57 results about "Pars plana" patented technology

A device is described that can be used by surgeons to provide accurate tissue-lifting and tightening maneuvers that uses minimal external incisions, enhances accuracy, reduces inadvertent consequences while speeding the procedure. The device is comprised of a shaft with a relatively planar but possibly lenticulate or even slightly curved tip that can divide and energize various tissue planes causing net contraction via the fibrous tissue modification. Various forms of energy can also be delivered to cause desirable tissue alterations.

Described herein are vascular remodeling devices that include a proximal section, an intermediate section, and a distal section. During deployment, the proximal section can expand from a compressed delivery state to an expanded state and anchors the device in an afferent vessel of a bifurcation. The distal section expands from the compressed delivery state to an expanded state that may be substantially planar, approximately semi-spherical, umbrella shaped, or reverse umbrella shaped. The distal section is positioned in a bifurcation junction across the neck of an aneurysm or within an aneurysm. The intermediate section allows perfusion to efferent vessels. Before or after the device is in position, embolic material may be used to treat the aneurysm. The distal section can act as a scaffolding to prevent herniation of the embolic material. The device can be used for clot retrieval with integral distal embolic protection.

A frame ensures that the alignment between a high intensity focused ultrasound (HIFU) transducer designed for vaginal use and a commercially available ultrasound image probe is maintained, so that the HIFU focus remains in the image plane during HIFU therapy. A water-filled membrane placed between the HIFU transducer and the treatment site provides acoustic coupling. The coupling is evaluated to determine whether any air bubbles exist at the coupling interface, which might degrade the therapy provided by the HIFU transducer. HIFU lesions on tissue appear as hyperechoic spots on the ultrasound image in real time during application of HIFU therapy. Ergonomic testing in humans has demonstrated clear visualization of the HIFU transducer relative to the uterus and showed the potential for the HIFU transducer to treat fibroids from the cervix to the fundus through the width of the uterus.

A device and method for intravascular treatment of atherosclerotic plaque prior to balloon angioplasty which microperforates the plaque with small sharp spikes acting as serrations for forming cleavage lines or planes in the plaque. The spikes may also be used to transport medication into the plaque. The plaque preparation treatment enables subsequent angioplasty to be performed at low balloon pressures of about 4 atmospheres or less, reduces dissections, and avoids injury to the arterial wall. The subsequent angioplasty may be performed with a drug-eluting balloon (DEB) or drug-coated balloon (DCB). The pre-angioplasty perforation procedure enables more drug to be absorbed during DEB or DCB angioplasty, and makes the need for a stent less likely. Alternatively, any local incidence of plaque dissection after balloon angioplasty may be treated by applying a thin, ring-shaped tack at the dissection site only, rather than applying a stent over the overall plaque site.

Described herein are vascular remodeling devices that include a proximal section, an intermediate section, and a distal section. During deployment, the proximal section can expand from a compressed delivery state to an expanded state and anchors the device in an afferent vessel of a bifurcation. The distal section expands from the compressed delivery state to an expanded state that may be substantially planar, approximately semi-spherical, umbrella shaped, or reverse umbrella shaped. The distal section is positioned in a bifurcation junction across the neck of an aneurysm or within an aneurysm. The intermediate section allows perfusion to efferent vessels. Before or after the device is in position, embolic material may be used to treat the aneurysm. The distal section can act as a scaffolding to prevent herniation of the embolic material. The device can be used for clot retrieval with integral distal embolic protection.

Systems, devices, and methods for treating a glaucomatous eye are provided. An amount of pulsed laser energy is delivered to the pars plana of the eye by a hand-holdable device which comprises a hand-holdable elongate member and a contact member disposed on an end of the elongate member. A contact surface of the contact member is placed in direct contact with the eye so that a reference edge of the contact member aligns with the limbus and a treatment axis defined by the elongate member is angularly offset from the optical axis of the eye. The amount of pulsed laser energy delivered is insufficient to effect therapeutic photocoagulation but is sufficient to increase uveoscleral outflow so as to maintain a reduction from pre-laser treatment intraocular pressure. Amounts of pulsed laser energy will be transmitted to a circumferential series of tissue regions of the eye.

