM> is about <NUM> to about <NUM> times the thickness of the radially outer portion <NUM>. In some embodiments the thickness of the radially inner portion <NUM> is about <NUM> to about <NUM> times the thickness of the radially outer portion <NUM>.

Fluid chamber <NUM> is disposed in the radially outer portion of haptic <NUM>. Substantially the entire radially inner region of haptic <NUM> in this section is bulk material. Since the fluid chamber <NUM> is defined by surfaces <NUM> and <NUM> (see <FIG>), the positioning and size of fluid chamber <NUM> depends on the thickness of the radially inner portion <NUM> and the radially outer portion <NUM>.

<FIG> illustrates Section C-C shown in <FIG>. In Section C-C radially inner portion <NUM> is not as thick as radially inner portion <NUM> in sections A-A and B-B, although in Section C-C radially inner portion <NUM> is slightly thicker than radially outer portion <NUM>. In this particular embodiment radially inner portion <NUM> is about. <NUM> in Section C-C. Radially outer portion <NUM> has a thickness about the same as the radially outer thickness in Sections A-A and B-B, about. The outer surface of haptic <NUM> does not have the same configuration as the outer surface in Sections A-A and Section B-B. In Section C-C the radially inner outer surface of haptic <NUM> is more linear than in Sections A-A and Section B-B, giving the outer surface of haptic in Section C-C a general D-shape. In Section C-C fluid chamber <NUM> has a general D-shape, as in Sections A-A and Section B-B. The haptic, in Section C-C has a fluid chamber configuration that is substantially the same as the fluid chamber configurations in Sections A-A and B-B, but has an outer surface with a configuration different than the configuration of the outer surface of haptic <NUM> in Sections A-A and B-B.

The thinner radially inner portion <NUM> in Section C-C also creates access pathways <NUM> that are shown in <FIG>. This space between optic portion <NUM> and haptics <NUM> allows a physician to insert one or more irrigation and/or aspiration devices into space <NUM> during the procedure and apply suction to remove viscoelastic fluid that may be used in the delivery of the intraocular lens into the eye. The pathways <NUM> could also be anywhere along the length of the haptic, and there could be more than one pathway <NUM>.

<FIG> shows a view through Section D-D from <FIG>. Haptic <NUM> includes opening <NUM> therein, which is adapted to receive the buttress from the optic portion as described herein. The height of opening <NUM> in this embodiment is about. The width, or thickness, of the opening is about <NUM>.

<FIG> illustrates relative diameters of optic portion <NUM> (not shown) and of the peripheral portion, which includes two haptics <NUM> (only one haptic is shown). In this embodiment the optic has a diameter of about <NUM>, while the entire accommodating intraocular lens, including the peripheral portion, has a diameter of about <NUM>. The dimensions provided are not intended to be strictly limiting.

<FIG> is a top view of haptic <NUM>, showing that haptic <NUM> subtends an angle of about <NUM> degrees around optic (i.e., substantially <NUM> degrees). The optic portion is not shown for clarity. The two haptics therefore each subtend an angle of about <NUM> degrees around the optic. A first region <NUM> of haptic <NUM> is shown to subtend exemplary angle of about <NUM> degrees. This is the radially outermost portion of haptic <NUM>, is adapted to engage the capsular bag, and is adapted to be most responsive to capsular shape changes. Region <NUM> can be thought of as the most responsive part of haptic <NUM>.

The angle between Sections A-A and B-B, which are considered the boundaries of the stiffer radially inner portion of the haptic, is about <NUM> degrees. The stiff radially inner portion of haptic <NUM> is positioned directly adjacent the periphery of the optic. The dimensions and angles provided are not intended to be strictly limiting.

<FIG> illustrate a portion of accommodating intraocular lens <NUM> positioned in a capsular bag ("CB") after a native lens has been removed from the CB. The anterior direction is on top and the posterior direction is on bottom in each figure. <FIG> shows the accommodating intraocular lens in a lower power, or dis-accommodated, configuration relative to the high power, or accommodated, configuration shown in <FIG>.

The elastic capsular bag "CB" is connected to zonules "Z," which are connected to ciliary muscles "CM. " When the ciliary muscles relax, as shown in <FIG>, the zonules are stretched. This stretching pulls the capsular bag in the generally radially outward direction due to radially outward forces "R" due to the general equatorial connection location between the capsular bag and the zonules. The zonular stretching causes a general elongation and thinning of the capsular bag. When the native lens is still present in the capsular bag, the native lens becomes flatter (in the anterior-to-posterior direction) and taller in the radial direction, which gives the lens less power. Relaxation of the ciliary muscle, as shown in <FIG>, provides for distance vision. When the ciliary muscles contract, however, as occurs when the eye is attempting to focus on near objects, the radially inner portion of the muscles move radially inward, causing the zonules to slacken. This is illustrated in <FIG>. The slack in the zonules allows the capsular bag to move towards a generally more curved configuration in which the anterior surface has greater curvature than in the disaccommodated configuration, providing higher power and allowing the eye to focus on near objects. This is generally referred to as "accommodation," and the lens is said to be in an "accommodated" configuration.

In section A-A (which is the same as section B-B ) of haptic <NUM>, illustrated in <FIG>, radially inner portion <NUM> includes thicker bulk material that provides haptic <NUM> with stiffness in the anterior-to-posterior direction. When capsular bag forces are applied to the haptic in the anterior-to-posterior direction, the inner portion <NUM>, due to its stiffness, deforms in a more repeatable and predictable manner making the base state of the lens more predictable. Additionally, the haptic, due to its stiffer inner portion, deforms the capsule in a repeatable way in the anterior-to-posterior direction. Additionally, because the haptic is less flexible along the length of the haptic, the accommodating intraocular lens's base state is more predictable because bending along the length of the haptic is one way in which fluid can be moved into the optic (and thereby changing the power of the lens). Additional advantages realized with the stiffer inner portion are that the haptics are stiffer to other forces such as torqueing and splaying because of the extra bulk in the inner portion.

