CA1322261C

CA1322261C - Accommodating intraocular lens

Info

Publication number: CA1322261C
Application number: CA000607516A
Authority: CA
Inventors: Bruce A. Christie; Brian Monroe Mcmaster; J. Warren Blaker
Original assignee: Storz Instrument Co
Current assignee: Bausch and Lomb Inc
Priority date: 1988-08-15
Filing date: 1989-08-03
Publication date: 1993-09-21
Anticipated expiration: 2010-09-21
Also published as: JPH0744938B2; DE68902614T2; EP0356050A1; BR8904102A; US4932966A; DE68902614D1; EP0356050B1; ES2030637T3; ES2030637T1; JPH02167157A

Abstract

ABSTRACT OF THE DISCLOSURE

An accommodating intraocular lens apparatus preferably includes a lens member having a relatively flexible portion and a relatively rigid portion, with a fluid-filled chamber therebetween. The preferred intraocular lens also includes a hydraulic or other fluid accommodation provision for changing the shape or position of the flexible lens by changing the fluid pressure in the fluid-filled chamber in response to muscle movement of the eye.

Description

:L '~2~61 ~CCCMMCDATTNG INrRAOCUL~R IENS

B~CKGRCUND AND 5UMMARY OF IHE INVENTI0N
__ _~ ____ qhe ~ ntion relate~ generally bo in~ra~cular len5e3 for the human eye and, ~ore particularly, ~o intraocular lenses that ~hange in re~ractive pcwer ~i.e. "accommodaten) ~n re~ponse to eye m~scle mcv~ment to focus on objects at different distances as vi~wed from the viewex.
Figures 1 through 4 illustrate the ~ccommodation function ~f a normal, natural human eye, with Figure 1 shGwlng a hNman eye in cro~s-section. m e eye ~ ~ ~ncludes a cGrnea 13, an iris 16, a ciliary body 17, ~uspensory ligaments or zonules ~f zinn ~8, a crys~all me lens 19 surroucdcd by a Cap5Ular bag 20, and a retina 27. ffl e ciliary body 17 in~ludes ~uscle tissue, which -~cntrols the focal length of the lens 19.
~hen individual cincumferential muscle fibers 21 of the cili3ry body 17 relax (i.e., when the dimensions 23 increase~, the aperture dl~meter 25 ~ thin the ciliary body 17 ~nc~ases, as ~hown in Figures 2A and 2B.
AS ~ n ~n Figures ~A and 3B, this lncrease in aperture diametex puts tension o~ ~he zcnules lB, which in turn ~tretch the crystalline lens 19, causing the lens 19 to ~ssume elongated ~h3pe l9E. m e elongated lens l9E has a re~ractive power ~ui~able ~or fcc~sing distant objects upon the retina 27. ~e~3 it is ne~essary ~ ~o~us near~ objects, the n~scle fibers f ciliaxy bo~r 17 o~ntract, ~eas~ the ~e di~ter 25 shawn in Fig~re 2A. 1~ re~;ponse to thi9 ~wltractio~, the ~herent elastici~ of the lens 19 causes ilt to contract to the unstretc}~ed shape shown in Figure 3A.
qh:is abilit~ of the }n~nan c~ptical ~ em to ~ nge the E~hape t)f ~he ler~s 19 land thus the refractive p~wer) ~n oxder to ~ocus on ei~her di~tant or nearby dbjects is called "acccm~odationn.