A method of ablating tissue in the heart to treat atrial fibrillation introduces into a selected atrium an energy emitting element. The method exposes the element to a region of the atrial wall and applies ablating energy to the element to thermally destroy tissue. The method forms a convoluted lesion pattern comprising elongated straight lesions and elongated curvilinear lesions. The lesion pattern directs electrical impulses within the atrial myocardium along a path that activates the atrial myocardium while interrupting reentry circuits that, if not interrupted, would cause fibrillation. The method emulates the surgical maze procedure, but lends itself to catheter-based procedures that do not require open heart surgical techniques. A composite structure for performing the method is formed using a template that displays in planar view a desired lesion pattern for the tissue. An array of spaced apart element is laid on the template. Guided by the template, energy emitting and non-energy emitting zones are formed on the elements. By overlaying the elements, the composite structure is formed, which can be introduced into the body to ablate tissue using catheter-based, vascular access techniques.

Absorbable implants for breast surgery that conform to the breast parenchyma and surrounding chest wall have been developed. These implants support newly lifted breast parenchyma, and / or a breast implant. The implants have mechanical properties sufficient to support a reconstructed breast, and allow the in-growth of tissue into the implant as it degrades. The implants have a strength retention profile allowing the support of the breast to be transitioned from the implant to regenerated host tissue, without significant loss of support. Three-dimensional implants for use in minimally invasive mastopexy / breast reconstruction procedures are also described, that confer shape to a patient's breast. These implants are self-reinforced, can be temporarily deformed, implanted in a suitably dissected tissue plane, and resume their preformed three-dimensional shape. The implants are preferably made from poly-4-hydroxybutyrate (P4HB) and copolymers thereof. The implants have suture pullout strengths that can resist the mechanical loads exerted on the reconstructed breast.

A device and method for intravascular treatment of atherosclerotic plaque perforates the plaque with microperforations by small sharp spikes to act as serrations for forming cleavage lines or planes in the plaque. In preferred embodiments, expansion may be obtained by mechanical apparatus, expansion balloon, or balloon-assisted deployment. The plaque treatment enables a subsequent balloon angioplasty to be performed without creating substantial dissections and at low balloon pressure so as to avoid injury to the arterial wall. The plaque treatment may include dilatation of the plaque at low pressure, sufficiently that no subsequent balloon angioplasty is needed. The plaque preparation may be followed by applying one or a few ring tacks to secure the compressed plaque with minimal emplacement of foreign material.

A frame ensures that the alignment between a high intensity focused ultrasound (HIFU) transducer designed for vaginal use and a commercially available ultrasound image probe is maintained, so that the HIFU focus remains in the image plane during HIFU therapy. A water-filled membrane placed between the HIFU transducer and the treatment site provides acoustic coupling. The coupling is evaluated to determine whether any air bubbles exist at the coupling interface, which might degrade the therapy provided by the HIFU transducer. HIFU lesions on tissue appear as hyperechoic spots on the ultrasound image in real time during application of HIFU therapy. Ergonomic testing in humans has demonstrated clear visualization of the HIFU transducer relative to the uterus and showed the potential for the HIFU transducer to treat fibroids from the cervix to the fundus through the width of the uterus.

Radical hysterectomy, i.e., a surgical method for treating cervical carcinoma, is put forward by Wertheim over 100 years before, becomes a classic of surgical treatment of cervical carcinoma, contributes to increasing the five-year survival rate of a patient suffering from cervical carcinoma by 80-90 percent, but has the defects of great damages, the occurrence rate of 70-85 percent of postoperative urinary bladder dysfunction, and influence on the postoperative life. Laparoscope cervical carcinoma radical-curing nerve-sparing surgery can be used for improving the urinary bladder function after a cervical carcinoma surgery and protecting hypogastric nerves, and is an important surgical link for protecting urinary bladder and rectum functions. Through simulation teaching, doctors are taught with a safe and effective method, students can contact ''patients'' by means of surgical skills before starting a surgery, and damages to nerves in the true surgery are avoided. In the simulation teaching, surgical instruments are needed, but above all model ''patients'' are needed. An anatomic plane and a repeatedly-operated simulation surgery model are taken as the teaching bases of surgeries, so that the students grasp anatomic positions and surgical separation skills. A surgical planar model disclosed by the invention promotes further development of surgery simulation teaching all over the world.

