Systems and methods for spectacle independence using refractive index writing with an intraocular lens

1. A system for improving vision of a subject, the system comprising:

a pulsed laser system configured to apply a plurality of laser pulses to selected areas of an intraocular lens (IOL) implanted in an eye of a subject to change the refractive index of the selected areas by refractive index writing; and

a control system configured to receive parameters related to spectacle dependence of the eye of the subject after implantation of the IOL and to calculate, based on the parameters, a pattern of laser pulses and selected areas of the intraocular lens to which the laser pulses are to be applied to provide a change in phase profile of the IOL to increase spectacle independence;

wherein the control system is coupled to the pulsed laser system and is configured to control the pulsed laser system to apply the calculated pattern of laser pulses to the calculated selected areas of the intraocular lens, and

wherein the control system is further configured to estimate phase delay based at least in part on measurements associated with subject-specific through-focus visual acuity.

2. The system of claim 1 , wherein the parameters related to spectacle dependence comprise measurements associated with subject-specific through-focus visual acuity, wherein the control system is configured to determine the change in phase profile, and wherein determining the change in phase profile comprises:

predicting, based at least in part on the subject-specific through-focus visual acuity measurements, an estimated phase profile for increasing near vision for the subject while maintaining distance vision, or for increasing distance vision for the subject while maintaining near vision.

3. The system of claim 1 , wherein the parameters related to spectacle dependence comprise measurements associated with subject-specific through-focus visual acuity;

wherein the control system is configured to determine the change in phase profile, and wherein determining the change in phase profile comprises: predicting, based at least in part on the subject-specific through-focus visual acuity measurements, an estimated phase profile for increasing intermediate vision for the subject while maintaining distance vision, or increasing distance vision for the subject while maintaining intermediate vision.

4. The system of claim 1 , wherein the parameters related to spectacle dependence comprise measurements associated with subject-specific through-focus visual acuity;

wherein the control system is configured to determine the change in phase profile, and wherein determining the change in phase profile comprises:

predicting, based at least in part on the subject-specific through-focus visual acuity measurements, an estimated phase profile for increasing intermediate vision for the subject while maintaining near vision, or for increasing near vision for the subject while maintaining intermediate vision.

5. The system of claim 1 , wherein the IOL is a multifocal IOL and the refractive index writing produces a phase profile on the IOL that changes the add power of the multifocal IOL.

6. The system of claim 5 , wherein the control system is configured to calculate the change of the add power produced by the refractive index writing phase profile based on at least one of:

through-focus visual acuity of the subject;

comfortable reading distance of the subject; and

subject biometry.

7. The system of claim 6 , wherein the subject biometry comprises at least one of axial length of the subject's eye, IOL position, and corneal power.

8. The system of claim 1 , wherein the control system is configured to determine the change in phase profile, prior to the application of the laser pulses to the IOL, based at least in part on at least one of:

subject-specific reading habits, including reading distances;

pupil size; and

subject-specific data indicating common lifestyle tasks performed by the subject and/or lighting conditions associated with respective tasks.

9. The system of claim 1 , wherein the parameters related to spectacle dependence comprise at least one of:

through-focus visual acuity of the subject;

comfortable reading distance of the subject;

subject biometry, including at least one of axial length of the subject's eye, IOL position, and corneal power;

subject-specific reading habits, including reading distances;

pupil size; and

subject-specific data indicating common lifestyle tasks performed by the subject and/or lighting conditions associated with respective tasks.

10. The system of claim 1 , wherein the change in phase profile is estimated by calculating a phase difference between an existing phase profile of the implanted IOL and a desired phase profile expected after the refractive index writing.

11. The system of claim 1 , wherein improving spectacle independence comprises one or more of:

improving the subject's through-focus visual acuity at one or more distances;

improving the subject's through-focus visual acuity at one or more first distances while maintaining the subject's through-focus visual acuity at one or more second distances;

extending depth of focus of the IOL;

providing the IOL with at least partial presbyopia correction;

improving presbyopia correction of the IOL; and

adapting presbyopia correction of the IOL to subject-specific requirements, wherein the subject-specific requirements include subject biometry or subject-specific lifestyle data.