Laser trabeculodissection

• US 5,370,641 A
• Filed: 05/22/1992
• Issued: 12/06/1994
• Est. Priority Date: 05/22/1992
• Status: Expired due to Fees

• Current Assignee: Lasersight Centers Incorporated (Lasersight Incorporated), Lasersight Incorporated, MRF, Inc. (Lasersight Incorporated), Lasersight Technologies Inc. (Xianding Weng)
• Original Assignee: Lasersight Centers Incorporated (Lasersight Incorporated)
• Inventors: O'Donnell, Francis E. Jr.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Harris, Sonya C.
• Application Number:
  US07/886,926
• Time in Patent Office: 928 Days
• Field of Search: 606/6, 606/5, 606/4, 606/166, 128/898
• US Class Current: 606/4
• CPC Class Codes: A61F 2009/00868 Ciliary muscles or trabecular meshwork
• CPC Class Codes: A61F 2009/00891 Glaucoma
• CPC Class Codes: A61F 9/00781 Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment drainage implants in general A61M27/002
• CPC Class Codes: A61F 9/008 using laser

Abstract

This invention contemplates the use of a surgical laser device characterized by ultra-violet or infrared radiation to achieve controlled trabeculodissection in selected regions of the trabecular meshwork and Schlemm'"'"'s Canal. The surgical laser is positioned over the corneoscleral bed for non-contact delivery, or, alternatively, it is inserted under a sclera flap with a contact tip and laser radiation is directed toward the trabecular meshwork and canal of Schlemm creating an ultra-thin trabecular meshwork and Canal of Schlemm. The outflow of aqueous humor through the disected trabecular meshwork functions as a self-limiting end point to the surgery when the aqueous humor absorbs the laser energy.

Claims

1. A method for performing a non-penetrating trabeculectomy on the sclera and conjunctiva at the corneasclera bed for treating glaucoma which has formed blockage in the passage of aqueous humor from the anterior chamber and through the trabecular meshwork and the Schlemm'"'"'s Canal, comprising:

(a) cutting a flap in the sclera;

(b) positioning a laser surgical instrument under the scleral flap;

(c) utilizing laser energy to remove tissue in micron sizes from the trabecular meshwork and to form a substantially small passage through the Schlemm'"'"'s Canal, and thereby creating a smooth and even treatment surface thereat, thereby enhancing the outflow of fluid through the trabecular meshwork and through the Schlemm'"'"'s Canal;

(d) withdrawing the laser surgical instrument from under the formed scleral flap;

(e) replacing the scleral flap; and

(f) replacing and fixing the scleral flap in place through one of suture and laser welding.

2. The method of claim 1 wherein the cutting of the scleral flap further comprising the cutting through the conjunction and sclera with a scalpel.

3. The method of claim 1 wherein the removal of tissue from the corneasclera bed is performed with the laser in micron steps leaving a smooth and even treatment surface upon the trabecular meshwork and the Schlemm'"'"'s Canal.

4. The method of claim 1 wherein the creating of the scleral flap further comprises cutting through the conjunctiva with a scalpel and then cutting through the sclera with a surgical scissors.

5. The method of claim 1 wherein the inserting of the laser through the scleral flap further comprising inserting one of an ultraviolet and infrared energy emitting laser.