LASER THERAPY SYSTEM WITH UVA AND IR LASER LIGHT FOR DIRECTIONAL GENERATION OF A DERMAL COLLAGEN MATRIX

• US 20130023966A1
• Filed: 07/19/2012
• Published: 01/24/2013
• Est. Priority Date: 07/20/2011
• Status: Active Grant

• Current Assignee: Telesto GmbH
• Original Assignee: Telesto GmbH
• Inventors: Depfenhart, Markus, Mller, Jrg
• Granted Patent: US 9,486,284 B2
• Time in Patent Office: Days
• US Class Current: 607/89
• CPC Class Codes: A61B 18/203 applying laser energy to the outside of the body
• CPC Class Codes: A61B 2018/0047 Upper parts of the skin, e.g. skin peeling or treatment of wrinkles
• CPC Class Codes: A61B 2018/207 mixing two wavelengths
• CPC Class Codes: A61N 5/062 Photodynamic therapy, i.e. excitation of an agent

Abstract

The present invention refers to a Laser therapy system and a method for skin treatment, comprising:

• • a unit for dispensing a Photosensitizer containing agent;
  • a first light source which generates at least one first light with a first wavelength;
  • a second light source as a Laser light source which generates at least a second light with a second wavelength;
  • an optical system which is connected to the first and to the second light source, comprising an electromechanical displacement device with an optical deflection and focusing system such that the first and second light gets focused and a respective focus point can be controllably positioned in the skin; and
  • a control unit for controlling the electromechanical displacement device and the first and the second light source such that the respective light spot with a controlled energy and position in the skin is produced.

Claims

1. Laser therapy system for skin treatment in a volume-like treatment region in a depth of the skin, comprising:

a) a dispensing unit for dispensing a Photosensitizer containing agent for application on the skin, wherein the Photosensitizer containing agent mediates a collagen and elastin cross-linking in a targeted manner during an UVA light irradiation;

b) a first light source which generates at least one first light with a first wavelength in an UVA range whose first light intensity and first light-pulse duration are controllable, the first wavelength, the first light intensity and the first light-pulse duration being adapted to and controllable such that in a focus point of such focused light in the skin, collagen and elastin cross-links are formed in the presence of the Photosensitizer containing agent;

c) a second light source as Laser light source which generates at least one second light beam with a second wavelength whose second light intensity and second light-pulse duration are controllable, the second wavelength, the second light intensity and the second light-pulse duration being adapted to and controllable such that in the focus point of said second light beam an end arteriole in the region of the stratum papillare becomes permeable for blood corpuscles without injuring or perforating an epidermis lying above the end arteriole;

d) an optical system

which is integrally connected to the first and the second light source and with which the at least one first and second light is taken up;

comprising an optical deflection and focusing system which has an electromechanical adjustment device and a highly transparent adapter plate as a light exit of the optical system, wherein the optical deflection and focusing system is embodied and electrically controllable by the electromechanical adjustment device such that said first and second light is further guided, deflected and focused with a certain focal length to a respective focus point, such that the respective resulting focused light exits behind the adapter plate with a first cross-sectional area and such that the respective focus point is precisely controlled and navigated in x/y/z coordinates to behind the adapter plate and with reference to the adapter plate in to the volume-like treatment area, and

e) a control unit

for controlling the electromechanical adjustment device of the optical system for said navigation of the respective focus point, and

for controlling the first and the second light source so that the respective light source generates the first or the second light intensity and the first or the second light-pulse duration, respectively, adapted to produce in this manner said respective light spot in said respective focus point for a respective reaction such as the collagen and elastin cross-linking or a permeability of the end arterioles for the corpuscular blood components.

