阅读说明：本技术 原位可调人工晶状体 (In situ tunable intraocular lenses ) 是由 A·阿金娜依 姜旭卫 刘建 刘景波 于 2020-04-06 设计创作，主要内容包括：本披露提供了一种人工晶状体(IOL)或眼科装置,所述IOL或眼科装置包括光学器件和至少一个袢,所述至少一个袢的至少一部分由比如多畴偶氮液晶聚合物网络(PD-LCN)等光响应形状记忆聚合物网络形成。本披露进一步提供了用于使用偏振激光辐射来调整这种IOL或其他眼科装置的位置的系统和方法。(The present disclosure provides an intraocular lens (IOL) or ophthalmic device comprising an optic and at least one haptic formed at least in part from a photoresponsive shape memory polymer network such as a multidomain azo liquid crystal polymer network (PD-LCN). The present disclosure further provides systems and methods for adjusting the position of such IOLs or other ophthalmic devices using polarized laser radiation.)

1. An intraocular lens IOL, comprising:

an optical device; and

at least one tab, at least a portion of the at least one tab comprising a multidomain azo liquid crystal polymer network PD-LCN.

2. The IOL of claim 1, wherein the at least one haptic comprises a haptic junction, wherein at least a portion of the haptic junction is formed from PD-LCN.

3. The IOL of claims 1-2, wherein the at least one haptic is attached to the optic via the haptic joint.

4. The IOL of claims 1-2, wherein the IOL further comprises a base configured to hold the optic, and the at least one haptic is attached to the base.

5. The IOL of claims 1-4, wherein the IOL comprises a plurality of haptics and at least a portion of each of the plurality of haptics comprises a PD-LCN.

6. The IOL of claims 1-5, wherein the PD-LCN comprises cross-linked diacrylate liquid crystal monomers and diacrylate azobenzene liquid crystal monomers.

7. The IOL of claim 6, wherein the PD-LCN comprises 25 wt% or less of azobenzene diacrylate liquid crystal monomer.

8. The IOL of claim 6, wherein the PD-LCN has a molecular mass of 1.0mol/dm³And 8.0mol/dm³Cross-link density of (a).

9. The IOL of claim 6, wherein the diacrylate liquid crystal monomer comprises 4- (3-acryloxypropoxy) -benzoate 2-methyl-1, 4-phenyl ester.

10. The IOL of claim 6, wherein the diacrylate azobenzene liquid crystal monomer comprises 4,4' -bis [ 6-acryloyloxy) hexyloxy ] azobenzene.

11. A method of adjusting an intraocular lens, IOL, the method comprising illuminating a portion of a haptic of the IOL, the haptic comprising a photoresponsive shape memory polymer network, PD-LCN, with polarized laser radiation to cause the PD-LCN to bend to a bend angle to push against a capsular bag in which the IOL is located and adjusting a position of the IOL in the capsular bag.

12. The method of claim 11, wherein the polarized laser radiation has a wavelength in a range of 440nm to 514nm, inclusive.

13. The method of claims 11-12, wherein the position of the IOL is adjusted axially forward or backward.

14. The method of claims 11-13, wherein the position of the IOL is adjusted radially by an angle θ.

15. The method of claims 11-14, wherein the illuminated portion of the tab that includes the PD-LCN includes a tab junction.

Technical Field

The present disclosure relates to an intraocular lens (IOL) whose position can be adjusted in situ in the capsular bag of the eye. The disclosure further relates to a method of adjusting the position of such an IOL and a system for adjusting the position of an IOL.

Background

The human eye includes a cornea and a lens intended to focus light entering the pupil of the eye onto the retina. However, the eye may exhibit a variety of different refractive errors that result in the inability of light to properly focus on the retina and possibly a reduction in visual acuity. Many interventions have been developed over the years to correct various visual aberrations. These interventions include spectacles, contact lenses, keratomileusis such as laser-assisted in situ keratomileusis (LASIK) or keratoplasty, and IOLs. IOLs are also used to treat cataracts by replacing the natural diseased lens of a patient's eye. During a typical IOL insertion procedure, an IOL is inserted into the patient's capsular bag to replace the natural crystalline lens.

