WO2024133805A1 - Lens for implantation in an eye - Google Patents

Abstract

The invention relates to a lens (10) for implantation in an eye, to a method for producing a lens, and to a method for modifying the optical imaging through a lens. The invention relates to a lens (10) for implantation in an eye, having a transparent lens body (11) comprising a main lens (12) having at least one optical region (14, 16), and comprising an optical secondary layer (22) which is provided on the main lens, wherein the optical region of the main lens and/or the secondary layer have/has at least one optically effective relief structure (19) having at least one height profile (21), and the main lens and the secondary layer have different material compositions, and the material composition of an element selected from the main lens and the secondary layer has at least one material which is variable in order to modify the optical imaging through the lens by means of at least one stimulus which is intrinsic and/or extrinsic to the eye.

Description

Lens for implantation in an eye

The invention relates to a lens for implantation into an eye, a method for producing a lens and a method for modifying the optical image of a lens.

The implantation of intraocular lenses (IOL) is a common treatment for cataracts. The lens of the eye that has become cloudy due to the cataract is removed and replaced with an intraocular lens. However, the insertion of an intraocular lens may also be necessary for other reasons. Recently, for example, optical concepts have been developed that enable the correction of presbyopia and/or astigmatism. As a result, cataract surgery has undergone a change from the classic operation for the elderly to refractive surgery with the aim of achieving freedom from glasses at all viewing distances and with the highest quality of vision.

From CN 1 13413237 A a foldable intraocular lens with a concentric ring pattern and a surface modified by a degradable drug release coating is known. WO94/07687A discloses a method for producing intraocular lenses in which an insoluble coating is applied to the optical part of the lens to protect the surface during one or more processing steps. US7837326 B relates to a lens with a first polymer matrix and a refraction-modulating composition dispersed therein that is capable of stimulus-induced polymerization. W02006/002128 A1 relates to an amniotic membrane with increased stiffness as a biocompatible device that can be implanted. The amniotic membrane contains one or more polymers that can be cross-linked to enable durability and easy implantation. WO2015/138187 A1 relates to optical hydrogels whose shape and/or refractive indices can be modified by the application of light. The publications "Biodegradable Polymers, Materials 2009, 2, 307-344; doi:10.3390/ma2020307" and "Biodegradable polymers as biomaterials, Prog. Polym. Sci. 32 (2007) 762-798," describe biodegradable polymers. The publication "UV degradation of poly(lactic acid) materials through copolymerisation with a sugar-derived cyclic xanthate, Craig Hardy, Gabriele Kociok-Köhn, Antoine Buchard, Chemical Communications, 2022; 58 (36): 5463 discloses poly(lactide-co-xanthan) copolymers which are degradable when irradiated with UV light. There are monofocal and multifocal intraocular lenses. US2019/0029809 A1 describes a multifocal intraocular lens that comprises stimulus-orientable optically anisotropic components. US8287593 B2 describes an adjustable multifocal intraocular lens system. Another multifocal intraocular lens is known from WO2021/156203 A1, for example. This multifocal intraocular lens comprises a lens body whose surface has zones with diffractive microstructures. The diffractive microstructures each have a relief structure, and a cross-section of the relief structure has a height profile. EP2098192 A1 describes a refractive multifocal intraocular lens. US5260727 describes that a pinhole lens can be produced by etching surface areas of a lens. WO2021127148 A1 describes an intraocular lens that provides an extended depth of field. The lens comprises a virtual aperture, wherein the virtual aperture comprises a plurality of hexagonal microstructures.

Some patients who have had a multifocal intraocular lens implanted are unable to neuro-adapt to multifocality and its side effects. For other patients, an implanted monofocal intraocular lens does not produce the desired result. If a patient is dissatisfied with the refractive result or depth of focus of an implanted intraocular lens, the implanted lens is typically removed and replaced with another intraocular lens.

The task is to provide a lens for implantation into an eye that enables optimization of implantation results.

This object is achieved by a lens according to claim 1, a method for producing a lens according to claim 12, a method for modifying the optical image according to claim 13 and a lens according to claim 15. Further developments are specified in the dependent claims.

A first embodiment relates to a lens for implantation in an eye, with a transparent lens body, comprising a base lens with at least one optical region; and an optical supplementary layer provided on the base lens, wherein the supplementary layer at least partially covers the optical region; wherein the optical region of the base lens and/or the supplementary layer has at least one optically effective relief structure with at least one height profile; the base lens and the supplementary layer have different material compositions; and the material composition of at least one element selected from the base lens and the supplementary layer has at least one respective material that can be changed to modify the optical image of the lens by at least one stimulus that is intrinsic and/or extrinsic to the eye. The lens for implantation in an eye provides, for example, an ophthalmic intraocular lens. By acting on the changeable material of the base lens and/or the optical supplementary layer, also called supplementary layer, the optical image of the lens can be modified by the intrinsic and/or extrinsic stimulus. Depending on the duration of exposure and the intensity of the intrinsic and/or extrinsic stimulus, the optical image, e.g. the focality and/or the depth of field, of the lens can be changed completely or partially or, in particular, gradually. For example, a monofocal lens can be at least partially converted into an optically advanced lens, such as a refractive and/or diffractive multifocal lens, a lens with extended depth of field (EDoF) or a pinhole lens, ie a line with an aperture effect. The conversion can, for example, take place slowly and gradually after implantation by applying a stimulus intrinsic to the eye, so that the neural adaptation of a patient can take place gradually and gradually and can also be supported. An optically further developed lens can also be at least partially transformed into a monofocal lens, such as a multifocal lens into an EDoF, a multifocal lens into a monofocal lens, an EDoF into a monofocal lens. The conversion can be brought about, for example, by applying a stimulus extrinsic to the eye. The aforementioned conversions from one lens type to another lens type can take place completely or end at an intermediate stage, resulting in transitional forms or mixed forms of the lens types and their optical properties. The time period for the change in the optical properties can range from a few months to a few hours, e.g. 5 years to less than 5 weeks or less than 5 hours. The modification of the optical image using intrinsic and/or extrinsic stimuli can be carried out in the non-implanted or implanted state of the lens, ie extracorporeally or intracorporeally. The use of costly laser systems and laser procedures for refractive correction after implantation can be avoided. Correction of the implantation result using invasive treatment methods can also be avoided. Furthermore, the possible modifications to the optical image can be predetermined during the manufacture of the lens.

