The present invention relates to a method of altering the refractive properties of the eye, the method including forming a pocket in a cornea of an eye of a patient so as to gain access to tissue bounding the pocket; after the pocket in the cornea has been formed, applying a photosensitizer inside the pocket so that the photo sensitizer permeates at least a portion of the tissue bounding the pocket, the photosensitizer facilitating cross-linking of the tissue bounding the pocket; inserting a lens implant into the pocket so as to change the refractive properties of the eye; and irradiating the cornea so as to activate cross-linkers in the portion of the tissue bounding the pocket and thereby stiffen the cornea and prevent corneal ectasia of the cornea.

A ophthalmic laser-assisted corneal lenticule extraction procedure that uses wavefront measurements to guide the formation of the corneal lenticule. The wavefront map measured from a free eye using a wavefront aberrometer is registered to the cornea of a docked eye based on comparisons of iris images and corneal markings. The docked-eye cornea-registered wavefront map is then corrected to be consistent with the Munnerlyn formula for the spherical power, and adjusted for any physician adjustments and/or myopia error due to a flat add in the lenticule, using Zernike polynomials. The corrected and adjusted wavefront map is then used to calculate the profiles of the bottom and top lenticule incisions in the applanated cornea, where higher-order components in the wavefront map are distributed to the bottom lenticule incision alone and lower-order components in the wavefront map are distributed to both the bottom and the top lenticule incision.

A ophthalmic laser-assisted corneal lenticule extraction procedure that uses wavefront measurements to guide the formation of the corneal lenticule. The wavefront map measured from a free eye using a wavefront aberrometer is registered to the cornea of a docked eye based on comparisons of iris images and corneal markings. The docked-eye cornea-registered wavefront map is then corrected to be consistent with the Munnerlyn formula for the spherical power, and adjusted for any physician adjustments and/or myopia error due to a flat add in the lenticule, using Zernike polynomials. The corrected and adjusted wavefront map is then used to calculate the profiles of the bottom and top lenticule incisions in the applanated cornea, where higher-order components in the wavefront map are distributed to the bottom lenticule incision alone and lower-order components in the wavefront map are distributed to both the bottom and the top lenticule incision.

A system for incising tissue with a plasma comprises an elongate electrode configured to incise the tissue along a tissue incision profile and a tissue contact element configured to shape the tissue, which comprises one or more of a channel or a protrusion to form one or more of a corresponding protrusion or indentation in a tissue surface while the tissue is incised with the electrode along the incision profile. The tissue contact element shapes the tissue sufficiently to allow the tissue to form one or more complimentary features along the incision profile when the tissue relaxes to a free-standing configuration with removal of the tissue contact element. The complementary features may be incised into the tissue to provide increased mechanical stability between the separated tissue regions, such as with nominally interlocking protrusion(s) and indentation(s).

A system for incising tissue with a plasma comprises an elongate electrode configured to incise the tissue along a tissue incision profile and a tissue contact element configured to shape the tissue, which comprises one or more of a channel or a protrusion to form one or more of a corresponding protrusion or indentation in a tissue surface while the tissue is incised with the electrode along the incision profile. The tissue contact element shapes the tissue sufficiently to allow the tissue to form one or more complimentary features along the incision profile when the tissue relaxes to a free-standing configuration with removal of the tissue contact element. The complementary features may be incised into the tissue to provide increased mechanical stability between the separated tissue regions, such as with nominally interlocking protrusion(s) and indentation(s).

A surgical kit includes a surgical instrument for creating a passageway though scleral tissue and a shunt locatable in the passageway for diverting aqueous fluid from an eye chamber. The shunt includes an elongate duct defining a fluid passageway for diverting aqueous humor from the chamber and a fixation body located on the duct for fixing the duct within scleral tissue. The fixation body defines an internal passage within which the duct is received. The surgical instrument has a flat cutting blade having a first maximal cross-sectional dimension which is larger than a second maximal cross-sectional dimension of the duct, which is less than a third maximal cross-sectional dimension of the fixation body. The flat cutting blade is minimally invasive, reducing the risk of aqueous fluid leakage and allowing the use of a fixation body having a relatively small cross-sectional dimension.

Methods and devices are adapted for implanting into the eye. An incision is formed in the cornea of the eye and a shunt is inserted through the incision into the anterior chamber of the eye. The shunt includes a fluid passageway. The shunt is passed along a pathway from the anterior chamber through the scleral spur of the eye into the suprachoroidal space and positioned in a first position such that a first portion of the fluid passageway communicates with the anterior chamber and a second portion of the fluid passageway communicates with the suprachoroidal space to provide a fluid passageway between the suprachoroidal space and the anterior chamber.

A surgical tool with an elongated implement of enhanced stiffening character due to the use of a stiffening coating and/or a lumen of inconsistent diameter. The stiffening coating may be supplied by a deposition technique utilizing materials tailored to biocompatibility, stiffening and even to reducing glare. The lumen of inconsistent diameter may include a distal end taking up a minority of the lumen that is of a larger diameter than a proximal portion of substantially smaller diameter for increasing wall thickness and stiffening of the majority of the implement.

A surgical tool with an elongated implement of enhanced stiffening character due to the use of a stiffening coating and/or a lumen of inconsistent diameter. The stiffening coating may be supplied by a deposition technique utilizing materials tailored to biocompatibility, stiffening and even to reducing glare. The lumen of inconsistent diameter may include a distal end taking up a minority of the lumen that is of a larger diameter than a proximal portion of substantially smaller diameter for increasing wall thickness and stiffening of the majority of the implement.

An incisional instrument and method of use for creating accurate, reproducible surgical incisions. An exemplary embodiment includes an incisional instrument configured for attachment to a patient's eye and for use performing arcuate limbal relaxing incisions (LRIs). The incisional instrument is made up of two coaxial, interconnecting pieces: a docking piece and a cutting piece. The docking piece includes a suction mechanism and is configured for being secured to a patient's eye just outside the corneal limbus. The cutting piece is configured to fit flush within the docking piece and includes cutting blades and one or more handles for rotating the cutting piece relative to the docking piece. When assembled, the cutting blades extend into a patient's eye a desired LRI depth. An embodiment further includes an arcuate guide template with stoppers for providing lateral, arcuate stops for precise cuts in the desired LRI locations. An LRI method includes the steps of utilizing the incisional instrument in an ophthalmologic LRI procedure.