US2012016350A1PendingUtilityA1

Lenticular refractive surgery of presbyopia, other refractive errors, and cataract retardation

41
Individually held — no corporate assignee on recordPriority: Mar 21, 1996Filed: Sep 23, 2011Published: Jan 19, 2012
Est. expiryMar 21, 2016(expired)· nominal 20-yr term from priority
Inventors:Raymond MyersRonald R. Krueger
A61F 9/008A61F 9/00736A61F 9/00804A61F 9/00838A61F 9/009A61F 2009/0087A61F 2009/00872A61F 2009/00887A61F 2009/00895A61F 2009/00897
41
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Claims

Abstract

Methods for the creation of microspheres treat the clear, intact crystalline lens of the eye with energy pulses, such as from lasers, for the purpose of correcting presbyopia, other refractive errors, and for the retardation and prevention of cataracts. Microsphere formation in non-contiguous patterns or in contiguous volumes works to change the flexure, mass, or shape of the crystalline lens in order to maintain or reestablish the focus of light passing through the ocular lens onto the macular area, and to maintain or reestablish fluid transport within the ocular lens.

Claims

exact text as granted — not AI-modified
1 - 36 . (canceled) 
     
     
         37 . An ophthalmic surgical laser system for use in separating lens tissue of a natural human crystalline lens of an eye using femtosecond laser pulses, wherein the lens comprises: 1) an anterior lens capsule at a surface of the lens and 2) a lens nucleus in an interior of the lens, the system comprising:
 a femtosecond laser for delivering a pulsed laser beam;   optics for focusing the laser beam to a plurality of focal points located at lens tissue of a natural human crystalline lens of an eye, wherein at each of the plurality of focal points the laser beam is focused into a sufficiently small spot to achieve photodisruption of the tissue so as to separate the tissue; and   wherein the plurality of focal points are positioned at predetermined locations in and on the lens.   
     
     
         38 . The system of  claim 37 , wherein the laser beam comprises the following characteristics: a pulse width of from about 1 femtosecond to about 500 femtoseconds, an energy range of about 0.1 mJ per pulse to about 50 mJ per pulse, and a repetition rate of greater than 1 kHz. 
     
     
         39 . The system of  claim 37 , wherein the system is configured to provide a treatment regimen comprising at least about 100,000 laser pulses. 
     
     
         40 . The system of  claim 37 , wherein the system is configured to provide a treatment regimen comprising: at least about 100,000 laser pulses and wherein the laser beam comprises the following characteristics: a pulse width of from about 1 femtosecond to about 500 femtoseconds, an energy range of about 0.1 mJ per pulse to about 50 mJ per pulse, and a repetition rate of about 1 Hz to about 50 kKz. 
     
     
         41 . The system of  claim 37 ,  38  or  40 , wherein at least a portion of the plurality of focal points is positioned on the surface of the lens. 
     
     
         42 . The system of  claim 37 ,  38  or  40 , wherein a first portion of the plurality of focal points is positioned within the lens nucleus of the lens, and a second portion of the plurality of focal points is positioned on the surface of the lens. 
     
     
         43 . The system of  claim 37 , 38  or  40 , wherein at least a portion of the plurality of focal points is positioned within the lens nucleus of the lens. 
     
     
         44 . The system of  claim 37 ,  38  or  40 , comprising a beam control system for directing the laser beam in a predetermined pattern to the plurality of focal points. 
     
     
         45 . The system of  claim 37 ,  38  or  40 , comprising a beam control system for directing the laser beam in a predetermined pattern to the plurality of focal points, wherein at least a portion of the plurality of focal points defines an annular pattern. 
     
     
         46 . The system of  claim 37 ,  38  or  40 , comprising a beam control system for directing the laser beam in a predetermined pattern to the plurality of focal points, wherein at least a portion of the plurality of focal points defines a planar pattern. 
     
     
         47 . The system of  claim 37 ,  38  or  40 , comprising a beam control system for directing the laser beam in a predetermined pattern to the plurality of focal points, wherein a first portion of the plurality of focal points defines an annular pattern and a second portion of the plurality of focal points defines a planar pattern. 
     
     
         48 . The system of  claim 37 ,  38  or  40 , comprising a means for obtaining biometric measurements of the lens. 
     
     
         49 . The system of  claim 37 ,  38  or  40 , comprising a means for controlling fixation of an eye, wherein the means for controlling fixation is fixed to a suction ring on an anesthetized cornea of the eye. 
     
