SYSTEM AND METHOD FOR RESHAPING AN EYE FEATURE

• US 20090209954A1
• Filed: 09/11/2008
• Published: 08/20/2009
• Est. Priority Date: 01/23/2008
• Status: Active Grant

• Current Assignee: Avedro, Inc. (Glaukos Corporation)
• Original Assignee: Avedro, Inc. (Glaukos Corporation)
• Inventors: Muller, David, Marshall, Neal, Scharf, Ronald, Ryan, Thomas, Wu, Artie
• Granted Patent: US 8,348,935 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/1405 Electrodes having a specific shape
• CPC Class Codes: A61B 2018/1807 using light other than laser radiation
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• 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 9/009 Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses apparatus for eye examination A61B3/0008

Abstract

A system for applying therapy to an eye includes an applicator having a conducting element configured to direct energy from an energy source to an application end of the conducting element, where the application end has at least one eye contact portion. A positioning system positions the at least one eye contact portion in stable engagement with the eye surface. The conducting element is disposed within a housing for the applicator and at least one adjustment system is employed to move the conducting element relative to the housing. The at least one adjustment system enables controlled movement of the conducting element and the at least one eye contact portion against the corneal surface. In particular embodiments, sufficient contact between the applicator and the cornea is determined by causing applanation of the cornea. In other embodiments, at least one measurement device is employed to determine when sufficient contact has been established.

Claims

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

an electrical energy source; and

an electrical energy conducting element extending from a proximal end to a distal end, the energy conducting element operably connected to the electrical energy source at the proximal end and configured to direct electrical energy to an eye positioned at the distal end, the energy conducting element including;

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap; and

an adjustment system configured to move at least one contact area at the distal end of the energy conducting element into engagement with a surface of the eye until a force between the at least one contact area and the surface of the eye achieves a predetermined value, the adjustment system including a force measurement element determining the force between the at least one contact area and the surface of the eye.

2. The system according to claim 1, wherein the inner conductor and the outer conductor are movable relative to each other.

3. The system according to claim 2, wherein the at least one contact area is disposed on the inner conductor and the adjustment system is configured to move the inner conductor relative to the outer conductor into engagement with the surface of the eye.

4. The system according to claim 3, wherein the force measurement element determines the movement of the inner conductor relative to the outer conductor when the outer conductor is in contact with the surface of the eye, the movement of the inner conductor indicating the force between the at least one contact area disposed on the contact area and the surface of the eye.

5. The system according to claim 2, wherein the at least one contact area is disposed on the outer conductor and the adjustment system is configured to move the outer conductor relative to the inner conductor into engagement with the surface of the eye.

6. The system according to claim 2, wherein the at least one contact area includes an inner contact area disposed on the inner conductor and an outer contact area disposed on the outer conductor, a first adjustment system being configured to move the inner contact area into engagement with the surface of the eye until an inner force between the inner contact area and the surface of the eye determined by a first force measurement element achieves a first predetermined value, and a second adjustment system being configured to move the outer contact area into engagement with the surface of the eye until an outer force between the outer contact area and the surface of the eye determined by a second force measurement element achieves a second predetermined value, the first predetermined value being different from the second predetermined value.

7. The system according to claim 1, wherein the adjustment system is configured to further move the at least one contact area in response to the electrical energy conducting element directing the electrical energy to the eye.

8. The system according to claim 1, wherein the adjustment system includes at least one electromechanical device configured to move at least one of the inner conductor and the outer conductor.

9. The system according to claim 8, wherein the at least one electromechanical device includes an electric motor.

10. The system according to claim 9, wherein the force measurement element determines the force as a function of current in the electric motor.

11. The system according to claim 1, wherein the force measurement element includes a piezoelectric sensor.

12. The system according to claim 1, wherein the force measurement element includes a strain gauge.

13. The system according to claim 1, wherein the predetermined value corresponds with the engagement causing a partial applanation of the surface of the eye.

