Method of altering the refractive properties of an eye

Patent metadata

Field	Value
Publication number	US-9814567-B2
Application number	US-201615186331-A
Country	US
Kind code	B2
Filing date	Jun 17, 2016
Priority date	Nov 7, 2001
Publication date	Nov 14, 2017
Grant date	Nov 14, 2017

Abstract

The present invention relates to a method of altering the refractive properties of the eye, the method including forming a pocket in a cornea of an eye of a patient so as to gain access to tissue bounding the pocket; after the pocket in the cornea has been formed, applying a photosensitizer inside the pocket so that the photosensitizer permeates at least a portion of the tissue bounding the pocket, the photosensitizer facilitating cross-linking of the tissue bounding the pocket; inserting a lens implant into the pocket so as to change the refractive properties of the eye; and irradiating the cornea so as to activate cross-linkers in the portion of the tissue bounding the pocket and thereby stiffen the cornea and prevent corneal ectasia of the cornea.

First claim

The invention claimed is:

1. A method of altering the refractive properties of an eye, said method comprising the steps of:
forming a pocket in a cornea of an eye of a patient so as to gain access to tissue bounding the pocket, wherein the forming of the pocket in the cornea of the eye severs some corneal nerves supplying a front surface of the cornea so as to reduce the postoperative pain sensation that is felt by the patient, but does not sever all of the corneal nerves supplying the front surface of the cornea so as to prevent a formation of dry eye in the patient;
after the pocket in the cornea has been formed, applying a photosensitizer inside the pocket so that the photosensitizer permeates at least a portion of the tissue bounding the pocket, the photosensitizer facilitating cross-linking of the tissue bounding the pocket;
inserting a lens implant into the pocket so as to change the refractive properties of the eye; and
irradiating the cornea so as to activate cross-linkers in the portion of the tissue bounding the pocket and thereby stiffen the cornea and prevent corneal ectasia of the cornea;
wherein the cross-linking of the tissue bounding the pocket does not adhere the lens implant to the tissue bounding the pocket so that the lens implant is capable of being subsequently replaced, and the cross-linking of the tissue bounding the pocket does not adhere spaced apart portions of the tissue bounding the pocket to one another.

2. The method according to claim 1 , wherein the step of forming the pocket in the cornea of the eye severs less than one-half of the corneal nerves supplying the anterior corneal sub-epithelial plexus so as to prevent the formation of dry eye in the patient.

3. The method according to claim 1 , wherein the step of forming the pocket in the cornea of the eye comprises forming the pocket in stromal tissue of the cornea.

4. The method according to claim 1 , wherein the pocket formed in the cornea of the eye has a diameter between about 1 millimeter and about 12 millimeters.

5. The method according to claim 1 , wherein the pocket formed in the cornea of the eye has a shape selected from the group consisting of: (i) a disk shape, (ii) a ring or doughnut shape, and (iii) a sectorial shape.

6. The method according to claim 1 , wherein the photosensitizer comprises riboflavin in a biocompatible fluid, the riboflavin being provided in a concentration of between approximately 0.2% and approximately 4.0% in the biocompatible fluid; and
wherein the step of applying the photosensitizer inside the pocket comprises injecting the biocompatible fluid containing the riboflavin inside the pocket using a needle.

7. The method according to claim 6 , wherein the biocompatible fluid containing the riboflavin is injected into the pocket for a time duration that is sufficient to enable the riboflavin to penetrate at least 20 microns into the tissue bounding the pocket.

8. The method according to claim 1 , further comprising the step of:
applying the photosensitizer inside the pocket one or more additional times and irradiating the cornea one or more additional times to cross-link the tissue bounding the pocket so as to prevent any cellular invasion in an area surrounding the lens implant after the initial implantation of the lens implant without adhering the lens implant to the tissue bounding the pocket and without adhering the spaced apart portions of the tissue bounding the pocket to one another.

9. The method according to claim 1 , wherein the lens implant has a thickness between approximately 10 microns and approximately 400 microns.

10. The method according to claim 1 , wherein the lens implant has a shape selected from the group consisting of: (i) a disk shape, (ii) a ring or doughnut shape, and (iii) a sectorial shape.

11. The method according to claim 1 , further comprising the step of:
replacing the lens implant with a new lens implant in order to correct the remaining refractive error of the eye or to correct a new refractive error that has developed in the eye.

12. The method according to claim 1 , wherein the lens implant has a predetermined refractive index and a predetermined curvature, and wherein one or both of the predetermined refractive index and the predetermined curvature of the lens implant are used to change the refractive properties of the eye.

13. The method according to claim 1 , wherein the lens implant is formed from a transparent organic biocompatible material, a transparent synthetic biocompatible material, or a combination of a transparent organic biocompatible material and a transparent synthetic biocompatible material.

14. The method according to claim 1 , wherein the lens implant has a plurality of holes disposed therein, each of the plurality of holes having a hole diameter between approximately 0.1 microns and approximately 100 microns.

15. The method according to claim 14 , wherein the lens implant comprises a first subset of the plurality of holes within a central region and a second subset of the plurality of holes within a peripheral region outside the central region, the central region having a diameter of 5 millimeters; and
wherein each of the first subset of the plurality of holes has a hole diameter between approximately 0.1 microns and approximately 4 microns, and each of the second subset of the plurality of holes has a hole diameter between approximately 1 micron and approximately 100 microns.

16. The method according to claim 1 , wherein the lens implant has a dioptric power between −20 diopters and +20 diopters for spherical correction and a dioptric power between −6 diopters and +6 diopters for correction of astigmatism.

17. The method according to claim 1 , wherein the lens implant is disposed in a corneal location selected from the group consisting of: (i) a center location over the visual axis of the eye for correcting myopia, hyperopia, or astigmatism, (ii) an off-center location from the visual axis of the eye for correcting presbyopia, (iii) a location surrounding a central portion of the cornea, but not overlapping the visual axis of the eye for creating a bifocal cornea, (iv) a location circumscribing a peripheral portion of the cornea for treating a peripheral degenerative corneal disease, and (v) a peripheral location overlapping a sectorial portion of the cornea.

18. The method according to claim 1 , wherein the lens implant comprises a circular plate made of a cross-linked collagen so as to add structural rigidity to the cornea of the eye; and wherein the method further comprises the step of:
implanting a mesh formed from nanoparticles into the pocket formed in the cornea so as to add further structural rigidity to the cornea of the eye.

19. The method according to claim 18 , wherein the nanoparticles forming the mesh comprise graphene.

20. The method according to claim 1 , further comprising the step of:
after the lens implant has been inserted into the pocket, ablating the front surface of the cornea so as to further alter the refractive properties of the eye and to eliminate any residual refractive error remaining after initial refractive error correction by the lens implant.

21. The method according to claim 20 , wherein the step of ablating a front surface of the cornea so as to change the refractive properties of the eye comprises performing a mini-photorefractive keratectomy (mini-PRK) procedure on the front surface of the cornea, the mini-PRK procedure being limited to a central region of the cornea having a diameter b

Assignees

• Peyman Gholam A

Inventors

• Peyman Gholam A

Classifications

• A61F2007/0004

  Eyes or part of the face surrounding the eyes · CPC title

• A61F9/0079

  using non-laser electromagnetic radiation, e.g. non-coherent light or microwaves · CPC title

• A61F9/00821

  for coagulation · CPC title

• A61F7/007

  characterised by electric heating · CPC title

• A61F9/00812

  Inlays; Onlays; Intraocular lenses [IOL] · CPC title