Whether implanted for refractive error or for treating cataracts, the IOL may not always be in the predicted position after surgery. Furthermore, the IOL may over time undergo rotational or axial or combined movement within the capsular bag such that it is no longer in the predicted position. Improperly positioned IOLs can negatively impact the patient's visual quality because the position of the IOL in the eye can affect refractive power and, where applicable, astigmatic correction. Thus, the predicted location of the IOL in the eye is used to plan the surgery and select a particular IOL for the patient. The results may not be ideal when the actual position of the IOL deviates from the predicted position in the surgical plan.

Disclosure of Invention

The present disclosure provides an intraocular lens (IOL) comprising an optic and at least one haptic formed at least in part from a multidomain azo liquid crystal polymer network (PD-LCN).

In further detail, which can be combined with each other or any other part of the disclosure in any combination (unless clearly mutually exclusive), the disclosure further provides:

i) the at least one tab may include a tab engagement portion, at least a portion of the tab engagement portion being formed from PD-LCN;

ii) the at least one tab can be attached to the optic via the tab junction;

iv) the IOL further can comprise a base, the optic, and the at least one haptic can be attached to the base;

v) the IOL may comprise a plurality of haptics, and at least a portion of each haptic may be formed of PD-LCN;

vi) each tab may include a tab engaging portion, at least a portion of which may be formed from PD-LCN;

vii) the PD-LCN may include cross-linked diacrylate liquid crystal monomers and diacrylate azobenzene liquid crystal monomers;

viii) the PD-LCN may include 25 wt% or less of azobenzene diacrylate liquid crystal monomer;

ix) the PD-LCN may have a molar fraction of 1.0mol/dm³And 8.0mol/dm³Cross-link density of;

x) the diacrylate liquid crystal monomer may include 4- (3-acryloxypropoxy) -benzoate 2-methyl-1, 4-phenyl ester;

xi) the diacrylate azobenzene liquid crystal monomer may include 4,4' -bis [ 6-acryloyloxy) hexyloxy ] azobenzene;

xii) the diacrylate liquid crystal monomer may include 4- (3-acryloyloxypropyl) -benzylurea 2-methyl-1, 4-phenyl ester, and the diacrylate azobenzene liquid crystal monomer may include 4,4' -bis [ 6-acryloyloxy) hexyloxy ] azobenzene.

The present disclosure further provides an ophthalmic device comprising a base comprising an opening configured to receive an optic of an intraocular lens and at least one haptic coupled to the base, at least a portion of the at least one haptic comprising a light responsive shape memory polymer network.

In further detail, which can be combined with each other or any other part of the disclosure in any combination (unless clearly mutually exclusive), the disclosure further provides:

i) the photo-responsive shape memory polymer network may comprise a multidomain azo liquid crystal polymer network (PD-LCN);

ii) the at least one tab may include a tab engaging portion, at least a portion of which may be formed from the photoresponsive shape memory polymer network;

iii) the at least one tab can be attached to the optic via the tab junction;

iv) the at least one tab can comprise a plurality of tabs, and at least a portion of each tab can be formed from the light responsive shape memory polymer network;

v) the PD-LCN may include cross-linked diacrylate liquid crystal monomers and diacrylate azobenzene liquid crystal monomers;

vi) the PD-LCN may include 25 wt% or less of an azobenzene diacrylate liquid crystal monomer;

vii) the PD-LCN may have a molar fraction of 1.0mol/dm³And 8.0mol/dm³Cross-link density of (a).

viii) the diacrylate liquid crystal monomers may include 4- (3-acryloxypropoxy) -benzoate 2-methyl-1, 4-phenyl ester;

ix) the diacrylate azobenzene liquid crystal monomer may include 4,4' -bis [ 6-acryloyloxy) hexyloxy ] azobenzene;

x) the diacrylate liquid crystal monomer may include 4- (3-acryloyloxypropyl) -benzylurea 2-methyl-1, 4-phenyl ester, and the diacrylate azobenzene liquid crystal monomer includes 4,4' -bis [ 6-acryloyloxy) hexyloxy ] azobenzene. (ii) a

The present disclosure may include a method of adjusting an IOL or ophthalmic device. The IOL or ophthalmic device may be any of the IOLs or ophthalmic devices described above or elsewhere in this disclosure. The method may include irradiating a portion of a haptic of the IOL or ophthalmic device with polarized laser radiation, wherein the haptic includes a photoresponsive shape memory polymer network, such as PD-LCN, to cause the photoresponsive shape memory polymer network, such as PD-LCN, to bend to a bend angle to push against a capsular bag in which the IOL or ophthalmic device is located and adjust a position of the IOL or ophthalmic device within the capsular bag.

