EYE THERAPY SYSTEM

• US 20100185192A1
• Filed: 11/12/2009
• Published: 07/22/2010
• Est. Priority Date: 11/11/2008
• Status: Active Grant

• Current Assignee: Avedro, Inc. (Glaukos Corporation)
• Original Assignee: Avedro, Inc. (Glaukos Corporation)
• Inventors: Pertaub, Radha, Ryan, Thomas, Dresher, Russ, Meyers, Steven, Muller, David, Scharf, Ronald
• Granted Patent: US 8,882,757 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61F 9/0079 using non-laser electromagnetic radiation, e.g. non-coherent light or microwaves

Abstract

Systems and methods improve operation of an applicator that delivers heat-generating energy to an eye as a part of an eye therapy. For example, reflected power may be measured to determine whether sufficient contact has been established between the applicator and the eye for accurate and precise delivery of energy to the eye. In addition, at least one of forward and reflected power may be measured to monitor the application of coolant pulses that control the generation of heat in the eye when the applicator delivers energy to the eye. Further, the forward and reflected power may be measured to determine an efficiency of energy transfer or an impedance mismatch. Based on the efficiency of energy transfer or the impedance mismatch, an adjustable parameter of a tuning element may be modified.

Claims

1. A method for treating an eye disorder, comprising:

positioning a distal end of an applicator at or proximate to a surface of an eye;

supplying an amount of energy from an energy source to the applicator to apply therapy to the eye, a first portion of the energy supplied to the applicator being transmitted through the distal end to the eye and a second portion of the energy supplied to the applicator being reflected from the distal end of the applicator;

detecting a signal corresponding to the reflected energy; and

determining an amount of contact based on the signal.

2. The method of claim 1 further comprising ceasing supply of energy to the applicator based on the amount of contact.

3. The method of claim 2 further comprising:

after ceasing supply of energy, moving the applicator towards the surface of the eye; and

resuming supply of energy to the applicator.

4. The method of claim 1, wherein the amount of contact includes no contact.

5. The method of claim 1, wherein the signal corresponding to the reflected energy has a power and the method further comprises detecting a decrease in the power.

6. The method of claim 1, wherein the signal corresponding to the reflected energy has a power and the method further comprises detecting an increase in the power.

7. The method of claim 1, wherein the signal corresponding to the reflected energy has a power that decreases as the amount of contact increases.

8. The method of claim 7, wherein the signal corresponding to the reflected energy has a power and the method further comprises determining whether the power is less than a threshold value.

9. The method of claim 1, wherein the signal corresponding to the reflected energy has a power that increases as the amount of contact increases.

10. The method of claim 9, wherein the signal corresponding to the reflected energy has a power and the method further comprises determining whether the power is greater than a threshold value.

11. The method of claim 1 further comprising moving the applicator towards the eye until a desired amount of contact is determined based on the signal corresponding to the reflected energy.

12. The method of claim 1, wherein the applicator comprises:

a conducting element, the conducting element being configured to conduct energy from the energy source to apply therapy to an eye; and

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the conducting element being deliverable to the eye through the interface surface.

13. The method of claim 12, wherein the covering forms an enclosure over a portion of the conducting element and the applicator further comprises a coolant delivery system, the coolant delivery system being operable to deliver coolant within the enclosure to cool the interface surface of the covering and the eye, and the enclosure preventing the coolant from directly contacting the eye.

14. The method of claim 1, wherein the detecting is performed by a dual directional coupler.

15. The method of claim 1, wherein the energy supplied to the applicator is a microwave energy.

16. A method for treating an eye disorder, comprising:

positioning a distal end of an applicator at or proximate to an eye;

supplying an amount of energy to the applicator from an energy source to apply therapy to the eye, a first portion of the energy supplied to the applicator being transmitted through the distal end to the eye and a second portion of the energy supplied to the applicator being reflected from the distal end;

supplying a coolant pulse to the eye; and

detecting a signal corresponding to at least one of the energy supplied to the applicator and the energy reflected from the distal end, the signal further corresponding to the coolant pulse.