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The lens l9 of the hum3n eye ~an, hcwever, ~uffer disease, ~uch as a cataract, in which case ~urgical remcval of the l~ns 19 m~y be necessary.
After removal, the natuxal lens 19 can be ~eplaoed by an srtificial lens 32 shown Ln Figure 4 which is termed ~n intraocular lens ~IOL)~ ~ne type of IOL 32 is shcwn m Figures 5A and 5B. The len~ 32 is Fupp~r~d ~y haptics 36, which rest genexally at p~ints 37 in Figure 4 after ~ lantation in the eye, me IOL 32 restores nuch of the vi6ual acuity of the e~e, ~ut has the characteristic of prcperly foc~sing only images of object5 34 in Figure 4 whlch are within the dep~h of field 39 of ~he focNslng Eystem, ~aid ~ystem being oompri~ed of the IOL 3? and the cornea 13. O~her dbjec*$, ~uch as the bbject 41 lccated in the far field 43, ~re nLt ~n ~ocus, and thus appear blurred. It is also possIble, instead, -for the focuslng ~ystem to properly focus objects in ~he far field 43 but not ln the near field 39. The ~ccommodation necessary to selectively focus on both near and far objects, ~or~erly provided by the cry5talline lens 19, ha5 ~hus been ~e*uced or lost.
It is therefore highly desirable tD restore ~cco=mldation in order to allow the patient with an ICL to selectively ~ocus objects located at all distances. Thus ~ne ~f ~he primary objects of ~he p~esent ~nve~icn is to pruvide an i~proved intraocular lens that ~an focus cbjects located at differ~nt distances upo~ ~he retina, dqpending upon the relaxed or oontracted 6tate of the ciliary body mNscles.
One fonm of the invention comprises a replacement lens for the human eye, which ch3nges in ~ocal le ~ as the ciliary muscle sontracts and relaxes.
Acoording to the present inventionp an ~ccGmm~dati~g intxaocular lens apparatus includes a lens nEmber having a flex~ble portion and a relatively rigid portion, with a chamber therebetween, m e apparatus also ,'.: ' -.' ' 2 ~ ~ l i~cludes an accommodation prwislon or changing the ~hape or position of the flexible lens m~mber m ~esponse ~o ~uscle ~ovement of the ~ye. Such accommcdation feature provides ~he ~echani~sm to change the refractive chaxacteristlcs of the flexible lens member and thus allows the lntraocular lens patient t~ focus on objects a~ varying dis~ances much ln the ~ame way as did the patient's natural crystalll~e lens~ In ~he preferred e~bodiments, such accommodation capability is pxovided by way of a hydraulic or other fluld ~ystem incDrporated into the intraQcular lens apparabus for selectively pressurizihg and de~pressuriz mg a fluid-filled (liquid or gaseous) chamber defined by the flexible lens nember and a relatively rigid supporting member ~n order to ~electively vaxy the refractive powers or charac~eristics of the w erall lens ~y6tem.
Additional objects, ~dvantages ~nd featuxes of the present invention will become ~pparent fro~ the following descrip~ion and appended claims taken in ccnjunction wi~h the accompanying dr~wings.

BRrEF DESCRIPTICN OF THE DR~WI~G
Figure 1 diagrammati~ally illustrates a hum~n eve in cr~ss-section.
: Figures 2A ~nd 2B diagr~mmatically illu~trate dilaticn of ~he ciliary body of ~he eye.
Figures 3A and 3B diagr~mmatically illustratz how the dilaticn ~hown in Figure 2B 6tretches the ~rystalline lens and ~hanges its focal : length.
Figure ~ illustrates an intraocular l~ns that can be used to replace the natural 12ns 19 in Figure lo Figures 5A and 5B are enlarged views of a csnmLn type of $ntraocular lens.

- ~ 3~2~L

~ igure 6 illustxates an ~xploded view of ~n intraocular lens apparatus accordmg tD one foDm of the invention.
Figure 7 lllustrates a detailed view of the ~ traDcul~r lens apparatus of Figure 6 ~hcwn in cross-secticn.
Pigures 8A and ~B illustrate the change in ~hape of the cha~ber of the lens appara~us shown in Figure 7, which occurs during use of ~he inventiGn.
Figur~ 9 illustrates one form of the intraocular lens apparatus of the present i~vention.
Figure 10 illustrates ~nokhex form of the in~raocular lens apparatus of the present ~n~ention implanted withLn the cili~ry body of the eye.
Figure 11 illustrates a prefer~ed ~m o~ the present inventic~, including pressure sources used to inflate flexible bladders, which cvntact or ~ d in resp~nse tD action Df the ciliary body.
Figure 12 shows in ~ch~matic form hcw the ~iliary body compresses ~ne p2ir of ~he bladders shown ~n Figure 11.
Figure 13 shows the a~paratus of Figure 11 ~n p~rzpective, cut-away orm.
Figure 14 is a view similar t~ ~hat of Figure 10, but illustrating 6till ~nokher form of the lntraocular lens ~pparatus of ~he present invention.
~ igure 15 i8 a partial detail view o the lens ~pparatus of Figure 14, illustratin~ a hollcw haptic ~ber.
Figure lfi is a view similar tv that o ~igure 15, but illustratLn~
how ~he ciliary body deforms th~ hollow hapti~ memker to ~s~se acc~G]odation~
Figure 17 is a cross-s~ctio~al vi~w taken generally along line 17-17 of Figure 15.

