EYE THERAPY SYSTEM

• US 20100076423A1
• Filed: 09/18/2009
• Published: 03/25/2010
• Est. Priority Date: 09/19/2008
• Status: Active Grant

• Current Assignee: Avedro, Inc. (Glaukos Corporation)
• Original Assignee: Avedro, Inc. (Glaukos Corporation)
• Inventors: MULLER, DAVID
• Granted Patent: US 8,398,628 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2018/00011 with fluids
• 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: A61F 9/013 Instruments for compensation of ocular refraction A61F9/008 takes precedence; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea

Abstract

The cornea is reshaped in multiple steps according to varying amounts of energy in varying patterns and/or at varying locations to achieve a customized reshaping of the cornea to address the specific needs of an individual patient. The varying amounts of energy may be applied via one or more conducting elements, which include an outer conductor and an inner conductor disposed within the outer conductor, a distal end of the outer conductor and the inner conductor defining the varying patterns. For example, one step may form a substantially circular lesion to flatten a first portion of the cornea to treat presbyopia, while another step may form a substantially circular and concentric lesion having a greater diameter to steepen a second portion of the cornea to treat hyperopia. Advantageously, continuous transitional regions are formed relative to the reshaped portions to provide vision for intermediate distances.

Claims

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

positioning a contact area of an energy conducting element at a surface of an eye, the energy conducting element being operably connected to an 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;

applying, with the energy conducting element, an initial amount of energy to the eye, the initial amount of energy causing an initial reshaping of an aspect of the eye; and

in response to the specified amount of reshaping not being achieved, applying, with the energy conducting element, one or more additional amounts of energy to the eye to cause further reshaping.

2. The method according to claim 1, wherein the step of applying the initial amount of energy comprises applying the initial amount of energy according to a pattern defined by the distal end of the outer conductor and the inner conductor of the energy conducting element, and the step of applying one or more additional amounts of energy comprises applying the one or more additional amounts of energy according to the same pattern.

3. The method according to claim 1, further comprising applying a coolant to the eye in association with at least one of the application of the initial amount of energy and the application of the one or more additional amounts of energy.

4. The method according to claim 1, further comprising determining at least one of the initial amount of energy and the one or more additional amounts of energy according to patient characteristics, including age, gender, and corneal thickness.

5. The method according to claim 1, further comprising determining, with a measurement device, whether a specified amount of reshaping of has been achieved by the initial amount of energy

6. The method according to claim 5, wherein the measurement device is a keratometer, a topographer, an autorefractor, or an interferometer.

7. The method according to claim 1, wherein the reshaping of the eye is caused by the shrinkage of corneal fibers.

8. The method according to claim 1, wherein at least a portion of the gap includes a dielectric.

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

applying, with an initial energy conducting element, an initial amount of energy according to an initial pattern to an eye, the initial amount of energy and the initial pattern causing an initial reshaping of an aspect of the eye; and

in response to the specified amount of reshaping not being achieved, applying, with one or more additional energy conducting elements, one or more additional amounts of energy according to one or more additional patterns to the eye to cause further reshaping.

10. The method according to claim 9, wherein the step of applying the initial amount of energy comprises applying the initial amount of energy according to an initial pattern that is centered about an initial location, and the step of applying one or more additional amounts of energy comprises applying the one or more additional amounts of energy according to one or more additional patterns that are substantially centered about the initial location.

11. The method according to claim 9, wherein the step of applying the initial amount of energy comprises applying the initial amount of energy according to an initial pattern that is centered about an initial location, and the step of applying one or more additional amounts of energy comprises applying the one or more additional amounts of energy according to one or more additional patterns that are centered about one or more additional locations.

12. The method according to claim 9, wherein the initial energy conducting element and the one or more additional energy conducting elements each include an outer conductor and an inner conductor disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, a distal end of the outer conductor and the inner conductor defining the initial pattern or the one or more additional patterns, respectively.

13. The method according to claim 12, wherein at least a portion of the gap includes a dielectric.

14. The method according to claim 9, further comprising applying a coolant to the eye in association with at least one of the application of the initial amount of energy and the application of the one or more additional amounts of energy.

15. The method according to claim 9, wherein an applicator includes the first energy conducting element and the one or more additional energy conducting elements, the applicator comprising an outer conductor and an inner conductor disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, a distal end of the outer conductor and the inner conductor being modifiable by a plurality of applicator end pieces, the applicator end pieces being removably attachable to the energy conducting element, the initial energy conducting element being defined by an initial applicator end piece, and the one or more additional energy conducting elements being defined by one or more additional applicator end pieces, respectively.

