309 results about "Laser surgery" patented technology

The present invention provides an energy delivery device for use with a medical treatment system for the more efficacious treatment of patients during laser surgery which limits the number of uses or prevents reuse of the energy delivery device after a certain threshold limit has been reached. The energy delivery device comprises a diffusing optical fiber and a memory device having data programmed therein and being operatively connected to an energy generator the optical fiber includes a temperature sensor for generating a temperature signal in a closed loop manner. The data stored in the memory device includes a multiplicity of use parameters, usage limits, usage counts, and count limits all relating to the properties of the medical treatment system. The use parameters may include an elapsed time, a total treatment time, and a number of treatment sites. A main processor is also included for calculating a temperature from the temperature signal and for updating the use parameters in response to data received by the main processor. The main processor is also used to compare the use parameters to their corresponding usage limits. The main processor can create and increment a usage count when at least one of the use parameters exceeds its corresponding usage limit. Thereafter, the main processor compares the usage count to the count limit and disables the energy delivery device when the usage count exceeds a predetermined count limit.

A disposable stabilization and applanation device for reconfiguring the cornea of an eye for ophthalmic laser surgery, includes an applanation lens that is disposed in a particular spatial position with respect to an incident laser beam. The applanation lens is inserted into the central opening of an attachment ring and applanates the eye in response to pressure from a lens cone. The attachment ring is coupled to the eye and includes a skirt which surrounds the applanation lens and extends outwardly therefrom to define a chamber. The skirt is formed with a groove which defines a suction channel between the attachment ring skirt and the corneal surface of an eye. A vacuum source is connected and fluid communication with the suction channel and is selectively activated to create a partial vacuum in the channel.

Failure events detected by a laser surgery monitoring feedback circuit are analyzed in order to distinguish between events that result from fiber breakdown and those arising from other sources, such as burning of tissues. If the number of failure events within a predetermined time exceeds a predetermined count, then it is determined that the radiation is the result of fiber breakdown. If the number of failure events within the predetermined time is less than the predetermined count, then it is determined that the failure events result from other causes, such as heating of tissues by the laser. Based on the analysis, an override switch or alarm may be initiated.

A laser treatment device and process with controlled cooling. The device contains a cooling element with high heat conduction properties, which is transparent to the laser beam. A surface of the cooling element is held in contact with the tissue being treated while at least one other surface of the cooling element is cooled by the evaporation of a cryogenic fluid. The cooling is coordinated with the application of the laser beam so as to control the temperatures of all affected layers of tissues. In a preferred embodiment useful for removal of wrinkles and spider veins, the cooling element is a sapphire plate. A cryogenic spray cools the top surface of the plate and the bottom surface of the plate is in contact with the skin. In preferred embodiments the wavelength of the laser beam is chosen so that absorption in targeted tissue is low enough so that substantial absorption occurs throughout the targeted tissue. In a preferred embodiment for treating large spider veins with diameters in the range of 1.5 mm, Applicants use an Er:Glass laser with a wavelength of 1.54 microns.< / PTEXT>

Optical coherence tomography (OCT) is used to map the surface elevation and thickness of the cornea. The OCT maps are used to plan laser procedures for the treatment of an irregular, opacified or weakened cornea, and in the treatment of refractive errors. In the excimer laser phototherapeutic keratectomy (PTK) procedure, the OCT data is used to plan a map of ablation depth needed to restore a smooth optical surface. In the excimer laser photorefractive keratectomy procedure, OCT mapping of epithelial thickness is used to achieve clean laser epithelial removal. In femtosecond laser anterior keratoplasty procedure, OCT data is used to plan the depth of femtosecond laser dissection to remove an anterior layer of the cornea, leaving a smooth recipient bed of uniform thickness to receive a disk of donated corneal tissue. The linkage of an OCT system to a precise laser surgical system enables the performance of new procedures that are safer, less invasive and produce faster visual recovery than conventional surgical procedures.