1 3222~1 Figure 18 is a cross~ nal view ~imilar ts) that of Figure 17, but illustrating al~ alternate haptic ccnstruction.
Figure l 9 is a cross-secti~nal view sim~lar to that of Figures 17 and 18, but illustrating still another alternate haptic csoslst~ction.
Figure 20 is a view s~nilar to that of Figures 10 and 14, but diagramatically illustrate still ar~ther forrn of the present ~m~entiGn.
Figure 21 is a partial cros5-sectional View talcen generally al~g line 21-21 of Figure 20.
Figure 22 is a cross-secti~nal Yie~ ta)cen genf~rally al~ng line 22-22 of Figure 20.
Figure 23 is a partial cross-sectional view sLmilar to that of Figure 22, ~ut illustrating an alternate CC;r~;tructioql~
Figure 24 is a partial ~t~iled view of the a~paratus of Figure 20, D~TAILED D~SCRI~N OF T~3E PREF~RRED ~OD~trS 0~ THE INV~rIa~

Figures 6 through 24 depict e~c~nplary ~bodim~nts of the present imrention for purpo~s of illustration. ~e ~killed in ~e a~t will readily recognize fran the ~oll~ description and the ~cc~anyislg draw~ngs that the principles of the p~esent imrenti~n are al~ Ahle to ~ntraocular lenses ~ther than those depict~d in the dr~s.
Figure 6 illustra~es o~e ex~nplary form of the i~vention, ~n which an IOI/ 48 is shc~ ~n cross-~ection in ~igure 7. A $hin, nE~rane like lens 50 is æaled alon-~ its perip~ery 52 to a thi~lcer sup~ort lens 54, which o~ntain~ a circulæ recessed cavity 53, th~reby fonni~ a ~uid-filled (li~d or gaseous) .vit~ or chamber S6 (shown ~ Figure 7) be~n the t~
lenses. Fluid pressure is applied ~o 'che cha~er S~ an apparatus di~cussed belaw, in order to dri~e the m~rbrane-lens 5û into the ~hape or 2 fi ~
position 59 (shown in phantom lines in Figure 7~. This change m position or ~hape changes the refractive powers or characteri~tics of the cverall lens system 48, which includes the tw~ :lensPs 50 ar~ 54 ~d the fluid ch~r 56.
The abcNe-mentioned change in refractive characteristics is caus~d pr ~ ily by the ~hange ~n shape of the chamber 56 from ~he ~hape ~hcwn in Figure BA to that 6hown in Figure a~. Since the ~ er 56 is fluid-filled, as is discussed belcw, it tDo acts as a lens, and the altered shape shown m Figure 8B provides a refraction ~hat is different from that of the former ~hape shcwn in Fig~re 8A. The fluid-~illed chamber 56 thus effectively functions as a lens of a variable focal length, m~k mg the overall lens 48 have a variable focal length~
In cne fonm of the ~nNentiOn, the IOL 48A of Figure 6 ~an be implanted using standard ~ ics 36, auch as those ~hcwn in Figure 9, with the dashed circle 52 indicating the periphery of ~he n~brane lens 50 in Figure 6. Alternately, a n~mber of suppor ~ bladders 70A are preferably used to lodge the IOL 48B within the capsular bag 20, as ~hown in Figures 10 thro~gh 13, and as described in more detail ~elow. me support ~ bla~ders 70A allow an IOL of fixed 6ize, having a giv~n di~meter 67, ~uch as ~hat ~hown ~n Figure 9, t~ be used in eye~ hav m g any of Yeveral diameters 25 of the capsular bag equator as shown in Figure 2. Thus the invention ls ~daptable bo patients having ~apsular bags of dif~erent ~izes.
As ls ~hcwn diagr~m~atically in Figures 11 and 13, the ~upporting bladders 70A axe all ccnnccted to a ccmmon manlfold 75, called a ~upport n~nifold, which distribute5 fluid pressure to the bladders 70A. During mplantation in the eye, the fluid pressuIe is appl~ed by a sDurce, ~uch as a ~yringe 77, through a line 79, which is then removed fro~ a valve B1 when the proper pressure i~ attained. The bladders 70R are inflated and pressuri~ed ~
.
: 6-132%~