The modification of the optical image of the lens can be a predetermined and/or targeted modification. The optical image can be adjustable and/or set to at least one predetermined level and/or to at least one predetermined intermediate level and/or to at least one predetermined value. In particular, the optical image can be adjustable and/or set to at least one predetermined level, to at least one predetermined intermediate level and/or to at least one predetermined value of a focality, a depth of field, an aperture effect and/or a refractive index. An arbitrary modification of the optical image by, for example, a any biological degradation of a material that may occur can be avoided. The at least one respective changeable material of the material composition of at least one element selected from the base lens and the supplementary layer can be at least partially changeable by the at least one stimulus that is intrinsic and/or extrinsic to the eye in order to modify the optical image of the lens to at least one predetermined level and/or to at least one predetermined intermediate level and/or to at least one predetermined value. The at least one respective changeable material of the material composition of at least one element selected from the base lens and the supplementary layer can be a material that is at least partially degradable and/or at least partially chemically changeable by the at least one stimulus that is intrinsic and/or extrinsic to the eye. The at least one respective changeable material of the material composition of at least one element selected from the base lens and the supplementary layer can be a material that is at least partially changeable by a magnetic field.

In preferred embodiments, the material composition of the supplementary layer may comprise the at least one material that can be changed to modify the optical image of the lens by at least one stimulus that is intrinsic and/or extrinsic to the eye.

In a second embodiment, the optical supplementary layer can have at least one optically effective, in particular diffractive, relief structure with at least one height profile. Before the lens is converted from multifocal (diffractive) to monofocal, the light is first divided into several, e.g. two or three, focal points that correspond to different viewing distances. This is shown schematically in Fig. 1 a on the left using a lens 1 a in a side cross-sectional view. The lens 1 a is provided with haptics that are provided on the edges of the base lens and serve to anchor the lens in the eye. In the second embodiment, the material composition of the supplementary layer can comprise the at least one material that can be changed to modify the optical image of the lens by at least one stimulus that is intrinsic and/or extrinsic to the eye. In the second embodiment, only the optical supplementary layer can have the changeable material. The optical supplementary layer can be broken down, e.g. dissolved, by the action of the intrinsic and/or extrinsic stimulus on the changeable material of the optical supplementary layer, or its refractive index can be adjusted to the refractive index of the aqueous humor. In both cases, the light is ultimately distributed in only one focal point (distance vision). In the case of a reversibly adjustable refractive index of the supplementary layer, the opposite happens when the lens is converted from monofocal to multifocal. In an EDOF lens that is converted to monofocal, the light is first focused on a or two focal points, but the focal points are stretched so that they enable continuous vision, which is shown schematically in Fig. 1 b on the left using a lens 1 b with haptics in a side cross-sectional view. After converting the lens from EDOF to monofocal, the light is no longer stretched but concentrated in a single point (far focus), which is shown schematically in Fig. 1 b on the right. These conversions can also take place incompletely, so that finally intermediate stages between the multifocality and the monofocality of the lens are obtained.

In a third embodiment, the optical region of the base lens can have at least one optically effective relief structure with at least one height profile; and the optical supplementary layer can at least partially cover the optical region and fill the height profile completely or up to at least one height. Before the lens is converted from monofocal to multifocal (diffractive), the light is only distributed in one focal point. In the third embodiment, the material of the material composition of the base lens and/or the supplementary layer can be changeable. If the optical supplementary layer has the changeable material, the supplementary layer can be broken down, e.g. dissolved, by the action of the intrinsic and/or extrinsic stimulus, for example, or its refractive index can be adapted to the refractive index of the aqueous humor. As a result, the relief structure of the optical region of the base lens is at least partially exposed or effective and the light is divided into several, e.g. two or three, focal points that correspond to different viewing distances. In the case of a reversibly adjustable refractive index of the supplementary layer, the opposite happens when the lens is converted from multifocal to monofocal. If the base lens has the changeable material, the refractive index of the base lens can be adjusted to the refractive index of the supplementary layer by applying the intrinsic and/or extrinsic stimulus.

In a preferred fourth embodiment, the optical region of the base lens can have at least one optically effective relief structure with at least one height profile; and the optical supplementary layer can at least partially cover the optical region and fill the height profile completely or up to at least one height, wherein only the material composition of the supplementary layer has the at least one material that can be changed to modify the optical image of the lens by at least one stimulus that is intrinsic and/or extrinsic to the eye. Thus, the material of the optical supplementary layer can be changed by the stimulus, but not the material of the base lens. The optical supplementary layer changes its properties and/or morphology and/or optical performance due to the stimulus, which causes, for example, a dissolution, a biodegradation and/or a refractive index change of the optical supplementary layer. The base lens, which can be monofocal or multifocal, can be a standard IOL lens made of materials such as ophthalmic acrylates (hydrophilic and hydrophobic) or ophthalmic implant materials such as silicone, PMMA or others.

The optically effective relief structure can be designed as a multifocal relief structure, as a diffractive relief structure, as a refractive relief structure, as a scattering relief structure, as an E-DoF relief structure and/or as a pinhole relief structure. Any combination of the relief structures mentioned can be provided. For example, relief structures with different optical effects can be adjacent to one another or arranged at a distance from one another. Furthermore, relief structures with different optical effects can be superimposed on one another and form a common height profile. The lens can be an aphakic lens or a phakic lens.

In embodiments of the lens, the supplementary layer can completely or partially cover the at least one optical region across its width. The relief structure can be provided in an anterior surface and/or in a posterior surface of the lens. The at least one relief structure can be ring-shaped and/or concentric with respect to a central optical axis of the lens. The at least one height profile of the relief structure can lie in a cross-sectional plane of the lens that includes an axis, e.g. the central optical axis of the lens. The heights of the height profile can relate to heights along the axis or the central optical axis. The height profile can have maxima and minima. Peaks, e.g. square or rounded peaks, can be provided as maxima, and valleys and/or recesses can be provided as minima.

In the third or fourth embodiment, the supplementary layer can completely cover the optical region of the base lens in relation to the heights of the height profile. The relief structure with its maxima and minima, e.g. peaks, valleys and/or recesses, is completely covered in this case and the effect of the relief structure and the resulting optical image is eliminated. Alternatively, the supplementary layer can cover the optical region in relation to the heights of the height profile up to at least one height, i.e. partially. In this case, maxima, e.g. peaks, of the relief structure are partially uncovered by the supplementary layer and protrude beyond it. The effect of the relief structure of the base lens, i.e. the resulting optical image, can thus be reduced and/or partially eliminated. The supplementary layer can at least partially have a counter-profile that is complementary to the height profile of the relief structure of the optical region. The supplementary layer can be designed in such a way that it itself does not have an optical region with a relief structure or provides one. For example, the surface of the supplementary layer opposite the counter profile of the supplementary layer is flat, smooth and/or curved. Through these configurations of the third or fourth embodiment, the optical imaging of the optical region of the base lens can be eliminated, reduced or modified by the supplementary layer. The materials of the lens can be biocompatible. Furthermore, the relief structure can be designed as a microrelief.

