CN105534618B - The manufacture method of multifocal intraocular lenses - Google Patents
The manufacture method of multifocal intraocular lenses Download PDFInfo
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- CN105534618B CN105534618B CN201511011145.2A CN201511011145A CN105534618B CN 105534618 B CN105534618 B CN 105534618B CN 201511011145 A CN201511011145 A CN 201511011145A CN 105534618 B CN105534618 B CN 105534618B
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- 238000004519 manufacturing process Methods 0.000 title claims abstract description 29
- 238000000034 method Methods 0.000 title claims abstract description 21
- 230000003287 optical effect Effects 0.000 claims abstract description 36
- 238000002513 implantation Methods 0.000 claims abstract description 5
- 210000002159 anterior chamber Anatomy 0.000 claims description 70
- 210000001742 aqueous humor Anatomy 0.000 claims description 61
- 230000000007 visual effect Effects 0.000 claims description 50
- 230000004438 eyesight Effects 0.000 claims description 36
- 210000004087 cornea Anatomy 0.000 claims description 19
- 239000011521 glass Substances 0.000 claims description 5
- 238000005259 measurement Methods 0.000 claims description 3
- 230000004323 axial length Effects 0.000 description 51
- 238000003384 imaging method Methods 0.000 description 20
- 230000002980 postoperative effect Effects 0.000 description 12
- 210000001525 retina Anatomy 0.000 description 12
- 208000001491 myopia Diseases 0.000 description 11
- 238000010586 diagram Methods 0.000 description 9
- 210000004127 vitreous body Anatomy 0.000 description 7
- 230000008569 process Effects 0.000 description 6
- 208000002177 Cataract Diseases 0.000 description 5
- 230000004075 alteration Effects 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000006872 improvement Effects 0.000 description 2
- 239000003550 marker Substances 0.000 description 2
- 201000010041 presbyopia Diseases 0.000 description 2
- 206010020675 Hypermetropia Diseases 0.000 description 1
- 206010036346 Posterior capsule opacification Diseases 0.000 description 1
- 230000004308 accommodation Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
- 239000013078 crystal Substances 0.000 description 1
- 230000036040 emmetropia Effects 0.000 description 1
- 210000000871 endothelium corneal Anatomy 0.000 description 1
- 238000005530 etching Methods 0.000 description 1
- 230000004305 hyperopia Effects 0.000 description 1
- 201000006318 hyperopia Diseases 0.000 description 1
- 238000005286 illumination Methods 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 230000004379 myopia Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
- A61F2/1616—Pseudo-accommodative, e.g. multifocal or enabling monovision
- A61F2/1618—Multifocal lenses
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0053—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in optical properties
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- Health & Medical Sciences (AREA)
- Ophthalmology & Optometry (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
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Abstract
The present invention proposes a kind of method for manufacturing multifocal intraocular lenses, and it includes step：Determine the physiological parameter of the art eye of patient；Determine one or more sighting distances of art eye；One or more additional optical focal powers of the multifocal intraocular lenses for art eye are determined according to the physiological parameter of art eye and one or more sighting distances, wherein, one or more additional optical focal powers correspond respectively to one or more sighting distances；And multifocal intraocular lenses of the manufacture with one or more additional optical focal powers so that the multifocal intraocular lenses provide one or more sighting distances after implantation art eye.
Description
Technical Field
The present invention relates to a method of manufacturing a multifocal intraocular lens, and more particularly, to a method of manufacturing a multifocal intraocular lens capable of accurately achieving personalized visual distance(s) of a patient's operated eye.