until they contact the oillary bod~ 17, as ~hown in Figure 13, at which tlme the extern~l preSQUre source 77 ig removed.
In either of the ~xemplary IOL'~ 48A ~r 48B, a nunber of bladders 70B shcwn in Figures 9 thraugh 11, which are tRrmed focu~ing ~r ac ~ tion bladders, are all oonnected to a second, accomm~dation ~ ~DJd ~5, which is illustrated by a thicker line in order to distinguish it frc~n the ~ port nanif~ld 7S. In addition, the ~ccc~rrdation nanifold 85 ccnnects in fluid communication with the fluid chamber 56, as l~dlcated by fluid arrcw~ 89.
Dur mg implantation into the eye, ~he acoommodation bladders 70B are m flated by ~n external pres3ure ~ouxce 77 ~s deÆibed ~b3ve, but to ~ lGwer final pressure than ~hat of the aupport bladders 70A.
m e ~embran2 lens 50 in Figures 9 and 10 ~unctions much like a wall o a pressure ~essel, which is defined by ~he chamber 56 and which is in fluid ccmmunlcation with the ac~om~odation m2nifold 85 and the ac ~ tion bladders 70B. m e n~mbrane 50 is a flexible nfmber in tension and supported only at its cir~ular periphery 52, and thus can resist only ~mall internal pressures within the chanber 56 without def~ti3n. Since the flexible ~rane 50 has a very law n~rent of i~ertia, it deforms into the positio~ 59 in Figure 7 under a ~light increase ~n fluid pressure.
When focusing, the eye defo~ns either the IOL of the present invention or the natural crystalline len~ 19 ~n Figure 1 in ~imilar ways.
~hen the IOL 48A or 48B of the present lnvention is ~planted, ~he ciliary body 17 contracts, and the fo ~ ~ng bladders 70B be~ome ccmpressed a~ shown m Figure 12. ~his compre~sion forces ~luid into the chamber 56 as indicated by fluid arrows 89 in Figure 11. The ~e~brane lens 50 is thus slightly pressurized and deforms into the ~hape or position 59 ~hswn ~n phanto~ lines in Figure 7 as the chamber 56 deforms into the shape indicat2d in Figure 8~.

-- 13~22~
As discussed abcve, ~his defon~ti.on allGw~ the lens system to focus nearly cbjects onto the retin~.
Relaxati~n of the ciliary bod~ 17 operates .Ln reverse, all~Ymg the me~brane lens 50 to return to its former position shown in solid lines in Figure 7, and allcwin~ the excess fluid to flow out of ~he chamber 56 back ~o the bladders 70B. Similarly, the ch~mber 56 adcpts its Q~iginal shape as shown in Figure 8A, which is prcper for focusing dist~nt objects.
It is important to note that the accommodation or focusing IOL 48A
or 48B of the present invention functions cnly when enclosed by ~he capsular bag 20 in order to restrain ~he lens in its proper position. Since cataracts can be remcved while leaving the capsular bag intact (extracapsular cataract extractiQn), the IOL 48A or 48B can be inserted into the capsular bag during Lmplantation. This allows the ciliary body muscles to relax, increas mg the aperture diameter and putting the suspensory ligaments or zonules into tension, which in turn tends to flatten the c2psular bag and enhance the capability of the ICL to change its shape and refracti~e characteristicsO
It should be no~ed that the drawings show the invention in exaggerated ~onn for ease of illustration and are not drawn to scale. For example, the diameter 67 in Figure 9 is preferably ahout 7.5 mm, while the thickness of the membrane lens 50 in Figure 6 (i.e.~ dimension 63) is preferably less than 0.5 mm. Thus, a ~uch larger difference in size exists than the drawings apFear to show. Furthenmore, the distance 68 in Figure 11 between the periphery 52 of the mæmbrane lens 50 and the outer edge 71 of the lens body 54 is preferably apyroximately 1.5 mm, but appears to be qreater in Figure 11, b~cause the diameter of the nembrane lens 50 is preferably appro~i~ately 6~0 mm.
The chanber 56 is shown in Figure 7 as having a finite thickness, indicated by dimension 90, with a suitable thickness being approximately n.

