A noninvasive method is described for performing accurate and controlled reshaping of the anterior surface of the cornea in order to correct ocular refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. The invention uses a light source emitting a wavelength or wavelengths with correct optical penetration depth(s) to induce changes in corneal stromal collagen without damaging the corneal endothelium, together with a light delivery and control means for producing the required irradiance, exposure time, and geometric pattern, in order to achieve the desired change in corneal shape. Corneal shape is monitored before, during, and after the procedure by a corneal topography system. Anterior corneal surface cooling by a transparent heat sink is used to prevent damage to the epithelium and to Bowman's layer.

A laser beam ophthalmological surgery method for ablating a cornea of a patient's eye includes the steps of generating a laser beam and directing the generated laser beam onto a scanner and scanning the laser beam in a random scanning pattern with a generated random scanning pattern signal on the surface of the cornea of a patient to ablate the surface of the cornea of a patient's eye. A computer generates the random pattern laser beam control signal which controls the scanner to scan in the random scanning pattern over the cornea and includes selecting a database of non-random scanning points to scan the laser beam onto the cornea of a patient's eye and then randomly select the non-random scanning points for the random scanning of predetermined scanning points. A laser ophthalmological surgery apparatus is provided which includes a laser for generating a laser beam along with a scanner positioned for receiving the laser beam and producing a predetermined scanning pattern onto the cornea of an eye. A computer is used to generate a random scanning pattern signal and is connected to the scanner for controlling the scanner in a random overlapping scanning beam pattern over a predetermined area.

Apparatus for illuminating a central area of an eye by generally lamellar lighting during eye surgery. Basically, a support fixture carrying a light emitter is adapted to be placed adjacent to the surgical field. The support fixture, when in place on an eye, directs light from the light emitter toward the surgical field tangentially to the cornea, at an angle of from about 0.degree. to 90.degree. to the plane of the eye iris. The light entering the eye travels along the lamellae of the cornea in the manner of a light pipe. Very little, if any light reaches the back of the eye, avoiding patient discomfort, or is directed toward the surgical microscope as glare. This generally lamellar lighting combines scleral scatter and retro illumination. In preferred embodiments, the light emitter may be mounted on, or incorporated in, a conventional eyelid speculum or a fixation ring.

Apparatus for illuminating a central area of an eye by lamellar lighting during eye surgery. Basically, a support fixture carrying a light emitter is adapted to be placed adjacent to the surgical field. The support fixture, when in place on an eye, directs light from the light emitter toward the surgical field tangentially to the cornea, at an angle of from about 0 to 45.degree. to the plane of the eye iris. The light entering the eye travels along the lamellae of the cornea in the manner of a light pipe. Very little, if any light reaches the back of the eye, avoiding patient discomfort, or is directed toward the surgical microscope as glare. This lamellar lighting combines scleral scatter and retro illumination. In preferred embodiments, the light emitter may be mounted on, or incorporated in, a conventional eyelid speculum or a fixation ring.

A multi-function surgical instrument for facilitating ophthalmic surgery of the eye by laser means. Included are a lower ring and an upper ring. The lower ring includes a central aperture to capture the limbus and aid in positioning of the eye. Protuberances on the lower surface of the lower ring, application of vacuum between the lower surface of the ring and the eye, or both may be used to more firmly grip the eye. Ports disposed on the upper surface of the lower ring and connected to a vacuum source may be used to control hydration of the surgical field. Attached to and extending above the upper surface of the lower ring is a sterile platform for reposing temporarily removed tissues during the administration of laser pulses to other tissues. The upper ring is disposed above the surgical bed. Ports disposed along the upper ring and connected to a vacuum source may be used to control smoke and splatters resulting from the ablative procedure and create additional airflow to further control hydration of the surgical field.