Background
The normal human eye has the function of focusing parallel rays at infinity onto the retina by refraction through a dioptric medium, and seeing objects at a distance clearly. Before presbyopia occurs, the eye changes the power of the lens by accommodation to enable viewing of objects at close distances and reading. After cataract operation, the eye adjusting device is changed, the adjusting function is correspondingly disappeared, after the monofocal artificial lens is implanted, the ability of seeing far is recovered, but the ability of seeing near is not improved, and the postoperative myopia can be recovered only by depending on a presbyopic glasses. The purpose of refractive cataract surgery is to surgically remove the cataract while implanting an intraocular lens to restore the post-operative patient's physiological vision functions, including looking far, looking near, bright, dark, etc. The implantation of the multifocal artificial lens is an effective measure for solving the dependence of postoperative reading on presbyopia glasses of a patient.
The design principle of the multifocal intraocular lens is that light bands of different focal planes are constructed on an optical surface of the intraocular lens with the diameter of about 6mm by adopting a simultaneous watching mode, so that the function of clear vision for other visual distances except infinity is realized. When the near-looking image is focused on the retina, the far-looking image is out of focus on the retina, and when the far-looking image is focused on the retina, the near-looking image is out of focus on the retina, that is, the far-looking image is focused on the object at the far distance only, and the near-looking image is focused on the object at the near distance only, and the imaging diagram is shown in fig. 1.
Multifocal intraocular lenses include bifocal intraocular lenses, trifocal intraocular lenses, and large focal depth intraocular lenses. The bifocal artificial lens has two focal powers, namely far vision focal power and near vision focal power, and can provide good far vision and near vision for a patient. The trifocal intraocular lens has three focal powers, a far vision focal power, an intermediate vision focal power and a near vision focal power, and can provide good far, intermediate and near vision for a patient. The artificial lens with large focal depth also has three focal powers, and is characterized in that the difference between adjacent focal power values is within 1.5D, the difference between the maximum focal power and the minimum focal power is controlled within 2.5D, and no visual blind spot exists within a certain distance range from infinity. More generally, multifocal intraocular lenses include intraocular lenses capable of providing a distance vision power and one or more distance vision powers.
In contrast to monofocal intraocular lenses, multifocal intraocular lenses function to provide clear vision to the patient at other viewing distances than distance vision. Clear vision at different visual distances is realized by depending on the additional focal power of the multifocal intraocular lens, the additional focal power of the multifocal intraocular lens in the prior art is determined according to the near-vision and intermediate-range working distances commonly used by presbyopic patients, such as the distances for reading, writing and operating computers, and the value is single and fixed, for example, the TECNIS multifocal intraocular lens near-vision additional focal power of AMO is + 4.0D; AcrySof RESTOR multifocal intraocular lens of Alcon has a near add power of + 3.0D; the acri, lisa multifocal intraocular lens of Zeiss has a near add power of + 3.75D; the AT Lisa tri 839M trifocal intraocular lens from Zeiss has a add power of +1.66D in the middle of the eye and a near add power of +3.33D in the near eye. The multifocal artificial lens with single fixed additional focal power can only realize single visual distance for a patient, and for the patient with unmatched visual distance between the visual distance in a natural state and the visual distance provided by the additional focal power, long-term training is needed to change the conventional usual visual distance habit after the lens is implanted, so that the multifocal artificial lens is adapted to the specific visual distance provided by the human eye; meanwhile, different patients have different ocular physiological parameters, such as corneal diopter, anterior chamber depth, ocular axis length and the like, which affect the visual range of the multifocal intraocular lens implanted into the human eye, that is, even if the intraocular lens with the same additional focal power is implanted, the visual range obtained by different patients is different, and the prior art cannot accurately predict the postoperative visual range for the patient before the operation, thereby bringing troubles to doctors and patients.
The choice of multifocal intraocular lenses is dominated by emmetropia, the power of which is calculated to favor the postoperative mid-range and near vision. The postoperative refractive state of the patient should be hypermetropia at 0 degrees to achieve good distance and visual range vision. The accuracy of intraocular lens power calculation is affected by many factors: the accuracy of the measurement of the axial length of the eye, the corneal power and the like, the selection of an IOL calculation formula and the prediction of the postoperative anterior chamber depth are also important factors influencing the selection of the intraocular lens power. Along with the improvement of the accuracy of the eye measuring instrument for measuring the physiological parameters of the eye structure and the continuous improvement of the calculation formula of the diopter of the artificial lens, a doctor can accurately give the far-vision focal power of the artificial lens of the eye of a patient, but cannot determine the additional focal power required by realizing good vision at the visual distance.
