Accommodating intraocular lens
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Expired 24 August 2014, 12.1 years ago.
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51 claims: 10 independent, 41 dependent
- 1自然の被膜房 (20) 内で人間の眼 (10) 内に埋め込まれる ように構成されている 調節可能な眼内レンズ (32) にして、通常の前側部及び後側部を有するレンズ本体であって、可撓性の 、中実の 光学素子 (34) と、該光学素子 (34) の直径方向両側部に接続された内端及び対向する外端を有する板状の触覚部分 (36) とを含む前記レンズ本体を備え、前記 光学素子(34) が、前記 触覚部分(36)の前記外端 に関して前方に且つ後方に可動であり 、且つ近視野のために前記眼(10)の虹彩(18)の方へ可動であり、 更に、前記レンズが前記被膜房の前記内径に近似する長さを有することを特徴とする調節可能な眼内レンズ。
- 2請求の範囲第1項に記載の調節可能な眼内レンズにして、前記レンズ本体が、前記板状の触覚部分の内端を前記光学素子に接続するヒンジを備え、該ヒンジを中心として、前記触覚部分が前記光学素子に関して前方に且つ後方に枢動可能であることを特徴とする調節可能な眼内レンズ。
- 3請求の範囲第2項に記載の調節可能な眼内レンズにして、前記ヒンジが、前記レンズ本体の可撓性部分であることを特徴とする調節可能な眼内レンズ。
- 4請求の範囲第2項に記載の調節可能な眼内レンズにして、前記レンズ本体が、前記触覚部分の内端に沿って前記本体の側部の少なくとも一つに構成された溝を備え、該溝が前記ヒンジを形成するレンズ本体の可撓性の薄厚部分を形成することを特徴とする調節可能な眼内レンズ。
- 5請求の範囲第1項に記載の調節可能な眼内レンズにして、前記触覚部分が、その全長に亙って前記光学素子に関して前方向及び後方向に撓み可能であることを特徴とする調節可能な眼内レンズ。
- 6調節可能な眼内レンズにして、通常の前側部及び後側部を有するレンズ本体であって、可撓性の光学素子と、該光学素子の直径方向両側部から伸長し、前記光学素子に隣接する内端及び対向する外端を有する板状の触覚部分と、ヒンジ手段とを備える前記レンズ本体を備え、前記ヒンジ手段は、それを中心として、前記触覚部分が前記光学素子に関して前方に且つ後方に枢動し得るよう前記板状触覚部分の内端を前記光学素子に枢動可能に接続することを特徴とする調節可能な眼内レンズ。
- 7請求の範囲第6項に記載の調節可能な眼内レンズにして、前記ヒンジ手段が、前記レンズ本体の可撓性のヒンジ部分を備えることを特徴とする調節可能な眼内レンズ。
- 8請求の範囲第7項に記載の調節可能な眼内レンズにして、前記ヒンジ部分が、前記レンズ本体の可撓性の薄肉部分を備えることを特徴とする調節可能な眼内レンズ。
- 9請求の範囲第1項に記載の調節可能な眼内レンズにして、前記レンズ本体が、弾性記憶を有する材料で形成され、前記本体が、前記触覚部分、光学素子及びヒンジ手段が略共通の面内に配置される非応力状態の形態 を有する ことを特徴とする調節可能な眼内レンズ。
- 10請求の範囲第1項に記載の調節可能な眼内レンズにして、前記レンズ本体が、弾性記憶を有する材料で形成され、前記本体が、前記触覚部分が前記光学素子に関して後方に伸長する通常の非応力状態にある前方にアーチ状の形態 を有する ことを特徴とする調節可能な眼内レンズ。
- 11請求の範囲第1項に記載の調節可能な眼内レンズにして、前記レンズ本体が、弾性記憶を有する材料で形成され、前記本体が、前記触覚部分が前記光学素子に関して前方に伸長する通常の非応力状態にある後方にアーチ状の形態 を有する ことを特徴とする調節可能な眼内レンズ。
- 12請求の範囲第1項に記載の調節可能な眼内レンズにして、前記光学素子が、前記触覚部分の 外端 に関して後方にずらした位置に配置されることを特徴とする調節可能な眼内レンズ。
- 13請求の範囲第1項に記載の調節可能な眼内レンズにして、前記光学素子が、前記触覚部分の 外端 に関して前方にずらした位置に配置されることを特徴とする調節可能な眼内レンズ。
- 14請求の範囲第1項に記載の調節可能な眼内レンズにして、前記光学素子に隣接して前記触覚部分の前側部に取り付けられ且つ触覚部分に沿ってその外端に向けて伸長するばねを備え、前記ばねが、触覚部分に向けて弾性的に偏 倚 され且つ眼の虹彩の上方に亙って係合して調節動作を支援し得るようにしたことを特徴とする調節可能な眼内レンズ。
- 15自然の被膜房(20)内で人間の眼(10)内に埋め込まれるように構成されている 調節可能な眼内レンズ (32) にして、通常の前側部 及び 後側部 を 有するレンズ本体であって、可撓性の 、中実の 光学素子 (34) と、該光学素子 (34) の直径方向両側部に接続された内端及び対向する外端を有する板状の触覚部分 (36) とを含む前記レンズ本体を備え、前記 光学素子(34) が、前記 触覚部分(36)の前記外端 に関して前方に且つ後方に可動であり 、且つ近視野のために前記眼(10)の虹彩(18)の方へ可動であり、更に、 (a)レンズを被膜房内に位置決めすること、及び(b)触覚部分の外端を前記眼内で固定することの少なくとも一方のため、前記触覚部分に設けられた固定手段 (114、118、126、130、134、142、154、164、186、198、224、240、242、244、264、266、274、278、302、318、424、602、702、802、920、920b、922c、図43) を備えることを特徴とする調節可能な眼内レンズ。
- 16請求の範囲第15項に記載の調節可能な眼内レンズにして、前記固定手段が、線維組織形成がその周りで行われる、前記触覚部分の外端に設けられた突起を備えることを特徴とする調節可能な眼内レンズ。
- 17請求の範囲第15項に記載の調節可能な眼内レンズにして、前記固定手段が、前記触覚部分の外端に形成された開口部を備え、該開口部を通じて線維組織形成が行われるようにしたことを特徴とする調節可能な眼内レンズ。
- 18請求の範囲第15項に記載の調節可能な眼内レンズにして、前記固定手段が、その周りで線維組織形成が行われる、触覚部分の外端に設けられたループを備えることを特徴とする調節可能な眼内レンズ。
- 19請求の範囲第15項に記載の調節可能な眼内レンズにして、前記固定手段が、その周りで線維組織形成が行われる、前記触覚部分の外端に設けられたばねループを備えることを特徴とする調節可能な眼内レンズ。
- 20請求の範囲第15項に記載の調節可能な眼内レンズにして、前記固定手段が、長手方向ソケット内を摺動して、前記触覚部分の外端に入る独立的な固定要素を備え、前記眼内レンズ及び固定要素が分離可能であることを特徴とする調節可能な眼内レンズ。
- 21請求の範囲第20項に記載の調節可能な眼内レンズにして、前記固定要素が、前記触覚部分のソケット内を摺動可能な脚部を有する略U字形のループを備えることを特徴とする調節可能な眼内レンズ。
- 22請求の範囲第20項に記載の調節可能な眼内レンズにして、前記固定要素が、前記触覚部分のソケット内を摺動可能に一端に設けられたジヤーナルと、その他端に設けられたクロス・アームとを有する略十字形の部材を備えることを特徴とする調節可能な眼内レンズ。
- 23請求の範囲第20項に記載の調節可能な眼内レンズにして、前記固定要素が、前記眼内レンズを眼内に埋め込む間に、前記レンズ本体及び固定要素を組み立てた状態に固着する着脱可能な縫合材を受け入れる手段を備えることを特徴とする調節可能な眼内レンズ。
- 24請求の範囲第15項に記載の調節可能な眼内レンズにして、前記固定手段が、前記板状の触覚部分か ら伸 長する湾曲した弾性的なばねアームを備えることを特徴とする調節可能な眼内レンズ。
- 25請求の範囲第15項に記載の調節可能な眼内レンズにして、前記固定手段が、前記触覚部分の外端に設けられたばね (242、424、602、702、802、920、920b、922c、図43) を備え、該ばねがその隣接する板状の触覚部分の外端を越え て伸 長して、前記房の外周と弾性的に係合して、レンズを房内で強固に位置決めすると共に、レンズがずれるのを防止する、通常の非応力位置を有する該ばねであるようにしたことを特徴とする調節可能な眼内レンズ。
- 26請求の範囲第25項に記載の調節可能な眼内レンズにして、前記ばねがばねループを備えることを特徴とする調節可能な眼内レンズ。
- 27請求の範囲第25項に記載の調節可能な眼内レンズにして、前記ばねが、前記板状の触覚部分に固定された基端と、対向する自由端とを有するばねアーム (424、602、702、802、920、920b) を備え、前記ばねアームの各々が、そのそれぞれの触覚部分の外端か ら外 方に湾曲 する ことを特徴とする調節可能な眼内レンズ。
- 28請求の範囲第25項に記載の調節可能な眼内レンズにして、前記ばねが、板状の触覚部分の各々の外端に設けられた単一のばねアーム (424、602、920、920b、図43) を備え、該ばねアームが、前記触覚部分の一つの長手方向縁端に隣接してそれ ぞ れの触覚部分に固定された基端と、対向する自由端とを有し、前記ばねアームの各々が、そのそれぞれの触覚部分の外端か ら外 方 に湾曲する ことを特徴とする調節可能な眼内レンズ。
- 29請求の範囲第25項に記載の調節可能な眼内レンズにして、前記ばねが、前記触覚部分の各々の外端に設けられ た一 対のばねアーム (242、702) を備え、該ばねアームが、前記触覚部分の長手方向中心線に沿ってそれぞれの触覚部分に固定された共通の基端と、対向する自由端とを有し、前記触覚部分の各々に設けられた前記ばねアームが、そのそれぞれの触覚部分の外端か ら外 方に湾曲し且つその共通の基端からその自由端まで触覚部分の対向する長手方向縁端に向け て湾 曲することを特徴とする調節可能な眼内レンズ。
- 30請求の範囲第25項に記載の調節可能な眼内レンズにして、前記ばねが、前記触覚部分の各々の外端に設けられ た一 対のばねアーム (802) を備え、該ばねアームが、触覚部分の長手方向縁端にそれぞれ隣接してそれぞれの触覚部分に固定された基端と、対向する自由端とを有し、前記触覚部分の各々に設けられた前記ばねアームが、そのそれぞれの触覚部分の外端か ら外 方に湾曲し且つその基端からその自由端ま で互 いの方向に湾曲することを特徴とする調節可能な眼内レンズ。
- 31請求の範囲第25項に記載の調節可能な眼内レンズにして、前記ばね及び隣接する触覚部分の外端が、介在する開口部 (432、918、918c) を形成し、該開口部を通じて線維組織形成が行われるようにしたことを特徴とする調節可能な眼内レンズ。
- 32調節可能な眼内レンズにして、通常の前側部及び後側部を有し且つ可撓性の光学素子と、板状の触覚部分とを有するレンズ本体であって、該触覚部分が、前記光学素子の直径方向両側部に接続された内端と、対向する外端とを有する前記レンズ本体と、前記本体の側部の一方に設けられて、前記レンズの長さに対して直角に前記触覚部分の内端を横断するように伸長する溝 (40、320、249、916、924) であって、前記触覚部分が前記光学素子に関して前方に且つ後方に撓むときの中心となるヒンジを形成する前記溝とを備えることを特徴とする調節可能な眼内レンズ。
- 33請求の範囲第32項に記載の調節可能なレンズにして、前記溝が、前記レンズ本体の前記前側部に配置されることを特徴とする調節可能なレンズ。
- 34調節可能な眼内レンズにして、通常の前側部及び後側部を有し、且つ円形の可撓性の光学素子と 、板状の触覚部分であって、 前記光学素子と前記触覚部分との間の接続部において、直径方向に対向した前記光学素子の縁端部分に接続された内端と、対向する外端とを含む板状の触覚部分とを有する前記レンズ本体を備え、前記レンズの長さに対して直角に測定した前記接続部の幅が、前記光学素子の直径よりも実質的に小さく、これにより、前記光学素子が、前記接続部の間で実質的に周方向長さの自由縁端部分を有し、該自由な縁端部分の各々の周方向長さが、各接続部の幅を実質的に上廻り、前記 光学素子 が、前記 触覚部分 に関して前方及び後方に可動であることを特徴とする調節可能な眼内レンズ。
- 35請求の範囲第34項に記載の調節可能な眼内レンズにして、前記触覚部分が、前記接続部の幅に比べて比較的幅の広い外端部分 であって 、該触覚部分の外端に隣接して設けられた開口部を有する 外端部分を有する ことを特徴とする調節可能な眼内レンズ。
- 36請求の範囲第34項に記載の調節可能な眼内レンズにして、前記接続部が、ヒンジ接続部であり、該ヒンジ接続部を中心として前記触覚部分が前記光学素子に関して前方に且つ後方に可動であり、前記触覚部分が、前記接続部の幅に比べて比較的幅の広い外端部分 であって 、該触覚部分の外端を貫通して開口する、開放した側部を有する切欠きの形態の開口部 を有する外端部分 を有し、前記レンズが、前記触覚部分の外端に設けられたばねアームを備え、該ばねアームが、前記切欠きの一側部にて一端が触覚部分の外端に固定され、隣接する触覚部分の端部に対して離間した関係にて、前記切欠きの開放した側部を横断して触覚部分の横方向に伸長し、前記ばねアームが、隣接する触覚部分の端部に向けて且つ該端部から離れる方向に弾性的に撓み可能であることを特徴とする調節可能な眼内レンズ。
- 37請求の範囲第34項に記載の調節可能な眼内レンズにして、前記接続部が、ヒンジ接続部であり、該ヒンジ接続部を中心として前記触覚部分が前記光学素子に関して前方に且つ後方に可動であり、前記触覚部分が、前記接続部の幅に比べて比較的幅の広い外端部分 であって 、前記触覚部分 の外端 に隣接する開口部を有する 外端部分と 、前記触覚部分の開口部の隣接する側部に沿って触覚部分の外端を横断するように伸長し且つ前記触覚部分の開口部の隣接する側部を閉鎖する比較的細い架橋部分とを含むことを特徴とする調節可能な眼内レンズ。
- 38請求の範囲第34項に記載の調節可能な眼内レンズにして、前記接続部が、ヒンジ接続部であり、該ヒンジ接続部を中心として前記触覚部分が前記光学素子に関して前方に且つ後方に可動であり、前記触覚部分が、前記接続部の幅に比べて比較的幅の広い外端部分 であって 、前記触覚部分 の外端 に隣接する開口部 を有する外端部分 と、前記触覚部分の開口部の隣接する側部に沿って触覚部分の外端を横断するように伸長する比較的細い架橋部分とを有し、前記レンズが、前記触覚部分の外端に設けられたばねアームを備え、該ばねアームが、触覚部分の一つの長手方向縁部に隣接して、その一端が触覚部分の外端に固定され且つ前記触覚部分の端部方向で前記架橋部分に対して離間した関係にて、その対向する長手方向縁部に向けて触覚部分の横方向に伸長し、前記ばねアームが、レンズの端部方向で前記架橋部分に向け且つ該架橋部分から離れるように、弾性的に撓み可能であることを特徴とする調節可能なレンズ。
- 39請求の範囲第3 4 項に記載の調節可能な眼内レンズにして、前記接続部が、ヒンジ接続部であり、該ヒンジ接続部を中心として前記触覚部分が前記光学素子に関して前方に且つ後方に 枢動可能 であり、前記触覚部分が、前記接続部から該触覚部分の外端部分に向けて漸進的に狭小幅となるテーパー付きの内端部分を備えることを特徴とする調節可能な眼内レンズ。
- 40請求の範囲第3 4 項に記載の調節可能な眼内レンズにして、前記触覚部分が内端部分を有し、前記接続部がヒンジ接続部であり、該ヒンジ接続部を中心として、前記触覚部分 が 枢動可能で ある ことを特徴とする調節可能な眼内レンズ。
- 41請求の範囲第3 4 項に記載の調節可能な眼内レンズにして、前記光学素子及び触覚部分が、通常の前方面及び後方面を有し、前記接続部が、前記光学素子の縁端部分に近接し且つ前記触覚部分の長さに対して直角に該触覚部分の前方面に設けられた溝により形成された可撓性のヒンジ接続部であり、該ヒンジ接続部が、前記光学素子の縁端部分及び前記触覚部分の内端部分を接続する可撓性のヒンジ部分を備え、前記光学素子が、該光学素子の前記前方面が前記触覚部分の前記前方面の前方に突出するように該触覚部分に関して前方にずらした位置に配置され、前記触覚部分の縁端部分及び前記可撓性のヒンジ部分の双方が、該触覚部分の厚さ部分内で且つ該触覚部分の面の間に配置されることを特徴とする調節可能な眼内レンズ。
- 42請求の範囲第3 4 項に記載の調節可能な眼内レンズにして、前記光学素子及び触覚部分が、通常の前方面及び後方面を備え、前記接続部が、前記光学素子の縁端部分及び前記触覚部分の内端を接続する可撓性のヒンジ部分を備え、前記光学素子が、該光学素子の前記前方面が前記触覚部分の前記前方面から突出するように、前記触覚部分に関して前方にずらした位置に配置され、前記光学素子の縁端部分及び前記可撓性のヒンジ部分の双方が、前記触覚部分の前方面の前方に配置されることを特徴とする調節可能な眼内レンズ。
- 43自然の被膜房(20)内で人間の眼(10)内に埋め込まれるように構成されている 調節可能な眼内レンズ埋込み体にして、通常の前側部及び後側部を有する眼内レンズ (32) であって、 中央の、 可撓性の 中実の 光学素子 (34) と、該光学素子 (34)の両縁部から伸長する触覚部分であって、前記光学素子(34) に接続された内端及び対向する外端を 有する 板状の触覚部分 (36) とを含む前記眼内レンズを備え 、前記光学素子が、前記触覚部分の前記外端 に関して 前方に且つ後方に可動であり、且つ近視野のために前記眼(10)の虹彩(18)の方へ可動である ことを特徴とするレンズ埋込み体。
- 44請求の範囲第43項に記載のレンズ埋込み体にして、前記レンズが、前記触覚部分の内端を前記光学素子に接続するヒンジを備え、前記該ヒンジを中心として触覚部分が前記光学素子に関して前方に且つ後方に枢動可能であることを特徴とするレンズ埋込み体。
- 45請求の範囲第44項に記載のレンズ埋込み体にして、前記レンズが、前記触覚部分の内端に沿って前記レンズの側部の一方に形成された溝を有し、該溝が、前記ヒンジを構成する、前記レンズの可撓性の薄肉部分を形成することを特徴とするレンズ埋込み体。
- 46請求の範囲第43項に記載のレンズ埋込み体にして、前記触覚部分が、その全長に亙って、前記光学素子に関して前方向及び後方向に撓み可能であることを特徴とするレンズ埋込み体。
- 47請求の範囲第43項に記載のレンズ埋込み体にして、前記レンズが、前記線維状組織内に強固に定着されて、前記レンズが前記被膜房内でずれるのを確実に防止すべく、前記触覚部分の外端に設けられた固定手段を備えることを特徴とするレンズ埋込み体。
- 48請求の範囲第47項に記載のレンズ埋込み体にして、前記固定手段及び触覚部分が、前記レンズを前記被膜房から取り出し且つ該レンズを該被膜房内で交換し得るように分離可能であることを特徴とするレンズ埋込み体。
- 49請求の範囲第43項に記載のレンズ埋込み体にして、前記レンズが、前記触覚部分の外端に設けられ、前記被膜房の外周に係合し且つ前記線維状組織により封止されたばねを備えることを特徴とするレンズ埋込み体。
- 50請求の範囲第1項に記載の調節可能な眼内レンズにして、前記触覚部分から前方に伸長する突出手段を更に備えることを特徴とする調節可能な眼内レンズ。
- 51請求の範囲第6項に記載の調節可能な眼内レンズにして、前記触覚部分から前方に伸長する 突起 を更に備えることを特徴とする調節可能な眼内レンズ。
Independent claims51
1 paragraph, as filed
<u style="single">Technical field</u>The present invention generally relates to an intraocular lens, more specifically in the capsule tuft of the human eye from which the natural lens matrix has been removed, leaving the posterior and anterior capsule of the natural lens intact in the eye. Regarding an adjustable intraocular lens to be implanted. The present invention also relates to a novel method of using an intraocular lens in the human eye to give a patient a regulatory function capable of responding to normal ciliary muscle movements.<u style="single">Conventional technology</u>The human eye has an anterior chamber between the cornea and the iris, a posterior chamber of the posterior iris containing the crystalline lens, a posterior crystalline lens containing vitreous humor, and a retina posterior to the crystalline lens. The crystalline lens of a normal human eye is attached to the ciliary muscle of the eye by a zonule around its perimeter and has a crystalline lens capsule containing a crystalline lens matrix. The lens capsule has optically transparent and elastic anterior and posterior thin-film walls, commonly referred to by ophthalmologists as anterior and posterior capsular, respectively. Between the iris and the ciliary muscle, there is an annular crevasse-like space called the ciliary groove. The human eye has a natural accommodation function. Natural accommodation relaxes and tensions the ciliary muscles by the brain, allowing the eye to see near and far vision. This movement of the ciliary muscles is automatic, resulting in a natural crystalline lens shape in optical form suitable for focusing the light rays entering the eye from the visual scene onto the retina. The human eye is prone to various abnormalities that reduce or completely ruin the ability of the eye to function properly. One of the more common of these abnormalities is the gradual clouding of the natural lens matrix, resulting in the formation of what is called a cataract. Surgical removal of the human lens of cataract and replacement of the natural lens with an artificial intraocular lens is now a common practice. There are a wide variety of intraocular lenses in the prior art for this purpose. Examples of such lenses include the following patents. That is, U.S. Pat. Nos. 4,254,509, 4,298,996, 4,409,691, 4,424,597, 4,573,998, 4,664,666, 4,673,406, 4,738,680, 4,753,655, and 4,753,655. 4,778,463, 4,813,955, 4,840,627, 4,842,601, 4,963,148, 4,994,082, 5,047, It is No. 051. As is clear from the above patents, intraocular lenses differ greatly in their physical appearance and structure. The present invention comprises a central optical region, i.e., an optical element and a tactile portion that extends outward from the optical element and engages the interior of the eye in such a way that the optical element can be supported on the axis of the eye. It relates to the type of intraocular lens to have. The above-mentioned patent 5,047, filed at the same time as the applicant's earlier patent application No. 07 / 515,636, 051 discloses an intraocular lens having an anchor plate as a tactile portion, an optical element located at the center of the longitudinal direction of the plate, and an elastic tactile portion loop fixed to the end of the plate. ing. Until the late 1980s, intracapsular removal, which involves removing the entire human eye, including both the outer lens capsule and the inner lens matrix, or removal of the precapsule and inner lens matrix of the lens. However, the posterior capsule of the crystalline lens was surgically removed of cataract (opaque part of the crystalline lens) by one of the extracapsular removal methods that left the lens intact. Such intracapsular and extracapsular removal methods are prone to postoperative complications and therefore carry undesired risks in their use. The most serious of these complications are posterior capsule opacity, intracapsular lens eccentricity, cystic edema, retinal detachment and astigmatism after removal of the extracapsular lens. Anterior to alleviate the above and other postoperative complications and to reduce the risk associated with removal of intracapsular and extracapsular cataracts. capsulorhexis) was developed. This precapsular ripping method is simply a step of forming a hole in the anterior capsule of the natural lens and an elastic posterior capsule, the remnants or edges of the precapsule around the anterior capsule opening, anterior. It includes a step of completely leaving a capsule tuft inside the eye with an annular groove referred to herein as a capsular tuft groove between the rest of the capsule and the outer circumference of the posterior capsule. This tuft remains attached to the ciliary muscle, whose perimeter surrounds the eye by the zonules of the eye. The natural lens substrate with cataract is removed from the capsule through the anterior capsular opening by phacoemulsification and suction, or some other method, after which the intraocular lens is intratumoral through the opening. Embedded in. A relatively modern and improved form of precapsular incision known as capsulorhexis is essentially a capsular incision that tears continuously in a circular or round shape. The capsular tear method involves tearing the precapsule of the natural lens along a substantially circular fissure line that is approximately coaxial with the axis of the lens and removing the substantially circular portion of the precapsule that surrounds the fissure line. Is done by. The film tearing method, which cuts continuously in a circular shape, forms a substantially circular opening in the anterior capsule of the natural lens approximately coaxially with the axis of the eye, and the opening is a circumference. It should be surrounded by an annular remnant or edge of the anterior coating in the direction and have a relatively smooth and continuous inner edge that borders the opening. However, when performing a continuous circular tearing method, the anterior edge is often accidentally torn, sliced, or torn, or fibrous tissue formation, as described below. Occasionally, when stress is applied to the edges, the inner edges may be cut out or sliced in such a way that the edges are more likely to be torn. Another precapsular