NON-PENETRATING FILTRATION SURGERY

• US 20110092965A1
• Filed: 12/30/2010
• Published: 04/21/2011
• Est. Priority Date: 05/08/2000
• Status: Abandoned Application

• Current Assignee: I Optima Ltd.
• Original Assignee: I Optima Ltd.
• Inventors: Shargil, Adi, SLATKINE, Michael, Harel, Alex, Assia, Ehud
• Application Number:
  US12/981,585
• Publication Number:
  US 20110092965A1
• Time in Patent Office: Days
• US Class Current: 606/5
• CPC Class Codes: A61F 2009/00865 Sclera
• CPC Class Codes: A61F 2009/00868 Ciliary muscles or trabecular meshwork
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 9/00802 for photoablation
• CPC Class Codes: A61F 9/00821 for coagulation
• CPC Class Codes: A61F 9/00825 for photodisruption

Abstract

Apparatus for ophthalmic surgery, especially non-penetrating filtration surgery, comprising a laser source that ablates sclera tissue at steps of intermediate thickness. Optionally, the beam is scanned using a scanner and its results viewed using an ophthalmic microscope.

Claims

1. Apparatus for ophthalmic surgery on an eye comprising:

a laser source that generates a laser beam having a wavelength; and

an ophthalmicly effective position controller adapted to aim said beam at said eye from outside said eye for a dwell time and a power density configured to ablate a sclera tissue thickness of between 5 and 50 microns in a single dwell.

2. Apparatus according to claim 1, wherein said thickness is between 5 and 30 microns.

3. Apparatus according to claim 1, wherein said laser source and said position controller are configured so that said ablation is without causing substantial shockwave or thermal damage to said eye.

4. Apparatus according to claim 1, wherein said beam contacts said eye for a dwell time of above 100 micro-seconds, per dwell.

5. Apparatus according to claim 1, wherein said beam contacts said eye with a spot size of over 100 microns.

6. Apparatus according to claim 1, comprising an ophthalmic microscope operative to view an eye during an ophthalmic procedure that uses said laser beam.

7. Apparatus according to claim 6, comprising a monitor for displaying a view of said tissue removal viewed by said microscope.

8. Apparatus according to claim 6, comprising a beam combiner for combining a line of sight of said laser and said microscope.

9. Apparatus according to claim 8, comprising an optical system integral with said combiner and configured to allow manual adjustment of a focus of said laser source so that it is in a same plane as the focus of said microscope.

10. Apparatus according to claim 1, wherein said position controller comprises an ophthalmic frame operative to fix a relative position and angle of said laser source and an eye of a patient.

11. Apparatus according to claim 1, wherein said position controller comprises a scanner comprising an input for said laser beam and an output of a spatially scanned laser beam.

12. Apparatus according to claim 11, comprising controlling circuitry that drives said scanner to remove tissue in a desired pattern on the eye, said pattern being suitable for non-penetrating filtration surgery on the eye.

13. Apparatus according to claim 12, wherein said pattern has dimensions of between 2 and 5 mm in each of two orthogonal axes.

14. Apparatus according to claim 12, wherein said circuitry controls said laser source.

15. Apparatus according to claim 12, wherein said circuitry drives said scanner to coagulate tissue using said laser source.

16. Apparatus according to claim 12, wherein said circuitry drives said scanner to ablate tissue in an adjustable thickness.

17. Apparatus according to claim 12, wherein said circuitry drives said scanner to perform said ablation by causing repeated ablations of thicknesses at a location, which repeated ablations add up to said thickness.

18. Apparatus according to claim 12, wherein said circuitry drives said scanner to ablate tissue at a location only after a delay from a previous ablation thereat, said delay being configured to be sufficient to detect percolation thereat.

19. Apparatus according to claim 12, comprising an aiming beam laser source and wherein said circuitry drives said scanner to show said pattern boundaries using said aiming beam.

20. Apparatus according to claim 12, comprising a sensor which monitors an indication of progression of said surgery, on said eye, to produce a progression signal.

21. Apparatus according to claim 20, wherein said sensor comprises:

a camera which acquires an image of said tissue removal; and

an image processor that processes said image.

22. Apparatus according to claim 20, comprising circuitry that uses said progression signal to generate an indication of the tissue removal state.

23. Apparatus according to claim 22, wherein said circuitry uses said indication to close a control loop of said tissue removal.

24. Apparatus according to claim 22, wherein said indication of tissue removal state comprises an indication of the thickness of remaining tissue in the area of tissue removal.

25. Apparatus according to claim 22, wherein said indication of tissue removal state comprises an indication of a percolation rate through the remaining tissue in the area of tissue removal.

26. Apparatus according to claim 20, wherein said sensor is a non-penetrating sensor.

27. Apparatus according to claim 20, wherein said sensor is a contact sensor.

28. Apparatus according to claim 20, wherein said controlling circuitry receives signals from said sensor.

29. Apparatus according to claim 20, comprising a user input, wherein said controlling circuitry is adapted to receive and interpret entries on said input as indicating signals from said sensor.

30. Apparatus according to claim 1, comprising a frame attached to said combiner, which frame blocks said laser beam from at least one part of said eye.

31. Apparatus according to claim 1, wherein said wavelength has an absorption length of 1/e of greater than 5 microns in water.

32. Apparatus according to claim 1, wherein said laser source comprises a CO2 laser source.

33. Apparatus according to claim 1, wherein said laser source comprises an isotopic 13C16O2 laser source.

34. Apparatus according to claim 1, wherein said laser source comprises an Erbium:

YSGG laser source.

35. Apparatus according to claim 1, wherein said laser source comprises a diode laser source.

36. Apparatus according to claim 1, wherein said laser source comprises a UV laser source.

37. Apparatus according to claim 1, wherein said laser source generates a second, visible wavelength, aiming beam aligned with said laser beam.

38. Apparatus according to claim 1, wherein said laser beam is a pulsed laser, each pulse corresponding to a single dwell.

39. Apparatus according to claim 1, wherein said laser beam is a pulsed laser, a plurality of pulses being grouped for a single dwell.

40. Apparatus according to claim 1, wherein said laser beam is a continuous laser that is artificially gated to generate shots.

41. Apparatus according to claim 38, wherein said dwell time is over 1 milliseconds.

42. Apparatus according to claim 11, wherein said circuitry is configured to remove sclera tissue in the shape of a reservoir suitable for non-penetrating trabeculectomy.

43. Apparatus according to claim 11, wherein said circuitry is configured to remove sclera tissue in the shape of a percolation area suitable for non-penetrating trabeculectomy.

44. Apparatus according to claim 43, wherein said forming includes removing in a concave pattern.

45. Apparatus according to claim 1, wherein said beam has a power of over 5 watts.

46. Apparatus according to claim 1, wherein said beam has an energy density of between 3 and 20 J/cm², per dwell.

47. Apparatus according to claim 1, wherein said laser ablates between 10 and 30 microns in a single dwell.

48. Apparatus according to claim 1, wherein said laser ablates between 16 and 25 microns in a single dwell.

49. Apparatus according to claim 1, wherein said laser ablates between 16 and 20 microns in a single dwell.