     
         50 . The system of  claim 49 , wherein the means for controlling fixation comprises an applanation plate. 
     
     
         51 . The system of  claim 37 ,  38  or  40 , comprising a real-time feedback system for determining a location of one of the plurality of focal points. 
     
     
         52 . An ophthalmic surgical laser system for use in separating lens tissue of a natural human crystalline lens of an eye using femtosecond laser pulses, wherein the lens comprises: 1) an anterior lens capsule at a surface of the lens and 2) a lens nucleus in an interior of the lens, the system comprising:
 a femtosecond laser for delivering a pulsed laser beam, wherein the laser beam comprises the following characteristics: a pulse width of less than about 50 femtoseconds, and a pulse repetition rate of greater than 10 kHz;   optics for focusing the laser beam to a plurality of focal points located at lens tissue of a natural human crystalline lens of an eye, wherein at each of the plurality of focal points the laser beam is focused into a sufficiently small spot to achieve photodisruption of the tissue so as to separate the tissue; and   a treatment regimen comprising at least about 100,000 laser pulses;   a beam control system for directing the laser beam in a predetermined pattern to the plurality of focal points;   a means for controlling fixation of an eye, wherein the means for controlling fixation is fixed to a suction ring on an anesthetized cornea of the eye; and   wherein the system is configured whereby the beam control system and the optics deliver the predetermined laser pattern to the plurality of focal points positioned at predetermined locations within and on the lens.   
     
     
         53 . The system of  claim 52 , wherein the treatment regimen comprises a first regimen and a second regimen. 
     
     
         54 . The system of  claim 53 , wherein the first treatment regimen comprises forming at least a portion of the plurality of focal points on the surface of the lens. 
     
     
         55 . The system of  claim 53 , wherein the first treatment regimen comprises forming at least a portion of the plurality of focal points within the lens. 
     
     
         56 . The system of  claim 55 , wherein the second treatment regimen comprises forming at least a second portion of the plurality of focal points on the surface of the lens. 
     
     
         57 . The system of  claim 52 , wherein at least a portion of the plurality of focal points defines an annular pattern. 
     
     
         58 . The system of  claims 52 , wherein at least a portion of the plurality of focal points defines a planar pattern. 
     
     
         59 . The system of  claim 52 , comprising a real-time feedback system for determining a location of one of the plurality of focal points. 
     
     
         60 . The system of  claim 52 , comprising a means for obtaining biometric measurements of the lens. 
     
     
         61 . The system of  claim 60 , wherein the means for obtaining biometric measurements of the lens comprises an A-scan. 
     
     
         62 . The system of  claim 60 , wherein the means for obtaining biometric measurements of the lens comprises a B-scan. 
     
     
         63 . The system of  claim 60 , wherein the means for obtaining biometric measurements of the lens comprises optical coherency tomography. 
     
     
         64 . An ophthalmic surgical laser system for use in creating penetrating channels in lens tissue of a natural human crystalline lens of an eye using femtosecond laser pulses, wherein the lens comprises: 1) an anterior lens capsule at a surface of the lens and 2) a lens nucleus in an interior of the lens, the system comprising:
 a femtosecond laser for delivering a pulsed laser beam, wherein the laser beam comprises the following characteristics: a pulse width of from about 1 femtosecond to about 500 femtoseconds, an energy range of about 0.1 mJ per pulse to about 50 mJ per pulse, and a repetition rate of greater than 1 kHz;   an optics assembly for focusing the laser beam to a plurality of focal points located within and on the lens, wherein at each of the plurality of focal points the laser beam is focused into a sufficiently small spot to achieve photodisruption of the lens tissue; and   the plurality of focal points defining a first shot pattern and a second shot pattern, wherein the plurality of focal points are positioned at predetermined locations within and on the lens and wherein the first shot pattern defines an annular shape at a predetermined location relative to the lens of the eye;   a beam control system associated with the laser and the optics assembly for directing the laser beam to the first and second shot patterns; wherein the beam control system comprises a predetermined treatment regime comprising the delivery of at least about 100,000 laser pulses to the lens; and   means for maintaining the eye in a predetermined position with respect to the plurality of focal points.   
     
     
         65 . The system of  claim 64 , comprising a means for obtaining biometric measurements of the lens. 
     
     
         66 . The system of  claim 65 , wherein the means for obtaining biometric measurements of the lens comprises an A-scan. 
     
     
         67 . The system of  claim 65 , wherein the means for obtaining biometric measurements of the lens comprises a B-scan. 
     