incision, called the envelope capsular incision, is a horizontal incision in the precapsule of the natural crystalline capsule, which then intersects the horizontal incision and rises from the horizontal incision. Precapsulate the vertical incision and finally start at the top of the vertical incision and make the vertical incision. It comprises a step of tearing the anterior capsule along a tear line having an upward arcuate portion that is continuous to a lower vertical portion parallel to the portion, the vertical incision extending downward and then , Intersects the second vertical incision. This method forms the coating opening in a substantially arcuate shape centered on the axis of the eye. This opening borders the horizontal incision at its bottom, and has a vertical incision on one side in the vertical direction and a precapsule on the vertical side on the opposite side. It borders the second vertical incision portion and the upper arcuate portion of the coating cut portion at the upper portion thereof. Adjacent ends of the vertical and horizontal incisions form a flexible flap on one side of the opening. Adjacent ends of the vertical incision edge and the horizontal incision form a second flap on the opposite side of the opening. A third capsulotomy, called a beer can or can opener capsulotomy, is in front of the natural lens at multiple locations along an arc that is approximately coaxial with the axis of the eye. It includes a step of piercing the capsule and then removing a substantially circular portion of the capsule surrounded by this line in the circumferential direction. This method forms a substantially circular anterior capsule opening that is substantially coaxial with the axis of the eye and borders the annular remnant tissue or edge of the anterior capsule in the circumferential direction. The inner edge of this edge has a large number of scallops formed by the edges of the puncture holes in the anterior capsule, when the anterior capsule is such that fibrous tissue formation occurs, as described below. When stress is applied to the edge portion, the annular remnant structure or the edge portion tends to be easily torn in the radial direction. Intraocular lenses are also different in terms of their adjustment function and their position within the eye. This adjustment is a function that the intraocular lens adjusts, that is, a function that focuses the eye on the near field and the far field. Joint patent application of the applicant No. 07/744, No. 472 and some of the patents mentioned above describe adjustable intraocular lenses. The other patents mentioned describe non-adjustable intraocular lenses. Most non-adjustable lenses have single-focus optics that focus the eye only at a certain distance and require spectacles to change its focus. Other non-adjustable lenses include bifocal optics that image both near-field and far-field objectives on the retina of the eye. The brain selects the appropriate image and suppresses the other images, so the bifocal intraocular lens provides both near and far vision without spectacles. However, this bifocal intraocular lens has the disadvantage that each of its bifocal images represents only about 40% of the available light and the remaining 20% of the light is scattered and lost. There are four possible positions for placing an intraocular lens within the eye. That is, (a) in the anterior chamber, (b) in the posterior chamber, (c) in the capsule chamber, and (d) in the glass water chamber. The intraocular lens disclosed in the applicant's joint patent application No. 07 / 744,472 is intended to be placed in a capsule.<u style="single">Disclosure of invention</u>According to one of its forms, the present invention is intraocular after removing the natural substrate from the human crystalline lens capsule by a precapsular incision method, preferably through a precapsular opening formed by the capsular incision method. Provided is an adjustable intraocular lens for implantation in a human capsular chamber that remains in the eye. The accommodative intraocular lens according to the present invention includes a central optical element and a tactile portion that extends outward from both sides of the optical element in the radial direction and is movable forward and backward with respect to the optical element. It has. In some of the lens embodiments described, the tactile moiety is connected to the optics at its inner end by a hinged junction referred to herein as a hinge, which causes forward / backward movement of the tactile moiety. Includes the pivotal movement of the tactile part of the hinge. In other of the described embodiments, the tactile portion is elastically flexible, and forward / backward movement of the tactile portion with respect to the optical element includes elastically flexing or bending the tactile portion. In this regard, expressions such as "bending," "bending," and "flexible" are used in a broad sense to include both hinged and elastically bendable tactile portions. It is important to first recognize that it is a thing. Some of the examples of lenses described herein are simple plate haptic lenses. It is called lens). These simple plate-shaped tactile partial lenses are intended to be used to properly perform the capsular incision method used in ocular surgery and remain intact when the lens is implanted. Moreover, it provides not only the absence of crevices, crevices, etc., but also the residual tissue or edges of the anterior capsule that can remain intact during subsequent fibrous tissue formation. These latter lenses are intended for use in capsular incisions that result in the residual tissue of the anterior capsule that is not complete or that cannot remain intact during fibrous tissue formation. Both types of lenses are intended to be embedded in the capsule tuft of the eye at a position where the lens optical element is aligned with the opening of the anterior capsule of the tuft on the axis of the eye. , It is placed in the groove of the coating tuft in contact with the groove wall. At this time, the normal posterior side of the lens faces the elastic posterior capsule of the tuft. Current preferred lens embodiments of the present invention include a circular optical element and a tactile portion in which inner ends are connected to both edges of the optical element by a relatively narrow connection. These connections occupy only the relatively small edges of the optics that face each other in the radial direction, leaving the main circular edges of the optics that remain between the connections free. In the preferred lenses described herein, these connections are hinge connections in which the tactile portion is movable forward and backward with respect to the optical element. These bendable or hinged connections are the cross-linked portions between the optics and the plate-like tactile portions, which form the cross-linked portions fixed in place within the anterior and posterior capsules by fibrous tissue formation. .. These cross-linked portions are tapered, with the widest end adjacent to the optics. This allows the crosslinked portion to slide in and out of the margin of the anterior capsule formed by fibrous tissue formation and the void formed by the posterior capsule, and the plate-like tactile portion Allows the optics to move forward when compressed towards the edges. During the postoperative period of about 3 weeks, active endoderm cells in the posterior part of the margin of the anterior capsule Fibrous tissue formation fuses the edges to the elastic posterior capsule. This fibrous tissue formation is such that the tactile area is effectively "shrink-wrapped" by the tufts, creating a radial void between the anterior and posterior capsule edges. In a way, it is done around the tactile part. These voids, including the tactile portion, serve to position and center the lens in the eye. During fibrous tissue formation, the edges of the anterior capsule contract. This contraction, combined with the shrink wrap of the tactile part, compresses the lens towards the end in such a way that it deflects the center of the lens along the axis of the eye with respect to the outer end of the fixed tactile part. .. The edge of the fibrous tissue-formed intact anterior capsule prevents anterior deflection of the lens, so that the lens deflection due to fibrous tissue formation occurs posteriorly and at this deflection position the lens. Is pressed against the elastic posterior coating, which stretches the posterior coating posteriorly. A preferred lens embodiment of the present invention comprises a circular optical element having a diameter capable of penetrating the opening of the anterior coating. These suitable lenses are structured and arranged so that the optical element adjusts and the optical element protrudes through the opening of the front coating so that the adjustment range of the lens is maximized. .. According to another important form of the invention, the ciliary muscle is paralyzed in its relaxed state at the beginning of surgery and during surgery and by fibrous tissue formation the remnants or edges of the anterior capsule. Is kept in this relaxed state both after surgery to fuse to the posterior capsule. In this way, the ciliary muscle is relaxed by putting a ciliary muscle relaxant (ie, a cycloplegic) in the eye. Although various ciliary muscle numbing agents can be used, suitable ciliary muscle numbing agents are atropine in that they have a relatively long shelf life compared to other ciliary muscle numbing agents. Is. This ciliary muscle paralyzing agent is first placed in the eye at the beginning of surgery to dilate the pupil and paralyze the ciliary muscle in its relaxed state. During the post-operative healing period of sufficient time (usually about 2-3 weeks) after surgery The patient instills a drop of ciliary muscle paralysis and keeps the ciliary muscle in its relaxed state until fibrous tissue formation is complete. The relaxed state of the ciliary muscle caused by this drug prevents muscle contraction and immobilizes the capsular tuft during fibrous tissue formation. By this means, the lens is fixed in place in the eye with respect to the retina for far vision. When the effect of the ciliary muscle numbing agent disappears and the ciliary muscle contracts again, this contraction causes compression of the ends on the plate, which causes the optics to move forward for near vision. move. If the ciliary muscle is not kept in its relaxed state, the ciliary muscle undergoes a substantially normal visual field regulatory contraction and relaxation due to the midbrain during fibrous tissue formation. The movement of the ciliary muscle during fibrous tissue formation not only causes improper formation of tactile pickets in the fibrous tissue, but also the contraction of the ciliary muscle during fibrous tissue formation causes the capsule. The tufts may be compressed radially and the lens may be compressed endward, causing the lens to deviate from its proper position within the tuft. The adjustable lens according to the invention has a normal non-stressed form, so that when deflected from this normal non-stressed form, the lens generates an internal elastic strain energy force. This energetic force biases the lens into its normal non-stressed form in a state that facilitates adjustment. In this normal non-stressed form, the lens is substantially flat and can be arcuate in the front or arcuate in the rear. One disclosed embodiment of the lens includes an auxiliary spring that assists in the adjustment of the lens. Some of the disclosed lens embodiments provide an integral fixing means at the end of the tactile portion, and fibrous tissue formation at the anterior edge of the capsule is performed around the end of the tactile portion to provide the lens. Fix it in the eye so that it does not shift. Other disclosed embodiments include a fixed element that separates the lens itself from this fixed element so that the lens can be replaced at its exact initial position in the eye for subsequent replacement or correction, and to replace the lens. Allows removal. As mentioned above, the simple plate tactile partial lens of the present invention is in perfect condition as a result of anterior capsular incision made in the eye and fibrous tissue formation. It is intended to be used when the residual structure or edge of the anterior coating continuous in the middle and circumferential directions is obtained. The spring lens of the plate-like tactile part is intended to be used when the residual tissue of the anterior capsule or the edge of the capsule tuft is torn, that is, when it is cut or torn, or when it is likely to become such a state during fibrous tissue formation. Is to be. Rupture of the coating edge occurs due to various causes. For example, if the continuous circular incision or capsule incision method is inappropriate, the anterior edge may be erroneously cut or torn. On the other hand, beer cans or can opener capsular incisions have medial scalloped edges with stress-generating areas that are not perfect and have edges that are more likely to tear during surgery or subsequent fibrous tissue formation. .. Envelope capsular incision, by its very nature, results in tearing and incomplete precapsular remnants. If the remnant structure or edge of the broken anterior coating is torn, the simple plate-tactile partial lens of the present invention cannot be used for the following reasons. The torn edge is unable to hold the tactile partial lens firmly in the groove of the capsule during fibrous tissue formation, which tends to cause the lens to eccentric and / or shift posteriorly or anteriorly. The torn coating edge cannot take a taut trampoline-like state at the unbroken edge. In this case, the torn capsular edge cannot completely deflect the plate tactile partial lens posteriorly to the posterior capsule due to the far vision during and after fibrous tissue formation. In practice, the torn coating edge allows the lens to deflect forward. In either case, the magnification of the lens is chosen to suit the individual patient and is determined by his or her eyesight, and the lens optics must be at an accurate distance from the retina in order to obtain a good image without wearing glasses. Therefore, the simple plate tactile partial lens of the present invention cannot be used with the remnants or edges of the torn anterior capsule. The adjustable plate tactile partial spring lens of the present invention is intended to be used when the remnant tissue of the anterior coating or the edge of the coating tuft is torn. These plate tactile partial spring lenses are similar to simple plate tactile partial lenses. However, it has an elastic spring such as a spring loop provided at the end of the