Disclosure of Invention
The present invention provides a method of manufacturing a multifocal intraocular lens comprising the steps of: determining a physiological parameter of an operative eye of a patient; determining one or more viewing distances of the operative eye; determining one or more additional optical powers for a multifocal intraocular lens of the operative eye as a function of the physiological parameters of the operative eye and one or more visual distances of the operative eye, wherein the one or more additional optical powers correspond to the one or more visual distances, respectively; and manufacturing a multifocal intraocular lens having the one or more additional optical powers such that the multifocal intraocular lens provides the one or more vision distances after implantation in the operative eye.
Compared with the prior art, the invention has the advantages that one or more additional optical powers of the multifocal intraocular lens are determined according to different visual distance requirements and physiological parameters of the operative eye of the patient, and the visual distance of the operative eye of the patient is not determined by the inherent properties of the existing multifocal intraocular lens. The manufacturing method of the multifocal artificial lens is a personalized method, can customize the multifocal artificial lens which meets one or more visual distances of the operative eye of the patient according to the actual requirement of the operative eye of the patient, and avoids the trouble and puzzlement that the patient needs to adapt to a new visual distance after the operative eye operation.
Drawings
A more complete understanding of the present disclosure may be derived and other advantages may be realized by reference to the following detailed description and claims when considered in conjunction with the accompanying drawings. Like reference symbols in the various drawings indicate like elements. In the drawings:
FIG. 1 shows an imaging schematic of a multifocal intraocular lens;
figure 2a shows a schematic view of a refractive multifocal intraocular lens;
figure 2b shows a schematic imaging of a refractive multifocal intraocular lens;
figure 3a shows a schematic view of a diffractive multifocal intraocular lens;
figure 3b shows an imaging schematic of a diffractive multifocal intraocular lens;
FIG. 4 shows a flow chart of a design of a personalized multifocal intraocular lens;
FIG. 5 is a schematic diagram of the optical path of distance vision power versus the parameters of the eye, with the light traveling in the left-to-right direction;
fig. 6 shows a schematic diagram of the optical path for determining the additional power, the direction of propagation of the light rays being from left to right.
Detailed Description
There are two optical principles for implementing multifocal intraocular lenses: the refraction principle and the diffraction principle. Multifocal intraocular lenses manufactured using the principle of refraction are called refractive multifocal intraocular lenses, and multifocal intraocular lenses manufactured using the principle of diffraction are called diffractive multifocal intraocular lenses. Whether refractive or diffractive multifocal intraocular lenses, the critical manufacturing parameter that determines them is the add power.
The refractive multifocal intraocular lens is formed by constructing refractive light bands with different curvature radiuses on an optical surface, wherein the annular bands provide far vision and clear vision distance, the structural schematic diagram is shown in figure 2a, and the imaging schematic diagram is shown in figure 2 b. The far vision zone and the visual distance zone are alternately distributed, the far vision zone provides clear far vision, and the curvature radius of the far vision zone is determined by the far vision focal power; the distance zone provides clear distance vision, the radius of curvature of which is determined by the distance power, the difference between the distance power and the distance power being the add power.
The diffractive multifocal intraocular lens is formed by etching diffraction zone zones with certain width and height on the optical surface of the intraocular lens, the structural schematic diagram is shown in figure 3a, incident light is distributed to far vision distance and visual distance in a diffractive mode by utilizing different diffraction orders of the diffraction zone zones, and the imaging schematic diagram is shown in figure 3 b. The radius of curvature of the optical surface of the diffractive multifocal intraocular lens is determined by the distance power, the width of the diffractive ring is determined by the add power, and the height of the diffractive ring is determined by the ratio of the optical power distribution at distance and distance.
