A laser instrument for therapy on the human eye, designed for surgery of the cornea, the sclera, the vitreous body or the crystalline lens, especially suitable for use in immediate succession with other instruments for eye diagnosis or eye therapy, in such a way that during the alternating use of the various instruments, the eye or at least the patient preferably remains in a predetermined position and alignment within one and the same treatment area.

An apparatus includes a laser source and a scanner. The laser source is configured to generate electromagnetic radiation. The scanner scans at least part of a limbal area of an eye with the electromagnetic radiation generated by the laser source, thereby directing the electromagnetic radiation through an entire thickness of the limbal area of the eye without any contact with the eye and irradiating one or more regions of a trabecular meshwork of the eye with the electromagnetic radiation.

A photo detector is selectively coupled to a first integrator or a second integrator with switching circuitry when the laser pulses. An integration time of the signal from the photo detector can be substantially greater than an amount of time between successive laser beam pulses in order to provide an accurate measurement of each laser beam pulse of a high repetition rate pulsed laser. The laser may comprise a clock coupled to an optical switch of the laser system, and control circuitry can control switching and coupling of the detector to the first integrator or the second integrator in response to the clock signal. The first integrator and the second integrator can be selectively coupled to an output such that the first integrator or the second integrator is coupled to the output of the energy detection circuitry when the other integrator is coupled to the detector.

Embodiments of this invention generally relate to ophthalmic laser procedures and, more particularly, to systems and methods for lenticular laser incision. In an embodiment, an ophthalmic surgical laser system comprises a laser delivery system for delivering a pulsed laser beam to a target in a subject's eye, an XY-scan device to deflect the pulsed laser beam, a Z-scan device to modify a depth of a focus of the pulsed laser beam, and a controller configured to form a top lenticular incision and a bottom lenticular incision of a lens in the subject's eye, where each of the top and bottom lenticular incision includes a center concave portion and an edge transition portion that has a smooth convex shape and is smoothly joined to the center concave portion.

A method of corneal implantation with cross-linking is disclosed herein. In one or more embodiments, the method includes the steps of: (i) prior to implantation, treating an implant formed from donor corneal tissue or a tissue culture grown corneal stroma with a solution of sodium dodecyl sulfate (SDS), Triton X-100, benzalkonium chloride (BAK), Igepal, genipin, 100% glycerol, or alcohol for making the implant acellular, and for killing any bacteria, viruses, or parasites prior to implantation; (ii) implanting the implant into a recipient cornea; (iii) applying laser energy to the implant so as to modify the refractive power of the implant while being monitored using a Shack-Hartmann wavefront system so as to achieve a desired refractive power for the implant; and (iv) applying a cross-linking solution and irradiating the implant to cross-link the implant to prevent an immune response to the implant and/or rejection of the implant by a patient.

Apparatus to treat an eye comprises an annular retention structure to couple to an anterior surface of the eye. The retention structure is coupled to a suction line to couple the retention structure to the eye with suction. A coupling sensor is coupled to the retention structure or the suction line to determine coupling of the retention structure to the eye. A fluid collecting container can be coupled to the retention structure to receive and collect liquid or viscous material from the retention structure. A fluid stop comprising a porous structure can be coupled to an outlet of the fluid collecting container to inhibit passage of the liquid or viscous material when the container has received an amount of the liquid or viscous material. The coupling sensor can be coupled upstream of the porous structure to provide a rapid measurement of the coupling of the retention structure to the eye.

The presently disclosed subject matter provides techniques for inducing collagen cross-linking in human tissue, such as cartilage, by inducing ionization of the water contained in the tissue to produce free radicals that induce chemical cross-linking in the human tissue. In an embodiment, a femtosecond laser operates at sufficiently low laser pulse energy to avoid optical breakdown of the tissue being treated. In an embodiment, the femtosecond laser operates in the infrared frequency range.

An example method for cutting a plurality of lenticules from a donor cornea includes receiving a donor cornea, cutting a first layer of a first set of lenticules from the donor cornea, and cutting a second layer of a second set of lenticules from the donor cornea. The lenticules are cut according to a pattern that to maximizes the number of lenticules, thereby maximizing the number of implants from the single donor cornea. An example implant handling device includes a body. The body includes a flattened end configured to receive a corneal implant and keep the corneal implant from rolling or folding. The flattened end has a width and a height, the width being greater than the height. The body includes a slit opening to the flattened end, the slit opening configured to allow the corneal implant to pass into the flattened end.

Generation of treatment recommendations for topographic-based excimer laser surgical procedures is described that includes generating accurate cylinder compensation and spherical compensation values that are adjusted to compensate for unique characteristics of topographic-based excimer laser surgical systems. Generating treatment recommendations generally includes determining a topographic vector, a posterior astigmatism vector and an anterior astigmatism vector, and generating an internal astigmatism vector using the topographic vector, the posterior astigmatism vector, the anterior astigmatism vector, and a manifest astigmatism vector. In embodiments, the cylinder compensation is generated using multiple vectors while subtracting the internal astigmatism vector and the posterior astigmatism vector which remain in the eye after treatment, and the spherical compensation is generated using an initial spherical compensation modified by addback modifiers and a regression analysis nomogram. In procedures where the corneal epithelium is removed, an epithelial refractive vector is determined from an epithelial thickness/topography map and added to the other vectors.

A system and method for inserting an intraocular lens in a patient's eye includes a light source for generating a light beam, a scanner for deflecting the light beam to form an enclosed treatment pattern that includes a registration feature, and a delivery system for delivering the enclosed treatment pattern to target tissue in the patient's eye to form an enclosed incision therein having the registration feature. An intraocular lens is placed within the enclosed incision, wherein the intraocular lens has a registration feature that engages with the registration feature of the enclosed incision. Alternately, the scanner can make a separate registration incision for a post that is connected to the intraocular lens via a strut member.