The at least one material can be selected such that the material composition of the supplementary layer is at least partially degradable, in particular biodegradable, by the aqueous humor or by at least one intrinsic medium of the eye, in particular by at least one component of the aqueous humor of the eye and/or by at least one enzyme of the aqueous humor of the eye, as an intrinsic stimulus. The term “degradation” can include, for example, dissolution, hydrolysis, temperature-induced degradation and/or pH-induced degradation. An enzymatic reaction with a lipase and/or a proteinase, e.g. proteinase K, can be used as enzymatic degradation. At least partial degradability can mean that at least one material of the material composition is degradable. Thus, by degrading, e.g. dissolving, at least one material of the supplementary layer, the latter can be completely or only partially removed from the base lens. With this design, for example, the focality of the lens can be changed.

Furthermore, the at least one material can be selected such that the refractive index of the material composition of the supplementary layer can be at least partially, in particular reversibly, adjusted to the refractive index of the aqueous humor of the eye or to the refractive index of the material composition of the base lens by the stimulus. The term “refractive index of the material composition of the base lens” is to be understood as synonymous with the term “refractive index of the base lens”. The term “refractive index of the material composition of the supplementary layer” is to be understood as synonymous with the term “refractive index of the supplementary layer”. Depending on the design of the lens, the refractive index of the base lens and the refractive index of the supplementary layer can be the same or different. The term “adjustable” means that the relevant refractive index can be set to the refractive index of the aqueous humor or the supplementary layer or the base lens or to an intermediate level between the relevant refractive indices. With these designs of the supplementary layer, for example, the depth of field of the lens can be optimized. The supplementary layer can be understood as a supplementary element for the base lens.

The refractive index of the material composition of the base lens can be in a range from 1.33 to 1.6, preferably 1.39 to 1.5. The refractive index of the material composition of the supplementary layer can be in a range from 1.33 to 1.6, preferably 1.35 to 1.55. more preferably 1.39 to 1.5. The refractive index of the aqueous humor is approximately 1.33. The refractive index of the base lens and the refractive index of the supplementary layer may be the same.

A layer of an adhesion promoter can be provided between the base lens and the optical supplementary layer. The elastic modulus of the material composition of the base lens and the elastic modulus of the material composition of the optical supplementary layer can be the same or close to each other. Alternatively, the material composition of the optical supplementary layer can be softer than the material composition of the base lens, i.e. have a lower elastic modulus. The same applies to a layer of an adhesion promoter between the base lens and the optical supplementary layer, if present.

The base lens can be a multifocal lens and/or an EDoF (enhanced depth of field) lens and/or a pinhole lens, and the combination of the base lens and the supplementary layer before and/or after the change in the at least one material can be at least partially a monofocal lens. The base lens can be a monofocal lens and the combination of the base lens and the supplementary layer before and/or after the change in the at least one material can be at least partially a multifocal lens and/or an EDoF (enhanced depth of field) lens and/or a pinhole lens. The at least one material can be changed in such a way that the optical imaging of the lens can be changed, in particular gradually changed, from a value in a range of 100% and more than 0% monofocal to a value in a range of more than 0% and 100% multifocal or EDoF or pinhole, ie aperture effect. The at least one material can be changed in such a way that the optical image of the lens can be changed, in particular gradually changed, from a value in a range of 100% and more than 0% multifocal or EDoF or pinhole to a value in a range of more than 0% and 100% monofocal. The above embodiments enable a gradual, slow modification of the optical image and/or a modification of the optical image that ends at intermediate stages of the optical image of different lens types. The at least one material of the base lens and/or the supplementary layer can be changed to modify the refractive power, the diopter number and/or the depth of field of the lens. The optics of the pinhole lens of embodiments can be realized in particular by a diffractive structure and/or a selective surface roughening. In the case of the selective surface roughening, an opaque roughness can be present that is greater than an optical wavelength, e.g. a roughness in the range of approximately 0.5 to 2 pm. The pinhole lens of embodiments can be understood as a subcategory of EDoF lenses. The at least one material can be changed in such a way that the optical image of the lens can be modified from monofocal to multifocal, EDoF, and/or pinhole. The at least one material can be changed in such a way that the optical image of the lens can be modified from multifocal and/or EDoF and/or pinhole to monofocal. The at least one material can be changed in such a way that the optical image of the lens can be modified from refractive to diffractive and/or from diffractive to refractive, in particular gradually from refractive to diffractive and/or gradually from diffractive to refractive. The at least one material can be changed reversibly. In particular by using two or more different, in particular opposing, stimuli at different times, the modification of the optical image and/or the change of the at least one material can be at least partially reversible.

In one embodiment of the lens, the intrinsic stimulus can be at least one intrinsic medium of the eye, the aqueous humor of the eye, at least one component of the aqueous humor of the eye and/or at least one enzyme of the aqueous humor of the eye. Furthermore, the extrinsic stimulus can be a solvent that is selective for the material composition and/or the at least one material of the supplementary layer and/or an agent that selectively induces the degradation of the material composition and/or the at least one material of the supplementary layer, which can be applied in particular as eye drops or injection. In another embodiment, the at least one material can be photochemically changeable and the extrinsic stimulus can be a light with a wavelength and/or intensity that triggers the photochemical change in the material. The at least one material can be electrochemically changeable and the extrinsic stimulus can be a voltage that triggers the electrochemical change in the material. The at least one material can be chemically changeable and the extrinsic stimulus can be a reactant that is selective for the at least one material and can be applied in particular as eye drops or injection. The at least one material can be changeable by a magnetic field and the extrinsic stimulus can be a magnetic field that triggers the change in the material. These embodiments enable the use of different extrinsic stimuli. In particular, the stimulus can be selected from an enzyme, a pH-adjusting component, a chemical solvent, a drug, light, a magnetic field, a voltage and/or an electrical impulse.

Further embodiments of the lens may include that the at least one material is selected from a hydrogel; a polymer; a refractive index adjusting component; a refractive index adjusting component that binds to chemical groups of another material of the at least one material; refractive index adjusting ions and/or nanoparticles that bind to chemical groups of another material of the at least one material. at least one material; a material doped with refractive index adjusting ions or nanoparticles; and any combination thereof. For example, a polymer blend containing a long chain polymer, e.g. polyethylene glycol (PEG), and/or a hydrogel may be used. Hydrogels or hydrogel blends may be used that change shape and/or swell and/or transform into another hydrogel or dissolve upon cleavage of bonds in one or more of the polymeric hydrogels. Some of these processes are reversible in some hydrogels.