The method for manufacturing the multifocal intraocular lens of the present invention comprises: determining a physiological parameter of an operative eye of a patient; determining one or more viewing distances of the operative eye; determining one or more additional optical powers for a multifocal intraocular lens of the operative eye based on the physiological parameters of the operative eye and one or more visual distances of the operative eye, wherein the one or more additional optical powers correspond to the one or more visual distances, respectively; a multifocal intraocular lens is manufactured according to the determined one or more add powers. In particular, the process for determining one or more additional powers according to the method of the invention comprises the steps of: determining the relation between the physiological parameters of the operative eye and the far vision focal power of a multifocal artificial lens of the operative eye of the patient under the condition of parallel light incidence; and under the condition of incidence of the point light source, determining one or more additional optical powers of the multifocal artificial lens of the operative eye according to one or more visual distances and physiological parameters of the operative eye of the patient. A schematic flow diagram of this process is shown in fig. 4.
The physiological parameters of the operated eye comprise corneal parameters, aqueous humor refractive index, anterior chamber depth and vitreous refractive index.
In one embodiment, the corneal parameter may be corneal power. In another embodiment, the corneal parameter may be data for calculating corneal power, the data for calculating corneal power including a refractive index of the cornea and including a curvature or a radius of curvature of the cornea.
The above process of determining the add power for the apparent distance of the operative eye of the patient is performed in a model of the human eye. The basic structure of the human eye model comprises an optical system consisting of a cornea, aqueous humor, an artificial lens, a vitreous body and a retina. The incident light rays being in air with refractive index markersAqueous refractive index markerRefractive index mark of glass bodyCorneal diopter scaleHuman anterior chamber depth value markerThe distance between the intraocular lens and the retina is markedMultifocal intraocular lens distance vision power markVisual distance power markLine-of-sight markingAnd the add power is marked。
Under the condition of parallel light incidence, light rays in air are incident on the surface of the cornea in a direction perpendicular to the main plane of the cornea, sequentially pass through the cornea, aqueous humor, an artificial lens and a vitreous body, and finally are imaged on a retina. The purpose of this step is to determine the far-vision power of the multifocal intraocular lens and the anterior chamber depth of the operated eye with the physiological parameters of the operated eye and the far-vision power of the multifocal intraocular lens knownAnd the distance between the intraocular lens and the retinaThe optical path is schematically shown in FIG. 5.
Under the condition of point light source incidence, a point light source in the air is incident on the surface of the cornea under the condition of certain visual distance, sequentially passes through the cornea, the aqueous humor, the artificial lens and the vitreous body, and finally is imaged on the retina. The purpose of this step is to determine the optical power of the multifocal intraocular lens at the optical distance and at the addition power, with the optical path schematic shown in figure 6, given the known optical distance and surgical eye parameters.
The difference between the apparent distance focal power and the apparent distance focal power is the additional focal power.
The above-mentioned process of determining the distance-of-sight optical power and the add power for the distance-of-sight of the operative eye of the patient can be performed in a model of the human eye, and the required parameter is the corneal diopterAnterior chamber depthDistance between intraocular lens and retinaRefractive index of airRefractive index of aqueous humorRefractive index of vitreous bodyDistance of sightThese parameters may be measured by means known in the art.
Under the condition of parallel light incidence (see fig. 5), the imaging is divided into two parts of cornea imaging and intraocular lens imaging.
Marking object distances of incident light during corneal imagingPicture distance markingAccording to the principle of lens imaging
Thereby obtaining
（1）
During the imaging of the intraocular lens, the object distance isAn image distance of(distance between intraocular lens and retina) according to the principle of lens imaging
Thereby obtaining
（2）
Under the condition of the incidence of the point light source (shown in figure 6), the imaging is still divided into two parts of cornea imaging and artificial lens imaging.
