Eye therapy system

• US 8,992,516 B2
• Filed: 09/10/2007
• Issued: 03/31/2015
• Est. Priority Date: 07/19/2007
• Status: Active Grant

• Current Assignee: Avedro, Inc. (Glaukos Corporation)
• Original Assignee: Avedro, Inc. (Glaukos Corporation)
• Inventors: Muller, David
• Primary Examiner(s): CRANDALL, LYNSEY P
• Application Number:
  US11/898,189
• Publication Number:
  US 20090024117A1
• Time in Patent Office: 2,759 Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1807 using light other than laser radiation
• CPC Class Codes: A61B 2018/206 the laser light passing along a liquid-filled conduit
• CPC Class Codes: A61F 2009/00853 Laser thermal keratoplasty or radial keratotomy
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 9/0079 using non-laser electromagnetic radiation, e.g. non-coherent light or microwaves
• CPC Class Codes: A61F 9/008 using laser
• 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
• CPC Class Codes: A61N 1/36046 of the eye
• CPC Class Codes: A61N 1/403 for thermotherapy, e.g. hyperthermia

Abstract

A system for applying therapy to an eye selectively applies coolant to the corneal surface to minimize heat-related damage to the corneal surface during thermokeratoplasty. Embodiments may include an energy source, a conducting element, a coolant supply, and at least one coolant delivery element. The conducting element is operably connected to the energy source and extends from a proximal end to a distal end. The conducting element directs energy from the energy source to the distal end, which is positionable at the eye. The coolant delivery elements are in communication with the coolant supply and are operable to deliver a micro-controlled pulse of coolant to the distal end.

Claims

1. A system for applying therapy to an eye, the system comprising:

an electrical energy source;

an electrical energy conducting element, comprising two conductors separated by a gap of a selected distance and extending from a proximal end to a distal end, the electrical conducting element operably connected to the electrical energy source and adapted to receive, at the proximal end, electrical energy generated by the electrical energy source and direct the electrical energy at the distal end, the distal end being positionable at an eye;

a coolant supply; and

at least one coolant delivery element in communication with the coolant supply, the at least one coolant delivery element being operable to deliver a pulse of coolant to the distal end, wherein the at least one coolant delivery element is positioned to deliver the pulse of coolant in the gap between the two conductors,

wherein the electrical energy conducting element and the at least one coolant delivery element are included in a enclosed assembly, a dielectric material forming a bottom surface at the distal end, and the at least one coolant delivery element applies the pulse of coolant to the dielectric material positioned over the eye at the distal end, the at least one coolant delivery element delivering the coolant without forming a cooling layer between the dielectric and the eye.

2. The system according to claim 1, wherein the pulse of coolant is less than 100 milliseconds.

3. The system according to claim 1, wherein the pulse of coolant comprises a liquid with a boiling point below 37°

C.

4. The system according to claim 1, wherein the electrical energy at the distal end has a frequency in the range from 500 MHz to 3000 Mhz.

5. The system according to claim 1, wherein the electrical energy directed at the distal end is delivered in an energy pulse.

6. The system according to claim 5, wherein the energy pulse is shorter than a thermal diffusion time in the eye.

7. The system according to claim 5, wherein the energy pulse is between 10 milliseconds and 1 second.

8. The system according to claim 7, wherein the energy pulse has a power in the range of 500 W to 3 KW.

9. The system according to claim 1, wherein the at least one coolant delivery element comprises a nozzle and an electrically controlled solenoid valve.

10. The system according to claim 1, further comprising a pressure relief structure in communication with an exterior environment, the pressure relief structure providing a passage of evaporated coolant to the exterior environment.

11. The system according to claim 10, wherein the pressure relief structure is a vent passage or a pressure relief valve.

12. The system according to claim 1, further comprising a vacuum source and at least one vacuum channel connected to the vacuum source, the at least one vacuum channel having an opening positioned at the distal end.

13. The system according to claim 12, wherein the vacuum channel opening is adapted to engage the eye and position the distal end for delivery of the pulse of coolant and the electrical energy to the eye.

14. The system according to claim 12, wherein the vacuum channel opening is adapted to draw away the coolant delivered by the pulse of the at least one nozzle.

15. The system according to claim 1, further comprising at least one heat sink element adapted to draw heat further from the distal end.

16. The system according to claim 1, further comprising a pressure relief structure in communication with an exterior environment, the pressure relief structure providing a release of pressure to the exterior environment.

