A system for forming a corneal implant includes a cutting apparatus, which includes a laser source that emits a laser and optical elements that direct the laser. The system includes a controller implemented with at least one processor and at least one data storage device. The controller generates a sculpting plan for modifying a first shape of a lenticule formed from corneal tissue and achieving a second shape for the lenticule to produce a corneal implant with a refractive profile to reshape a recipient eye. The sculpting plan is determined from measurements relating to the lenticule having the first shape and information relating to a refractive profile for a corneal implant. The controller controls the cutting apparatus to direct, via the one or more optical elements, the laser from the laser source to sculpt the lenticule according to the sculpting plan to produce the corneal implant with the refractive profile.

A conformable covering comprises an outer portion with rigidity to resist movement on the cornea and an inner portion to contact the cornea and provide an environment for epithelial regeneration. The inner portion of the covering can be configured in many ways so as to conform at least partially to an ablated stromal surface so as to correct vision. The conformable inner portion may have at least some rigidity so as to smooth the epithelium such that the epithelium regenerates rapidly and is guided with the covering so as to form a smooth layer for vision. The inner portion may comprise an amount of rigidity within a range from about 1104 Pa*m3 to about 5104 Pa*m3 so as to deflect and conform at least partially to the ablated cornea and smooth an inner portion of the ablation with an amount of pressure when deflected.

A system for forming a corneal implant includes a cutting apparatus, which includes a laser source that emits a laser and optical elements that direct the laser. The system includes a controller implemented with at least one processor and at least one data storage device. The controller generates a sculpting plan for modifying a first shape of a lenticule formed from corneal tissue and achieving a second shape for the lenticule to produce a corneal implant with a refractive profile to reshape a recipient eye. The sculpting plan is determined from measurements relating to the lenticule having the first shape and information relating to a refractive profile for a corneal implant. The controller controls the cutting apparatus to direct, via the one or more optical elements, the laser from the laser source to sculpt the lenticule according to the sculpting plan to produce the corneal implant with the refractive profile.

A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.

Example eye treatments detennine an area at a surface of a cornea for delivery of a cross-linking agent. The example treatments disrupt tissue at the area at the surface of the con1ea up to a depth corresponding to apical layers of superficial squamous cells of the cornea, e.g., no greater than approximately 10 m to approximately 15 lm. The example treatments apply a cross-linking agent to the area at the surface of the cornea. The cross-linking agent is transmitted through the disrupted area at a greater rate relative to non disrupted areas of the cornea. The example treatments deliver photoactivating light to the cornea. The photoactivating light activates the cross-linking agent to generate cross-linking activity in the cornea.

To treat corneal ectatic disorders, systems and methods can precisely apply photoactivating light to specified areas of a cornea treated with a cross-linking agent. An example system includes a light source that provides a photoactivating light to photoactivate a cross-linking agent applied to an eye. The system includes optical element(s) that transmit the photoactivating light to the eye according to a pattern defined by a plurality of treatment zones. The treatment zones are delivered to different respective areas on the eye. The plurality of treatment zones includes at least a first treatment zone and a second treatment zone. The first treatment zone provides a first dose of the photoactivating light. The second treatment zone provides a second dose of the photoactivating light. The first dose is greater than the second dose. The first treatment zone is disposed within an inner boundary of the second treatment zone.

Methods of crosslinking collagenous tissue include contacting the tissue with a sugar; and illuminating the tissue with any one or more of UV-A light or a femtosecond laser, the illuminating being performed under conditions sufficient to give rise to crosslinking within the tissue is a method of treating a tissue of a cornea. Method of treating a tissue of a cornea include restricting oxygen replenishment of the tissue; contacting the tissue with a sugar; and illuminating the tissue with at least one of UV-A light or a femtosecond laser, the illuminating being performed under conditions sufficient to give rise to crosslinking within the tissue. Methods of treating a collagenous tissue include contacting the tissue with a sugar; and illuminating the tissue with any one or more of UV-A light or a femtosecond laser, the illuminating being performed under conditions sufficient to give rise to crosslinking within the tissue.

Example eye treatments detennine an area at a surface of a cornea for delivery of a cross-linking agent. The example treatments disrupt tissue at the area at the surface of the conlea up to a depth corresponding to apical layers of superficial squamous cells of the cornea, e.g., no greater than approximately 10 m to approximately 15 lm. The example treatments apply a cross-linking agent to the area at the surface of the cornea. The cross-linking agent is transmitted through the disrupted area at a greater rate relative to non disrupted areas of the cornea. The example treatments deliver photoactivating light to the cornea. The photoactivating light activates the cross-linking agent to generate cross-linking activity in the cornea.

To treat corneal ectatic disorders, systems and methods can precisely apply photoactivating light to specified areas of a cornea treated with a cross-linking agent. An example system includes a light source that provides a photoactivating light to photoactivate a cross-linking agent applied to an eye. The system includes optical element(s) that transmit the photoactivating light to the eye according to a pattern defined by a plurality of treatment zones. The treatment zones are delivered to different respective areas on the eye. The plurality of treatment zones includes at least a first treatment zone and a second treatment zone. The first treatment zone provides a first dose of the photoactivating light. The second treatment zone provides a second dose of the photoactivating light. The first dose is greater than the second dose. The first treatment zone is disposed within an inner boundary of the second treatment zone.

A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.