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Ophthalmic surgery system    
United States Patent4648400   
Link to this pagehttp://www.wikipatents.com/4648400.html
Inventor(s)Schneider; Richard T. (Gainesville, FL); Keates; Richard H. (Columbus, OH)
AbstractAn ophthalmic surgery system (10) for performing corneal keratotomies and resectomies utilizes a light source (12) which generates a pulsed beam in the ultraviolet/vacuum ultraviolet region. The beam is received by a sealed base unit (16) and attached rotatable subunit (18) which shape, focus, and project the beam onto a protective mask (20) mounted directly on the eye (22) of a patient. The mask (20) includes a normally closed shutter (148) which opens responsive to a counter (32) positioned along the beam path and sensors (156) positioned on opposite sides of a control slit (154) to apply a predetermined number of pulses while the mask is aligned to effect precise cutting of the cornea to the desired depth.
   














 Title Information Submit all comments and votes
 
Patent Text Patent PDF Print Page Summary File History
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Drawing from US Patent 4648400
Ophthalmic surgery system - US Patent 4648400 Drawing
Ophthalmic surgery system
Inventor     Schneider; Richard T. (Gainesville, FL); Keates; Richard H. (Columbus, OH)
Owner/Assignee     RTS Laboratories, Inc. (Gainesville, FL)
Patent assignment
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Publication Date     March 10, 1987
Application Number     06/731,121
PAIR File History     Application Data   Transaction History
Image File Wrapper   Patent Term   Fees
Litigation
Filing Date     May 6, 1985
US Classification     606/3 219/121.61 219/121.74 219/121.75 219/121.83 606/5 606/12 606/18
Int'l Classification     A61B 017/36
Examiner     Cohen; Lee S.
Assistant Examiner    
Attorney/Law Firm     Merchant, Gould, Smith, Edell, Welter and Schmidt
Address
Parent Case    
Priority Data    
USPTO Field of Search     128/303.1 128/395 128/396 128/397 128/398 219/121 LA 219/121 LB 219/121 LP 219/121 LQ 219/121 LR 219/121 LZ
Patent Tags     ophthalmic surgery
   
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 Technical Review Submit all comments and votes
 Claims Submit all comments and votes
 


What is claimed is:

1. Apparatus for performing corneal surgery on an eye, comprising:

means for generating a pulsed light beam in the ultraviolet/vacuum ultraviolet region;

means for shaping, focusing, and directing the beam toward the eye;

means for counting the number of pulses of light generated; and

means covering the eye and responsive to said counting means for selectively exposing predetermined portions of the cornea to the beam for a predetermined number of pulses sufficient to effect cutting of the cornea to the desired depth.

2. The apparatus of claim 1, wherein said light beam generating means produces electromagnetic radiation having a wavelenth between about 1000-2000 angstroms and a power density between about 1 and 10 megawatts per square centimeter.

3. The apparatus of claim 1, wherein said beam generating means comprises a pulsed ArF laser.

4. The apparatus of claim 1, wherein said beam generating means comprises a pulsed KrF laser.

5. The apparatus of claim 1, wherein said beam shaping, focusing, and directing means comprises:

a base unit connected in optical communication with said beam generating means;

a subunit having upper and lower ends;

means for connecting the upper end of said subunit to said base unit in fluid and optical communication and for rotation about a generally upright axis;

a first mirror mounted in said base unit for reflecting the beam from said beam generating means into the upper end of said subunit, said first mirror being treated to effect predetermined modification of the beam intensity distribution upon reflection;

a lens mounted in said subunit for focusing the beam from said first mirror;

a second mirror mounted in said subunit for reflecting the focused beam from said lens;

a window mounted in the lower end of said subunit offset from the rotational axis of said subunit; and

a third mirror mounted in said subunit for reflecting the beam from said second mirror through said window out of said subunit.

6. The apparatus according to claim 5, wherein said lens comprises a cylinder lens.

7. The apparatus according to claim 5, wherein said lens comprises a spherical lens.

8. The apparatus according to claim 5, further including:

means for supporting said second mirror for adjustable linear movement toward and away from said lens, and for adjustable pivotal movement relative to said third mirror; and

means for supporting said third mirror for adjustable pivotal movement relative to said second mirror and said window.

9. The apparatus according to claim 5, further including:

a prism mounted in the lower end of said subunit adjacent to said window for effecting projection of the beam passing through said window in a direction substantially parallel to but offset from the rotational axis of said subunit.

10. The apparatus of claim 1, wherein said counting means comprises:

a beam splitter; and

a photo diode counter coupled to said beam splitter for sensing pulses of light.

11. The apparatus of claim 1, wherein said eye covering means comprises:

an opaque mask including an offset predetermined control slit defining the shape of the incision to be cut into the cornea;

means for releasably securing said mask to the eye over the cornea;

a central window in said mask formed of material opaque to the cutting light beam but transparent to visible light;

an array of sensors positioned along opposite sides of the control slit in said mask;

a shutter mounted on said mask for movement into and out of blocking position relative to the control slit;

means for normally biasing said shutter to a blocking position; and

means responsive to said sensors and said counting means for opening said shutter to expose the cornea to the beam only when the measured beam intensities on opposite sides of the control slit are within predetermined limits and only for a predetermined number of pulses.