     
         68 . The system of  claim 65 , wherein the means for obtaining biometric measurements of the lens comprises optical coherency tomography. 
     
     
         69 . The system of  claim 64 , comprising a real-time feedback system. 
     
     
         70 . An ophthalmic surgical laser system for penetrating lens tissue of a natural human lens of an eye using femtosecond laser pulses, without damage to or cutting of a cornea or other external structures of the eye, the system comprising:
 a femtosecond laser for delivering a pulsed laser beam, wherein the laser beam comprises the following characteristics: a pulse width of from about 1 femtosecond to about 500 femtoseconds, an energy range of about 0.1 mJ per pulse to about 50 mJ per pulse, and a repetition rate of greater than 1 kHz;   an optics assembly for focusing the laser beam to a plurality of focal points within and on the lens, wherein at each of the plurality of focal points the laser beam is focused into a sufficiently small spot at the focal point to achieve photodisruption of the lens tissue at the focal point and thereby to penetrate the lens tissue;   the plurality of focal points defining a first shot pattern and a second shot pattern, wherein the first shot pattern is positioned at predetermined locations within the lens and the second shot pattern is positioned at predetermined locations on the lens;   a beam control system associated with the laser and the optics assembly for directing the laser beam to the first and second shot patterns; wherein the beam control system comprises a predetermined treatment regime comprising the delivery of at least about 100,000 laser pulses to the lens; and   means for maintaining the eye in a predetermined position with respect to the plurality of focal points.   
     
     
         71 . The system of  claim 70 , wherein those plurality of focal points defining the first shot pattern define a cylindrical pattern. 
     
     
         72 . The system of  claim 70 , wherein those plurality of focal points defining the first shot pattern define a lens dividing pattern within the lens. 
     
     
         73 . The system of  claim 72 , wherein a majority of the lens tissue within the lens is not photodisrupted by the laser beam pulses. 
     
     
         74 . The system of  claim 72 , wherein a majority of the lens tissue within the lens is photodisrupted by the laser beam pulses. 
     
     
         75 . The system of  claim 72 , wherein the lens dividing shot pattern defines a radial pattern. 
     
     
         76 . The system of  claim 72 , wherein the lens dividing shot pattern defines a spoked pattern. 
     
     
         77 . The system of  claim 72 , wherein the lens dividing shot pattern defines a segmented pie pattern. 
     
     
         78 . The system of  claim 70 , comprising a means for obtaining biometric measurements of the lens. 
     
     
         79 . The system of  claim 78 , wherein the means for obtaining biometric measurements of the lens comprises an A-scan. 
     
     
         80 . The system of  claim 78 , wherein the means for obtaining biometric measurements of the lens comprises a B-scan. 
     
     
         81 . The system of  claim 78 , wherein the means for obtaining biometric measurements of the lens comprises optical coherency tomography. 
     
     
         82 . The system of  claim 70 , comprising a real-time feedback system. 
     
     
         83 . An ophthalmic surgical laser system for cutting and separating lens tissue of a natural human lens of an eye using femtosecond laser pulses, without damage to or cutting of a cornea or other external structures of the eye, the system comprising:
 a femtosecond laser for delivering a pulsed laser beam, wherein the laser beam comprises the following characteristics: a pulse width of from about 1 femtosecond to about 500 femtoseconds, an energy range of about 0.1 mJ per pulse to about 50 mJ per pulse, and a repetition rate of greater than 1 kHz;   an optics assembly for focusing the laser beam to a plurality of focal points within and on the lens, wherein at each of the plurality of focal points the laser beam is focused into a sufficiently small spot at the focal point to achieve photodisruption of the lens tissue at the focal point and thereby to cut and separate the lens tissue;   the plurality of focal points defining a first shot pattern and a second shot pattern, wherein the first shot pattern is positioned at predetermined locations within the lens and the second shot pattern is positioned at predetermined locations on the lens;   a beam control system associated with the laser and the optics assembly for directing the laser beam to the first and second shot patterns; wherein the beam control system comprises a predetermined treatment regime comprising the delivery of at least about 100,000 laser pulses to the lens; and   means for maintaining the eye in a predetermined position with respect to the plurality of focal points.   
     
     
         84 . The system of  claim 83 , whereby those plurality of focal points defining the first shot pattern define a cylindrical pattern. 
     
     
         85 . The system of  claim 83 , whereby those plurality of focal points defining the first shot pattern define a lens dividing pattern within the lens. 
     
