Internal keratome apparatus and method for using the same to form a pocket/flap between layers of a live cornea

Abstract

An apparatus and method for forming a circularly or substantially circularly shaped pocket between layers of a live cornea, and then, expanding the pocket to form a flap-like layer at the front of the live cornea which is pivotally attached to the remainder of the cornea by a flap connecting section. The cutting tool of the apparatus preferably has a circular or substantially circular cutting portion which is inserted into the cornea and reciprocated to form the pocket. Suction is applied to the front surface of the cornea to stabilize the cornea during the pocket forming process.

What is claimed is:  
     
         1 . An apparatus for separating a layer from a patient's live cornea, comprising: 
 a suction mechanism, adaptable to apply suction to a front surface of the live cornea; and    a separating tool, adaptable to move in a reciprocating motion to form a pocket between the layer of the live cornea and a remaining portion of the live cornea.    
     
     
         2 . An apparatus as claimed in    claim 1   , wherein: 
 the separating tool has first and second portions, the first portion having a separating edge which is adaptable to separate the layer from the remaining portion of the live cornea;    the first and second portions being arranged in a tool extending direction toward the separating edge and transverse to a reciprocating direction along which the separating tool reciprocates; and    the width of at least some of the first portion taken along the reciprocating direction is larger than the width of the second portion taken along the reciprocating direction.    
     
     
         3 . An apparatus as claimed in    claim 2   , wherein the first portion is substantially circularly shaped with a diameter thereof extending along the reciprocating direction and a rotational axis thereof extending substantially perpendicular to the tool extending direction.  
     
     
         4 . An apparatus as claimed in    claim 2   , wherein: 
 the tool has first and second surfaces on opposite sides thereof, each comprising a portion of the first and second portions, the first surface being longer than the second surface in the tool extending direction and being adaptable to be positioned closer than the second surface to the front surface of the live cornea when the tool is inserted into the live cornea; and    the tool further has a third surface disposed at an angle other than 0° with respect to the first surface, the third and first surfaces connecting to form the separating edge.    
     
     
         5 . An apparatus as claimed in    claim 2   , wherein: 
 the tool has first and second surfaces on opposite sides thereof, each comprising a portion of the first and second portions, the first surface having a first section extending at an angle other than 0°with respect to the tool extending direction.    
     
     
         6 . An apparatus as claimed in    claim 5   , wherein the first surface further has a second section which is substantially parallel with the second surface.  
     
     
         7 . An apparatus as claimed in    claim 5   , wherein the first section is a portion of the first portion and is angled with respect to the second surface such that the distance between the first section and the second surface measured proximate to the separating edge is less than the distance between the first section and the second surface measured at a location along the first section away from the separating edge in a direction opposite to the tool extending direction.  
     
     
         8 . An apparatus as claimed in    claim 1   , wherein the suction mechanism comprises a guiding mechanism adaptable to guide the separating tool toward the live cornea.  
     
     
         9 . An apparatus as claimed in    claim 1   , wherein the suction mechanism comprises a guide adaptable to position the separating tool to form the pocket in the live cornea at a designated distance from the front surface of the live cornea.  
     
     
         10 . An apparatus as claimed in    claim 1   , wherein the suction mechanism comprises a viewing device, adaptable to enable a user to view the front surface of the live cornea to which suction is being applied.  
     
     
         11 . An apparatus as claimed in    claim 10   , wherein the viewing device has a surface adaptable to contact the front surface of the live cornea when suction is being applied to the live cornea.  
     
     
         12 . An apparatus as claimed in    claim 1   , wherein the separating tool is adaptable to be removably attached to the suction mechanism.  
     
     
         13 . An apparatus as claimed in    claim 1   , further comprising a device which is adaptable to be positioned in a first position to restricting the reciprocating motion of the separating tool to cause the separating tool to form the pocket in the live cornea; and 
 wherein the device is further adaptable to be positioned in a second position to unrestrict the reciprocating motion of the separating tool to cause the separating tool to expand the pocket in the live cornea to form a flap-like layer at the front surface of the live cornea.    
     