12. Apparatus for performing corneal surgery on an eye, comprising:

means for generating a pulsed light beam in the ultraviolet/vacuum ultraviolet region having a wavelength of about 1000-2000 Angstroms and a power density of about 1-10 megawatts per square centimeter;

a base unit connected in optical communication with said beam generating means;

means for counting the number of pulses of light generated and delivered to said base unit;

a subunit having upper and lower ends;

means for connecting the upper end of said subunit to said base unit in fluid and optical communication and for rotation about a generally upright axis;

a first mirror mounted in said base unit for shaping the normal intensity distribution of the beam from said beam generating means and reflecting the shaped beam into the upper end of said subunit;

a lens mounted in said subunit for focusing the beam from said first mirror;

a second mirror mounted in said subunit for reflecting the focused beam from said lens;

a window mounted in the lower end of said subunit;

a third mirror mounted in said subunit for reflecting the beam from said second mirror through said window out of said subunit; and

means covering the eye and responsive to said counting means for selectively exposing predetermined portions of the cornea to the beam for a predetermined number of pulses sufficient to effect cutting of the cornea to the desired depth.

13. The apparatus according to claim 12, wherein said lens comprises a cylinder lens.

14. The apparatus according to claim 12, wherein said lens comprises a spherical lens.

15. The apparatus according to claim 12, further including:

means for supporting said second mirror for adjustable linear movement toward and away from said lens, and for adjustable pivotal movement relative to said third mirror; and

means for supporting said third mirror for adjustable pivotal movement relative to said second mirror and said window.

16. The apparatus according to claim 12, further including:

a prism mounted in the lower end of said subunit adjacent to said window for effecting projection of the beam passing through said window in a direction substantially parallel to but offset from the rotational axis of said subunit.

17. The apparatus of claim 12, wherein said counting means comprises:

a beam splitter; and

a photo diode counter coupled to said beam splitter for sensing pulses of light.

18. The apparatus of claim 12, wherein said eye covering means comprises:

an opaque mask including an offset predetermined control slit defining the shape of the incision to be cut into the cornea;

means for releasably securing said mask to the eye over the cornea;

a central window in said mask formed of material opaque to the beam but transparent to visible light;

an array of sensors positioned along opposite sides of the control slit in said mask;

a shutter mounted on said mask for movement into and out of blocking position relative to the control slit;

means for normally biasing said shutter to a blocking position; and

means responsive to said sensors and said counting means for opening said shutter to expose the cornea to the beam only when the measured beam intensities on opposite sides of the control slit are within predetermined limits and only for a predetermined number of pulses.

19. A method for performing corneal surgery on an eye, comprising the steps of:

(a) providing a light source;

(b) generating with the light source a pulsed light cutting beam in the ultraviolet/vacuum ultraviolet region;

(c) positioning between the eye and light source a shutter with a normally closed control slit offset from the optical axis of the eye;

(d) modifying the normal intensity distribution of the cutting beam;

(e) focusing the modified beam;

(f) projecting the modified, focused beam on the shutter;

(g) sensing the beam intensity across the control slit of the shutter;

(h) opening the shutter to expose the cornea to the modified, focused beam when the measured beam intensities across the control slit are within predetermined limits;

(i) counting the beam pulses applied to the cornea while the shutter is open; and

(j) closing the shutter after a predetermined number of pulses have been applied to form a corneal incision of predetermined shape, length, width and depth.

20. The method of claim 19, wherein the light beam has a wavelength between about 1000 and 2000 angstroms and a power density between about 1 and 10 megawatts per square centimeter.

21. The method of claim 19, further including the step of:

rotating the shutter relative to the eye so that successive circumferentially spaced-apart radial incisions about a central uncut portion of the cornea can be formed.

22. The method according to claim 21, wherein step (e) is accomplished with a cylinder lens.

23. The method of claim 19, further including the step of: rotating the shutter relative to the eye so that a circular incision can be formed about a central uncut portion of the cornea.

24. The method according to claim 23, wherein step (e) is accomplished with a spherical lens.

25. The method of claim 19, wherein step (d) is accomplished by reflection with a mirror covered with a partiallyabsorbing film of variable density.

26. The method of claim 19, wherein the shutter is attached directly to the eye over the cornea.

27. The method of claim 19, further including the step of: positioning along the optical axis between the eye and the light source a window of material that is opaque to the cutting beam but transparent to visible light.
 Description Submit all comments and votes
 


TECHNICAL FIELD

The present invention relates generally to an ophthalmic surgery system. More particularly, this invention concerns a system incorporating a high-energy light source in the ultraviolet/vacuum ultraviolet region for performing keratotomies and resectomies.

BACKGROUND ART

A major percentage of the American population is myopic or nearsighted. Glasses and contact lenses have been the two most common approaches to correction of nearsightedness. Another approach is the radial keratotomy, whereby a number of precise incisions are made directly into the cornea of the eye in radial fashion about the central uncut optical zone of the cornea to relax its radius of curvature thereby increasing the focal length to correct or improve vision.

It will be appreciated, however, that radial keratotomies are extremely delicate procedures requiring extreme precision and safety. Eyes in general, and corneas in particular, are extremely sensitive and delicate. The cornea is a transparent lens tissue covering the iris and pupil through which light is admitted into the eye. The sizes and thicknesses of corneas vary from patient to patient. In performing a radial keratotomy, the length, width, depth and spacing of the incisions must be precisely controlled in order to accomplish the desired result without otherwise damaging the eye or cornea. This is complicated by the fact that eyes are subject to involuntary movements and are difficult to stabilize.

The history of radial keratotomy dates back to about 1869 when Snellen first described surgical methods for the correction of astigmatisms and raised the possibility of altering corneal curvature to correct vision. However, it was not until 1894 when Bates attempted to do just that by using a method called unsutured wedge resection. This essentially involved removing wedge-shaped sections of the cornea along radial lines centered on the visual axis.

In 1939, Sato reported on a series of cases in which incisions were performed on both the anterior (inside) and posterior (outside) surfaces of the cornea. The purpose of these incisions was to correct the preexisting irregular