In further detail, which can be combined with each other or any other part of the disclosure in any combination (unless clearly mutually exclusive), the disclosure further provides:

i) the polarized laser radiation may have a wavelength in the range of 440nm to 514nm, inclusive;

ii) the position of the IOL can be adjusted axially forward or backward;

iii) the position of the IOL can be adjusted radially by an angle;

iv) the actual location of the IOL in the capsular bag may be different from a target location, and adjusting the position of the IOL may include moving the IOL to the target location;

v) the irradiation may be performed for between 0.5 seconds and 5 minutes, inclusive.

The present disclosure provides a method of correcting ametropia. The method comprises the following steps: implanting an IOL or ophthalmic device comprising at least one haptic in an eye of a patient, at least a portion of the at least one haptic comprising a photoresponsive shape memory polymer network; obtaining post-operative biometric data for the patient's eye; determining a post-operative refractive error of the patient's eye; generating a nomogram to control a laser to apply polarized laser radiation to the photoresponsive shape memory polymer network to cause a change in shape of the loop and thereby cause at least one of translation or rotation of the intraocular lens in the patient's eye to correct the post-operative refractive error based on the post-operative biometric data and post-operative refractive error; and irradiating the photo-responsive shape memory polymer network with the laser. The IOL or ophthalmic device may be any of the IOLs or ophthalmic devices described above or elsewhere in this disclosure.

In further detail, which can be combined with each other or any other part of the disclosure in any combination (unless clearly mutually exclusive), the disclosure further provides:

i) the photo-responsive shape memory polymer network comprises PD-LCN;

ii) the polarized laser radiation may have a wavelength in the range 440nm to 514nm, inclusive;

iii) the position of the IOL can be adjusted axially posteriorly or anteriorly;

iv) the position of the IOL can be adjusted radially by an angle θ;

v) the irradiation may be performed for between 0.5 seconds and 5 minutes, inclusive;

vi) the illuminated portion of the tab that includes the PD-LCN may include a tab junction.

The present disclosure further provides a surgical system for adjusting the position of an IOL or ophthalmic device, such as any of the IOLs or ophthalmic devices described above or elsewhere in the present disclosure. The system comprises: a laser capable of providing laser radiation in the range of 440nm to 514nm, inclusive; a polarizing filter capable of adjusting the angle or polarization of radiation from the laser; and a computer comprising a processor, a memory, and a communication interface, wherein the computer is capable of executing instructions stored in the memory using the processor to cause instructions to be sent through the communication interface to cause the laser and the polarizing filter to irradiate at least a portion of an IOL or a haptic of an ophthalmic device located in a capsular bag of a patient's eye with polarized laser radiation, wherein the irradiated portion comprises a photo-responsive shape memory polymer network (including, for example, PD-LCN) and bends to a certain bending angle in response to the irradiation. The instructions may include all or part of any of the methods described above or otherwise disclosed herein.

In further detail, which can be combined with each other or any other part of the disclosure in any combination (unless clearly mutually exclusive), the disclosure further provides:

i) the illuminated portion of the tab includes a tab engagement portion;

ii) the laser may comprise a femtosecond laser or an excimer laser.

Drawings

For a more complete understanding of this disclosure, reference is now made to the following descriptions taken in conjunction with the accompanying drawings which illustrate various aspects of the disclosure, in which like parts bear like numerals, including modified letter designations, such as 10a, 10b, and in which:

FIG. 1A is a schematic top view of a one-piece IOL having two haptics;

FIG. 1B is a schematic side view of the one-piece IOL of FIG. 1A;

fig. 1C is a schematic side view of the one-piece IOL of fig. 1A and 1B, the PD-LNC bent to a bend angle of about 40 °.

