US20030195621A1 - IOL for reducing secondary opacification - Google Patents

Abstract

An IOL implantable in an eye comprising an optic having an optical portion for directing light toward the retina of the eye and a cell barrier portion for inhibiting cell growth from the eye in front of or in back of the optical portion. The cell barrier portion circumscribes the optical portion, is incapable of focusing light on the retina and includes an irregularly configured structure, for example, irregular grooves. At least one elongated fixation member is coupled to the optic for use in fixing the optic in the eye.

Description

CROSS-REFERENCE TO RELATED CASE
• This application is a continuation of U.S. Ser. No. 08/919,292, which in turn is a continuation of U.S. Ser. No. 08/703,470, which in turn was a continuation-in-part of U.S. Ser. No. 08/437,656, filed May 9, 1995, (U.S. Pat. No. 5,549,670), and of U.S. Ser. No. 08/627,723 filed Apr. 2, 1996.[0001]
BACKGROUND OF THE INVENTION
• This invention relates to intraocular lenses and in particular to intraocular lenses (IOL's) which reduce secondary opacification.[0002]
• An intraocular lens is commonly used to replace the natural lens of the human eye when warranted by medical conditions. It is common practice to implant an IOL in a region of the eye known as the capsular bag or posterior capsule.[0003]
• One problem that is experienced with many IOL's following their implantation is that cells from the eye, particularly lens epithelial cells from the capsular bag, tend to grow on the capsular bag in front of and/or in back of the optical portion of the IOL. This tends to block the optical portion of the IOL and to impair vision.[0004]
• A common treatment for this condition is to use a laser to destroy the cells and a central region of the capsular bag. Although this treatment is effective, the laser is expensive and is not available throughout the world. There is also cost associated with the laser treatment as well as some patient inconvenience and risk of complications. Finally, the laser treatment may affect the performance of some IOL's.[0005]
• Davenport U.S. Pat. No. 4,743,254 discloses an IOL which includes glare reducing sections on the opposite sides of an optic. These glare reducing sections are fully or partially opaque and their surfaces are not smooth. It has been observed that cell migration across the glare reducing sections appears to be reduced. A similar result has been observed in a plate IOL in which a plate, which is used as a haptic for fixing the IOL in the eye, surrounds the optic. Specifically cell migration across the plate, which has a somewhat textured surface, appears to be reduced.[0006]
• Kelman U.S. Pat. No. 4,808,181 discloses an IOL including a lens assembly having an anterior surface formation and a posterior surface formation. At least a portion of the posterior surface formation constitutes a planar contact region adapted to seat against the posterior capsule of the eye to permanently anchor the lens assembly. The contact region is provided with a roughened surface area defined by a series of ordered narrow linear depressions extending transverse of the plane of the contact region. This patent teaches that these ordered narrow linear depressions accelerate adhesion and enhance anchoring of the tissue of the posterior capsule to the lens assembly. This patent is not concerned with secondary opacification and provides no solution to this problem.[0007]
SUMMARY OF THE INVENTION
• This invention provides an IOL which is believed to solve the secondary opacification problem discussed above. With this invention, an optical portion, which is adapted to be placed in the capsular bag of an eye, directs light toward the retina of the eye, and a cell barrier portion circumscribes the optical portion. With this construction, the optical portion serves the normal function of directing and focusing light at or near the retina. The cell barrier portion inhibits cell growth from the eye, for example, from the capsular bag, in front of and/or in back of (behind) the optical portion. The optical portion and the cell barrier portion may be considered as being portions of the optic.[0008]
• The cell barrier portion of the optic circumscribes the optical portion so as to not leave any path available for the migration of cells in front of or in back of the optical portion. The cell barrier portion is constructed so as to be incapable of or ineffective in focusing light on the retina. The cell barrier portion is preferably partially or wholly opaque to eliminate light scattering.[0009]
• At least one fixation member, preferably an elongated fixation member, is coupled to, and preferably extends outwardly from, the optic for use in fixing the optic in the eye. Viewed from a different perspective, a structure other than the cell barrier portion is employed for fixing the optic in the eye. Such structure may include one or more fixation members of various different configurations coupled to the optic. The fixation members may be separate members attached to the optic or members which are integral with the optic, and they may comprise elongated filaments or one or more wider plate or plate-like members.[0010]