tactile portion of the plate. When the plate contact partial spring lens is embedded in the capsule tuft, the tactile partial spring is pressed outward against the wall of the capsular tuft groove to secure the lens in the tuft during fibrous tissue formation. A method in which the torn anterior capsule residue is fused to the posterior capsule to firmly secure the spring, and thus the tactile region, in the tuft, and also to deflect the lens posteriorly to the elastic posterior capsule during fibrous tissue formation. Fibrous tissue formation occurs around the spring in the manner in which it is obtained. After fibrous tissue formation on the torn capsular edge, due to the contraction and relaxation of the ciliary muscles caused by the brain, the plate tactile region in exactly the same way as a simple plate tactile lens and an intact capsular edge. The spring lens is adjusted. While the plate tactile partial spring lenses of the present invention are intended for use with the remnants or edges of the torn anterior coating, these lenses can also be used with intact edges. A plate-tactile partial spring lens corrects when the lens is improperly placed in the eye with one end of the lens placed in the capsule and the other end in the ciliary groove of the eye. do. In this regard, the advantage of the plate tactile partial spring lens of the present invention over the simple plate tactile partial lens is that of the simple plate tactile partial lens for use with an intact coated edge and the plate tactile partial lens thereof. As an alternative, the need to prepare both plate-tactile partial spring lenses in the operating room is eliminated by the spring lenses. Another advantage of the plate tactile partial spring lens over the simple plate tactile partial lens of the present invention is that this tactile partial spring lens has a simple plate tactile sensation in which the diameter of its optical element is usually limited to the range of 4 to 7 mm. The point is that it enables an optical element having a diameter larger than that of a partial lens. Thus, the tactile partial spring lens utilizes the tactile partial spring rather than the remnant tissue or edges of the coating to hold the lens in place during fibrous tissue formation. As a result, the residual structure or edges of the coating with a narrow radial width, or the cracked or torn coating edges, are more effective than possible with a simple plate tactile lens. These lenses can be used with both coating edges, which provide a large front coating opening. On the other hand, the large anterior capsule opening allows for larger optic diameters, which provides certain ophthalmological advantages. According to one embodiment of the invention, after fibrous tissue formation is complete, a laser is used to cut the edges of the anterior capsule in the radial direction or by cutting the edges in the circumferential direction to widen the opening. , Such a large opening is provided. Yet another embodiment of the invention is an adjustable lens of the invention that allows adjustment in the human eye in which the natural lens matrix has been removed from the lens capsule by a method involving an anterior capsular incision of the natural lens. It is about a new way to use. This method is used to replace the natural crystalline lens with cataracts removed and to allow the patient to see better without the use of spectacles. It can be used to correct the error. For example, the present invention requires reading spectacles or bifocal lenses for near vision by using an accommodative intraocular lens according to the invention in place of a transparent crystalline lens substrate that does not cause cataracts in the eye. It can be used to correct refraction errors and restore accommodation for humans in their mid-40s. According to the method utilizing the plate tactile partial spring lens of the present invention, after the fibrous tissue formation is completed, the residual tissue of the anterior capsule or the edge of the capsule tuft is radially cracked or cut. The front coating opening can be enlarged to allow the use of relatively large diameter optical elements of 6 mm or 7 mm or more. It relates to a novel method using an adjustable lens of the present invention that allows adjustment in the human eye in which the natural lens substrate has been removed from the lens capsule by a method involving an anterior capsular incision of the lens. This method is used to replace the natural crystalline lens with cataracts removed and to allow the patient to see better without the use of spectacles. It can be used to correct the error. For example, the present invention requires reading spectacles or bifocal lenses for near vision by using an accommodative intraocular lens according to the invention in place of a transparent crystalline lens substrate that does not cause cataracts in the eye. It can be used to correct refraction errors and restore accommodation for humans in their mid-40s. According to the method utilizing the plate tactile partial spring lens of the present invention, after the fibrous tissue formation is completed, the residual tissue of the anterior capsule or the edge of the capsule tuft is radially cracked or cut. The front coating opening can be enlarged to allow the use of relatively large diameter optical elements of 6 mm or 7 mm or more. It relates to a novel method using an adjustable lens of the present invention that allows adjustment in the human eye in which the natural lens substrate has been removed from the lens capsule by a method involving an anterior capsular incision of the lens. This method is used to replace the natural crystalline lens with cataracts removed and to allow the patient to see better without the use of spectacles. It can be used to correct the error. For example, the present invention requires reading spectacles or bifocal lenses for near vision by using an accommodative intraocular lens according to the invention in place of a transparent crystalline lens substrate that does not cause cataracts in the eye. It can be used to correct refraction errors and restore accommodation for humans in their mid-40s. According to the method utilizing the plate tactile partial spring lens of the present invention, after the fibrous tissue formation is completed, the residual tissue of the anterior capsule or the edge of the capsule tuft is radially cracked or cut. The front coating opening can be enlarged to allow the use of relatively large diameter optical elements of 6 mm or 7 mm or more.<u style="single">[Simple explanation of drawings]</u>FIG. 1 is a cross-sectional view of the human eye from which the natural crystalline matrix has been removed by surgery with an anterior capsular incision, such as a natural lens capsular tear, into the capsular chamber of the eye. FIG. 1A is a cross-sectional view of a normal human eye, FIG. 2 is a front side view of the intraocular lens of FIG. 1, and FIG. 3 is a view showing an embedded simple adjustable plate tactile partial lens according to the present invention. , FIG. 2 is a cross-sectional view along line 3-3 of FIG. 2, FIG. 4 is a cross-sectional view of FIG. 1 along line 4-4, and FIGS. A diagram showing a method of utilizing the intraocular lens of FIG. 4, FIGS. 9 to 12 are cross-sectional views similar to those of FIG. 3 of an adjustable intraocular lens according to a modification of the present invention, which has a different optical shape. FIG. 13 is a cross-sectional view similar to FIG. 3 of an adjustable intraocular lens according to a modification of the present invention showing the lens in its normal non-stressed state, and FIG. 14 shows the lens in its far-field position. , FIG. 15 is a cross-sectional view similar to FIG. 16, FIG. 15 is a cross-sectional view of an adjustable intraocular lens according to a modification of the present invention having a forward displaced optical axis, FIG. 16 is a lens in the capsule chamber of the eye. Anterior side view of an adjustable intraocular lens according to a modification of the present invention having an integral fixing means for fixing, FIG. 17 is a sectional view taken along line 17-17 of FIG. 16, FIGS. 18 to 21 are Anterior side view of an adjustable intraocular lens according to a modification of the invention, which has another integral means of fixing the lens in the capsule of the eye, FIG. 22 has a spring that assists in the adjustment. Anterior side view of an adjustable intraocular lens according to a modification of FIG. 23, FIG. 23 shows the lens of FIG. 22 implanted in the human capsule as in FIG. 1, and immediately after surgery and with constant adjustment. A diagram showing a lens in a rear position, FIG. 24 is a diagram similar to FIG. 23 showing a lens in a rear far vision position, and FIGS. 25 to 30 are in the intraocular capsule of the human eye as in FIG. Anterior side view of an adjustable intraocular lens according to a modification of the present invention, which has an independent fixing means for fixing the lens to the lens, FIGS. 31 to 34, according to a modification of the present invention having an integral fixing means. The figure of the adjustable intraocular lens, FIGS. 35-37, is a capsule incision method that continuously cuts in a circle, (capsulorhexis))), a diagram showing the coatings formed by the beer can coating incision method and the envelope coating incision method, FIG. 38 is a front view of the plate tactile partial spring lens according to the present invention, and FIG. 39 is an implant in the eye. A view similar to FIG. 4, showing a plate tactile partial spring lens of FIG. 38, FIG. 40 is an enlarged cross-sectional view along line 40-40 of FIG. 39, and FIGS. 41 and 42 are after the completion of fibrous tissue formation. FIG. 43 shows a front side view of a modified plate tactile partial lens according to the present invention, showing two methods of enlarging the capsule incision portion of the capsule tuft to allow a relatively large lens optical element to move forward. 44 to 46 are views of the plate tactile partial spring lens according to a modification of the present invention, FIG. 47 is a plan view of the front side of the current suitable adjustable lens according to the present invention, and FIG. 48 is FIG. 47. A cross-sectional view along lines 48-48, FIG. 49 shows the lens of FIG. 47 embedded in the capsule of the eye and in the posterior far-field position, FIG. 50 shows the adjustment of the lens. FIG. 51 is a view similar to FIG. 49 showing a lens at or near the front limit point, FIG. 51 is a cross-sectional view similar to FIG. 48 of an adjustable lens according to a modification of the present invention, and FIG. 52 is a view of the present invention. FIG. 53, a view similar to FIG. 47 of an adjustable lens according to still another modification, is a diagram similar to FIG. 47 of an adjustable lens according to yet another modification of the present invention.FIG. 43 is a front side view of the modified plate tactile partial lens according to the present invention, FIGS. 44 to 46 are views of the plate tactile partial spring lens according to the modified example of the present invention, and FIG. 47 is the current suitable adjustment according to the present invention. Top view of the anterior side of a possible lens, FIG. 48 is a cross-sectional view along lines 48-48 of FIG. 47, FIG. 49 shows the lens of FIG. 47 embedded in the capsule of the eye and far behind it. A diagram showing a lens in the visual field position, FIG. 50 shows a lens at or near the front limit of the adjustment, a diagram similar to FIG. 49, FIG. 51 is an adjustable lens according to a modification of the present invention. FIG. 48 is a sectional view similar to that of FIG. 48, FIG. 52 is a view similar to FIG. 47 of an adjustable lens according to still another modification of the present invention, and FIG. 53 is an adjustable lens according to still another modification of the present invention. It is the same figure as FIG. 47 of.FIG. 43 is a front side view of the modified plate tactile partial lens according to the present invention, FIGS. 44 to 46 are views of the plate tactile partial spring lens according to the modified example of the present invention, and FIG. 47 is the current suitable adjustment according to the present invention. Top view of the anterior side of a possible lens, FIG. 48 is a cross-sectional view along lines 48-48 of FIG. 47, FIG. 49 shows the lens of FIG. 47 embedded in the capsule of the eye and far behind it. A diagram showing a lens in the visual field position, FIG. 50 shows a lens at or near the front limit of the adjustment, a diagram similar to FIG. 49, FIG. 51 is an adjustable lens according to a modification of the present invention. FIG. 48 is a sectional view similar to that of FIG. 48, FIG. 52 is a view similar to FIG. 47 of an adjustable lens according to still another modification of the present invention, and FIG. 53 is an adjustable lens according to still another modification of the present invention. It is the same figure as FIG. 47 of.