     
         14 . An apparatus for forming a substantially circularly shaped pocket between layers of a patient's live cornea, comprising: 
 a mechanism, adaptable to substantially stabilize the live cornea; and    a separating tool, adaptable to move in a reciprocating motion to form the substantially circularly shaped pocket between layers of the live cornea.    
     
     
         15 . An apparatus as claimed in    claim 14   , wherein the separating tool has a substantially circularly shaped blade adaptable for forming the substantially circularly shaped pocket.  
     
     
         16 . An apparatus as claimed in    claim 14   , wherein the stabilizing mechanism further comprises a device, adaptable to restrict the reciprocating movement of the blade to cause the blade to form the pocket between the layers of the live cornea; and 
 the device is further adaptable to unrestrict the reciprocating movement of the blade to enable the blade to expand the pocket to form a flap-like layer at the front of the live cornea.    
     
     
         17 . An apparatus as claimed in    claim 14   , wherein the stabilizing mechanism is adaptable to apply suction to the front surface of the live cornea to stabilize the live cornea.  
     
     
         18 . A separating tool for separating a layer from a patient's live cornea, comprising: 
 first and second portions, the first portion having a separating edge which is adaptable to separate the layer from a remaining portion of the live cornea;    the first and second portions being arranged in a tool extending direction toward the separating edge; and    the width of at least some of the first portion taken in a direction transverse to the tool extending direction being larger than the width of the second portion taken along said transverse direction.    
     
     
         19 . A separating tool as claimed in    claim 18   , wherein the first portion is substantially circularly shaped with a diameter thereof extending along a direction transverse to the tool extending direction and a rotational axis thereof extending substantially perpendicular to the tool extending direction.  
     
     
         20 . A separating tool as claimed in    claim 18   , wherein: 
 the tool further has first and second surfaces on opposite sides thereof, each comprising a portion of the first and second portions;    the first surface being longer than the second surface in the tool extending direction, and being adaptable to be positioned closer than the second surface to the front surface of the live cornea when the tool is inserted into the live cornea.    
     
     
         21 . A separating tool as claimed in    claim 18   , wherein: 
 the tool has first and second surfaces on opposite sides thereof, each comprising a portion of the first and second portions;    the first surface having a first section which extends at an angle other than 0° with respect to the tool extending direction.    
     
     
         22 . A separating tool as claimed in    claim 21   , wherein the first surface further has a second section which is substantially parallel with the second surface.  
     
     
         23 . A separating tool as claimed in    claim 21   , wherein the first section is a portion of the first portion and is angled with respect to the second surface such that the distance between the first section and the second surface measured proximate to the separating edge is less than the distance between the first section and the second surface measured at a location along the first section away from the separating edge in a direction opposite to the tool extending direction.  
     
     
         24 . A separating tool as claimed in    claim 18   , further comprising a mechanism adaptable to move the separating tool in a reciprocating motion in a direction transverse to the tool extending direction.  
     
     
         25 . A method for separating a front layer of a patient's live cornea from a remainder of the live cornea, comprising the steps of: 
 stabilizing the live cornea to substantially restrict the live cornea from moving;    inserting a separating tool into the live cornea at a first depth to separate a portion of the front layer of the live cornea from a portion of an adjacent layer of the live cornea to form a space between the front and adjacent layers defined by edges of other portions of the front and adjacent layers which remain attached to each other, the space having a length extending between two of the edges in a direction transverse to an optical axis of the live cornea;    moving the separating tool from the first depth to a second depth in the live cornea; and    while the separating tool is at the second depth, moving the separating tool in a reciprocating motion, transverse to the optical axis of the live cornea, to separate sections of the other portions of the front and adjacent layers of the live cornea from each other to form a pocket between the front and adjacent layers which is defined by new edges of the other portions of the front and adjacent layers which remain connected, such that the pocket has a length extending between two of the new edges in a direction transverse to the optical axis of the live cornea, the length of the pocket being greater than the length of the space.    
     