In the process of imaging the cornea, the object distance (visual distance) isPicture distance markingAccording to the principle of lens imaging
Thereby obtaining
（3）
During the imaging of the intraocular lens, the object distance isAn image distance ofAccording to the principle of lens imaging
Thereby obtaining
（4）
Obtaining an additional power according to the formulae (1) to (4)Is expressed as
（5）。
According to the manufacturing method of the multifocal artificial lens, the additional focal power of the multifocal artificial lens is related to the visual distance of an operative eye, the corneal diopter, the anterior chamber depth, the aqueous humor refractive index, the vitreous body refractive index and the air refractive index, and the specific relation is shown in the formula (5).
The conditions related to the present invention, such as the cornea parameters of the operative eye, the refractive index of aqueous humor, the anterior chamber depth and the refractive index of vitreous body, are not limited to these conditions, and are all protection contents included in the present invention as long as the patient can achieve the required and accurate visual distance according to the parameters and visual distance of the operative eye.
One or more of the corneal parameters, aqueous refractive index, anterior chamber depth, and vitreous refractive index of the operative eye described in the present invention may be measured in practice not using prior art means, but using statistical averages or approximations in the art. In one embodiment, the anterior chamber depth may be measured using the operative eye, and the corneal parameters, aqueous humor refractive index, and vitreous refractive index may be statistically averaged or approximated in the art. In one embodiment, the corneal parameters and anterior chamber depth can be measured using the operative eye, and the aqueous humor refractive index and the vitreous refractive index can be statistically averaged or approximated in the art. In one embodiment, the corneal parameters, anterior chamber depth, and aqueous humor refractive index may be measured using the surgical eye, and the vitreous refractive index may be taken using statistical averages or approximations known in the art. In one embodiment, the corneal parameters, anterior chamber depth, aqueous humor refractive index, and vitreous refractive index may all be measured using the operated eye. Furthermore, the refractive index of the glass body can be replaced or approximated by the refractive index of aqueous humor.
Those skilled in the art will appreciate that good distance vision is achieved for the patient, while effective near and intermediate distance vision is achieved, achieving satisfactory post-operative vision quality. According to the daily life needs and professional characteristics of patients, the crystal types and parameters of the operative eyes of the patients need to be individually designed.
For the patient with cataract of single eye, the operation eye can select refractive multifocal artificial lens and can also select diffractive multifocal artificial lens, and the additional optical power is determined by physiological parameters and visual distance of the operation eye.
For the patient with the binocular cataract, refractive multifocal artificial lenses can be implanted into both eyes simultaneously, or diffractive multifocal artificial lenses can be implanted into both eyes simultaneously, or refractive multifocal artificial lenses can be implanted into one eye and diffractive multifocal artificial lenses can be implanted into the other eye. Under different illumination conditions, the diffractive multifocal intraocular lens and the refractive multifocal intraocular lens have complementary effects, the diffractive multifocal intraocular lens has strong near distance effect under strong light, and the refractive multifocal intraocular lens has strong near distance effect under dark light. The combined implantation of two different types of multifocal intraocular lenses can improve the postoperative visual range of the patient and provide high quality full-range vision.
For patients with cataract in both eyes, multifocal intraocular lenses of the same add power can be implanted in both eyes simultaneously or multifocal intraocular lenses of different add powers can be implanted in both eyes. Alternatively, a monofocal intraocular lens may be implanted in one eye and a multifocal intraocular lens may be implanted in the other eye. Alternatively, one eye may be implanted with a multifocal intraocular lens and the other eye may be implanted without an intraocular lens. For some patients, a multifocal intraocular lens with low add power is implanted in one eye and a multifocal intraocular lens with high add power is implanted in the other eye, one postoperative eye of the patient has clear vision at distance while the other postoperative eye is satisfied with near vision, and postoperative binocular synergy enables reasonably good depth of focus. For patients who do not read much, multifocal artificial lenses with low additional focal power can be implanted into both eyes, satisfactory distance vision can be obtained after operation, and the requirement of daily near-distance work can be met by near vision; if the reading requirement of the patient is more, the patient can choose to implant a multifocal artificial lens with high additional optical power in both eyes, and good near vision can be provided after the operation.