<u style="single">The best mode for carrying out the invention</u>Reference to the above drawings, first of all, FIGS. 1 and 1A, shows the human eye 10 in which the natural crystalline lens substrate has been pre-removed by surgery with a continuous tear circular capsular incision or capsular dissection. is there. This natural crystal has a lens coating with elastic anterior and posterior walls A, respectively, which are referred to by ophthalmologists and herein as anterior and posterior coatings, respectively. The natural lens capsule (Fig. 1A) usually contains an optically clear lens substrate M. In many humans, this crystalline matrix becomes cloudy with aging, resulting in a so-called cataract. Currently, it is a common practice to remove cataracts from the natural lens and restore the visual acuity of cataract patients by using an artificial intraocular lens in place of the lens matrix. As mentioned above, the continuous circular capsular incision or capsular dissection method is a substantially circular incision in such a way that a circular opening with a relatively smooth edge can be formed in the center of the precapsule. Includes the step of tearing the anterior capsule A along the line. Cataracts remove the natural crystalline lens from the capsule through this opening. After this surgery is complete, the eye will have an optically clear anterior cornea 12, an opaque sclera 14 with the retina 16 of the eye inside, an iris 18, and a capsule 20 behind this iris. It has a vitreous cavities 21 behind the scleral bunches filled with gel-like vitreous fluid. The capsular tuft 20 is the structure of the natural lens of the eye that remains intact in the eye after performing a continuous circular dissection and removing the natural lens substrate from the natural lens. The capsular tuft 20 comprises an annular anterior capsular remnant or edge 22 and an elastic posterior capsule 24 that are connected along the perimeter of the tuft and between the margin and the posterior capsule. An annular crevasse-like film tuft groove 25 is formed in the ring. The capsular edge 22 is the remnant tissue of the precapsule of the natural lens that remains after performing the capsular tearing process on the natural lens. This edge surrounds a substantially circular anterior opening 26 (capsular incision) in the center of the capsular tuft in the circumferential direction, and the natural lens substrate is pre-removed from the natural lens through this opening. Capsule bunch 2 0 is anchored to the ciliary muscle of the eye by a zonule 30 around its perimeter. Natural accommodation in the normal human eye with a normal crystalline lens involves the steps in which the brain automatically contracts, ie, tensions and relaxes the ciliary muscles of the eye in response to looking at objectives at different distances. Including. The relaxed state of the ciliary muscle, which is the normal state of the ciliary muscle, sets the shape of the human crystalline lens with respect to the distant visual field. The tension of the ciliary muscle sets the shape of the human crystalline lens with respect to the near vision. The brain-induced changes from far-field to near-field are called regulation. An accommodative intraocular lens 32 according to the present invention, which replaces the removed human crystalline lens and performs its accommodative function, is embedded in the capsule tuft 20 of the eye 10. The lens 32 will be described as a simple plate tactile partial lens in order to distinguish it from the plate tactile partial spring lens of the present invention described later. As can be easily understood from the above and below, this adjustable intraocular lens is a substantially completely defective natural lens, such as a cataracted natural lens, or spectacles at some distance. It can be used to replace any of the natural crystalline lenses, which gives a satisfactory field of view without wearing glasses, but does not provide a satisfactory field of view without wearing glasses at another distance. For example, the accommodative intraocular lens of the present invention corrects the refractive error of humans in their mid-40s who require reading glasses or bifocal lenses for near vision and restores their accommodation function. Can be used for. The intraocular lens 32 includes a body 33 that can be formed of a relatively hard material, a relatively soft flexible semi-rigid material, or a combination of both the hard and soft materials. Examples of relatively hard materials suitable for this lens body are methyl methacrylate, polysulfone, and other relatively hard bioinert optical materials. Examples of relatively soft materials suitable for the lens body are silicones, hydrogels, heat resistant materials (thermolabile). materials), and other flexible, semi-rigid, biologically inert optical materials. The lens body 33 has a substantially rectangular shape, and the lens body includes a central optical region, that is, an optical element 34, and a plate tactile portion 36 extending from both radial edges of the optical element. ing. The tactile portion comprises an inner end connected to the optical element and an opposite free outer end. The tactile portion 36 is movable forward and backward with respect to the optical element 34, that is, the outer end of the tactile portion is movable forward and backward with respect to the optical element. An embodiment of the special lens illustrated is made of an elastic semi-rigid material, which lens comprises a flexible hinge 38 that connects the inner end of the tactile portion to an optical element. The tactile portion is relatively rigid and can flex forward and backward with respect to the optical element around the hinge. These hinges are formed by a groove 40, which enters the front side of the lens body and extends along the inner edge of the tactile portion. The tactile portion 36 can bend forward and backward of the optical element about the hinge 38. The lens is in the relatively flat, non-stressed form shown in FIGS. 2 and 3, in which case the tactile portion 36 and its hinge 38 are in a common plane intersecting the optical axis of the optical element 34. It is arranged. As the tactile portion deflects forward and backward around its hinge 38, the lens deforms from this unstressed form, resulting in an elastic strain energy force in the hinge, which causes the lens. Is biased towards its unstressed form. If the lens is made of a relatively hard optical material, it is necessary to use the same type of pivot hinge instead of the flexible hinge 38. In the latter embodiment of the present invention, the tactile part hinge is omitted, and the tactile part is made flexible over its entire length. The adjustable intraocular lens 32 is implanted in the capsule tuft 20 of the eye 10 at the positions shown in FIGS. 1 and 5. When the lens is implanted in the tuft, the ciliary muscle 28 of the eye is kept in its relaxed state, in which case the ciliary muscle has the capsular tuft 20. Stretch to its maximum diameter. The lens is inserted into the tuft through the anterior capsule opening 26 and placed at the positions shown in FIGS. 1 and 4. At this position, the lens optics 34 are aligned with the opening 26 on the axis of the eye, the posterior portion of the lens points towards the elastic posterior coating 24 of the tuft, and the outer edge of the tactile portion 36 of the lens. Is arranged in the groove 25 at the radial outer periphery of the tuft. The overall length of the lens is approximately equal to the inner diameter (10-11 mm) of the stretched coating tuft, so that the lens has a stretched coating with the outer edge of its tactile portion in contact with the inner circumference of the tuft, as shown. It fits snugly in the cell. This prevents the lens from moving away from the center, which allows the optics 34 to be smaller, so that the optics move forward within the edges of the coating during the adjustments described below. Can be done. After the lens 32 is surgically implanted in the capsule tuft 20, the epithelial cells below the anterior capsule margin 22 of the tuft are rimmed by fibrous tissue formation during the postoperative healing period of about 2 to 3 weeks. Is fused to the posterior coating 24. This fibrous tissue formation occurs around the lens tactile portion 36, where the capsular tuft 20 "shrink-wraps" the tactile portion, which forms a void 42 within the fibrous tissue-formed material F (FIG. 4). And FIGS. 6 to 8). These voids work with the tactile portion of the lens to position and center the lens in the eye. The ciliary muscle 28 does not become tense from its relaxed state in order to ensure that the tactile space 42 is properly formed and to prevent the lens from shifting due to the tension of the ciliary muscle during fibrous tissue formation. In addition, sufficient time must be allowed to allow fibrous tissue formation to complete. According to one important form of the invention, this is a ciliary muscle relaxant (ciliary body) prior to surgery in order to dilate the pupil and paralyze the ciliary muscle in its relaxed state. Ciliary muscle paralysis drug) is administered to the eye, and the patient regularly instills ciliary muscle paralysis drug drops for a sufficient period (2 to 3 weeks) after surgery without straining the ciliary muscle. It is done so that fibrous tissue formation is completed. The ciliary muscle numbing drug keeps the ciliary muscle 28 in its relaxed state, which is the state. At, the coating tuft 20 is stretched and fixed to its maximum diameter, and the anterior coating edge 22 is stretched to a taut trampoline-like state or position. The rim forms fibrous tissue from this taut state. The ciliary muscle palsy drug enters the fluid in the eye through the cornea of the eye and then enters the ciliary muscle from this fluid. Although other ciliary muscle numbing agents can be used, atropine is a suitable ciliary muscle numbing agent because it has a longer-lasting paralytic effect than other ciliary muscle numbing agents. .. For example, atropine is effective for 2 weeks with a single drop. However, with a margin, patients are advised to instill a drop of atropine daily during fibrous tissue formation. The capsular edge 22 contracts during fibrous tissue formation, thereby causing the capsular tuft 20 to contract slightly in its radial direction. This contraction, combined with the shrink wrap of the tactile portion 36 of the lens, counteracts this contraction of the lens towards the end, resulting in the lens optics flexing or flexing at its hinge 38. As a result, the lens optical element 34 is moved along the axis of the eye. If not suppressed, this lens deflection will occur either forward or backward. The taut anterior coating edge 22 is pushed rearward with respect to the lens, thereby preventing the lens from bending forward. The compression of the lens by this fibrous tissue formation is not large enough to prevent the proper formation of tactile space in the fibrous tissue formed tissue or to shift the lens. Thus, due to compression towards the lens end due to fibrous tissue formation, the lens is shown in FIGS. 1 and 5, which is assisted by the taut coating edge being pressed posteriorly against the tactile portion 36 of the lens. It bends backward from the initial position to the position shown in Fig. 6. The lens tactile portion 36 is formed to be sufficiently rigid, and the tactile portion does not bend or bend due to the force of fibrous tissue formation. Upon completion of fibrous tissue formation, the lens reaches the posterior position of FIG. 6, at which point the lens is pressed posteriorly against the elastic posterior capsule 24, stretching the capsule posteriorly. Next, the posterior coating is Ren Gives an elastic eccentric force forward. The position behind this lens is its far-field position. Flexion of the lens 32 by the ciliary muscle during fibrous tissue formation can be resisted or prevented by placing a suture in the hinge groove 40. To remove these sutures after the fibrous tissue formation is complete, use a suture that can be adsorbed to the fluid in the eye, or use a suture made of a material such as nylon that can be removed with a laser. Can be done by The natural accommodation of the normal human eye is the step of setting the shape of the natural crystalline lens by automatically tensioning and relaxing the ciliary muscles of the eye by the brain and focusing the lens at different distances. including. The relaxation of the ciliary muscles causes the natural crystalline lens to be shaped for far vision. The tension of the ciliary muscles causes the natural lens to be shaped relative to the near vision. The adjustable intraocular lens 32 utilizes the movement of this ciliary muscle, the fibrous tissue-formed capsular edge 22, the elastic posterior capsule 24, and the vitreous pressure within the vitreous cavity 21 of the eye. It has a unique structure in which the lens optical element 34 adjusts the movement of the lens optical element 34 between the far-field position in FIG. 6 and the near-field position in FIG. 8 along the optical axis. Thus, when looking at a distant scene, the brain relaxes the ciliary muscle 28. Due to the relaxation of the ciliary muscle, the capsular tuft 20 stretches to its maximum diameter and also stretches its fibrous tissue-formed anterior edge 22 to a taut trampoline-like state, i.e., to the position described above. The taut edge deflects the lens posteriorly to the posterior far-field position of FIG. 6, at which point the elastic posterior coating 24 is stretched posteriorly by the lens, thereby deflecting it forward to the lens. Give power. When looking at a nearby scene, such as when reading a book, the brain contracts or strains the ciliary muscles. This ciliary muscle tension increases the pressure in the vitreous cavity and relaxes the capsular tuft 20, especially its fibrous tissue-formed capsular edge 22, and to the end of the lens tactile portion 36. A compressive force in the end direction is applied so as to face each other, and as a result, the lens is pressed in the end direction. It has the triple effect of shrinking. The relaxation of the capsule edge causes the edge to flex anteriorly, which combines the anterior eccentric force exerted on the lens by the posteriorly stretched posterior capsule with the increased pressure in the vitreous cavity. During the first adjustment operation, the lens is pushed forward from the position shown in FIG. 6 to the middle adjustment position shown in FIG. When in this intermediate adjustment position, the lens is substantially flat and the tactile portion of the lens and the end of its hinge 38 are approximately located in a common plane perpendicular to the axis of the eye. During the first accommodation, the lens bends backwards, which causes the lens to compress towards the end due to the tension of the ciliary muscles, causing the lens to flex backwards, which is the first force. Resist the adjustment. However, the increased pressure in the vitreous cavity and the anterior eccentric force of the stretched posterior capsule outweigh this resistant posterior flexion force, and the lens is adjusted anteriorly in the middle of FIG. It is sufficient to be at least slightly above the position. At this point, the tense ciliary muscle compresses the lens toward the end, causing the lens to flex forward, and this force goes beyond the midpoint in FIG. 7 and is close to in FIG. Make the final adjustment of the lens to the field of view position. After that, the ciliary muscle 28 relaxes at the command of the brain in response to seeing a distant scene, which reduces the pressure in the vitreous tooth cavity, and the capsular tuft 20 extends to its maximum diameter and anterior. The coating edge 22 returns to its taut trampoline-like state, and the lens returns to its far-field position in FIG. During the adjustment, the lens optics 34 move toward or away from the retina 16 along the axis of the eye. The magnification of the optics is selected by brain command so that the incident light can be clearly focused on the retina over the entire range of this regulatory action. The lens tactile portion 36 bends at its hinge 38 with respect to the lens optics 34 during adjustment. All elastic strain energy generated in the hinge during this flexing process creates additional forward and / or backward forces on the lens. For example, when the lens is relatively flat, i.e. in the normal