Furthermore, the at least one material of the supplementary layer can be at least partially inhomogeneously or homogeneously degradable, in particular inhomogeneously or homogeneously biodegradable. The degradation profile and/or the degradation rate of the supplementary layer can be determined by at least one structure selected from a geometric structure and a chemical structure. For example, the degradation rate can be predetermined by varying the material composition of the region of the lens to be degraded. The supplementary layer can have zones, in particular radial zones, of the at least one material. The zones can differ by different materials, by different levels of crosslinking, in particular by different levels of chemical and/or physical crosslinking, by different crystallinity and/or by different geometric structure, and the zones can be degraded zone by zone at different degradation rates, in particular radially from the outside to the inside. These embodiments can provide a variety of ways of modifying the optical image. Furthermore, the degradation rate can be predetermined in time and/or space, e.g. starting from the center to the periphery of the lens or slowly by reducing the thickness of the supplementary layer. The geometric structure of the supplementary layer can be designed such that the thickness of the supplementary layer varies from the center to the periphery, e.g. the thickness of the supplementary layer can be less in the center than in the periphery or vice versa. In addition to the at least one material, the supplementary layer can have a drug, e.g. lidocaine, which is released when the supplementary layer is broken down. The drug can be anti-inflammatory, antibiotic or an active ingredient for preventing glaucoma. This can promote the optimization of the implantation result.

The material composition of the supplementary layer can contain as the at least one material a hydrolytically degradable polymer and/or a light-induced degradable polymer and/or an enzymatically degradable polymer and/or a biodegradable polymer. The materials mentioned below can be present in modified form as derivatives, e.g. in the form of an ester, a cyclic diester or in salt form. The biodegradable polymer can be selected from polyglycolic acid (PGA), poly-L-lactic acid (PLLA), poly-DL-lactic acid (PDLLA), poly-p-dioxanone (PDS), poly-beta-hydroxy-butyric acid (PHBHA), poly(a-ester), polycaprolactone (PCL), polyurethane and any combination thereof. The lactic acid compounds mentioned can be present as lactide. These materials are hydrolytically and/or light-induced degradable. The degradation can depend on and be controlled by the crystallinity. The degradation period can be weeks to months or years. The degradation can be triggered after the implantation of the lens by hydrolysis and/or by light as a stimulus.

The biodegradable polymer can be selected from poly(esteramide), poly(orthoester), polyanhydride, poly(anhydride-co-imide), cross-linked polyanhydride, poly(propylene fumarate), pseudo-poly(amino acid), poly(alkyl cyanoacrylate), polyphosphazene, polyphosphoester, and any combination thereof. These materials are hydrolytically degradable. Degradation can be initiated after implantation of the lens.

The biodegradable polymer can be selected from a protein, poly(amino acid) collagen, synthetic poly(amino acids), natural poly(amino acids), elastin, elastin-like materials, aluminum, fibrin, polysaccharide of human or non-human origin, silk protein, and any combination thereof. These materials are enzymatically degradable, e.g. by an eye drop stimulus or an injection into the eye, a self-controlled stimulus, and/or an automatically controlled biodegradation.

The material composition of the supplementary layer may contain as the at least one material a biodegradable hydrogel selected from silk, DNA, collagen, gelatin, fibrin, elastin, methacrylate, hyaluronic acid, alginate, agarose and any combination thereof.

The material composition of the base lens can contain as the at least one material at least one component selected from an acrylate, silicone, polymethyl methacrylate (PMMA) and any combination thereof. These material compositions of the supplementary layer and/or the base lens can promote a biocompatible degradation of the supplementary layer.

In a further embodiment of the lens, the refractive index of the base lens and the refractive index of the supplementary layer can be greater than the refractive index of the aqueous humor of the eye and the refractive index of the supplementary layer can be at least partially adapted to the refractive index of the aqueous humor of the eye, in particular reversibly. In one embodiment of the lens, the refractive index of the base lens and the refractive index of the supplementary layer can be greater than the refractive index of the aqueous humor of the eye and the material composition of the supplementary layer can be at least partially degradable, in particular biodegradable. The material composition of the supplementary layer can contain a material that is homogeneously degradable. Alternatively, the supplementary layer can contain a plurality of zones, in particular radial zones, wherein the zones have different materials, the material of the zones is cross-linked to different degrees, the zones have different crystallinities and/or the zones are geometrically structured differently in order to provide different axial and/or radial degradation rates. For example, the thickness of the supplementary layer can vary from the center to the periphery of the lens, in particular the supplementary layer can have a greater thickness in the periphery than in the center.

In further embodiments in which the optical region of the base lens has at least one optically effective relief structure with at least one height profile, and the optical supplementary layer at least partially covers the optical region and fills the height profile completely or up to at least one height, the material of the material composition of the base lens can be changed. For example, the at least one material can be selected such that the refractive index of the material composition of the base lens can be at least partially, in particular reversibly, adjusted to the refractive index of the material composition of the supplementary layer by the stimulus. One design of the lens can include the refractive index of the base lens being greater than the refractive index of the aqueous humor of the eye and being adjustable to the refractive index of the aqueous humor of the eye, in particular reversibly, and the refractive index of the supplementary layer corresponding to the refractive index of the aqueous humor of the eye. According to one embodiment of the lens, the refractive index of the supplementary layer and the refractive index of the base lens can be greater than the refractive index of the aqueous humor of the eye and the refractive index of the base lens can be greater than the refractive index of the supplementary layer and can be adjusted to the refractive index of the supplementary layer, in particular reversibly. Furthermore, in an embodiment in which the material of the material composition of the supplementary layer is changeable, the optical region of the base lens has the optically effective relief structure with at least one height profile and the optical supplementary layer at least partially covers the optical region and fills the height profile completely or up to at least one height, the refractive index of the base lens can be greater than the refractive index of the aqueous humor of the eye and the refractive index of the supplementary layer can correspond to the refractive index of the aqueous humor of the eye and can be adjusted to the refractive index of the base lens, in particular reversibly. The optical image, in particular the focality, of the lens can also be modified with these embodiments. A further embodiment relates to a method for producing a lens according to one of the above embodiments and configurations, with the steps: providing the base lens and applying the supplementary layer to the at least one relief structure of the base lens, or forming the supplementary layer as a solid layer with at least one relief structure and placing and attaching the supplementary layer to the base lens, or forming the supplementary layer by applying a layer with the changeable material to the base lens and mechanically processing the layer. The layer can be applied to the base lens or the supplementary layer can be applied to the relief structure of the base lens, for example, by surface coating, e.g. PVD, CVD, casting, spray coating, spin coating, dip coating, 3D printing, and/or electrospinning. The attachment of the supplementary layer as a solid layer can be done, for example, by chemical and/or thermal bonding and/or physical surface activation (plasma, UV light). The mechanical processing of the layer can include turning, milling and/or laser engraving.

For the base lens, the same manufacturing processes as for other IOL implants designed as monofocal, multifocal and EDOF IOLs can be used, including mechanical processing (turning, milling), surface or volume modifications by laser engraving, plasma surface treatment, chemical or physical etching, coatings by physical or chemical vapor deposition (PVD, CVD).

