Non-penetrating filtration surgery

• US 7,135,016 B1
• Filed: 05/08/2000
• Issued: 11/14/2006
• Est. Priority Date: 05/08/2000
• Status: Expired due to Term

• Current Assignee: I Optima Ltd.
• Original Assignee: Optotech Ltd.
• Inventors: Asia, Ehud, Harel, Alex, Shargil, Adi
• Primary Examiner(s): Farah, A.
• Application Number:
  US10/240,505
• Time in Patent Office: 2,381 Days
• Field of Search: 606 4- 6, 606 10- 12, 606/17, 606/18, 607/88, 607/89, 607/91, 128/898
• US Class Current: 606/5
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61F 2009/00855 Calibration of the laser system
• CPC Class Codes: A61F 2009/00865 Sclera
• 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 9/008 using laser
• CPC Class Codes: A61F 9/00802 for photoablation
• CPC Class Codes: A61F 9/00821 for coagulation

Abstract

This invention is an apparatus for ophthalmic surgery comprising a laser source (52) that generates a laser beam (54); a scanner (56) comprising an input for said laser beam, and an output of a spatially scanned laser beam (54); controlling circuitry that drives said scanner (56) to remove tissue in a desired pattern on the eye (40); a microscope (58) for viewing said tissue removal; and a beam combiner (70) comprising a first input for a line of sight of said microscope (58) and second input for said spatially scanned beam (54).

Claims

1. Apparatus for ophthalmic surgery comprising:

a laser source that generates a laser beam;

a scanner comprising an input for said laser beam and an output of a spatially scanned laser beam; and

controlling circuitry configured to drive said laser beam over an eye in order to remove tissue, in a pattern suitable for achieving percolation for non-penetrating filtration of the eye, in which sufficient tissue is removed to allow percolation of fluid out of the eye and provide a reduction in an elevated intra-ocular pressure, without penetrating into the eye.

2. Apparatus according to claim 1, comprising:

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

an image processor that processes said image.

3. Apparatus according to claim 2, wherein said circuitry uses said processing by said image processor to generate an indication of the tissue removal state.

4. Apparatus according to claim 3, wherein said circuitry uses said indication to close a control loop of said tissue removal.

5. Apparatus according to claim 3, wherein said indication of tissue removal state comprises an indication of the thickness of remaining tissue in the area of tissue removal.

6. Apparatus according to claim 3, wherein said indication of tissue removal state comprises an indication of a percolation rate through the remaining tissue in the area of tissue removal.

7. Apparatus according to claim 1, comprising a frame adapted to block the laser beam from impinging on an area of said eye.

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

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

10. Apparatus according, to claim 1, comprising an additional laser source adapted to generate a second, visible wavelength, aiming beam aligned with said laser beam.

11. Apparatus according to claim 1, wherein said laser beam is intense enough to remove sclera tissue by ablation.

12. Apparatus according to claim 1, comprising:

a microscope for viewing said tissue removal.

13. Apparatus according to claim 12, comprising a monitor for displaying a view of said tissue removal from said microscope.

14. Apparatus according to claim 12, comprising:

a beam combiner comprising a first input for a line of sight of said microscope and a second input for said spatially scanned beam.

15. Apparatus according to claim 1, wherein the controlling circuitry is adapted to drive the scanner over an area greater than 9 square millimeters.

16. Apparatus according to claim 1, wherein the controlling circuitry is adapted to drive the scanner in a pattern determined responsive to feedback on percolation formation in a scanned area.

17. Apparatus for ophthalmic surgery comprising:

a laser source that generates a laser beam;

a scanner comprising an input for said laser beam and an output of a spatially scanned laser beam;

controlling circuitry that drives said scanner to remove tissue in a desired pattern on the eye;

a camera that acquires at least one image of said tissue removal; and

an image processor that processes said acquired image to provide an indication of a percolation rate in at least one location on the eye, as an input to said controlling circuitry.

18. Apparatus according to claim 17, wherein said image processor generates an indication of a remaining tissue thickness in at least one location on said eye.

19. Apparatus according to claim 17, wherein said control circuitry varies a scanning path of said scanner, in response to said input.

20. Apparatus according to claim 17, wherein said control circuitry varies a beam intensity of said laser beam, as a function of the beam location, in response to said input.

21. Apparatus according to claim 17, wherein said control circuitry varies a spot size of said laser beam, as a function of the beam location, in response to said input.

22. Apparatus according to claim 17, wherein said control circuitry varies a pulse duration of said laser beam, as a function of the beam location, in response to said input.

23. Apparatus according to claim 17, wherein said control circuitry varies a scanning rate of said laser beam, as a function of the beam location, in response to said input.

24. A method of treating an eye, comprising:

providing a laser scanner for eye treatment, including;

a laser source that generates a laser beam;

a scanner comprising an input for said laser beam and an output of a spatially scanned laser beam; and

controlling circuitry configurable to drive the scanner to direct the laser beam in a desired pattern;

identifying an area of the eye overlying at least one of a Schlemm canal and a trabecular meshwork; and

driving the laser scanner to ablate tissue in the identified area until percolation is achieved in at least a portion of the area, in a manner suitable for reducing an elevated intra-ocular pressure, without penetrating into the eye.

25. A method according to claim 24, comprising (a) forming a flap in the identified area;

and (b) after said driving inserting a spacer between said flat and said eye.

26. A method according to claim 24, wherein identifying the area comprises identifying an area at least partially in sclera tissue of the eye.

27. A method according to claim 24, wherein the laser source comprises a CO₂ laser source.

28. A method according to claim 24, comprising collecting feedback on progression of the ablation and wherein driving the laser scanner comprises driving responsive to the collected feedback.