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- :L322~
mm. ~ever, it may ~e desirable to reduce ~he thickne~s to practically zero, ~n which ~ase the membrane lens 50 wculd co~tact the base lens 54 ~n pressure wi~hin the chamber 56 was absent. In ~his instance, the membrane lens 50 would be separated from the base lens 54 ~y anly ~ thln layer of fluid wetting the chaTber 6urfaces 95 ~nd 97 ~hown in Figure 8A. In either case, it is preferred that the surfaces 95 and 97 have ~he aame radius of curva~ure and thus that the thickness 90 is substantially uniform.
m e lens ~ody 54 is preferabiy cons~ruc*ed of p~lymethylethacylate (PMMA), the nembrane lens 50 and both bladders 70A and 70B are preferably constructed of a ~ilico~e elastomer~ and the fluld contained within the bladders and nanifolds ~s preferably a ~ilicone oil. The di ~ ters of the n~nifolds and channels ~n Fi~ure 11 ure preerab1y app ~ ately 0.25 mm.
Ihe radius 99 of ~urvature of the ~uxface 101 ~n Fiyuxe 7 is preferably approximately 16 nm, and the radius 102 of ~Nrvature of the nE~brane lens 50 iB preferably in the range of approx ~ tely 11 mm to lb nm, ~ ndLng upon the fluid pres ~ e applied.
Tw~ ~upport blad2ers 70A and tw3 focusing bladders 70~ are ~h~wn in ~igure 11. Bbwev~r, different ~umbers of each bladder ~ype can be used in aocordance wlth the invention. It is exp~cted that satisfactory performance ln accordance w~th the present inventlcn can be ~ecured with cne, tWD~ three, ~our, or even re ~upport ~nd/or ~commDdation blaadexs on the IOL.
Hbw~ver, it is al50 possible to ~upport the IOL without the support bladders 70A, but rather with ccnventional haptic~ 36, as shown ln Figure 9 and di5cu8sed ~bove~
It is pDssible in some circumstances, that ViSCoUS fluld forces hith~n the manifold 85 æhown in Figure 11 can retard fluid ~low ~nd increase the time Deeded to ~ill and ~mpty the cha~ber 56. Cbn~eqyently, it m~y be desirable to spring-bias the acocmmodati~n or focusLng bladders 70B by _g_ - :L 3 ~
sprLngs (as ~hown in Fiyure 13). Thus, ~hen ~he pressure from the ciliary bod~ 17 ~s xelaxed, the sprinqs act t~ expand the fccus~ng bladder 70B, thus apply ~ a negative pressure ~ the chamber 56. Thls ~egative pressure assists in overccmlng the viscous fluid ~orces. Ihese ~prings can ~e the ooil ~prings 110, or the opti~al leaf springs 112 ~ttached tn ~he lens body 54, or other known ~ es of resilient biasing devices.
It is preferred that the lens bcdy 54 in Figure 7 is positioned posterior to ~he menbrane lens 50 in the event ~hat a phenamenon called posterior capsule qpacification occuxs. In this event7 the p~sterior surface of ~he capsular bag 20, which formerly contalned the cry~talline lens 19 and which, after ~mplantation, oan~ains an IOL, beccme~ cloudy or opaque~ A
typical treatment ~or this condition i8 bo remove p~rt of ~he capsule, or to xupture it, using an Yttrium-Alumln ~ et iY~G3 laser, Bcwever, ~he proKimity of ~he posterior of the capsular bag to the posterior of the IO~
possibly c~uld result in the laser damag ~ the IOL. In the pre~ent invention, h~wevert ~he lens base 54 is quite thick and thus more resistant to ~uch damage than ls the membrane len,s 50.
The di2meter of the wembrane lens 50 ~hculd ~e ~pprsxLmately 6.0 nm, which generally i5 ~ufficient bo occupy the fully dllated human iris. In this way, the pupil does not expose any ~f the apparatus in Figure 11, which is positioned r~;ally oubwaxd of the periphery 52.
In order to protect against ~he possibility of failure of ~he ocrcmmodating IOL 48A or 48B, ~he lens i~ designed ~uch that when the ~embrane lens 50 in Figure 7 is fully relaxed, the refractive characteristics of ~he lens 6ystem 48A or 4BB allow the patient tD v$ew dbjects in a range of infimty to 6 feet (depending on pupil sizP and c~erall refractive error in the patient's ~ye), Xn this way, reduced, but acceptable, ~ision is still ailable to the patient without, Q~ prior to, replacemen~ of a failed lens.

.

Figures 14 through ~4 il:Lustrate further alternate ~mbcd.umRnts of an intraccular lens apparatus according to the present inv~ntion. Many o the elements of the en~dIments depicted in Figures 14 ~ gh 24 are generally sim1lar, at least m tenms of their functicn, ~o corresp~nding elements of ~he ~mbodLments ~hown in Fi~ures 6 through 13. Therefore, similar referen~e nu~erals have been used in Figures 14 through 24 to indicate such oorresponding elements, ~xc~>t that the reference numerals Figures 14 through 24 have either one h~ndred or th~-hundred prefixes~
Figures 14 through 19 depict various ~ersions of an ~lternate entydiment of the inventi~n, wherein I~L 148 is ~ubs~antially ~dentical to ~he lens apparatus shown ~n Fi~ures 6 thrcugh 13, exoept that ~he ~ datiGn bladders 70B ~ the ~rt bla~lders 70A are replaced by ~e or n~re acca ~ ating haptic ~ rs 170B. me ~ ndating haptic n~r~ers 170B are c~nstructed in the ~onm of a generally h~llcw~ elongated, tubular-shaped haptic member cçntaining fluid and attached to the ~uter periphery of the I~L 148 m fluid ocmm~nication with the fluld chamber 156.
When focus ~ , the mNscle fibers 121 of the cilfary body contract ~nd expand in ord~^ ~o ~orcibly deform or relax ~he h~llow ~ccxnm dating h~ptic ~embers 170B, thereby forc ~ fluid ~nto, or withdr ~ fluid frcm, the chamber 156 ~n a Fanner 8Imilar to that d2scribed abcve in ccn~ection with Figures 9 thxough 13. In ~his way, the acccmmodation ~eature of ~he present lnvention can ~e advantageousl~y combined with the ~upporting function of the haptic nYmbers 36 or the ~upport ~ bladders 70A described abcve.
~hen the nuscle fibers 121 of the ciliary ~ contract in a manner diagrammatically il~strated in Figure 16, the hollow acoo~modating haptic members 170B are c~ :essed and may even deform inbo the kinked oo~figuration ~hown for purposes of illustration in Figure 16. Thus, i~ m~y be found ~o be desirable to guard ~gainst the h~llow accQmmodating hap~ic member 170B

