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WO1998005279A1 - Correction de la vision - Google Patents

Correction de la vision Download PDF

Info

Publication number
WO1998005279A1
WO1998005279A1 PCT/US1996/012855 US9612855W WO9805279A1 WO 1998005279 A1 WO1998005279 A1 WO 1998005279A1 US 9612855 W US9612855 W US 9612855W WO 9805279 A1 WO9805279 A1 WO 9805279A1
Authority
WO
WIPO (PCT)
Prior art keywords
vision correction
region
cornea
powers
regions
Prior art date
Application number
PCT/US1996/012855
Other languages
English (en)
Inventor
James R. Largent
Original Assignee
Allergan
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Allergan filed Critical Allergan
Priority to JP10506888A priority Critical patent/JP2000515044A/ja
Priority to PCT/US1996/012855 priority patent/WO1998005279A1/fr
Priority to EP96930497A priority patent/EP0858303A1/fr
Publication of WO1998005279A1 publication Critical patent/WO1998005279A1/fr

Links

Classifications

    • 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
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • 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
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00802—Methods or devices for eye surgery using laser for photoablation
    • A61F9/00804—Refractive treatments
    • A61F9/00808—Inducing higher orders, e.g. for correction of presbyopia
    • 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
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00802—Methods or devices for eye surgery using laser for photoablation
    • A61F9/00817—Beam shaping with masks
    • 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
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00872—Cornea
    • 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
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00885—Methods or devices for eye surgery using laser for treating a particular disease
    • A61F2009/00895—Presbyopia