2. Laser therapy system according to claim 1, wherein the Laser therapy system additionally comprises an imaging unit with a camera system and a monitor,

wherein a camera unit of the camera system is connected to the optical system and has a detection field (94) which, by means of an optical path of the optical system, covers the treatment region behind the adapter plate;

wherein an image of the treatment region with x/y/z coordinates represented on the monitor (10) correlates with the x/y/z coordinates of the optical system, with the control unit and finally with the focus point such that by means of a navigated cross hair in the image, the light spot is also created in the treatment region at precisely the displayed site, and/or

wherein the control unit also takes into account, during calculation of the x/y/z coordinates of the respective focus point in the treatment region behind the adapter plate, the light refraction of the skin and any additional foil or a band-aid between the adapter plate and the skin.

3. Laser therapy system according to claim 2, wherein the camera system comprises an Optical Coherence Tomography (OCT), a fluorescence microscopy or a fluorescence tomography and allows a three-dimensional representation of the treatment region of the skin and makes visible collagen fibers, elastin, hair roots, papillae, arterioles, end arterioles, treated skin tissue, yet untreated skin tissue or combinations thereof.

4. Laser therapy system according to claim 2, wherein the camera system is based on a light reflection measurement or on an light extinction measurement by means of the camera unit, wherein for image acquisition an illumination with a first illumination wavelength is selected which in arterial regions of the skin is absorbed or reflected particularly strongly so that a region with arterial blood flow and, therefore, the arterioles and end arterioles, are detected and represented in the image with particularly strong contrast.

5. Laser therapy system according to claim 2, wherein the camera system provides an illumination source with at least two different illumination wavelengths for light-reflection measurement, in a first step at least two camera images being generated and stored with the different illumination wavelengths, the respective illumination wavelength being adapted to the skin parts to be detected in particular and contrasted, and one of the illumination wavelengths being equal or unequal to the first or the second wavelength, and in a second step the image of the treatment region being generated and represented by image processing from the at least two stored camera images, wherein the image processing adds the two camera images or subtracts them from each other or logarithmizes them and then subtracts them from each other and/or additionally performs edge enhancement or evaluates the camera images in an RGB-color-selective manner.

6. Laser therapy system according to claim 2, wherein the image indicates the treatment region behind the adapter plate and wherein a processor unit recognizes, based on a pattern recognition, the papillary region with the papillae and determines the positions which are to be treated with light spots in the first and/or the second wavelength range and together form the light spot matrix.

7. Laser therapy system according to claim 2, wherein one of the processors of the Laser therapy system recognizes, by a second continuous pattern recognition in the image of the treatment region behind the adapter plate, a possible displacement of the adapter plate on the skin and recognizes in addition which region of the treatment region has already been treated so as to then treat only the region of the treatment region further which is still untreated, wherein the treated region and the untreated region of the treatment region is represented in different colors on the monitor.

8. Laser therapy system according to claim 1, wherein the Photosensitizer containing agent is a cream or a gel with the effect of penetrating the skin and supporting the formation of collagen and elastin, and contains riboflavin (vitamin B2) and coenzymes for a synthesis of collagen and elastin, namely vitamin A, vitamin E and/or vitamin C, and/or

wherein the dispense unit for dispensing the Photosensitizer containing agent is a tube, a tin, a dosing unit, a gel band-aid or an applicator with a disposable syringe, and/or

wherein the Photosensitizer containing agent is fluorescent for determining the penetration depth into the skin, and/or

wherein the Laser therapy system additionally has an alarm timer indicating that the agent has been sufficiently absorbed into the skin.

9. Laser therapy system according to claim 1, wherein the first light source comprises at least one UVA Laser or a UVA lamp with the first wavelength within the range of 340-450 nm.

10. Laser therapy system according to claim 1, the second light source comprising at least one IR Laser with the second wavelength within a range of 800-2000 nm.

11. Laser therapy system according to claim 1, the second light source comprising a Laser or a plurality of Laser diodes with the second wavelength in a range of 450-550 nm or 550-650 nm or of 650-800 nm and being selected preferably such that it is absorbed as well as possible by hemoglobin and as little as possible by a remaining tissue of the skin.

12. Laser therapy system according to claim 1, the first and/or the second light source comprising several individual light sources arranged with specific spacing so as to generate several first and/or second light beams simultaneously so that these can be applied simultaneously at different sites of the treatment region.