It will be appreciated by those skilled in the art that for a plurality of viewing distances, the viewing distance power and add power corresponding to each viewing distance may be calculated separately according to the above formula.
The process of determining the visual distance focal power and the additional focal power of the multifocal intraocular lens according to the physiological parameters of the operative eye and the visual distance of the operative eye can be realized in an eye model by adopting a ray tracing mode. Parallel rays sequentially pass through a cornea, aqueous humor, an artificial lens and a vitreous body to form an image on a retina, and when the aberration of an image point is minimum, the focal power of the corresponding multifocal artificial lens is determined as the far vision focal power; the point light source light sequentially passes through the cornea, the aqueous humor, the artificial lens and the vitreous body to form an image on the retina, and when the aberration of an image point is minimum, the focal power of the corresponding multifocal artificial lens is the focal power of the visual range. The difference between the visual distance focal power and the visual distance focal power is the additional focal power.
Some specific examples according to the principles of the present invention are given below
Bifocal intraocular lens embodiments
1. Determining visual range and manufacturing parameters of bifocal intraocular lens under different operative eye structure physiological parameters
1.1 corneal diopter and anterior chamber depth determination, multifocal intraocular lens manufacturing parameters at different axial lengths of the eye
Example 1:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 28.40 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.85D.
Example 2:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.85D.
Example 3:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 20.50 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.85D.
1.2 determination of anterior chamber depth and axial Length of eye, manufacturing parameters of multifocal intraocular lenses with different corneal diopters
Example 4:
the corneal diopter was 35.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.75D.
Example 5:
the corneal diopter was 44.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.88D.
Example 6:
the corneal diopter was 50.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.97D.
1.3 manufacturing parameters of multifocal intraocular lenses at different anterior chamber depths with corneal diopter and axial length determinations
Example 7:
the corneal diopter was 42.25D, the anterior chamber depth value L2=0.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.37D.
Example 8:
the corneal diopter was 42.25D, the anterior chamber depth value L2=2.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 2.69D.
Example 9:
the corneal diopter was 42.25D, the anterior chamber depth value L2=4.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 3.09D.
Example 10:
the corneal diopter was 42.25D, the anterior chamber depth value L2=6.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm, the add power determined was + 3.58D.
2. Determination of physiological structure parameters of operative eye and manufacturing parameters of bifocal artificial lens under different visual distances
Example 11:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 30cm, the add power determined was + 4.08D.
Example 12:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 38cm, the add power determined was + 3.20D.
Example 13:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 53cm, the add power determined was + 2.32D.
Example 14:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 68cm, the add power determined was + 1.81D.
The data from the above examples are summarized in table 1.
Trifocal intraocular lens embodiments
1. Determining visual distance, and manufacturing parameters of trifocal intraocular lens under different operative eye structure physiological parameters
1.1 corneal diopter and anterior chamber depth determination, multifocal intraocular lens manufacturing parameters at different axial lengths of the eye
Example 1:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 28.40 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +2.85D and the add power 2 was determined to be + 1.23D.
Example 2:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 is determined to be +2.85D and the add power 2 is determined to be + 1.23D.
Example 3:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 20.50 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +2.85D and the add power 2 was determined to be + 1.23D.
1.2 determination of anterior chamber depth and axial Length of eye, manufacturing parameters of multifocal intraocular lenses with different corneal diopters
Example 4:
the corneal diopter was 35.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +2.75D and the add power 2 was determined to be + 1.19D.
Example 5:
the corneal diopter was 44.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 is determined to be +2.88D and the add power 2 is determined to be + 1.24D.
