The present invention pertains generally to systems and methods for performing ophthalmic surgery. More particularly, the present invention pertains to systems and methods for stabilizing an eye during ophthalmic surgery. The present invention is particularly, but not exclusively, useful as a system and method that draws the anterior surface of an eye into contact with a stabilizing lens to spread the cornea and thereby avoid creating wrinkles on the posterior surface of the cornea that would otherwise distort the laser beam being used for the ophthalmic surgery.
Surgical lasers are now commonly used in a variety of ophthalmic surgical procedures, including the treatment of ocular diseases and the correction of optical deficiencies. As an example, corneal reshaping procedures using lasers, such as the well known LASIK procedure, are now widely available. In these procedures, the surgical laser is often chosen as the tool of choice because of the ability of the laser to be accurately focused on extremely small amounts of ocular tissue. In addition, the ability of the laser to be guided to prescribed locations within the eye with precision and reliability has enabled a whole new class of ophthalmic procedures that require nothing short of pinpoint accuracy as the laser beam travels through various levels of the eye. Anatomical characteristics of the eye, however, can undermine the effectiveness of the laser procedure. In particular, this is so for ophthalmic laser surgery that is to be performed on tissue behind (i.e. posterior) the cornea. Specifically, it can happen that the beam of a laser can be significantly degraded by wrinkles that may be induced predominantly on the posterior surface of the cornea of an eye, when the eye is being stabilized by a contact lens. The effect of these wrinkles becomes most acute when the laser beam is used for procedures on tissues in the deeper regions of the eye beyond the cornea, such as the lens.
Typically, when an eye stabilizing device is required, it is placed against the anterior surface of the eye and pressed in a downward direction. As a consequence, the cornea may be squeezed in a manner that will cause wrinkles to be created through the cornea and predominantly over the posterior surface of the cornea. These wrinkles can then cause an undesirable dispersion and degradation of the laser beam as it passes through the cornea. Several other consequences may also result. For one, when the beam is degraded in this way, it can happen that the energy required for a procedure may need to be increased as much as five-fold to compensate for the degradation. Further, when the beam is dispersed, it becomes increasingly difficult to reach the Laser Induced Optical Breakdown (LIOB) threshold at the desired location, and non-targeted tissue can be unintentionally damaged.
In light of the above, it is an object of the present invention to dock the eye in preparation for a laser surgical procedure by using suction to draw the eye upwards, to thereby avoid creating wrinkles in the cornea of an eye. Another object of the present invention is to minimize the distortion and degradation of a laser beam as it travels through the cornea to perform an ophthalmic procedure on tissue in the eye, behind the cornea. Still another object of the present invention is to provide a docking device that includes a vacuum that can be adjusted to different levels to allow for a selective distortion of the cornea. Yet another object of the present invention is to provide a device and method for docking a patient's eye with an interface using suction that is easy to use, relatively simple to manufacture, and comparatively cost effective.
In accordance with the present invention, a system and method are provided for docking an eye with an interface device that will avoid or minimize the creation of wrinkles on the posterior surface of the cornea of the human eye during a stabilization of the eye. For the present invention, this is accomplished by drawing the anterior surface of the eye into contact with a contact lens to effectively spread the cornea. This is done instead of pressing the contact lens downward onto the eye in a manner that will likely cause wrinkles in the cornea and on the posterior surface of the cornea. The object here is to avoid the wrinkles that could otherwise distort or degrade a laser beam.
Structurally, the system of the present invention includes an interface device that is constructed by securely affixing a base member and an attachment member to one another. For this combination, the base member is formed as a hollow, tapered cylinder having a proximal end and a distal end, with the proximal end having a larger diameter than the distal end. The base member defines a longitudinal axis, and a contact lens is located at the distal end on the longitudinal axis. For the present invention, the contact lens is transparent and it has a concave distal surface with a radius of curvature, Rc. As envisioned for the present invention, the contact lens may be either a rigid contact lens, a semi-rigid contact lens, or a non-rigid (i.e. soft) contact lens. The base member may also include an annular rib that is formed onto the outer surface of the base member near the proximal end. When so included, the annular rib projects outward from the outer surface, is centered on the axis, and extends completely around the base member.
