Method for patterned plasma-mediated modification of the crystalline lens

• US 8,968,375 B2
• Filed: 02/08/2010
• Issued: 03/03/2015
• Est. Priority Date: 03/13/2007
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Culbertson, William, Seibel, Barry, Friedman, Neil, Schuele, Georg, Gooding, Phillip
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US12/702,242
• Publication Number:
  US 20100137850A1
• Time in Patent Office: 1,849 Days
• Field of Search: 606 2- 19, 607/88, 607/89, 607/92
• US Class Current: 607/88
• CPC Class Codes: A61F 2/16 Intraocular lenses
• CPC Class Codes: A61F 2/1613 having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
• CPC Class Codes: A61F 2/1637 Correcting aberrations caused by inhomogeneities; correcting intrinsic aberrations, e.g. of the cornea, of the surface of the natural lens, aspheric, cylindrical, toric lenses
• CPC Class Codes: A61F 2/1648 Multipart lenses
• CPC Class Codes: A61F 2/1662 Instruments for inserting intraocular lenses into the eye
• CPC Class Codes: A61F 2002/1683 having filiform haptics
• CPC Class Codes: A61F 2002/16901 Supporting structure conforms to shape of capsular bag
• CPC Class Codes: A61F 2009/00859 considering nomograms
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/0088 based on wavefront
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 9/00 Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand caps with means for protecting the eyes A42B1/018; visors for helmets A42B3/22; retractors A61B17/02; manipulators specially adapted for use in surgery A61B34/70; appliances to aid invalids to move about A61H3/00; exercisers for the eyes A61H5/00; eye baths A61H35/02; sunglasses or goggles having the same features as spectacles G02C
• CPC Class Codes: A61F 9/00754 for cutting or perforating the anterior lens capsule, e.g. capsulotomes
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00812 Inlays; Onlays; Intraocular lenses [IOL]
• CPC Class Codes: A61F 9/00825 for photodisruption
• CPC Class Codes: A61F 9/009 Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses apparatus for eye examination A61B3/0008

Abstract

A method of treating a lens of a patient'"'"'s eye includes generating a light beam, deflecting the light beam using a scanner to form a treatment pattern of the light beam, delivering the treatment pattern to the lens of a patient'"'"'s eye to create a plurality of cuts in the lens in the form of the treatment pattern to break the lens up into a plurality of pieces, and removing the lens pieces from the patient'"'"'s eye. The lens pieces can then be mechanically removed. The light beam can be used to create larger segmenting cuts into the lens, as well as smaller softening cuts that soften the lens for easier removal.

Claims

1. A method of treating a cataractous lens of a patient'"'"'s eye, comprising:

a. generating a light beam;

b. deflecting the light beam using a scanner to form a treatment pattern of the light beam;

c. delivering the treatment pattern to the lens of the patient'"'"'s eye to create a plurality of cuts in the lens in the form of the treatment pattern within the lens and segment the lens tissue into a plurality of patterned pieces, the treatment pattern comprising;

a plurality of outer laser incision planes each extending along a length between a posterior cutting limit within the lens and an anterior surface of the lens capsule, wherein the plurality of the outer laser incisions are inclined so as to create a treatment zone in the lens having an anterior portion with a lateral cross-section larger than a lateral cross-section of a posterior portion;

d. mechanically breaking the lens into a plurality of pieces along the cuts; and

e. removing the plurality of lens pieces from the patient'"'"'s eye.

2. The method of claim 1, further comprising:

a. deflecting the light beam using the scanner to form a softening treatment pattern of the light beam; and

b. delivering the softening treatment pattern to the lens of the patient'"'"'s eye to create a plurality of softening cuts that soften one or more portions of the lens before the removal of the lens pieces from the patient'"'"'s eye.

3. The method of claim 2, wherein the cuts formed by the treatment pattern are larger than the softening cuts formed by the softening treatment pattern.

4. The method of claim 1, wherein delivering the treatment pattern comprises creating a plurality of inclined planar incisions in the lens of the eye, each of which diverge away from an optical axis of the eye as viewed from posterior to anterior positions along the optical axis.

5. The method of claim 4, wherein the plurality of inclined planar incisions comprises 3 inclined planar incisions.

6. The method of claim 4, wherein the plurality of inclined planar incisions comprises 4 inclined planar incisions.

7. The method of claim 4, wherein the plurality of planar incisions is axisymmetric.

8. The method of claim 1, wherein the treatment pattern comprises a plurality of inner incision planes segmenting the lens, each disposed within the treatment zone and extending along a length between the posterior cutting limit and an anterior surface of the lens capsule.

9. The method of claim 1, further comprising positioning an intraocular lens in the patient'"'"'s lens capsule.

10. The method of claim 1, comprising incising an opening in an anterior surface of the lens capsule.

11. A method of treating a cataractous lens of a patient'"'"'s eye, comprising:

a. generating a light beam;

b. deflecting the light beam using a scanner to form a treatment pattern of the light beam;

c. delivering the treatment pattern to the lens of the patient'"'"'s eye to create a plurality of cuts in the lens in the form of the treatment pattern so as to segment the lens tissue into a plurality of patterned pieces, the treatment pattern comprising a plurality of outer laser incision planes each extending along a length between a posterior cutting limit within the lens and an anterior surface of the lens capsule, wherein the plurality of the outer laser incisions are inclined so as to create a treatment zone of the lens having an anterior portion with a lateral cross-section larger than a lateral cross-section of a posterior portion;

d. separating the plurality of patterned pieces; and

e. removing the plurality of patterned pieces from the patient'"'"'s eye.

12. The method of claim 11, wherein the cutting region is spaced anterior to the lens posterior capsular bag surface.

13. The method of claim 12, wherein the spacing of the cutting region defines a safety zone between the posterior cutting limit and the posterior capsular bag comprising a length of 10 μ

m to 1000 μ

m.

14. The method of claim 11, wherein the treatment pattern comprises a plurality of inner incision planes segmenting lens tissue disposed within the treatment zone.

15. The method of claim 11, comprising operating an imaging system to acquire image signals from targeted structures of the patient'"'"'s lens;

and operating a computer electronics system to process data comprising acquired image signals, so as to determine one or more parameters of a treatment zone positioned within the lens.

16. The method of claim 15, wherein the processed data further comprises user input data.

17. The method of claim 11, comprising incising an opening in an anterior surface of the lens capsule prior to delivering the treatment pattern.

18. A method of treating a cataractous lens of a patient'"'"'s eye, comprising:

a. operating an imaging system to acquire image signals from targeted structures of the patient'"'"'s lens, wherein one or more parameters of a treatment zone positioned within the lens are determined at least in part based on the imaging;

b. deflecting a generated light beam using a scanner to form a treatment pattern of the light beam;

c. delivering the treatment pattern to the lens of the patient'"'"'s eye to create a plurality of cuts in the lens in the form of the treatment pattern so as to segment the lens tissue into a plurality of patterned pieces, the treatment pattern comprising;

a plurality of outer laser incision planes each extending along a length between a lower axial cutting boundary within the lens and an upper axial cutting boundary, wherein the plurality of the outer laser incision planes are inclined such that the treatment region comprises an anterior portion with a lateral cross-section larger than a lateral cross-section of a posterior portion; and

a plurality of intersecting inner incision planes segmenting lens tissue within the treatment zone;

d. separating the plurality of patterned pieces; and

e. removing the plurality of patterned pieces from the patient'"'"'s eye.

19. The method of claim 18, wherein delivering the treatment pattern to the lens comprises cutting the segmented pieces into a plurality of patterned fragments for subsequent removal from the patient'"'"'s eye.