Example 6:
the corneal diopter was 50.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +2.97D and the add power 2 was determined to be + 1.28D.
1.3 manufacturing parameters of multifocal intraocular lenses at different anterior chamber depths with corneal diopter and axial length determinations
Example 7:
the corneal diopter was 42.25D, the anterior chamber depth value L2=0.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +2.37D and the add power 2 was determined to be + 1.02D.
Example 8:
the corneal diopter was 42.25D, the anterior chamber depth value L2=2.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +2.69D and the add power 2 was determined to be + 1.16D.
Example 9:
the corneal diopter was 42.25D, the anterior chamber depth value L2=4.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +3.09D and the add power 2 was determined to be + 1.33D.
Example 10:
the corneal diopter was 42.25D, the anterior chamber depth value L2=6.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 43cm 1 and a viewing distance of 100cm 2, the add power 1 was determined to be +3.58D and the add power 2 was determined to be + 1.55D.
2. Determination of physiological structure parameters of operative eye and manufacturing parameters of trifocal artificial lens under different visual distances
Example 11:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 30cm 1 and a viewing distance of 80cm 2, the add power 1 was determined to be +4.08D and the add power 2 was determined to be + 1.54D.
Example 12:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 38cm for 1 and 90cm for 2, add power 1 was determined to be +3.2D and add power 2 was determined to be + 1.37D.
Example 13:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance 1 of 53cm and a viewing distance 2 of 110cm, the add power 1 is determined to be +2.32D and the add power 2 is determined to be + 1.12D.
Example 14:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 68cm 1 and a viewing distance of 120cm 2, the add power 1 is determined to be +1.81D and the add power 2 is determined to be + 1.03D.
The data from the above examples are summarized in table 2.
Large focal depth intraocular lens embodiments
1. Determining visual range and manufacturing parameters of artificial lens with large focal depth under different eye structure physiological parameters
1.1 corneal diopter and anterior chamber depth determination, Large focal depth intraocular lens manufacturing parameters at different axial lengths
Example 1:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 28.40 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the determined add power 1 is +2.05D and the determined add power 2 is + 1.03D.
Example 2:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the determined add power 1 is +2.05D and the determined add power 2 is + 1.03D.
Example 3:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 20.50 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the determined add power 1 is +2.05D and the determined add power 2 is + 1.03D.
1.2 determining the anterior chamber depth and the length of the ocular axis, and manufacturing parameters of the artificial lens with large focal depth under different cornea diopter conditions
Example 4:
the corneal diopter was 35.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the add power 1 is determined to be +1.97D and the add power 2 is determined to be + 0.99D.
Example 5:
the corneal diopter was 44.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance 1 of 60cm and a viewing distance 2 of 120cm, the determined add power 1 is +2.07D and the determined add power 2 is + 1.04D.
Example 6:
the corneal diopter was 50.0D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the determined add power 1 is +2.13D and the determined add power 2 is + 1.07D.
1.3 corneal diopter and axial length determination, and large focal depth artificial lens manufacturing parameters under different anterior chamber depth conditions
Example 7:
the corneal diopter was 42.25D, the anterior chamber depth value L2=0.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the add power 1 is determined to be +1.70D and the add power 2 is determined to be + 0.85D.
Example 8:
the corneal diopter was 42.25D, the anterior chamber depth value L2=2.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the add power 1 is determined to be +1.93D and the add power 2 is determined to be + 0.97D.
Example 9:
the corneal diopter was 42.25D, the anterior chamber depth value L2=4.30mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance 1 of 60cm and a viewing distance 2 of 120cm, the add power 1 is determined to be +2.22D and the add power 2 is determined to be + 1.11D.
Example 10:
the corneal diopter was 42.25D, the anterior chamber depth value L2=5.80mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 60cm 1 and a viewing distance of 120cm 2, the add power 1 is determined to be +2.48D and the add power 2 is determined to be + 1.24D.