-- ~322~1 collapsing and clos mg off the ~nterior ~ er 190, which could cause undesirably high fluid pressures in the interior ~hamber 190 or the fluid-filled chamk~r 156 ~f the lens portion of the apparatus. ~hus, it may be desirable to form the interior chamber 190 in a nLn-c~x~ular or non~cylindrical shape. Two examples of ~uch non-circ~lar cross-sectional shape are illustrated Ln Figures 18 and 19, wherein the thicXness of the haPtiC Wa11 191C and 191D, respectiVely~ 1B non-uniform about the hollow ~aptic members 170C and 170D9 respectively, Such n~n-unifonm wall thickness ~s created by the prcvision of internal disoontinuities 192C and l9~D, respec*ively, whlch ~erve to sub~tantially preYent ~otal closlng off of ~he fluid flow paths ~n the event of ~llapse of all or ~ portion o~ the hollow h3ptic nem~er durin~ ciliary aontracti~n.
In addition, 8LnC2 ~he ~ ression, deformation or kinking of the ~llow haptic n~nber~ 170B must be c ~ le of beLng accomplished ~rely by the ~orce of ciliary n~cle contraction, it also may b~ desirable to provide ribs or other disoontinuities 193 on the ex*ernal periphery of ~he hollow accommodating haptic ne~bers 170B. Al.so, a ~uitable means for mt ~ c mg fluid into the hollow h~ptic membexs 170B and ~h~s the fluid-filled ~ha~ber 156B Ehculd a1B~ be provided, 6uch as ~he fill port 195 shown for purpc~es of lllustratiosl in Figurss 14 and 16.
Figures 20 thr~h 24 illustra~e ~till another ~odi~nt of the p~esent irnrentio~, wherein the It~L 248 is ~pped with a fluid-filled holl~7 r~ng or ccn~uit 270B ~ng the lens portion of ~e IOL 248 . Ihe ~ircular ~uit 270s fi%lctions in a manner generally 6imilar to that de~cribed above in co~ection with Figures 14 ~hrwgh 19, and has its interior cha ~ 290 in flu~d c~TDunicatio~ with the fluid-fill~d c ~ r~ r 256 by way of one or mDre interconnecting h~llow ducts 294 ~12-- :l322~6:~