The present invention provides an improved surgical blade and trocar system for accessing the retina and other parts of the eye while doing vitreo-retinal and cataract surgeries, including surgeries for macular degeneration. The eye surgeon uses an improved surgical blade for vitreo-retinal and cataract surgeries having a generally flat, V-shaped, W-shaped, or “extended W” shaped cross-section. Using the improved surgical blade, the surgeon creates a multi-planar, self-sealing surgical wound, first by directing the surgical blade substantially perpendicular to the eye surface, then redirecting the blade to follow the general curvature of the eye globe, and finally redirecting the blade to enter the interior of the eye. The improved surgical blade is used with an improved trocar system having two main parts-a relatively rigid, wide-mouthed outer segment and a generally thin-walled, collapsible plastic polymer or metal mesh sleeve that spans the surgical wound and substantially molds to its contour. The improved surgical blade and trocar system can be adapted for use in either vitreo-retinal or cataract surgeries.

Applicant has proposed a combination of the subretinal and epiretinal methods by placing the electronics external to the eye, entering the eye through the pars plana and the piercing the retina (retinotomy) from inside the eye to stimulate subreintally.The present invention is an improved electrode array for subretinal stimulation. A hard polymer such as polyimide is biocompatible and strong for supporting an electrode array and supporting traces in a thin flex circuit array. In the present invention applicant takes advantage of the sharp nature of thin polyimide making a point on the end of the electrode array. This allows the flexible circuit electrode array to be both electrode array and surgical tool to cut the retinal and slide the array under the retina in a single action.

Methods, devices, and systems for treating the support structures of the body, particularly for incontinence, take advantage of two mechanisms to enhance the support provided by the fascia, ligaments and tendons: first, the invention increases a modulus of elasticity of these tissues, and particularly of the fascial tissues. The increase in modulus can be effected by directing sufficient energy to the fascial tissue so as to promote the formation of scar tissue. The second mechanism attaches tissue planes together, often by directing energy to an interface between adjacent fascial tissues.

Repair of a spine from a posterior approach especially for locating an implant between a lower and upper human vertebra includes making an incision in the skin lateral to the midline, making an incision through the Erector Spinae Aponeurosis (ESA) following the ELIF groove, separating the ESA from the Longissimus Thoracis Pars Lumborum (LTPL), atraumatic separating the Multifidus from the LTPL using the interfascial boundary between the Multifidus and the LTPL, and creating a surgical plane having an angle of 20°-60°.

Eye wall anchored fixtures each including at least one elongated anchor member for driven lengthwise insertion into an eye's eye wall in a transverse direction to its thickness for supporting an intraocular device in the eye's vitreous cavity. Fixtures are preferably anchored in circumferential incisions in a human adult eye's pars plana preferably 3.5 mm posterior to its corneal limbus, and perpendicular to a circumferential incision. The fixtures are either generally L-shaped with a single elongated anchor member designed for withdrawal from an eye wall or self-anchoring thereinto, or generally T-shaped with a pair of oppositely directed self-anchoring elongated anchor members for sealing a throughgoing incision. Intraocular devices can be designed for intraocular drug delivery, for acquiring intraocular physiological measurements, and the like.