The present invention provides an energy delivery device for use with a medical treatment system for the more efficacious treatment of patients during laser surgery which limits the number of uses or prevents reuse of the energy delivery device after a certain threshold limit has been reached. The energy delivery device comprises a diffusing optical fiber and a memory device having data programmed therein and being operatively connected to an energy generator the optical fiber includes a temperature sensor for generating a temperature signal in a closed loop manner. The data stored in the memory device includes a multiplicity of use parameters, usage limits, usage counts, and count limits all relating to the properties of the medical treatment system. The use parameters may include an elapsed time, a total treatment time, and a number of treatment sites. A main processor is also included for calculating a temperature from the temperature signal and for updating the use parameters in response to data received by the main processor. The main processor is also used to compare the use parameters to their corresponding usage limits. The main processor can create and increment a usage count when at least one of the use parameters exceeds its corresponding usage limit. Thereafter, the main processor compares the usage count to the count limit and disables the energy delivery device when the usage count exceeds a predetermined count limit.

Methods and systems are disclosed for detecting overheating in an optical device before harmful consequences, such as severe local heating, can result. In one embodiment of the invention, a blackbody emitter is disposed in close proximity to a therapeutic optical fiber to absorb therapeutic radiation at a fault and re-emit blackbody (infrared) radiation. The emitter can be coupled to the fiber but, during normal operation, lies outside the optical path between the output of the laser radiation and the site of treatment. Systems and catheters incorporating such emitters are also described for effective monitoring of the laser power transmitted along the optical fiber within the phototherapy device.

A refractive laser surgery process is disclosed for using compact, low-cost ophthalmic laser systems which have computer-controlled scanning with a non-contact delivery device for both photo-ablation and photo-coagulation in corneal reshaping. The basic laser systems may include flash-lamp and diode pumped UV solid state lasers (193-215 nm), compact excimer laser (193 nm), free-running Er:glass (1.54 microns), Ho:YAG (2.1 microns), Q-switched Er:YAG (2.94 microns), and tunable IR lasers, (750-1100) nm and (2.5-3.2) microns. The advantages of the non-contact, scanning device used in the process over other prior art lasers include being safer, reduced cost, more compact and more precise and with greater flexibility. The theory of beam overlap and of ablation rate and coagulation patterns is also disclosed for system parameters. Lasers are selected with energy of (0.01-10) mJ, repetition rate of (1-10,000), pulse duration of 0.01 nanoseconds to a few hundreds of microseconds, and with spot size of (0.05-2) mm for use with refractive laser surgery.

A system for positioning the eye of a patient, relative to a stationary surgical laser unit, includes a chair for moving the patient. An eye stabilizing element is held against the eye, with a tapered receptacle extending outwardly therefrom. Also, an alignment device with a tapered tip is mounted on the surgical laser unit. In operation, the patient is moved to engage the receptacle of the eye stabilizing element with the tip of the alignment device, to thereby align the patient's eye with the surgical laser unit for laser surgery.

Improved devices, systems, and methods for diagnosing, planning treatments of, and / or treating the refractive structures of an eye of a patient incorporate results of prior refractive corrections into a planned refractive treatment of a particular patient by driving an effective treatment vector function based on data from the prior eye treatments. The exemplary effective treatment vector employs an influence matrix which may allow improved refractive corrections to be generated so as to increase the overall accuracy of laser eye surgery (including LASIK, PRK, and the like), customized intraocular lenses (IOLs), refractive femtosecond treatments, and the like.

