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.

Microsurgical instruments having combined illumination, laser ablation, and viscoelastic injection functions. A surgical instrument includes a probe having a main lumen and a port at a distal end thereof. The probe may further include one or more optical fibers within the main lumen, the optical fibers configured to project laser light and illumination light. Laser light may be emitted from the distal end of the probe for disrupting an ocular tissue, while illumination light may be simultaneously emitted, axially or laterally, to provide enhanced visualization of the intraocular space during tissue disruptance. Upon disrupting the tissue, a viscoelastic fluid may be injected from the port to maintain an integrity of the intraocular space.

An intraocular cyclophotocoagulation device having a proximal, reusable portion and a distal, disposable portion. The reusable portion includes laser treatment assembly comprising a laser diode and a collimating lens positioned a distance distal to the laser diode and configured to collimate light from the laser diode into a collimated laser beam and direct the collimated laser beam towards a distal end region of the proximal housing portion; and an imaging assembly. The disposable portion includes a laser guide extending through an elongate shaft and an aspheric lens positioned within the distal housing portion to receive the collimated laser beam from the proximal reusable portion and direct the collimated laser beam toward a proximal end of a fiberoptic of the laser guide and an illumination light guide and an illumination source positioned within the distal housing portion. Related devices, systems, and methods are provided.

Some embodiments of the present disclosure relate to a method and system where a fiber optic probe is obtained. In some embodiments, the fiber optic probe comprises a distal end. In some embodiments, the fiber optic probe is introduced between an outer surface of an eye and an anterior chamber of an eye. In some embodiments, the fiber optic probe is advanced into one or more portions of the eye. In some embodiments, a plurality of pulses of laser radiation are delivered through a laser and into the eye. In some embodiments, the laser is disposed at a distal end of the fiber optic probe. In some embodiments, ocular tissue of the eye is ablated with the plurality of pulses of laser radiation. In some embodiments, the ablating generates a drainage channel that extends from the anterior chamber of the eye to the subconjunctival space of the eye.

An ab externo automated laser treatment system for treating an eye in a subject, includes a non-contact laser source configured to generate a laser beam having at least one wavelength to treat the eye by directing the laser beam from a location spaced from the eye, wherein the at least one wavelength is a near-infrared wavelength in the range of about 0.5-2.2 μm, a laser scanner optically coupled to the non-contact laser source to receive the laser beam from the non-contact laser source and to scan the laser beam relative to the eye, and a processor, and memory including stored computer-readable instructions that, responsive to execution by the processor, cause the laser treatment system to direct the laser beam to a plurality of trans-scleral treatment locations to be irradiated in a predetermined treatment pattern on an external surface of the eye, wherein the trans-scleral treatment locations are 0-4 mm posterior to the corneolimbal junction, and wherein the laser beam is repetitively directed to the same irradiated trans-scleral treatment locations on the surface of the eye, and the trans-scleral treatment locations are irradiated at intervals sufficient to induce protective thermal preconditioning and therapeutic bio-stimulation of one or more of the trabecular meshwork and/or ciliary body without photocoagulation of the tissue of the eye. Trans-pupillary systems, patient interfaces, and methods are also disclosed.

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

An ophthalmic phototherapy device and associated phototherapy treatment method tor promoting healing of damaged or diseased eye tissue. The ophthalmic phototherapy device includes a light emitting mechanism for transmitting light of at least one preselected wavelength to the eye tissue. The ophthalmic phototherapy method includes directing light of at least one wavelength for a selected period of time to a portion of damaged or diseased eye tissue, whereby the light transmitted to the damaged or diseased eye tissue stimulates cellular activity in the eye tissue to promote healing.

A target volume of ocular tissue is treated with a laser having a direction of propagation toward the target volume, where the target volume is characterized by a distal extent, a proximal extent, and a lateral extent. A layer of tissue at an initial depth corresponding to the distal extent of the target volume is initially photodisrupted using a femtosecond laser by scanning the laser in multiple directions defining an initial treatment plane. Tissue at one or more subsequent depths between the distal extent of the target volume and the proximal extent of the target volume is subsequently photodisrupted using a femtosecond laser by moving a focus of the laser in a direction opposite the direction of propagation of the laser and then scanning the laser in multiple directions defining an subsequent treatment plane. Photodisruption is repeated at different subsequent depths until tissue at the proximal extent of the target volume is photodisrupted.

Apparatuses and methods for the treatment of glaucoma are provided. The instrument uses either cauterization, a laser to ablate, sonic or ultrasonic energy to emulsify, or mechanical cutting of a portion of the trabecular meshwork. The instrument may also be provided with irrigation, aspiration, and a footplate. The footplate is used to enter Schlemm's canal, serves as a guide, and also protects Schlemm's canal.

An ophthalmic laser ablation system is described with various optional features, some especially suitable for non-penetrating filtration on an eye. In one example, focusing of an ablation laser uses a movable lens coupled to a pair of converging light sources, which converge at the focal distance of the lens. In another example, laser ablation settings are selected for optimal ablation and minimal amount of thermal damage of a layer of percolating scleral tissue.