Definitions

  • This invention relates to vision correction and more particularly to vision correction by shaping of the cornea.
  • vision correction is often obtained through the use of ophthalmic lenses, such as eye glasses and/or contact lenses. It is also known to employ corneal inlays, corneal onlays and intraocular lenses. Another technique for vision correction is to modify the cornea, and this can be done, for example, through a radial keratotomy procedure. It is also known to shape the cornea utilizing a laser and to correct for nearsightedness, farsightedness or astigmatism. It is not uncommon, however, for a patient to require correction for both near and far distances, and some patients also need correction for intermediate distances. It is also desirable at least in some instances to provide a patient with progressive vision correction powers. Although this can be accomplished thorough the use of ophthalmic lenses, so far as I am aware, ultifocal correction and progressive correction through cornea shaping are not taught in the prior art .
  • This invention provides a method of vision correction which achieves multifocal and/or progressive vision correction through shaping of the cornea thereby enabling these corrections to be obtained without the need for an ophthalmic lens.
  • the shaping of the cornea alters the configuration of the anterior surface of the cornea thereby changing its refraction.
  • This cornea shaping technique can be utilized for patients having their natural lens or an intraocular lens.
  • the method of vision correction may include shaping first and second regions of the anterior surface of a cornea to provide the first region with a surface configuration which provides a first vision correction power and to provide the second region with a surface configuration which provides a second vision correction power which is different from the first vision correction power to enhance vision at first and second different distances, respectively.
  • the distances may be near and far distances to thereby provide a bifocal effect.
  • the cornea shaping may be carried out to achieve trifocal correction or any other desired number of steps of vision correction.
  • the cornea may be shaped to provide progressive vision correction powers.
  • the step of shaping may include shaping a third region of the cornea between the first and second regions to provide a surface configuration which provides the progressive vision correction powers with the progressive vision correction powers including vision correction powers which are between the first and second vision correction powers .
  • the preferred method includes shaping a fourth region of the cornea to provide a surface configuration which provides progressive vision correction powers which include progressive vision correction powers which are between the first and second vision correction powers.
  • the second region is between the third region and the fourth region.
  • each of the shaped regions is annular with the annular regions being in appropriate circumscribing relationship.
  • the central region of the cornea is shaped to provide a vision correction power intermediate the first and second vision correction powers.
  • the vision correction power of the central region includes an intermediate vision correction power.
  • the shaping of the cornea may be carried out in any suitable way, it is currently preferred to shape the cornea utilizing laser energy. Although this can be accomplished by scanning a laser beam across the cornea, it is preferred to utilize a mask which appropriately modulates the laser energy so the laser energy can shape the regions of the cornea to provide the desired vision correction powers.
  • laser energy is directed to a mask to provide a modulated laser beam having different energy levels at different locations across the modulated laser beam.
  • the laser beam is then directed to the cornea to ablate the cornea to different degrees to provide the cornea with progressive vision correction powers and/or bifocal or trifocal powers.
  • the different energy levels of the modulated laser beam enable the laser beam to accomplish differential ablation of the cornea to achieve the desired shape of the cornea.
  • the mask may have variable or differential transmissivity or reflectivity to the laser energy provided by the laser.
  • the mask may provide the modulated laser beam with appropriate annular zones which are capable of ablating annular regions of the cornea to achieve the desired cornea shaping effect .
  • Fig. 1 is a schematic illustration of one form of apparatus which can be used to carry out the vision correction method of this invention.
  • Fig. 2 is a schematic plan view showing one arrangement of vision correction powers which can be provided by shaping the cornea using the system of Fig. 1.
  • Fig. 3 is a plot of vision correction power versus distance from the center of the cornea for another preferred cornea shape . Description of the Preferred Embodiment
  • Fig. 1 shows a system 11 of the type which can be used to carry out the vision correction method of this invention to shape a cornea 13 of a human patient.
  • the system 11 is much like the system shown and described in common assignees U.S. Patent No. 4,842,782, and the disclosure of that patent is incorporated by reference herein.
  • the system 11 comprises a laser 15 which directs laser energy toward a beam expander 17 which expands the cross section of the laser beam.
  • the laser 15 is preferably an excimer laser of the type which can safely be used for delicate human tissue such as the cornea .
  • the laser energy from the beam expander 17 is directed toward a mask 19 which modulates the laser energy and provides a modulated laser beam having different energy levels at different locations across the modulated laser beam.
  • the modulated laser beam from the mask 19 is directed toward a positive lens 21 having focal point 23.
  • the lens 21, which in this embodiment, is a biconvex lens images the mask on the anterior surface 25 of the cornea 13. For this purpose, the patient's head is positioned accurately with respect to the system 11 and is held against movement with respect to the system 11 utilizing conventional techniques.
  • the modulated laser beam is therefore directed to the cornea 13 where it ablates the anterior surface 25 of the cornea to different degrees to alter the refraction of the cornea to provide the cornea with multifocal vision correction powers.
  • the nature of the vision correction powers, i.e. the vision correction powers that are created at each location of the cornea is a function of the characteristics of the mask 19.
  • the mask 19 may be erodible to different degrees at different locations along the mask or have different transmissivity or reflectivity to the laser energy at different locations over the surface of the mask. In the embodiment illustrated, the mask 19 has different transmissivity to laser energy at different locations on the mask.
  • the vision correction power of a refractive element is a function of the curvature of the surface of the refractive element. This is explained, for example, in Portney Patent Nos . 5,270,744 and 5,225,858 both of which are incorporated by reference herein.
  • the zones of the mask 19 which are the most transmissive to laser energy provide a stronger laser beam portion which ablates more of the cornea at the corresponding region.
  • a zone of the mask 19 which is of lesser transmissivity to the laser energy provides a relatively weak laser beam portion which is capable of a lesser degree of ablation of the corresponding region of the cornea.
  • the cornea 13, and in particular the anterior surface 25 of the cornea can be shaped curved or configured as desired. This enables the curvature of the cornea to be changed at different regions of the cornea to achieve the desired multifocal effect, and this may include progressive vision correction powers.
  • Fig. 2 illustrates one example of the refractive power that may be placed on the anterior surface 25 of the cornea.
  • a central region C of the cornea which preferably has an intermediate vision correction power.
  • the power in the central region may be progressive .
  • the central region is circumscribed by coaxial annular regions.
  • the annular region F provides far vision correction powers
  • the annular region Pl provides progressive vision correction powers
  • the annular region N provides near vision correction powers
  • the annular region P2 provides progressive vision correction powers.
  • the regions F and N may also include progressive vision correction powers, but their primary purpose is to achieve far and near correction, respectively.
  • Each of the regions Pl and P2 includes progressive vision correction powers which are between or intermediate the far and near vision correction powers of the regions F and N, and preferably all of the progressive vision correction powers of the regions Pl and P2 are intermediate the far vision correction powers of the region F and the near vision correction powers of the region N.
  • the progressive vision correction powers of the region Pl include progressive vision correction powers which increase in a radial outward direction.
  • the progressive vision correction powers of the region P2 include progressive vision correction powers which decrease in a radial outward direction.
  • the progressive vision correction powers of the regions Pl and P2 would also reverse such that the vision correction powers of the region Pl would decrease in a radial outward direction and the vision corrections powers of the region P2 would increase in a radial outward direction.
  • Fig. 3 illustrates another example of the refractive power that may be placed on the cornea.
  • Fig. 3 shows a plot of the power of the cornea versus distance from the optical axis or center of the cornea.
  • the power curve of Fig. 3 is very similar to the power curve shown in Fig. 11 of Portney U.S. Patent No. 5,225,858.
  • Shaping the anterior surface 25 of the cornea 13 to achieve the power curve of Fig. 3 requires that the cornea have a central zone C in which the power increases slightly in a radial outward direction from the optical axis O and then decreases toward the periphery of the central region.
  • the central zone C is circumscribed by a number of annular regions, and these include in radial outward order a far region FI, a progressive region Pl, a near region Nl, a progressive region P2 , a far region F2 , a progressive region P3 , a near region N2, a progressive region P4 , and a far region F3.
  • the progressive regions Pl and P3 are of increasing vision correction power in a radial outward direction whereas the progressive regions P2 and P4 are of decreasing vision correction power in a radial outward direction.
  • the far regions FI, F2 and F3 and the near regions Nl and N2 all include some progressive powers.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Optics & Photonics (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Laser Surgery Devices (AREA)
  • Eyeglasses (AREA)

