Method And Apparatus For Integrating Cataract Surgery With Glaucoma Or Astigmatism Surgery

• US 20100324543A1
• Filed: 06/24/2010
• Published: 12/23/2010
• Est. Priority Date: 09/18/2007
• Status: Abandoned Application

• Current Assignee: Alcon LenSx, Inc. (Alcon Incorporated)
• Original Assignee: Alcon LenSx, Inc. (Alcon Incorporated)
• Inventors: Juhasz, Tibor, Kurtz, Ronald M.
• Application Number:
  US12/823,072
• Publication Number:
  US 20100324543A1
• Time in Patent Office: Days
• US Class Current: 606/6
• CPC Class Codes: A61F 2009/00851 Optical coherence topography [OCT]
• CPC Class Codes: A61F 2009/00853 Laser thermal keratoplasty or radial keratotomy
• CPC Class Codes: A61F 2009/00865 Sclera
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00889 Capsulotomy
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00825 for photodisruption
• CPC Class Codes: A61F 9/00827 Refractive correction, e.g. lenticle

Abstract

A method for integrated eye surgery can include determining a cataract-target region in a lens of the eye; applying cataract-laser pulses to photodisrupt a portion of the determined cataract-target region; determining a glaucoma-target region or an astigmatism-target region in a peripheral region of the eye; and applying surgical laser pulses to create one or more incisions in the glaucoma- or astigmatism-target region by photodisruption; wherein the steps of the method are performed within an integrated surgical procedure. The laser pulses can be applied before making an incision on a cornea of the eye. The integrated surgical procedure may involve using the same pulsed laser source for three functions: for photodisrupting the target region, for making an incision on the capsule of the lens and for making an incision on the cornea of the eye.

Claims

1. A method for integrated eye surgery, comprising the steps of:

determining a cataract-target region in a lens of the eye;

applying cataract-laser pulses to photodisrupt a portion of the determined cataract-target region;

determining a glaucoma-target region in a peripheral region of the eye; and

applying glaucoma-laser pulses to create one or more incisions in the glaucoma-target region by photodisruption;

wherein

the steps of the method are performed within an integrated surgical procedure.

2. The method of claim 1, wherein:

the applying the cataract-laser pulses step is performed before the applying the glaucoma-laser pulses step.

3. The method of claim 1, wherein:

the applying the cataract-laser pulses step is performed after the applying the glaucoma-laser pulses step.

4. The method of claim 1, wherein:

the applying the cataract-laser pulses step is performed at least partially concurrently with the applying the glaucoma-laser pulses step.

5. The method of claim 1, the applying glaucoma-laser pulses step comprising:

applying the glaucoma-laser pulses into at least one of a sclera, a limbal region, an ocular angle portion, or an iris root.

6. The method of claim 1, the applying glaucoma-laser pulses step comprising:

applying the glaucoma-laser pulses according to a pattern in relation to at least one of a trabeculoplasty, iridotomy or iridectomy.

7. The method of claim 1, the applying glaucoma-laser pulses step comprising:

applying the glaucoma-laser pulses to form at least one of a drain channel or a humor outflow opening.

8. The method of claim 7, the method comprising:

inserting an implantable device into one of the drain channel or the humor outflow opening.

9. The method of claim 7, wherein:

the drain channel or the humor outflow opening is configured to connect an anterior chamber of a surgical eye to a surface of the surgical eye, thereby allowing a reduction of an intraocular pressure of an aqueous humor in the surgical eye.

10. The method of claim 7, comprising:

utilizing one laser for applying both the cataract-laser pulses and the glaucoma-laser pulses.

11. The method of claim 10, the applying glaucoma-laser pulses step comprising:

applying the glaucoma-laser pulses to an optimized glaucoma-target region,

wherein a location of the optimized glaucoma-target region is selected

to scatter the glaucoma-laser pulses less than a sclera of the eye, and

to perturb an optical pathway of the eye by the formed drain channel less than a centrally formed drain channel.

12. The method of claim 1, wherein:

the glaucoma-target region is one of

a limbus-sclera boundary region or a limbus-cornea intersection region.

13. The method of claim 1, the applying glaucoma-laser pulses step comprising:

applying the glaucoma-laser pulses to form a drain channel in a direction selected to optimize the competing requirements of

scattering the glaucoma-laser pulses less than a sclera of the eye, and

perturbing an optical pathway eye less than a centrally formed drain channel.

14. The method of claim 1, comprising:

determining a placement of the cataract-laser pulses and a placement of the glaucoma-laser pulses in a coordinated manner.

15. The method of claim 14, comprising:

imaging a photodisruption achieved by the cataract-laser pulses; and

determining at least portions of the glaucoma-target region in response to the imaged photodisruption.

16. The method of claim 14, comprising:

imaging a photodisruption achieved by the glaucoma-laser pulses; and

determining at least portions of the cataract-target region in response to the imaged photodisruption.

17. The method of claim 1, wherein:

the cataract-laser pulses are applied with a cataract-laser wavelength λ

-c; and

the glaucoma-laser pulses are applied with a glaucoma-laser wavelength λ

-g.

18. The method of claim 1, wherein:

the cataract-laser pulses are applied through a cataract-patient interface; and

the glaucoma-laser pulses are applied through a glaucoma-patient interface.

19. A multi-purpose ophthalmic surgical system, comprising:

a multi-purpose laser, configured

to place cataract-laser pulses into a cataract-target region, and

to place glaucoma-laser pulses into a glaucoma-target region; and

an imaging system, configured to image a photodisruption caused by at least one of the cataract-laser pulses and the glaucoma-laser pulses.

20. The multi-purpose ophthalmic surgical system of claim 19, wherein:

the multi-purpose laser is configured

to apply the cataract-laser pulses with a cataract-laser wavelength λ

-c, and

to apply the glaucoma-laser pulses with a glaucoma-laser wavelength of λ

-g.

21. The multi-purpose ophthalmic surgical system of claim 19, wherein:

the multi-purpose laser is configured

to apply the cataract-laser pulses through a cataract-patient interface, and

to apply the glaucoma-laser pulses through a glaucoma-patient interface.

22. The multi-purpose ophthalmic surgical system of claim 19, wherein:

the cataract-laser pulses and the glaucoma-laser pulses are applied by the same laser.

23. A method for integrated eye surgery, comprising the steps of:

determining a cataract-target region in a lens of the eye;

applying cataract-laser pulses to photodisrupt a portion of the determined cataract-target region;

determining an astigmatism-target region in a central, mid, or peripheral region of the eye; and

applying astigmatism correcting-laser pulses to create one or more incisions in the astigmatism-target region by photodisruption;

wherein

the steps of the method are performed within an integrated surgical procedure.

24. The method of claim 23, comprising:

imaging a photodisruption achieved by the cataract-laser pulses; and

determining at least portions of the astigmatism-target region in response to the imaged photodisruption.

25. A multi-purpose ophthalmic surgical system, comprising:

a multi-purpose laser, configured

to place cataract-laser pulses into a cataract-target region, and

to place astigmatism-laser pulses into an astigmatism-target region; and

an imaging system, configured to image a photodisruption caused by at least one of the cataract-laser pulses and the astigmatism-laser pulses.