Femtosecond Laser Glaucoma Surgery with OCT Feedback
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Solution Overview
Problem
Current laser treatments for glaucoma, such as Argon Laser Trabeculoplasty, Selective Laser Trabeculoplasty, and Excimer Laser Trabeculostomy, face limitations including tissue scarring, invasive procedures, and lack of control over intraocular pressure (IOP) reduction, making them less effective and repeatable.
Innovation Solution
A system integrating a femtosecond laser and OCT imaging for precise, non-invasive glaucoma surgery, which includes a control system to design and adjust treatment patterns based on real-time IOP measurements, allowing for targeted modification of ocular tissue to reduce trabecular meshwork resistance and create new outflow pathways without significant scarring.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional laser treatments (Argon Laser Trabeculoplasty, Selective Laser Trabeculoplasty, Excimer Laser Trabeculostomy) are used to reduce intraocular pressure, then IOP reduction is achieved, but tissue scarring occurs and repeatability is reduced
Solution Approach 1:
The patent changes the fundamental parameter of laser-tissue interaction from thermal/chemical processes to mechanical photodisruption. By using ultrafast laser pulses (femtosecond or picosecond duration), the interaction mechanism shifts from gradual heating and carbonization to instantaneous mechanical breakdown, eliminating scarring while maintaining IOP reduction effectiveness
Solution Approach 2:
The patent employs periodic ultrafast laser pulses delivered in controlled sequences to progressively modify trabecular meshwork tissue. The periodic delivery allows cumulative structural modification without excessive heat buildup, achieving effective tissue remodeling while preventing scarring
2Reliability
If conventional laser treatments are applied to modify ocular tissue, then some IOP reduction is achieved, but precision and control over IOP reduction level are insufficient
Solution Approach 1:
The patent replaces conventional thermal/mechanical surgical systems with an ultrafast laser system that uses photodisruption mechanics. This substitution enables precise control over tissue modification depth and extent, allowing accurate targeting of specific trabecular meshwork regions to achieve consistent and controllable IOP reduction
Solution Approach 2:
The system performs preliminary planning and simulation of treatment patterns before actual laser delivery. By pre-calculating the optimal laser parameter settings and treatment zones based on individual patient anatomy, the system ensures precise and consistent IOP reduction outcomes while minimizing unnecessary tissue exposure
3Reliability
If invasive procedures are used for glaucoma treatment, then IOP reduction can be achieved, but patient comfort and recovery time are adversely affected
Solution Approach 1:
The patent replaces invasive mechanical surgical instruments with non-contact ultrafast laser delivery. The laser energy is focused through the cornea to the target tissue without requiring incisions or physical contact, eliminating invasive procedures while maintaining effective and durable IOP reduction through precise photodisruption of trabecular meshwork resistance
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 approach enables safe and effective reduction of intraocular pressure with high precision, minimizing tissue damage and allowing for repeat treatments, thereby providing a more durable and controlled IOP reduction.
Implementation Method 1
instruct the laser source to deliver an initial laser treatment by scanning a laser beam across ocular tissue at an initial placement in the eye in accordance with the initial treatment pattern to thereby photo disrupt the initial volume of ocular tissue
Data Source
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AI summary
An initial treatment pattern defining an initial volume of ocular tissue to be modified for treating glaucoma is designed. An initial laser treatment is delivered by scanning a laser beam across ocular tissue at an initial placement in the eye in accordance with the initial treatment pattern to thereby photo disrupt the initial volume of ocular tissue. A postoperative measure of intraocular pressure (IOP) is evaluated relative to an IOP criterion to determine if the treatment was successful. If the treatment was not successful, meaning the IOP criterion was not satisfied, then a subsequent treatment pattern that defines a subsequent volume of ocular tissue to be modified, and/or a subsequent placement in the eye is determined. A subsequent laser treatment is delivered by scanning a laser beam across ocular tissue at the subsequent placement within the eye in accordance with the subsequent treatment pattern to thereby photo disrupt the subsequent volume of ocular tissue.