Other

Technolas Perfect Vision Gmbh

Luis Antonio Ruiz

Josef F Bille

Frieder Loesel

Eduardo Matallana

Arnoldo Narvaez

Sergio Lenchig G

A system and method for altering the shape of a lamina of transparent material (e.g. the cornea of an eye), as it is being subjected to a transverse pressure differential, requires a computer controlled laser unit. In accordance with specified input parameters, the computer directs the laser unit to perform LIOB over predetermined surfaces within the lamina. This weakens the material for a desired reshaping of the lamina in response to the pressure differential. With respect to a perpendicular axis that is defined by the lamina, surfaces parallel to the axis (e.g. cylindrical surfaces) are separated from each other by about two hundred microns. For surfaces perpendicular to the axis, the separation is about ten microns. In each instance, the cuts that result from LIOB are only about two microns thick.

Computer control for bio-mechanical alteration of the cornea

A system and method are provided for an ophthalmic surgical procedure to provide a refractive correction for an eye. Specifically, the procedure is indicated when the desired refractive correction 'd' exceeds the capability of a correction achievable when corneal tissue is only ablated. In accordance with the present invention, an optimized refractive correction 'd' is accomplished by the ablation of corneal tissue (e.g. by a PRK or LASIK procedure). The optimized correction is then followed by a complementary refractive correction &#x201c;d&#x201d; wherein stromal tissue is weakened with Laser Induced Optical Breakdown (LIOB). Together, the optimized refractive correction (ablation) and the complementary refractive correction (LIOB) equal the desire refractive correction (d=d+d).

System and method for refractive surgery with augmentation by intrastromal corrective procedure

A system for performing intrastromal ophthalmic laser surgery requires Laser Induced Optical Breakdown (LIOB) of stromal tissue without compromising Bowman's capsule (membrane). In detail, the system is computer-controlled to create symmetrical cuts in the stroma relative to a defined axis of the eye. Importantly, these cuts are all distanced from the axis. The actual location and number of cuts in the surgery will depend on the degree of visual aberration being corrected. Further, the system may create different types of cuts in the stroma. For example, the symmetrical cuts (by type) may include cylindrical, radial or annular layer cuts. The different type cuts may be intersecting or non-intersecting depending on the visual aberration being treated.

System for performing intrastromal refractive surgery

A method for correcting higher order aberrations in an eye requires Laser Induced Optical Breakdown (LIOB) of stromal tissue. In detail, the method identifies at least one volume of stromal tissue in the eye, with each volume defining a central axis parallel to the visual axis of the eye. Thereafter, a pulsed laser beam is focused to a focal spot in each volume of stromal tissue to cause LIOB of stromal tissue at the focal spot. Further, the focal spot is moved through the volume of stromal tissue to create a plurality of incisions centered about the respective central axis of the volume. As a result, a predetermined selective weakening of the stroma is caused for correction of the higher order aberration.

System and method for correcting higher order aberrations with changes in intrastromal biomechanical stress distributions

A system and method for simulating a corneal reconfiguration in response to LIOB uses a computer-programmed, finite element model. The model has a plurality of elements; with each element pre-programmed with coefficients based on diagnostic corneal data. Collectively the coefficients replicate biomechanical properties of the cornea. In use, designated biomechanical characteristics on a plurality of selected elements (i.e. selected coefficients) are minimized to simulate LIOB in an actual cornea. A computer then measures the resultant reconfiguration of the cornea model to assess an actual cornea's response to LIOB.

Finite element modeling of the cornea

A method for performing intrastromal ophthalmic laser surgery requires Laser Induced Optical Breakdown (LIOB) of stromal tissue without compromising Bowman's capsule (membrane). In detail, the method creates cuts in the stroma over all, or portions of, a plurality of concentric cylindrical surfaces (circular or oval). Importantly, these cuts are all centered on the visual axis of the patient's eye. In accordance with the present invention, cuts can be made either alone or in conjunction with the removal of predetermined volumes of stromal tissue. The actual location of cuts in the surgery will depend on whether the treatment is for presbyopia, myopia, hyperopia or astigmatism.