Eye wall anchored fixtures each including at least one elongated anchor member for driven lengthwise insertion into an eye's eye wall in a transverse direction to its thickness for supporting an intraocular device in the eye's vitreous cavity. Fixtures are preferably anchored in circumferential incisions in a human adult eye's pars plana preferably 3.5 mm posterior to its corneal limbus, and perpendicular to a circumferential incision. The fixtures are either generally L-shaped with a single elongated anchor member designed for withdrawal from an eye wall or self-anchoring thereinto, or generally T-shaped with a pair of oppositely directed self-anchoring elongated anchor members for sealing a throughgoing incision. Intraocular devices can be designed for intraocular drug delivery, for acquiring intraocular physiological measurements, and the like.

An ophthalmic visualization system can include an ocular lens positioned between a macular contact lens coupled to a procedure eye and a surgical microscope. The ocular lens can guide a light beam through the macular contact lens and into the procedure eye, and in combination with the macular contact lens generate an intermediate image of the procedure eye at an image plane between the procedure eye and the surgical microscope. The system can include a reduction lens positioned in the optical path between the surgical microscope and the ocular lens. The reduction lens and / or ocular lens can align a focus plane of the surgical microscope with the image plane. A method of visualizing a procedure eye in an ophthalmic procedure can include positioning an ocular lens and a reduction lens between a macular contact lens and a surgical microscope; and scanning the procedure eye with a light beam.

Applicant has proposed a combination of the subretinal and epiretinal methods by placing the electronics external to the eye, entering the eye through the pars plana and the piercing the retina (retinotomy) from inside the eye to stimulate subreintally. The present invention is an improved electrode array for subretinal stimulation. A hard polymer such as polyimide is biocompatible and strong for supporting an electrode array and supporting traces in a thin flex circuit array. In the present invention applicant takes advantage of the sharp nature of thin polyimide making a point on the end of the electrode array. This allows the flexible circuit electrode array to be both electrode array and surgical tool to cut the retinal and slide the array under the retina in a single action.

Systems, devices, and methods for treating a glaucomatous eye are provided. An amount of pulsed laser energy is delivered to the pars plana of the eye by a hand-holdable device which comprises a hand-holdable elongate member and a contact member disposed on an end of the elongate member. A contact surface of the contact member is placed in direct contact with the eye so that a reference edge of the contact member aligns with the limbus and a treatment axis defined by the elongate member is angularly offset from the optical axis of the eye. The amount of pulsed laser energy delivered is insufficient to effect therapeutic photocoagulation but is sufficient to increase uveoscleral outflow so as to maintain a reduction from pre-laser treatment intraocular pressure. Amounts of pulsed laser energy will be transmitted to a circumferential series of tissue regions of the eye.

A system is described for obtaining intraoral radiographic images using an anatomically conforming sensor and a method is described for correcting the projective distortions caused by the inclination of the plane of the imaging sensor relative to the x-ray beam. The purpose of the described sensor system is to reduce patient discomfort as compared to conventional planar intra-oral x-ray sensors, which tend to impinge on sensitive tissues within the oral cavity. An additional purpose of the described system is to allow for better coverage of the subject by allowing the sensor to fit closer against the surrounding tissues.

Applicant has proposed a combination of the subretinal and epiretinal methods by placing the electronics external to the eye, entering the eye through the pars plana and the piercing the retina (retinotomy) from inside the eye to stimulate subreintally. The present invention is an improved electrode array for subretinal stimulation. A hard polymer such as polyimide is biocompatible and strong for supporting an electrode array and supporting traces in a thin flex circuit array. In the present invention applicant takes advantage of the sharp nature of thin polyimide making a point on the end of the electrode array. This allows the flexible circuit electrode array to be both electrode array and surgical tool to cut the retinal and slide the array under the retina in a single action.

A device and method for intravascular treatment of atherosclerotic plaque prior to balloon angioplasty which microperforates the plaque with small sharp spikes acting as serrations for forming cleavage lines or planes in the plaque. The spikes may also be used to transport medication into the plaque. The plaque preparation treatment enables subsequent angioplasty to be performed at low balloon pressures of about 4 atmospheres or less, reduces dissections, and avoids injury to the arterial wall. The subsequent angioplasty may be performed with a drug-eluting balloon (DEB) or drug-coated balloon (DCB). The pre-angioplasty perforation procedure enables more drug to be absorbed during DEB or DCB angioplasty, and makes the need for a stent less likely. Alternatively, any local incidence of plaque dissection after balloon angioplasty may be treated by applying a thin, ring-shaped tack at the dissection site only, rather than applying a stent over the overall plaque site.