FIG. 2A is a schematic top view of a two-piece IOL;

FIG. 2B is a schematic side view of the two-piece IOL of FIG. 2A;

FIG. 3 is a schematic top view of a one-piece IOL having three haptics;

FIG. 4 is a schematic top view of a one-piece IOL having four haptics;

FIG. 5 is a schematic top view of a monolithic IOL having two structurally complex haptics;

FIG. 6 is a schematic top view of a one-piece IOL having two annular haptics;

FIG. 7 is a schematic perspective view of a one-piece IOL having two three-dimensional haptics;

FIG. 8 is a flow chart of a method of implanting and adjusting an IOL;

FIG. 9 is an exemplary graph of the relationship between PD-LCN bend angle and polarization angle of laser radiation;

figure 10 is a diagram of a surgical system for adjusting the position of an IOL.

Detailed Description

The present disclosure relates to intraocular lenses (IOLs) whose position may be adjusted in situ. The disclosure further relates to a method of adjusting the position of such an IOL and a system for adjusting the position of an IOL. In particular, the IOLs of the present disclosure may include at least one haptic formed at least in part from a photoresponsive shape memory polymer network, such as a multidomain azo liquid crystal polymer network (PD-LCN). In response to a particular laser radiation wavelength having a particular polarization, the PD-LCN will predictably bend in a given direction, allowing adjustment of the IOL position within the eye. In addition, the PD-LCN will retain its shape so that the adjusted IOL position is preserved. Further, the PD-LCN bending and IOL position adjustment are reversible in response to different polarizations of the laser radiation.

The IOLs of the present disclosure may be one-piece or modular IOLs (e.g., two-piece or three-piece IOLs). In general, an IOL includes at least one optic and at least one haptic. Haptics are located on one (both) sides of the optic and help maintain the IOL in a stable position within the eye. Depending on the IOL design, the haptics may be integral with or directly coupled to the optic. In some designs, the IOL may also include a separate or integrated base with which the optic and/or haptics may be integrated or coupled. The base may hold the optic, and the tab may be attached to the base. The tab region attached to the optic or base is referred to herein as the tab junction. The components of the modular IOL may be inserted separately and assembled within the eye during surgery.

The entire tab, a portion thereof, or only the tab junction may be formed from PD-LCN. Some IOLs of the present disclosure may include haptics. In this case, all of the loops may include at least a portion formed of PD-LCN. For example, all loops may have a loop junction formed from PD-LCN. In some IOLs with multiple haptics, symmetrically placed haptics, such as haptics opposing each other or haptics at an angle of 120 degrees, may have the same PD-LCN placement to allow for symmetric adjustment of the IOL position. Furthermore, in some IOLs having multiple haptics, the set of haptics, particularly sets of symmetrically placed haptics members thereof, may have different PD-LCN placements to allow the haptics to respond differently to polarized laser radiation, thereby allowing the IOL position to be more finely adjusted.

All IOLs occasionally experience improper placement and therefore the present disclosure is compatible with any type of IOL. A specific IOL is depicted in fig. 1-7 to demonstrate how the PD-LCN may be used in an IOL. One of ordinary skill in the art, with the benefit of this disclosure, may determine the appropriate placement of a PD-LCN in many other types of IOLs besides those specifically described.

Fig. 1A is a schematic diagram of an IOL10a that includes an optic 20a and two haptics 30a attached to the optic 20a and/or base (not shown). Each tab 30a has an arm 40a and a tab junction 50a between the arm 40a and the optic 20 a. Tab engagement portion 50a may attach tab 30a to optic 20a (or base). The IOL also has a center 60 a. Once implanted and secured in the capsular bag, IOL10a may be rotated an angle θ in direction 70 or direction 80 about center 60a by irradiating one or more haptic junctions 50a to cause the PD-LNC to change shape. IOL10a may also be moved anteriorly (anteriorly) in the eye in direction 90 or posteriorly (posteriorly) in direction 100 in the eye as shown in FIG. 1B. Fig. 1C shows IOL10a pushed posteriorly (posteriorly) in direction 100 in the eye after both haptic junctions 50a have been irradiated to cause the PD-LNC to bend to an approximately 40 ° bend angle.

Fig. 2A is a schematic view of IOL10 b, which includes optic 20b and two haptics 30b attached to optic 20b or a base (not shown). Each tab 30b has an arm 40b and a tab junction 50b between the arm 40b and the optic 20 b. After implantation and fixation in the capsular bag, the optic of IOL10 b may be rotated about center 60b in either direction 70 or direction 80 by angle θ. Further, as shown in fig. 2B, optic 20B of IOL 10B may be adjusted anteriorly or posteriorly in the eye in directions 90 or 100, respectively, by illuminating haptic junction 50B to cause PD-LNC to change shape. Figure 2B also illustrates how optic 20B may be positioned within base 110 according to some embodiments of a two-piece IOL.