     
         26 . A method as claimed in    claim 25   , wherein the inserting step comprises the step of: 
 while the separating tool is at the first depth in the live cornea, moving the separating tool in a reciprocating motion, transverse to the optical axis of the live cornea, to separate the portion of the front layer from the portion of the adjacent layer of the live cornea to form the space between the front and adjacent layers.    
     
     
         27 . A method as claimed in    claim 25   , further comprising the steps of: 
 moving the separating tool from the second depth to a third depth in the live cornea; and    while the separating tool is at the third depth, moving the separating tool in a reciprocating motion, transverse to the optical axis of the live cornea, to separate additional sections of the other portions of the front and adjacent layers of the live cornea from each other to form a further portion of the pocket between the front and adjacent layers which is defined by additional new edges of the other portions of the front and adjacent layers which remain connected.    
     
     
         28 . A method as claimed in    claim 27   , wherein the step of moving the separating tool in a reciprocating motion at the third depth comprises the step of restricting movement of the separating tool such that the further portion of the pocket has a length extending between two of the additional new edges in a direction transverse to the optical axis of the live cornea, the length of the further portion of the pocket being less than the length of the pocket.  
     
     
         29 . A method as claimed in    claim 25   , further comprising the step of further separating sections of the other portions of the front and adjacent layers from each other to form the front layer as a flap which remains pivotably attached to the adjacent layer at a connection portion thereof.  
     
     
         30 . A method as claimed in    claim 25   , wherein the stabilizing step comprises the step of applying suction to the front surface of the live cornea to stabilize the live cornea.  
     
     
         31 . A method for forming a substantially circularly shaped pocket between layers of a patient's live cornea, comprising the step of: 
 substantially stabilizing the live cornea; and    moving a separating tool in a reciprocating motion transverse to the optical axis of the cornea to form the substantially circularly shaped pocket between layers of the live cornea.    
     
     
         32 . A method as claimed in    claim 31   , wherein the separating tool has a substantially circularly shaped blade, and the moving step comprises the steps of: 
 positioning the blade at a depth in the cornea; and    moving the blade in the reciprocating motion to form the substantially circularly shaped pocket.    
     
     
         33 . A method as claimed in    claim 31   , further comprising the steps of: 
 restricting the reciprocating movement of the blade to cause the blade to form the pocket between the layers of the live cornea; and    unrestricting the reciprocating movement of the blade to enable the blade to expand the pocket to form a flap-like layer at the front of the live cornea.    
     
     
         34 . A method as claimed in    claim 31   , wherein the stabilizing step further comprises the step of applying suction to the front surface of the live cornea to stabilize the live cornea.  
     
     
         35 . An apparatus, adaptable for removing epithelium cells from the surface of a live cornea, comprising: 
 a member having walls defining an opening therein at an end of the member which is adaptable to contact the surface of a live cornea; and    an absorbing device, disposed in the opening of the member, and being adaptable to absorb a solution which, when applied to the surface of the live cornea by the member, will remove epithelium cells from the surface of the live cornea.    
     
     
         36 . An apparatus as claimed in    claim 35   , wherein the opening defined by the wails of the member is one of circular, semi-circular, rectangular and square.  
     
     
         37 . A method for removing epithelium cells from the surface of a live cornea, comprising the steps of: 
 positioning an apparatus, containing a solution capable of removing epithelium cells therein, aproximate to the surface of a live cornea to deposit the solution onto the surface of the live cornea; and    removing the solution from the surface of the live cornea after a predetermined period of time dependent on a characteristic of the solution.    
     
     
         38 . A method as claimed in    claim 37   , wherein the positioning, applying, and removing steps are performed prior to performing a step of separating a layer of the live cornea from the front surface of the live cornea.  
     
     
         39 . A method as claimed in    claim 37   , wherein the solution includes alcohol, and the characteristic is the concentration of alcohol in the solution.