unstressed state of the lens. It is assumed that the tactile portion 36 of the lens is in the common plane shown in FIG. In this case, the lens deflects backward from the position of FIG. 1 to its far-field position of FIG. 6, and an elastic strain energy force is generated in the hinge 38, and this energy force causes the lens to be unstressed in FIG. It is returned to the state position, thereby assisting the lens in performing the initial adjustment movement described above in response to the tension of the ciliary muscles. The lens finally adjusts and flexes from its midpoint in FIG. 7 to its near-field position in FIG. 8 to generate elastic strain energy in the hinge 38, which causes the lens to stress-free. It urges posteriorly towards position, thereby assisting the lens to initially return from its near-field position to its far-field position in response to relaxation of the ciliary muscle. The lens can, of course, be designed to be in other normal non-stressed positions, where all elastic strain energy generated in the lens during tactile flexion is the non-stressed eye. Corresponding to the position, the lens assists or resists the adjustment motion of moving to its near-field position and returning to its far-field position, or both assists and resists. During the adjustment operation, the tactile portion 36 of the lens slides toward the end in the tissue space 42 in which the fibrous tissue is formed. As best illustrated in FIGS. 2 and 3, the tactile portions are tapered in width and thickness towards the edges, allowing the tactile portions to move freely in the void. The lens optical element 34 moves toward and away from the anterior coating edge 22. The diameter of the optical element should be as large as possible so that its optical image formation function can be maximized. The optics should be smaller than the diameter of the anterior coating opening 26 to allow the optics to move in and out of the opening without being disturbed by the coating edge 22 and to maximize the adjustment range. Is preferred, but not necessarily. The actual lens diameter is determined by the patient's eye size. The dimensional range of the simple plate-tactile partial intraocular lens according to the present invention is as follows. Optical axis diameter: 3.0mm to 7.0mm Overall length of lens: 9. 35mm Next, FIGS. 9 to 15 showing some alternative shapes possible for adjustable intraocular lenses will be described. The lens 50 of the modified embodiment shown in FIG. 9 is the same as the lens 32 of FIGS. 1 to 8, the only difference is that the tactile part hinge 38 of the lens 32 is omitted in the lens 50, and the tactile sensation of the lens 50. Part 52 is a point that can be flexed over its entire length, as shown by the broken line in FIG. The lens 54 of the modified embodiment of FIG. 10 has an arch-shaped non-stressed shape in front, and the lens has a biconvex optical element 56, a flexible hinge 58, and a convex front surface 62. It has an arched tactile portion 60 in front of it. The convex front surface 64 of the optical element 56 and the convex front surface 62 of the tactile portion are rounded to a common radius. The intraocular lens 66 of the modified embodiment of FIG. 11 is relatively flat, and the lens has a planar Fresnel front surface 70 and a convex rear surface 72, a tactile portion 73, and a flexible tactile portion. It includes an optical element 68 with a hinge 74. The lens 76 of the modified embodiment of FIG. 12 has an arched non-stressed shape at the rear, and the lens has an optical element 78 having a flat front surface 80 and a convex rear surface 82, and a convex shape. It includes a tactile portion 84 having a rear surface 86 and a tactile portion hinge 88. The rear surface 82 of the optical element 78 and the rear surface 86 of the tactile portion 84 are rounded to a common radius. The lens 90 of the modified embodiment shown in FIGS. 13 and 14 includes an optical element 92 and a flexible tactile portion 94, and the lens is close to the non-stressed state shown in FIG. It has the form of a visual field. The tactile portion bends to allow the lens to deflect backwards to the far-field form of FIG. The optical element 92 is displaced rearward with respect to the inner edge of the tactile portion, allowing the optical element to be displaced more forward during the adjustment operation without contacting the anterior coating edge 22 of the coating tuft 20. To do. The intraocular lens 100 of the modified embodiment of FIG. 15 includes a tactile portion 102 and an optical element 104 displaced forward with respect to the inner end of the tactile portion. These tactile parts are separated by a flexible hinge 106. It is connected to the side portion of the optical element facing in the radial direction. The intraocular lens of the modified embodiment of FIGS. 9 to 15 is embedded in the capsule tuft 20 of the eye 10, and the lens is the same as the method described for the intraocular lens 32 of FIGS. 1 to 8. The posterior eccentric force of the capsular edge 22 and the posterior capsule 24 formed by the method is used to change and regulate the vitreous sinus pressure and the movement of the patient's ciliary muscle. In the case of the lens 100 of FIG. 15, the outer end of the tactile portion 102 is embedded in the capsule tuft 20 in essentially the same manner as the tactile portion of the lens 32, and thus will be described with reference to FIGS. 1 to 8. The fibrous tissue formation of the edge 22 is performed centering on the tactile part by the same method as in the above method. On the other hand, the optical element 104 of the lens 100 displaced forward projects through the anterior opening 26 of the capsular 20 and is located in front of the edge and between the edge and the iris 18 of the eye. There is sufficient space between the rim and the iris to adjust the optics of the lens of the proper size without the optics touching the iris. 16 to 20 show an adjustable intraocular lens according to a modified embodiment of the present invention, in which the intraocular lens becomes a posterior capsule when the posterior capsule 24 is torn or the posterior capsule becomes cloudy. When a posterior capsular incision method must be performed, the tactile portion of the lens is fixed or fixed in the capsular chamber 20 to prevent the lens from entering the vitreous cavity 21 of the eye. Except as described below, the intraocular lens of the modified embodiment of FIGS. 16 to 20 is the same as the lens 32 of FIGS. 1 to 8, and is the same method as the method described with respect to FIGS. 1 to 8. It is implanted in the capsular tuft 20 of the eye 10. The intraocular lens 110 of FIGS. 16 and 17 is the same as the lens 32, except that the outer end of the tactile portion 112 of the lens includes a raised shoulder 114. The fibrous tissue formation of the capsular edge 22 around the tactile portion 112 and its shoulder 114 anchors or anchors the lens 110 within the capsular tuft 20. The intraocular lens 116 of FIG. 18 is the same as the lens 32, except that the flexible stalk knob 118 extends diagonally from the outer edge of the tactile portion 120 of the lens plate. It is one. The distance between the outer ends of the knobs 118 facing in the radial direction is slightly longer than the distance between the outer ends of the tactile portion of the lens and slightly larger than the diameter of the capsule bunch 20. The knob is set wider than the width of the lens body. These two features help center the intraocular lens within the capsule tuft, so that the lens optics are centered in the tuft just behind the circular capsular incision portion 26. The lens 116 is secured within the capsular tuft 20 by fibrous tissue formation of the tactile portion 120 and the capsular edge 22 around its knob 118. The intraocular lens 122 of FIG. 19 is identical to the lens 32, except that the outer end of the tactile portion 124 of the lens has an opening 126. Fibrous tissue formation at the capsular edge 22 takes place around the tactile portion 124 and through its opening 126, fixing the lens 122 within the capsular tuft 20. The intraocular lens 128 of FIG. 20 is similar to the lens 122, which has an opening 130 at the outer end of its tactile portion 132, through which fibrous tissue formation of the capsular edge 22 is formed. It arises and secures the lens in the capsule bunch 20. However, unlike the lens 122, the tactile portion opening 130 borders the spring loop 134 along the outer edge of the tactile portion. The total length of the lens 128 measured between the centers of the spring loop 134 is slightly larger than the maximum diameter of the capsule tuft. The spring loop 134 presses against the outer circumference of the capsule and is slightly inwardly deformed by the outer circumference during fibrous tissue formation to center the lens in the eye. The modified intraocular lens 140 of FIG. 21 is provided with a central nipple 142 protruding from the outer end of the tactile portion 144 of the lens toward the end in order to correct a slight difference between patients in the diameter of the human capsule tuft 20. Except for this, it is the same as the lens 32 of FIGS. 1 to 8. Thus, the diameter of the capsular tufts ranges from about 11 mm in very myopic to about 9. There is a difference up to 5 mm. The central nipple 142 prevents a difference in the degree to which the tactile portion 144 flexes within the capsule tufts of different diameters. For example, in the eye of a hyperopic person with a small tuft, the lens tactile region flexes more due to the fibrous tissue-formed capsule edge than the small arch of the tactile region that occurs in a very myopic person with a relatively large capsular tuft. Is significantly arched backwards. The nipple itself penetrates the outer circumference of the capsule tuft to compensate for the difference in the tuft, thereby positioning the lens in the center of the tuft. The intraocular lens 150 of the modified embodiment shown in FIGS. 22 to 24 has a U-shaped shape made of a biologically inactive spring material and a lens body 152 which is the same as the lens body of FIGS. 1 to 8. It has a spring 154 in the form of a loop. The ends of these springs are fixed to the anterior side of the lens tactile portion 156, adjacent to the tactile portion hinge 158 so that the arcuate end of the spring extends a small distance beyond the outer end of the tactile portion. Will be done. These springs are stressed so that they are normally located relatively close to the anterior part of the tactile portion. The lens body 152 is embedded in the capsule tuft 20 of the eye 10 in the same manner as described for the lens 32 of FIGS. 1-8, and the arcuate outer end of the lens spring 154 is the iris 18 and the cornea 12. Placed in the groove 19 of the eye between. The spring 154 is relatively close to the anterior side of the tactile portion 156 of the lens when the lens is in the position of FIG. 23, which is the position immediately after surgery and after adjusting the degree. The posterior displacement of the fibrous tissue-formed capsular edge 22 causes the spring to deflect posteriorly from the tactile part of the lens, as shown, while the lens is displaced posteriorly to the far vision position of FIG. Generates an elastic strain energy force in the spring, which is regulated in response to the tension of the ciliary muscle 28, while the stretched posterior capsule 24 and the vitreous cavity sinus forward the lens. It has the effect of displacing. 25 to 32 show an intraocular lens according to a modified embodiment of the present invention, which has a lens body and an independent lens fixing element that positions the lens within the capsule bunch 20. It is done. Fibrous tissue formation at the capsule edge 22 takes place around these fixation elements in a manner that ensures that the fixation elements are fixed in the tuft. In some drawings, the lens body separates from the fixed element, allowing the lens to be removed from its initial position in the eye and the lens to be replaced. In other drawings, the lens body and fixing elements are fixed so that they do not separate, and when a crevice occurs in the posterior coating 24 of the tuft or a posterior capsule incision is performed on the coating, the lens body enters the glass tuft. To prevent. The lens 160 of the modified embodiment of FIG. 25 is provided with the same lens body 162 of the lens 32 of FIGS. 1 to 8 and an independent fixing element provided at the outer end of the lens tactile portion 166, except for the points described below. It has 164. These fixed elements and tactile portions are engaged with each other in such a manner that the fixed elements and the tactile portions can move relatively in the longitudinal direction of the tactile portions when the tactile portions bend during adjustment of the lens. The fixed element 164 of FIG. 25 is a substantially U-shaped loop made of a bioactive material, the loop of which slides in the longitudinal socket 170 and enters the outer end of the tactile portion 166. It has a part 168. The tactile portion 166 is slightly shorter than the tactile portion of the lens 32, and the total length of the lens measured between the arcuate outer ends of the fixed loop 164 when its leg 168 abuts on the bottom of its socket 170 is ciliary. It is smaller than the maximum diameter of the capsular tuft 20 when the morphological muscle 28 is relaxed, and larger than the diameter of the tuft when the ciliary muscle is completely contracted for regulation. The lens 160 is embedded in the capsule tuft 20 of the eye 10 and the outer ends of the fixed loop 164 and the tactile portion 166 are placed between the anterior edge 22 and the posterior capsule 24 of the capsular tuft 20. The arcuate outer end of the loop is located on the outer circumference of the tuft. Fibrous tissue formation at the capsular edge 22 takes place around the outer edge of the lens tactile portion 166 and the exposed outer edge of the fixed loop 164, and through the space between the tactile portion and the loop, the loop It is firmly anchored in the capsular tuft so that the tactile part forms a void 42 in the fibrous tissue-forming tissue F. Ciliary muscle 28 relaxes When this is done, the posterior eccentric force of the fibrous tissue-formed capsular edge 22 causes the lens to be posteriorly displaced to its far-field position, thereby rearwarding in the same manner as described with respect to FIGS. 1-8. The coating 24 is stretched posteriorly. As the ciliary muscle contracts during regulation, the vitreous cavity pressure increases and the capsular edge 22 relaxes, thereby again in the same manner as described with respect to FIGS. 1-8. The stretched posterior capsule and vitreous cavity