EYE THERAPY SYSTEM

• US 20090069798A1
• Filed: 09/11/2008
• Published: 03/12/2009
• Est. Priority Date: 07/19/2007
• Status: Active Grant

• Current Assignee: Avedro, Inc. (Glaukos Corporation)
• Original Assignee: Avedro, Inc. (Glaukos Corporation)
• Inventors: Wu, Artie, Muller, David, Pertaub, Radha, Marshall, Neal, Scharf, Ronald, Ryan, Thomas
• Granted Patent: US 8,202,272 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1807 using light other than laser radiation
• CPC Class Codes: A61F 2009/00853 Laser thermal keratoplasty or radial keratotomy
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 9/007 Methods or devices for eye surgery
• CPC Class Codes: A61F 9/0079 using non-laser electromagnetic radiation, e.g. non-coherent light or microwaves
• CPC Class Codes: A61F 9/009 Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses apparatus for eye examination A61B3/0008
• CPC Class Codes: A61H 2201/0207 heated
• CPC Class Codes: A61H 2201/0214 cooled
• CPC Class Codes: A61H 2201/0242 by a fluid circulating in the apparatus
• CPC Class Codes: A61H 2201/0292 with microwaves
• CPC Class Codes: A61H 2201/10 with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2230/50 Temperature
• CPC Class Codes: A61H 35/02 : for the eyes

Abstract

A system for applying therapy to an eye selectively applies coolant to the corneal surface to minimize heat-related damage to the corneal surface during thermokeratoplasty. Embodiments may include an energy source, a conducting element, a coolant supply, and a coolant delivery system. The conducting element is operably connected to the energy source and extends from a proximal end to a distal end. The conducting element directs energy from the energy source to the distal end, which is positionable at the eye. The coolant delivery system is in communication with the coolant supply and is operable to deliver a micro-controlled pulse of coolant to the distal end.

Claims

1. A system for applying therapy to an eye, the system comprising:

an electrical energy source; and

an electrical energy conducting element extending from a proximal end to a distal end, the energy conducting element operably connected to the electrical energy source at the proximal end and adapted to direct electrical energy to the distal end, the energy conducting element including;

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, the inner conductor having an opening at the distal end and a contact area along a periphery of the opening, the contact area being positionable at a surface of an eye, and the electrical energy being applied to the eye according to the contact area.

2. The system according to claim 1, wherein the outer conductor and the inner conductor are substantially cylindrical at the distal end.

3. The system according to claim 1, wherein the contact area is a substantially annular surface.

4. The system according to the claim 3, wherein the substantially annular surface has a radial thickness having a value in a range of approximately 50 μ

m to approximately 200 μ

m.

5. The system according to claim 3, wherein the contact area delivers energy to a corneal surface of the eye in an annular pattern defined by the contact area, the annular pattern having a substantially constant radial thickness.

6. The system according to claim 2, wherein the gap is a substantially annular gap.

7. The system according to claim 6, wherein the substantially annular gap has a radial thickness having a value in a range of approximately 0.5 mm to approximately 1.5 mm.

8. The system according to claim 1, wherein the opening is defined by a hollow portion extending into the inner conductor from the distal end toward the proximal end.

9. The system according to claim 8, wherein the hollow portion is defined by a substantially concave surface within the inner conductor.

10. The system according to claim 1, further comprising:

a coolant supply; and

a coolant delivery system in communication with the coolant supply, the coolant delivery system being operable to deliver a micro-controlled pulse of coolant to the distal end.

11. The system according to claim 10, wherein the inner conductor includes at least one coolant delivery opening coupled to the coolant delivery system, the at least one coolant delivery opening configured to deliver coolant toward the distal end.

12. The system according to claim 11, wherein the at least one coolant delivery opening includes at least one of:

at least one interior coolant delivery opening configured to deliver coolant through the opening and at least one exterior coolant delivery opening configured to deliver coolant outside of the periphery of the inner conductor.

13. The system according to claim 12, wherein the at least one exterior coolant delivery opening extends through an exterior wall of the inner conductor.

14. The system according to claim 12, wherein the opening is defined by a hollow portion extending into the inner conductor from the distal end toward the proximal end, and the at least one interior coolant delivery opening is disposed within the hollow portion.

15. The system according to claim 14, wherein the energy conducting element includes at least one interior vent connecting the hollow portion to the gap between the inner conductor and the outer conductor, and at least one exterior vent connecting the gap to an exterior area outside the energy conducting element.

16. The system according to claim 14, wherein the hollow portion is defined by a substantially concave surface within the inner conductor.

17. The system according to claim 11, wherein the coolant delivery system includes at least one cooling channel coupled to the at least one coolant delivery opening.

18. The system according to claim 17, wherein the cooling channel extends centrally through the inner conductor from the substantially concave surface toward the distal end.

19. The system according to claim 11, wherein the energy conducting element includes at least one venting opening connecting an interior area where the coolant is delivered to an exterior area outside the energy conducting element.

20. A method for applying therapy to an eye, the method comprising:

positioning a contact area of an electrical energy conducting element at a surface of an eye, the energy conducting element being operably connected to an electrical energy source at the proximal end and extending to the contact area at a distal end, the energy conducting element including;

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, the inner conductor including the contact area, the contact area being disposed along a periphery of an opening at the distal end of the inner conductor; and

applying electrical energy through the electrical energy conducting element to the eye according to the contact area.

21. The method according to claim 20, wherein the outer conductor and the inner conductor are substantially cylindrical at the distal end.