The radially outer portion <NUM> is the portion of the haptic that directly engages the portion of the capsular bag that is connected to the zonules. Outer portion <NUM> of the haptics is adapted to respond to capsular reshaping forces "R" that are applied generally radially when the zonules relax and stretch. This allows the haptic to deform in response to ciliary muscle related forces (i.e., capsular contraction and relaxation) so that fluid will flow between the haptic and the optic in response to ciliary muscle relaxation and contraction. This is illustrated in <FIG>. When the ciliary muscles contract (<FIG>), the peripheral region of the elastic capsular bag reshapes and applies radially inward forces "R" on radially outer portion <NUM> of haptic <NUM>. The radially outer portion <NUM> is adapted to deform in response to this capsular reshaping. The deformation decreases the volume of fluid channel <NUM>, which forces fluid from haptic chamber <NUM> into optic chamber <NUM>. This increases the fluid pressure in optic chamber <NUM>. The increase in fluid pressure causes flexible anterior element <NUM> and flexible posterior element <NUM> to deform, increasing in curvature, and thus increasing the power of the intraocular lens.

The haptic is adapted to be stiffer in the anterior-to-posterior direction than in the radial direction. In this embodiment the radially outer portion <NUM> of haptic <NUM> is more flexible (i.e., less stiff) in the radial direction than the stiffer inner portion <NUM> is in the anterior-to-posterior direction. This is due to the relative thicknesses of outer portion <NUM> and inner portion <NUM>. The haptic is thus adapted to deform less in response to forces in the anterior-to-posterior direction than to forces in the radial direction. This also causes less fluid to be moved from the haptic into the optic in response to forces in the anterior-to-posterior direction than is moved into the optic in response to forces in the radial direction. The haptic will also deform in a more predictable and repeatable manner due to its stiffer radially inner portion.

The peripheral portion is thus more sensitive to capsular bag reshaping in the radial direction than to capsular bag reshaping in the anterior-to-posterior direction. The haptics are adapted to deform to a greater extent radially than they are in the anterior-to-posterior direction. The disclosure herein therefore includes a peripheral portion that is less sensitive to capsular forces along a first axis, but is more sensitive to forces along a second axis. In the example above, the peripheral portion is less sensitive along the posterior-to-anterior axis, and is more sensitive in the radial axis.

An exemplary benefit of the peripheral portions described above is that they deform the capsular bag in a repeatable way and yet maintain a high degree of sensitivity to radial forces during accommodation. The peripheral portions described above are stiffer in the anterior-to-posterior direction than in the radial direction.

An additional example of capsular forces in the anterior-to-posterior direction is capsular forces on the peripheral portion after the accommodating intraocular lens is positioned in the capsular bag, and after the capsular bag generally undergoes a healing response. The healing response generally causes contraction forces on the haptic in the anterior-to-posterior direction, identified in <FIG> by forces "A. " These and other post-implant, such as non-accommodating-related, capsular bag reshaping forces are described in<CIT>. For example, there is some patient to patient variation in capsular bag size, as is also described in detail in <CIT>. When an intraocular lens is positioned within a capsular bag, size differences between the capsule and intraocular lens may cause forces to be exerted on one or more portions of the intraocular lens in the anterior-to-posterior direction.

In the example of capsular healing forces in the anterior-to-posterior direction, the forces may be able to deform a deformable haptic before any accommodation occurs. This deformation changes the volume of the haptic fluid chamber, causing fluid to flow between the optic fluid chamber and the haptic fluid chambers. This can, in some instances undesirably, shift the base power of the lens. For example, fluid can be forced into the optic upon capsular healing, increasing the power of the accommodating intraocular lens, and creating a permanent myopic shift for the accommodating intraocular lens. Fluid could also be forced out of the optic and into the haptics, decreasing the power of the accommodating intraocular lens.

As used herein, "radial" need not be limited to exactly orthogonal to the anterior-to-posterior plane, but includes planes that are <NUM> degrees from the anterior-to-posterior plane.

Exemplary fluids are described in <CIT>, and in <CIT>. For example, the fluid can be a silicone oil that is or is not index-matched with the polymeric materials of the anterior and posterior elements. When using a fluid that is index matched with the bulk material of the optic portion, the entire optic portion acts a single lens whose outer curvature changes with increases and decreases in fluid pressure in the optic portion.

In the embodiment in <FIG> above the haptic is a deformable polymeric material that has a substantially uniform composition in Sections A-A, B-B, and C-C. The stiffer radially inner body portion <NUM> is attributed to its thickness. In alternative embodiments the radially inner body portion has a different composition that the outer body portion, wherein the radially inner body portion material is stiffer than the material of the radially outer body portion. In these alternative embodiments the thicknesses of the radially inner and outer portions can be the same.

<FIG> illustrates haptic <NUM>, which is the same haptic configuration as in shown in <FIG>. The radially outer portion <NUM> is identified. The haptic has axis "A" halfway through the height of the haptic, or alternatively stated, axis A passes through the midpoint of the height of the haptic in the anterior-to-posterior direction. Opening <NUM>, in which the optic buttress is disposed, is on the posterior side of axis A. In this embodiment the optic sits slightly closer to the posterior-most portion of the haptics than the anterior-most portion of the haptics. That is, in this embodiment the optic is not centered with the haptics in the anterior-to-posterior direction.

<FIG> illustrates an alternative haptic <NUM> (optic not shown), wherein the radially outer portion <NUM> is identified. Haptic <NUM> includes axis "A" halfway through the thickness of the haptic, or alternatively stated, axis A passes through the midpoint of the height of the haptic in the anterior-to-posterior direction. Opening <NUM> is symmetrical about the axis A, and an axis passing through the midpoint of opening <NUM> is aligned with axis A. Additionally, axis A is an axis of symmetry for haptic <NUM>. The symmetry of the haptic along axis A can improve the ability to mold low relatively low stress components. <FIG> shows an embodiment of intraocular lens <NUM> in which the optic <NUM> is coupled to two haptics <NUM>, which are the haptics shown in <FIG>. The optic sits further in the anterior direction that in the embodiment in which the opening is not along the midline of the haptic. In this embodiment, optic <NUM> is centered, in the anterior-to-posterior direction, with the haptics. The cross sections A-A, B-B, and C-C of haptic <NUM> are the same as those shown in other embodiments shown above, but the haptics can have any alternative configuration as well.