17. The system according to claim 16, wherein the pressure relief structure is a pressure relief valve in communication with an exterior environment, the pressure relief valve adapted to open in response to pressure from the pulse of coolant delivered from the at least one nozzle.

18. The system according to claim 16, wherein the pressure relief structure is a vent passage in communication with an exterior environment, the vent passage providing a release of pressure to the exterior environment.

19. The system according to claim 1, wherein the electrical energy conducting element comprises a cylindrical outer conductor and a cylindrical inner conductor positioned within the outer conductor, the outer conductor and the inner conductor defining a annular gap extending from the proximal end to the distal end.

20. The system according to claim 19, wherein the at least one coolant delivery element includes more than one coolant delivery element positioned within the annular gap.

21. The system according to claim 1, further comprising a controller connected to the at least one coolant delivery element, the controller being operable to signal the at least one coolant delivery element to deliver the pulse of coolant toward the distal end, whereby the pulse of coolant is applied toward the eye positioned at the distal end.

22. The system according to claim 1, further comprising a controller connected to the electrical energy conducting element, the controller being operable to deliver the electrical energy from the electrical energy source to the conductors to deliver the electrical energy to the distal end.

23. The system according to claim 1, further comprising a controller connected to the at least one coolant delivery element and the electrical energy conducting element, the controller being operable, in a timed sequence, to signal the at least one coolant delivery element to deliver the pulse of coolant toward the distal end and to deliver the electrical energy from the electrical energy source to the conductors to deliver the electrical energy to the distal end.

24. The system according to claim 23, wherein the controller is operable to deliver the pulse of coolant to the distal end before and after delivering an energy pulse of electrical energy to the distal end.

39. The system according to claim 19, wherein the at least one coolant delivery element applies the pulse of coolant within the annular gap.

25. A system for applying therapy to an eye, the system comprising:

an energy source;

a conducting element operably connected to the energy source and extending from a proximal end to a distal end, the conducting element adapted to direct energy from the energy source to the distal end, the distal end being positionable at an eye;

at least one coolant delivery element being operable to deliver a pulse of coolant to the distal end positioned over the eye; and

a low pressure source that generates a low pressure at the distal end and causes evaporative cooling at the distal end when the pulse of coolant is delivered to the distal end

wherein a dielectric material forms a bottom surface at the distal end of the conducting element, and the at least one coolant delivery element applies the pulse of coolant within a enclosed assembly to the dielectric material positioned over the eye at the distal end.

26. The system according to claim 25, wherein the low pressure source comprises a vacuum source coupled to at least one vacuum channel, the at least one vacuum channel having an opening positioned at the distal end and the vacuum source being operable to lower the pressure at the distal end.

27. The system according to claim 25, wherein the low pressure source comprises a vacuum source coupled to the enclosed assembly, the vacuum source being operable to lower the pressure within the enclosed assembly.

28. The system according to claim 25, further comprising a controller connected to the at least one coolant delivery element, the controller being operable to signal the at least one coolant delivery element to deliver the pulse of coolant to the distal end.

29. The system according to claim 25, further comprising a controller connected to the conducting element, the controller being operable to deliver energy from the energy source through the conducting element to the distal end.

30. The system according to claim 25, further comprising a controller connected to the at least one coolant delivery element and the conducting element, the controller being operable, in a timed sequence, to signal the at least one coolant delivery element to deliver the pulse of coolant to the distal end and to deliver energy from the energy source through the conducting element the conducting element to the distal end.

31. The system according to claim 30, wherein the controller is operable to deliver the pulse of coolant to the distal end before and after delivering an energy pulse to the distal end.

32. The system according to claim 25, wherein the energy source is an electrical energy source and the conducting element comprises two electrical conductors separated by a gap.

33. The system according to claim 25, wherein the pulse of coolant is less than 100 milliseconds.

34. The system according to claim 25, wherein the energy directed at the distal end is delivered in a energy pulse.

35. The system according to claim 25, further comprising a source of liquid with a boiling point below 37°

C., wherein the at least one coolant delivery element delivers the pulse from the source of liquid.

36. The system according to claim 25, wherein the delivered pulse of coolant is drawn away from the distal end in association with the cooling at the distal end.

37. The system according to claim 25, wherein the electrical energy conducting element comprises a cylindrical outer conductor and a cylindrical inner conductor positioned within the outer conductor, the outer conductor and the inner conductor defining a annular gap extending from the proximal end to the distal end.

38. The system according to claim 37, wherein the at least one coolant delivery element applies the pulse of coolant within the annular gap.