A fistula is created in the sclera of a glaucoma patient by creating a passageway through the conjunctiva into the subconjunctival space of the patient. The passageway may be realized by an incision but is preferably realized as the inner lumen of a needle or sheath. One option for creating such an incision is to use an optical fiber shaped like a needle to create the incision. The passageway enables an optical fiber to pass into the subconjunctival space. Liquid is then infused into the subconjunctival space to raise the conjunctiva slightly to heighten maneuverability of the optical fiber within the subconjunctival space. The optical fiber is then positioned near a target sight on the sclera of the patient's eye. Laser radiation is transmitted down the optical fiber to create a fistula.
A glaucoma drain implanting device having a body portion including a proximal end and a distal end, a separate nozzle portion connected to the distal end of the body and including a drain delivery passageway, a plunger having a plunger tip movably disposed relative to the drain delivery passageway, and a drain receiver. A method of using the drain implant device includes the steps of advancing a glaucoma drain into the drain delivery passageway of the device, thereby placing the glaucoma drain in a staged configuration, and, placing an exit of the drain delivery passageway proximately to the eye and further advancing the glaucoma drain to cause the glaucoma drain to pass through the exit of the drain delivery passageway and into the tissue of the eye.
A laser and a laser probe are used in conjunction with a suture to remove a blockage in Schlemm's canal. The suture is advanced into Schlemm's canal until the suture comes into contact with tissue blocking the canal. The laser probe follows the path of suture until the laser probe is proximal to tissue blocking the canal. The laser is activated to apply pulsed laser energy to the tissue blocking the canal, thereby ablating the occluding tissue to reopen Schlemm's canal.
A method of percutaneous and subcutaneous laser treatment of the tissue of a patient is provided. The tip of an optical fiber is be passed through the skin, advanced through the tissue subcutaneously to a desired treatment area and withdrawn. Laser energy can be emitted at different levels during any or all of the skin penetration, advancement, tissue treatment and withdrawal phases. The present invention is useful for surgical treatments, and is especially suitable for minimally invasive plastic or cosmetic surgical and dermatological procedures without bleeding and with less edema, erythema and swelling and faster healing than conventional surface laser energy application, abrasion, scalpel surgery or chemical peel procedures.
A laser is used to reopen the natural drainage passageways in the eye or to form new passageways to enable the drainage of the aqueous humor from the eye. In one procedure, an Er:YAG laser is used to ablate occluding tissue in Schlemm's canal. In another procedure, the Er:YAG laser is used to open occluded openings in the ciliary body. In yet another procedure, the Er:YAG laser is used to form a new passageway comprising a plurality of interconnected passageway segments from the exterior of the eye through the sclera to the anterior chamber to enable the drainage of the aqueous humor.
An optically pumped mid-infrared solid-state laser with high pulse repetition rate is described for use in laser surgery. The laser produces a wavelength between 1.7 and 4.0 microns, and is optically pumped. The rise and fall times of the pump pulses are sufficiently short to avoid thermal lensing induced instability. The laser provides an increased rate of tissue cutting without necessitating an increase in the pulse energy.
