Hydrokeratome for refractive surgery
First Claim
1. An apparatus for ophthalmic surgery, including:
- a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue;
jet carrier means for supporting said jet nozzle;
an instrument body;
means for releasably securing said instrument body to the corneal portion of an eye;
means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction;
means for translating said jet carrier selectively with precise positional control along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue;
at least one guide member for controlling placement and conformation of the incision in the corneal tissue formed by said high velocity liquid jet;
said guide member further including quick connect means for releasably securing said guide member to said instrument body.
2 Assignments
0 Petitions
Accused Products
Abstract
An apparatus for guiding a high speed liquid jet used in forming ophthalmic incisions includes an instrument body having an elongated rectangular portion and a tapered end portion. A cylindrical housing is secured to the tapered end, and is provided with a stepped opening extending axially therethrough. A jet carrier includes a longitudinally extending body, and a pair of high precision crossed roller slides join the carrier and body to permit lateral translation of the jet carrier. A micro-motor assembly secured within the rectangular body portion is joined to a pinion gear which engages a rack gear joined to the jet carrier to drive the jet carrier in lateral translation. The jet carrier includes a proximal connector for a high pressure fluid hose, and a jet nozzle assembly extending from the distal end. A plurality of guide members are provided, all having common structural features adapted to engage the stepped opening of the distal end of the instrument body. Each guide member includes a generally cylindrical body and a central portion comprised of a reticle and applanation plate, with differing guide members having applanation plates of various thicknesses. The guide member may include an adaptive applanator member that is selectively variably curved. The cylindrical body also includes an annular vacuum suction ring to selectively secure the device on the eye. The guide member has a jet slot extending in the sidewall thereof to receive the jet nozzle.
58 Citations
42 Claims
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1. An apparatus for ophthalmic surgery, including:
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a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue; jet carrier means for supporting said jet nozzle; an instrument body; means for releasably securing said instrument body to the corneal portion of an eye; means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction; means for translating said jet carrier selectively with precise positional control along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue; at least one guide member for controlling placement and conformation of the incision in the corneal tissue formed by said high velocity liquid jet; said guide member further including quick connect means for releasably securing said guide member to said instrument body. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. An apparatus for ophthalmic surgery, including:
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a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue; jet carrier means for supporting said jet nozzle; an instrument body; means for releasably securing said instrument body to the corneal portion of an eye; means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction; means for translating said jet carrier selectively with precise positional control along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue; said means for translating said jet carrier including a micro-motor assembly secured in said instrument body, and a pinion gear connected to the output of said micro-motor assembly and protruding from said instrument body. - View Dependent Claims (22, 23)
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24. An apparatus for ophthalmic surgery, including:
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a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue; jet carrier means for supporting said jet nozzle; an instrument body; means for releasably securing said instrument body to the corneal portion of an eye; means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction; means for translating said jet carrier selectively with precise positional control along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue; and
,a guide member for controlling placement and conformation of incisions in the corneal tissue formed by said high velocity liquid jet; said guide member including adaptive applanator means defining a selectively variable curved surface for impinging on the apex of the cornea.
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25. An apparatus for ophthalmic surgery, including:
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cutting means capable of cutting corneal tissue; an instrument body, and means for releasably securing said instrument body to the corneal portion of an eye; translating means supported on said instrument body for moving said cutting means through a portion of the cornea secured to said instrument body to form an incision in the cornea; adaptive applanator means for impinging on the corneal portion of the eye, said adaptive applanator means including a selectively variable curved surface impinging on the corneal portion to temporarily alter the curvature of the outer surface of the corneal portion in a predetermined manner. - View Dependent Claims (26, 27, 28, 29)
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30. An apparatus for ophthalmic surgery, including:
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a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue; jet carrier means for supporting said jet nozzle; an instrument body; means for releasably securing said instrument body to the corneal portion of an eye; means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction; means for translating said jet carrier selectively along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue; and
,safety shutter means for selectively blocking said high velocity liquid jet. - View Dependent Claims (31, 32)
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33. An apparatus for ophthalmic surgery, including:
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a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue; jet carrier means for supporting said jet nozzle; an instrument body; means for releasably securing said instrument body to the corneal portion of an eye; means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction; means for translating said jet carrier selectively along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue; and
,aiming beam means for permitting direct visualization of said high velocity liquid jet. - View Dependent Claims (34, 35, 36)
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37. A method for resection of the cornea, including the steps of:
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providing an adaptive applanator having a applanation surface of selectively variable conformation; securing said adaptive applanator to the corneal portion of an eye while said applanation surface is disposed in a first selected curvature and impinged on the corneal portion; forming a first lateral surgical incision in the corneal portion to create an apical flap; reconfiguring said adaptive applanator to cause said applanation surface to adopt a second selected curvature impinging on said corneal portion; forming a second lateral surgical incision in the corneal portion, said first and second lateral surgical incsions defining a lenticular wafer of corneal tissue; removing said lenticular wafer; and
,replacing said apical flap on the stromal bed of the removed lenticular wafer. - View Dependent Claims (38, 39, 40, 41)
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42. A method for resection of the cornea, including the steps of:
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providing a plurality of guide members, said guide members having applanator plates of various thicknesses and applanation surface curvatures; providing a surgical instrument having linear cutting means tranversing a planar path;
said planar path being closely spaced apart from the applanation surface of a guide member;securing one of said guide members in the surgical instrument, said one guide member having a predetermined spacing of said applanation surface from said planar path; operating said linear cutting means to form a first lateral incision in the cornea and create an apical flap; removing said one guide member from said instrument body and securing a second guide member in said instrument body, said second guide member having a second predetermined spacing of said applanation surface from said planar path; operating said linear cutting means to form a second lateral incision in the cornea and create an lenticular wafer of corneal tissue; removing said lenticular wafer; and
,replacing said apical flap on the stromal bed of the removed lenticular wafer.
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Specification