Fig. 1c shows a schematic side cross-sectional view of a monofocal base lens (without haptics) at the top, which is provided with the supplementary layer having the relief structure in the process. This is done by applying the layer with the changeable material to the base lens and mechanically processing, e.g. turning, milling, laser engraving, the layer to obtain the supplementary layer with the relief structure. This produces the multifocal lens 1a, the multifocality of which can be modified by changing the supplementary layer under the action of the stimulus. Fig. 1d shows a schematic side cross-sectional view of a multifocal base lens (without haptics) at the top, which has the relief structure and which is provided with the supplementary layer in the process. This is done by applying the supplementary layer with the changeable material to the relief structure of the base lens and by at least partially covering the height profile of the relief structure. This creates a monofocal lens 1c whose monofocality can be modified by changing the supplementary layer under the influence of the stimulus. Another embodiment relates to a method for modifying the optical image of a lens, with provision of a lens according to one of the above embodiments and configurations of the lens; and changing the at least one material of at least one element selected from the base lens and the supplementary layer by exposure to the stimulus intrinsic and/or extrinsic to the eye for the respective material to be modified. In the method for modifying the optical image of a lens, the modification of the at least one material can take place before or after the lens is implanted in the eye. The modification of the optical image and/or the modification of the at least one material can be reversible and/or reversed, in particular by using two or more different stimuli at different times.

The modification of the optical image of the lens can be a predetermined and/or targeted modification. The optical image can be adjustable and/or set to at least one predetermined level and/or to at least one predetermined intermediate level and/or to at least one predetermined value. In particular, the optical image can be adjustable and/or set to at least one predetermined level, to at least one predetermined intermediate level and/or to at least one predetermined value of a focality, a depth of field, an aperture effect and/or a refractive index. An arbitrary modification of the optical image due to, for example, a possible biological degradation of a material can be avoided. The at least one respective changeable material of the material composition of at least one element selected from the base lens and the supplementary layer can be at least partially changed to modify the optical image of the lens to at least one predetermined level and/or to at least one predetermined intermediate level and/or to at least one predetermined value by the at least one stimulus that is intrinsic and/or extrinsic to the eye. The at least one respective changeable material of the material composition of at least one element selected from the base lens and the supplementary layer can be at least partially degraded and/or at least partially chemically changed by the at least one stimulus intrinsic and/or extrinsic to the eye. The at least one respective changeable material of the material composition of at least one element selected from the base lens and the supplementary layer can be at least partially changed by a magnetic field.

Fig. 2a shows a schematic top view of a conversion of a monofocal lens 2, which is designed according to the fourth embodiment, and which is modified to a multifocal base lens. Fig. 2b shows a schematic top view of a conversion of a monofocal lens 3, which is designed according to the fourth embodiment, and which is modified to a pin-hole base lens. Fig. 2c shows a schematic top view of a conversion of a multifocal Lens 4, which is designed according to the second embodiment and which is modified to a monofocal base lens. The lenses 2, 3 and 4 are each shown provided with haptics 11.

The complete or incomplete conversion of the monofocality of the lens 2 shown in Fig. 2a to multifocality can be reversible, as illustrated in Fig. 5b in plan view. For example, a reversible conversion of the lens 2 can be realized by the supplementary layer having a material that adjusts the refractive index, which either increases or decreases the refractive index of the supplementary layer through different stimuli, e.g. light with different wavelengths, i.e. reversibly changes it. The complete or incomplete conversion of the multifocality of the lens 4 shown in Fig. 2c to monofocality can also be reversible, as illustrated in Fig. 5a in plan view. Here too, a reversible conversion of the lens 4 can be realized by the supplementary layer having a material that adjusts the refractive index, which either increases or decreases the refractive index of the supplementary layer, i.e. reversibly changes it, through different stimuli, e.g. different pH values of eye drops.

3a to 3c, 4a and 4b each show, in lateral cross-sectional views, a schematic sequence of modifying the optical image of exemplary lenses, wherein only the optical region of the lenses with the respective relief structure is shown.

Fig. 3a shows schematically the modification of the optical image of a lens 5 according to the fourth embodiment. In the lens 5, the relief structure of the base lens is covered with a supplementary layer which has radial zones of the at least one changeable material. The zones can differ by different materials, by different levels of cross-linking, in particular by different levels of chemical and/or physical cross-linking, by different crystallinity and/or by different geometric structures, and the zones can be degraded one after the other, zone by zone, at different rates of degradation, in particular radially from the outside to the inside. Thus, the effect of the stimulus can cause the change, in this case the degradation, of the supplementary layer 22 to take place inhomogeneously.

Fig. 3b shows schematically the modification of the optical image of a lens 6 according to the fourth embodiment. In the lens 6, the relief structure of the base lens is covered with a supplementary layer, the changeable material of which can be homogeneously degraded. By acting on the stimulus, the change, in this case the degradation, of the supplementary layer can take place homogeneously. Fig. 3c shows schematically the modification of the optical image of a lens 7 according to the fourth embodiment. In the lens 7, the relief structure of the base lens is covered with a supplementary layer whose refractive index can be changed. By applying the stimulus, the refractive index of the supplementary layer can be adjusted to that of the surroundings of the lens 7, in particular to the refractive index of the aqueous humor.

In the examples in Fig. 3a to 3c, depending on the duration and selected intensity of the stimulus applied, an incomplete or complete conversion of the monofocality of the relevant lens 5, 6 or 7 to the multifocality of the respective base lens takes place. The middle representations in Fig. 3a to 3c schematically illustrate the incomplete conversion or a transition stage to the fully converted lens according to the right-hand representation in Fig. 3a to 3c.

Fig. 4a shows, in side cross-sectional views, schematically the modification of the optical image of a lens 8 according to the second embodiment. In the lens 8, the supplementary layer has the relief structure and the changeable material of the supplementary layer can be broken down inhomogeneously. The base lens of the lens 8 has no relief structure. By acting on the stimulus, e.g. through components of the aqueous humor of the eye, the change, in this case the breakdown, of the supplementary layer can take place, e.g. starting from the center to the periphery of the lens, until finally the surface of the base lens is exposed, as shown on the right in Fig. 4a.

Fig. 4b shows schematically in lateral cross-sectional views the modification of the optical image of a lens 9 according to the second embodiment. In the lens 9, the supplementary layer with the changeable material has the relief structure and the base lens of the lens 9 has no relief structure. The refractive index of the supplementary layer can be adjusted to that of the environment of the lens 9, in particular to the refractive index of the aqueous humor, by the action of the stimulus.