Method for intrastromal refractive surgery

A method for performing intrastromal ophthalmic laser surgery requires Laser Induced Optical Breakdown (LIOB) of stromal tissue without compromising Bowman's capsule (membrane). In detail, the method creates cuts in the stroma along planes radiating from the visual axis of the eye. Importantly, these cuts are all distanced from the visual axis. The actual location and number of cuts in the surgery will depend on the degree of visual aberration being corrected. Further, the method may include the additional step of creating cylindrical cuts in the stroma. The radial cuts and cylindrical cuts may be intersecting or non-intersecting depending on the visual aberration being treated.

Method patterns for intrastromal refractive surgery

A process and system for addressing presbyopia of an eye is disclosed and features the resecting of an eye to expose a corneal stroma and system and method for determining an eye sculpturing center point found in a nasal-superior region of the eye. Sculpturing through use of an ablation laser is then carried out relative to the determined eye sculpturing centerpoint which sculpturing includes leaving a central optic zone unable relative to the presbyopic corrective process. Following sculpturing the resected portion of the eye is returned to cover over the sculptured region. The sculpturing profile is also formed with ablation control to define an advantageous (e.g., aspherical) ablation profile in the stroma.

Apparatus and method for performing presbyopia corrective surgery

A system and method particularly suited for controlled ablation of the cornea, using ultraviolet laser radiation, with the cornea sculpturing action resulting from a computer driven digital programmed distribution of excimer flux density across a controllable liquid crystal matrix mask to achieve a desired volume and shape of ablation for the correction of the curvature of the cornea. The optical mask, in one embodiment, is based on an arrayable matrix of individual optical pixel cells with two optical states between fully transparent to fully opaque or mirror like to the UV light. The system provides a highly versatile system for correcting known corneal defects in both regular and irregular corneas by simply executing computer customized patterns in very short time and with great precision and detail.

Controllable liquid crystal matrix mask particularly suited for performing ophthamological surgery, a laser system with said mask and a method of using the same

An eye laser system which includes a laser and a laser delivery system for delivering a laser beam generated by the laser to the eye and an eyetracking system which monitors movement of the eye and conveys eyetracking information to the laser delivery system with the eyetracking system including a non-invasive eye tilt reference marker. The reference marker projects an energy beam that is preferably visible so as to reflect off the iris of the eye and provide microscope and surgical field illumination. The reference marker includes a plurality of points arranged concentrically about the pupil of the eye and/or a concentric ring marking device. This arrangement provides information as to eye tilt for use in, for example, video frame review during an initial reference setting or a subsequent eye tracking stage. Also described are laser delivery systems including an eye tilt accommodation laser delivery systems that are well suited for use with the eyetracking system described above which provides an indication of eye tilt and provide data sufficient for determining an angle of eye tilt and hence an angle required by the laser accommodating system to provide a laser beam coincident with the axis of tilt for a tilted eye.

Method and apparatus for precision laser surgery

A system and method for correcting corneal irregularities through reshaping of an eye's cornea to provide a desired corrective corneal curvature. A preferred embodiment of the invention includes a topography device for mapping in detail the irregularities and surface deviations of a cornea, an interface system for receiving and manipulating topographical data and for providing directions to a laser system or the like to carry out a predetermined ablation profile on a substrate such as a corneal stroma and for providing a variety of actual and simulated pre and post operative visual depictions. The interface system, which can be a stand alone item, provides a tool for use by a surgeon or the like which allows a surgeon to input his expertise in the development of a clinical ablation profile that is well suited for the eye characteristics, review and also simulate a wide variety of potential surgical alternatives for a wide variety of corneal defects including irregular eye shapes and corneal surface irregularities.

Interactive corrective eye surgery system with topography and laser system interface