Fig. 3 is a schematic view of another IOL10 c that includes an optic 20c and three haptics 30c attached to optic 20c or a base (not shown). Each tab 30c has an arm 40c and a tab junction 50c between the arm 40c and the optic 20 c. Tab engagement portion 50c may attach tab 30c to optic 20 c. The IOL also has a center 60 c. After implantation and fixation in the capsular bag, the optic of IOL10 c may be adjusted posteriorly or anteriorly in the eye by illuminating one or more haptic joints 50c to cause the PD-LNC to change shape by an angle θ in direction 70 or direction 80 about center 60c and/or.

Fig. 4 is a schematic view of another IOL10 d that includes an optic 20d and four haptics 30d attached to optic 20d or a base (not shown). Each tab 30d has an arm 40d and a tab junction 50d-1 or 50d-2 between the arm 40d and the optic 20 d. Each tab engagement portion 50d-1 or 50d-2 can attach tab 30d to optic 20d or a base. The IOL also has a center 60 d. After implantation and fixation in the capsular bag, the optic of IOL10 d may be adjusted posteriorly or anteriorly in the eye by rotating angle θ in direction 70 or direction 80 about center 60d and/or by illuminating one or more of haptic junctions 50d-1 and/or 50d-2 to cause the PD-LNC to change shape. The tab junction 50d-1 can be formed from the same PD-LCN as the tab junction 50d-2 or from a different PD-LCN. For example, tab junction 50d-1 may have a different wt% of azobenzene diacrylate liquid crystal monomer or a different crosslink density than tab junction 50d-2, allowing the tab junction to respond differently to polarized laser radiation.

Fig. 5 is a schematic view of another IOL10 e that includes an optic 20e and two haptics 30e attached to optic 20e or a base (not shown). Both haptics 30e have an arm 40e and a haptic joint 50e between the arm 40e and the optic 20 e. Tab engagement portion 50e may attach tab 30e to optic 20 e. The IOL also has a center 60 e. After implantation and fixation in the capsular bag, optic 20e of IOL10 e may be adjusted posteriorly or anteriorly in the eye by illuminating one or more haptic junctions 50e to cause the PD-LNC to change shape in direction 70 or direction 80 by an angle of rotation θ about center 60 e.

Fig. 6 is a schematic view of another IOL10 f, which includes an optic 20f and two loop haptics 30f attached to optic 20f or a base (not shown). Each tab 30f has an arm 40f and at least one tab junction 50f between arm 40f and optic 20 f. A tab engagement portion 50f may attach tab 30f to optic 20 f. The IOL also has a center 60 f. After implantation and fixation in the capsular bag, optic 20f of IOL10 f may be adjusted posteriorly or anteriorly in the eye by rotating angle θ in direction 70 or direction 80 about center 60f by illuminating one or more haptic joints 50f to cause the PD-LNC to change shape.

FIG. 7 is a schematic view of another IOL10 g, which includes an optic 20g and two haptics 30g attached to the optic 20g or base (not shown). Each tab 30g has an arm 40g, which in this example has a complex three-dimensional structure, and at least one tab junction 50g between the arm 40g and the optic 20 g. Tab engagement portion 50g may attach tab 30g to optic 20 g. The IOL also has a center 60 g. After implantation and fixation in the capsular bag, the optics of IOL10 g may be adjusted posteriorly or anteriorly in the eye by illuminating one or more haptic joints 50g to cause the PD-LNC to change shape about center 60g by an angle θ in direction 70 or direction 80 and/or.

In fig. 1A-7, the entire loop 30 may be formed of PD-LCN, or only a portion thereof may be formed of PD-LCN. In particular, tab joint 50 may be formed from PD-LCN and attached to the rest of tab 30 (such as arm 40) and optics 20 or base 110. Further, the tab 30 or tab junction 50 may be formed from more than one type of PD-LCN. For example, the PD-LCN in different portions of tab 30 or tab junction 50 may vary in composition or crosslink density to provide different degrees of response to polarized laser radiation.