In the examples in Fig. 4a and 4b, depending on the duration and selected intensity of the stimulus applied, an incomplete or complete conversion of the multifocality of the respective lens 8 or 9 to the monofocality of the respective base lens takes place. The middle representations in Fig. 4a and 4b schematically illustrate the incomplete conversion or a transition stage to the complete conversion of the respective lens according to the right-hand representation in Fig. 4a or 4b. In one embodiment, a lens, in particular a lens according to one of the preceding embodiments and configurations, is provided, obtained by a method according to one of the preceding embodiments.

It is understood that the features mentioned above and those to be explained below can be used not only in the combinations specified, but also in other combinations or on their own, without departing from the scope of the present invention.

The invention is explained in more detail below using embodiments with reference to the accompanying drawings, which also disclose features essential to the invention. These embodiments are for illustrative purposes only and are not to be interpreted as restrictive. For example, a description of an embodiment with a large number of elements or components is not to be interpreted as meaning that all of these elements or components are necessary for implementation. Rather, other embodiments can also contain alternative elements and components, fewer elements or components, or additional elements or components. Elements or components of different embodiments can be combined with one another, unless otherwise stated. Modifications and variations described for one of the embodiments can also be applied to other embodiments. To avoid repetition, identical or corresponding elements in different figures are designated with the same reference numerals and are not explained more than once. The figures show:

Fig. 1 a and 1 b each show schematically an example of a lens in a lateral cross-section.

Cross-sectional view before and after modification of the optical image;

Fig. 1 c and 1 d each schematically show an example of a method for producing a lens;

Fig. 2a to 2c each schematically show an example of a modification of the optical imaging of the lens;

Fig. 3a to 3c each schematically show an example of a modification of the optical imaging of the lens;

Fig. 4a and 4b each schematically show an example of a modification of the optical imaging of the lens;

Fig. 5a and 5b each schematically show an example of a modification of the optical imaging of the lens;

Fig. 6 schematically shows an example of the lens;

Fig. 7 shows schematically another example of the lens.

Fig. 8 schematically shows another example of the lens; and Fig. 9 schematically shows another example of the lens.

The terms “changeable”, “modifiable”, “degradable” and “adaptable” and “change”, “modify”, “degrade” and “adapt” as well as grammatical variations thereof are to be understood in such a way that the respective processes are brought about by the respective stimulus.

Fig. 6 shows schematically an example of a lens 10 in a lateral cross-sectional view. The lens 10 has a base lens 12 which is designed as a multifocal lens. The base lens 12 has a lens body 11 with two annular optical regions 14, 16. The annular region 14 has a diffractive relief structure 19 and a height profile 21. The annular region 16 has a diffractive relief structure 18 and a height profile 20. The regions 14, 16 are shown separated by lines in Fig. 6. The relief structure can be provided in an anterior surface or in a posterior surface of the base lens 12. The height profiles 20, 21 of the relief structures have peaks and valleys and in this example lie in a cross-sectional plane of the lens 10 which contains a central optical axis 13 of the lens. The optical regions 14 and 16 of the base lens 12 are designed to focus light that passes through the uncoated relief structures 18, 19 onto the optical axis 13 at spaced-apart focal points (not shown). In the present example, the heights of the height profiles 20, 21 refer to heights along the central optical axis 13.

An optical supplementary layer 22 is provided on the base lens 12, which covers the optical regions 14, 16 and completely fills the height profiles 20, 21. The base lens 12 and the optical supplementary layer 22 have the same or different refractive indices. The relief structure of the base lens with its peaks and valleys is completely covered in this example. The relief structure of the supplementary layer, which is complementary to the relief structure of the base lens and is present in the contact area with the base lens, is not optically effective.

If the refractive indices of the base lens 12 and the supplementary layer 22 are approximately the same, the diffractive effect of the relief structures 18, 19 and the resulting optical images are cancelled out. As a result, the lens 10 forms a monofocal lens when the base lens 12 is covered with the supplementary optical layer 22. This means that light that passes through the lens 10 is focused on only one focal point on the optical axis 13.

The base lens 12 and the supplementary layer 22 have different biocompatible material compositions. The material composition of the supplementary layer 22 has at least one respective material that can be changed to modify the optical image of the lens 10 by at least one stimulus that is intrinsic and/or extrinsic to the eye. The supplementary layer is applied to the base lens by spin coating. The relief structures 18, 19 with their peaks and valleys are completely covered and the diffractive effects of the relief structures 18, 19 and the resulting optical images are eliminated.

Example 1

In Example 1, the base lens 12 of the lens 10 shown in Fig. 6 consists of, for example, Acrylmex. The material composition of the supplementary layer 22 contains, for example, a polyglycolic acid (PGA) compound, which can be degraded by hydrolysis in a solution corresponding to the aqueous humor of the eye as an extrinsic stimulus or in the aqueous humor of the eye as an intrinsic stimulus of the eye. The refractive indices of the base lens 12 and the supplementary layer 22 are approximately the same.

If the monofocal lens 10 of the solution is exposed to the aqueous humor in the area of the anterior chamber or posterior chamber of a patient's eye after implantation of the lens 10, the supplementary layer 22 is gradually and at least partially broken down homogeneously by hydrolysis, but not the base lens 12, as shown in Fig. 3b. In the case of complete degradation, the relief structures 18, 19 of the base lens 12 are completely exposed so that their multifocal diffractive optical imaging becomes effective. The monofocal lens 10 is thereby converted into the multifocal base lens 12, as shown in Fig. 2a. In this way, the patient can be supported in neuro-adaptation to multifocality after implantation of the lens 10.

Example 2

In this example, the base lens 12 of the lens 10 shown in Fig. 6 consists of, for example, Acrylmex. The material composition of the supplementary layer 22 contains, for example, a silk protein that can be gradually broken down by hydrolysis using a solution that can be administered as eye drops, i.e. an extrinsic stimulus to the eye. The refractive indices of the base lens 12 and the supplementary layer 22 are approximately the same. The hydrolysis can take place completely, homogeneously or inhomogeneously, by exposing the monofocal lens 10 extracorporeally to the solution or by administering the solution of the implanted lens 10 as eye drops until the base lens 12 is completely multifocal, as shown in the right-hand representations of Figs. 3b and 3a. The degradation of the supplementary layer 22 can take place incompletely by exposing the lens 10 to the solution outside the eye or by administering the eye drops to the eye only until the multifocality of the base lens 12 is partially present, as illustrated in the middle illustrations of Fig. 3b and 3a. In this way, an intermediate stage of focality between the lens 10 and the base lens 12, e.g. the lens 10 is then 50% monofocal and 50% multifocal.

Example 3

The lens 15 of this example, which is shown schematically in a side cross-sectional view in Fig. 7, differs from the lens 10 of Example 2 in that a non-diffractive base lens 12 is provided. The supplementary layer 22 with the ring-shaped relief structure 18, 19 with the height profile 20 is formed on the optical regions 14, 16 of the base lens 12, which are not diffractively structured on the surface. The relief structure 18, 19 is diffractive and is produced by structuring a layer of the variable material applied to the optical region 14, 16 by laser engraving.

