Transcorneal and fiberoptic laser delivery systems and methods for the treatment of eye diseases wherein energy is delivered by wavelengths transparent to the cornea to effect target tissues in the eye for the control of intraocular pressure in diseases such as glaucoma by delivery systems both external to and within ocular tissues. External delivery may be affected under gonioscopic control. Internal delivery may be controlled endoscopically or fiberoptically, both systems utilizing femtosecond laser energy to excise ocular tissue. The femtosecond light energy is delivered to the target tissues to be treated to effect precisely controlled photodisruption to enable portals for the outflow of aqueous fluid in the case of glaucoma in a manner which minimizes target tissue healing responses, inflammation and scarring.

An ophthalmological laser therapy device including a laser system, an x-y scanner, collecting optics and a z-scanner. The invention also relates to a method for processing a tissue of an eye by a therapeutic laser beam of an ophthalmological laser therapy device. The invention provides an ophthalmological laser therapy device and a corresponding method which permit, with minimal engineering complexity, a very quick positioning of the laser spot in a large volume region, in particular in a large x-y region perpendicular to the optical axis. The problem is also solved by a method for processing a tissue of the eye or a material located in an eye using an ophthalmological laser therapy device, wherein each sub-section of the tissue of the eye is processed using a corresponding positioning or the device for the adjustable redirecting of the laser beam in an image field of the collection optics.

A method for a minimally invasive, cell-selective laser therapy on the eye. The method, based on a short-pulse laser system, allows for different selective types of therapy on the eye. The method is based on a frequency-doubled, continuously working solid-state laser including a pump source and a control unit. The control unit regulates the pump source such that the solid-state laser emits individual pulses with pulse lengths ranging from 50 ns to continuous, wherein pulse lengths ranging from 50 ns to 50 μs are provided for selective therapies and pulse lengths ranging from 50 μs to continuous are provided for coagulative or stimulating therapies, in particular in the range from 1 ms to 500 ms. The proposed method enables a selective treatment of melanin-containing cells in the different areas of the eye via the targeted control of the pump source.

A system (20) includes a radiation source (48) and a controller (44), configured to display a live sequence of images of an eye (25) of a patient (22), while displaying the sequence of images, cause the radiation source to irradiate the eye with one or more aiming beams (84), which are visible in the images, subsequently to causing the radiation source to irradiate the eye with the aiming beams, receive a confirmation input from a user, and in response to receiving the confirmation input, treat the eye by causing the radiation source to irradiate respective target regions of the eye with a plurality of treatment beams. Other embodiments are also described.

Intraocular pressure in an eye is reduced by delivering a high resolution optical coherence tomography (OCT) beam and a high resolution laser beam through the cornea, and the anterior chamber into the irido-corneal angle along an angled beam path. The OCT beam provides OCT imaging for surgery planning and monitoring, while the laser beam is configured to modify tissue or affect ocular fluid by photo-disruptive interaction. In one implementation, a volume of ocular tissue within an outflow pathway in the irido-corneal angle is modified to create a channel opening in one or more layers of the trabecular meshwork. In another implementation, a volume of fluid in the Schlemm's canal is affected by the laser to bring about a pneumatic expansion of the canal. In either implementation, resistance to aqueous flow through the eye is reduced.

A probe as disclosed herein is capable of treating both the Schlemm's canal (SC) and the trabecular meshwork (TM), or both the pars plicata and the iris root site of the eye, with electromagnetic radiation (e.g., laser light) to improve aqueous humor outflow and thus decrease intraocular pressure (IOP). The laser probe can include a tip capable of being placed on an eye, such as on a corneal limbus or a scleral limbal area of the eye. The tip can include an optical waveguide angled to direct laser light through both the SC and TM, or both the pars plicata and the iris root site of the eye. The laser light can be continuous or pulsed, and can be configured to provide appropriate therapy to both the SC and TM, or to both the pars plicata and the iris root site. The laser probe can facilitate performing trans-scleral trabeculoplasty treatment, especially trans-scleral Schlemm trabeculoplasty, and performing iridoplasty treatment.

The invention provides an excimer laser system including a means for calibrating laser output to compensate for increased variation in laser optical fibers.

A structure in an irido-corneal angle of an eye is located by directing a laser beam toward the irido-corneal angle of the eye, and advancing a focus of the laser beam to a location in the irido-corneal angle, which location is at or near the target structure. The focus is determined to be at or near the structure based on changes in an intensity of a spot of second harmonic light generated by an encounter between the focus and tissue.

Optical scanning system and method for performing therapy on trabecular meshwork of a patient's eye, including a light source for producing alignment and therapeutic light, a scanning device for deflecting the alignment and therapeutic light to produce an alignment therapeutic patterns of the alignment and therapeutic light, and an ophthalmic lens assembly for placement over a patient's eye that includes a reflective optical element for reflecting the light patterns onto the trabecular meshwork of the patient's eye. The reflective optical element can be a continuous annular mirror (e.g. smooth or with multiple facets) to image the entire trabecular meshwork, or a reflective optical element that moves in coordination with the deflection of the beam. Visualization of the alignment and therapeutic patterns of light on the eye can be implemented by reflection thereof off a visualization mirror that transmits a portion of light emanating from the trabecular meshwork.

An imaging probe comprises a camera or endoscope with an external detector array, in which the probe is sized and shaped for surgical placement in an eye to image the eye from an interior of the eye during treatment. The imaging probe and a treatment probe 500 can be coupled together with a fastener or contained within a housing. The imaging probe and the treatment probe 500 can be sized and shaped to enter the eye through an incision in the cornea and image one or more of the ciliary body band or the scleral spur. The treatment probe 500 may comprise a treatment optical fiber or a surgical placement device to deliver an implant. A processor coupled to the detector can be configured with instructions to identify a location of one or more of the ciliary body band, the scleral spur, Schwalbe's line, or Schlemm's canal from the image.