pressure pushes the lens body 162 forward towards its near vision position. In response to the contraction of the ciliary muscle during the accommodative movement, the capsular tuft contracts, resulting in an inward force on the fixed loop 164. These inward forces urge the loop inward within its tactile socket 170 until the loop abuts on the bottom of the socket. Next, the inward force applied to the loop causes the lens body 162 to bend forward, and this action assists the adjustment of the lens by the posterior coating. During this adjustment, the lens tactile portion 166 flexes posteriorly with respect to the lens optics 172 and also slides inward within its fibrous tissue formation void 42 and along the leg 168 of the fixed loop 164. However, this operation is assisted by the hinge 38. The fixed loop has a hole 174 at its arched outer end, through which the suture 176 is extended and connected to assemble the loop and lens body while implanting the lens in the capsule tuft. Hold in the state. This suture is removed at the end of surgery. Hole 174 can also be used to position the lens within the capsular chamber during surgery. The lens tactile portion 166 is separable from the fixed loop 164 and re-engaged with the loop. This allows at any time after surgery to remove the lens body 162 from the eye, adjust or replace the lens optics 172, and then reattach it to its original position in the eye. To do. The intraocular lens 180 of the modified embodiment of FIG. 26 is the same as the lens of FIG. 25 except for the following differences. First, the tactile portion 182 of the lens 180 is approximately equal in length to the tactile portion of the lens 32, and , It has a notch 184 on its outer edge. The leg 188 of the fixed loop 186 slides in the socket 190 that enters the bottom edge of the notch 184. When the lens is embedded in the capsular tuft 20, the tongue-shaped tactile portions on both sides of the tactile portion notch 184 and the arcuate outer ends of the fixed loop 186 are located within the perimeter of the tuft. Similar to the lens of FIG. 25, fibrous tissue formation at the capsular edge 22 takes place around the tactile portions 182 and the fixed loop 186 and through the space between the tactile portions and the loops, encouraging the loops into the capsule tufts. When fixed and also forms a void and the tactile portion bends during lens adjustment, the tactile portion slides in this void. Second, the socket 190 formed on the leg 188 and the lens tactile portion 182 of the fixed loop 186 allows the loop and tactile portions to move relatively freely when the tactile portion bends during adjustment. It is tapered. Third, the fixation loop is provided with a fixation nipple 192 at its arched outer end, which penetrates into the outer circumference of the capsular tuft 20 and holds the lens stationary with respect to the tuft during fibrous tissue formation. Hold. FIG. 27 is similar to the lens 180 shown in FIG. 26, except that the legs 198 of the fixed loop 200 and the tactile sockets 202 that receive these legs are provided with collaborative shoulders 204, 206. The intraocular lens 196 of the modified embodiment is shown. These shoulders allow the lens body 208 and loops to have limited relative movement when the tactile portion 210 flexes during lens adjustment, but the lens body and loops are not completely separated. It prevents the lens body from entering the glass bunch 21 when it sticks and tears occur in the posterior coating 24 or when a capsule incision is made. Another difference between the lens 196 and the lens 180 is that the hinge 212 connecting the inner end of the tactile portion 210 to the lens optical element 214 extends so as to cross only the middle portion of the width of the tactile portion. The remaining lateral portion of the inner end of the tactile portion beyond the end of the hinge is separated from the optics by an arcuate slot 216 centered on the axis of the tactile portion. There is. As a result of the tactile portion being thus separated from the optical element, the optical element can freely enter and exit the front opening 26 of the coating tuft 20 without being disturbed by the coating edge 22 during lens adjustment. It becomes. The substantially triangular tactile portion adjacent to slot 216 prevents the edge 22 of the capsular tuft 20 from forming fibrous tissue between the lens optics 214 and the inner edge of the lens tactile portion 210, thereby preventing the tactile portion. Restricts movement towards the end within the fibrous tissue-formed void 42. The lens 220 of the modified embodiment of FIG. 28 includes a lens body 222 and an independent fixing element 224 provided at the outer end of the lens tactile portion 226. The inner end of the tactile portion is curved in a convex shape and is arranged in a substantially tangential state with respect to the side portion of the lens optical element 228 facing in the radial direction, and is provided between the optical element and the inner end of the tactile portion. It provides a relatively large clearance space 230. These tactile and optical elements are connected along their tangential portion by a flexible hinge 232. The fixing element 224 is a substantially cross-shaped pin, which has an inner journal 234 sliding within a bearing hole 236, which journal is the bottom edge of a notch 238 at the outer end of the tactile portion 226. to go into. These fixing pins include a hole 240 between both ends thereof, an outer cross arm 242, and a nipple 244 provided at the outer end thereof. The length of the lens 222 measured between the outer edge of the tactile portion 226 and the fixing pin 224 approximates the maximum inner diameter of the capsular tuft 20 when the ciliary muscle is relaxed. The fixed pin journal 234 and its holes 236 are provided with collaborative shoulders 246, 248, which are relative to the lens body and fixed pins when the tactile portion flexes during adjustment. However, for the same reason as described with respect to FIG. 27, the main body and the fixing pin are fixed so as not to be completely separated. If desired, the shoulders 246 and 248 may be omitted so that the fixing pin and the lens body can be separated for the same reasons as described with respect to FIG. Detachable stitching if these shoulders are omitted The mixture may be passed through and connected to the holes 240 of the fixing pin to hold the fixing pin and the lens body in the assembled state during the embedding of the lens, as described with respect to FIG. These holes can also be used to position the lens within the capsule while embedding the lens. When the lens 220 is implanted in the capsule tuft 20 of the eye 10, the outer edges of the lens tactile portion 226 and the fixing pin 224 are the caps 22 and tufts in exactly the same way as described with respect to FIGS. 25-27. It is placed between the posterior coating 24. The nipple 244 penetrates the outer periphery of the tuft to secure the lens so that it does not rotate in the circumferential direction of the tuft during fibrous tissue formation at the edge 22, and also positions the lens in the eye. Fibrous tissue formation at the capsule edge takes place around the tactile part and the outer edge of the fixation pin, firmly fixing the pin in the tuft and forming a void in the fibrous tissue to receive the tactile part. When the ciliary muscle 28 relaxes, the lens body 222 is urged backward to its far-field position by the posterior eccentric force of the coating edge 22, while the post-coating 24 stretches during adjustment. When urged anteriorly towards its near-field position and further contraction of the ciliary muscles, it increases the pressure in the vitreous cavity, all of which is substantially the same as described with respect to FIGS. 25-27. It is done by the method of. While adjusting the lens forward, the capsular tuft 20 contracts in response to the contraction of the ciliary muscles, exerting an inward force on the outer edge of the tactile portion 226, thereby exerting an inward force on the lens body 222. A forward bending moment is generated in the lens, which assists the lens adjustment by the posterior capsule. During fibrous tissue formation at the edge 22, the cross-arm 242 of the fixation pin 224 is surrounded by fibrous tissue-forming tissue F, and in the process of adjusting the lens, with the center of rotation of the pin while the lens body bends. Provides a pivotal point. The space 230 between the inner edge of the tactile portion 226 and the optical element 228 is unobstructed by the surrounding coating edge 22 and allows the optical element to move in and out of the opening 26 of the coating tuft. Intraocular resection of the modified embodiment of FIGS. 29 and 30 The lenses 260 and 262 are identical to the lenses 180 and 196 of FIGS. 26 and 27, respectively, except that the same fixed pins 264 and 266 as in FIG. 28 are used in place of the fixed loop of the latter lens. .. In the intraocular lenses 270 and 272 of the modified embodiments of FIGS. 31 and 32, the lens 270 is provided with a lateral spring arm 274 extending from the tactile portion hinge 276, and the lens 272 is the edge of the lens tactile portion 280. It is the same as the lens 32 of FIGS. 1 to 8 except that it includes a lateral spring arm 278 that extends from. These arms 274, 278 extend laterally from the outer edge of the tactile portion of the lens and longitudinally towards the outer edge, and when in their normal non-stressed position, these arms extend along the longitudinal axis of the lens. It should be arranged at an acute angle with respect to. The length of the arm is set as follows. That is, when the lens is embedded in the capsule tuft 20 of the eye, the outer end of the arm is pressed against the outer circumference of the tuft, so that the length is such that the lens is curved or compressed to the position indicated by the broken line. When the capsular tuft expands in response to relaxation of the ciliary muscle during lens far-field adjustment, the curvature or compression of this arm becomes smaller, and during lens near-field adjustment, ciliary muscle contraction. As the tuft contracts in response to, its degree of curvature or compression increases. The engagement of the arm with the outer circumference of the capsule tuft centers the lens at a position within the tuft, at which point the lens optics 282 and 284 are coaxially aligned with the opening 26 of the anterior chamber. To do. The fibrous tissue formation of the capsular edge 22 takes place around the spring arm, fixing the lens in the capsular tuft and around the tactile part of the lens to form a void, which flexes the tactile part during lens adjustment. When the lens is removed, the tactile part slides in this space. With reference to FIGS. 32 and 4-8, reference numeral 286 is shown in FIG. 32 so that the film tear can be separated from the optical element when the film tear site contracts from the form shown in FIGS. 5-8. It is preferable to provide protrusions as shown in the above in various examples of the present invention. Due to this separation, the anterior coating edge 22 having the relatively small coating opening 26 is coated. Prevents entry into the optics during fibrous tissue formation at the edge 22. As illustrated in FIG. 32, the protrusion 286 extends forward and outward from the tactile surface of the plate, is also arranged around the optical element, and is separated from the optical element. The protrusions are typically about 1 to 1. It does not extend further outward beyond the outer edge of the optical element, which is 5 mm high. These protrusions are in the form of a continuous arc (not shown) and can be tilted outward with respect to the optics. The adjustable intraocular lens 290 of the modified embodiment of FIG. 33 is a pair of a circular optical element 292 and a curved flexible tactile portion 298, 300 extending from both edges of the optical element 294, 296. It has. These tactile parts are in the form of relatively thin arms. At the outer end of the tactile part is an extended knob 302. The two tactile portions 298 of each pair of tactile portions 294 and 296 extend outward from the tactile portion 292 in a mutually expanding relationship, and as shown, are curved in a direction away from each other toward the outer end thereof. ing. The four tactile portions are arranged symmetrically with respect to the plane of symmetry including the axis of the optical element and extend between the two of each tactile portion pair. These two tactile portions 298 are arranged at positions facing each other in the radial direction, and the two tactile portions 300 are also arranged at positions facing each other in the radial direction. The radial distance measured between the outer ends of the haptic portions 298 and 300 facing in the radial direction is slightly larger than the maximum diameter of the capsular tuft 20. The lens 290 is embedded in the tuft in substantially the same manner as in the previous embodiment of the present invention, and the outer edges of the lens tactile portions 298 and 300 are located between the anterior coating edge 22 and the posterior coating 24 of the tuft. Have been placed. The outer edge of the coating is elastically pressed against the outer circumference of the tuft and bends or bends to accept tufts of different diameters and center the optics 292 behind the anterior capsular incision in the tuft. The anterior capsule edge 22 of the tuft forms fibrous tissue around the capsule to secure the lens in the tuft. After fibrous tissue formation is complete, brain-commanded relaxation and contraction of the ciliary muscle 28 of the eye is effective in adjusting the lens between near-field and far-field positions in much the same way as described above. Is. During this adjustment, the lens bends and the tactile portion bends forward and backward in much the same way as described above with respect to the optical element 292. Fibrous tissue formation at the capsule edge around the tactile knob 302 As a result, when a tear or incision is formed in the posterior capsule 24 of the tuft, the lens is fixed in the tuft to prevent it from shifting. The adjustable intraocular lens 310 of the modified embodiment of FIG. 34 is similar to the lens 290 of FIG. 33, but differs from the lens 290 only in the following points. The four tactile portions 312 and 314 of the lens 310 are not the thin curved arms as in the case of the lens 290, but from the relatively wide inner end connected to the lens optical element 316 to the relatively narrow outer end. It is tapered symmetrically up to. At the outer ends of the tactile parts 312 and 314, there is an extended knob 318. A groove 320 is formed at the inner end of the tactile portion, which forms a flexible hinge 322, which allows the tactile portion to flex forward and backward of the optical element around the hinge. The diametrical distance between the outer ends of the haptic portions 312, 314 facing in the diametrical direction is equal to or slightly greater than the maximum diameter of the capsular tuft 20. The lens 310 is implanted in the tuft and fibrous tissue formation at the anterior capsule edge 22 of the tuft is performed around the tactile portion of the lens in the same manner as described above for the lens 290. After fibrous tissue formation is complete, lens adjustment is performed in the same manner as described above for lens 290 by relaxation and contraction of the ciliary muscle 28 of the eye at the command of the brain. The fibrous tissue formation of the capsular edge around the tactile knob 318 locks the lens in the capsular tuft and causes it to shift when a torn or capsular incision is formed in the posterior capsule 24 of the tuft. To prevent. The adjustable plate-tactile partial lens described in this regard will be described herein as a simple plate-tactile partial lens. These lenses are intact by anterior capsular incision performed on the eye and provide a circumferentially continuous annular anterior capsule remnant and margin during fibrous tissue formation to provide fibrous tissue formation. It is intended to be used when it has a sufficient radial width to hold the lens in place in and / or afterwards in the capsule tuft. According to another embodiment of the present invention, the present invention has FIGS. 38 to 40 and FIGS. 43 to 4. 