22. The method according to claim 20, wherein the contact area is a substantially annular surface.

23. The method according to the claim 22, wherein the substantially annular surface has a radial thickness having a value in a range of approximately 50 μ

m to approximately 200 μ

m.

24. The method according to claim 22, wherein applying electrical energy through the electrical energy conducting element comprises applying energy to a corneal surface of the eye in an annular pattern defined by the contact area, the annular pattern having a substantially constant radial thickness.

25. The method according to claim 20, wherein the gap is a substantially annular gap.

26. The method according to claim 25, wherein the substantially annular gap has a radial thickness having a value in a range of approximately 0.5 mm to approximately 1.25 mm.

27. The method according to claim 20, wherein the opening is defined by a hollow portion extending into the inner conductor from the distal end toward the proximal end.

28. The method according to claim 27, wherein the hollow portion is defined by a substantially concave surface within the inner conductor.

29. The method according to claim 20, further comprising:

delivering a pulse of coolant to the eye with a coolant delivery system in communication with a coolant supply.

30. The method according to claim 29, wherein the inner conductor includes at least one coolant delivery opening coupled to the coolant delivery system, the at least one coolant delivery opening configured to deliver coolant to the distal end.

31. The method according to claim 30, wherein the at least one coolant delivery opening includes at least one of:

at least one interior coolant delivery opening configured to deliver coolant through the opening and at least one exterior coolant delivery opening configured to deliver coolant outside of the periphery of the inner conductor.

32. The method according to claim 31, wherein the at least one exterior coolant delivery opening extends through an exterior wall of the inner conductor.

33. The method according to claim 31, wherein the opening is defined by a hollow portion extending into the inner conductor from the distal end toward the proximal end, and the at least one interior coolant delivery opening is disposed within the hollow portion.

34. The method according to claim 33, wherein the hollow portion is defined by a substantially concave surface within the inner conductor.

35. The method according to claim 34, wherein the coolant delivery system includes at least one cooling channel coupled to the at least one coolant delivery opening.

36. The method according to claim 35, wherein the cooling channel extends centrally through the inner conductor from the substantially concave surface toward the distal end.

37. A method for applying therapy to an eye, the method comprising:

positioning an electrical energy conducting element at a surface of an eye, the energy conducting element extending from a proximal end to a distal end, the energy conducting element operably connected to an electrical energy source at the proximal end; and

applying a selected amount of electrical energy through the electrical energy conducting element to the eye, the selected amount of electrical energy being applied according to a power parameter and a time parameter, the power parameter and the time parameter generating structural changes in a localized volume in the eye, the selected amount of electrical energy being deliverable according to a range of power values and a range of corresponding time values, the power parameter being an upper power value in the range of power values, and the time parameter being a lower time value in the range of time values.

38. The method according to claim 37, wherein the upper power value has a value in a range of approximately 300 W to approximately 500 W.

39. The method according to claim 37, wherein the selected amount of electrical energy has a value in a range of approximately 2 J to approximately 25 J.

40. The method according to claim 37, wherein the localized volume has a value of approximately 0.1 mm³ to approximately 2.0 mm³.

41. The method according to claim 37, wherein applying an amount of electrical energy generates a temperature greater than approximately 55°

C. in the eye.

42. The method according to claim 37, wherein applying an amount of electrical energy comprises applying an amount of electrical energy to the cornea of the eye.

43. The method according to claim 37, wherein the energy conducting element comprises:

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, the inner conductor including a contact area positionable at the surface of the eye, the contact area defining a pattern of energy applied to the eye.

44. The method according to claim 43, wherein the contact area is disposed along a periphery of an opening at the distal end of the inner conductor.

45. The method according to claim 44, wherein the contact area is a substantially annular surface having a radial thickness with a value in a range of approximately 50 μ

m to approximately 200 μ

m.

46. The method according to claim 37, further comprising:

delivering a pulse of coolant to the eye with a coolant delivery system in communication with a coolant supply.

47. A method for applying therapy to an eye with an electrical energy conducting element, the energy conducting element extending from a proximal end to a distal end, the energy conducting element operably connected to an electrical energy source at the proximal end and configured to deliver electrical energy to generate a structural changes in the eye positioned at the distal end, the method comprising:

positioning the energy conducting element to the eye; and

applying a selected amount of electrical energy through the electrical energy conducting element to the eye according to a power parameter and a time parameter, the power parameter being greater than a threshold value determining structural changes in a localized volume in the eye, and a time parameter being less than a value of approximately 100 ms.

48. The method according to claim 47, wherein the selected amount of electrical energy has a value in a range of approximately 2 J to approximately 25 J.

49. The method according to claim 47, wherein the localized volume has a value of approximately 0.1 mm³ to approximately 2.0 mm³.

50. The method according to claim 47, wherein applying an amount of electrical energy generates a temperature of greater than approximately 55°

C. in the eye.

51. The method according to claim 47, wherein applying an amount of electrical energy comprises applying an amount of electrical energy to the cornea of the eye.

52. The method according to claim 47, wherein the energy conducting element comprises:

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, the inner conductor including a contact area positionable at the surface of the eye, the contact area defining a pattern of energy applied to the eye.

53. The method according to claim 52, wherein the contact area is disposed along a periphery of an opening at the distal end of the inner conductor.

54. The method according to claim 53, wherein the contact area is a substantially annular surface having a radial thickness with a value in a range of approximately 50 μ

m to approximately 200 μ

m.

55. The method according to claim 47, further comprising delivering a pulse of coolant to the eye with a coolant delivery system in communication with a coolant supply.