A laser-based method and apparatus for corneal surgery. The present invention is intended to be applied primarily to ablate organic materials, and human cornea in particular. The invention uses a laser source which has the characteristics of providing a shallow ablation depth (0.2 microns or less per laser pulse), and a low ablation energy density threshold (less than or equal to about 10 mJ / cm2), to achieve optically smooth ablated corneal surfaces. The preferred laser includes a laser emitting approximately 100–50,000 laser pulses per second, with a wavelength of about 198–300 nm and a pulse duration of about 1–5,000 picoseconds. Each laser pulse is directed by a highly controllable laser scanning system. Described is a method of distributing laser pulses and the energy deposited on a target surface such that surface roughness is controlled within a specific range. Included is a laser beam intensity monitor and a beam intensity adjustment means, such that constant energy level is maintained throughout an operation. Eye movement during an operation is corrected for by a corresponding compensation in the location of the surgical beam. Beam operation is terminated if the laser parameters or the eye positioning is outside of a predetermined tolerable range. The surgical system can be used to perform surgical procedures including removal of corneal scar, making incisions, cornea transplants, and to correct myopia, hyperopia, astigmatism, and other corneal surface profile defects.

A method of corneal laser surgery is disclosed. A first periphery is defined at an anterior surface of the cornea. This first periphery bounds a first planar area. A second periphery is defined within stromal tissue of the cornea. This second periphery bounds a second planar area. The second planar area is sized differently than the first planar area. A layer of stromal tissue which is bounded by the second periphery is subsequently incised. Stromal tissue between substantial portions of the first periphery and the second periphery is also incised, such that at least some corneal tissue disposed between the first and second peripheries remains connected to corneal tissue outside of the first and second peripheries.

A method and system is described that greatly improves the safety and efficacy of ophthalmic laser surgery. The method and system are applicable to precise operations on a target subject to movement during the procedure. The system may comprise the following elements: (1) a user interface, (2) an imaging system, which may include a surgical microscope, (3) an automated tracking system that can follow the movements of an eye, (4) a laser, (5) a diagnostic system, and (6) a fast reliable safety means, for automatically interrupting the laser firing.

A manual and automatic fluid control system and method for use in open and laparoscopic laser surgery and electrosurgery is disclosed. The system includes a manual mode along with several automatic modes which can effectuate both suction and irrigation, either individually or simultaneously. In the various automatic modes, the suction and / or irrigation is automatically activated during activation of a medical apparatus for laser surgery or electrosurgery without requiring separate activation from the surgeon or operating room staff. Several safety features for monitoring the fluid control system are also incorporated within the system such as fluid sensors for detecting the absence of irrigation fluid, pressure sensors and vacuum systems for monitoring fluid pressure, fluid sensors for monitoring fluid volume, and warning signals for detecting empty containers. All of the safety features are designed to automatically deactivate suction and / or irrigation means contained within the fluid control system upon detection of unsafe levels. Finally, specially designed suction / irrigation hand pieces are disclosed for use in connection with the fluid control system.

A device and method for steering a laser beam to a focal point in target tissue requires generating a laser beam. Diversions of the laser beam from a central beam path are minimized by a sequential arrangement of optical steering components. In order, the beam is first directed to the center of a z-scanning apparatus which will move the focal point in the medium in a z-direction. The beam is then passed to the center of a first galvanometric mirror which introduces focal point movements in the x-direction. A second galvanometric mirror then compensates for the x-direction movement by redirecting the beam to the center of a third galvanometric mirror where focal point movements in the y-direction are introduced.

A system for positioning the eye of a patient, relative to a stationary surgical laser unit, includes a chair for moving the patient. An eye stabilizing element is held against the eye, with a tapered receptacle extending outwardly therefrom. Also, an alignment device with a tapered tip is mounted on the surgical laser unit. In operation, the patient is moved to engage the receptacle of the eye stabilizing element with the tip of the alignment device, to thereby align the patient's eye with the surgical laser unit for laser surgery.

A system for adaptive laser scanning correction includes a laser scanner coupled to a controller. The controller develops control signals for the laser scanner for a directed scan pattern that is modified to compensate for a characteristic scan-pattern distortion introduced by the laser scanner. The laser scanner responds to the control signals to provide an actual scan pattern approaching a target scan-pattern shape. The system may be useful for ophthalmologic laser surgery and other applications requiring precise control over scan pattern shape and a high scanning speed.