Abstract

Procédé de correction de la vision qui consiste à donner une forme à des première et seconde régions de la cornée pour conférer à la première région une première puissance de correction et à la seconde région une seconde puissance de correction, différente de la première puissance, afin d'améliorer la vision respectivement à des première et seconde distances.
PCT/US1996/012855 1996-08-07 1996-08-07 Correction de la vision WO1998005279A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
JP10506888A JP2000515044A (ja) 1996-08-07 1996-08-07 視覚矯正
PCT/US1996/012855 WO1998005279A1 (fr) 1996-08-07 1996-08-07 Correction de la vision
EP96930497A EP0858303A1 (fr) 1996-08-07 1996-08-07 Correction de la vision

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US1996/012855 WO1998005279A1 (fr) 1996-08-07 1996-08-07 Correction de la vision

Publications (1)

Publication Number Publication Date
WO1998005279A1 true WO1998005279A1 (fr) 1998-02-12

Family

ID=22255566

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1996/012855 WO1998005279A1 (fr) 1996-08-07 1996-08-07 Correction de la vision

Country Status (3)

Country Link
EP (1) EP0858303A1 (fr)
JP (1) JP2000515044A (fr)
WO (1) WO1998005279A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1389968A4 (fr) * 2001-04-24 2006-03-29 High Power Peripheral Cornea C Procede et appareil pour traiter la presbytie
US10940042B2 (en) 2015-10-23 2021-03-09 The Trustees Of Columbia University In The City Of New York Laser induced collagen crosslinking in tissue
US11497403B2 (en) 2016-06-10 2022-11-15 The Trustees Of Columbia University In The City Of New York Devices, methods, and systems for detection of collagen tissue features
US11666481B1 (en) 2017-12-01 2023-06-06 The Trustees Of Columbia University In The City Of New York Diagnosis and treatment of collagen-containing tissues
US11963868B2 (en) 2020-06-01 2024-04-23 Ast Products, Inc. Double-sided aspheric diffractive multifocal lens, manufacture, and uses thereof

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107582237A (zh) * 2017-09-28 2018-01-16 深圳市华星光电技术有限公司 可穿戴式显示装置及视力矫正方法

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1993025166A1 (fr) * 1992-06-10 1993-12-23 Summit Technology, Inc. Correction de la presbytie par keratectomie photoretractive

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1993025166A1 (fr) * 1992-06-10 1993-12-23 Summit Technology, Inc. Correction de la presbytie par keratectomie photoretractive

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1389968A4 (fr) * 2001-04-24 2006-03-29 High Power Peripheral Cornea C Procede et appareil pour traiter la presbytie
US10940042B2 (en) 2015-10-23 2021-03-09 The Trustees Of Columbia University In The City Of New York Laser induced collagen crosslinking in tissue
US11559433B2 (en) 2015-10-23 2023-01-24 The Trustees Of Columbia University In The City Of New York Laser induced collagen crosslinking in tissue
US11957622B2 (en) 2015-10-23 2024-04-16 The Trustees Of Columbia University In The City Of New York Laser induced collagen crosslinking in tissue
US11497403B2 (en) 2016-06-10 2022-11-15 The Trustees Of Columbia University In The City Of New York Devices, methods, and systems for detection of collagen tissue features
US11666481B1 (en) 2017-12-01 2023-06-06 The Trustees Of Columbia University In The City Of New York Diagnosis and treatment of collagen-containing tissues
US11963868B2 (en) 2020-06-01 2024-04-23 Ast Products, Inc. Double-sided aspheric diffractive multifocal lens, manufacture, and uses thereof

Also Published As

Publication number Publication date
JP2000515044A (ja) 2000-11-14
EP0858303A1 (fr) 1998-08-19

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