Laser sclerostomy procedure

• US 5,129,895 A
• Filed: 05/16/1990
• Issued: 07/14/1992
• Est. Priority Date: 05/16/1990
• Status: Expired due to Fees

• Current Assignee: 21X Capital Ltd., Rjw Acquisitions, L.C
• Original Assignee: Sunrise Technologies Incorporated (Electro Switch Corp.)
• Inventors: Hennings, David R., Vassiliadis, Arthur
• Primary Examiner(s): Shay, David M.
• Application Number:
  US07/525,165
• Time in Patent Office: 790 Days
• Field of Search: 128/385, 128/397, 128/398, 128/897, 128/898, 606/2-4, 606/6, 606/7, 606/13-18
• US Class Current: 606/6
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61B 2090/0454 by reflection
• CPC Class Codes: A61F 2009/00868 Ciliary muscles or trabecular meshwork
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 9/008 using laser

Abstract

A fiber optic probe and its use in performing a sclerostomy (forming a small hole in the sclera of an eye) as a treatment of glaucoma. The minimally dimensioned probe is designed to direct laser light out of its side and, as a result, allows a sclerostomy procedure to be performed with minimal trauma to the conjunctiva and other surrounding ocular tissues of the patient. A series of pulses of infrared laser radiation delivered through the side of the probe forms the hole in the sclera.

Claims

1. An ophthalmologic procedure, comprising the steps of:

forming a hole through a conjunctiva layer of a patient'"'"'s eye,

providing a probe at an end of a length of an optical fiber, said probe characterized by directing substantially an entire light output thereof through a side area near an extreme probe end,

inserting said extreme probe end through said conjunctiva hole,

positioning said probe side area against an outer surface of a sclera of the patient'"'"'s eye tangentially to the limbus and adjacent a cornea, thereby to form a light path from the probe against the sclera, and

exposing the sclera to at least one pulse of laser light through the probe side area sufficient to make an opening through said sclera.

4. The procedure according to any one of claims 1, 3, 2 wherein the exposing step includes directing laser light along the length of the optical fiber within a wavelength range extending substantially from 1.8 microns to 3.2 microns.

5. The procedure according to any one of claims 1, 3, 2 wherein the exposing step includes the use of a laser which utilizes a laser medium including a material selected from a group consisting of holmium, lithium and erbium.

6. The procedure according to any one of claims 1, 3, 2 wherein the step of providing a probe includes providing said probe with an external diameter that is less than one millimeter.

7. The procedure according to any one of claims 1, 3, 2 allowing the hole to close without the use of sutures.

2. An ophthalmologic procedure, comprising the steps of:

providing a probe at an end of a length of optical fiber, said probe including a sleeve attached to said fiber in a position surrounding and enclosing said fiber end in a manner to provide an interface with a surface formed by the fiber at a critical difinite angle with respect to a longitudinal axis of the fiber in order that substantially all of any laser light traveling therealong is reflected out of a defined area of a side surface of said fiber and through a facing defined region of a side of said sleeve, at least the defined region of said sleeve being substantially transparent and positioned a distance from said fiber side defined area in a manner to provide an air gap therebetween, said probe further being characterized by an absence of any anti-reflection coating on said first fiber end and sleeve in the path of laser light exiting from the fiber and sleeve, thereby resulting in some laser light being reflected by fiber and sleeve surfaces back toward a region of the sleeve that is opposite the defined region of said sleeve, and means carried by said probe for blocking said reflected laser light from being directed away from the probe through the opposite region of said sleeve,

forming a hole through a conjunctiva layer of a patient'"'"'s eye,

inserting the probe through said hole,

gently advancing the probe subconjunctivally and orienting the probe with the defined region of said sleeve positioned against the sclera adjacent to the cornea, thereby to establish a laser light path from the probe against the sclera while substantially no laser light path is provided to the conjuctiva layer, and

exposing the sclera to at least one pulse of laser light through the probe sleeve defined region that is sufficient to make an opening through said sclera.

3. An ophthalmologic procedure, comprising the steps of:

providing a radiation delivery probe formed at an end of a length of optical fiber and including a substantially cylindrical sleeve of substantially optically transparent material that is enclosed at one end and opened at another end, an end of a length of an optical fiber core and cladding inserted into said sleeve through said opened end of the sleeve and held fixed thereto in a manner that a volume of air is trapped between an outside surface of said cladding and an inside surface of said sleeve, said fiber end terminating in a surface oriented at a critical finite angle with respect to a longitudinal axis of said fiber, thereby to reflect out of a side of the fiber through an exiting region of a side of said sleeve substantially all optical radiation traveling down said length of optical fiber toward said end, and a canula positioned against an outside surface of said sleeve and extending substantially an entire length of said sleeve while extending around only a portion of an outside circumference of said sleeve for at least a portion of the length of said sleeve in order that said sleeve radiation exiting region remains uncovered by said canula, said canula being substantially opaque to optical radiation,

forming a hole through a conjunctiva layer of a patient'"'"'s eye,

inserting the probe through said hole,

advancing the probe subconjunctivally to position said exiting sleeve region against the sclera adjacent to the cornea, thereby to form a path of optical radiation from the probe to the sclera, and

exposing the sclera to at least one pulse of optical radiation from the probe that is sufficient to make an opening through said sclera.