An apparatus and method for ultrafast real-time optical imaging that can be used for imaging dynamic events such as microfluidics or laser surgery is provided. The apparatus and methods encode spatial information from a sample into a back reflection of a two-dimensional spectral brush that is generated with a two-dimensional disperser and a light source that is mapped in to the time domain with a temporal disperser. The temporal waveform is preferably captured by an optical detector, converted to an electrical signal that is digitized and processed to provide two dimensional and three dimensional images. The produced signals can be optically or electronically amplified. Detection may be improved with correlation matching against a database in the time domain or the spatial domain. Embodiments for endoscopy, microscopy and simultaneous imaging and laser ablation with a single fiber are illustrated.

Surgical method and apparatus for presbyopia correction and glaucoma by laser removal a portion of the sclera and / or ciliary tissue are disclosed. The disclosed preferred embodiments of the system consists of a beam spot controller, an articulated arm and an attached end-piece. The basic laser beam includes UV laser having wavelength ranges of (0.19-0.36) microns, generated from UV excimer lasers of ArF, XeCl or solid state lasers of Nd:YLF, Nd:YAG, Ti:sapphire with harmonic generation using nonlinear crystals. Presbyopia is treated by ablation of the treated surface tissue in predetermined patterns outside the limbus to increase the accommodation of the eye. Glaucoma is treated by decreasing of intra ocular pressure of the laser surgery.

A system and method are provided for fragmenting a crystalline lens, to facilitate its removal from the lens bag during an ophthalmic laser surgery. First, a predetermined pattern is used to make Laser Induced Optical Breakdown (LIOB) cuts that section the lens into asymmetrical, operational segments. At least one operational segment is then selected and softened with a plurality of compact LIOB cuts. Once softened, the selected segment is aspirated. The remaining operational segments are then subsequently removed. During a procedure, an imaging unit can monitor movements of the lens bag to ensure proper placement of the LIOB cuts on the lens.

A hand-held, portable diode laser surgical device includes a power supply, at least one laser diode, integral control interface and display, and a multi-component sterile, disposable tip apparatus featuring assembly for alignment of a self-contained optical fiber to the surgical device, and releasably locking assembly between the tip apparatus and surgical device. An embodiment includes wireless foot pedal on / off control and a dock providing sterile, antiseptic recharging environment.

A laser surgical device for removal of intraocular tissue including a handpiece and a tip. The handpiece has a sleeve that creates a passage way for irrigation fluid. An optic fiber or similar light conveying means is contained within the handpiece. A passageway for aspiration is included in the handpiece and continues into the tip. The tip is configured with a photon trap that captures stray laser light and prevents it from continuing into the eye.

A laser-based method and apparatus for corneal surgery. The present invention is intended to be applied primarily to ablate organic materials, and human cornea in particular. The invention uses a laser source which has the characteristics of providing a shallow ablation depth (0.2 microns or less per laser pulse), and a low ablation energy density threshold (less than or equal to about 10 mJ / cm.sup.2), to achieve optically smooth ablated corneal surfaces. The preferred laser includes a laser emitting approximately 100-50,000 laser pulses per second, with a wavelength of about 198-300 nm and a pulse duration of about 1-5,000 picoseconds. Each laser pulse is directed by a highly controllable laser scanning system. Described is a method of distributing laser pulses and the energy deposited on a target surface such that surface roughness is controlled within a specific range. Included is a laser beam intensity monitor and a beam intensity adjustment means, such that constant energy level is maintained throughout an operation. Eye movement during an operation is corrected for by a corresponding compensation in the location of the surgical beam. Beam operation is terminated if the laser parameters or the eye positioning is outside of a predetermined tolerable range. The surgical system can be used to perform surgical procedures including removal of corneal scar, making incisions, cornea transplants, and to correct myopia, hyperopia, astigmatism, and other corneal surface profile defects.