16. The method according to claim 15, wherein at least a portion of the gap includes a dielectric.

17. The method according to claim 9, further comprising determining at least one of the initial amount of energy and the one or more additional amounts of energy according to patient characteristics, including age, gender, and corneal thickness.

18. The method according to claim 9, further comprising determining, with a measurement device, whether a specified amount of reshaping has been achieved by the initial amount of energy and the initial pattern.

19. The method according to claim 18, wherein the measurement device is a keratometer, a topographer, an autorefractor, or an interferometer.

20. The method according to claim 9, further comprising selecting the one or more additional patterns according to a result of previous applications of energy, the result being a function of at least an initial refractive state of the eye and previous patterns for the previous applications of energy.

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

forming a first lesion on the eye corresponding to a first diopter by delivering, with a first energy conducting element, a first application of energy to the eye, the first lesion reshaping a first portion of the eye; and

forming a second lesion on the eye corresponding to a second diopter by delivering, with a second energy conducting element, a second application of energy to the eye, the second lesion reshaping a second portion of the eye,

wherein reshaping the first portion of the eye and the second portion of the eye provides a multifocal correction of the eye.

22. The method according to claim 21, wherein the first lesion and the second lesion are substantially circular and are substantially concentric.

23. The method according to claim 22, wherein the first lesion has a larger diameter than the second lesion, the first lesion steepening the first portion of the eye and providing visualization of objects at a first distance range, the second lesion flattening the second portion of the eye and providing visualization of objects at a second distance range, the first distance range being farther from the eye than the second distance range.

24. The method according to claim 23, wherein a continuous transitional region is formed relative to the first portion of the eye and the second portion of the eye, the transitional region providing visualization of objects at an intermediate distance range between the first distance range and the second distance range.

25. The method according to claim 24, wherein the first lesion and the second lesion are determined according to patient characteristics, including age, gender, and corneal thickness.

26. The method according to claim 21, further comprising selecting the second energy conducting element according to a result of the first application of energy to the eye, the result being a function of at least an initial refractive state of the eye and a shape of the first energy conducting element.

27. The method according to claim 21, wherein the first energy conducting element and the second conducting element each include an outer conductor and an inner conductor disposed within the outer conductor, a distal end of the outer conductor and the inner conductor defining a shape of the first lesion or the second lesion, respectively.

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

a first energy conducting element that delivers an initial amount of energy according to an initial pattern to an eye, the initial amount of energy and the initial pattern causing a reshaping of an aspect of the eye; and

one or more additional energy conducting elements that delivers one or more additional amounts of energy according to one or more additional patterns to the eye to cause further reshaping.

29. The system according to claim 28, wherein the initial pattern and the one or more additional patterns are substantially centered about a same location on the eye, and the deliveries of the initial amount of energy and the one or more additional amounts of energy are centered about the same location.

30. The system according to claim 28, wherein the initial pattern is centered about an initial location on the eye, and the one or more additional patterns are centered about one or more additional locations on the eye.

31. The system according to claim 28, wherein the first energy conducting element and the one or more additional energy conducting elements each include an outer conductor and an inner conductor disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, a distal end of the outer conductor and the inner conductor defining the initial pattern or the one or more additional patterns, respectively.

32. The system according to claim 31, wherein at least a portion of the gap includes a dielectric.

33. The system according to claim 28, wherein the first energy conducting element and the one or more additional energy conducting elements each include a coolant delivery system to deliver coolant to the eye in association with the application of the initial amount of energy or the application of the one or more additional amounts of energy, respectively.

34. The system according to claim 28, wherein an applicator includes the first energy conducting element and the one or more additional energy conducting elements, the applicator comprising an outer conductor and an inner conductor disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, a distal end of the outer conductor and the inner conductor being modifiable by a plurality of applicator end pieces, the applicator end pieces being removably attachable to the energy conducting element, the initial energy conducting element being defined by an initial applicator end piece, and the one or more additional energy conducting elements being defined by one or more additional applicator end pieces, respectively.

35. The system according to claim 34, wherein at least a portion of the gap includes a dielectric.

36. The system according to claim 28, further comprising a measurement device that determines whether a specified amount of reshaping has been achieved by the initial amount of energy and the initial pattern.

37. The system according to claim 36, wherein the measurement device is a keratometer, a topographer, an autorefractor, or an interferometer.

38. The system according to claim 28, wherein the first energy conducting element and the one or more additional energy conducting elements are substantially circular and are substantially concentric.

39. The system according to claim 28, wherein the initial pattern and the one or more additional patterns define different shapes.

40. The method according to claim 28, wherein the one or more additional patterns are selected according to a result of previous applications of energy, the result being a function of at least an initial refractive state of the eye and previous patterns for the previous applications of energy.