PD-LCNs suitable for use in the present disclosure may be any biocompatible PD-LCN that bends in response to exposure to polarized laser radiation in the range of 440nm to 514nm, in the range of 457nm to 514nm or in the range of 440nm to 445nm, or particularly 442nm, where the ranges are inclusive.

The PD-LCN may include cross-linked diacrylate liquid crystal monomers and diacrylate azobenzene liquid crystal monomers. The diacrylate azobenzene liquid crystal monomer may be present at 25 wt% or less, 20 wt% or less, 15 wt% or less, 10 wt% or less, 5 wt% or less, between 0.1 wt% and 25 wt%, between 0.1 wt% and 20 wt%, between 0.1 wt% and 15 wt%, between 0.1 wt% and 10 wt%, between 0.1 wt% and 5 wt%, between 1 wt% and 25 wt%, between 1 wt% and 20 wt%, between 1 wt% and 15 wt%, between 1 wt% and 10 wt%, between 1 wt% and 5 wt%, between 3 wt% and 25 wt%, between 3 wt% and 20 wt%, between 3 wt% and 15 wt%, between 3 wt% and 10 wt%, between 3 wt% and 5 wt%, between 5 wt% and 25 wt%, between 5 wt% and 20 wt%, between 5 wt% and 15 wt%, between 5 wt% and 10 wt%, between 5 wt%, between 10 wt% and 15 wt%, or more, An amount between 10 wt% and 25 wt%, between 10 wt% and 20 wt%, between 10 wt% and 15 wt%, between 15 wt% and 25 wt%, between 15 wt% and 20 wt%, or between 20 wt% and 25 wt%, wherein a range between two amounts includes the endpoints.

PD-LCNs with lower crosslink densities exhibit more pronounced bending responses when exposed to polarized laser radiation than PD-LCNs with higher crosslink densities. For many IOLs, a more pronounced bending response is desired to limit the time required to induce a response. However, for IOLs useful for more controlled bending, the PD-LCN crosslink density may be increased. In addition, some degree of crosslinking is required to form stable PD-LCNs.

The crosslink density may be affected by the formation conditions, particularly the length of the monomers that are photocured in the presence of each other to induce crosslinking. Furthermore, the crosslink density may be affected by the molecular weight of the monomer, with lower molecular weight monomers yielding PD-LCNs with higher crosslink densities, all other factors being equal.

Typically, the PD-LCN used in tab 30 or tab junction 50 will have a crosslink density between 1.0mol/dm3 and 8.0mol/dm 3.

One suitable diacrylate liquid crystal monomer for use in the present disclosure is 4- (3-acryloxypropoxy) -benzoate 2-methyl-1, 4-phenyl ester (also known as 2-toluene-1, 4-diacylbis {4- [3- (acryloxy) propoxy ] benzoate }), which has the following structural formula:

suitable diacrylate azobenzene liquid crystal monomers for use in the present disclosure include 4,4' -bis [ 6-acryloyloxy) hexyloxy ] azobenzene having the following structural formula:

and diacrylates of 4-heptyl 4 '-propylazobenzene, 4-octyl 4' -propylazobenzene, 4-cyano 4 '-heptyloxyazobenzene, and 4-cyano 4' -octyloxyazobenzene.

Although PD-LCN is discussed in detail as an example of an optically responsive shape memory polymer network, other optically responsive shape memory polymer networks can be used in the same manner as PD-LCN. For example, a photoresponsive shape memory polymer network having one or more crosslinkers other than a diacrylate or having different monomers may be used. In a light responsive shape memory polymer network comprising PD-LCN, additives may be used. In general, a photoresponsive shape memory polymer network need only bend in a predictable manner, such as at a predictable bend angle, in response to polarized laser radiation, particularly in response to polarized laser radiation having a given polarization angle.

The present disclosure further provides a method 200 of implanting and adjusting an IOL (such as IOL 10) comprising a light responsive shape memory polymer network (such as PD-LCN) in an eye of a patient, as shown in the flow chart in fig. 8. In step 210, the lens (typically the natural lens, but could be a previous IOL) is removed from the capsular bag. In step 220, the IOL is placed in the capsular bag. During this step, the surgeon attempts to place the IOL in the selected location, but this is not always successful. In step 230, the eye is allowed to heal for a period of time, typically two to four weeks. During this time, the IOL may move or change position within the eye.