An electro-optical patternable mask is provided which is controllable by way of a processor for presenting a variety of patterns to electromagnetic radiation. In one embodiment of the mask, the electro-optical mask includes an electrochromic layer that works in conjunction with deposited electrode layers (at least one with an x-y pixel array) to present a pattern of non-transmission (colored) and transmission (bleached clear) pixel cells. The sandwiched electrochromic material is supported in one embodiment with a UV grade support substrate with the electrochromic cells of the mask being individually (e.g., individual cells or small groups of individual cells in an array) controlled by a processor and interface to achieve a sequence of different or the same patterns to achieve desired ablation volume upon transmitting ultraviolet energy through the mask such as in conjunction with an opthalmic laser surgery process. In an alternate embodiment a substrate-dispersed liquid crystal material is used in the mask as the means for controlling the transmission of electromagnetic energy such as ultraviolet light of a pulsed laser. An electro-optical device featuring a stacked, preferably monolithic multiple substrate dispersed liquid crystal layer member is also described to ensure blockage of ultraviolet light that hits a pixel cell. The multi-series or multi-stacked substrate dispersed liquid crystal material cell has its field states controlled with electric field generating device which maintains an intermediate substrate-dispersed layer with an electric field across it while the outer substrate dispersed liquid crystal layers can be switched from a no field-blockage mode to an electric-field on full transmission through cell mode. The multi-stack or series electro-optical device is useful as a mask pixel cell as well as in a variety of other field involving wavelength across the visible and ultraviolet spectrum, for example. The various mask embodiments provide a reusable controllable mask well suited for ablation processes such as corneal resurfacing using an opthamological laser surgery (e.g., LASIK) system. The electro-optical mask of the present invention provides for rapid large beam application with a smooth and high precision ablation.

Controllable electro-optical patternable mask, system with said mask and method of using the same

An eye dryer device has a main body that includes a chamber which receives gas from an external source through an inlet port formed in the main body. The main body includes a lower shell section that has a plurality of exit ports such as 25 to 125 exit ports of relatively small size such as 0.5 mm to 2 mm which are arranged above the eye for providing a gentle, highly dispersed plurality of gas streams well suited for quickly drying a flap or cap of an eye following repositioning in a laser surgery (LASIK) procedure. The main body features an outer cover section which is joined such as by way of an adhesive with the lower or inner shell section about their common periphery or integrally joined such as by way of a common hardened melt region or an initial monolithic formation. The chamber is positioned between the inner shell section and outer cover section with each preferably having a convex-shape with a generally oval-shaped periphery for sealing position over an eye. A system is provided that includes the eye dryer together with a source of clean (filtered) gas, a gas communication line and a handle with an internal gas passageway which is received preferably by way of a friction plug-in receptor secured to the eye dryer and in gas communication with the inlet port leading into the chamber. A line on/off valve is provided to allow a surgeon to control the onset and conclusion of eye drying gas which typically only involves less than a half of a minute and often 20 seconds with the arrangement of the above described eye dryer.

Eye dryer, eye dryer system and method of using the same

A system and process for correcting presbyopia with the system including a tissue removal system that preferably includes a laser system with means for forming a predetermined presbyopia correction contour corresponding to a predetermined ablation profile through controlled ablation of an exposed corneal stroma area of the eye such that a central zone of about 1-3 mm or, more preferably, 1.4 to 1.8 mm is left intact with a main, maximum presbyopia ablation zone bordering the untouched or hardly touched (e.g., a radiused transition edge) central zone. The annular maximum ablation zone in the stroma is defined by a smoothly curving, steep profile section which extends out from a central, non-ablation section of the profile. Further outward from the maximum ablation zone in the stroma is an annular treatment zone that is determined by a further section of the presbyopia correcting profile generally represented by a smoothing transition section that extends into another zone which is an unablated zone. The method and device for controlling the formation of the desired corneal stroma configuration preferably involves a presbyopic corrective module based on a predetermined profile determining equation that utilizes certain inputs which preferably include values determined by eye measurements and, preferably, also values pulled from a plurality of zone diameter ranges and a range for maximum depth. The manner in which this profile controlling information is implemented in the ablation or tissue removal process is preferably provided by modification of a present control system of one or more preexisting laser systems such as those used in hyperopia and myopia correction procedures. This modification can include, for example, an added software or hardware module, the formation of a mask with or without a mask movement assembly, or the formation of a suitable mold or shaping device for forming, for example, an erodible mask that can input the desired contour to the exposed corneal stroma. The system and apparatus of the present invention also preferably involve a microkeratome or the like for forming resections in the eye to expose the corneal stroma. A positioning marker, cleaning system and drying system are also preferably used in the present invention to facilitate, for example, corneal flap formation, laser positioning, flap repositioning on a clean surface following ablation and providing a dry corneal stroma surface to the ablating laser. With the system and method of the present invention there is provided a way to efficiently and safely correct problems associated with presbyopia while retaining good near and far vision capabilities and with reduced undesirable post-operative symptoms.

Growing community of inventors

Santafe de Bogota, D.C., Colombia

Luis Antonio Ruiz