13. Laser therapy system according to claim 1, the optical system with its optical deflection and focusing system comprising at least one lens, one concave lens, one cylindrical lens, one diffuser lens, one Fresnel lens, one liquid lens, one first lens system, one second lens system, one light conductor, one fiber-optic light guide, one light adapter or a combination thereof, and/or

wherein the cross-sectional area in the focus point is smaller by a multiple than the cross-sectional area of the light entry into the skin, the multiple being 3-1000.

14. Laser therapy system according to claim 1, the optical system comprising a plurality of optical deflection and focusing systems arranged therein adapted to generate a corresponding plurality of focused light-beam beams and focus points with corresponding light spots behind the adapter plate and in the treatment region at the same time.

15. Laser therapy system according to claim 1, wherein the focus points of the focused light of the first wavelength correspond to the focus points of the focused light of the second wavelength, with the exception of deviations due to different refractive indices with the different wavelengths, or wherein the focus points of the focused light of the first wavelength are offset from the focus points of the focused light of the second wavelength by a defined offset.

16. Laser therapy system according to claim 1, the electromechanical adjustment device comprising actuators which are connected, for the purpose of a light deflection and/or a shifting of the focus point, with reflecting mirrors, semitransparent mirrors, with lens systems, shutters, shifting elements, light guides, optical filters or combinations thereof, so as to be able to position the respective focus points in the treatment region in the x/y/z direction in a targeted manner.

17. Laser therapy system according to claim 1, wherein the control unit generates the light spots with the first and/or the second wavelength behind the adapter plate in the treatment region of the skin in an automated manner along a predefined or previously determined light spot matrix, the light spots being either created by at least two light spots at a time simultaneously or by a sequence of individual light spots.

18. Laser therapy system according to claim 1, wherein calibration parameters are kept stored in the Laser therapy system and/or wherein before a treatment, the Laser therapy system is calibrated by means of a calibration dummy.

19. Laser therapy system according to claim 1, wherein the adapter plate itself or an upstream highly transparent cooling plate has a cooling effect and is adapted to be applied directly on the skin above the treatment region below it.

20. Laser therapy system according to claim 1, the Laser therapy system additionally comprising a dispense unit for a skin-glue and/or for a band-aid, wherein the skin-glue consists of a mixture of an organic skin-glue and the Photosensitizer containing agent and wherein the band-aid consists of a material which is highly transparent for the first wavelength and/or for the second wavelength and which at the bottom has an adherent effect on the skin.

21. Laser therapy system for skin treatment in a volume-like treatment region in a depth of the skin and thus of the conjunctiva or sclera of the eye, comprising:

a) a dispensing unit for dispensing a Photosensitizer containing agent for application on the skin, wherein the Photosensitizer containing agent mediates a collagen and elastin cross-linking in a targeted manner during an UVA light irradiation;

b) a first light source which generates at least one first light with a first wavelength in an UVA range whose first light intensity and first light-pulse duration are controllable, the first wavelength, the first light intensity and the first light-pulse duration being adapted to and controllable such that in a focus point of such focused light in the skin, collagen and elastin cross-links are formed in the presence of the Photosensitizer containing agent;

c) a second light source as Laser light source which generates at least one second light beam with a second wavelength whose second light intensity and second light-pulse duration are controllable, the second wavelength, the second light intensity and the second light-pulse duration being adapted to and controllable such that in the focus point of said second light beam an end arteriole becomes permeable for blood corpuscles without injuring or perforating a skin lying above the end arteriole;

d) an optical system

which is integrally connected to the first and the second light source and with which the at least one first and second light is taken up;

comprising an optical deflection and focusing system which has an electromechanical adjustment device and a highly transparent adapter plate as a light exit of the optical system, wherein the optical deflection and focusing system is embodied and electrically controllable by the electromechanical adjustment device such that said first and second light is further guided, deflected and focused with a certain focal length to a respective focus point, such that the respective resulting focused light exits behind the adapter plate with a first cross-sectional area and such that the respective focus point is precisely controlled and navigated in x/y/z coordinates to behind the adapter plate and with reference to the adapter plate in to the volume-like treatment area, and

e) a control unit

for controlling the electromechanical adjustment device of the optical system for said navigation of the respective focus point, and

for controlling the first and the second light source so that the respective light source generates the first or the second light intensity and the first or the second light-pulse duration, respectively, adapted to produce in this manner said respective light spot in said respective focus point for a respective reaction such as the collagen and elastin cross-linking or a permeability of the end arterioles for the corpuscular blood components.