• The cell barrier portion may be of any construction which performs the function of inhibiting cell growth from the eye in front of or in back of the optical portion. In this regard, the cell barrier portion may include an irregularly configured structure or surface feature, such as an irregularly roughened or textured surface region and/or one or more annular grooves which are at least partially defined by irregular surfaces.[0011]
• As used herein, the terms “irregular” or “irregularly” refer to a thing, for example, an irregularly roughened surface region, or series of things, for example, irregular surfaces, which do not have a consistent order, pattern or configuration. In one embodiment, these terms refer to a thing or series of things which are substantially unordered or which have a pattern or configuration with a significant or substantial degree of randomness, or even substantially complete randomness. In one embodiment, the irregularity in accordance with the present invention is sufficient to result in the irregularly configured structure, present in an otherwise optically clear cell barrier portion to be at least about 50% opaque (that is frosty or hazy), more preferably at least about 80% opaque and still more preferably substantially completely opaque.[0012]
• The irregularly configured structure or surface feature of the cell barrier portion preferably has a radial dimension of no more than about 2 mm, more preferably no more than about 0.75 mm and still more preferably no more that about 0.25 mm. If the cell barrier portion includes an annular groove, the groove preferably has a maximum width and a maximum depth each no greater than about 0.02 mm. In one preferred construction, the cell barrier portion includes at least about 20 annular grooves.[0013]
• The optic has anterior and posterior faces. The irregularly configured structure, for example, surface roughening or texturing and/or grooves, may be provided on ny surface or surfaces along which the cells may migrate and completely circumscribes the optical portion. Preferably, the irregularly configured structure is provided at least on the posterior face and/or anterior face of the optic in the cell barrier portion.[0014]
• The irregularly configured structure or surface feature can be included in/on the cell barrier portion using any suitable technique or methodology. Of course, it is important that this structure or surface feature be sufficiently irregular to achieve the desired inhibition of cell migration or cell growth so that the risk of secondary opacification is reduced. The technique or methodology chosen to include this structure or surface feature should take this basic criterion into account. This structure or surface feature can be formed during the initial formation, for example, the molding, of the cell barrier portion or optic, or can be included after the cell barrier portion or optic is produced, for example, using a laser, lathe, other mechanical implement and the like. In one particularly useful embodiment, a lathe is employed to form a spiral array of annular grooves defined by irregular surfaces in the cell barrier portion. Cell barrier portions may be processed in a manner similar to the glare reducing sections of Davenport U.S. Pat. No. 4,743,254 to yield fully or partially opaque structures the surfaces of which are irregular and not smooth. The disclosure of this patent is incorporated in its entirety herein by reference.[0015]
• The cell barrier portion may be integral with the optical portion, or may be a separate member coupled to the optical portion. Also, the fixation member or members may be integral with the cell barrier portion and/or the optical portion, or may be a separate element or elements, e.g., filament or filaments, coupled to the optical portion or the cell barrier portion.[0016]
• The invention, together with additional features and advantages thereof may best be understood by reference to the following description taken in connection with the accompanying illustrative drawings.[0017]
BRIEF DESCRIPTION OF THE DRAWING
• FIG. 1 is a plan view of one form of IOL constructed in accordance with the teachings of this invention.[0018]
• FIG. 1A is an elevational view of the IOL shown in FIG. 1.[0019]
• FIG. 2 is an enlarged fragmentary view of the region generally bounded by the[0020]arc2 in Fit1 and showing a more detailed view of the cell barrier portion of the IOL.
• FIG. 3 is an enlarged fragmentary sectional view taken generally along[0021]3-3 of FIG. 2.
• FIG. 4 is an enlarged fragmentary sectional view taken generally along line[0022]3-3 of FIG. 2 and showing the growth of cells from the capsular bag of the eye on only a portion of the cell barrier region.
• FIG. 5 is a plan view of a second form of IOL constructed in accordance with the teachings of this invention.[0023]
• FIG. 6 is an enlarged fragmentary sectional view taken generally along line[0024]6-6 of FIG. 5.