~ s fihown ln Figuxe 21, the contrac~ion of the ~scle fibers (shc~n diagramTatically ~t reference nuneral 221~ causes ~n inwardly-directed force on the co~uit 270B. miS force canpresses or ~ef~nns the co~uit 270B to force fluid fran the ~nduit 270E~, thmugh t:he interco~ectis!g ~ucts 294, and ~nto the fluid-filled cham~r 256. ~erl the n~cle fibers 221 relax, the ooq~duit 270B returns to its relatively relaxed and undefonned c ~ diticn, thereby all ~ g the fluid pressure ~n the fluid-~illed chamber 256 to be relie~ed, simdlar to the function described abGve in ccnnection with the previously-mentioned embod1rents of ~he pr~nt invention. Also, like the h~llaw a ~ ating haptic mE$bers 170B shcwn in Figures 14 ~ cugh 19, the ~cnduit 270B also Eerves the function of s~pport ~ ~he IOL 248 in ~he eye, 3nd thus acts as a hapti~ member.
Although the inecrcDnnef ting ducts 294 are ~hown as extending in generally radial directions and intercrrnccted w~th the lens portion of the IOL 248 in a generally straigh~-on relationship the ~ th, it may be found t~
be de~irable ~o ~onm the ducts 294 in a "swept" or arcuate oonfiguration, hav ~ a more ~tangential" lnteroonn~ction wi~h the lens portion o~ the IOL
248, similar to that ~hown for purposes of illl~stration in Figure 22.
Al~o, ~s was ~nt$cned above ~n ~ on with the embodiment dbpic*ed ~n Figures 14 through 19, the conduit 270B can be desirably equipped with ribs or ~kher di6c~ntinuities 293 in order to facilitate the prcQer compres~ion and expansion ~n response to ~iliary kody n~scle n~vement. In this regard, it ~hculd be ~oted that at lea3t a portion of ~he ribs or other disoontinuities 293 can ~e in the ~orm of a c~rcumferentially collapsable and expandable portion of the oonduit 270B, as fihown in Figure 24. 5uch an arrangement allow~ the oircumference of the condNit 270B ~ be ~justably increased or decreased ~n order to fit a ~ariety of eye 8~ zes. ~his is especially ~dvantageous ~ince the conduit 270B also serves the ~ 2~2~
~bove-mention~d haptic function of h~lding and ~upporting the IOL 248 in the eye.
Finally, as illustrat0d in Figure 23, one or m~re interconnecting m~mbers 296, which need not be hollow, can be pInvided to w pport ffhe conduit 270B in ~ts spaced-aFart relationship with ~he l~ns poxtlGn of ~he IOL 248.
Such non-hollcw interconnecting mmbers 296 lif included) function merely to aid in ~aintain mg the lens portion of the IOL 248 in it~ proper position after implantation in the eye.
m e foregoinq discussion discloses and describes exemplary embodiments of ~he present invention. One ~killed in the art wqll readily recoqnize ~rom ~uch discussion, and from the acoorp~nying drawings and claims, that various changes, ~difications ~nd variations can be ~ade ~herein without d ~ from the spirit a~d 6cope of the invention as dbfined in the folluwing ~la~ms.

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Claims

1. An intraocular apparatus for implantation in an eye, said apparatus comprising:

a lens assembly including inner and outer light-transmissive lens members defining a fluid-filled chamber located between said lens members, at least a portion of said outer lens member being flexible; and accommodation means for changing the shape of said chamber in response to muscle movement in the eye in order to change the overall refractive characteristics of said lens assembly, said accommodation means including fluid means for selectively changing the fluid pressure in said fluid-filled chamber in order to change the position of said alter lens member relative to said inner lens member.

2. An intraocular apparatus according to claim 1, wherein said fluid means includes a flexible fluid-filled bladder, said chamber being in fluid communication with said fluid-filled chamber, said bladder being in contact with muscles in the eye and being contractable and expandable in response to said eye muscle movement in order to respectively force fluid into, and withdraw fluid out of, said chamber in order to cause a change in the position of said outer lens member relative to said inner lens member in response to said eye muscle movement.

3. An intraocular lens apparatus adapted to be implanted to the eye, said apparatus comprising:

a transparent and flexible outer lens membrane;

a transparent and relatively rigid inner support lens member located adjacent said flexible membrane, said flexible lens membrane and said support lens member being spaced apart and sealed to one another and defining a fluid chamber therebetween; and accommodation means for injecting a pressurized fluid into said fluid chamber between alter lens membrane and said inner support lens member in response to eye muscle movement order to resiliently deform said flexible alter lens membrane and thereby change the refractive characteristics of said intraocular lens apparatus.

4. An intraocular lens apparatus according to claim 3, wherein said accommodation means includes at least one fluid-filled inflatable accommodation bladder in fluid communication with said fluid chamber, said accommodation bladder being selectively contractable and expandable in response to eye muscle movement in order to selectively inject and withdraw said pressurized fluid into and out of said fluid chamber.

5. An intraocular lens apparatus according to claim 4, wherein said apparatus further comprises at least one flexible fluid-filled support bladder, said support bladder being disposed between the outer periphery of said inner support lens member and the ciliary body of the eye in order to support said intraocular lens apparatus in the eye.

6. An intraocular lens apparatus according to claim 5, wherein said intraocular lens apparatus is adapted for implantation in the capsular bag of the eye.

7. An intraocular lens apparatus according to claim 5, wherein said accommodation bladder and said support bladder are separate bladders,

8. An intraocular lens apparatus according to claim 5, wherein said accommodation bladder and said support bladder are the same bladder.

9. An intraocular lens apparatus according to claim 4, wherein said apparatus further comprises at least one haptic member, said haptic member being disposed between the outer periphery of said inner support lens member and the ciliary body of the eye in order to support said intraocular lens apparatus in the eye.

10. An intraocular lens apparatus according to claim 9, wherein said intraocular lens apparatus is adapted for implantation in the capsular bag of the eye.

11. An intraocular lens apparatus according to claim 4, wherein said apparatus further includes resilient biasing means for resiliently biasing said accommodation bladder toward its expanded condition.

12. An intraocular lens apparatus according to claim 11, wherein said resilient biasing means includes a spring disposed within said accommodation bladder.