22. Method for skin treatment in a depth of the skin with a Laser therapy system, comprising a first light source with a first wavelength in the UVA range, a second light source as a Laser with a second wavelength larger than the first wavelength, an optical deflection and focusing system through which the light of the first and the second light source is combined, transmitted and guided to exit in a focused manner behind an adapter plate for the skin treatment, and a control unit for controlling the first and the second light source and for navigation of a respective light spot,

the method comprising the following steps:

a) applying a Photosensitizer containing agent on the skin to be treated, wherein the Photosensitizer containing agent has characteristics of penetrating the skin and catalyzing in the skin, under UVA light irradiation, a collagen and elastin cross-linking in the sense of an aldol condensation, similar to the lysyloxidase reaction, between and around papillae,

b) irradiation of the skin with the UVA light of the first wavelength, wherein the UVA irradiation is applied in a targeted manner and by a plurality of focused light spots around the papillae in such a way that in this manner, a first collagen and elastin basic structure is produced,

wherein the UVA light spots are created in the skin by a respective focal length, an energy and pulse duration such that the skin between the papillae and a light entry into the skin is stressed and damaged as little as possible,

c) irradiation of the papillae of the skin with the Laser light of the second wavelength as focused second light spots,

wherein the second light spots are created in a targeted manner and by a respective focal length, pulse duration and energy such that;

due to the light energy in the light spot, the respective end arteriole of the respective papilla becomes permeable for corpuscular blood components, such as thrombocytes, such as to release in this manner growth factors and cytokines and activate fibroblasts which together cause a growth of additional collagen and elastin along the previously generated collagen and elastin basic structure,

and that the skin between the light spots on the papillae and the light entry into the skin is stressed and damaged as little as possible.

23. Method according to claim 22, wherein with targeted application of the UVA light spots and of the second light spots, an imaging unit for determining skin structures in a depth of the skin is used, wherein by the imaging unit in step (b), the skin structure of the papillae is made visible and by the control unit the UVA light spots are created in a targeted manner around the papillae and/or in step (c) the skin structure of the respective papillae with their end arterioles is made visible and the second light spots are generated in a corresponding targeted manner at the end arterioles by the control unit.

24. Method according to claim 22, wherein for wound treatment skin parts or wound rims are first interconnected by means of a transparent band-aid or with transparent silicone fibers or with an organic skin glue, after which the wound rims and the wound ground are treated with the UVA light spots according to step (b) and with the second light spots according to step (c), wherein transparent means being transparent at least for the UVA light.

25. Method according to claim 24, wherein the band-aid is a silicone band-aid or plaster transparent for UVA light.

26. Method according to claim 24, wherein the organic skin glue is based on a mixture of dihydroxy acetone and a Photosensitizer containing agent, such as riboflavin.

27. Method according to claim 22 for treatment of the skin of the eyeball and mainly of the conjunctiva, in a depth of the skin, wherein the UVA and the second light spots are positioned in the conjunctiva in such a targeted manner that after a healing process, due to the growth of collagen and elastin the white color of the conjunctiva is again more strongly enhanced.

28. Method according to claim 22 for treatment of the skin of the eyeball, and mainly of the sclera, in a depth of the skin, wherein the UVA and the second light spots are positioned in the sclera in such a targeted manner that during the healing process, due to the growth of collagen and elastin the eyeball is strengthened and thus shortened along its optical axis and thus a myopia is corrected.