<FIG> illustrates intraocular lens <NUM> including optic <NUM> and two haptics <NUM>. The optic is the same as the optic portions described herein. Haptics <NUM> are not as tall, measured in the anterior-to-posterior direction, as haptic <NUM>, haptic <NUM>, or haptic <NUM>. In exemplary embodiments haptics <NUM> are between about <NUM> and about <NUM> tall, and in some embodiments they are about <NUM> tall. Intraocular lens <NUM> can be considered a size "small" accommodating intraocular lens for patients with a capsular bag that is below a certain threshold size. The posterior surface of posterior element <NUM> is disposed slightly further in the posterior direction than the posterior-most portions <NUM> of haptics <NUM>.

<FIG> illustrates an accommodating intraocular lens <NUM> that includes an optic body <NUM> and a peripheral non-optic body, which in this embodiment includes haptics <NUM> and <NUM>. Optic body <NUM> can be in fluid communication with one or both haptics <NUM> and <NUM>, and fluid movement between the optic and haptics in response to ciliary muscle movement can change the power of the intraocular lens. This general process of fluid-driven accommodation in response to deformation of the haptics can be found herein. Optic <NUM> includes anterior element <NUM> secured to posterior element <NUM>, together defining an optic fluid chamber in communication with haptic fluid chambers <NUM> and <NUM> in the haptics. The "height" of the components in this disclosure is measured in the anterior-to-posterior direction. Optic <NUM> has a greatest height "H1" dimension measured in the anterior to posterior direction along the optic axis. Haptics <NUM> and <NUM> have greatest height "H2" dimensions measured in the anterior to posterior direction parallel to the optical axis. The optic body has a centerline B, measured perpendicular to the optical axis and passing through the midpoint of H1. The haptics also have centerlines, B, measured perpendicular to the optical axis and passing through the midpoint of H2. In this embodiment the centerlines coincide and are the same centerline B. Stated alternatively, the anterior-most surface or point of anterior element <NUM> is spaced from the anterior-most point or surface of the haptics the same distance as is the posterior-most surface or point of posterior element <NUM> from the posterior-most point or surface of the haptics. They can be considered substantially the same lines in some embodiments even if they do not coincide, but are near in space to one another (e.g., a few millimeters away). An optic centered with the haptics is also shown in <FIG>.

In this embodiment the position of the optic <NUM> relative to the haptics can provide some benefits. For example, during folding and/or insertion, the centered (or substantially centered) optic, measured in the anterior-to-posterior direction, can prevent or reduce the likelihood of one or more haptics from folding over the anterior element <NUM> or posterior element <NUM>, which may happen when the optic body is not substantially centered relative to the haptics. For example, an optic that is much closer to the posterior side of the lens may increase the likelihood that a haptic (e.g., a haptic free end) can fold over the anterior surface of the optic during deformation, loading, or implantation.

An additional benefit to having the optic body <NUM> centered or substantially centered relative to the peripheral body is that is it easier for the optic to pass through the capsulorhexis when placed in the eye. When the optic is closer to the posterior side of the lens, it may be more difficult for it to rotate into the capsular bag.

An additional benefit is that, compared to optics that are further in the posterior direction, glare from the intraocular lens is reduced. By moving the optic in the anterior direction (it will be closer to the iris once implanted), less light can reflect off of the radially outer peripheral edge of the optic (i.e., the edge surface adjacent the haptics), thus reducing glare from edge effect.

In some embodiments of the intraocular lens in <FIG>, anterior element <NUM> can have a height between <NUM> and <NUM>, such as between. <NUM>, such as about <NUM>, and the posterior element <NUM> can have a height between <NUM> and <NUM>, such as between. <NUM>, such as about <NUM>.

Prior to insertion, such as during manufacturing, the intraocular lens shown in <FIG> can be filled with fluid. In some embodiments the intraocular lens has a base state (at zero fluid pressure in the optic; or no fluid inside it) less than 15D, such as about 13D. About 13D, as used herein, refers to base states about 10D to about 15D. By having a base state of about 13D, it may be possible to generally only have to change the fluid pressure in one direction - higher. When the base state of an intraocular lens is higher, such as about 20D, it may be necessary to change the fluid pressure either higher or lower, depending on the desired vision correction and the intended use of the intraocular lens. By having a lower base state, the changes to the state of the lens become more predictable by only having to change the base state in one direction.

One aspect of this disclosure is an accommodating intraocular lens, optionally fluid-filled and fluid-driven, that has an aspheric optical surface after manufacture and prior to implantation. That is, the intraocular lens is manufactured with an aspheric optical surface. An aspheric optical surface can avoid spherical aberration when the pupil is fully dilated. There can be challenges in manufacturing an intraocular lens, particularly an accommodating, fluid-driven intraocular lens, with aspheric optical surfaces.

In some embodiments the accommodating intraocular lens is manufactured with an aspheric anterior surface and/or an aspheric posterior surface. One exemplary manner in which a fluid-filled accommodating intraocular lens can have an anterior or posterior optical surface with built-in asphericity is to, during manufacturing, create the optical surface with a spherical configuration prior to fluid filling, then create the asphericity in the optical surface during the fill process. For example, during manufacture, one or both of the anterior surface and the posterior surface can be manufactured to have spherical outer optical surfaces. The anterior surface can then be secured to the posterior surface. One or more haptics can then be secured to the optic. In some embodiments the optic is manufactured, but prior to filling, to have a base state (at zero fluid pressure in the optic; or no fluid inside it) less than 15D, such as about 13D. About 13D, as used herein, refers to base states about 10D to about 15D. When a fluid is injected into the accommodating intraocular lens (e.g., via a septum), the fluid filling step can increase the fluid pressure in the optic and cause the anterior surface and/or the posterior surface of the optic to have an aspherical configuration. One aspect of this disclosure is thus a method of manufacturing an accommodating intraocular lens that includes creating an optic with a fluid-filled state prior to insertion, which has asphericity built into one or more optical surfaces, such as an anterior optic surface. The method of manufacturing can include manufacturing the optic wherein the optical surface is spherical prior to fluid filling.