6 shows an adjustable intraocular lens of a modified embodiment called a plate tactile partial spring lens, which is used when the remnant tissue of the anterior coating or the coating edge is torn, i.e. cut. It is intended for use when the lens cannot be held firmly in place during and / or after fibrous tissue formation due to tearing or tearing or narrow radial width. As mentioned above, the remnant tissue or edges of the torn coating occur in different forms. For example, a continuous incision circular capsular incision, or capsular incision method (Fig. 35), cuts the natural crystalline lens anterior capsule along a circular fissure line and a circular opening or capsular incision in the anterior capsule. It comprises the step of forming a portion 400 so that the opening is circumferentially surrounded by the annular remnant structure of the anterior coating or the edge 402. If this coating tearing method is improperly performed, a cut or a torn portion 404 is likely to occur at the coating edge. The beer can or can opener capsule incision method (Fig. 36) involves piercing the precapsule of the natural lens at a number of closely spaced positions 404 along a circular line and the anterior capsular edge within the puncture line. Includes the step of removing the circular portion of the lens to form a precapsular opening 406 surrounded by an annular edge 408 in the circumferential direction. This edge is initially intact and continuous in the circumferential direction, while the edge is provided with a scalloped inner edge 410 having a stress-relieving region, which allows during surgery or during surgery. During subsequent fibrous tissue formation, the edges are prone to radial tearing, as illustrated by reference numeral 411. The envelope capsule incision method (FIG. 37) involves cutting the anterior capsule of the natural lens along the horizontal line 412 and then along the vertical line 414 that extends upward from the horizontal slit and intersects the slit. Steps and then along a cut line 416 that extends upward from the top of the vertical slit portion in an arc and then vertically downwards to connect to the second vertical notch. Including the step of tearing the precapsule. This capsular tear method is cut at locations 412, thus forming a precapsular opening 418 bordering the fragile coating remnant tissue 420. Remnants or edges of torn anterior capsule The unit may interfere with the use of the simple plate-tactile partial lens of the present invention for the following reasons. The torn edge cannot hold the lens tactile part firmly in the groove of the capsular tuft during fibrous tissue formation. As a result, if the lens is eccentric and / or misaligned and the posterior capsule tears or becomes cloudy over time, it reaches the vitreous cavity and the portion is cut by a laser into the posterior capsule. A capsular incision can be formed. The torn coating edge cannot take a taut trampoline-like state of the intact coating edge. As a result, the torn capsular edge cannot completely deflect the plate tactile partial lens posteriorly during and after fibrous tissue formation and cannot be in the far-field position with respect to the posterior capsular. Also, the torn capsular edges facilitate the lens being deflected forward during fibrous tissue formation. In either case, the magnification of the intraocular lens is chosen to suit each individual patient, and to accommodate his or her eyesight and to obtain a good view without glasses, the entire range of accommodation. Therefore, the simple plate-tactile partial lens of the present invention can be used for the remnants or edges of the torn anterior capsule because the lens optics must be placed accurately at the correct distance from the retina. Can not. 38-40 show the adjustable plate tactile partial spring intraocular lens of the invention used with the remnants or edges of a torn anterior capsule such as any one of those illustrated in FIGS. 35-37. 420 is shown. This plate tactile partial spring lens includes a lens main body 422 of the same type as the lens main body of the plate tactile partial lens 32 of FIGS. 1 to 8, and a spring 424 provided at an end portion of the main body. The lens body 422 includes a central optical element 426 and flexible plate tactile portions 428 extending outward from both sides of the optical element in the radial direction. These tactile portions are connected to the optical element by a hinge 429 formed by a groove formed on the front side of the lens. The spring 424 is an elastic loop in which one end is fixed to the end of the tactile portion 428 on both sides of the longitudinal central axis of the lens body. These spring loops It bends outward in the longitudinal direction of the lens body from its fixed end to its center and then returns to its free end from its center towards the lens body. The end of the tactile portion 428 has a recess 430 so that the spring loop extends above the recess so that the loop and the edge of the recess form an opening 432 between them. The end of the spring loop is provided with a hole 433 that receives an instrument that positions the lens in the eye. The plate tactile partial spring lens 420 is implanted in the capsule tuft 20 of the eye in the same manner as described above for the simple plate tactile partial lens of the present invention. That is, while the ciliary muscle 28 is paralyzed in its relaxed state, the lens 420 is implanted in the eye, thereby extending the capsular tuft to its maximum diameter (9-11 mm). The total length of the lens body 422 measured between the ends of the lens tactile portion 428 at one side of the recess 430 of the tactile portion is approximately equal to the inner diameter of the elongated coating tuft. When the loop is in its normal unstressed state, the total length of the lens measured between the outer edges of the spring loop 424 at its center is slightly longer than this inner diameter of the stretched capsular tuft. For example, when the inner diameter of the stretched coating tuft is in the range of 10 to 10.6 mm, the lens body 422 has a total length of 10 to 10.6 mm measured between the outer edges of the tactile portion of the lens, and is a spring loop in a non-stressed state. The total length of the lens measured between the centers of is 11-12. It is in the range of 5 mm. 39 and 40 show the inside of the capsular tuft 20 having a torn anterior capsular edge 22 due to stretching due to relaxation of the ciliary muscle 28 and improper implementation of the continuous circular dissection method. A plate tactile partial spring lens 420 embedded in is shown. Due to the tearing of this edge, the lens body 422 cannot fit snugly into the stretched tuft as it does when the film edge is an intact edge with no tear. However, the tactile partial spring loop 424 is pressed outward against the wall of the capsular tuft groove around the edge of the tuft to secure the lens in the tuft during fibrous tissue formation after surgery. Fibrous tissue formation at the torn capsular edge 22 occurs around the outer edge of the plate tactile portion 428, around the spring loop 424, and through the opening 432 between the loop and the tactile moiety end, the torn edge. The part, or more precisely, the remnant tissue of the torn edge, is fused to the posterior capsule 24 of the capsule tuft. Thereby, in substantially the same manner as described above for the simple plate tactile partial lens of the present invention, the tactile moiety and the outer end of the spring loop are shrink-wrapped by fibrous tissue formation. The torn capsular edge 22 cannot stretch to the taut trampoline-like state described above when the ciliary muscle relaxes, but shrinks the lens during fibrous tissue formation of the torn edge. The wrap secures the lens firmly in the tufts and deflects the lens slightly backwards against the elastic trampoline 24. Therefore, after the fibrous tissue formation of the torn capsular edge is completed, the contraction and relaxation of the ciliary muscle 28 at the command of the brain is abbreviated as a simple plate tactile partial lens having an intact capsular edge without a torn part. The plate tactile partial spring lens is adjusted in the same way, but the degree of adjustment is considered to be unequal. Although the plate tactile partial spring lens 420 is intended to be used on the remnant tissue or edges of a torn anterior coating, the lens can also be used on intact edges. Further, in the plate tactile partial spring lens, since the spring loop extends outward and engages with both the inner edge of the tuft and the wall of the ciliary groove, one end of the lens is arranged in the capsular tuft, and other than the lens. The edge is Corrects the improper placement in the eye while it is placed in the ciliary groove of the eye. In this regard, the advantages of the plate tactile partial spring lens of the present invention over the simple plate tactile partial lens are the simple plate tactile partial lens used with the intact capsular edge and the edge torn during surgery. It is eliminated by a spring lens that does not require both the plate tactile partial spring lens and the plate tactile partial spring lens to be prepared in the operating room as a spare part for the plate tactile partial spring lens in case. Another advantage of the tactile partial spring lens 420 is that it is possible to use a lens having an optical element whose optical diameter is usually larger than that of a simple plate tactile partial lens in the range of 4-7 mm. Thus, the tactile partial spring lens utilizes a spring loop 424 rather than the remnant tissue or edge 22 of the coating to hold the lens in place during fibrous tissue formation, thus making the lens simple. It has a smaller radial width than is required when used in plate tactile partial adjustment lenses, and therefore can be used for remnants or edges of the coating with a larger anterior coating opening. Of course, the larger diameter anterior capsular opening allows the use of larger diameter optics in the range of 7-9 mm, which provides certain ophthalmic advantages. The large diameter anterior capsule opening required to accommodate the large optics spring adjustment lens is a large predetermined continuous circular capsule incision, the desired large diameter beer can external incision, during the initial surgery. It can be formed by a predetermined envelope outer incision method or by cutting the anterior capsule edge in the radial direction during surgery after implanting a spring-adjusting lens in the capsule. According to another of this form, the present invention provides a method of forming the desired large anterior capsule opening following the initial surgery after the completion of fibrous tissue formation. In this method, after the fibrous tissue formation is completed, the annular capsule edge is radially cut with a laser into a large number of flap-like residual tissues 434 (Fig. 41), and these residual tissues are lensed during the adjustment operation. More easily displaced so that the lens optics can pass through the openings in the anterior coating. this Alternatively, a laser cuts the edge of the coating radially outward along curve 436 (FIG. 42) concentrically with the first edge of the opening and opens. By expanding the portion, the opening of the anterior coating can be enlarged. In the plate tactile partial spring lens 500 according to the modified embodiment of FIG. 43, the tactile portion 502 is not hinged to the lens optical element 504 and is elastic over the entire length as in the case of the plate tactile partial lens of FIG. It is the same as the above-mentioned lens 420 except that it can be flexed. FIG. 44 shows a plate tactile partial spring lens 600 according to yet another modified embodiment of the present invention, wherein the spring loop 602 of the lens is integrally formed with the lens tactile portion 604. Except, it is the same as the lens 420. The lenses 700 and 800 according to the modified embodiments of FIGS. 45 and 46 are the same as the lenses 600, except that the lenses of these modified embodiments have a pair of spring loops at each end. The spring loop 702 of the lens 700 is directed towards both the end and lateral directions of the lens with a common base 704 integrally connected to the end of the lens tactile portion 706 along the longitudinal centerline of the lens. It has a free end that curves outward from the base portion. The spring loop 802 of the lens 800 has a base portion 804 that is integrally connected to the end of the lens tactile portion 806 along the longitudinal edge of the tactile portion and a freedom that curves inward with respect to the lateral direction of the lens. It has an edge. 47-50 show the current suitable adjustable intraocular lenses of the present invention. The illustrated lens 900 includes a plate tactile sensation including a main body 902 having a circular biconvex optical element 904 and a plate tactile portion 906 connected to side portions of the optical element facing each other in the radial direction by a hinge connecting portion 908. It is a partial spring lens. The