The material composition of the supplementary layer 22 contains, for example, the silk protein, which can be gradually broken down by hydrolysis using a solution that can be administered as eye drops, i.e. an extrinsic stimulus to the eye. The refractive indices of the base lens 12 and the supplementary layer 22 are approximately the same. The hydrolysis can take place completely after an implantation by administering the solution of the implanted lens 15 as eye drops until the base lens 12 is completely monofocal. The breakdown of the supplementary layer 22 takes place incompletely by only administering the eye drops until the base lens 12 is partially monofocal. As a result, the relief structures 18, 19 are completely or incompletely removed, so that their multifocal, diffractive, optical image is completely or partially deleted.

Example 4

The lens 100 of this example, which is shown schematically in a side cross-sectional view in Fig. 8, differs from the lens 10 of Example 2 in that a base lens 112 is provided which is designed as a pinhole lens. The base lens 112 has an annular relief structure 118 with a height profile 120 which provides an aperture effect, i.e. a pinhole effect as an optical image. The relief structure 118 with the pinhole effect is produced by roughening at least one optical region of the surface of the base lens 112 by etching. In the present example, the base lens 112 has the roughened optical region 114 with the relief structure 118, which is designed to scatter light. In the roughened optical region 114, the light striking the uncovered base lens 112 is at least partially scattered, e.g. essentially backscattered and thus not directed onto the retina of the eye. The uncovered roughened optical region 114 is ring-shaped and its relief structure 118 acts like a pinhole, ie like an aperture. In the lens 100, the roughened optical region 114 is completely covered by the supplementary layer 22 and the lens 100 produces a monofocal optical image. The silk protein of the supplementary layer 22 can be gradually broken down by hydrolysis using the solution, which can be administered as eye drops, i.e. a stimulus extrinsic to the eye. The hydrolysis can be complete, homogeneous or inhomogeneous, by exposing the monofocal lens 100 extracorporeally to the solution or by administering the solution of the implanted lens 100 as eye drops until the complete diaphragm effect of the base lens 112 is present, as illustrated in Fig. 2b. Incomplete degradation of the supplementary layer 22 can also be carried out by exposing the lens 100 to the solution outside the eye only for so long or by administering the eye drops to the eye only for so long until the diaphragm effect of the base lens 112 is partially present.

In a variation of this example, the optical region 114 of the base lens 112 is not roughened, but has a diffractive relief structure (not shown) that is designed to generate destructive interference. This destructive interference causes light that strikes the uncovered base lens 112 to at least partially cancel itself out in such a way that the effect of a pinhole is generated.

Example 5

The lens 200 of this example is shown schematically in a side cross-sectional view in Fig. 9. It differs from the lens 10 of example 2 in that a base lens 212 is provided which is designed as an EDoF lens. The base lens 212 is therefore an intraocular lens which provides an extended depth of field (EDoF). The base lens 212 contains the diffractive optical region 14 with the relief structure 19 and an optical region 124 designed as an annular virtual aperture with an optically effective relief structure 128. The annular aperture 124 has a plurality of surface microstructures. The optical region 14 has the height profile 21 and the virtual aperture 124 has a height profile 130. The relief structures 19 and 128 provide a diffractive lens effect with extended depth of field as an optical image for the uncovered base lens 212.

In the lens 200, the optical area 14 and the virtual aperture 124 are completely covered by the supplementary layer 22 and the lens 200 produces a monofocal optical image. The silk protein of the supplementary layer 22 can be gradually broken down by hydrolysis using the solution, which can be administered as eye drops. The hydrolysis can be homogeneous or inhomogeneous, in each case completely, by extra- poral is exposed to the solution for so long or the solution of the implanted lens 200 is administered as eye drops until the complete EDoF effect of the base lens 212 is present. The degradation of the supplementary layer 22 can also be carried out incompletely by exposing the lens 200 to the solution outside the eye for only so long or by administering the eye drops to the eye for only so long until the EDoF effect of the base lens 212 is partially present.

The modifications of the optical imaging of the lenses 10, 15, 100 and 200 described in the above examples can be carried out inside an eye and/or outside an eye by the action of the intrinsic and/or extrinsic stimulus.

In modifications of the above embodiments and examples, a modification of the lenses 10, 100 or 200 is provided as the starting lens for modifying the optical imaging and/or for implantation, in which at least one of the optical regions of the respective base lens is not completely covered with the supplementary layer 22. For example, only one of the optical regions of the respective base lens is covered with the supplementary layer 22 and/or the supplementary layer 22 covers at least one of the height profiles of the respective base lens up to at least one height below the maximum height, e.g. below one or more peaks, of the respective height profile. In this case, the optical imaging of the starting lens corresponds to an intermediate stage of the optical imaging between the lens 10, 100 or 200, whose optical regions are completely covered with the supplementary layer 22, and the respective uncovered base lens.

In further modifications of the above embodiments and examples, the optically effective relief structures 18, 19, 118 and/or 128 are additionally or alternatively designed to be refractive. The relevant height profile 20, 21, 120 or 130 additionally or alternatively has at least one surface curvature that causes the refractive optical imaging, in particular several corresponding different surface curvatures. For example, the base lens can be a multifocal refractive lens with different surface curvatures. In an example of a combination of a diffractive and a refractive relief structure, the diffractive relief structure can be provided on a refractive relief structure and forms a common height profile with it.

