Contact Probe for Laser Energy Delivery in Glaucoma Treatment
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Solution Overview
Problem
Current laser-based treatments for glaucoma, such as laser cyclophotocoagulation, often result in permanent tissue destruction and adverse side effects like phthisis bulbi, due to the challenge of accurately aiming laser energy at the ciliary body.
Innovation Solution
A hand-holdable laser energy delivery handpiece is designed to deliver pulsed laser energy to the pars plana of the eye, using a contact member with a contoured surface that aligns with the limbus, allowing for precise targeting of the pars plana and pars plicata regions without causing permanent thermal damage.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional laser cyclophotocoagulation is used to reduce intraocular pressure, then aqueous humor production is reduced, but permanent tissue destruction and adverse side effects like phthisis bulbi occur
Solution Approach 1:
The patent applies local quality by using a contact probe with a specific geometry (spherical contact surface with radius of curvature matching the eye) that concentrates laser energy precisely at the ciliary body region while limiting thermal spread to adjacent tissues. The probe design ensures that only the target tissue receives sufficient energy for cyclophotocoagulation, while surrounding tissues are protected from damaging thermal effects.
Solution Approach 2:
The contact probe serves as an intermediary device between the laser source and the eye. It transmits laser energy through its transparent spherical contact surface to the ciliary body, enabling precise energy delivery while the probe itself acts as a thermal barrier and positioning reference. The probe's reference edge aligns with the limbus to ensure accurate targeting and prevent accidental damage to the cornea or other structures.
2Reliability
If laser energy is delivered to the ciliary body to increase aqueous humor outflow, then IOP is reduced, but accurate aiming is challenging leading to misdirected energy
Solution Approach 1:
The contact probe is designed with pre-established geometric relationships between its reference edge and laser output tip. The reference edge is positioned at a specific distance (e.g., 3.4mm) from the laser output tip, and when the reference edge is aligned with the limbus, the laser energy is automatically directed to the correct location in the ciliary body. This preliminary geometric configuration eliminates the need for complex real-time aiming adjustments.
Solution Approach 2:
The patent utilizes the natural color contrast between the limbus (cornea-sclera junction) and surrounding tissues as a visual reference. The reference edge of the probe is designed to align with this distinct anatomical landmark, providing a clear visual cue for proper probe positioning. The limbus serves as a natural reference feature that is easily identifiable during the procedure.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This method effectively reduces intraocular pressure by increasing uveoscleral outflow, achieving significant and long-lasting pressure reduction without the adverse effects associated with conventional laser treatments.
Implementation Method 1
an amount of laser energy is delivered from the positioned probe to a first pars plana region of the eye such that permanent thermal damage to the pars plicata is avoided
Implementation Method 2
the amount of laser energy is insufficient to effect therapeutic photocoagulation and is sufficient to increase uveoscleral outflow
Data Source
AI summary
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.