tactile portion 906 includes a relatively wide outer end portion 910, an inwardly tapered central portion 912, and a relatively narrow tapered inner end portion 914. The inner end portion 914 is connected to an edge portion of the circular optical element 904 facing in the radial direction. To the length of the lens The width of the outer end portion 910 of the tactile portion measured at a right angle to the right angle is substantially equal to the diameter of the optical element. The width of the inner end portion 914 of the tactile portion, measured at right angles to the length of the lens, is substantially smaller than the diameter of the optical element. The outer edge portion 910 of the tactile portion and the tapered central portion 912 are equal to the principal length of the tactile portion measured in the longitudinal direction of the lens. The tapered inner end portion 914 of the tactile portion is tapered inward toward the outer end of the tactile portion to a width portion that gradually narrows. These inner end portions effectively form a crosslinked portion between the optical element and the wide outer main portion 910 of the tactile portion. The inner end portion of the tactile portion is close to the edge portion of the optical element 904, preferably intersecting the lens length in a substantially tangential relationship with the edge portion and crossing the front side portion of these end portions. It is equipped with a V-shaped groove 916 that extends. The outer end portion 910 of the tactile portion 906 has a relatively large opening 918 in the form of a notch that penetrates and opens the outer end of the tactile portion. One end of the spring arm 920 is connected to the outer end of the tactile portion at one side of the open end of the tactile portion notch 918. These arms extend laterally across the outer edge of the tactile portion, and these arms are elastically flexible towards the edge of the lens. As illustrated in FIG. 48, the optical element 904 is displaced forward with respect to the plate tactile portion 906. That is, the surface (intermediate surface) including the peripheral edge of the lens is parallel to the front side portion and the rear side portion thereof, and the surface (intermediate surface) of the lens penetrates the tactile portion in the middle of these side portions. It is in a position shifted forward along the axis. By arranging the optical element at a position shifted forward, a groove-shaped recess 924 is provided on the rear side portion of the lens along the connection portion between the optical element and the inner end 914 of the tactile portion. The relatively thin web-like portion of the lens body between the anterior groove 916 and the rear recess 924 is elastically flexible, and the web-like portion forms a hinge connection 908 and is tactile to the lens. The part can bend forward and backward with respect to the lens optics around this hinge connection. To. Referring to FIG. 49, the lens 900 is implanted in the capsular tuft 20 of the patient's eye, and after completion of fibrous tissue formation, the ciliary body is exactly the same as described for the lens of the previous embodiment of the present invention. Adjustments are made in response to contraction and relaxation of ciliary muscle 28. The spring arm 920 of the lens is pressed outward against the outer circumference of the tuft, even if the anterior remnant tissue 22 of the tuft has cracks, crevices, or other intact condition, as described with reference to FIGS. 38-40. Position the lens in the tuft in the same way as you did. After surgery, the fibrous tissue formation takes place around the lens tactile part 906 and through the tactile opening 918, while the anterior capsule edge 22 of the tuft 20 forms fibrous tissue to the elastic posterior capsule 24. , Fix the lens in the capsule tuft. By administering the ciliary muscle palsy drug to the eye as described above, the ciliary muscle 28 is kept in its relaxed state until the fibrous tissue formation is completed. Placing the optical element 904 in a suitable lens 900 at a forward offset provides two advantages. One of its advantages is that the placement of the hinge connection 908, which accompanies the placement of the optical element 904 in a forward-shifted position, promotes forward flexion of the lens, which causes the ciliary muscle 28 to contract. The point is to allow the optics to make adjustments with respect to the outer edge of the tactile portion 906 in response to the lens being compressed towards the edge. Another advantage is that the width of the hinge connection 908, which connects the tactile portion 906 to the diametrically opposed edge portion of the optical element 904, is relatively narrow compared to the diameter of the optical element, which is particularly preferred. In addition, as shown in the figure, it is a point narrower than the radius of the tuft. In this way, the hinge connection occupies only the relatively small circumferential edge of the optical element. The remaining circumferential edge portion of the optic between the connections is a free edge portion, which is not disturbed by the tactile portion at all, and both are the main parts of the outer circumference of the optical element. To configure. The diameter of the optic is equal to or slightly smaller than the anterior coating opening 26 of the capsule tuft in which the lens is embedded. Is formed. These features of the lens allow the lens to make large forward adjustment movements from the far vision position behind it in FIG. 49 to the front adjustment limit point in FIG. 50, at which the front adjustment limit position is optical. The element projects from the anterior capsule opening 26 in response to contraction of the ciliary muscle 28. The medial cross-linking portion of the tactile portion or the inward taper of the end 914 allows the tactile portion to enter and exit the tactile portion void of the capsule during the lens adjustment operation. The actual dimensions of a suitable lens will vary depending on the dimensions of the patient's eye. Next, the dimensions of a typical lens are listed. Total length of lens: 10.5mm Total length of lens including spring: 11.5mm Optical diameter: 4.50mm Outer end width of tactile part: 4.50mm End taper angle of tactile part: 30 ° Length of inner end part of tactile part: 0.75 mm Tactile thickness: 0.25-0.4mm Width of hinge connection: 1.50mm Lens material: Silicon In the lens 900 of FIGS. 48 to 50, the optical element 904 is arranged at a position shifted forward with respect to the tactile portion 906 within the thickness portion of the tactile portion, and the peripheral end of the optical element and the hinge connection portion 908. Both are arranged within the thickness of the tactile portion and between its anterior and posterior surfaces. FIG. 51 is a vertical cross-sectional view similar to FIG. 48 showing an intraocular lens 900a according to a modified embodiment of the present invention, which is the same as the lens 900, and the only difference between the lenses is the optical element 904a of the lens 900a. Is a point that is arranged at a position shifted forward with respect to the tactile portion 906a on the outside of the thick portion of the tactile portion. That is, in the lens 900a, both the peripheral edge of the optical element 904a and the hinge connecting portion 908a between the optical element and the tactile portion are arranged at positions in front of the front surface of the tactile portion 906a. The morphology of the lens according to this modified embodiment provides the same advantages as in FIGS. 48-50. The adjustable intraocular lens 900b according to the modified embodiment of FIG. 52 is substantially the same as the lens 900, except for the following differences. A relatively thin cross-linked or arched portion 922b that borders the adjacent side or end of the tactile opening 918b and closes the side or end is outside the lens tactile portion 906b at that end. It is integrally connected to the end and extends across the outer end. These arches are typically 0.20 mm wide and are centered on the optical axis of the lens optical element 904b. It is curved to a radius of 25 mm. These arches can be either elastically flexible, relatively flexible, or relatively rigid. The spring arm 922b of the lens 900b extends laterally across the open end or the outer end of the tactile portion facing the side of the tactile portion opening 918b and is also flexible towards the end of the lens. .. The adjustable lens 900c according to the modified embodiment of FIG. 53 is similar to the lens 900b of FIG. 52 in many respects, but differs from the lens in the following respects. In the lens 900c, the spring arm 920b of the lens 900b is omitted. The inner end or the crosslinked portion 914c of the tactile portion 906c of the lens has an extremely short length in the end direction of the lens. In reality, the length of the inner end portion 914c of the tactile portion is approximately equal to or slightly longer than the width of the open side portion of the groove 916c of the tactile portion, and the groove 916c of the tactile portion is lens optics. A hinge connection portion 908c between the element 904c and the tactile portion is formed, and the tactile portion can bend forward and backward with respect to the optical element about the connection portion. As a result, these hinge connections occupy approximately the entire length of the inner end portion 914c of the tactile portion, that is, constitute the entire length. The end arch portion 922c of the tactile portion can be either relatively flexible or relatively rigid. Lenses 900a, 900b, 900c of FIGS. 51-53 are implanted in the capsule of the patient's eye and respond to ciliary muscle contraction and relaxation in much the same way as lenses 900 of FIGS. 47-50. You can adjust your eyesight. However, in the case of lenses 900b, 900c, fibrous tissue formation takes place through the closed openings 918b, 918c of the tactile part of the lens and around the end arches 922b, 922c of the tactile part, and the lens is placed in the patient's eye. Fix it inside. The lens 900c can be sized to be intermediate in length to the outer dimensions of its arched portion 922c so that it can fit tightly into the capsule when the ciliary muscles relax, and these arched portions , Elastically bendable, and the arch is pressed against the outer circumference of the tuft
Every citation, both ways
| Document | Relation | Office | Cited during |
|---|---|---|---|
| WO2017026771A1 | Cited by | World Intellectual Property Organization (WIPO) | International search |
| US10368978B2 | Cited by | United States of America | Applicant |
| JP01080359A | Cites | Japan | – |
| JP63024937A | Cites | Japan | – |
| JP61279241A | Cites | Japan | – |
| JP61159964A | Cites | Japan | – |
| JP60077765A | Cites | Japan | – |
| JP02501363A | Cites | Japan | – |
| US04254509A | Cites | United States of America | – |
| US04790847A | Cites | United States of America | – |
| US04244060A | Cites | United States of America | – |
| US04304012A | Cites | United States of America | – |
| US04585457A | Cites | United States of America | – |
| WO92021304A1 | Cites | World Intellectual Property Organization (WIPO) | – |
| JP61257642A | Cites | Japan | – |
| JP63089154A | Cites | Japan | – |
88 members in 11 offices
Priority claims9
| Document | Office | Kind | Date |
|---|---|---|---|
| 08113215 | United States of America | – | |
| 11321593 | United States of America | A | |
| 11321593 | United States of America | A | |
| 9409654 | United States of America | W | |
| 9409654 | United States of America | W | |
| 1993113215 | – | – | – |
| 199409654 | – | – | – |
| US19930113215 | – | – | – |
| WO1994US09654 | – | – | – |
Members88
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| US5476514A | United States of America | A | |
| US5496366A | United States of America | A | |
| EP0715509A1 | European Patent Office (EPO) | A1 | |
| JPH09501856A | Japan | A | |
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| EP0715509A4 | European Patent Office (EPO) | A4 | |
| US5674282A | United States of America | A | |
| CA2313521A1 | Canada | A1 | |
| CA2558710A1 | Canada | A1 | |
| CA2558728A1 | Canada | A1 | |
| CA2558778A1 | Canada | A1 | |
| WO9929266A1 | World Intellectual Property Organization (WIPO) | A1 | |
| US6051024A | United States of America | A | |
| EP1037572A1 | European Patent Office (EPO) | A1 | |
| CN1283974A | China | A | |
| US6197059B1 | United States of America | B1 | |
| US2001001836A1 | United States of America | A1 | |
| US2001016771A1 | United States of America | A1 | |
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| WO0164135A1 | World Intellectual Property Organization (WIPO) | A1 | |
| AU4184501A | Australia | A | |
| EP1037572A4 | European Patent Office (EPO) | A4 | |
| US6322589B1 | United States of America | B1 | |
| JP2001525220A | Japan | A | |
| DE9422429U1 | Germany | U1 | |
| EP0715509B1 | European Patent Office (EPO) | B1 | |
| EP1186276A1 | European Patent Office (EPO) | A1 | |
| AT214255T | Austria | T | |
| ATE214255T1 | Austria | T1 | |
| US2002035398A1 | United States of America | A1 | |
| DE69430125D1 | Germany | D1 | |
| DE69430125T2 | Germany | T2 | |
| EP0715509B8 | European Patent Office (EPO) | B8 | |
| EP1261299A1 | European Patent Office (EPO) | A1 | |
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| US6494911B2 | United States of America | B2 | |
| CN1424896A | China | A | |
| JP2003524502A | Japan | A | |
| EP1261299A4 | European Patent Office (EPO) | A4 | |
| EP1186276B1 | European Patent Office (EPO) | B1 | |
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| EP1462071A2 | European Patent Office (EPO) | A2 | |
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| EP1637094A3 | European Patent Office (EPO) | A3 | |
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| ATE387894T1 | Austria | T1 | |
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| DE69433855T3 | Germany | T3 | |
| EP1637094B1 | European Patent Office (EPO) | B1 | |
| AT454107T | Austria | T | |
| ATE454107T1 | Austria | T1 | |
| DE69435264D1 | Germany | D1 | |
| EP0715509B2 | European Patent Office (EPO) | B2 | |
| EP1522279B1 | European Patent Office (EPO) | B1 | |
| ES2390860T3 | Spain | T3 |
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Numbers
- Publication
- 3677040
- Publication, DOCDB
- 3677040
- Publication, EPODOC
- JP3677040B
- Application
- 50819395
- Application, DOCDB
- 50819395
- Application, EPODOC
- JP19950508193
Titles2
- Japanese
- 調節可能な眼内レンズ
- English
- Adjustable intraocular lens
Classification
- CPC, 6
- B29D11/026
- A61F2/1629
- A61F2002/1689
- A61F2220/0091
- A61F2/15
- A61F2002/1681
- IPC, 1
- A61F2 16