A universal gonioscope-contact lens system suitable for both diagnostics and / or intraocular laser surgery that consists of a conical gonioscope body with a plurality of mirrors on the inner side of the body and a contact lens that consists of a contact lens portion intended for contact with the patient's eye cornea and a rear main optical portion that may have any arbitrary shape, provided that it has beveled flat surfaces arranged perpendicular to the beams reflected from the gonioscope mirrors. The aforementioned rear main optical portion can be conveniently used for manipulating the contact lens and for arranging optical lens components such as a concave lens and convex lens. The convex lens component may be used for focusing a laser beam, while the flat areas and the concave lens can be used respectively for delivery and diverging of the illumination light. The contact lens portion can be made from a material softer than the main optical portion. The entire assembly can be disposable as a whole or the contact lens portion may have disposable soft inserts attachable to the front end of the contact lens and selectively used to match the curvature of the patient's eye cornea.

A disposable or reusable surgical laser handpiece having an extendable and retractable active laser fiber tip and housed in a body comprising an actuating handle for use in various surgical laser procedures. The fiber tip when extended can be given a specific configuration by associating the fiber with a shaped memory member. The housing can also be constructed to incorporate bipolar or unipolar electrosurgical electrodes.

Systems and methods are disclosed for registering a corneal flap for laser surgery on an eye. The method includes generating a first image of the eye during a diagnostic procedure, determining a corneal flap geometry referenced to the first image, generating a second image of the eye during to a treatment procedure, comparing the first image with the second image, and registering the corneal flap geometry of the first image to the second image.

A disposable lens for reconfiguring the cornea of an eye for ophthalmic laser surgery includes a lens which has a flat anterior surface that is formed opposite a contact surface. A skirt surrounds the contact surface and extends outwardly therefrom to define a chamber. The skirt is formed with a groove which creates a suction channel between the skirt and the contact surface in the chamber. In its operation, the lens is positioned over the cornea and a vacuum pump is selectively activated to create a partial vacuum in the suction channel. Due to this partial vacuum, the cornea is drawn into the chamber where it is urged against the contact surface of the lens. The result of this is that the cornea is flattened into a configuration where the introduction of spherical aberration and coma into a light beam passing into the cornea is reduced or eliminated.

Fiber optic end faces produced by laser ablation, as opposed to “cleave” or mechanical polish, offer advantages in some severe environment applications such as laser surgery and delivery of extremely high energy density. The “laser polished” fiber faces are more resistant to physical damage as well as less prone to damage other structures, owing to a lack of sharp, fragile edges and laser polished faces may be formed on fibers in planes and curvatures normal to the fiber axis or off normal, as desired.

Methods, devices, and systems establish an optical surface shape that mitigates or treats a vision condition in a patient. An optical surface shape for a particular patient can be determined using a set of patient parameters for the specific patient by using a compound modulation transfer function (CMTF). The compound modulation transfer function can include a combination of modulation transfer functions (MTF's) at a plurality of distinct frequencies.

A medical apparatus and method useful for the efficacious thermal treatment of lumen such as varicose veins during laser surgery is provided. The method includes inserting an optical fiber into a lumen at a treatment site which has at least two treatment segments. The light-emitting section of the optical fiber is aligned with a first treatment segment within the treatment site. Energy is emitted into the lumen at the first treatment segment and a temperature of the lumen is measured at the first treatment segment. The energy delivered to the treatment segment can be adjusted in response to the temperature measurement. The light-emitting section is moved to at least a second treatment segment within the lumen and energy is emitted into the lumen at the second treatment segment. During treatment at the second treatment segment, the temperature of the lumen is measured at the second treatment segment. This method can also include storing a temperature target in the memory device; generating a temperature signal using the temperature sensor; utilizing the temperature signal to determine the measured temperature; and comparing the measured temperature to the temperature target stored in the memory device. The light-emitting section is moved to the next treatment segment when the measured temperature is equal or greater than the temperature target.