13. An intraocular lens apparatus according to claim 11, wherein said resilient biasing means includes a spring disposed between a portion of said support lens and said accommodation bladder.

14. An intraocular apparatus for implantation in an eye, said apparatus comprising:

a lens assembly including inner and outer light-transmissive lens members defining a fluid-filled chamber located between said lens members, at least a portion of said outer lens members being flexible; and accommodation means for changing the shape of said chamber in response to muscle movement in the eye in order to change the overall refractive characteristics of said lens assembly, said accommodation means including fluid means for selectively changing the fluid pressure in said fluid-filled chamber in order to change the position of said outer lens member relative to said inner lens member, said fluid means further including at least one elongated hollow and generally tubular-shaped haptic member interconnected with said inner and outer lens members, said hollow haptic member including external peripheral surface thereon and an interior wall defining an interior volume, said interior volume of said hollow haptic member, said interior volume having said fluid therein and being in fluid communication with said fluid-filled chamber, at least a portion of said hollow haptic member being contractable and least in response to said eye muscle movement in order to respectively force fluid into, and withdraw fluid out of, said fluid-filled chamber in order to cause a change in the position of said cuter lens member relative to said inner lens member in response to said eye muscle movement.

15. An intraocular lens apparatus according to claim 14, wherein said hollow haptic member has external discontinuities on said external peripheral surface, said discontinuities tending to facilitate said contraction and expansion in response to said eye muscle movement.

16. An intraocular lens apparatus according to claim 15, wherein said discontinuities include ribs extending arund at least a portion of said external peripheral surface.

17. An intraocular lens apparatus according to claim 14, wherein said hollow haptic member er has a non-circular hollow internal cross-sectionalshape in order to substantially prevent complete collapse of said hollow haptic member during said contraction.

18. An intraocular lens apparatus according to claim 17, wherein said hollow haptic member has external discontinuities on said external peripheral surface, said discontinuities tending to faciliate said contraction and expansion in response to said eye muscle movement.

19. An intraocular lens apparatus according to claim 18, wherein said discontinuities include ribs extending around at least a portion of said external peripheral surface.

20. An intraocular lens apparatus according to claim 17, wherein said internal cross-sectional shape of said hollow haptic member includes at least one inwardly-protruding portion on said interior wall.

21. An intraocular lens according to claim 17, wherein the lateral distance between said external peripheral surface and said interior wall being non-uniform around said hollow haptic member.

22. An intraocular apparatus for implantation in an eye, said apparatus comprising:

a lens assembly including inner and outer light-transmissive lens members defining a fluid-filled chamber located between said lens members, at least a portion of said outer 1 ens member being flexible and accommodation means for changing the shape of said chamber in response to muscle movement in the eye in order to change the overall refractive characteristics of said lens assembly, said accommodation means including fluid means for selectively changing the fluid pressure in said fluid-filled chamber in order to change the position of said alter lens member relative to said inner lens member, said fluid means further including an elongated generally circular hollow conduit extending circumferentially around the periphery of said inner and outer lens members, said hollow conduit including an external peripheral surface thereon and an interior wall defining an interior volume of said hollow conduit, said interior volume having said fluid therein and being in fluid communication with said fluid-filled chamber, at least a portion of said hollow conduit being contractable and expandable in order to respectively force fluid into, and withdraw fluid out of, said fluid-filled chamber in order to cause a change in the position of said outer lens member relative to said inner lens member in response to said eye muscle movement.

23. An intraocular lens apparatus according to claim 22, wherein said hollow conduit has external discontinuities on said external perpheral surface, said discontinuities tending to facilitate said contraction and expansion in response to said eye muscle movement.

24. An intraocular lens apparatus according to claim 23, wherein said discontinuities include ribs extending around at least a portion of said external peripheral surface.

25. An intraocular lens apparatus according to claim 22, wherein at least a portion of said hollow conduit is spaced apart from said periphery of said inner and outer lens members, said interior volume being interconnected with said fluid-filled chamber by one or more interconnecting hollow ducts extending between said hollow conduit and said inner and outer lens members.

26. An intraocular lens apparatus according to claim 25, wherein said hollow duct extends generally radially between said hollow conduit and said inner and outer lens members.

27. An intraocular lens apparatus according to claim 25, wherein said hollow duct extends along a generally arcuate path between said hollow conduit and said inner and outer lens members.

28. An intraocular lens apparatus according to claim 25, wherein a portion of said hollow conduit is selectively expandable and contractable circumferentialy at least prior to said implantation in the eye in order to allow said apparatus to be sized to fit a number of different eye sizes.