INTRAOCULAR ACCOMMODATING LENS AND METHODS OF USE
Described herein are intraocular lenses and methods of implantation. In one aspect, the lens includes a shape changing optical element; a force translation element having a first end region coupled to the optical element and a second end region extending towards a ciliary structure, and an attachment portion coupled to the second end region of the force translation element and configured to contact the ciliary structure. The force translation element is configured to functionally transmit movements of the ciliary structure into a force exerted upon the optical element to effect an accommodating and a disaccommodating change of the optical element.
1 . An intraocular lens, comprising:
a shape changing optical element;
a force translation element having a first end region coupled to the optical element and a second end region extending towards a ciliary structure, wherein the force translation element is configured to functionally transmit movements of the ciliary structure into a force exerted upon the optical element to effect an accommodating and a disaccommodating change of the optical element; and
an attachment portion coupled to the second end region of the force translation element and configured to contact the ciliary structure.
2 . The lens of claim 1 , wherein the force translation element can be customized for fit during implantation.
3 . The lens of claim 2 , wherein the mechanism for customizing the fit is selected from the group consisting of sliding, twisting, turning, cutting, rolling, expanding, bending, and applying energy to the force translation element.
4 . The lens of claim 1 , wherein the force translation element is coated with an expandable material.
5 . The lens of claim 1 , wherein at least one of the optical element, the force translation element, and the attachment portion is coated with an agent having biological activity.
6 . The lens of claim 5 , wherein the agent is selected from the group consisting of heparin, a steroid and rapamicin.
7 . The lens of claim 1 , wherein the first end region of the force translation element is coupled to an equator of the optical element.
8 . The lens of claim 1 , further comprising a plurality of force translation elements coupled near an equator of the optical element.
9 . The lens of claim 1 , wherein the attachment portion is configured to contact the ciliary structure.
10 . The lens of claim 1 , wherein the attachment portion is configured to abut and not penetrate the ciliary structure.
11 . The lens of claim 1 , wherein the ciliary structure is selected from the group consisting of the ciliary muscle, the ciliary body, a ciliary process, and a zonule.
12 . The lens of claim 1 , wherein the attachment portion is formed of an elastic material.
13 . The lens of claim 1 , wherein the attachment portion comprises one or more rods.
14 . The lens of claim 13 , wherein the one or more rods are curved.
15 . The lens of claim 1 , wherein the attachment portion comprises a three dimensional element that fills a space adjacent the ciliary structure.
16 . The lens of claim 1 , wherein the attachment portion comprises a fillable element.
17 . The lens of claim 1 , wherein the attachment portion comprises a glue, hydrogel or fixation material.
18 . The lens of claim 1 , wherein the attachment portion elicits a healing response in the ciliary structure to induce soft tissue integration of the attachment portion.
19 . The lens of claim 1 , wherein the optical element has a power in the range of about ±3 diopters to about ±5 diopters.
20 . The lens of claim 1 , wherein the accommodating change of the optical element comprises a change from an ovoid shape to a more spherical shape.
21 . The lens of claim 1 , wherein the accommodating change of the optical element comprises a change in spatial configuration along the optical axis in an anterior direction.
22 . The lens of claim 1 , wherein the force translation element is formed of a material generally harder than a material of the optical element.
23 . The lens of claim 1 , further comprising a second lens positioned within the capsular bag of the eye.
24 . The lens of claim 23 , wherein the optical element is positioned anterior to the second lens.
25 . The lens of claim 24 , wherein the optical element is positioned within the capsular bag of the eye.
26 . The lens of claim 24 , wherein the optical element is positioned posterior to the iris.
27 . The lens of claim 24 , wherein the optical element is positioned anterior to the iris.
28 . The lens of claim 23 , wherein the second lens comprises an implanted intraocular lens.
29 . The lens of claim 1 , further comprising a haptic coupled to and extending outward from the optical element.
30 . The lens of claim 29 , wherein the haptic is positioned within a sulcus.
31 . The lens of claim 30 , wherein the force translation element is coupled to the haptic.
32 . The lens of claim 1 , wherein the force translation element is coupled to the ciliary body and configured to push on the optical element.
33 . The lens of claim 1 , wherein the force translation element is coupled to the ciliary body and configured to pull on the optical element.
34 . The lens of claim 1 , wherein the accommodating and disaccommodating change comprises a shape change effected over the entire surface of the optical element.
35 . The lens of claim 1 , wherein the accommodating and disaccommodating change comprises a shape change effected over a portion of the surface of the optical element.
36 . The lens of claim 35 , wherein the portion preferentially bulges upon an accommodating change.
37 . The lens of claim 35 , wherein the shape change effected over a portion is due to a difference in modulus of the portion of the optical element compared to the modulus of another portion of the optical element.
38 . The lens of claim 37 , wherein a center region of the optical element comprises a lower modulus material than an outer region of the optical element.
39 . The lens of claim 38 , wherein the lower modulus material gives way causing a bulge and a change in dioptric effect.