It may be desirable to maintain good optical quality in at least one surface of the central portion of the optic as it is deformed, either throughout disaccommodation or throughout accommodation. One of the aspects of the disclosure is an optic that has a very controlled and somewhat stable amount of asphericity in a central region of the optic, across the whole range of powers. This may be referred to herein as "beneficial asphericity" in a central region of the optic. The beneficial asphericity includes lens surfaces with surface aberrations that are configured to compensate for the spherical aberrations in the optical system of the eye, and contribute to maintaining optical quality. The beneficial asphericity is maintained across all or substantially all of the range of powers during accommodation and disaccommodation. In some instances the asphericity can be controlled such that the spherical aberration of the whole lens systems can remain low (or zero) across all range of power. The optic region outside of the central region may have larger, more uncontrolled amount of asphericity.

In some embodiments the central region of the optic, or the region of beneficial asphericity, has a diameter of less than <NUM>, less than <NUM>, less than <NUM>, less than <NUM>, less than <NUM>, less than <NUM>, less than <NUM>, or even less than <NUM>. In some embodiments the central region has a diameter between <NUM> and <NUM>. In some embodiments the central region of the optic with beneficial asphericity has a diameter less than <NUM>% of the diameter of the optic body, less than <NUM>%, less than <NUM>%, or less than <NUM>%. The diameter of the optic can be between <NUM> and <NUM>, such as between <NUM> and <NUM>. In some embodiments the central region is between <NUM> and <NUM>, and the optic diameter is between <NUM> and <NUM>. In some embodiments the central region is between <NUM> and <NUM>, and the optic diameter is between <NUM> and <NUM>.

The configuration of the anterior element and the posterior element can influence the configurations that they assume throughout deformation, either throughout accommodation or disaccommodation. In some embodiments, one or both of the anterior element and the posterior element is contoured, or configured, such that the central region of the optic has the beneficial asphericity that is controlled and beneficial to the overall system of the eye. In this embodiment anterior element <NUM>, and to a lesser extent posterior element <NUM>, are configured so that an anterior surface of anterior element <NUM> and a posterior surface of posterior element <NUM> maintain the controlled, beneficial asphericity in a central region of the optic during accommodation. In this embodiment one aspect of the configuration that contributes to the central portion maintaining beneficial asphericity is that anterior element <NUM>, and optionally the posterior element <NUM>, has a thickness (also referred to as "height" herein) that is greater in the center (such as at the apex of the anterior element <NUM>) than at the periphery of the anterior element <NUM>. An additional aspect of the configuration that contributes to beneficial asphericity is that the anterior element is flatter on the inner surface (posterior surface) than on the outer surface (anterior surface). During accommodation, the central region of the anterior element <NUM> steepens in the center (which increases power of the AIOL), but the optic body maintains its beneficial asphericity, due at least in part to the relatively larger thickness of the anterior element central region. It may also be aspherical prior to accommodating in the exemplary embodiments in which asphericity is built into the anterior element, described below.

The thickness contours of the anterior and posterior elements can contribute to the optic maintaining the beneficial asphericity across all powers, an example of which is the thickness of the anterior and posterior elements.

<FIG> illustrates an exemplary haptic that can be part of any of the accommodating intraocular lenses herein or other suitable IOLs not described herein. One or both haptics can be configured as shown in <FIG>. The haptic in <FIG> is labeled as "<NUM>," but it is understood that the haptic in <FIG> can be a part of intraocular lenses other than that shown in <FIG>. The haptic includes a surface <NUM> that is secured to an outer edge of the optic body. Surface <NUM> is a radially inner surface of the haptic, and is configured with a slight curve to it (along the length of the haptic) that is substantially the same curve as the outer edge of the optic so that the entire surface <NUM> interfaces the optic body outer edge surface(s). Surface <NUM> has a configuration relative to the optic such that an extension of the surface does not pass through an optic axis of the optic. An adhesive can be used to secure surface <NUM> to the optic outer edge surface(s). In this embodiment the coupling between the haptic and the optic body does not include one of the haptic and optic being disposed within a channel, bore, or aperture in the other, as can be used for some haptic/optic coupling designs, such as in the embodiment shown in <FIG>. Some exemplary advantages of this type of design are described below.

<FIG> shows a perspective view of optic <NUM>, with the haptics excluded for clarity. Surface <NUM> of the haptic (not shown) is secured to both anterior element <NUM> and posterior element <NUM> of the optic body <NUM>. Most of surface <NUM> interfaces posterior portion <NUM>, but a portion of surface <NUM> interfaces anterior element <NUM>. This is because the outer edge of the optic body is largely comprised of the posterior element <NUM>. With different optic configurations, surface <NUM> could be secured to more of the anterior element than the posterior element. It is also noted that the height H3 of surface <NUM> (see <FIG>) is substantially the same as the height of the outer edge of the optic body.