In step 240, the patient undergoes a diagnostic eye examination to obtain postoperative data, typically days, weeks, or months after surgery. In step 240, biometric data of the eye may be obtained. In step 240, vision quality data may also be obtained, such as refractive error, including simple refractive measurements, or more complex measurements, such as axis of astigmatism, where appropriate. Step 240 may also begin as an IOL maintenance step, typically weeks, months, or years after initial IOL placement.

In step 250, it is determined whether the patient's visual quality can be improved based at least in part on information from diagnostic eye examinations, such as post-operative biometric data and post-operative refractive error. For example, the patient may experience sub-optimal refraction of the eye, or may still experience astigmatism. For example, a diagnostic eye examination may use, for example, a refractometer or aberrometer to measure refraction or a cylindrical lens.

In step 250, based on data from the diagnostic eye examination, such as post-operative biometric data and post-operative refractive error, a nomogram may be generated to control a laser to apply polarized laser radiation to a photo-responsive shape memory polymer network (such as PD-LCN) to cause a change in the shape of the haptics and thereby cause at least one of translation or rotation of the intraocular lens in the patient's eye to correct the post-operative refractive error. For example, alignment charts can be used to determine the bend angle of an optically responsive shape memory polymer network (such as a PD-LCN), and polarized laser radiation including a polarization angle that will achieve the bend angle. Alternatively, the laser may be controlled in the same manner using a non-nomographic based algorithm. Nomograms may be generated or non-nomogram-based algorithms may be executed using a programmed computer, which may also be capable of receiving and storing data from diagnostic eye exams.

In step 260, polarized laser radiation having a polarization angle is applied to at least the portion of the IOL haptic containing the photoresponsive shape memory polymer network (such as PD-LCN) for a time sufficient to cause bending of the portion of the IOL, adjusting the position of the IOL in the capsular bag.

The illuminated portion of the IOL containing the photoresponsive shape memory polymer network (such as PD-LCN) can be a haptic junction, or another portion of a haptic that can be reached via polarized laser radiation as the pupil of the eye dilates. Thus, prior to illuminating the portion of the IOL haptic containing the light responsive shape memory polymer network (such as the PD-LCN) with polarized laser radiation, the pupil of the patient's eye can be dilated to allow access to the light responsive shape memory polymer network, such as the PD-LCN. In methods where the portion of the IOL containing the light responsive shape memory polymer network (such as PD-LCN) is typically covered by the pupil and not exposed to light, the patient may not need to wear protective eyewear after any surgery to implant or adjust the IOL position.

The polarized laser radiation may be provided by any laser capable of providing a wavelength capable of causing bending of an optically responsive shape memory polymer network (such as a PD-LCN) when passing through the polarizing filter. For example, the laser may be a femtosecond or excimer laser. The wavelength may be in the range of 440nm to 514nm, in the range of 457nm to 514nm, or in the range of 440nm to 445nm, or especially 442nm, wherein these ranges are inclusive.

The polarizing filter may be part of the laser or otherwise placed between the laser and the eye using suitable optics.

The polarization angle may be selected based on the degree of curvature to be achieved by the photoresponsive shape memory polymer network (e.g., PD-LCN). As shown in fig. 9, a thin strip of PD-LCN, such as may be included in a tab, will bend a predictable angle in response to a certain degree of polarized laser radiation. The relationship between the bending angle and the polarization angle tends to be linear. The responsiveness of the bend angle may be determined in part by the crosslink density of the PD-LCN.

The polarized laser light is continuously illuminated for an amount of time determined to be suitable for achieving the target bend angle. For example, the amount of time can be 5 minutes or less, 2 minutes or less, one minute or less, between 0.5 seconds and 1 minute, between 0.5 seconds and 2 minutes, between 0.5 seconds and 5 minutes, between 5 seconds and 1 minute, between 5 seconds and 2 minutes, or between 5 seconds and 5 minutes, wherein a range between two amounts includes the endpoints. The illumination may be constant or pulsed.

The same loop can be illuminated multiple times to obtain the correct bending angle. Further, while only one tab may be illuminated, for many adjustments more than one or all tabs will be illuminated.

Depending on the physical shape of the illuminated portion of the haptic (the haptic illuminated), the location of the haptic(s) in the capsular bag, and the degree of curvature of the resulting photoresponsive shape memory polymer network (such as PD-LCN), the IOL will move to an adjusted position within the capsular bag.