17. The method of claim 16, wherein the applicator comprises:

a conducting element, the conducting element being configured to conduct energy from the energy source to apply therapy to an eye;

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the conducting element being deliverable to the eye through the interface surface, the covering forming an enclosure over a portion of the conducting element; and

a coolant delivery system, the coolant delivery system being operable to deliver coolant within the enclosure to cool the interface surface of the covering and the eye, and the enclosure preventing the coolant from directly contacting the eye.

18. The method of claim 16, wherein the signal corresponds to the energy supplied to the applicator, the signal having a power, the power decreasing when coolant is delivered to the interface surface.

19. The method of claim 16, wherein the signal corresponds to the energy reflected from the distal end of the applicator, the signal having a power, the power increasing when coolant is delivered to the interface surface.

20. The method of claim 16, wherein the detecting is performed by a dual directional coupler.

21. The method of claim 16, wherein the energy supplied to the applicator is a microwave energy.

22. A method for treating an eye disorder, comprising:

supplying an amount of energy from an energy source to a distal end of an applicator to apply therapy to an eye, a first portion of the energy supplied to the applicator being transmitted through the distal end to the eye and a second portion of the energy supplied to the applicator being reflected from the distal end;

detecting a forward signal corresponding to the energy supplied to the applicator;

detecting a reflected signal corresponding to the reflected energy;

determining an efficiency of energy transfer based on the forward signal and the reflected signal; and

based on the efficiency of energy transfer, modifying at least one adjustable parameter of a tuning element corresponding to the applicator.

23. The method of claim 22, wherein the determining the efficiency of energy transfer comprises measuring at least one of a magnitude change and a phase change of the forward signal and the reflected signal.

24. The method of claim 22, wherein the at least one adjustable parameter is an inductance.

25. The method of claim 22, wherein the at least one adjustable parameter is a capacitance.

26. The method of claim 22, wherein the at least one adjustable parameter is not modified when the efficiency of energy transfer is determined to be greater than a first threshold value.

27. The method of claim 22, wherein the tuning element is electrically connected to the applicator in parallel.

28. The method of claim 22, wherein the tuning element is integral with the applicator.

29. The method of claim 22, wherein the tuning element comprises an inner conductor, an outer conductor and a short connector, the inner conductor and the outer conductor being concentric cylinders having a gap therebetween, the short connector electrically connecting the inner conductor to the outer conductor, the short connector being axially moveable within the gap.

30. The method of claim 29, wherein the tuning element further comprises a controller configured to provide signals to a motor, the motor being configured to mechanically move the short connector within the gap.

31. The method of claim 22, wherein the applicator comprises:

a conducting element, the conducting element being configured to conduct energy from the energy source to apply therapy to an eye; and

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the energy conducting element being deliverable to the eye through the interface surface.

32. The method of claim 22, wherein a dual directional coupler detects the forward signal and the reflected signal.

33. The method of claim 22, wherein the energy supplied to the applicator is a microwave energy.

34. A method for treating an eye disorder, comprising:

supplying an amount of energy from an energy source to a distal end of an applicator to apply therapy to an eye, a first portion of the energy supplied to the applicator being transmitted through the distal end to the eye and a second portion of the energy supplied to the applicator being reflected from the distal end;

detecting a forward signal corresponding to the energy supplied to the applicator;

detecting a reflected signal corresponding to the reflected energy;

determining an impedance mismatch between the eye and the applicator based on the forward signal and the reflected signal; and

based on the impedance mismatch, modifying at least one adjustable parameter of a tuning element corresponding to the applicator.

35. The method of claim 34, wherein the determining the impedance mismatch comprises measuring at least one of a magnitude change and a phase change of the forward signal and the reflected signal.

36. The method of claim 34, wherein the at least one adjustable parameter is an inductance.

37. The method of claim 34, wherein the at least one adjustable parameter is a capacitance.

38. The method of claim 34, wherein the at least one adjustable parameter is not modified when the impedance mismatch is determined to be less than a threshold value.