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

an electrical energy source; and

an electrical energy conducting element extending from a proximal end to a distal end, the energy conducting element operably connected to the electrical energy source at the proximal end and configured to direct electrical energy to an eye positioned at the distal end, the energy conducting element including;

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, the inner conductor being movable relative to the outer conductor; and

an adjustment system configured to move at least one of the inner conductor and the outer conductor until at least one of an inner contact area of the inner conductor and an outer contact area of the outer conductor moves into engagement with a surface of the eye.

15. The system according to claim 14, wherein the adjustment system is configured to move the inner contact area into engagement with the surface of the eye until a force between the inner contact area and the surface of the eye achieves a predetermined value, the adjustment system including a force measurement element determining the force between the inner contact area and the surface of the eye.

16. The system according to claim 15, wherein the force measurement element determines the movement of the inner conductor relative to the outer conductor when the outer conductor is in contact with the surface of the eye, the movement of the inner conductor indicating the force between the inner contact area and the surface of the eye.

17. The system according to claim 14, wherein the adjustment system is configured to move the outer contact area into engagement with the surface of the eye until a force between the outer contact area and the surface of the eye achieves a predetermined value, the adjustment system including a force measurement element determining the force between the outer contact area and the surface of the eye.

18. The system according to claim 14, wherein a adjustment system is configured to move the inner contact area into engagement with the surface of the eye until an inner force between the inner contact area and the surface of the eye determined by a first force measurement element achieves a first predetermined value, and to move the outer contact area into engagement with the surface of the eye until an outer force between the outer contact area and the surface of the eye determined by a second force measurement element achieves a second predetermined value, the first predetermined value being different from the second predetermined value.

19. The system according to claim 14, wherein the engagement causes a partial applanation of the surface of the eye.

20. The system according to claim 14, wherein the adjustment system is configured to further move the at least one of the inner conductor and the outer conductor in response to the electrical energy conducting element directing the electrical energy to the eye.

21. A method for applying therapy to an eye, the method comprising:

positioning at least one contact area of an energy conducting element into engagement with a surface of an eye until a force between the at least one contact area and the surface of the eye achieves a predetermined value, the energy conducting element being operably connected to an electrical energy source at the proximal end and extending to the at least one contact area at a distal end, the energy conducting element comprising;

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap;

determining, during the step of positioning the at least one contact area, the force between the at least one contact area and the surface of the eye; and

applying electrical energy through the electrical energy conducting element to the eye according to the at least one contact area.

22. The method according to claim 21, wherein the inner conductor and the outer conductor are movable relative to each other.

23. The method according to claim 22, wherein the contact area is disposed on the inner conductor, and the step of positioning the at least one contact area comprises moving the inner conductor relative to the outer conductor into engagement with the surface of the eye.

24. The method according to claim 23, wherein the step of determining the force comprises determining the movement of the inner conductor relative to the outer conductor when the outer conductor is in contact with the surface of the eye, the movement of the inner conductor indicating the force between the at least one contact area disposed on the contact area and the surface of the eye.

25. The method according to claim 22, wherein the contact area is disposed on the outer conductor, and the step of positioning the at least one contact area comprises moving the outer conductor relative to the outer conductor into engagement with the surface of the eye.

26. The method according to claim 22, wherein the at least one contact area includes an inner contact area disposed on the inner conductor and an outer contact area disposed on the outer conductor, and the step of positioning the at least one contact area comprises moving the inner contact area into engagement with the surface of the eye until an inner force between the inner contact area and the surface of the eye achieves a first predetermined value, and moving the outer contact area into engagement with the surface of the eye until an outer force between the outer contact area and the surface of the eye achieves a second predetermined value, the first predetermined value being different from the second predetermined value.

27. The method according to 21, further comprising positioning the at least one contact area of the energy conducting element in response to the step of applying the electrical energy to the eye.

28. The method according to claim 21, wherein the step of positioning the at least one contact area includes operating an electromechanical device to move at least one of the inner conductor and the outer conductor.