• FIG. 7 is a plan view with portions broken away of a third from of IOL constructed in accordance with the teachings of this invention.[0025]
• FIG. 8 is an enlarged fragmentary sectional view taken generally along line[0026]8-8 and illustrating another construction of the cell barrier portion.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
• FIGS. 1 and 1A show an[0027]IOL11 which generally comprises an optic13 andfixation members15 and17. In this embodiment, the optic13 may be considered as including anoptical portion19 for focusing light on or near the retina f the eye and acell barrier portion21 circumscribing the optical portion and being incapable of focusing light on the retina.Optical axis22 passes through the center ofoptic13 in a direction generally transverse to the plane of the optic.
• In this embodiment, the optic[0028]13 is circular in plan and biconvex; however, this is purely illustrative as other configurations and shapes may be employed. The optic13 may be constructed of any of the commonly employed materials commonly used for rigid optics, such as polymethylmethacrylate (PMMA), or commonly used for resiliently deformable optics, such as silicone polymeric materials, acrylic polymeric materials, hydrogel-forming polymeric materials, mixtures thereof and the like.
• The[0029]fixation members15 and17 in this embodiment are generally C-shaped and are integral with the optic13. However, this is purely illustrative as thefixation members15 and17 may be of other configurations and/or may be separate members affixed to the optic in any of a variety of conventional ways.
• The optic[0030]13 has ananterior face23, aposterior face25 and aperipheral edge27. In this embodiment, thefaces23 and25 are convex and theperipheral edge27 is cylindrical, but as indicated above, these shapes are shown only by way of example.
• The optic[0031]13 is designed to be placed in the capsular bag. The diameter of the optic13 may be conventional, and as such, may be about 6 mm or less. Theoptical portion19 performs the normal function of the optic of an IOL, i.e. to appropriately focus light at or near the retina. Theoptical portion19 may be monofocal or multifocal.
• In this embodiment, the[0032]cell barrier portion21 is integral with theoptical portion19. Thecell barrier portion21 is incapable of focusing light on the retina of the eye and includes an irregularly configured structure or surface feature effective to inhibit, and preferably substantially prevent, cell growth radially inwardly across the cell barrier portion. In the embodiment of FIGS.1-6, thecell barrier portion21 includes a concentric array ofannular grooves29 each of which is at least partially defined by irregular surfaces. Similar arrays of thegrooves29 are in either theanterior face23 or theposterior face25, or both. Although various different arrangements can be employed, in this embodiment thegrooves29 are concentric and substantially equally spaced apart.
• Without wishing to limit the invention to any particular theory of operation, it is believed that[0033]grooves29, acts to disrupt or otherwise interfere with the process of eye cell, for example, lens epithelial cell, migration or growth so that the cumulative effect of this irregular structure is to significantly reduce, or even eliminate, the migration or growth of cells in front of or in back of theoptical portion19 afterIOL11 is implanted in the eye. FIG. 4 illustrates thateye cells30 from thecapsular bag32 do migrate or grow to some extent onto and cover a portion of thecell barrier portion21. This limited cell migration is advantageous in at least assisting or facilitating the effective fixation ofIOL11 in the eye. Thus, the present invention preferably provides for such advantageous limited eye lens epithelial cell migration or growth while preventing excessive cell migration or growth in front of or in back of theoptical portion19, as shown in FIG. 4.
• Another way of viewing the degree of irregularity of the irregularly configured structure, for example,[0034]grooves29, oncell barrier portion21 is opacity. Thegrooves29 are sufficiently irregular so that thecell barrier portion21 is substantially completely opaque to the transmission of light. When viewed by the naked eye,cell barrier portion21 is a white or frosty band on the otherwise opticallyclear optic13.
• Preferably, the radial dimension of the[0035]cell barrier portion21 is no greater than about 2 mm, and more preferably no greater than 0.25 mm.
• In the embodiment shown in FIGS.[0036]1 to4, the number ofgrooves29 is about 50 to about 100. In order to obtain an advantageous degree of cell migration inhibition, it is preferred that the number of grooves included incell barrier portion2 be at least about 20, although fewer grooves can provide some useful benefits.
• The[0037]grooves29 are located wherever it is desired to inhibit cell migration. In the present embodiment, thegrooves29 are placed on both theanterior face23 and theposterior face25 so that thecell barrier portion21 is on both faces of the optic13. However, the cell barrier portion can be eliminated from a particular face if it is determined that cell migration in front of that face is not likely to occur.