For example, if the IOL's haptics are subjected to laser radiation of a polarization angle that causes the haptics to push against the posterior region of the capsular bag, the IOL will move axially forward in the capsular bag to a more anterior position in the eye. If the IOL's haptics are subjected to laser radiation of a polarization angle that causes the haptics to push against the anterior region of the capsular bag, the IOL will move axially posteriorly in the capsular bag to a more posterior position in the eye. These simple anterior and posterior axial adjustments can change the power of the IOL and correct refractive errors.

More complex IOLs can bend to push against different portions of the capsular bag or undergo internal rotation, allowing the IOL optic to rotate about a center by a target angle. This may be useful, for example, when the patient has astigmatism and the IOL is not properly aligned with the astigmatism axis.

The location and extent of the bend and the polarization angle can be calculated using a computer programmed to access data about the eye and the IOL to calculate the effect of the laser illumination on the bend and location of the IOL optic and to select the appropriate laser illumination location and duration to achieve the target location of the IOL.

The location and duration of the laser radiation, and in some systems, the placement of the polarizing filter, and thus the angle of polarization, may also be implemented using a computer programmed to control the laser. The computer may be the same computer programmed to calculate how to achieve the target position of the IOL or may be a different computer.

For the purposes of this disclosure, a computer includes a processor, memory, and a communication interface.

In step 270, the eye is allowed to recover for a duration sufficient to obtain accurate eye examination results. Typically, the pupil is dilated before step 260, so the duration may be at least long enough to stop over the pupil dilation. For example, the duration may be at least one day or at least one week.

The process then returns to step 240 and the patient is again evaluated to determine if the actual IOL location is the target location.

Although method 200 is described as having multiple steps, the present disclosure includes other methods that include only a portion of those steps (such as steps 240-260, or steps 250-270).

After bending, the photoresponsive shape memory polymer network (such as PD-LCN) remains in place indefinitely, so that permanent adjustments are made using method 200 unless the IOL is moved for other reasons. However, by irradiating the photo-responsive shape memory polymer network (such as PD-LCN) with laser radiation having different polarization angles, the photo-responsive shape memory polymer network (such as PD-LCN) may easily bend multiple times to different degrees. Thus, for example, if the IOL optic is moved too far forward in the eye in step 260, the same haptic can be illuminated with laser radiation of a different polarization angle, thereby bending it to a lesser extent, effectively moving the IOL optic backward in the eye.

The present disclosure further includes a surgical system 300, as shown in FIG. 10, for adjusting the position of an IOL, such as IOL10, in the capsular bag of an eye. System 300 includes a computer 310 that includes a processor 320, a memory 330, and a communication interface 340. The system 300 further comprises a laser 350 capable of providing laser radiation in a suitable range to induce a shape change in the loop material, such as in the range of 440nm to 514nm, 457nm to 514nm, or 440nm to 445nm, or particularly 442nm, where these ranges are inclusive. System 300 may further include a polarizing filter 360 that is capable of adjusting the polarization angle of the radiation from laser 350. The polarizing filter 360 may be part of the laser 350 or a separate component.

Computer 310 may include instructions in memory 330 that, when executed by processor 320, cause the instructions to be sent over communication interface 340 to cause laser 350 and polarizing filter 360 to illuminate portions of the IOL in the capsular bag of a patient's eye to cause the light responsive shape memory polymer network (such as PD-LCN) of the IOL to bend. In particular, when executed by processor 320, the instructions may cause laser 350 and polarizing filter 360 to implement step 260 of method 200. Additionally, memory 330 may store instructions for generating an algorithm or nomogram based on patient-specific biological characteristics, wavefronts, and/or other measurements taken post-operatively, to cause laser 350 to apply light to haptics to cause a shape change that will cause the lens to change position and thus correct any residual refractive error and/or toric misalignment.

The above-disclosed subject matter is to be considered illustrative, and not restrictive, and the appended claims are intended to cover all such modifications, enhancements, and other embodiments, which fall within the true spirit and scope of the present disclosure. Thus, to the maximum extent allowed by law, the scope of the present disclosure is to be determined by the broadest permissible interpretation of the following claims and their equivalents, and shall not be restricted or limited by the foregoing detailed description.