29. The method according to claim 28, wherein the electromechanical device includes an electric motor.

30. The method according to claim 29, wherein the step of determining the force comprises measuring the force as a function of current in the electric motor.

31. The method according to claim 21, wherein the step of measuring the force comprises determining the force with a piezoelectric sensor.

32. The method according to claim 21, wherein the step of determining the force comprises determining the force with a strain gauge.

33. The method according to claim 21, wherein positioning the contact area comprises causing a partial applanation of the surface of the eye with the contact area.

34. A method for applying therapy to an eye, the method comprising:

moving at least one of an inner conductor and an outer conductor of an energy conducting element until at least one of an inner contact area of the inner conductor and an outer contact area of the outer conductor engages a surface of an eye, the inner conductor being movable relative to the outer conductor, the energy conducting element being operably connected to an electrical energy source at the proximal end and extending to the contact area at a distal end, the energy conducting element comprising;

the outer conductor extending to the distal end; and

the inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap; and

applying electrical energy through the electrical energy conducting element to the eye according to the contact area.

35. The method according to claim 34, wherein moving at least one of an inner conductor and an outer conductor comprises moving the inner contact area into engagement with the surface of the eye until a force between the inner contact area and the surface of the eye achieves a predetermined value.

36. The method according to claim 35, further comprising determining the movement of the inner conductor relative to the outer conductor when the outer conductor is in contact with the surface of the eye, the movement of the inner conductor indicating the force between the inner contact area and the surface of the eye.

37. The method according to claim 34, wherein moving at least one of an inner conductor and an outer conductor comprises moving the outer contact area into engagement with the surface of the eye until a force between the outer contact area and the surface of the eye achieves a predetermined value.

38. The method according to claim 34, wherein moving at least one of an inner conductor and an outer conductor comprises moving the inner contact area into engagement with the surface of the eye until a first force between the inner contact area and the surface of the eye determined by a first force measurement element achieves a first predetermined value, and moving the outer contact area into engagement with the surface of the eye until a second force between the outer contact area and the surface of the eye determined by a second force measurement element achieves a second predetermined value, the first predetermined value being different from the second predetermined value.

39. The method according to claim 34, wherein moving at least one of an inner conductor and an outer conductor comprises causing a partial applanation of the surface of the eye with at least one of the inner contact area and the outer contact area.

40. The method according to 34, further comprising positioning the at least one the inner conductor and the outer conductor in response to the step of applying the electrical energy to the eye.

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

an electrical energy source; and

an electrical energy conducting element extending from a proximal end to a distal end, the energy conducting element operably connected to the electrical energy source at the proximal end and configured to direct electrical energy to an eye positioned at the distal end, the energy conducting element including;

an outer conductor extending to the distal end; and

an inner conductor extending to the distal end and disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap; and

an adjustment system configured to measurably move the outer conductor and the inner conductor relative to each other, the relative movement between the outer conductor and the inner conductor being measurable to indicate an engagement between the inner conductor or the outer conductor with a surface of an eye.

42. The system according to claim 41, wherein, with the outer conductor prepositioned against the surface of the eye, the adjustment system moves the inner conductor relative to the outer conductor according to a predetermined distance to achieve a predetermined engagement between the inner conductor and surface of the eye.

43. A method for applying therapy to an eye, the method comprising:

positioning a first conductor of an energy conducting element into engagement with a surface of an eye, the energy conducting element being operably connected to an electrical energy source and including the first conductor and a second conductor, the second conductor being movable relative to the first conductor;

moving the second conductor relative to the first conductor into engagement with the surface of the eye;

measuring the relative movement between the second conductor and the first conductor to determine the engagement between the second conductor and the surface of the eye; and

applying electrical energy through the electrical energy conducting element to the eye.

44. The method according to claim 43, wherein the first conductor is an outer conductor and the second conductor is an inner conductor disposed within the outer conductor, the outer conductor and the inner conductor being separated by a gap, and the step of moving the second conductor comprises moving the inner conductor according to a predetermined relative movement.