• The[0038]IOL11 can be implanted in the capsular bag of the eye in accordance with conventional techniques. When so implanted, thecell barrier portion21 defines a radially relatively narrow annular barrier for inhibiting cell growth radially inwardly in front of or in back of theoptical portion19 where the cells could cause secondary opacification.
• The present invention is applicable to IOLs including a hard or rigid optic, such as the optics made from PMMA, and those which include a foldable or deformable optic, such as optics comprising silicone polymeric materials, other acrylic polymeric materials, hydrogel-forming polymeric materials, such as polyhydroxyethylmethacrylate (poly HEMA), and the like. Such foldable/deformable optics are particularly advantageous since they can be inserted into the eye through a small incision. The[0039]fixation members15 and17, are flexible and strandlike or filaments so that they can be easily inserted into the eye. Thefixation members15 and17 can be formed integrally with the optic13 or can be separately coupled to the optic.
• FIGS. 5 and 6 show an IOL[0040]11awhich is identical to theIOL11 in all respects not shown or described herein. Portions of the IOL11acorresponding to portions of theIOL11 are designated by corresponding reference numerals followed by the letter a.
• The only difference between the IOL's[0041]11 and11ais that in the IOL11athegrooves29 are replaced with an irregularly roughened or texturedsurface31. The cell barrier portion21a, in particular the roughened or texturedsurface31, is sufficiently irregular as to be at least partially, and preferably substantially completely, opaque to the transmission of light. This not only provides cell migration inhibition, but also avoids glare from the interaction of light with the cell barrier portion21a. Thetextured surface31 may be textured or roughened in any of a variety of ways including machining as with a lathe, chemical etching, abrading or the like. If the optic13ais molded, as for example when it is constructed of silicone polymeric material or other soft foldable material, the texturing or roughening of thetextured surface31 may be imparted by the mold.
• The degree of irregularity of the roughening of the[0042]surface31 should be sufficient to enable the textured surface to perform the inhibition of cell migration function.
• FIGS. 7 and 8 show an IOL[0043]11bwhich is identical to theIOL11 in all respects not shown or described herein. Portions of the IOL11bcorresponding to portions of theIOL11 are designated by corresponding reference numerals follows by the letter b.
• There are two primary differences between the IOL's lib and[0044]11. First, in the IOL11b, thefixation members15band17bare separate strands or filaments which are attached to the optic13bin an suitable conventional manner. Secondly, the cell barrier portion21bis in the form of a separate member coupled to theoptical portion19b.
• In this embodiment, the cell barrier[0045]21bincludes spacedlegs33 joined by a web35. Thelegs33 engage the faces23band25b, respectively, and the web35 confronts and engages the peripheral edge27b. The cell barrier portion21bis annular and extends completely around theoptical portion19band is mounted on the optical portion in a manner similar to a tire. The cell barrier portion21bmay have a radial width of up to about 2 mm or about 1 mm, for example, about 0.25 mm.
• While this invention has been described with respect to various specific examples and embodiments, it is to be understood that the invention is not limited thereto and that it can be variously practiced within the scope of the following claims.[0046]

Claims (2)

What is claimed is:

1. An intraocular lens implantable in an eye comprising:

an optical portion adapted for placement in the capsular bag of the eye and for directing light toward the retina of the eye;

a cell barrier portion for inhibiting cell growth from the eye in front of or in back of said optical portion;

said cell barrier portion circumscribing said optical portion, including an irregularly configured structure and being incapable of focusing light on the retina; and

at least one elongated fixation member coupled to said optical portion for use in fixing said intraocular lens in the eye.

2. An intraocular lens implantable in an eye comprising:

an optic, adapted for placement in the capsular bag of the eye, having an optical portion for directing light toward the retina of the eye and a cell barrier portion for inhibiting cell growth from the eye in front of or in back of the optical portion;

said cell barrier portion circumscribing the optical portion, including an irregularly configured structure and being incapable of focusing light of the retina; and

a member other than the cell barrier portion for fixing the optic in the eye.

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