Haptic <NUM> surface <NUM> has a first end region <NUM> (see <FIG>) that has a configuration with a larger surface than second end region <NUM>. End region <NUM> of surface <NUM> has a larger surface area than end region <NUM> of surface <NUM>, and includes at least partially beveled surfaces B, as shown in <FIG>. The width W1 of end region <NUM> is greater than width W2 of end region <NUM>. The configuration of end region <NUM> can provide exemplary benefits. For example, as part of a process of loading the intraocular lens into a delivery device and/or into an eye of a patient, one or both of haptics <NUM> and <NUM> may be "splayed" relative to optic. That is, one or both haptics can be reconfigured from the natural at rest configuration shown in <FIG> by moving free end <NUM> of haptic away from the optic body. The extent to which the free end (and a large portion of the haptic) is moved away from the optic during splaying can vary. In some methods of loading, one of both haptics can be splayed substantially, such that the haptic is oriented behind or in front of the optic. In some instances the haptic free end (i.e., the end of the haptic not coupled directly to the optic) is "pointing" substantially <NUM> degrees from where it is pointing in the at-rest configuration. In general, splaying the haptic(s) causes stresses at the coupling interface between the haptic and optic. The coupling interface between the optic and haptic must be able to withstand these forces so that the haptic does not disengage from the optic. When splaying haptics, there can be a high stress location at the optic/haptic coupling at the end of the interface <NUM>, which is closer to the free end. End region <NUM> is thus the location where the haptic / optic interface is most likely to fail. End region <NUM>, with its larger surface area and tapering and beveled configuration, acts to distribute the applying stresses (or stresses anytime haptic is reoriented relative to the optic) and prevent the haptic from disengaging from the optic.

The configuration of surface <NUM> can be modified in many ways to provide the desired joinery between the haptic and the optic. Joining the haptic and the optic in this manner (as opposed to having one component fit within the other) thus allows for many more interface configurations, which provides more flexibility in design.

In the embodiment of the haptic in <FIG>, fluid aperture <NUM> is centered along the midline of the haptic. The centerline is defined in the same manner as described in <FIG>. The centerline passes through the midpoint of the haptic height (measured in an anterior-to-posterior direction) in a side view of the haptic.

Other aspects of the haptic can be the same as described herein, such as a thicker radially inner wall thickness along a portion of the haptic, and one or both haptics that follows the curvature of the periphery of the optic from the coupled end to the free end, and the anterior most aspect of the haptic extending further anteriorly than the anterior-most aspect of the optic.

The posterior element <NUM> has two fluid channels <NUM> therein that are in fluid communication with the haptic fluid chambers <NUM> and <NUM>. The outer edge of the posterior element <NUM> includes two apertures therein that define ends of the fluid channels <NUM>. The haptic/optic interface (which can be a glue joint) surrounds the two fluid apertures in the posterior element <NUM>. In some alternatives the optic only has one fluid channel instead of two.

<FIG> is another view of haptic <NUM>, showing the slight curvature of optic interface surface <NUM> and fluid aperture <NUM> therein.

<FIG> is a perspective view of the intraocular lens from <FIG>, viewed from the posterior side. Fluid channels <NUM> can be seen in the posterior element <NUM>, two of which are associated with each haptic. The interface between the haptics and optic can also be seen. <FIG> shows section A-A that is shown in <FIG>.

<FIG> shows an additional view of the intraocular lens from <FIG>, in which spacings <NUM> between the outer edge of optic and haptics can be seen, as well as the coupling between the optic and haptics.

In some embodiments in which one or more haptics are adhered to the optic body at discrete locations, rather than <NUM> degrees around the optic, a curing step that cures an adhesive that secures the haptic to the optic body may cause shrinkage of the material at the location where the two components are adhered. This shrinkage at the discrete locations can cause distortions in the lens, such as astigmatism. It can be beneficial, or necessary, to prevent or reduce the extent of the distortions. <FIG> illustrates an exploded perspective view of alternative accommodating intraocular lens <NUM>. <FIG> illustrates a top view of AIOL <NUM>. <FIG> illustrates a perspective view of option <NUM> of AIOL <NUM>. <FIG> is a view of section A-A shown in <FIG>.

<FIG> illustrate an exemplary interface between an exemplary optic body <NUM> (see <FIG>) and haptics <NUM> that may help alleviate distortions due to shrinkage at the location where the optic body and haptics are secured. The interface between the optic body <NUM> and the haptics <NUM> is relocated radially away from the optic body <NUM>, and specifically the optical surfaces, compared to other embodiments such as in <FIG>. By moving the interface, and thus the location of potential shrinkage, away from the optical surfaces, the amount of distortion caused to the optical surfaces by the curing step can be reduced. A coupling region <NUM> of haptics <NUM> each interface with an optic projection <NUM>, such that the interface between the haptics and the projection <NUM> is radially away from the optical surface of the optic. This type of interface can be used with non-accommodating or accommodating intraocular lenses, but in this embodiment the lens is an accommodating intraocular lens.

For example, the accommodating intraocular lens <NUM> can comprise the optic body <NUM> (see <FIG>), and haptics <NUM>. Is this embodiment, haptics <NUM> are manufactured separately from the optic <NUM>, and then secured to the optic <NUM>. The haptics <NUM> each include a radially inner flat surface <NUM> (only one labeled in <FIG>) that is secured to a radially peripheral surface <NUM> of the optic <NUM>. In this embodiment surface <NUM> is a radially inner surface of the coupling region <NUM> of haptic <NUM>. For example, an adhesive can be used to secure surface <NUM> to the radially peripheral surface <NUM> of the optic <NUM>. The process of securing the haptic to the optic may affect the optical performance of the optic <NUM>, as discussed above. For example, the curing process of the adhesive may cause shrinkage of the optic <NUM> at two discrete locations, thus possibly resulting in distortion and aberration such as astigmatism of the intraocular lens.

In this embodiment, the intraocular lens comprises two projections <NUM> extending radially outwards away from a peripheral surface <NUM> of the posterior element <NUM> of optic <NUM>. The projections <NUM> can be thought of as projections from the general curved periphery of the optic, as defined by outer edge surface <NUM>. The haptics <NUM> can each have a first portion <NUM> secured to the projection <NUM> and a free second portion <NUM> disposed away from the first portion <NUM>, wherein a radially inner surface of each of the haptics follows a radially outer peripheral surface of the optic. Projection <NUM> may also be referred to herein as a "landing" or "land" in this disclosure.