Claims

Patent claims 1. Lens (10; 100; 200) for implantation in an eye, with a transparent lens body (11), comprising a base lens (12; 112; 212) with at least one optical region (14, 16; 114; 124); and an optical supplementary layer (22) which is provided on the base lens (12; 112; 212), wherein the supplementary layer at least partially covers the optical region; wherein the optical region (14, 16; 114; 124) of the base lens and/or the supplementary layer (22) has at least one optically effective relief structure (18, 19; 118; 128) with at least one height profile (20, 21; 120; 130); the base lens and the supplementary layer have different material compositions; and the material composition of at least one element selected from the base lens (12; 112; 212) and the supplementary layer (22) comprises at least one respective material that can be changed to modify the optical image of the lens (10; 100; 200) by at least one stimulus that is intrinsic and/or extrinsic to the eye. 2. Lens according to claim 1, wherein the optical supplementary layer (22) has at least one optically effective relief structure (18, 19; 1 18; 128) with at least one height profile (20, 21; 120; 130). 3. Lens according to claim 1 or 2, wherein the optical region (14, 16; 114; 124) of the base lens has at least one optically effective relief structure (18, 19; 118; 128) with at least one height profile (20, 21; 120; 130); and the optical supplementary layer (22) at least partially covers the optical region and fills the height profile completely or up to at least one height. 4. Lens according to one of the preceding claims, wherein the at least one material is selected such that the material composition of the supplementary layer (22) is at least partially degradable by the aqueous humor or by at least one intrinsic medium of the eye, in particular by at least one component of the aqueous humor of the eye and/or by at least one enzyme of the aqueous humor of the eye, as an intrinsic stimulus, in particular in particular biodegradable; and/or the refractive index of the material composition of the supplementary layer (22) can be at least partially, in particular reversibly, adjusted to the refractive index of the aqueous humor of the eye or to the refractive index of the material composition of the base lens (12; 112; 212) by the stimulus. 5. Lens according to one of the preceding claims, wherein the base lens (12; 112; 212) is a multifocal lens and/or an EDoF (enhanced depth of field) lens and/or a pinhole lens and the combination of the base lens (12; 112; 212) and the supplementary layer (22) before and/or after the change in the at least one material is at least partially a monofocal lens; and/or wherein the base lens is a monofocal lens and the combination of the base lens and the supplementary layer before and/or after the change in the at least one material is at least partially a multifocal lens and/or an EDoF (enhanced depth of field) lens and/or a pinhole lens; and/or wherein the at least one material is changeable such that the optical image of the lens is changeable from a value in a range of 100% and more than 0% monofocal to a value in a range of more than 0% and 100% multifocal or EDoF or pinhole; and/or wherein the at least one material is changeable such that the optical image of the lens is changeable from a value in a range of 100% and more than 0% multifocal or EDoF or pinhole to a value in a range of more than 0% and 100% monofocal; and/or wherein the at least one material is changeable to modify the refractive power and/or the depth of field of the lens; and/or wherein the at least one material is changeable such that the optical image of the lens is changeable from monofocal to multifocal, EDoF and/or pinhole; and/or wherein the at least one material can be changed such that the optical image of the lens can be modified from multifocal and/or EDoF and/or pinhole to monofocal; and/or wherein the at least one material can be changed such that the optical image of the lens can be modified from refractive to diffractive and/or from diffractive to refractive, in particular gradually from refractive to diffractive and/or gradually from diffractive to refractive; and/or wherein the at least one material can be changed reversibly, in particular by using two or more different stimuli at different times. 6. Lens according to one of the preceding claims, wherein the intrinsic stimulus is at least one intrinsic medium of the eye, the aqueous humor of the eye, at least one component of the aqueous humor of the eye and/or at least one enzyme of the aqueous humor of the eye; and/or wherein the extrinsic stimulus is a solvent that is selective for the material composition and/or the at least one material of the supplementary layer (22) and/or an agent that selectively induces the degradation of the material composition and/or the at least one material of the supplementary layer (22), which can be applied in particular as eye drops or injection; and/or wherein the at least one material is photochemically changeable and the extrinsic stimulus is a light with a wavelength and/or intensity that triggers the photochemical change in the material; and/or wherein the at least one material is electrochemically changeable and the extrinsic stimulus is a voltage that triggers the electrochemical change in the material; and/or wherein the at least one material is chemically changeable and the extrinsic stimulus is a reactant that is selective for the at least one material, which can be applied in particular as eye drops or injection; and/or wherein the at least one material is changeable by a magnetic field and the extrinsic stimulus is a magnetic field that triggers the change in the material. 7. Lens according to one of the preceding claims, wherein the at least one material is selected from a hydrogel; a polymer; a component that adjusts the refractive index; a component that adjusts the refractive index and binds to chemical groups of another material of the at least one material; ions and/or nanoparticles that adjust the refractive index and bind to chemical groups of another material of the at least one material; a material that is doped with ions or nanoparticles that adjust the refractive index; and any combination thereof; and/or wherein the at least one material of the supplementary layer (22) is at least partially inhomogeneously or homogeneously degradable, in particular inhomogeneously or homogeneously biodegradable; and/or wherein the degradation profile and/or the degradation rate of the supplementary layer (22) is determined by at least one structure selected from a geometric structure and a chemical structure; and/or wherein the supplementary layer (22) has zones, in particular radial zones, of the at least one material, the zones differ by different materials, by a different degree of cross-linking, by a different crystallinity and/or by a different geometric structure, and the zones can be degraded one after the other, zone by zone, at different degradation rates, in particular radially from the outside to the inside; and/or wherein the supplementary layer (22) comprises, in addition to the at least one material, a drug which is released upon degradation of the supplementary layer (22). 8. Lens according to one of the preceding claims, wherein the material composition of the supplementary layer (22) contains as the at least one material a hydrolytically degradable polymer and/or a light-induced degradable polymer and/or an enzymatically degradable polymer and/or a biodegradable polymer. 9. Lens according to one of the preceding claims, wherein the refractive index of the base lens (12; 112; 212) and the refractive index of the supplementary layer (22) are greater than the refractive index of the aqueous humor of the eye and the refractive index of the supplementary layer (22) is at least partially adaptable to the refractive index of the aqueous humor of the eye, in particular reversibly. 10. Lens according to one of the preceding claims, wherein the refractive index of the base lens (12; 112; 212) and the refractive index of the supplementary layer (22) are greater than the refractive index of the aqueous humor of the eye and the material composition of the supplementary layer (22) is at least partially degradable, in particular biodegradable. 11. Lens according to one of the preceding claims, wherein the material composition of the supplementary layer (22) contains as the at least one material a material that is homogeneously degradable; and/or wherein the supplementary layer (22) contains a plurality of zones, in particular radial zones, wherein the zones have different materials, the material of the zones is cross-linked to different degrees, the zones have different crystallinities and/or the zones are geometrically structured differently in order to provide axially and/or radially different degradation rates. 12. A method for producing a lens (10; 15; 100; 200) according to any one of the preceding claims, comprising the steps Providing the base lens (12; 112; 212), and Applying the supplementary layer (22) to the at least one relief structure (18, 19; 118; 128) of the base lens (12; 112; 212), or Forming the supplementary layer (22) as a solid layer with at least one relief structure and placing and fixing the supplementary layer on the base lens, or Forming the supplementary layer (22) by applying a layer with the variable Material onto the base lens and mechanical processing of the layer. 13. Method for modifying the optical image of a lens, comprising providing a lens (10; 100; 200) according to one of claims 1 to 11; and changing the at least one material of at least one element selected from the base lens (12; 112; 212) and the supplementary layer (22) by allowing the stimulus intrinsic and/or extrinsic to the eye to act for the respective material to be changed. 14. The method according to claim 13, wherein the changing of the at least one material takes place before or after the implantation of the lens into the eye; and/or wherein the modification of the optical image and/or the changing of the at least one material is reversible and/or is reversed, in particular by the use of two or more different stimuli at different times. 15. Lens (10; 100; 200), in particular a lens according to one of claims 1 to 11, obtained by a method according to one of claims 12 to 14.