2. Determination of physiological structure parameters of operative eye and manufacturing parameters of artificial lens with large focal depth under different visual distances
Example 11:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 50cm 1 and a viewing distance of 100cm 2, the add power 1 is determined to be +2.46D and the add power 2 is determined to be + 1.23D.
Example 12:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 70cm 1 and a viewing distance of 110cm 2, the add power 1 is determined to be +1.76D and the add power 2 is determined to be + 1.12D.
Example 13:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 80cm 1 and a viewing distance of 120cm 2, the add power 1 is determined to be +1.54D and the add power 2 is determined to be + 1.03D.
Example 14:
the corneal diopter was 42.25D, the anterior chamber depth value L2=3.16mm, and the axial length L2+ L3 was 23.10 mm. Air refractive index n1=1, aqueous humor refractive index n2=1.336, and vitreous refractive index n3= 1.336. At a viewing distance of 90cm for 1 and 130cm for 2, the add power 1 was determined to be +1.37D and the add power 2 was determined to be + 0.95D.
The data from the above examples are summarized in table 3.
The terms:
visual range: the distance between the point source and the cornea is, in this patent, other than an infinite distance.
Anterior chamber depth: the distance between the corneal endothelium and the anterior surface of the lens is used in the schematic diagrams shown in fig. 5 and 6And (4) showing.
Visual distance focal power: under the condition of visual distance, the focal power required by clear vision is obtained.
Additional optical power: the difference between the apparent distance focal power and the apparent distance focal power.
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Claims (10)
1. A method of manufacturing a multifocal intraocular lens comprising the steps of:
determining a physiological parameter of an operative eye of a patient;
determining one or more viewing distances of the operative eye;
determining one or more additional optical powers for a multifocal intraocular lens of the operative eye from the physiological parameters of the operative eye and one or more visual distances of the operative eye, wherein the one or more additional optical powers correspond to the one or more visual distances, respectively, wherein an additional optical power is a difference between a visual distance optical power and a far vision optical power; and
manufacturing a multifocal intraocular lens having the one or more additional optical powers such that the multifocal intraocular lens provides the one or more vision distances after implantation in the operative eye.
2. The method of claim 1, wherein the physiological parameters of the operative eye include corneal parameters, anterior chamber depth, aqueous humor refractive index, and vitreous refractive index.
3. The method of claim 2, wherein anterior chamber depth employs measurements of the operative eye and corneal parameters, aqueous humor refractive index, and vitreous refractive index employ statistical averages or approximations.
4. The method of claim 2, wherein corneal parameters and anterior chamber depth are taken from measurements of the operative eye, and the aqueous humor refractive index and the vitreous refractive index are taken from statistical averages or approximations.
5. The method of claim 2, wherein the corneal parameters, anterior chamber depth, and aqueous humor refractive index are measured using the operative eye, and the vitreous refractive index is taken as a statistical average or approximation.
6. The method of claim 2, wherein the corneal parameters, anterior chamber depth, aqueous humor refractive index, and vitreous refractive index are all measured using the operative eye.
7. The method of any one of claims 2-6, wherein the corneal parameter is corneal diopters.
8. The method according to any one of claims 2-6, wherein the corneal parameter is data for calculating corneal power, the data for calculating corneal power comprising a refractive index of the cornea and comprising a curvature or radius of curvature of the cornea.
9. The method of claim 1, wherein the add power of the multifocal intraocular lens is determined according to the formula:，
wherein,in order to add an optical power to the optical system,is the diopter of the cornea,is the depth of the anterior chamber,in order to determine the distance of sight,is a refractive index of air and is,is the refractive index of aqueous humor, andis the refractive index of the glass body.
10. The method of claim 1, wherein the step of determining one or more additional powers for a multifocal intraocular lens of the operative eye is performed in a model of the human eye using ray tracing.
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