39. The method of claim 34, wherein the tuning element is electrically connected to the applicator in parallel.

40. The method of claim 34, wherein the tuning element is integral with the applicator.

41. The method of claim 34, wherein the tuning element comprises an inner conductor, an outer conductor and a short connector, the inner conductor and the outer conductor being concentric cylinders having a gap therebetween, the short connector electrically connecting the inner conductor to the outer conductor, the short connector being axially moveable within the gap.

42. The method of claim 34, wherein the applicator comprises:

a conducting element, the conducting element being configured to conduct energy from the energy source to apply therapy to an eye; and

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the energy conducting element being deliverable to the eye through the interface surface.

43. The method of claim 34, wherein a dual directional coupler detects the forward signal and the reflected signal.

44. The method of claim 34, wherein the energy supplied to the applicator is a microwave energy.

45. A system for treating an eye disorder, comprising:

an energy source;

an applicator for applying therapy to an eye, the applicator having a distal end, the applicator being configured to receive an amount of energy from the energy source, a first portion of the energy received by the applicator being transmitted through the distal end to the eye and a second portion of the energy received by the applicator being reflected from the distal end of the applicator; and

a dual directional coupler configured to detect a signal corresponding to the reflected energy, the signal further corresponding to an amount of contact between the distal end and the eye.

46. The system of claim 45, wherein the amount of contact includes no contact.

47. The system of claim 45, wherein the signal corresponding to the reflected energy has a power that decreases as the amount of contact increases.

48. The system of claim 47, wherein the signal corresponding to the reflected energy has a power and the system further comprises a controller configured to determine whether the power is less than a threshold value.

49. The system of claim 45, wherein the signal corresponding to the reflected energy has a power that increases as the amount of contact increases.

50. The system of claim 49, wherein the signal corresponding to the reflected energy has a power and the system further comprises a controller configured to determine whether the power is greater than a threshold value.

51. The system of claim 45, wherein the applicator comprises:

a conducting element configured to conduct energy from the energy source to apply therapy to an eye; and

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the conducting element being deliverable to the eye through the interface surface.

52. The system of claim 51, wherein the covering forms an enclosure over a portion of the conducting element and the applicator further comprises a coolant delivery system, the coolant delivery system being operable to deliver coolant within the enclosure to cool the interface surface of the covering and the eye, and the enclosure preventing the coolant from directly contacting the eye.

53. The system of claim 45, wherein the energy supplied to the applicator is a microwave energy.

54. A system for treating an eye disorder, comprising:

an energy source;

an applicator for applying therapy to an eye, the applicator having a distal end, the applicator being configured to receive an amount of energy from the energy source, a first portion of the energy received by the applicator being transmitted through the distal end to the eye and a second portion of the energy received by the applicator being reflected from the distal end of the applicator;

a coolant delivery system operable to deliver coolant to cool the eye; and

a dual directional coupler configured to detect at least one of the energy received by the applicator and the energy reflected from the distal end, the signal further corresponding to the coolant pulse.

55. The system of claim 54, wherein the applicator comprises:

a conducting element, the conducting element being configured to conduct energy from the energy source to apply therapy to an eye;

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the conducting element being deliverable to the eye through the interface surface, the covering forming an enclosure over a portion of the conducting element; and

the coolant delivery system.

56. The system of claim 55, wherein the coolant delivery system delivers coolant within the enclosure to cool the interface surface of the covering and the eye, and the enclosure prevents the coolant from directly contacting the eye.

57. The system of claim 54, wherein the signal corresponds to the energy supplied to the applicator, the signal having a power, the power decreasing when coolant is delivered to the interface surface.

58. The system of claim 54, wherein the signal corresponds to the energy reflected from the distal end of the applicator, the signal having a power, the power increasing when coolant is delivered to the interface surface.

59. The system of claim 54, wherein the signal corresponds to the energy reflected from the distal end of the applicator, the signal having a power, the power decreasing when coolant is delivered to the interface surface.