     
         86 . The system of  claim 83 , wherein a majority of the tissue within the lens is not photodisrupted by the laser beam pulses. 
     
     
         87 . The system of  claim 83 , wherein a majority of the tissue within the lens is photodisrupted by the laser beam pulses. 
     
     
         88 . The system of  claim 85 , wherein the lens dividing shot pattern defines a radial pattern. 
     
     
         89 . The system of  claim 85 , wherein the lens dividing shot pattern defines a spoked pattern. 
     
     
         90 . The system of  claim 85 , wherein the lens dividing shot pattern defines a segmented pie pattern. 
     
     
         91 . The system of  claim 83 , comprising a means for obtaining biometric measurements of the lens. 
     
     
         92 . The system of  claim 91 , wherein the means for obtaining biometric measurements of the lens comprises an A-scan. 
     
     
         93 . The system of  claim 91 , wherein the means for obtaining biometric measurements of the lens comprises a B-scan. 
     
     
         94 . The system of  claim 91 , wherein the means for obtaining biometric measurements of the lens comprises optical coherency tomography. 
     
     
         95 . The system of  claim 83 , comprising a real-time feedback system. 
     
     
         96 . A method of manipulating lens tissue of a natural human crystalline lens of an eye using femtosecond laser pulses, wherein the lens comprises: 1) an anterior lens capsule at a surface of the lens and 2) a lens nucleus in an interior of the lens, the method comprising:
 delivering a femtosecond pulsed laser beam;   focusing the laser beam to a plurality of focal points located at lens tissue of a natural human crystalline lens of an eye, wherein at each of the plurality of focal points the laser beam is focused into a sufficiently small spot to achieve photodisruption of the tissue so as to separate the lens tissue or create penetrating channels in the lens tissue; and   wherein the plurality of focal points are positioned at predetermined locations in and on the lens.   
     
     
         97 . The method of  claim 96 , wherein the laser beam comprises the following characteristics: a pulse width of from about 1 femtosecond to about 500 femtoseconds, an energy range of about 0.1 mJ per pulse to about 50 mJ per pulse, and a repetition rate of greater than 1 kHz. 
     
     
         98 . The method of  claim 96 , comprising delivering at least about 100,000 laser pulses. 
     
     
         99 . The method of  claim 96 , wherein at least a portion of the plurality of focal points is positioned on the surface of the lens. 
     
     
         100 . The method of  claim 96 , wherein a first portion of the plurality of focal points is positioned within the lens nucleus of the lens, and a second portion of the plurality of focal points is positioned on the surface of the lens. 
     
     
         101 . The method of  claim 96 , wherein at least a portion of the plurality of focal points is positioned within the lens nucleus of the lens. 
     
     
         102 . The method of  claim 96 , wherein at least a portion of the plurality of focal points defines an annular pattern. 
     
     
         103 . The method of  claims 96 , wherein at least a portion of the plurality of focal points defines a planar pattern. 
     
     
         104 . The method of  claim 96 , wherein at least a portion of the plurality of focal points defines a cylindrical pattern. 
     
     
         105 . The method of  claim 96 , wherein at least a portion of the plurality of focal points defines a lens dividing pattern within the lens. 
     
     
         106 . The method of  claim 105 , wherein the lens dividing shot pattern defines a radial pattern. 
     
     
         107 . The method of  claim 105 , wherein the lens dividing shot pattern defines a spoked pattern. 
     
     
         108 . The method of  claim 105 , wherein the lens dividing shot pattern defines a segmented pie pattern. 
     
     
         109 . The method of  claim 96 , wherein a majority of the lens tissue within the lens is not photodisrupted by the laser beam pulses. 
     
     
         110 . The method of  claim 96 , wherein a majority of the lens tissue within the lens is photodisrupted by the laser beam pulses. 
     
     
         111 . The method of  claim 96 , comprising obtaining biometric measurements of the lens. 
     
     
         112 . The method of  claim 111 , wherein the obtaining biometric measurements of the lens comprises an A-scan. 
     
     
         113 . The method of  claim 111 , wherein the obtaining biometric measurements of the lens comprises a B-scan. 
     
     
         114 . The method of  claim 111 , wherein the obtaining biometric measurements of the lens comprises optical coherency tomography. 
     
     
         115 . The method of  claim 96 , comprising controlling fixation of an eye. 
     
     
         116 . The method of  claim 96 , comprising determining a location of one of the plurality of focal points. 
     
     
         117 . The method of  claim 96 , wherein the laser beam does not damage or cutting a cornea or other external structures of the eye.

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