Presbyopia may be treated by implanting a scleral prosthesis within a plurality of elongated pockets formed in the tissue of the sclera of the eye. The implanted prosthesis exerts traction on the sclera in the region overlying the ciliary body which expands the sclera and the underlying ciliary body. This restores the effective working distance of the ciliary muscle and increases the amplitude of accommodation. A prosthesis of the present invention that contacts the sclera of an eyeball comprises a body having a first end and a second end. The body has (i) a planform for expanding the contacted sclera to increase the effective working distance of the ciliary muscle of the eyeball, and (ii) a structure that stabilizes the prosthesis within the surgically formed pocket within the sclera of the eyeball.

A method of ablating tissue in the heart to treat atrial fibrillation introduces into a selected atrium an energy emitting element. The method exposes the element to a region of the atrial wall and applies ablating energy to the element to thermally destroy tissue. The method forms a convoluted lesion pattern comprising elongated straight lesions and elongated curvilinear lesions. The lesion pattern directs electrical impulses within the atrial myocardium along a path that activates the atrial myocardium while interrupting reentry circuits that, if not interrupted, would cause fibrillation. The method emulates the surgical maze procedure, but lends itself to catheter-based procedures that do not require open heart surgical techniques. A composite structure for performing the method is formed using a template that displays in planar view a desired lesion pattern for the tissue. An array of spaced apart element is laid on the template. Guided by the template, energy emitting and non-energy emitting zones are formed on the elements. By overlaying the elements, the composite structure is formed, which can be introduced into the body to ablate tissue using catheter-based, vascular access techniques.

Corneal implant for introduction into the visual centre (Z) of the cornea of the human eye for the purpose of rectifying impaired vision, in particular presbyopia, or presbyopia in combination with hypermetropia or myopia. To make available a corneal implant which is suitable for use in the visual centre (Z) of the human eye and can be used to correct presbyopia on its own or in combination with hypermetropia or myopia, it is provided that the effective thickness (d) of the corneal implant (2), measured in the direction of the optic axis (5) of the eye, is more than 50[mu]m and the maximum width (b), measured in a plane perpendicular to the direction of thickness, is less than l mm, the corneal implant (2) having no imaging function in relation to the human eye.

A reusable surgical model of the eye has mating anterior and posterior segments. The posterior segment has structures corresponding to those of the eye, including a hollow globe and an image of the fundus positioned upon an interior, posterior portion of the globe. A mating connector is peripherally formed about an open end of the globe. The anterior segment includes structures corresponding to those of the eye, including a pars plana, an opening in a region corresponding to an iris, and a lens positionable within the opening. The anterior segment has a peripheral connector which mates with that of the posterior segment. The lens is removably connected to the anterior segment, and has a focal length corresponding to a natural eye. A coating is applied to the fundus to enable simulation of a membrane peeling procedure, and the globe is Tillable with a vitreous substitute.

Disclosed herein are materials and methods suitable for treating sites of pathological angiogenesis and abnormal neovascularization. Sites of pathological angiogenesis or abnormal neovascularization can be treated by contacting a surface at or adjacent or in the vicinity of an area of pathological angiogenesis or abnormal neovascularization with an implantable material. The implantable material comprises a biocompatible matrix and cells and is in an amount effective to treat the affected site. The composition can be a flexible planar material or a flowable composition. Diseases susceptible to treatment with the present invention include, for example, macular degeneration, rheumatoid arthritis, psoriasis, psoriatic arthritis, systemic inflammatory diseases, and treatment of tumors by surgical resection, radiation therapy or chemotherapy.