60. The system of claim 54, wherein the energy supplied to the applicator is a microwave energy.

61. A system for treating an eye disorder, comprising:

an energy source;

an applicator for applying therapy to an eye, the applicator having a distal end, the applicator being configured to receive an amount of energy from the energy source, a first portion of the energy received by the applicator being transmitted through the distal end to the eye and a second portion of the energy received by the applicator being reflected from the distal end of the applicator;

a dual directional coupler configured to detect a forward signal corresponding to the energy received by the applicator and a reflected signal corresponding to the reflected energy;

a tuning element having at least one adjustable parameter; and

one or more controllers configured to determine an efficiency of energy transfer based on the forward signal and the reflected signal and configured to cause the at least one adjustable parameter to be modified based on the efficiency of energy transfer.

62. The system of claim 61 further comprising at least one of a magnitude sensor and a phase sensor in electrical communication with the dual directional coupler to determine the efficiency of energy transfer based on the forward signal and the reflected signal.

63. The system of claim 61, wherein the at least one adjustable parameter is an inductance.

64. The system of claim 61, wherein the at least one adjustable parameter is a capacitance.

65. The system of claim 61, wherein the tuning element is electrically connected to the applicator in parallel.

66. The system of claim 61, wherein the tuning element is integral with the applicator.

67. The system of claim 61, wherein the tuning element comprises an inner conductor, an outer conductor and a short connector, the inner conductor and the outer conductor being concentric cylinders having a gap therebetween, the short connector electrically connecting the inner conductor to the outer conductor, the short connector being axially moveable within the gap.

68. The system of claim 67, wherein the tuning element further comprises a controller configured to provide signals to a motor, the motor being configured to mechanically move the short connector within the gap.

69. The system of claim 61, wherein at least one controller is configured to not cause the at least one adjustable parameter to be modified when the efficiency of energy transfer is determined to be greater than a threshold value.

70. The system of claim 61, wherein the applicator comprises:

a conducting element configured to conduct energy from the energy source to apply therapy to an eye; and

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the energy conducting element being deliverable to the eye through the interface surface.

71. The system of claim 61, wherein the energy supplied to the applicator is a microwave energy.

72. A system for treating an eye disorder, comprising:

an energy source;

an applicator for applying therapy to an eye, the applicator having a distal end, the applicator being configured to receive an amount of energy from the energy source, a first portion of the energy received by the applicator being transmitted through the distal end to the eye and a second portion of the energy received by the applicator being reflected from the distal end of the applicator;

a dual directional coupler configured to detect a forward signal corresponding to the energy received by the applicator and a reflected signal corresponding to the reflected energy;

a tuning element having at least one adjustable parameter; and

one or more controllers configured to determine an impedance mismatch between the eye and the applicator based on the forward signal and the reflected signal and configured to cause the at least one adjustable parameter to be modified based on the impedance mismatch.

73. The system of claim 72 further comprising at least one of a magnitude sensor and a phase sensor in electrical communication with the dual directional coupler to determine the impedance mismatch based on the forward signal and the reflected signal.

74. The system of claim 72, wherein the at least one adjustable parameter is an inductance.

75. The system of claim 72, wherein the at least one adjustable parameter is a capacitance.

76. The system of claim 72, wherein the at least one controller is configured to not cause the at least one adjustable parameter to be modified when the impedance mismatch is determined to be less than a threshold value.

77. The system of claim 72, wherein the tuning element is electrically connected to the applicator in parallel.

78. The system of claim 72, wherein the tuning element is integral with the applicator.

79. The system of claim 72, wherein the tuning element comprises an inner conductor, an outer conductor and a short connector, the inner conductor and the outer conductor being concentric cylinders having a gap therebetween, the short connector electrically connecting the inner conductor to the outer conductor, the short connector being axially moveable within the gap.

80. The system of claim 72, wherein the applicator comprises:

a conducting element configured to conduct energy from the energy source to apply therapy to an eye; and

a covering configured to be removably attached to the conducting element, the covering having an interface surface positionable at the eye, at least a portion of the interface surface including one or more dielectric materials, the energy from the energy conducting element being deliverable to the eye through the interface surface.

81. The system of claim 72, wherein the energy supplied to the applicator is a microwave energy.