Projections <NUM> can be raised areas extending between10 microns and <NUM>, optionally between <NUM> microns and <NUM> microns, radially outward from the periphery surface <NUM> of the optic. The radially peripheral surface <NUM> of the projections <NUM> can be between <NUM> microns and <NUM>, optionally between <NUM> microns and <NUM> microns, farther away radially from a center of the optic than the peripheral surface <NUM> of the optic. For example, projections <NUM> can be a raised area extending between100 microns and <NUM> microns radially outward from the periphery surface <NUM> of the optic. The radially outer peripheral surface <NUM> of projection <NUM> may be between <NUM> microns and <NUM> microns farther away radially from a center of the optic than the peripheral surface <NUM> of the optic. Values outside the above range are also possible. Projections <NUM> can move the securing surfaces or coupling surfaces away from the optic to prevent optic disruption due to shrinkage when curing the adhesive between the optic and the haptic.

In some embodiments the optic has a circular shape, in a top view, and the radially outer peripheral edge <NUM> of the optic is generally circular. When the projections are described herein as extending radially away from the optic body, the projections may be extending away from the general curve of the radially outer peripheral edge of the optic.

In some embodiments, the optic and the projections <NUM> of the intraocular lens can be a single integral body. For example, projections <NUM> can be molded as part of the optic. In some other embodiments, projections <NUM> can be attached to the optic, such as by gluing.

In some embodiments the optic <NUM> comprises a posterior element and an anterior element, optionally defining a fluid chamber therebetween, such as in embodiments above. For example, projections <NUM> can be part of the posterior element because the posterior has a thicker periphery. The projections may also be part of the anterior element. For yet another example, the projections can be part of the posterior element and anterior element of the optic.

Outer surfaces <NUM> of projections <NUM> and inner surfaces <NUM> of haptics <NUM> can all be flat, such that they interface at a butt joint. For example, the radially outer peripheral surface <NUM> of projections <NUM> can comprise a flat surface, optionally entirely flat. The radially inner surface <NUM> of haptics <NUM> can comprise a flat surface as well, optionally entirely flat. For another example, the radially outer peripheral surface <NUM> of projections <NUM> can comprise a curved surface, optionally entirely curved. The radially inner surface <NUM> of haptics <NUM> can comprise a curved surface as well, optionally entirely curved. A curvature of radially outer peripheral surface <NUM> can be the same as the curvature of the periphery surface <NUM> of the optic body, and in some embodiments can be larger or smaller than the curvature of the periphery surface <NUM> of the optic body.

Haptics <NUM> can comprise a peripheral fluid chamber as described herein. The projections <NUM> can comprise at least one fluid channel <NUM>, and optionally at least two channels, in fluid communication with the peripheral fluid chamber in the haptics. The raised projections <NUM> may provide more stability to the fluid channel because there is more optic material at the locations of the projections.

In general, the projection can be disposed on a non-accommodating (fixed power) intraocular lens that is manufactured by coupling haptics and optic as well. For example, a fixed power intraocular lens, where the intraocular lens is a non-fluid filled optic body with a single power (e.g., PMMA material) and two haptics, can comprise a projection extending radially outwards from a peripheral surface of the optic body as well.

The embodiment in <FIG> also illustrate an alternative haptic cross sectional configuration (see <FIG> for the cross section) that can be incorporated into any of the suitable optics herein, such as optic <NUM> shown in <FIG>. The height H (measured in anterior to posterior direction) of haptics <NUM> can be from <NUM> - <NUM>, and may be <NUM> to <NUM>. This may be smaller than other haptic heights for other intraocular lenses, such as heights above <NUM>. It may be advantageous, but not necessarily necessary, to have heights between <NUM> and <NUM> for the haptics. There is some patient to patient variability in the size of the anatomy in the eye. There is variability in capsular size, for example, or distance between capsule and the posterior side of the iris. With some haptics, there may be some rubbing between the haptic and the posterior side of the iris. And even if there is, it may not raise any concerns. It may thus be advantageous, merely in an abundance of caution, to have haptics heights that minimize the chance of such rubbing.

Haptics <NUM> also include a radially inner wall portion <NUM> on the radially inner side of fluid chamber <NUM>, which has a thickness "ti" that is greater than a thickness "to" of the haptic wall on the radially outer side of chamber <NUM>. In some embodiments "ti" is between four and nine times greater than "to," Radially inner wall portion <NUM> may be referred to herein as a "spacer. " As shown in <FIG>, the spacer extends along almost the entire length of haptic, but does not exist where the spacing exists between the optic and haptic. The fluid chamber <NUM> radially inner wall is, as shown, flatter than fluid chamber <NUM> radially outer wall. Haptics <NUM> are examples of haptics that have a cross section, in a plane passing through an optical axis of the optic portion, in which the haptic fluid chamber is disposed in a radially outer portion of the haptic, and wherein a radially inner portion of the haptic is non-fluid. Haptics <NUM> are examples of haptics that, in a cross section of a plane passing through an optical axis of the optic portion, and in a direction orthogonal to an optical axis of the optic portion through a midpoint of the haptic, have a radially inner fluid chamber wall thickness that is between four and <NUM> times the thickness of a radially outer fluid chamber wall thickness. Haptics <NUM> are examples of haptics that, in a cross section of a plane passing through an optical axis of the optic portion, has an outer surface that is not symmetrical about any axis passing through the peripheral portion and parallel to an optical axis of the optic portion, and wherein the haptic has, in a direction orthogonal to an optical axis of the optic portion through a midpoint of the haptic has a radially inner fluid chamber wall thickness greater than a radially outer fluid chamber wall thickness. Haptics <NUM> are examples of haptics that, in a cross section of a plane passing through an optical axis of the optic portion, having a height dimension measured in an anterior to posterior direction, wherein the greatest height of the peripheral portion in a radially outer half of the peripheral portion is greater than the greatest height of the peripheral portion in a radially inner half of the peripheral portion.