Similar to the base member, the attachment member is a hollow, tapered cylinder with an open proximal end and an open distal end. Like the base-member, the attachment member defines a longitudinal axis and has a greater diameter at its proximal end than at its distal end. Importantly, the periphery of the open distal end establishes a continuous abutment that surrounds an opening, and is centered on the longitudinal axis. This opening is preferably circular, but any appropriate symmetrical or asymmetrical shape will suffice for use with the present invention. An annular groove is formed onto the interior surface of the attachment member that is centered on the longitudinal axis and is located proximal the abutment. A vacuum port is provided to establish fluid communication between the outer surface of the attachment member and the groove. When an annular rib is included on the base member, an annular detent is also included on the inner surface of the attachment member proximal to the groove. This detent is substantially parallel to the groove and is configured to receive the annular rib.
For a construction of the interface device, the base member and the attachment member are securely affixed to one another to establish a vacuum channel between the inner surface of the attachment member and the outer surface of the base member. When a rib and detent are included, the detent of the attachment member receives the rib of the base member to secure the base member to the attachment member with an airtight seal. Thus, the vacuum channel extends from the groove to the distal end of the attachment member around the base member. A vacuum pump can then be connected in fluid communication with the vacuum channel via the vacuum port and the groove.
In an operation of the present invention, the interface device is positioned onto the eye of a patient. Preferably, the initial contact between the eye and the interface device is made by the continuous abutment of the attachment member contacting the sclera of the eye. When in contact with the sclera, the continuous abutment effectively surrounds the cornea. As a consequence of this contact, an air pocket is established between the distal surface of the contact lens and the anterior surface of the eye that is bounded by the continuous abutment. Contact is not established, however between the contact lens and the anterior surface of the eye. Consequently, the radius of curvature of the anterior surface of the eye remains anatomically normal with a radius of curvature, Ra. Importantly, this Ra is smaller than the radius of curvature of the distal surface of the contact lens, (i.e. Ra<Rc).
For the present invention, the air pocket is established in fluid communication with the vacuum channel and the vacuum port. The vacuum pump, which is attached to the vacuum port can then be activated to suction air from the air pocket and bring the anterior surface of the eye into contact with the distal surface of the contact lens. It should be noted that the vacuum pump can be operated to establish various vacuum levels. By adjusting the vacuum level, the portion of the anterior surface of the eye that is drawn against the contact lens can be controlled and varied at any time.
Once contact between the eye and the contact lens has been established, the radius of curvature of the anterior surface of the eye, Ra, becomes equal to the radius of curvature of the distal surface of the contact lens (i.e. Ra=Rc) at their interface. Consequently, the cornea is spread outwardly as the posterior surface of the cornea is effectively stretched. At this point, the cornea, or a predetermined portion of the cornea, is appropriately docked, or stabilized, and the occurrence of wrinkles has been avoided or minimized. The ophthalmic procedure can then be conducted without having to account for beam distortions or degradations caused by wrinkles in the posterior region of the eye. Upon completion of the ophthalmic procedure, the vacuum pump is turned off, and the interface device can be lifted off of the eye.
The novel features of this invention, as well as the invention itself, both as to its structure and its operation, will be best understood from the accompanying drawings, taken in conjunction with the accompanying description, in which similar reference characters refer to similar parts, and in which:
Referring initially to
Referring now to
The attachment member 22 is shown in
In
In an operation of the interface device 10 of the present invention, the device 10 is positioned against the eye 12 of a patient 14, substantially as shown in
After the interface device 10 has been positioned on the eye 12 as disclosed above, the vacuum pump 18 can be activated to create a partial vacuum in the air pocket 60. More specifically, via a fluid connection between the vacuum pump 18 and the vacuum port 50, the vacuum pump 18 can be selectively operated, at different vacuum levels, to draw different proportional areas of the anterior surface 58 of the cornea 56 into contact with the concave distal surface 36 of the contact lens 34. Stated differently, as the vacuum level is increased inside the air pocket 60, the area of contact between the anterior surface 58 of the cornea 56 and the concave distal surface 36 of the contact lens 34 will become proportionately larger. As shown in
As intended for the present invention, when a partial vacuum has been created in the air pocket 60 by the vacuum pump 18, the cornea 56 is drawn into contact with the contact lens 34. A consequence here is that the cornea 56, and its posterior surface 62, are generally spread out into a partially flattened configuration. A further consequence of this is that wrinkles (not shown), that might otherwise be created on the posterior surface 62 of the cornea 56 during a stabilization of the eye 12, are avoided.
While the particular System and Method for Docking a Cornea with a Patient Interface Using Suction as herein shown and disclosed in detail is fully capable of obtaining the objects and providing the advantages herein before stated, it is to be understood that it is merely illustrative of the presently preferred embodiments of the invention and that no limitations are intended to the details of construction or design herein shown other than as described in the appended claims.