Restoration of Accommodation by Lens Refilling

Abstract

A method for refilling a lens of an eye or increasing the elasticity of a lens of an eye includes removing a central portion of the lens core through the eye's cornea, a capsulorhexis in the eye's lens capsule and a gullet extending at least partially through the cortex of the lens. The lens is then refilled with a synthetic lens material. Sufficient lens core is left in place so that the synthetic material is not in contact with a lens capsule of the eye. The synthetic material used for refilling may be selected and may be formed in a shape and thickness so as to affect the refractive characteristics of the lens. An endocapsular lenticule may be inserted in the lens to affect the refractive characteristics of the lens.

1 . A method for refilling a lens of an eye having a lens with a lens core comprising a cortex surrounding a central nucleus, a lens capsule and lens epithelial cells enclosing the lens core and a cornea, the method including removing a central portion of the lens core through the cornea to create a void volume in the lens, creating an opening in the lens capsule, creating a gullet extending through the cortex from the opening to the void volume and filling the void volume through the opening and gullet with a synthetic lens material. 
     
     
         2 . The method of  claim 1 , wherein removing a central portion of the lens core comprises removing the central nucleus and substantially not any of the cortex. 
     
     
         3 . The method of  claim 1 , wherein removing a central portion of the lens core comprises removing the central nucleus and a central portion of the cortex. 
     
     
         4 . The method of  claim 3 , wherein removing a central portion of the lens core comprises leaving at least 10 μm of cortex in place adjacent the anterior lens capsule. 
     
     
         5 . The method of  claim 3 , wherein removing a central portion of the lens core comprises leaving at least 25 μm of cortex in place adjacent the anterior lens capsule. 
     
     
         6 . The method of  claim 3 , wherein removing a central portion of the lens core comprises leaving at least 50 μm of cortex in place adjacent the anterior lens capsule. 
     
     
         7 . The method of  claim 3 , wherein removing a central portion of the lens core comprises leaving at least 75 μm of cortex in place adjacent the anterior lens capsule. 
     
     
         8 . The method of  claim 4 , wherein removing a central portion of the lens core comprises leaving at least 10 μm of cortex in place adjacent the posterior lens capsule. 
     
     
         9 . The method of  claim 1  wherein removing a central portion of the lens core removes at least 12.5% of the volume of the lens core. 
     
     
         10 . The method of  claim 1  wherein removing a central portion of the lens core removes at least 30% of the volume of the lens core. 
     
     
         11 - 17 . (canceled) 
     
     
         18 . A method of altering the elasticity and the refractive characteristics of an eye comprising a pupil, a lens and a retina, the method comprising
 removing a portion of a core of the lens to create a void volume and leaving a remaining lens core;   filling the void volume with a synthetic material of higher elasticity than the removed portion of the lens core and of a different refractive index to the remaining lens core;   wherein   removing a portion of a core of the lens is controlled so that after the void volume has been filled with the synthetic material, light entering the eye through a pupil of the eye, before being received by a retina of the eye, traverses through a portion of the remaining lens core and through the synthetic material and is refracted so as to at least partially correct refractive error in the eye.   
     
     
         19 . The method of  claim 1 , wherein removing a portion of a core of the lens is controlled so that the synthetic material forms a shape to provide a power for said light entering the eye, the power selected to provide the at least partial correction of refractive error in the eye. 
     
     
         20 . The method of  claim 1 , wherein filling the void volume with a synthetic material comprises selecting a synthetic material with a refractive index that, in combination with a shape expected to be formed by the synthetic material when filling the void volume, provides a correction of refractive error in the eye. 
     
     
         21 . (canceled) 
     
     
         22 . (canceled) 
     
     
         23 . A device for making ablations on a lens of an eye, wherein the lens includes an inner central nucleus, a cortex and a capsule, the device including:
 a laser for controllably ablating ocular tissue at selected depths within the lens of the eye; and   a controller for controlling the laser, wherein the controller comprises instructions to cause the laser to create within the lens a posterior bounding ablation, central phaco block chopping cuts and an anterior bounding ablation.   
     
     
         24 . The device of  claim 23 , wherein the controller comprises instructions to cause the laser to form a gullet from an anterior surface of the capsule to the anterior bounding ablation. 
     
     
         25 . The device of  claim 23 , wherein the controller comprises instructions to cause the laser to create an opening in the anterior surface of the capsule. 
     
     
         26 . The device of  claim 23 , wherein the controller comprises instructions to cause the laser to create an incision in the cornea. 
     
     
         27 . The device of  claim 23 , wherein the controller comprises instructions to cause the  20  laser to create an opening in the anterior surface of the capsule and form a gullet from the opening to the anterior bounding ablation. 
     
     
         28 . The device of  claim 23 , wherein the posterior bounding ablation is located posterior to the central nucleus and the anterior bounding ablation is located anterior to the central nucleus. 
     
     
         29 . The device of  claim 23 , wherein the instructions cause the posterior bounding ablation, central phaco block chopping cuts and anterior bounding ablation to be created in that order. 
     
     
         30 . The device of  claim 23 , wherein the instructions cause the posterior bounding ablation, central phaco block chopping cuts and anterior bounding ablation to be substantially created in a postero-anterior order. 
     
     
         31 . The device of  claim 30 , wherein the instructions cause peripheral portions of the posterior bounding ablation, central phaco block chopping cuts and anterior bounding ablation to be created before central portions of the posterior bounding ablation, central phaco block chopping cuts and anterior bounding ablation. 
     
     
         32 - 35 . (canceled)