In some embodiments one or more aspects of the optic body have a refractive index that is between about <NUM> and <NUM>, such as between <NUM> and <NUM>. In some embodiments the refractive index of one or components is about <NUM>, about <NUM>, about <NUM>, about <NUM>, about <NUM>, about <NUM>, about <NUM>, or about <NUM>. There may be a designed mismatch in refractive index between any of the anterior element, fluid, and posterior element, but in some embodiments there is a designed index matching between at least two of the components, and optionally all three. When all components of the optic are designed to have the same or substantially the same index of refraction, they are said to be index-matched. Any of the properties of the intraocular lenses (e.g., refractive index, fluid, monomer compositions) described in <CIT> can be implemented in any of the intraocular lens designs herein.

Exemplary materials that can be used to make any of the IOLs, including fluid, herein, can be found in <CIT>.

Peripheral portions with any configuration described herein can be coupled to the optic portion using any of the coupling concepts described herein. For example, peripheral portions with the configuration and cross sectional configurations shown in <FIG> and <FIG> can be coupled to the optic portion even if the optic portion does not include a projection such as optic projection <NUM> shown in <FIG>. For example, the haptics <NUM> shown in <FIG> and <FIG> can be coupled to the optic portion using the coupling concepts and geometries shown in <FIG>. In such a scenario, the end of haptic <NUM> that is to be coupled to the optic would generally have a curved inner surface such as is shown in <FIG>, such that a curved inner surface of the haptic would abut with the curved outer surface of the optic.

Intraocular lenses can be positioned into the eye (optionally into a capsular bag) using known techniques. During the surgical implantation procedure, at least a portion of the IOL may receive out of plane forces in the anterior-to-posterior direction. To help resist these forces and make it easier to achieve planar placement of the intraocular lens during at least a portion of the surgical procedure, the IOL can optionally include one or more additional features that help stabilize the peripheral portion relative to the optic portion in the anterior to posterior direction.

In some embodiments, at least a portion of the optic can have a configuration or shape that is complimentary to at least a portion of the peripheral portion. It can be an optic peripheral surface that is complimentary to at least a portion of an inner surface of the peripheral portion.

To optionally make it easier to achieve planar placement of the IOL during implantation (planar in this context referring to a plane orthogonal to an optical axis of the optic portion), the optic portion can optionally be adapted to increase the stability of the peripheral portion in the axial direction to try to prevent, minimize and/or reduce the axial movement of the peripheral portion relative to the optic portion.

<FIG> illustrates a sectional view of an optic portion of an exemplary intraocular lens <NUM> (optionally accommodating) that includes optic <NUM>. The peripheral portion is not shown for clarity. Optic <NUM> includes anterior element <NUM> and posterior element <NUM>, and unless indicated otherwise the intraocular lens can have (but not necessarily) features found in any of the embodiments in <FIG>. The sectional view shown in <FIG> is the same sectional view taken along section A-A shown in <FIG>. One difference between optic <NUM> and the optic in <FIG> is that optic <NUM> includes a peripheral surface <NUM> (in this embodiment a depression) along at least a portion of its periphery. A "depression" as used in this context generally refers to a surface of the periphery of the optic that extends further radially inward than another portion of the optic periphery. In this example, peripheral surface <NUM> includes region <NUM> that is disposed further radially inward than optic region <NUM> and optic region <NUM>. In this example, optic region <NUM> is anterior to depression region <NUM> and optic region <NUM> is posterior to depression region <NUM>. The stability may be enhanced by having raised regions on both sides of the depression, but it is conceivable that in some embodiments the optic does not include regions both anterior and posterior to the depression that extend further radially outward that the depression, some examples of which are described below. For example, it may be desired to prevent movement of the peripheral portion in only one direction (e.g., anterior but not posterior, or posterior but not anterior).

The optic peripheral surface can have a variety of configurations, as long as it provides axial stability for the peripheral portion in at least one direction. The configuration of the peripheral surface may also depend on the peripheral portion configuration. In some embodiments the peripheral surface can have a general U-shape or a general C-shape (such as shown in <FIG>), a scallop shape, etc. The peripheral surface configuration can include curved and/or flat surfaces. In some embodiments the optic peripheral surface includes one or two raised ridges that extend further radially outward than a region of the optic periphery disposed radially inward relative to the at least one raised ridge.

The peripheral surfaces as described herein can be thought of capturing at least a portion of the peripheral portion and reducing or minimizing movement of at least a portion of the peripheral portion in at least one of the anterior and posterior directions.

<FIG> illustrates the same section A-A from <FIG>, but includes peripheral portion <NUM>, which in this embodiment includes first and second haptics, just as in the embodiment in <FIG>. The haptics in <FIG> can be the same as in other regards, or similar to, the haptics in <FIG>. The haptics include a body <NUM> that includes a portion <NUM> that extends further radially inward than a portion of the optic. In this embodiment haptic portion <NUM> extends further radially inward than optic region <NUM> and optic region <NUM>, with region <NUM> being anterior to the haptic where the haptic extends further radially inward than region <NUM>, and with region <NUM> being posterior to the haptic where the haptic extends further radially inward than region <NUM>. In this embodiment the portion of the haptic that extends within the depression is a radially inner portion of the haptic.

<FIG> illustrates a close-up view of only a portion of the intraocular lens, illustrating with a hypothetical dotted line and hashed marks the radially inner section <NUM> of a haptic that extends further radially inward than section <NUM> and <NUM> of the optic. It is this part <NUM> of the haptic that is considered to be radially within the optic peripheral surface.

In the embodiment in <FIG>, only a portion of the haptic (measured along its height in the anterior-posterior direction), is disposed within the optic depression. In this embodiment a central region of the haptic is disposed adjacent to and within the depression, and regions of the haptic anterior and posterior to the central haptic region are not considered radially disposed within the depression. In the embodiments, <NUM>% or less (measured along its height) of the peripheral portion is within the depression. In some embodiments <NUM>% or less of the peripheral portion is within the depression, and in some embodiments, <NUM>% or less of the peripheral portion is within the depression.

In the embodiment in <FIG>, the portion of the peripheral portion that is within the optic depression does not extend directly from the optic. This means that this portion of the peripheral portion is not coupled to or integrally formed with the optic in this cross section. That is, the peripheral portion that is within the depression is spaced away from where the peripheral portion is extending from the optic (e.g., coupled to or integrally formed therewith). This helps clarify that the depression is, at least in this embodiment, not at the coupling location between the peripheral portion and the optic, but is disposed away from the coupling location. Section A-A from <FIG> (which is the same section as in <FIG>) is an example of a location that is spaced away from where the peripheral portions is extending directly from the optic.

In this embodiment, the portion of the haptic that is radially within the depression is directly adjacent to the optic (but not extending from the optic at that location), and in some instances can be engaging the optic or very nearly engaging the optic. In some embodiments the peripheral portion inner surface that is adjacent the optic is <NUM> microns or less away from the optic surface, and may be <NUM> microns or less away.

In an alternative to what is shown in <FIG>, the depression can be solely in the anterior element (if the anterior element were thicker), or it can be formed in both the anterior and posterior elements.

In any of the accommodating intraocular lenses herein, the optic may not include separate anterior elements, and thus a depression as herein is not limited to being part of an anterior element or a posterior element (or both), but rather is considered part of the optic portion in general, regardless of the optic portion construction.

As set forth above, a depression can have a variety of configurations, and need not be symmetrical about an axis orthogonal to the optical axis of the optic. A depression may serve its purpose as long as it provides some axial stability to at least a portion of the peripheral portion. The configuration of the peripheral portion can therefore also influence the configuration of the periphery of the optic.

<FIG> illustrate sectional views of alternative examples of optics with peripheral surfaces that include one or more depressions (they can be the same section A-A shown in <FIG>). The optics in <FIG> illustrate that optics other than those specifically described herein can include one or more depressions, and that the particular construction of the optic is not critical. The optics in <FIG> are illustrated as monolithic structures to illustrate a variety of optics can have the depressions described herein. Additionally, any of the optics herein (including those in <FIG>) can be used with any of the peripheral portions herein (including any haptics herein). <FIG> do not show the peripheral portion for clarity.

<FIG> illustrate optic portion <NUM> having first and second depressions <NUM> and <NUM>, respectively, formed in the peripheral surface(s). In this embodiment the depressions have at least one flat surface.

<FIG> illustrates optic <NUM> with peripheral surfaces that have depressions <NUM> and <NUM>. Depressions <NUM> and <NUM> have flat surfaces, and generally define a valley.

<FIG> illustrates optic <NUM>, which includes peripheral surfaces that include depressions <NUM> and <NUM>. In this embodiment, the depressions are not symmetrical about an axis orthogonal to the optical axis of the optic. In this embodiment, a portion <NUM> of the optic would be anterior to the haptic within the depression, but the optic does not have a portion posterior to the haptic within the depression. This might be used if only anterior movement of the peripheral portion were a concern. Similarly, the orientation of the optic could be flipped such that portion <NUM> is on the posterior side of the haptic within the depression.

<FIG> includes optic <NUM>, which includes peripheral surfaces that include depressions <NUM> and <NUM> that extend along all or substantially all of the periphery of the optic (in the anterior-posterior direction).

A peripheral surface (i.e., a depression) may extend around (in a top view such as in <FIG>) any portion of the periphery of the optic or the entire periphery of the optic. A peripheral surface may in fact also extend around the region where the peripheral portion couples to the optic, but in general they do not.

In some embodiments, and in reference to <FIG>, the optic comprises a peripheral surface (i.e., a depression) at least where a portion of the peripheral portion inner surface is directly adjacent to the optic. For example, in reference to <FIG>, the depression could be present in the optic everywhere around the peripheral except at the coupling location and in the regions of spacings <NUM>. In this embodiment, this is where the haptics are directly adjacent the optic and whose position can be stabilized due to its close proximity to the optic (which may in fact be toughing the optic). A depression could of course extend further than just those regions. For example, a depression could extend adjacent spacing <NUM>, even if the depression in that area is not directly stabilizing a portion of the haptic. It may, for example, be easier to manufacture the depressions to be longer than needed.

In embodiments in which a depression does not extend around the entirety of the optic, there can thus be more than one depression separated by a region of the optic that does not include a depression. They can be any number of separate depressions as desired.

There may be peripheral portions that are more annular than the peripheral portions herein, and may in fact completely surround the optic. Depressions in these embodiments may extend around a substantial portion of the optic.

According to examples not belonging to the present invention, in any of the embodiments herein, the peripheral portion can alternatively have any of the depressions herein in the radially inner surface, and the peripheral surface of the optic can have a shape (e.g., radial extension outward), at least a portion of which is complementary to the peripheral portion depression. All other aspects of the disclosure can apply to these alternative examples.

Any of the depressions herein can be created during manufacturing one or more components of the intraocular lens, such as during machining or molding of one or more parts.

Any of the different ways of incorporating at least one depression can be incorporated into any of the different embodiments herein.

In the embodiments herein the surface is described an a depression. In examples not belonging to the present invention, a depression is just an exemplary peripheral surface (if part of the optic) and an exemplary radially inner surface (if part of the peripheral portion) and not intended to be limiting.

The embodiments in all of <FIG> are examples of an outer periphery of an optic portion that has a peripheral surface that is at least partially complimentary in shape to at least a portion of a radially inner portion of a peripheral portion of the IOL, wherein the optic surface is directly adjacent to the radially inner portion, and wherein the optic surface does not directly extend (coupled to or integrally formed therewith) from the radially inner portion where they are directly adjacent.

Claim 1:
An intraocular lens (<NUM>), comprising:
an optic portion (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>); and
a peripheral portion (<NUM>),
wherein an outer periphery of the optic portion (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>) has a peripheral surface (<NUM>), and
wherein the peripheral surface (<NUM>) comprises a depression (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>) and wherein <NUM>% or less of the peripheral portion (<NUM>), measured along its height, is configured to be disposed in the depression (<NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>).